ORCID Profile
0000-0003-2911-5381
Current Organisations
University of Western Australia
,
Ear Science Institute Australia
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: American Speech Language Hearing Association
Date: 10-2016
Abstract: Sections of the community face barriers to accessing audiology services. The aim of this study was to assess the barriers faced by people in typically underserved community settings and to provide audiology services in their natural environment. Information gathered by questionnaire was used to determine each site's candidacy as a potential tele-audiology site. Sixty-three participants were recruited across 3 community sites that were identified as gathering places for in iduals who experience barriers to accessing traditional clinical audiology services. Information about demographics and participant experience with barriers to access was gathered by a locally generated, self-administered questionnaire. Pure-tone air-conduction audiometric exams were performed on participants with an automated portable diagnostic audiometer. Afterward, the investigator provided counseling regarding hearing loss rehabilitation or hearing protection. Referrals were made when appropriate. Pure-tone averages were similar within sites but varied across sites. At least 30% of in iduals at each site reported they wanted to visit the audiologist more often. Each site reported different principal barriers to access, among them transportation, motivation, and money. Eleven in iduals were referred to the next level of care. Questionnaire results revealed special accommodations should be considered at each potential tele-audiology site. The present study provided audiology services to in iduals in their natural environment, identified many of the obstacles preventing in iduals from pursuing traditional audiology services and provided information for the foundation of a tele-audiology practice.
Publisher: Informa UK Limited
Date: 07-07-2014
DOI: 10.3109/14992027.2014.920965
Abstract: To determine if a smartphone application could be used as a calibrated screening audiometer with real-time noise monitoring for school screening using automated test sequences. The investigation comprised three studies. Study 1 evaluated calibration accuracy across four Samsung S5301 smartphones (Android v4.0.4) using commercial Sennheiser HD202 headphones. Study 2 involved referencing smartphone microphone sensitivity to narrowband noise intensity as measured in octave bands by a sound-level meter between 30 and 75 dB SPL (5 dB increments). Study 3 compared screening outcomes of smartphone based and conventional hearing screening. Study 2: 15 normal-hearing subjects (age range, 18-22 years all female). Study 3: 162 children (324 ears) aged 5 to 7 years. Smartphone calibration at 20, 30, and 40 dB was within 1 dB of recommended reference equivalent thresholds levels. Microphone calibration for noise monitoring had maximum variability across phones of 0.9, 0.6, and 2.9 dB at 1, 2, and 4 kHz, respectively, from reference intensities (30 to 75 dB SPL). Screening outcomes demonstrated no significant difference between smartphone and conventional audiometry with an overall referral rate of 4.3% and 3.7%, respectively. The newly developed smartphone application can be accurately calibrated for audiometry with valid real-time noise monitoring, and clinical results are comparable to conventional screening.
Publisher: Informa UK Limited
Date: 13-06-2022
DOI: 10.1080/14992027.2021.1928304
Abstract: To canvas the views of Australia-based hearing healthcare clinicians regarding group audiological rehabilitation practices. A national cross-sectional self-report survey. Data were analysed using descriptive statistics and content analysis. Sixty-two Australia-based hearing healthcare clinicians, with experience working in an adult rehabilitation setting. Clinicians appeared to positively view the provision of group audiological rehabilitation services, yet were limited in their ability to deliver these services due to organisational barriers. Although some organisational barriers were non-modifiable by the clinician (such as group AR services not prioritised within their workplace, a lack of support from colleagues/managers, lack of resources, and a lack of funding for the delivery of group AR services), others were within the clinicians' ability to change (such as habit formation for recommending these services during clinical appointments). Participants expressed a desire for resources to assist them in delivering group AR, including downloadable lesson plans and information sheets for clients, clinician training videos and client educational videos. Clinicians called for increased ersity in program offerings, specifically relating to the emotional, relational and social impacts of hearing loss. These results provide a framework for the development of interventional studies to increase the utilisation of group audiological rehabilitation services.
Publisher: BMJ
Date: 2000
DOI: 10.1136/BJO.84.1.28
Abstract: To assess serial, simultaneous stereo optic disc images by four methods for glaucomatous progression. Using varying techniques, two ophthalmologists assessed serial optic disc images of 52 eyes from 27 patients with a mean duration between images of 18 months. The neuroretinal rim width was qualitatively assessed by four assessment methods and compared with quantitative rim measurements made using PC based software. The highest sensitivity of 83% was achieved using computerised stereo chronoscopy. Stereo chronoscopy improved the detection of subtle optic disc changes when compared with simpler assessment techniques.
Publisher: Public Library of Science (PLoS)
Date: 10-05-2023
DOI: 10.1371/JOURNAL.PONE.0285443
Abstract: This study aimed to describe available evidence of cochlear implantation delivery arrangements in adults and the outcomes by which these service models are measured. Scoping review of English language, primary studies conducted on adults (≥18 years) with ten or more subjects, published between January 2000 and June 2022, which assessed the effects of delivery arrangements of cochlear implantation were included. MEDLINE, EMBASE, CINAHL Plus, AMED, PsycINFO, LILACS, KoreaMed, IndMed, Cochrane CRCT, ISRCTN registry, WHO ICTRP and Web of Science were systematically searched. Included studies had to have a method section explicitly measure at least one of the Cochrane Effective Practice and Organization of Care (EPOC) outcome category. Criteria for systematic reviews and delivery arrangement category based on EPOC taxonomy was included in data extraction. Data was narratively synthesized based on EPOC categories. A total of 8135 abstracts were screened after exclusion of duplicates, of these 357 studies fulfilled the inclusion criteria. Around 40% of the studies investigated how care is delivered, focusing on quality and safety systems. New care pathways to coordinate care and the use of information and communication technology were emerging areas. There was little evidence on continuity, coordination and integration of care, how the workforce is managed, where care is provided and changes in the healthcare environment. The main outcome measure for various delivery arrangements were the health status and performance in a test. A substantial body of evidence exists about safety and efficacy of cochlear implantation in adults, predominantly focused on surgical aspects and this area is rapidly growing. There is a lack of evidence on aspects of care delivery that may have more impact on patients’ experience such as continuity, coordination and integration of care and should be a focus of future research. This would lead to a better understanding of how patient’s view CI experience, associated costs and the value of different care models.
Publisher: American Speech Language Hearing Association
Date: 10-2016
Abstract: A better understanding of the attitudes of audiologists toward teleaudiology and their willingness to use teleaudiology is required to progress the application of teleaudiology technologies and services into clinical practice. Audiologists around the world were surveyed on their attitudes toward teleaudiology and their willingness to use it. An online survey was sent to audiologists through professional associations' mailing lists. The survey included questions on the use of computer and video-conferencing technologies, awareness and previous use of teleaudiology, and willingness to use teleaudiology. Responses were provided by 269 people from 28 different countries, representing a wide cross-section of experience, qualification, and work settings 77.8% of respondents were women. Almost all respondents had used PC-based video-conferencing most had used related technologies and reported positive attitudes toward using these. However, less than 25% had used teleaudiology. Despite positive attitudes toward telehealth and associated technology, the low number of audiologists who have used teleaudiology for services indicates limited clinical adoption.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 24-06-2020
DOI: 10.1097/AUD.0000000000000895
Abstract: To explore the factors influencing the uptake of cochlear implants in adults, determine the impact of each factor, and to conceptualize the journey to implantation from a multistakeholder perspective. Concept mapping was used to integrate input from multiple stakeholders, each with their own experience and expertise. This mixed participatory method collects qualitative and quantitative data collection and enables further quantitative analysis. There were two participant cohorts: clients (cochlear implant recipients, candidates, and family members) and professionals (cochlear implant audiologists, ear, nose, and throat surgeons, administration staff, managers. and manufacturer representatives). A total of 93 people participated in the study: client cohort (n = 60, M age = 66.60 years) and professional cohort (n = 33, M age = 45.24 years). Participants brainstormed statements in response to the question “What influences people’s decision to get/not get a cochlear implant?” They subsequently grouped the statements and named each group. They rated each statement as to its impact on the decision and prioritized the need for each to be changed/improved using a five-point Likert scale. Multidimensional scaling was used to produce a visual representation of the ideas and their relationship in the form of concepts. Further analysis was conducted to determine the differences between the cohorts, subcohorts, and concepts. One hundred ten unique statements were generated and grouped into six concepts which either directly affected the client or their environment. These concepts were: external influences (awareness and attitude of non-implant professionals about uptake, cost, logistics, the referral pathway, public awareness) uncertainties, beliefs, and fears (fears, negative effect of word of mouth, unsuccessful previous ear surgery, cosmetics of the device, misunderstanding of how a cochlear implant functions, eligibility for an implant and outcomes after implantation) health problems (mental and physical health) hearing difficulties (social, emotional, and communication impacts of hearing loss, severity of hearing loss, benefit from and experience with hearing aids) implant professionals (implant team’s attitude, knowledge and relationship with clients, quality of overall service) and goals and support (clients ’hearing desires and goals, motivation, positive impact of word of mouth, family support, having a cochlear implant mentor. The six concepts fell into two overarching domains: the client-driven domain with four concepts and the external domain with two concepts. The mean rating of concepts in terms of impact on a client’s decision to get an implant ranged from 2.24 (external influences, the main barrier) to 4.45 (goals and support, the main driver). Ratings significantly differed between the client and professional cohorts. This study increases our understanding of the factors, which influence a client’s decision choose a cochlear implant as a hearing treatment. It also provides new information on the influence of the other stakeholders on the client journey. The magnitude of the generated statements in the client-driven domain highlights the pivotal role of in idualized care in clinical settings in influencing a client’s decision and the need for the professionals to understand a client’s needs and expectations. A client’s persistent hearing difficulties, goals, and support network were identified as drivers to the uptake of cochlear implants. However, the barriers identified highlight the need for a collaborative multi- and interdisciplinary approach to raise awareness in and educate non-implant hearing professionals about the cochlear implant process, as well as providing information to empower clients to make educated decisions and consider a cochlear implant as a hearing management option.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2017
DOI: 10.1097/AUD.0000000000000378
Abstract: To evaluate the performance of smartphone-based hearing screening with the hearScreen ™ application in terms of sensitivity, specificity, referral rates, and time efficiency at two primary health care clinics. Nonprobability purposive s ling was used at both clinics. A total of 1236 participants (mean age: 37.8 ± SD 17.9 and range 3 to 97 years 71.3% female) were included in the final analysis. Participants were screened using the hearScreen ™ application following a two-step screening protocol and diagnostic pure-tone audiometry to confirm hearing status. Sensitivity and specificity for smartphone screening was 81.7 and 83.1%, respectively, with a positive and negative predictive value of 87.6 and 75.6%, respectively. Sex [ χ 2 (1, N = 126) = 0.304, p 0.05] and race [ χ 2 (1, N = 126) = 0.169, p 0.05)] had no significant effect on screening outcome for children while for adults age ( p 0.01 β = 0.04) and sex ( p = 0.02 β = −0.53) had a significant effect on screening outcomes with males more likely to fail. Overall referral rate across clinics was 17.5%. Initial screening test times were less than a minute (48.8 seconds ± 20.8 SD) for adults and slightly more than a minute for children (73.9 seconds ± 44.5 SD). The hearScreen ™ smartphone application provides time-efficient identification of hearing loss with adequate sensitivity and specificity for accurate testing at primary health care settings.
Publisher: Informa UK Limited
Date: 24-10-2020
Publisher: Wiley
Date: 26-07-2006
DOI: 10.1111/J.1749-4486.2006.01237.X
Abstract: To determine the quality of life (QOL) after stapes surgery and whether audiological parameters for hearing correlate with specific QOL factors. A retrospective cross-sectional study. A tertiary referral centre. A series of 35 patients who underwent stapes surgery of which three were excluded because they were <18 years of age, chronically or mentally ill, or in a dependant relationship. Response rate was 93% (30/32). Nine were further excluded because they had revision or bilateral surgery, or missing data. Twenty-one patients were included in this study. The Glasgow Benefit Inventory (GBI) was used to evaluate general QOL and the Hearing Disability and Handicap Scale (HDHS) was used as a disease-specific measure. The Belfast Rule of Thumb and Glasgow Benefit Plot assessed hearing outcomes. Operative success was 86% using the Belfast Rule of Thumb and 95% had closure of the air-bone gap to within 20 dB. 81.8% of patients reported a better overall QOL as surgery. Glasgow Benefit Inventory Social and GBI Physical scores correlated positively with the HDHS speech component (P < 0.05). The duration of hearing loss correlated inversely with the average HDHS score (P < 0.05). The majority of patients report a better QOL as undergoing stapes surgery. Speech impacts on people's physical and social QOL of patients. Quality of life tools, in addition to objective audiologic measurements can provide clinicians with patients' subjective perspective that helps guide clinical decision-making and counselling.
Publisher: Informa UK Limited
Date: 16-05-2017
Publisher: SPIE
Date: 07-06-2000
DOI: 10.1117/12.387520
Publisher: Wiley
Date: 20-02-2017
DOI: 10.1111/DME.13320
Abstract: To investigate the independent associations between hearing loss and dysglycaemia in a s le of middle-aged adults, including separate analysis of those aged < 60 years. The first 2023 participants in the cross-sectional Busselton Health Ageing Survey were assessed for hearing loss ≥ 26 dB (better ear) for four-frequency average (4FA) of pure-tone thresholds at 500, 1000, 2000 and 4000 Hz, and high-frequency average (HFA) of pure-tone thresholds at 4000 and 8000 Hz. Valid data from 1864 participants in the Busselton Health Ageing Survey [92.1% mean ± sd age 56.2 ± 5.5 years, 46.0% men, 120 (7.0%) with diabetes, 274 (14.7%) with prediabetes] were analysed, of whom 103 (5.5%) had four-frequency average hearing loss and 561 (30.1%) had high-frequency average hearing loss. In multivariable analyses, glycaemic status was not independently associated with four-frequency or high-frequency average hearing loss. In the 1286 participants aged < 60 years, there was no relationship between dysglycaemia and high-frequency average hearing loss, but the prevalence of four-frequency average hearing loss increased from 2.3% (95% CI 1.5-3.4) in participants with normoglycaemia to 5.7% (95% CI 3.0-10.6) in those with prediabetes and 10.2% (4.2-21.5) in those with diabetes (trend P = 0.003). In multivariable analysis with normoglycaemia as reference, the odds ratios for four-frequency average hearing loss were 2.84 (95% CI 1.29-6.27) for prediabetes and 5.93 (95% CI 1.67-21.05) for diabetes (P ≤ 0.01) in the < 60 year age group. There was progressively increasing mid-range hearing loss with worsening glucose tolerance in younger in iduals, suggesting dysglycaemia-associated early-onset presbycusis.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2022
DOI: 10.1097/MAO.0000000000003630
Abstract: To explore factors influencing postoperative experiences of adult cochlear implant (CI) recipients, determine the impact of each factor, and conceptualize recipients' postoperative journey. Participatory mixed methods concept mapping. Tertiary care (private and public). Ninety-three participated in the brainstorming activity. Eighty-nine completed the sorting tasks (96% retention rate): CI recipients (n = 44), significant others (n = 13), CI audiologists (n = 14) and surgeons (n = 5), CI clinics' administration staff (n = 5) and managers (n = 3), and CI manufactures' clinical support staff (n = 5). Rehabilitative (CIs). Statements were generated and rated by participants. Similarity of grouping of the statements informed the matrices used for cluster analysis to form concepts. Eighty-seven unique statements described the factors influencing adapting to, use, and maintenance of CIs after implantation. These were grouped, and five concepts were identified: financial considerations, complications, device usability and durability, device programming and adaptation, and patient motivation and supports. Although statements within the concepts financial considerations and complications were negatively rated, statements within the concepts device programming and adaptation, and patient motivation and supports were mostly rated as having positive influence in patients' postoperative journey. The concept device usability and durability contained both negatively and positively rated statements. Postoperative experience of adult CI recipients is a multifaceted journey with several challenges to address to improve services. Although support from and connection with family and clinicians, and simplicity of using a CI device facilitated the experience, medical and surgical complications, durability, and cost of maintaining the device challenged the postoperative experience.
Publisher: SPIE
Date: 07-06-2000
DOI: 10.1117/12.387522
Publisher: Informa UK Limited
Date: 22-02-2022
DOI: 10.1080/14992027.2022.2039965
Abstract: To examine willingness to consider and to pay for various one-to-one telehealth appointments and online group training/information sessions amongst hearing service clients interested in future telehealth. Online survey exploring telehealth usage and attitudes more broadly. One-hundred-and-sixty-eight (39.8%) of the 422 survey respondents who answered the question were interested in future hearing-related telehealth. Data were analysed for the 148 providing demographic information. At least some respondents were interested in each type of one-to-one appointment (∼30-60% for most types) and group training/information session (∼30-50% for most types). Some inconsistent associations were found between willingness to consider in idual appointment types and a metropolitan location, younger age, and female gender. Associations with having a hearing device fitted may have been influenced by the different needs of those without devices. Younger respondents were more likely to consider a wide range of appointment types. Being younger was associated with an interest in 7 of the 9 different group session types. The acceptable price range was AUD$30-$86 (USD$22-$62) ( Despite additional communication needs, hearing service clients have a strong interest in a range of in idual and group telehealth services.
Publisher: Mary Ann Liebert Inc
Date: 08-2022
Publisher: Wiley
Date: 11-1999
DOI: 10.1002/(SICI)1097-0320(19991101)37:3<165::AID-CYTO1>3.0.CO;2-A
Abstract: Various imaging properties of scanning laser ophthalmoscopes (SLO) such as contrast or depth discrimination, are superior to those of the traditional photographic fundus camera. However, most SLO are monochromatic whereas photographic systems produce colour images, which inherently contain information over a broad wavelength range. An SLO system has been modified to allow simultaneous three channel imaging. Laser light sources in the visible and infrared spectrum were concurrently launched into the system. Using different wavelength triads, digital fundus images were acquired at high frame rates. Favourable wavelengths combinations were established and high contrast, true (red, green, blue) or false (red, green, infrared) colour images of the retina were recorded. The monochromatic frames which form the colour image exhibit improved distinctness of different retinal structures such as the nerve fibre layer, the blood vessels, and the choroid. A multi-channel SLO combines the advantageous imaging properties of a tunable, monochrome SLO with the benefits and convenience of colour ophthalmoscopy. The options to modify parameters such as wavelength, intensity, gain, beam profile, aperture sizes, independently for every channel assign a high degree of versatility to the system.
Publisher: Informa UK Limited
Date: 31-03-2022
DOI: 10.1080/09638288.2021.1900928
Abstract: To investigate outcome measurement tools for the validation of teleaudiology hearing aid rehabilitation services for adults. A search strategy was developed to identify tools used to evaluate standard and teleaudiology hearing aid rehabilitation services for adults. A seven-domain hearing-health-care service model for validation was defined and used to analyse the applicability and suitability of patient- and service-centred tools. This model and the applicability and suitability criteria were based on the literature, the International Classification of Functioning (ICF) framework, and gold standard professional practice guidelines, which together formed the validation framework used in this study. Eighteen tools were identified and assessed against the validation framework. These tools were found to primarily assess aspects in the patient communication domain and rarely in the domain of service provision. All the included tools had some applicable items for teleaudiology hearing aid services three tools were judged as suitable and four partially suitable for validating these services. Although there is a set of suitable tools available to validate teleaudiology hearing aid rehabilitation services, none of them cover all the seven domains of the validation model used by this review and few are focussed on a specific domain. Further improvement and/or development of new tools to comprehensively validate these services is still necessary. At this stage, this still limits clinical audiology practice research, especially in teleaudiology.IMPLICATIONS FOR REHABILITATIONOutcome measurement tools are crucial for assessing the validity of hearing rehabilitation services.Findings of this study inform clinicians and researchers on how and what to assess and use to evaluate teleaudiology and standard hearing aid rehabilitation services.The use of the proposed validation framework may facilitate the standardisation of validation of both face-to-face and remotely delivered audiology rehabilitation services and improve consistency of methodology and reported real-world outcomes across studies and thus, the evidence.
Publisher: Wiley
Date: 09-2005
DOI: 10.1016/J.OTOHNS.2005.05.017
Abstract: To assess patients’ quality of life after cerebellopontine angle surgery, and in particular, quality of life related to unilateral profound hearing loss. Cross‐sectional in a tertiary referral center. Quality of life of 51 postoperative patients was assessed by using the Glasgow Benefit Inventory (GBI). Thirty patients with unilateral profound hearing loss who had undergone the translabyrinthine approach completed a subsequent quality‐of‐life questionnaire on speech discrimination and sound localization. Ninety‐four percent of respondents to the 2nd survey reported difficulties with speech discrimination, and 97%, with sound localization. The general health and overall GBI indices correlated significantly ( P .01) with a number of speech and localization difficulties. Unilateral profound hearing loss may be a significant factor in a change in quality of life after cerebellopontine angle surgery. Rehabilitation devices that improve discrimination and localization, and hearing preservation surgery, if indicated, should be considered for these patients.
Publisher: Informa UK Limited
Date: 20-06-2022
DOI: 10.1080/14992027.2021.1933620
Abstract: To explore the lived experience of social challenges and emotional distress in relation to hearing loss and the coping mechanisms employed to manage them. Two focus groups and two one-on-one semi-structured interviews were conducted during February 2020. Transcripts were first inductively analysed to identify experiential categories of social and emotional difficulty, and then deductively analysed using Leventhal's self-regulation model to identify how in iduals conceptualised these experiences and the coping mechanisms employed to manage them. Adults with hearing loss and self-reported emotional distress due to their hearing loss ( Participants described their social and emotional experiences of hearing loss in terms of negative consequences (social overwhelm, fatigue, loss, exclusion), identity impact (how they perceive themselves and are perceived by others), and emotional distress (frustration, grief, anxiety, loneliness, and burdensomeness). While many participants described a general lack of effective coping strategies, others described employing coping strategies including avoidance (helpful and unhelpful), controlling the listening environment, humour, acceptance, assertiveness, communication repair strategies, and accepting support from significant others. Many participants described a lack of effective coping strategies and tended to rely on avoidance of social interaction,deepening their isolation and loneliness.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2013
Publisher: Frontiers Media SA
Date: 17-03-2023
Publisher: Informa UK Limited
Date: 1999
Abstract: Two ophthalmic case histories requiring differing techniques to document the long-term outcomes of ocular tumours are presented. In the first case, after documenting a treated choroidal melanoma it was necessary to intervene with digital manipulation to enhance the images for clinical interpretation. Conversely, after documenting an iris tumour over an eight-year period, it was considered that the original images were suitable for interpretation without intervention. This raises the issue of images presented as legal evidence when digital technology is used to manipulate and enhance the images. Are these images admissible as evidence in court, and should the original data also be archived to prevent conflicting interpretations by the legal system? In light of The House of Lords recommendations on digital images as evidence, it is suggested that both the manipulated and original images are archived to avoid debate on the extent to which an image has been altered.
Publisher: Georg Thieme Verlag KG
Date: 2016
DOI: 10.3766/JAAA.15041
Abstract: Background: Poor follow-up compliance from school-based hearing screening typically undermines the efficacy of school-based hearing screening programs. Onsite diagnostic audiometry with automation may reduce false positives and ensure directed referrals. Purpose: To investigate the validity and time efficiency of automated diagnostic air- and bone-conduction audiometry for children in a natural school environment following hearing screening. Research Design: A within-subject repeated measures design was employed to compare air- and bone-conduction pure-tone thresholds (0.5–4 kHz), measured by manual and automated pure-tone audiometry. Study S le: Sixty-two children, 25 males and 37 females, with an average age of 8 yr (standard deviation [SD] = 0.92 range = 6–10 yr) were recruited for this study. The participants included 30 children who failed on a hearing screening and 32 children who passed a hearing screening. Data Analysis: Threshold comparisons were made for air- and bone-conduction thresholds across ears tested with manual and automated audiometry. To avoid a floor effect thresholds of 15 dB HL were excluded in analyses. The Wilcoxon signed ranked test was used to compare threshold correspondence for manual and automated thresholds and the paired s les t-test was used to compare test time. Statistical significance was set as p ≤ 0.05. Results: 85.7% of air-conduction thresholds and 44.6% of bone-conduction thresholds corresponded within the normal range (15 dB HL) for manual and automated audiometry. Both manual and automated audiometry air- and bone-conduction thresholds exceeded 15 dB HL in 9.9% and 34.0% of thresholds, respectively. For these thresholds, average absolute differences for air- and bone-conduction thresholds were 6.3 (SD = 8.3) and 2.2 dB (SD = 3.6) and they corresponded within 10 dB across frequencies in 87.7% and 100.0%, respectively. There was no significant difference between manual and automated air- and bone-conduction across frequencies for these thresholds. Conclusion: Using onsite automated diagnostic audiometry for children who fail hearing screening may improve the efficacy of school-based screening programs by reducing false positives and ensuring directed referrals for audiological or medical intervention or both.
Publisher: Mary Ann Liebert Inc
Date: 12-2012
Abstract: Hearing loss resulting from overexposure to entertainment-related sounds is a modern concern. "Epic Ear Defence" places the player in the three-dimensional environment of the ear canal and challenges the player to defend the ear from various noises, to delay the onset of noise-related hearing loss.
Publisher: SAGE Publications
Date: 2021
DOI: 10.1177/23312165211037525
Abstract: While the majority of cochlear implant recipients benefit from the device, it remains difficult to estimate the degree of benefit for a specific patient prior to implantation. Using data from 2,735 cochlear-implant recipients from across three clinics, the largest retrospective study of cochlear-implant outcomes to date, we investigate the association between 21 preoperative factors and speech recognition approximately one year after implantation and explore the consistency of their effects across the three constituent datasets. We provide evidence of 17 statistically significant associations, in either univariate or multivariate analysis, including confirmation of associations for several predictive factors, which have only been examined in prior smaller studies. Despite the large s le size, a multivariate analysis shows that the variance explained by our models remains modest across the datasets ([Formula: see text]–0.21). Finally, we report a novel statistical interaction indicating that the duration of deafness in the implanted ear has a stronger impact on hearing outcome when considered relative to a candidate’s age. Our multicenter study highlights several real-world complexities that impact the clinical translation of predictive factors for cochlear implantation outcome. We suggest several directions to overcome these challenges and further improve our ability to model patient outcomes with increased accuracy.
Publisher: Informa UK Limited
Date: 29-05-2013
DOI: 10.3109/14992027.2013.792437
Abstract: This report presents data from four studies to examine standard bone-conduction reference equivalent threshold force levels (RETFL), especially at 4 kHz where anomalous air-bone gaps are common. Data were mined from studies that obtained air- and bone-conduction thresholds from normal-hearing and sensorineural hearing loss (SNHL) participants, using commercial audiometers and standard audiometric transducers. There were 249 normal-hearing and 188 SNHL participants. (1) Normal-hearing participants had small air-bone gaps at 0.5, 1.0, and 2.0 kHz (-1.7 to 0.3 dB) and larger air-bone gaps at 4 kHz (10.6 dB). (2) SNHL participants had small air-bone gaps at 0.5, 1.0, and 2.0 kHz (-0.7 to 1.7 dB) and a larger air-bone gap at 4 kHz (14.1 dB). (3) The 4-kHz air-bone gap grew with air-conduction threshold from 10.1 dB when the air-conduction threshold was 5-10 dB HL to 21.1 dB when the air-conduction threshold was greater than 60 dB. (4) With the 4-kHz RETFL corrected by the average SNHL air-bone gap, the relationship between RETFL and frequency is linear with a slope of - 12 dB per octave. The 4-kHz air-bone gaps for listeners with SNHL could be avoided by adjusting the 4-kHz RETFL by - 14.1 dB.
Publisher: SPIE
Date: 18-04-2000
DOI: 10.1117/12.383057
Publisher: Elsevier BV
Date: 05-2016
DOI: 10.1016/J.IJPORL.2016.02.021
Abstract: This study aimed to describe the prevalence and characteristics of hearing loss in school-aged children in an urban South African population. Children from grade one to three from five schools in the Gauteng Province of South Africa formed a representative s le for this study. All children underwent otoscopic examinations, tympanometry and pure tone screening (25dB HL at 1, 2 and 4kHz). Children who failed the screening test and 5% of those who passed the screening test underwent diagnostic audiometry. A total of 1070 children were screened. Otoscopic examinations revealed that a total of 6.6% ears had cerumen and 7.5% of ears presented with a type-B tympanogram. 24 children (12 male, 12 female) were diagnosed with hearing loss. The overall prevalence of hearing loss was 2.2% with Caucasian children being 2.9 times more (95% confidence interval, 1.2-6.9) likely to have a hearing loss than African children. Hearing loss prevalence in urban South African school-aged children suggest that many children (2.2%) are in need of some form of follow-up services, most for medical intervention (1.2%) with a smaller population requiring audiological intervention (0.4%).
Publisher: Informa UK Limited
Date: 23-09-2020
Publisher: JMIR Publications Inc.
Date: 23-08-2023
DOI: 10.2196/46043
Abstract: The most common management option for hearing loss is hearing aids. In addition to devices, patients require information and support, including maintenance and troubleshooting. Mobile health (mHealth) technologies can support hearing aid management, acclimatization, and use. This study developed an mHealth acclimatization and support program for first-time hearing aid users and subsequently implemented and pilot-tested the feasibility of the program. The program was facilitated by community health workers (CHWs) in low-income communities in South Africa. This study aimed to evaluate the feasibility of an mHealth acclimatization and support program supported by CHWs in low-income communities. An application-based acclimatization and support was adapted and translated for use in low- and middle-income countries. This program was delivered in the form of 20 different voice notes accompanied by graphical illustrations via WhatsApp or 20 different SMS text messages. The program was provided to first-time hearing aid users immediately after a community-based hearing aid fitting in March 2021 in 2 low-income communities in the Western Cape, South Africa. The 20 messages were sent over a period of 45 days. Participants were contacted telephonically on days 8, 20, and 43 of the program and via open-ended paper-based questionnaires translated to isiXhosa 45 days and 6 months after the program started to obtain information on their experiences, perceptions, and accessibility of the program. Their responses were analyzed using inductive thematic analysis. A total of 19 participants fitted with hearing aids received the mHealth acclimatization and support program. Most participants (15/19, 79%) received the program via WhatsApp, with 21% (4/19) of them receiving it via SMS text message. Participants described the program as helpful, supportive, informative, sufficient, and clear at both follow-ups. A total of 14 participants reported that they were still using their hearing aids at the 6-month follow-up. Three participants indicated that not all their questions about hearing aids were answered, and 5 others had minor hearing aid issues. This included feedback (n=1), battery performance (n=1), physical fit (n=2), and issues with hearing aid accessories (n=1). However, CHWs successfully addressed all these issues. There were no notable differences in responses between the participants who received the program via WhatsApp compared with those who received it through SMS text message. Most participants receiving WhatsApp messages reported that the voice notes were easier to understand, but the graphical illustrations supplemented the voice notes well. An mHealth acclimatization and support program is feasible and potentially assists hearing aid acclimatization and use for first-time users in low-income communities. Scalable mHealth support options can facilitate increased access and improve outcomes of hearing care.
Publisher: American Speech Language Hearing Association
Date: 12-07-2019
DOI: 10.1044/2019_LSHSS-18-0085
Abstract: Children who are deaf and hard of hearing (DHH) face a wide array of issues that can impact their mental health and well-being. This study aimed to explore the role of schools and classroom teachers in supporting the mental health and well-being of DHH children. A qualitative study comprising telephone and semistructured interviews with 12 mainstream school classroom teachers who directly support the education and well-being of DHH children was conducted. Thematic analysis was used to analyze the data. Classroom teachers indicated they play an important role in supporting the mental health and well-being of DHH children but identified a range of constraints to providing this support. Four themes were identified: (a) “culture of professional practice,” (b) “operationalized practice,” (c) “constraints to practice,” and (d) “solutions for constraints.” Classroom teachers play an important role in supporting the mental health and well-being of DHH children but face several constraints in their practice, including limited training and awareness and access to resources. While further research is needed, this study suggests that classroom resources and teacher professional development are needed to enhance classroom teachers' understanding of how to support the mental health and well-being of DHH children.
Publisher: Georg Thieme Verlag KG
Date: 06-2013
DOI: 10.3766/JAAA.24.6.7
Abstract: Background: The baby boomer population will become high users of the health-care system in coming years. Self-report of hearing loss at a primary health-care visit may offer timely referrals to audiological services, but there has been no population-based study of self-reported hearing loss in the baby boomer generation. Purpose: To determine the clinical value and audiometric correspondence of self-reported hearing loss as a screening tool for the baby boomer population. Research Design: A population-based study, Busselton Healthy Ageing Study (BHAS), surveying baby boomers born between 1946 and 1964 from the shire of Busselton, Western Australia. Study S le: A randomized s le of noninstitutionalized baby-boomers listed on the electoral roll (n = 6690) and resident in the shire are eligible to participate. This study reports on data from the first 1004 attendees (53.5% female) with a mean age of 56.23 (SD = 5.43). Data Collection and Analysis: Data from a self-report question on hearing loss and diagnostic pure tone audiometry was utilized for this study. Analysis included screening performance measures of self-report compared to audiometric cut-offs, receiver operator curve (ROC) to determine optimal level, analysis of variance to compare hearing status to self-report, and binary logistic regression to determine best audiometric predictors. Results: Of the s le, 16% self-reported hearing loss (72.1% males). Logistic regression indicated 4000 Hz as the most important in idual frequency related to self-report while the four-frequency average (500, 1000, 2000, and 4000 Hz) dB in the worse ear was the most significant averaged cutoff with 68% sensitivity and 87% specificity. Of those who self-reported a hearing loss, 80% had either a four-frequency average hearing loss dB in the worse ear or a high-frequency average (4000 and 8000 Hz) hearing loss greater than 35 dB in the worse ear. Conclusions: Baby boomer adults who self-report hearing impairment on direct inquiry are most likely to have a hearing loss. A simple question at a primary health care visit may facilitate a timely referral for audiological services in a baby boomer adult, who may be more amenable to rehabilitation.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2010
Publisher: Informa UK Limited
Date: 14-07-2017
DOI: 10.1080/14992027.2017.1347289
Abstract: Although clinician administered surveys evaluating hearing aid handling skills exist, the development of a self-administered version may reduce clinical load, save consultation time, and facilitate more frequent use than face-to-face consultations allow. However, there is currently no evidence to support whether hearing aid owners can accurately self-report hearing aid handling skills via self-report survey that systematically evaluates the ability to accurately perform the in idual aspects of hearing aid handling required for effective hearing aid management. An explorative pilot study using a prospective research design. Nineteen adult hearing aid owners, aged between 65 and 93 years. The self-administered survey demonstrated high sensitivity when compared with clinician evaluation of skills, with 93% of participants accurately self-identifying and reporting whether hearing aid handling skill training was required. Hearing aid owners are able to accurately self-report hearing aid handling difficulties when provided with an itemised list of skills.
Publisher: Springer Science and Business Media LLC
Date: 11-08-2021
DOI: 10.1186/S12889-021-11578-Y
Abstract: Chronic medical conditions accumulate within in iduals with age. However, knowledge concerning the trends, patterns and determinants of multimorbidity remains limited. This study assessed the prevalence and patterns of multimorbidity using extensive in idual phenotyping in a general population of Australian middle-aged adults. Participants ( n = 5029, 55% female), born between 1946 and 1964 and attending the cross-sectional phase of the Busselton Healthy Ageing Study (BHAS) between 2010 and 2015, were studied. Prevalence of 21 chronic conditions was estimated using clinical measurement, validated instrument scores and/or self-reported doctor-diagnosis. Non-random patterns of multimorbidity were explored using observed/expected (O/E) prevalence ratios and latent class analysis (LCA). Variables associated with numbers of conditions and class of multimorbidity were investigated. The in idual prevalence of 21 chronic conditions ranged from 2 to 54% and multimorbidity was common with 73% of the cohort having 2 or more chronic conditions. (mean ± SD 2.75 ± 1.84, median = 2.00, range 0–13). The prevalence of multimorbidity increased with age, obesity, physical inactivity, tobacco smoking and family history of asthma, diabetes, myocardial infarct or cancer. There were 13 pairs and 27 triplets of conditions identified with a prevalence 1.5% and O/E 1.5. Of the triplets, arthritis ( 50%), bowel disease ( 33%) and depression-anxiety ( 33%) were observed most commonly. LCA modelling identified 4 statistically and clinically distinct classes of multimorbidity labelled as: 1) “Healthy” (70%) with average of 1.95 conditions 2) “Respiratory and Atopy” (11%, 3.65 conditions) 3) “Non-cardiometabolic” (14%, 4.77 conditions), and 4) “Cardiometabolic” (5%, 6.32 conditions). Predictors of multimorbidity class membership differed between classes and differed from predictors of number of co-occurring conditions. Multimorbidity is common among middle-aged adults from a general population. Some conditions associated with ageing such as arthritis, bowel disease and depression-anxiety co-occur in clinically distinct patterns and at higher prevalence than expected by chance. These findings may inform further studies into shared biological and environmental causes of co-occurring conditions of ageing. Recognition of distinct patterns of multimorbidity may aid in a holistic approach to care management in in iduals presenting with multiple chronic conditions, while also guiding health resource allocation in ageing populations.
Publisher: Informa UK Limited
Date: 17-08-2016
DOI: 10.1080/14992027.2016.1214756
Abstract: Evaluation of the Sennheiser HD 202 II supra-aural headphones as an alternative headphone to enable more affordable hearing screening. Study 1 measured the equivalent threshold sound pressure levels (ETSPL) of the Sennheiser HD 202 II. Study 2 evaluated the attenuation of the headphones. Study 3 determined headphone characteristics by analyzing the total harmonic distortion (THD), frequency response and force of the headband. Twenty-five participants were included in study 1 and 15 in study 2 with ages ranging between 18 and 25. No participants were involved in study 3. The Sennheiser HD 202 II ETSPLs (250-16000 Hz) showed no significant effects on ETSPL for ear laterality, gender or age. Attenuation was not significantly different (p > 0.01) to TDH 39 except at 8000 Hz (p 3%. Sennheiser HD 202 II supra-aural headphones can be used as an affordable headphone for screening audiometry provided reported MPANLs, maximum intensities and ETSPL values are employed.
Publisher: Elsevier BV
Date: 06-2005
DOI: 10.1016/J.IJPORL.2004.12.008
Abstract: To determine if digitised still eardrum images, with a clinical history, and audiometry and tympanometry data provide sufficient information to an ear specialist to make an assessment of a patient. 66 children (9 months to 16 years) from remote communities were assessed by an ear specialist by standard otoscopy, using a clinical history, audiometry and tympanometry. Up to five images of each ear were digitised. At a later date, the ear specialist made observations, diagnoses and recommendations for management from the images and clinical data. There was a significant correlation (p<0.01) between image quality and age of the subject. There were significant agreements for the clinically important observations of otorrhea, perforation, retracted tympanic membrane and atrophy of the tympanic membrane (p<0.05). There were significant agreements for the diagnoses of acute otitis media, chronic suppurative otitis media, otitis media with effusion and Eustachian tube dysfunction. The rate of recommendations for review or referral after a tele-otology assessment were between 4 and 16% higher than those in made in the field. The agreements between the various forms of advice or recommendations made in the field to those made by tele-otology were statistically significant (p<0.01). A tele-otology system that incorporates good quality digitised images of the tympanic membrane, audiological and tympanometric data, and a comprehensive clinical history provides the ear specialist with sufficient information to make a confident diagnose of existing middle ear disease, and provide management advice to the patients' primary care provider.
Publisher: Springer Science and Business Media LLC
Date: 07-01-2014
Publisher: Georg Thieme Verlag KG
Date: 03-2017
DOI: 10.3766/JAAA.16002
Abstract: Smartphone-based threshold audiometry with automated testing has the potential to provide affordable access to audiometry in underserved contexts. To validate the threshold version (hearTest) of the validated hearScreen™ smartphone-based application using inexpensive smartphones (Android operating system) and calibrated supra-aural headphones. A repeated measures within-participant study design was employed to compare air-conduction thresholds (0.5–8 kHz) obtained through automated smartphone audiometry to thresholds obtained through conventional audiometry. A total of 95 participants were included in the study. Of these, 30 were adults, who had known bilateral hearing losses of varying degrees (mean age = 59 yr, standard deviation [SD] = 21.8 56.7% female), and 65 were adolescents (mean age = 16.5 yr, SD = 1.2 70.8% female), of which 61 had normal hearing and the remaining 4 had mild hearing losses. Threshold comparisons were made between the two test procedures. The Wilcoxon signed-ranked test was used for comparison of threshold correspondence between manual and smartphone thresholds and the paired s les t test was used to compare test time. Within the adult s le, 94.4% of thresholds obtained through smartphone and conventional audiometry corresponded within 10 dB or less. There was no significant difference between smartphone (6.75-min average, SD = 1.5) and conventional audiometry test duration (6.65-min average, SD = 2.5). Within the adolescent s le, 84.7% of thresholds obtained at 0.5, 2, and 4 kHz with hearTest and conventional audiometry corresponded within ≤5 dB. At 1 kHz, 79.3% of the thresholds differed by ≤10 dB. There was a significant difference (p 0.01) between smartphone (7.09 min, SD = 1.2) and conventional audiometry test duration (3.23 min, SD = 0.6). The hearTest application with calibrated supra-aural headphones provides a cost-effective option to determine valid air-conduction hearing thresholds.
Publisher: Informa UK Limited
Date: 27-02-2023
Publisher: Wiley
Date: 07-01-2016
DOI: 10.1111/COA.12472
Abstract: To investigate the ability of cochlear implant (CI) recipients to physically handle and care for their hearing implant device(s) and to identify factors that may influence skills. To assess device management skills, a clinical survey was developed and validated on a clinical cohort of CI recipients. Survey development and validation. A prospective convenience cohort design study. Specialist hearing implant clinic. Forty-nine post-lingually deafened, adult CI recipients, at least 12 months postoperative. Survey test-retest reliability, interobserver reliability and responsiveness. Correlations between management skills and participant demographic, audiometric, clinical outcomes and device factors. The Cochlear Implant Management Skills survey was developed, demonstrating high test-retest reliability (0.878), interobserver reliability (0.972) and responsiveness to intervention (skills training) [t(20) = -3.913, P = 0.001]. Cochlear Implant Management Skills survey scores range from 54.69% to 100% (mean: 83.45%, sd: 12.47). No associations were found between handling skills and participant factors. This is the first study to demonstrate a range in cochlear implant device handling skills in CI recipients and offers clinicians and researchers a tool to systematically and objectively identify shortcomings in CI recipients' device handling skills.
Publisher: Wiley
Date: 07-2007
Publisher: SAGE Publications
Date: 27-03-2014
Abstract: Recipients of cochlear implants need to attend regular mapping sessions to adjust their speech processors. We developed a PC-based system for remote mapping, which employed voice, video and text communication. Eleven implant recipients had their implant electrodes programmed (mapped) both by conventional methods and remotely. Speech tests, conducted by a family member or research assistant, were used to test the outcome of the programming during the remote consultation. The recipient and audiologist were surveyed regarding aspects of the teleconsultation. There were no significant differences between conventionally and remotely programmed electrode settings. The speech test results were perfect in most cases. The average time to complete the conventional mapping session was 37 min and the average time for the remote mapping session was 42 min ( P = 0.034). Recipients and the audiologist reported favourably on most aspects of the consultations. Lack of synchronisation between voice and video was the most common problem, which disrupted communication. The assistant was important to overcome this problem. All but one participant indicated they would be willing to use tele-mapping in the future. Remote programming of cochlear implants can be conducted reliably with relatively simple equipment, potentially in the homes of remotely located patients assisted by a family member.
Publisher: Wiley
Date: 09-2007
DOI: 10.1016/J.OTOHNS.2007.02.034
Abstract: To evaluate the surgical outcome of patients undergoing obliteration of a persistently discharging mastoid cavity with specific soft tissue vascular flaps for chronic otitis media or cholesteatoma. A five‐year retrospective consecutive case review in a tertiary care referral center. Following mastoidectomy obliteration with a superiorly based middle temporal artery, axial periosteal flap and inferiorly based random pedicled musculoperi‐osteal flap was performed. The primary outcome was control of suppuration and the creation of a dry, low‐maintenance cavity as assessed by a semi‐quantitative scale. A total of 51 consecutive patients undergoing revision mastoidectomy with obliteration were identified with a minimum follow‐up of 12 months 43 (84%) had a small dry healthy mastoid cavity three ears (6%) had occasional otorrhea that was relatively easily managed by topical therapy. Obliteration using the middle temporal artery and inferior random flaps is an effective method to manage patients with pre‐existing cavities and also those not previously operated upon.
Publisher: American Speech Language Hearing Association
Date: 13-07-2018
DOI: 10.1044/2018_JSLHR-H-16-0397
Abstract: This review examined (a) the current evidence from studies on teleaudiology applications for rehabilitation of adults with hearing impairment with hearing aids and (b) whether it is sufficient to support the translation into routine clinical practice. A search strategy and eligibility criteria were utilized to include articles specifically related to hearing aid fitting and follow-up procedures that are involved in consultations for the rehabilitation of adults, where the service was provided by the clinician by teleaudiology. A search using key words and Medical Subject Headings (MeSH) was conducted on the main electronic databases that index health-related studies. The included studies were assessed using validated evaluation tools for methodological quality, level of evidence, and grade recommendations for application into practice. Fourteen studies were identified as being within the scope of this review. The evaluation tools showed that none of these studies demonstrated either a strong methodological quality or high level of evidence. Analysis of evidence identified 19 activities, which were classified into service outcomes categories of feasibility, barriers, efficiency, quality, and effectiveness. Recommendations could be made regarding the (a) feasibility, (b) barriers, and (c) efficiency of teleaudiology for the rehabilitation of hearing loss with hearing aids. This review provides up-to-date evidence for teleaudiology hearing aid services in new and experienced hearing aid users in different practice settings. Findings direct future research priorities to strengthen evidence-based practice. There is a need for further studies of many aspects of teleaudiology services for rehabilitation with hearing aids to support their implementation into clinical practice. 0.23641/asha.6534473
Publisher: S. Karger AG
Date: 2017
DOI: 10.1159/000488386
Abstract: This systematic review of the literature reveals which preoperative factors affect sequential cochlear implantation outcomes in adults. The findings can help health care professionals provide evidence-based advice on the expected benefits from a second cochlear implant (CI). We searched PubMed, EMBASE, and the Cochrane database from November 1977 to August 26, 2017, using the terms “sequential cochlear implantation” the most frequently cited predictors for unilateral cochlear implantation performance and other potential predictors for sequential implantation outcome and “speech perception,” “localization” as well as synonyms of all of the above. Ten studies were included. The effects of age, duration of hearing loss, time between implantations, preoperative hearing, etiology of hearing loss, hearing aid use and duration of follow-up on sequential cochlear implantation performance were studied. The literature has shown that duration of deafness, age at onset of deafness, etiology of hearing loss, and preoperative speech perception score are (inversely) related to unilateral cochlear implantation outcome in adults. One would expect that these factors would also affect sequential bilateral implantation outcome. However, the best available evidence to date shows that advanced age, a long duration of deafness, or a long interval between implantations should not be considered negative factors when considering sequential bilateral cochlear implantation.
Publisher: Wiley
Date: 02-1994
DOI: 10.1111/J.1442-9071.1994.TB01688.X
Abstract: The objective quantification of drusen (and other macular lesions) should have applications epidemiologically, in the study of the natural history of drusen, and with such instruments as the scanning laser ophthalmoscope. The automated extraction of drusen from photographs is technically difficult because of uneven macular reflectance, and the confusing pattern of darker vessels. We have developed a method using an IBM personal computer, an image digitising board and specially written software. Once the image is digitised, no further input from the operator is necessary. We present the results of manual counting versus automated counting on a small series of patients with drusen. The automated technique is highly reproducible, and will calculate the retinal area occupied by drusen. The area and numbers of drusen can be compared over time, giving an index of progression. Hard drusen are fairly well detected, but the detection of soft drusen with their lower contrast remains a problem. The technique cannot distinguish between drusen and other pale lesions (e.g., atrophic retinal changes).
Publisher: AOSIS
Date: 12-2016
Publisher: Cambridge University Press (CUP)
Date: 05-2016
Publisher: American Speech Language Hearing Association
Date: 17-07-2020
DOI: 10.1044/2020_JSLHR-19-00005
Abstract: The aim of the study was to examine whether otitis media (OM) in early childhood has an impact on language development in later childhood. We analyzed data from 1,344 second-generation (Generation 2) participants in the Raine Study, a longitudinal pregnancy cohort established in Perth, Western Australia, between 1989 and 1991. OM was assessed clinically at 6 years of age. Language development was measured using the Peabody Picture Vocabulary Test–Revised (PPVT-R) at 6 and 10 years of age and the Clinical Evaluation of Language Fundamentals–Third Edition at 10 years of age. Logistic regression analysis accounted for a wide range of social and environmental covariates. There was no significant relationship between bilateral OM and language ability at 6 years of age (β = −0.56 [−3.78, 2.66], p = .732). However, while scores were within the normal range for the outcome measures at both time points, there was a significant reduction in the rate of receptive vocabulary growth at 10 years of age (PPVT-R) for children with bilateral OM at 6 years of age (β = −3.17 [−6.04, −0.31], p = .030), but not for the combined unilateral or bilateral OM group (β = −1.83 [−4.04, 0.39], p = .106). Children with OM detected at 6 years of age in this cohort had average language development scores within the normal range at 6 and 10 years of age. However, there was a small but statistically significant reduction in the rate of receptive vocabulary growth at 10 years of age (on the PPVT-R measure only) in children who had bilateral OM at 6 years of age after adjusting for a range of sociodemographic factors.
Publisher: American Speech Language Hearing Association
Date: 08-06-2020
DOI: 10.1044/2019_AJA-19-00087
Abstract: Emotional and mental health is essential to overall health, but there has been little research on how to approach emotional and mental health in the audiology setting. This study provides a preliminary investigation into the current knowledge, beliefs, and practices of Australian audiologists in addressing the emotional and mental health needs of adults with hearing loss. A 22-item survey using open- and closed-ended questions was completed by 95 Australian audiologists using a cross-sectional study design. Two thirds of audiologists described being underconfident and lacking the skills required to provide emotional support to people with hearing loss. Barriers to delivering emotional support included feeling out of their depth (56.6%), time/caseload pressures (55.3%), and the perception that the provision of emotional support was not within an audiologist's scope of practice (31.6%). Audiologists described a desire to refer clients to mental health professionals yet highlighted significant barriers, including not knowing who to refer to (54.7%), when to make a referral (49.3%), or how to make a referral (38.6%). Audiologists overwhelmingly (96%) indicated that they would like to develop their knowledge and skills associated with the provision of emotional and mental health support in the audiological setting. Knowledge, skills, and time were identified as the key areas that require attention in order to allow audiologists to address the emotional and mental health needs of adults with hearing loss.
Publisher: SAGE Publications
Date: 20-09-2016
Abstract: Remote interpretation of automated audiometry offers the potential to enable asynchronous tele-audiology assessment and diagnosis in areas where synchronous tele-audiometry may not be possible or practical. The aim of this study was to compare remote interpretation of manual and automated audiometry. Five audiologists each interpreted manual and automated audiograms obtained from 42 patients. The main outcome variable was the audiologist’s recommendation for patient management (which included treatment recommendations, referral or discharge) between the manual and automated audiometry test. Cohen’s Kappa and Krippendorff’s Alpha were used to calculate and quantify the intra- and inter-observer agreement, respectively, and McNemar’s test was used to assess the audiologist-rated accuracy of audiograms. Audiograms were randomised and audiologists were blinded as to whether they were interpreting a manual or automated audiogram. Intra-observer agreement was substantial for management outcomes when comparing interpretations for manual and automated audiograms. Inter-observer agreement was moderate between clinicians for determining management decisions when interpreting both manual and automated audiograms. Audiologists were 2.8 times more likely to question the accuracy of an automated audiogram compared to a manual audiogram. There is a lack of agreement between audiologists when interpreting audiograms, whether recorded with automated or manual audiometry. The main variability in remote audiogram interpretation is likely to be in idual clinician variation, rather than automation.
Publisher: Wiley
Date: 04-2007
DOI: 10.1016/J.OTOHNS.2007.01.028
Abstract: We reviewed the progress of the implementation of expert diagnostic systems in the field of otology. We conducted a review of the literature at a research institute. The utilization of expert diagnostic systems in otology is very limited. Previous applications focused primarily upon the diagnosis of vertiginous disorders with the use of deterministic algorithms and, more recently, with adaptive algorithms such as neural networks. Expert systems provide greater diagnostic accuracy to physicians across a wide range of medical specialties. The success of such a system depends upon the strength of its reasoning algorithm, the validity of its knowledge base, and its ease of use. There have been no attempts to develop an adaptive expert system for the full range of otological conditions. Such a tool may be of great use to physicians as a diagnostic aid and educational resource, particularly for those located in isolated sites.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 1999
DOI: 10.1109/51.740963
Publisher: Wiley
Date: 06-2010
DOI: 10.1002/LARY.20998
Abstract: The aim of this study was to provide a detailed cytological account on the healing tympanic membrane (TM) over 14 days and to complement existing research into TM wound healing. The study is a prospective cohort study of 19 male Sprague-Dawley (Rattus norvegicus) rats. Rat TMs were perforated using a sterile needle and sacrificed at time points during the 14 days following perforation. The healing of the TM resembles cutaneous wound healing except that the TM is unique in the lack of a supportive matrix beneath the regenerating epithelia. This prevents the influx of reparative cells and nutrients and the in growth of the usual fibroblastic reaction. TM wound healing contrasts with cutaneous wound healing in that keratinocytes are the first cells to close the wound and not the last. A keratin scaffold may not be important in the healing process. The malleus plays a crucial role in the healing of the TM and is the site of significant mitotic activity during the healing process. Migration across layers of the TM appears to account for the closure of the perforation.
Publisher: American Speech Language Hearing Association
Date: 18-09-2017
Abstract: The purpose of this study is to raise awareness of interobserver concordance and the differences between interobserver reliability and agreement when evaluating the responsiveness of a clinician-administered survey and, specifically, to demonstrate the clinical implications of data types (nominal/categorical, ordinal, interval, or ratio) and statistical index selection (for ex le, Cohen's kappa, Krippendorff's alpha, or interclass correlation). In this prospective cohort study, 3 clinical audiologists, who were masked to each other's scores, administered the Practical Hearing Aid Skills Test–Revised to 18 adult owners of hearing aids. Interobserver concordance was examined using a range of reliability and agreement statistical indices. The importance of selecting statistical measures of concordance was demonstrated with a worked ex le, wherein the level of interobserver concordance achieved varied from “no agreement” to “almost perfect agreement” depending on data types and statistical index selected. This study demonstrates that the methodology used to evaluate survey score concordance can influence the statistical results obtained and thus affect clinical interpretations.
Publisher: Wiley
Date: 28-08-2018
DOI: 10.1111/COA.13193
Abstract: To identify which preoperative patient characteristics influence sequential bilateral cochlear implantation performance and to create a statistical model that predicts benefit. Multicentre retrospective cohort study. All patients were operated in four academic teaching hospitals in Perth, Australia, and followed up by audiologists of the Ear Science Institute Australia. A total of 92 postlingually deafened adult patients who had undergone sequential cochlear implantations between 19 June 1990 and 14 March 2016 were included. Patients were excluded if the 12-month follow-up consonant-nucleus-consonant (CNC) phoneme score was missing. The effect of 18 preoperative factors on the CNC phoneme score in quiet (at 65 dB SPL) with the second cochlear implant (CI2) one year after implantation. Two factors were positively correlated to speech understanding with CI2: Wearing a hearing aid (HA) before receiving CI2 (r = 0.46, P = 0.00) and the maximum CNC phoneme score with the first CI (CI1) (r = 0.21, P = 0.05). Two factors were negatively correlated: the length of hearing loss before CI2 in the second implanted ear (r = -0.25, P = 0.02) and preoperative pure tone average (PTA) (0.5, 1, 2 kHz) before CI2 in the second implanted ear (r = -0.27, P = 0.01). The following model could be created: predicted CNC phoneme score with CI2 (%) = 16 + (44 * HA use before CI2 (yes)) - (0.22 * length of hearing loss before CI2 (years)) + (0.23 * CNC phoneme score with CI1 (%)). Because the effect of HA use before implantation played such a major role, we also created a model after exclusion of the HA factor: Predicted CNC phoneme score with CI2 (%) = 82 - (0.17 * length of hearing loss before CI2 (years)) - (0.27 * PTA in second implanted ear before CI2 (0.5, 1, 2 kHz)) + (0.20 * CNC phoneme score with CI1 (%)). Advanced age or a long interval between implantations does not necessarily lead to poor CI2 results. Patients who are successful HA users before CI2, who have a low PTA before CI2, a high CNC phoneme score with CI1 and a limited length of hearing loss before CI2, are likely to be successful CI2 recipients.
Publisher: SAGE Publications
Date: 2018
Publisher: Informa UK Limited
Date: 06-2013
Publisher: Informa UK Limited
Date: 10-2021
DOI: 10.1080/14992027.2021.1983217
Abstract: To compare the asynchronous assessment of video otoscopic still images to recordings by an audiologist and ear, nose and throat surgeon (ENT) for diagnostic reliability and agreement in identifying middle-ear disease. A prospective cross-sectional study, asynchronously assessing video otoscopy, tympanometry and case history (Dx1). A subset was re-diagnosed (Dx2). Video otoscopy and data from 146 children recruited at two public community events a sub-set of 47 were re-assessed. The intra-rater diagnostic agreement between Dx1 and Dx2 was moderate ( k = 0.445-0.552) for the ENT surgeon, and almost-perfect ( k = 0.928) for the audiologist, in both procedures. The agreement between the two procedures was substantial ( k = 0.624) and moderate ( k = 0.416) for the ENT surgeon in Dx1 and Dx2 respectively, and almost-perfect for the audiologist ( k = 0.854-0.978) in both rounds. In Dx1, the inter-rater agreement between the clinicians was substantial using still images ( k = 0.672) and moderate using recordings ( k = 0.593) in Dx2 it was moderate using both procedures ( k = 0.477-0.488). Both video otoscopic procedures, in addition to tympanometry and case history information, can be reliably used for asynchronous diagnosis of childhood middle-ear disease. An audiologist has a potential role in triaging children with middle-ear abnormalities and, therefore, improving access to ear-health services.
Publisher: Springer Science and Business Media LLC
Date: 26-11-2012
DOI: 10.1007/S00276-011-0896-5
Abstract: To define the rotational anatomy of the osseous spiral lamina (OSL) at the hook region and along the basal turn of the cochlea and to illustrate the potential utility of high-resolution MRI images to study inner ear ultrastructure. Retrospective review of high-resolution temporal bone MRI images in 20 consecutive adult patients referred for imaging unrelated to hearing loss. The main outcome measure utilised images in an oblique sagittal plane to measure the rotation of the OSL relative to the vertical axis in the hook region and along the basal turn of the cochlea. The right OSL is noted to rotate in a clockwise direction as one proceeds anteriorly over the same distance, the left OSL rotates in an anti-clockwise direction. The average overall rotation for all subjects as measured over a distance of 1-7 mm from the posterior margin of the round window was 25.95°. Inter-subject variability was noted. Prominent rotation of the OSL was noted in the hook region, this being most pronounced in the proximity to the round window. This concept may have implications for cochleostomy site selection with implant surgery. The study highlights the feasibility of high-resolution MRI to be used to systematically study variations in intra-cochlear anatomy.
Publisher: WHO Press
Date: 19-06-2019
Publisher: Cambridge University Press (CUP)
Date: 09-2018
DOI: 10.1017/S002221511800155X
Abstract: To summarise the available literature related to wound healing post tonsillectomy, including the stages of healing, experimental models for assessing healing (in animals and humans) and the various factors that affect wound healing. A search of the English literature was conducted using the Ovid Medline database, with the search terms ‘tonsillectomy’ or ‘tonsil’ and ‘wound healing’. Thirty-one articles that objectively assessed tonsillectomy wound healing were included for analysis. The majority of assessments in humans investigating tonsillectomy wound healing involve serial direct clinical examinations of the oral cavity. Many patient and surgical factors have been shown to affect wound healing after tonsillectomy. There is some research to suggest that the administration of adjunctive treatment in the post-operative period may be beneficial to tonsillectomy wound healing. Wound healing post tonsillectomy has been poorly researched. Having a better understanding of the process of wound healing would allow surgeons to potentially prevent, anticipate and manage complications from the surgery that arise as part of the healing process.
Publisher: SAGE Publications
Date: 08-07-2016
Abstract: Access to ear and hearing health is a challenge in developing countries, where the burden of disabling hearing loss is greatest. This study investigated community-based identification of hearing loss using smartphone hearing screening (hearScreen™) operated by community health workers (CHWs) in terms of clinical efficacy and the reported experiences of CHWs. The study comprised two phases. During phase one, 24 CHWs performed community-based hearing screening as part of their regular home visits over 12 weeks in an underserved community, using automated test protocols employed by the hearScreen™ smartphone application, operating on low-cost smartphones with calibrated headphones. During phase two, CHWs completed a questionnaire regarding their perceptions and experiences of the community-based screening programme. Data analysis was conducted on the results of 108 children (2–15 years) and 598 adults (16–85 years). Referral rates for children and adults were 12% and 6.5% respectively. Noise exceeding permissible levels had a significant effect on screen results at 25 dB at 1 kHz ( p .05). Age significantly affected adult referral rates ( p 0.05), demonstrating a lower rate (4.3%) in younger as opposed to older adults (13.2%). CHWs were positive regarding the hearScreen™ solution in terms of usability, need for services, value to community members and time efficiency. Smartphone-based hearing screening allows CHWs to bring hearing health care to underserved communities at a primary care level. Active noise monitoring and data management features allow for quality control and remote monitoring for surveillance and follow-up.
Publisher: African Journals Online (AJOL)
Date: 22-06-2018
DOI: 10.4314/AHS.V18I2.16
Publisher: American Speech Language Hearing Association
Date: 09-12-2021
DOI: 10.1044/2021_AJA-21-00093
Abstract: Hearing loss causes emotional distress and can contribute to the development of psychological difficulties, yet emotional and psychological issues are not addressed within current audiology services. The purpose of this study was to use focus groups with consumer and community representatives to explore how we might improve the provision of support for clients experiencing emotional and psychological issues in relation to their hearing loss. Adults with hearing loss ( n = 19) and their significant others ( n = 9), as well as 10 hearing health care professionals ( n = 4 hearing health care clinicians, n = 4 reception staff, and n = 2 clinical managers), participated in consumer and community engagement focus groups. Consumer and community representatives were tasked with (a) identifying the stakeholders involved in supporting adults experiencing emotional or psychological difficulties on account of their hearing loss, (b) describing the behaviors undertaken by each stakeholder group, and (c) selecting target behavior(s) that could optimally form the basis of an intervention program to improve the quality and frequency of support provided to people experiencing emotional and psychological problems in the audiology setting. Participants identified 12 stakeholder groups involved in supporting adults with hearing loss experiencing emotional and psychological problems. The three behaviors voted by participants to be the most promising for a behavioral intervention included the clinician (a) asking about, (b) providing information on, and (c) delivering therapeutic intervention for emotional and psychological well-being within audiological service provision. Consumer and community stakeholder representatives indicate a general desire for hearing health care clinicians to deliver support for the emotional and psychological issues that arise relating to hearing loss.
Publisher: Informa UK Limited
Date: 08-04-2021
Publisher: Oxford University Press (OUP)
Date: 20-12-2023
Abstract: Substantial evidence supports the association between untreated hearing loss, cognitive decline, and dementia in the non-tonal language-speaking population. Whether a similar association between hearing loss and cognitive decline and dementia exists in Sinitic tonal language-speaking people is yet to be elucidated. We aimed to systematically review the current evidence on the association between hearing loss and cognitive impairment/decline, and dementia in older adults who speak a Sinitic tonal language. This systematic review considered peer-reviewed articles that employed objective or subjective hearing measurement and cognitive function, cognitive impairment, or diagnosis of dementia. All articles written in English and Chinese and published before March 2022 were included. Databases including Embase, MEDLINE, Web of Science, PsycINFO and Google Scholar, SinoMed, and CBM were utilized using MeSH terms and keywords. Thirty-five articles met our inclusion criteria. Of these, 29 unique studies with an estimated 372,154 participants were included in the meta-analyses. Among all included studies, the effect size of cognitive function with hearing loss, the regression coefficient was −0.26 (95% confidence interval [CI], −0.45 to −0.07). Among cross-sectional and cohort studies, a significant association was found between hearing loss and cognitive impairment and dementia, with odds ratios of 1.85 (95% CI, 1.59–2.17) and 1.89 (95% CI, 1.50–2.38), respectively. Most of the studies included in this systematic review observed a significant association between hearing loss and cognitive impairment and dementia. There was no significant difference to the findings in non-tonal language populations.
Publisher: AVES YAYINCILIK A.Ş.
Date: 16-09-2021
Publisher: Informa UK Limited
Date: 18-04-2023
DOI: 10.1080/14992027.2022.2056090
Abstract: To explore the barriers and facilitators faced by hearing healthcare clinicians (HHCs) with respect to asking adults with hearing loss (HL) about their emotional well-being. This qualitative study was conducted using semi-structured in idual interviews and focus groups. The interview topic guide was developed based on the COM-B model. Fifteen HHCs of a single hearing services organisation in Western Australia across 13 clinic locations participated. Barriers and facilitators that may influence HHCs' behaviour of routinely asking adults about their emotional well-being include having the knowledge and skills to ask about emotional well-being, forgetting to ask, awareness of the emotional impacts of HL, time and tools for asking, clients' reactions to being asked, supportive peers, normalisation of discussions relating to emotional well-being, presence of significant others, emotions associated with asking, being in the habit of asking, reminders, beliefs about consequences and confidence or capabilities, and scope of audiology practice. Application of the COM-B model identified barriers in capabilities (e.g. knowledge), opportunities (e.g. tools), and motivation (e.g. beliefs about benefits of asking about emotions) that need to be addressed for HHCs to ask their clients about their emotional well-being.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 05-1999
DOI: 10.1109/42.774168
Abstract: The registration of retinal images is required to facilitate the study of the optic nerve head and the retina. The method we propose combines the use of mutual information as the similarity measure and simulated annealing as the search technique. It is robust toward large transformations between the images and significant changes in light intensity. By using a pyramid s ling approach combined with simulated reannealing we find that registration can be achieved to predetermined precision, subject to choice of interpolation and the constraint of time. The algorithm was tested on 49 pairs of stereo images and 48 pairs of temporal images with success.
Publisher: Wiley
Date: 09-08-2018
DOI: 10.1111/COA.12936
Abstract: To investigate the relationship between hearing loss and cardiovascular disease risk factors. Cross-sectional study. Participants were recruited between May 2010 and December 2015 and answered a health and risk factor questionnaire. Physical and biochemical assessments were performed. A community-based population. A total of 5107 participants born within the years 1946-1964 enrolled in the Busselton Healthy Ageing Study. Hearing was assessed behaviourally through the best ear pure-tone average (500, 1000, 2000, 4000 Hz), low-frequency average (250, 500, 1000 Hz) and high-frequency average (4000, 8000 Hz). Self-reported hearing loss, tinnitus and hyperacusis were assessed via questionnaire. Cardiovascular risk factors were assessed via a patient-completed questionnaire and objective measurements including blood pressure, body mass index, waist circumference, lipid profile and glycated haemoglobin. Of the participants, 54% were female, with the mean age of 58 years (range 45-69 years). Age, sex and family history of hearing loss were consistently strong determinants of hearing loss outcomes. After adjusting for these, obesity, current smoking, peripheral arterial disease and history of cardiovascular disease were significantly associated with pure-tone, low-frequency and high-frequency hearing loss. In addition, high blood pressure, triglyceride and glycated haemoglobin were significantly associated with low-frequency hearing loss. There was a graded association between hearing loss and Framingham Risk Score for cardiovascular risk (P<0.001). Established cardiovascular disease and in idual and combined cardiovascular disease risk factors were found to be associated with hearing loss. Future research should prospectively investigate whether targeting cardiovascular disease can prevent hearing loss.
Publisher: Wiley
Date: 08-2018
DOI: 10.1111/COA.12937
Abstract: Age-related hearing loss (ARHL) is highly prevalent in older adults, and more than two-thirds above age of 70 years suffer from ARHL. Recent studies have established a link between ARHL and cognitive impairment however, most of the studies have used verbally loaded cognitive measures to investigate the association between ARHL and cognition. It is possible that due to hearing impairment, the elderly may experience difficulty in following verbal instructions or completing tasks that heavily rely on hearing during cognitive assessments. This may result in overestimation of cognitive impairment in such in iduals. This baseline cross-sectional study investigated the associations between untreated hearing loss and a number of cognitive functions using a battery of non-verbal cognitive tests. Further, association between hearing loss and psychological status of older adults was examined. Prospective case-controlled study. A total of 119 participants (54 males, M=66.33±10.50 years 65 females M=61.51±11.46 years) were recruited. All participants completed a hearing assessment, a computerised test battery of non-verbal cognitive functions and the depression, anxiety and stress scale. Hierarchical multiple regression analysis results revealed that hearing thresholds significantly associated with the working memory (P<0.05), paired associative learning scores (P<0.05), depression (P<0.001), and anxiety (P<0.001) and stress (P<0.001) scores. Analysis of covariance results revealed that participants with moderately-severe hearing loss performed significantly poorer in paired associative learning and working memory tasks and psychological function tests compared to those with normal hearing. Results of the current study suggest a significant relationship between ARHL and both cognition and psychological status. Our results also have some implications for using non-verbal cognitive tests to evaluate cognitive functions in post-lingually hearing impaired ageing adults, at least for those with more than moderately-severe levels of hearing loss.
Publisher: Wiley
Date: 24-02-2016
DOI: 10.1002/LARY.25896
Abstract: To determine the relationship between peripheral hearing loss (HL) in baby boomers (better-ear measure) and cognitive function, taking into account the impact of depression or cognitive reserve on this relationship and exploring binaural hearing. A prospective, epidemiology study. Data from 1,969 participants aged 45 to 66 years were collected in the Busselton Healthy Ageing Study. Participants were assessed using pure-tone air-conduction thresholds at octave frequencies (250 500 1,000 2,000 4,000 and 8,000 Hz). Hearing loss was grouped using 1) pure-tone averages across 4 frequencies (500 to 4000Hz) in the better ear (BE4FA) or 2) latent profile analysis (LPA) using all thresholds from both ears. Cognition was tested with the Cognitive Drug Research System, verbal fluency, and National Adult Reading Test (premorbid-IQ). Regression was used to determine the impact of HL relative to no HL on age and education-adjusted cognition, controlling for mood, sex, and premorbid-IQ. According to BE4FA, 4.7% had mild (26-40 dB) HL 0.8% had moderate (41-60 dB) HL and 0.3% had severe (61-80 dB) HL. Based on the LPA, 20.5% had high-frequency HL 7.8% had mid- to high-frequency HL and 1.9% had significant HL across all frequencies. The HL group was not a predictor of cognitive performance in any domain using BE4FA and explained just 0.5% and 0.4% of variance in continuity-of-attention and speed-of-memory retrieval using LPA. Critically, those with the worst hearing did not differ cognitively from those with the best. Hearing loss is not an important determinant of contemporaneous attention, memory, or executive function in middle-aged adults once age, education, depression, cognitive reserve, and sex are controlled. 4. Laryngoscope, 126:2367-2375, 2016.
Publisher: Informa UK Limited
Date: 15-12-2022
Publisher: Wiley
Date: 08-2004
Publisher: SAGE Publications
Date: 09-07-2016
Abstract: Standard criteria exist for diagnosing different types of hearing loss, yet audiologists interpret audiograms manually. This pilot study examined the feasibility of standardised interpretations of audiometry in a telehealth model of care. The aim of this study was to examine diagnostic accuracy of automated audiometry in adults with hearing loss in an asynchronous telehealth model using pre-defined diagnostic protocols. We recruited 42 study participants from a public audiology and otolaryngology clinic in Perth, Western Australia. Manual audiometry was performed by an audiologist either before or after automated audiometry. Diagnostic protocols were applied asynchronously for normal hearing, disabling hearing loss, conductive hearing loss and unilateral hearing loss. Sensitivity and specificity analyses were conducted using a two-by-two matrix and Cohen’s kappa was used to measure agreement. The overall sensitivity for the diagnostic criteria was 0.88 (range: 0.86–1) and overall specificity was 0.93 (range: 0.86–0.97). Overall kappa ( k) agreement was ‘substantial’ k = 0.80 (95% confidence interval (CI) 0.70–0.89) and significant at p 0.001. Pre-defined diagnostic protocols applied asynchronously to automated audiometry provide accurate identification of disabling, conductive and unilateral hearing loss. This method has the potential to improve synchronous and asynchronous tele-audiology service delivery.
Publisher: Springer Science and Business Media LLC
Date: 05-01-2022
DOI: 10.1186/S12887-021-03095-Z
Abstract: The majority of children with sensory impairments live in low- and middle-income countries. More studies of hearing and vision impairment prevalence are needed, in order to generate more accurate estimates of trends in sensory impairments. This study aimed to estimate the prevalence and describe the characteristics of hearing and vision loss among preschool children (4–7 years) in an underserved South African community following community-based mobile health (mHealth) supported hearing and vision services. A screening program of sensory impairments was undertaken of children attending preschools in the communities of Khayelitsha and Mitchell’s Plain, Cape Town, from September 2017 until June 2019. Hearing and vision screening were done by trained community health workers using mHealth technology. Children who failed hearing and vision screening were seen for follow-up assessments at their preschools. Follow-up assessments were conducted using smartphones that host point-of-care validated and calibrated hearing and vision testing applications (hearTest app, hearX Group, South Africa and PeekAcuity app, Peek Vision, United Kingdom). Descriptive statistical analysis and logistic regression analysis were conducted after extracting data from a secure cloud-based server (mHealth Studio, hearX Group) to Microsoft Excel (2016). A total of 10,390 children were screened at 298 preschools over 22 months. Of the children screened, 5.6 and 4.4% of children failed hearing and vision screening respectively. Community-based follow-up hearing tests were done at the preschools on 88.5% (514) of children of whom 240 children (54.2% female) presented with hearing loss. A preschool-based follow-up vision test was done on 400 children (88.1%). A total of 232 children (46.1% female) had a vision impairment, and a further 32 children passed the test but had obvious signs of ocular morbidity. Logistic regression analysis found that age was a significant predictor of vision loss ( p 0.05), but not for hearing loss ( p = 0.06). Gender was not a significant predictor of hearing ( p = 0.22) or vision loss ( p = 0.20). Hearing loss is prevalent in at least 22 per 1000 and vision loss in at least 23 per 1000 preschool children in an underserved South African community . Timely identification of sensory losses can be facilitated through community-based hearing and vision services supported by mHealth technology.
Publisher: Hindawi Limited
Date: 31-05-2021
DOI: 10.1155/2021/5534192
Abstract: Objectives. To generate a conceptual framework describing what is done to reduce the impact of chronic tinnitus on the lives of children and adolescents. Design. Views and experiences of 32 adults from two participant groups informed this concept mapping study: (i) a tinnitus group (adults who experienced tinnitus during childhood/adolescence, and primary carers of children/adolescents with tinnitus) and (ii) a clinicians’ group (clinicians who provided care for children/adolescents with tinnitus). Participants produced statements describing what is done to reduce the impact of chronic tinnitus on the lives of children and adolescents who experience it. Through grouping and rating processes, they identified key concepts and inferred their associated benefit. Results. The participants generated 102 unique statements across four concepts: (1) Education, Support, and Counselling (2) Support from Parents and Teachers (3) Clinical Assessments and Management and (4) Self-Management Techniques. Many statements highlighted the need for child-friendly and patient-centred care. Adults with personal experience of childhood tinnitus tended to perceive many of the statements as more beneficial than did the clinician group. Conclusions. Although many children will develop management strategies to assist them with their tinnitus, both the adults who experienced tinnitus as children and their parents valued strategies involving clinical care, knowledge, and expertise. Participants from the tinnitus group perceived a greater degree of benefit associated with strategies from all four clusters than the clinicians’ group. However, both groups perceived the greatest degree of benefit as being associated with activities and strategies within the Education, Support, and Counselling and the Clinical Assessments and Management clusters. Both groups identified that recognising the occurrence of tinnitus for children and adolescents, acknowledging the potential for associated distress, and initiating clinical care provide the nexus of effective management. Addressing the concerns and needs of parents was also perceived as valuable hence, approaching the management of tinnitus during childhood and adolescence from a family-centred care framework is recommended.
Publisher: JMIR Publications Inc.
Date: 03-08-2021
Abstract: earing loss affects 1 in 5 people worldwide and is estimated to affect 1 in 4 by 2050. Treatment relies on the accurate diagnosis of hearing loss however, this first step is out of reach for & % of those affected. Increasingly automated approaches are being developed for self-administered digital hearing assessments without the direct involvement of professionals. his study aims to provide an overview of digital approaches in automated and machine learning assessments of hearing using pure-tone audiometry and to focus on the aspects related to accuracy, reliability, and time efficiency. This review is an extension of a 2013 systematic review. search across the electronic databases of PubMed, IEEE, and Web of Science was conducted to identify relevant reports from the peer-reviewed literature. Key information about each report’s scope and details was collected to assess the commonalities among the approaches. total of 56 reports from 2012 to June 2021 were included. From this selection, 27 unique automated approaches were identified. Machine learning approaches require fewer trials than conventional threshold-seeking approaches, and personal digital devices make assessments more affordable and accessible. Validity can be enhanced using digital technologies for quality surveillance, including noise monitoring and detecting inconclusive results. n the past 10 years, an increasing number of automated approaches have reported similar accuracy, reliability, and time efficiency as manual hearing assessments. New developments, including machine learning approaches, offer features, versatility, and cost-effectiveness beyond manual audiometry. Used within identified limitations, automated assessments using digital devices can support task-shifting, self-care, telehealth, and clinical care pathways. >
Publisher: Wiley
Date: 24-04-2017
DOI: 10.1111/COA.12652
Abstract: To examine the long-term effects of predominant breastfeeding on incidence of otitis media. Prospective birth cohort study. The West Australian Pregnancy Cohort (Raine) Study recruited 2900 mothers through antenatal clinics at the major tertiary obstetric hospital in Perth, Western Australia, between 1989 and 1992. In total, 2237 children participated in a 6-year cohort follow-up, and a subset of 1344 were given ear and hearing assessments. OM diagnosis at 6 years of age (diagnosed by low-compliance tympanograms, 0-0.1 mmho). This was compared to OM diagnosed at the 3-year cohort follow-up using parent-report measures. Main exposure measures were duration of predominant breastfeeding (defined as the age other milk was introduced) and duration of partial (any) breastfeeding (defined as the age breastfeeding was stopped). There was a significant, independent association between predominant breastfeeding (OR = 1.33 [1.04, 1.69] P = 0.02) and OM, and breastfeeding duration (OR = 1.35 [1.08, 1.68] P = 0.01) with OM at 3 years of age. However, at 6 years of age, this relationship was no longer statistically significant (predominant breastfeeding OR = 0.78 [0.48, 1.06] P = 0.09 duration of breastfeeding, OR = 1.34 [0.81, 2.23] P = 0.25). Our findings are in line with a number of epidemiological studies which show a positive association between breastfeeding and OM in early childhood. However, the long-term follow-up of these children revealed that by 6 years of age, there was no significant influence of breastfeeding on presence of OM. These results suggest that the protective effect of predominant breastfeeding for at least 6 months does not extend to school-age children, where other social and environmental factors may be stronger predictors of OM.
Publisher: Wiley
Date: 27-08-2015
DOI: 10.1111/AJR.12227
Abstract: To examine whether self-reported hearing difficulty is an accurate measure of hearing loss compared with standard hearing screening with pure tone audiometry in rural and urban communities. Convenience s ling. Urban and rural areas of Western Australia. A total of 2090 participants (923 men 1165 women 2 unknown) aged 20-100 years presenting for community-based hearing screening in urban (982) and rural (1090) areas. Self-reported hearing difficulty assessed with the Hearing Handicap Inventory for the Elderly - Screening questionnaire. Hearing loss defined as average hearing thresholds >25 dB in the better ear using screening audiometry conducted at 500, 1000, 2000 and 4000 Hz. Nil. The Hearing Handicap Inventory for the Elderly - Screening was sensitive (≥60 years = 76.69% <60 years = 71.67%) but not specific (≥60 years = 45.15% <60 years = 49.63%) for identifying hearing loss. The <60 age group had a hearing loss prevalence of 25.6%, and a false-positive rate of 67.12% compared with a prevalence of 69.12% and false-positive rate of 29.77% for the ≥60 age group. For all ages, rural participants were more likely to have a disabling hearing loss (odds ratio 2.04 (95% confidence interval, 1.55-2.67) χ(2)(1) = 27.28 P < 0.001), but there were no significant differences in hearing aid uptake. Patients in rural areas presenting for hearing screenings are more likely to suffer hearing loss than adults in urban areas. We suggest rural health practitioners incorporate a self-reported hearing loss questionnaire into health check-ups for adults, particularly patients aged ≥60 years due to the high prevalence of hearing loss in this group.
Publisher: Informa UK Limited
Date: 18-09-2019
Publisher: SAGE Publications
Date: 28-02-2023
DOI: 10.1177/01632787231158402
Abstract: The objective of this scoping review was to describe the extent and type of evidence related to seeking help for tinnitus and satisfaction with healthcare providers including diagnosis, services and treatments along the clinical pathway. The selection criteria were adults aged 18 and over with tinnitus who sought help and where patient satisfaction with healthcare providers was reported. Online databases MEDLINE (OvidSP), Embase (OvidSP), PsycINFO (OvidSP) and CINAHL plus (EBSCO) were searched for original studies in English. The search had no date limit. Twenty-one records were eligible for data extraction. Studies reported that the most common healthcare providers seen were general practitioners, ear, nose and throat specialists and audiologists. Depression and tinnitus severity were related to an increase in the number of times help was sought and the type of healthcare provider seen may also impact patient satisfaction. The majority of participants were unlikely to receive a referral to a specialist at the initial GP consultation. Although there is limited research in this area, help-seekers for tinnitus were generally dissatisfied and reported negative interactions with healthcare providers. However, once in a specialised tinnitus clinical setting, studies reported that most help-seekers were satisfied and had positive interactions with healthcare providers.
Publisher: Medknow
Date: 2013
Abstract: To determine whether the Cheers for Ears Program on noise induced hearing loss prevention was effective in improving current knowledge of noise impact of personal listening devices on hearing, and in changing self-reported listening behavior of primary school students aged between 9 years and 13 years. A survey study was implemented at participating primary schools. Schools represented various levels of socio-economic status. Informed consent (parents and teachers) and informed assent (pupils) were obtained. All pupils participated in two interactive sessions (the second 6 weeks after first) and only those who provided assent and consent were surveyed at three points during the study: Prior to the first session (baseline), directly post-session and at 3 months post-session. A total of 318 pupils were surveyed. The median age of the participants was 11 years (nearly 50% of the total cohort). Significant changes are reported in their knowledge about hearing and in listening behavior of the participants as measured by pre- and post-measurement. The changes in behaviors were stable and sustained at 3 months post-intervention survey point and the success of the program can be attributed to the multimodal interactive nature of the sessions, the spacing of the sessions and the survey points. Wide-ranging support from schools and departments also played a role. The pilot Cheers for Ears Program is effective in increasing knowledge on the harmful effects of noise and therefore, it may prevent future noise-induced hearing loss.
Publisher: Informa UK Limited
Date: 11-2009
DOI: 10.1586/ERD.09.47
Abstract: Chronic perforations of the eardrum or tympanic membrane represent a significant source of morbidity worldwide. Myringoplasty is the operative repair of a perforated tympanic membrane and is a procedure commonly performed by otolaryngologists. Its purpose is to close the tympanic membrane, improve hearing and limit patient susceptibility to middle ear infections. The success rates of the different surgical techniques used to perform a myringoplasty, and the optimal graft materials to achieve complete closure and restore hearing, vary significantly in the literature. A number of autologous tissues, homografts and synthetic materials are described as graft options. With the advent and development of tissue engineering in the last decade, a number of biomaterials have been studied and attempts have been made to mimic biological functions with these materials. Fibroin, a core structural protein in silk from silkworms, has been widely studied with biomedical applications in mind. Several cell types, including keratinocytes, have grown on silk biomaterials, and scaffolds manufactured from silk have successfully been used in wound healing and for tissue engineering purposes. This review focuses on the current available grafts for myringoplasty and their limitations, and examines the biomechanical properties of silk, assessing the potential benefits of a silk fibroin scaffold as a novel device for use as a graft in myringoplasty surgery.
Publisher: Wiley
Date: 03-10-2012
Abstract: To objectively study mobile and standard landline telephone speech perception performance using cochlear implant recipients. Nonrandomized trial. Tertiary referral center. Twenty‐five subjects enrolled in this study from a pool of 50 cochlear implant recipients who had participated in an earlier questionnaire study from which demographic data were gathered. Preoperative speech perception scores were collated from preoperative audiological data. Postoperative speech perception scores were calculated with subjects listening to the Australian Version of the Bamford‐Kowal‐Bench Sentence Test read aloud in a soundproof booth via live voice, played back on a speaker, on a standard landline and mobile phone. Telephone speech perception scores were analyzed and banded into 3 performance categories: very good (90%‐100%), good (80%‐89%), and fair ( %). The mean speech perception scores were 88.6% (SD, 14.3%) for postoperative recorded speech and 92.3% (SD, 10.7%) for live voice listening, which were significantly better than the mean score of 37.2% (SD, 29.1%) listening to recorded voice preoperatively. The mean speech perception score was 84.3% (SD, 20.7%) using a mobile telephone and 57% (SD, 29.4%) using the standard landline. Further analysis showed better performance with mobile phones over standard landlines. Seventy‐six percent of subjects attained at least good telephone speech performance (score %). Older patients had poorer telephone speech perception than younger patients did. Many cochlear implant recipients achieve good objective telephone speech perception performance, indicating that they should be effective telephone users, especially when using mobile telephones and among younger implant recipients.
Publisher: Cambridge University Press (CUP)
Date: 05-2016
Publisher: American Speech Language Hearing Association
Date: 09-12-2021
DOI: 10.1044/2021_AJA-21-00004
Abstract: This study aimed to (a) identify participant factors associated with hearing aid review (HAR) appointment attendance, (b) investigate whether the completion of self-report survey identifying hearing aid–related problems affects HAR appointment attendance, and (c) investigate whether hearing aid problems and hearing aid management deficiencies are adequately addressed during HAR appointments. A prospective cohort study of adult hearing aid owners recruited from a single hearing clinic in Western Australia. Potential participants were invited to an annual HAR appointment via postal letter. The invitation included a paper-based self-report survey evaluating either (a) hearing aid problems, (b) hearing aid management skills, or (c) hearing aid outcomes, depending on which intervention/control group the potential participants were assigned to, and a reply paid addressed envelope. Two months later, potential participants were sent all three paper-based self-report surveys, irrespective of whether they had attended or not attended an HAR appointment. (a) There was no significant difference in gender or source of funding for hearing services between HAR appointment attendees and nonattendees. HAR nonattendees lived a greater distance from their clinic and were younger than attendees. (b) Survey completion did not influence HAR appointment attendance rates. (c) A significant reduction in in iduals' self-reported hearing aid problems was recorded following the attendance at the HAR appointment. No significant changes in hearing aid management skills or overall hearing aid outcomes were detected. Long travel distances may be a barrier to attendance at review appointments. HAR appointments appear to be effective in improving hearing aid problems.
Publisher: Informa UK Limited
Date: 17-09-2020
Publisher: SAGE Publications
Date: 2021
DOI: 10.1177/23312165211066174
Abstract: While cochlear implants have helped hundreds of thousands of in iduals, it remains difficult to predict the extent to which an in idual’s hearing will benefit from implantation. Several publications indicate that machine learning may improve predictive accuracy of cochlear implant outcomes compared to classical statistical methods. However, existing studies are limited in terms of model validation and evaluating factors like s le size on predictive performance. We conduct a thorough examination of machine learning approaches to predict word recognition scores (WRS) measured approximately 12 months after implantation in adults with post-lingual hearing loss. This is the largest retrospective study of cochlear implant outcomes to date, evaluating 2,489 cochlear implant recipients from three clinics. We demonstrate that while machine learning models significantly outperform linear models in prediction of WRS, their overall accuracy remains limited (mean absolute error: 17.9-21.8). The models are robust across clinical cohorts, with predictive error increasing by at most 16% when evaluated on a clinic excluded from the training set. We show that predictive improvement is unlikely to be improved by increasing s le size alone, with doubling of s le size estimated to only increasing performance by 3% on the combined dataset. Finally, we demonstrate how the current models could support clinical decision making, highlighting that subsets of in iduals can be identified that have a 94% chance of improving WRS by at least 10% points after implantation, which is likely to be clinically meaningful. We discuss several implications of this analysis, focusing on the need to improve and standardize data collection.
Publisher: American Speech Language Hearing Association
Date: 06-10-2022
DOI: 10.1044/2022_LSHSS-21-00178
Abstract: Children who are Deaf and Hard of Hearing (DHH), their parents, Teachers of the Deaf, and other community stakeholders were involved in co-designing a web-based resource to support students' social–emotional well-being. The resource was designed to provide families and teachers with strategies to enhance the social and emotional well-being of Grade 4–6 students who are DHH. This study reports outcomes of a pilot study of the web-based resource intervention. A pre–post pilot study was conducted to quantitatively examine reported anxiety, well-being, social relationships, school experience, student–teacher relationship, and parent and teacher self-efficacy. A total of 37 students, their parents ( n = 37), and their classroom teachers ( n = 40) participated in the intervention program and were provided access to the resource. In total, 19 students, 22 parents, and 17 teachers completed both pre- and postsurvey measures. Paired t tests revealed that there was a statistically significant increase in parents' self-efficacy scores from pre- to posttest. Multivariate analysis of covariance revealed a significant association between parent use of the website and student-reported improved peer support and reduced school loneliness. No other statistically significant differences were found. The use of a web-based resource codeveloped with students who are DHH, their parents, and teachers could potentially be beneficial for the well-being of students who are DHH as well as parents' self-efficacy. Further research is needed to confirm the benefits.
Publisher: Informa UK Limited
Date: 16-06-2015
DOI: 10.3109/14992027.2015.1052104
Abstract: To review and appraise the content and quality of surveys that evaluate hearing aid handling. A systematic and descriptive review. Twelve surveys were identified as containing at least one item evaluating hearing aid handling. Fifteen aspects of hearing aid handling were evaluated. None of the surveys evaluated all aspects of handling skills identified. While the majority of studies reported some psychometric evaluation during survey development, the quality of the methodology used and extent of psychometric evaluation reported varied considerably. There is currently no single survey that evaluates handling skills comprehensively. In the absence of an ideal survey, the Practical Hearing aid Skills Test appears to be the most inclusive clinician-administered survey and the Hearing aid User's Questionnaire appears to be the most inclusive self-report survey evaluating hearing aid handling precision however, there are limitations in the analysis of their psychometric properties. Nonetheless, use of these surveys in clinical practice could identify areas of handling that warrant additional training in order to improve hearing aid success. Research identifying the full range of hearing aid handling skills necessary for successful hearing aid use will further contribute knowledge to the complex construct of successful hearing aid-use.
Publisher: Springer Science and Business Media LLC
Date: 2001
Abstract: Differential imaging may be useful for understanding pathologies of the choroid. We use a prototype scanning laser ophthalmoscope capable of simultaneous multiple wavelength imaging to record fundus images. The advantages of simultaneous acquisition compared to serial acquisition are, reduced image capture times, and image registration is not required. The system is run under non-confocal conditions in using slit apertures with a width of up to 600 microm. The laser lines launched into the SLO were the 633 nm line of a HeNe- laser, and the 815 nm line from a tunable (740 nm to 840 nm) cw Ti:Sapphire-laser. The difference in absorption at these two wavelengths is used to produce a differential image. We compare conventional imaging with differential spectral imaging for viewing the choroidal vessels. Qualitative results show the contrast of choroidal vessels in differential imaging is improved compared with normal imaging in the region of the optic disk and for the level of pigmentation in the subjects examined.
Publisher: Informa UK Limited
Date: 03-04-2013
DOI: 10.3109/14992027.2013.769065
Abstract: To validate the air- and bone-conduction AMTAS automated audiometry system. Prospective study. Test-retest reliability was determined by assessing adults with AMTAS air- and bone-conduction audiometry. Accuracy was determined by comparing AMTAS and manual audiometry conducted on adults. AMTAS testing was conducted in a quiet room and manual audiometry in a sound booth. Ten participants for test-retest reliability tests and 44 participants to determine accuracy were included. Participants had varying degrees of hearing loss. For test-retest reliability the overall difference in air-conduction hearing thresholds (n = 119) was 0.5 dB. The spread of differences (standard deviation of absolute differences) was 4.9 dB. For bone-conduction thresholds (n = 99) the overall difference was - 0.2 dB, and the spread of differences 4.5 dB. For accuracy the overall difference in air-conduction hearing thresholds (n = 509) between the two techniques was 0.1 dB. The spread of differences was 6.4 dB. For bone-conduction thresholds (n = 295) the overall difference was 0 dB, and the spread of differences 7.7 dB. Variations between air- and bone-conduction audiometry for automated and manual audiometry were within normally accepted limits for audiometry. However, AMTAS thresholds were elevated but not significantly different compared to other contemporary studies that included an automated audiometer.
Publisher: Wiley
Date: 02-04-2018
DOI: 10.1111/COA.13094
Abstract: To examine the relationship between early life episodes of otitis media and later behavioural development with adjustment for confounders. Longitudinal cohort study. The Western Australian Pregnancy Cohort (Raine) Study recruited 2900 pregnant women from King Edward Memorial Hospital ( KEMH ) in Perth, Western Australia, between 1989 and 1991. Data from the children born were collected at both the Year 3 and Year 5 follow‐up. At Year 3, n = 611 were diagnosed with recurrent otitis media through parent‐report and clinical examination. At Year 5, n = 299 were considered exposed to otitis media based upon tympanometry results. Performance in the Child Behaviour Checklist ( CBCL ), a questionnaire completed by the primary caregiver at Year 10. Significant associations were found between recurrent otitis media at Year 3 and internalising behaviours ( P = .011), and the somatic ( P = .011), withdrawn ( P = .014), attention ( P = .003) and thought problems domains ( P = .021), and the total CBCL score ( P = .010). A significant association was also found between exposure to otitis media at Year 5 and externalising behaviours ( P = .026). A modest association was seen between recurrent otitis media at Year 3 and exposure to otitis media at Year 5 and a number of behaviour domains at Year 10.
Publisher: Informa UK Limited
Date: 22-07-2022
DOI: 10.1080/14992027.2021.1944675
Abstract: The aim of the study was to examine the mental well-being of audiologists in the midst of the COVID-19 pandemic. A cross-sectional online survey was conducted during the COVID-19 pandemic, between 23 June and 13 August 2020. A self-report survey included screening measures for psychological distress (PHQ-4: anxiety and depression) and loneliness (UCLA-3). 239 audiologists from around the world. The prevalence of psychological distress was 12.1% (subscales for anxiety 16.3% and depression 10.4%), and loneliness 32.2%. Depression and loneliness were higher in those participants self-reporting perceived job insecurity, with psychological distress (anxiety and depression) higher in those from South Africa. Accessibility to Employee Assistance Programs (EAPs) appears to be a protective factor. Well-being interventions, such as EAPS, are needed to support audiologists during challenging times like the COVID-19 pandemic.
Publisher: Frontiers Media SA
Date: 26-11-2021
DOI: 10.3389/FNINS.2021.749273
Abstract: Objectives: The objective of the study was to investigate the association between untreated age-related hearing loss and cognitive impairment in Mandarin-speaking older adults living in China. Methods: Older adults (293 111 males, M = 70.33 ± 4.90 years 182 females, M = 69.02 ± 4.08 years) were recruited. All participants completed a pure tone audiometric hearing assessment, Hearing Impairment-Montreal Cognitive Assessment Test (HI-MoCA), and a computerized neuropsychology test battery (CANTAB). The Mandarin version of the De Jong Gierveld Loneliness Scale was used to measure the loneliness, and the Mandarin version of the 21-item Depression Anxiety Stress Scale (DASS-21) was used to measure the current severity of a range of symptoms common to depression, stress, and anxiety of the participants. Results: A multiple stepwise regression analysis showed that the average of four mid-frequency thresholds in the better ear was related to CANTAB Paired Associates Learning (β = 0.20, p = 0.002), and the global cognitive function score (HI-MoCA) (β = −0.25, p & 0.001). The average of three high frequencies in the better ear was significantly associated with CANTAB Delayed Matching to S le (β = −0.16, p = 0.008), and Spatial Working Memory (β = 0.17, p = 0.003). Conclusion: The results revealed a significant relationship between age-related hearing loss and cognitive impairment in Mandarin-speaking older adults. These research outcomes have clinical implications specifically for hearing health care professionals in China and other populations that speak a tonal language, especially when providing hearing rehabilitation.
Publisher: American Speech Language Hearing Association
Date: 07-07-2021
DOI: 10.1044/2021_LSHSS-21-00008
Abstract: This study aimed to describe and compare the performance of two screening protocols used for preschool hearing screening in resource-constrained settings. Secondary data analysis was done to determine the performance of two protocols implemented during a preschool hearing screening program using mobile health technology in South Africa. Pure-tone audiometry screening at 25 dB HL for 1000, 2000, and 4000 Hz in each ear was used by both protocols. The fail criterion for the first protocol (2,147 children screened) constituted a no-response on one or more frequencies in either ear. The second protocol required two or more no-responses (5,782 children). Multivariate logistic regression models were used to investigate associations between outcomes and protocol, age, gender, and duration. Fail rates for the one-frequency fail protocol was 8.7% ( n = 186) and 4.3% ( n = 250) for the two-frequency fail protocol. Children screened with the two-frequency fail protocol were 52.9% less likely to fail ( p .001 OR = 0.471 95% confidence interval [0.385, 0.575]). Gender ( p = .251) and age ( p = .570) had no significant effect on screening outcome. A percentage of cases screened (44.7%) exceeded permissible noise levels in at least one ear at 1000 Hz across both protocols. True- and false-positive cases did not differ significantly between protocols. Protocol type ( p = .204), gender ( p = .314), and age ( p = .982) did not affect the odds of being a true-positive result. Average screening time was 72.8 s (78.66 SD ) and 64.9 s (55.78 SD ) for the one-frequency and two-frequency fail protocols, respectively. A two-frequency fail criterion and immediate rescreen of failed frequencies significantly reduced referral rate for follow-up services that are often overburdened in resourced-constrained settings. Future protocol adaptations can also consider increasing the screening levels at 1000 Hz to minimize the influence of environmental noise.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2016
Publisher: Mary Ann Liebert Inc
Date: 12-2003
DOI: 10.1089/153056203772744644
Abstract: The objectives of this study were to assess the quality of digitized video-otoscopes as well as its ease of use and safety. Four video-otoscopes available in Australia were used to image 96 patients. At least 22 patients (age range 5-70 years) were imaged with each video-otoscope, and the images were stored in a JPEG format. Three experienced otolaryngologists assessed all images for quality, clarity, color accuracy, orientation of eardrum and therefore ability to make a definitive diagnosis. The grading was a five-level scale: poor, adequate, good, very good and excellent. Two telescope systems produced high quality images (>80% were adequate or better), essential for accurate diagnosis, but both were associated with increased risk for injury in unskilled hands. The MedRx video-otoscope produced high-quality images (87% were adequate or better), while the Welch Allyn Compact Video-otoscope produced poor image quality (only 40% were adequate or better). Both devices were seen to be safer to use than the telescope systems. The telescope systems and MedRx otoscope provided optimum quality images necessary for tele-otology. However, the telescope units were considered to be unsafe in unskilled hands. The MedRx can be recommended as a safe device producing high-quality images.
Publisher: American Speech Language Hearing Association
Date: 08-03-2018
Abstract: The purpose of this study is to identify hearing aid owners' and clinicians' opinions of the knowledge, skills, and tasks required for hearing aid management and the importance of each of these to overall success with hearing aids. Concept mapping techniques were used to identify key themes, wherein participants generated, sorted, and rated the importance of statements in response to the question “What must hearing aid owners do in order to use, handle, manage, maintain, and care for their hearing aids?” Twenty-four hearing aid owners (56 to 91 years of age 54.2% men, 45.8% women) and 22 clinicians (32 to 69 years of age 9.1% men, 90.9% women) participated. Participants identified 111 unique items describing hearing aid management within 6 concepts: (a) “Daily Hearing Aid Use,” (b) “Hearing Aid Maintenance and Repairs,” (c) “Learning to Come to Terms with Hearing Aids,” (d) “Communication Strategies,” (e) “Working With Your Clinician,” and (f) “Advanced Hearing Aid Knowledge.” Clinicians' opinions of the importance of each statement varied only slightly from the opinions of the hearing aid owner group. Hearing aid owners indicated that all 6 concepts were of similar importance, whereas clinicians indicated that the concept “Advanced Hearing Aid Knowledge” was significantly less important than the other 5 concepts. The results highlight the magnitude of information and skill required to optimally manage hearing aids. Clinical recommendations are made to improve hearing aid handling education and skill acquisition.
Publisher: SAGE Publications
Date: 14-03-2023
DOI: 10.1177/1357633X231158839
Abstract: Shortage of ear, nose, and throat specialists in public hospitals can result in delays in the detection and management of otitis media. This study introduced a new hospital-based telehealth service, named the Ear Portal, and investigated its role in improving access to specialist care. The study included 87 children (aged 6 months to 6 years) referred to a tertiary children's hospital due to otitis media-related concerns. A specialist multidisciplinary team met fortnightly to review pre-recorded data and provide care plans. The service resulted in a median waiting time of 28 days to receive a diagnosis and care plan by the multidisciplinary team, compared to a mean waiting time of 450 days for a reference group receiving standard healthcare services. Most children (90.3%) received bilateral ear diagnosis. Normal findings were found in 43.9%. However, the majority required further ear, nose, and throat with or without audiology face-to-face follow-up due to a diagnosis of middle-ear disease, unknown hearing status, or concerns not related to ears. The mean time required for clinical assessments completion by research assistants and multidisciplinary team review was 37.6 and 5.1 min per participant, respectively. Children in the Ear Portal service received a diagnosis and care plan in a median of 28 days, which is within the clinically recommended timeframes. With sufficient clinical information, this service can provide faster access to specialist care than the standard healthcare pathway. The service can reduce the time required by the specialist to provide a diagnosis and care plan which may help increase the specialists’ capacity.
Publisher: JMIR Publications Inc.
Date: 02-02-2022
DOI: 10.2196/32581
Abstract: Hearing loss affects 1 in 5 people worldwide and is estimated to affect 1 in 4 by 2050. Treatment relies on the accurate diagnosis of hearing loss however, this first step is out of reach for % of those affected. Increasingly automated approaches are being developed for self-administered digital hearing assessments without the direct involvement of professionals. This study aims to provide an overview of digital approaches in automated and machine learning assessments of hearing using pure-tone audiometry and to focus on the aspects related to accuracy, reliability, and time efficiency. This review is an extension of a 2013 systematic review. A search across the electronic databases of PubMed, IEEE, and Web of Science was conducted to identify relevant reports from the peer-reviewed literature. Key information about each report’s scope and details was collected to assess the commonalities among the approaches. A total of 56 reports from 2012 to June 2021 were included. From this selection, 27 unique automated approaches were identified. Machine learning approaches require fewer trials than conventional threshold-seeking approaches, and personal digital devices make assessments more affordable and accessible. Validity can be enhanced using digital technologies for quality surveillance, including noise monitoring and detecting inconclusive results. In the past 10 years, an increasing number of automated approaches have reported similar accuracy, reliability, and time efficiency as manual hearing assessments. New developments, including machine learning approaches, offer features, versatility, and cost-effectiveness beyond manual audiometry. Used within identified limitations, automated assessments using digital devices can support task-shifting, self-care, telehealth, and clinical care pathways.
Publisher: SPIE
Date: 26-05-1999
DOI: 10.1117/12.349457
Publisher: IEEE Comput. Soc
Publisher: Informa UK Limited
Date: 12-01-2023
Publisher: S. Karger AG
Date: 2021
DOI: 10.1159/000519291
Abstract: b i Introduction: /i /b Many studies on hearing loss (HL) and cognition are limited by subjective hearing assessments and verbally administered cognition tests, the majority of the document findings in Western populations. This study aimed to assess the association of HL with cognitive impairment among ethnic Chinese Singaporean older adults using visually presented cognitive tests. b i Methods: /i /b The hearing of community-dwelling older adults was assessed using pure tone audiometry. Cognitive function was assessed using the Computerized Cambridge Cognitive Test Battery (CANTAB). Multiple regression analyses examined the association between hearing and cognitive function, adjusted for age, education, and gender. b i Results: /i /b HL (pure-tone average [PTA] of thresholds at 0.5, 1, 2, and 4 kHz in the better ear, BE4PTA) was associated with reduced performance in delayed matching and multitasking tasks (β = −0.25, i /i = 0.019, and β = 0.02, i /i = 0.023, respectively). Moderate to severe HL was associated with reduced performance in delayed matching and verbal recall memory tasks (β = −10.6, i /i = 0.019, and β = −0.28, i /i = 0.042). High-frequency HL was associated with reduced performance in the spatial working memory task (β = 0.004, i /i = 0.022). All-frequency HL was associated with reduced performance in spatial working memory and multitasking (β = 0.01, i /i = 0.040, and β = 0.02, i /i = 0.048). b i Conclusion: /i /b Similar to Western populations, HL among tonal language-speaking ethnic Chinese was associated with worse performance in tasks requiring working memory and executive function.
Publisher: Informa UK Limited
Date: 17-02-2023
Publisher: Informa UK Limited
Date: 21-09-2011
DOI: 10.3109/14992027.2011.606286
Abstract: In this study, we aimed to explore a variation of the NTT standard protocol that would be more beneficial for those patients with hearing loss >50 dB HL in the worst ear (average hearing thresholds at 0.5, 1, 2, and 4 KHz). This study involved 26 subjects who had previously undergone NTT at a single private practice. Patients with high level of hearing loss were ided into two groups: Standard protocol group (SP) concluded the treatment following the standard NTT protocol proposed by the treatment's developers and Neuromonics guidelines. Extended protocol group (EP) was treated using a variation of the standard protocol, in which patients continued in stage 1 of the treatment for a prolonged time. Consistent with previously reported studies of the NTT, the tinnitus reaction questionnaire was used to assess tinnitus distress. Clinical outcomes for the two groups were analysed. Both groups achieved statistically significant improvement of their tinnitus distress. EP group achieved quicker clinical benefits when compared to the SP group. Extension of high stimulation period from two to four months may be beneficial for patients with higher level of hearing loss undergoing NTT.
Publisher: Springer Science and Business Media LLC
Date: 09-1992
DOI: 10.1007/BF00917969
Publisher: Wiley
Date: 03-01-2022
DOI: 10.1002/WRNA.1707
Abstract: The high‐throughput sequencing of cellular RNAs has underscored a broad effect of isoform ersification through alternative splicing on the transcriptome. Moreover, the differential production of transcript isoforms from gene loci has been recognized as a critical mechanism in cell differentiation, organismal development, and disease. Yet, the extent of the impact of alternative splicing on protein production and cellular function remains a matter of debate. Multiple experimental and computational approaches have been developed in recent years to address this question. These studies have unveiled how molecular changes at different steps in the RNA processing pathway can lead to differences in protein production and have functional effects. New and emerging experimental technologies open exciting new opportunities to develop new methods to fully establish the connection between messenger RNA expression and protein production and to further investigate how RNA variation impacts the proteome and cell function. This article is categorized under: RNA Processing Splicing Regulation/Alternative Splicing Translation Regulation RNA Evolution and Genomics Computational Analyses of RNA
Publisher: Informa UK Limited
Date: 17-06-2022
DOI: 10.1080/14992027.2021.1937348
Abstract: This study surveyed the effects of the COVID-19 pandemic on the audiology workplace. The study used a cross-sectional survey design for audiologists across the globe ( Participants represented varied work settings and audiology services. Only a third (31.5%) provided psychosocial support, which may be important during the pandemic, as part of their services. Almost all (97%) audiologists reported changes to their workplace, with 76.4% reporting reduced caseloads during the COVID-19 pandemic. When rating their current and anticipated work conditions, 38.7% reported reduced working hours although only 13.8% anticipated reduced working hours in 6-months' time. Audiologists ranked services such as access to hearing assessment, hearing device adjustment and maintenance, and general audiological support as being more important during the pandemic than services such as psychosocial, emotional and tinnitus support. The COVID-19 pandemic has resulted in significant disruptions to audiological practice that highlights the need to adapt and incorporate new audiological practices including telehealth, to ensure patients have continued access to care and clinics remain sustainable during the ongoing COVID-19 pandemic and recovery phase.
Publisher: Wiley
Date: 22-05-2018
Abstract: To evaluate the recent developments in optical coherence tomography (OCT) for tympanic membrane (TM) and middle ear (ME) imaging and to identify what further development is required for the technology to be integrated into common clinical use. PubMed, Embase, Google Scholar, Scopus, and Web of Science. A comprehensive literature search was performed for English language articles published from January 1966 to January 2018 with the keywords “tympanic membrane or middle ear,”“optical coherence tomography,” and “imaging.” Conventional imaging techniques cannot adequately resolve the microscale features of TM and ME, sometimes necessitating diagnostic exploratory surgery in challenging otologic pathology. As a high‐resolution noninvasive imaging technique, OCT offers promise as a diagnostic aid for otologic conditions, such as otitis media, cholesteatoma, and conductive hearing loss. Using OCT vibrometry to image the nanoscale vibrations of the TM and ME as they conduct acoustic waves may detect the location of ossicular chain dysfunction and differentiate between stapes fixation and incus‐stapes discontinuity. The capacity of OCT to image depth and thickness at high resolution allows 3‐dimensional volumetric reconstruction of the ME and has potential use for reconstructive tympanoplasty planning and the follow‐up of ossicular prostheses. To achieve common clinical use beyond these initial discoveries, future in vivo imaging devices must feature low‐cost probe or endoscopic designs and faster imaging speeds and demonstrate superior diagnostic utility to computed tomography and magnetic resonance imaging. While such technology has been available for OCT, its translation requires focused development through a close collaboration between engineers and clinicians.
Publisher: Wiley
Date: 25-04-2011
DOI: 10.1002/LARY.21470
Abstract: Middle ear packing agents are used in otologic surgery to provide support to the middle ear structures, maintain aeration of the middle ear, and promote hemostasis. However, there is currently a lack of standardization regarding the use of different types of packing agents. The choice of materials and how they are used remain controversial. In fact, some have recently advocated for no packing. In view of this, this review focuses on the types of materials available, a brief historical account of each material, characteristics of an ideal packing agent, and a discussion on the techniques of insertion to optimize surgical outcomes.
Publisher: Informa UK Limited
Date: 25-03-2013
DOI: 10.3109/14992027.2012.750431
Abstract: This study was undertaken to determine the efficacy of the round window (RW) application of the vibrant soundbridge (VSB) in patients with mixed or conductive hearing loss. Speech in quiet and in noise were compared to preoperative data attained with conventional hearing aids so that each subject served as his or her own control in a single test protocol. Eighteen adults implanted monaurally with the VSB in the poorer hearing ear. Experience with the VSB ranged from nine to 25 months. Sixteen of the 18 subjects were successful VSB users, wearing their device all waking hours. There was no significant deterioration in the averaged bone conduction results preoperatively versus post-operatively (p>0.05). Speech recognition in quiet results were not significantly different to performance attained whilst wearing hearing aids (p>0.05). Speech recognition in noise performance was substantially improved with use of the VSB in most test conditions. For the majority of the subjects, the VSB was an effective method of hearing restoration for their mixed and conductive hearing loss.
Publisher: SAGE Publications
Date: 26-01-2023
Abstract: Video otoscopy plays an important role in improving access to ear health services. This study investigated the clinician-rated quality of video otoscopy recordings and still images, and compared their suitability for asynchronous diagnosis of middle-ear disease. Two hundred and eighty video otoscopy image–recording pairs were collected from 150 children (aged six months to 15 years) by an ear, nose, and throat (ENT) specialist, audiologists, and trained research assistants, and independently rated by an audiologist and ENT surgeon. On a five-point scale, clinicians rated the cerumen amount, field of view, quality, focus, light, and gave an overall rating, and asked whether they could make an accurate diagnosis for both still images and recordings. More video otoscopy recordings were rated as ‘good’ or ‘excellent’ compared to still images across all domains. The mean difference between the two otoscopic procedures ratings was significant across almost all domains ( p 0.05), except ‘cerumen amount’. The suitability to make a diagnosis significantly improved when using recordings (p .05). Younger participant age was found to have a significant, negative impact on the ratings across all domains ( p 0.03). The role of the tester conducting video otoscopy did not have a significant impact on the ratings. Video otoscopy recordings were found to provide clearer views of the tympanic membrane and increase the ability to make diagnoses, compared to still images, for both audiologists and ENT surgeons. Research assistants with limited practice were able to obtain video otoscopy images and recordings that were comparable to the ones obtained by clinicians.
Publisher: Mary Ann Liebert Inc
Date: 06-2000
Abstract: The objective was to evaluate digital images of the retina from a handheld fundus camera (Nidek NM-100) for suitability in telemedicine screening of diabetic retinopathy. A handheld fundus camera (Nidek) and a standard fundus camera (Zeiss) were used to photograph 49 eyes from 25 consecutive patients attending our diabetic clinic. One patient had cataracts, making it impossible to get a quality image of one of the eyes (retina). The Nidek images were digitized, compressed, and stored in a Fujix DF-10M digitizer supplied with the camera. The digital images and the photographs were presented separately in a random order to three ophthalmologists. The quality of the images was ranked as good, acceptable or unacceptable for diabetic retinopathy diagnosis. The images were also evaluated for the presence of microaneurysms, blot hemorrhages, exudates, fibrous tissue, previous photocoagulation, and new vessel formation. kappa Values were computed for agreement between the photographs and digital images. Overall agreement between the photographs and digital images was poor (kappa < 0.30). On average, only 24% of the digital images were graded as being good quality and 56% as having an acceptable quality. However, 93% of the photographs were graded as good-quality images for diagnosis. The results indicate that the digital images from the handheld fundus camera may not be suitable for diagnosis of diabetic retinopathy. The images shown on the liquid crystal display (LCD) screen of the camera were of good quality. However, the images produced by the digitizer (Fujix DF-10M) attached to the camera were not as good as the images shown on the LCD screen. A better digitizing system may produce better quality images from the Nidek camera.
Publisher: Wiley
Date: 18-04-2020
DOI: 10.1111/AJAG.12719
Publisher: Georg Thieme Verlag KG
Date: 21-07-2023
Abstract: There are many ex les of remote technologies that are clinically effective and provide numerous benefits to adults with hearing loss. Despite this, the uptake of remote technologies for hearing healthcare has been both low and slow until the onset of the COVID-19 pandemic, which has been a key driver for change globally. The time is now right to take advantage of the many benefits that remote technologies offer, through clinical, consumer, or hybrid services and channels. These include greater access and choice, better interactivity and engagement, and tailoring of technologies to in idual needs, leading to clients who are better informed, enabled, and empowered to self-manage their hearing loss. This article provides an overview of the clinical research evidence-base across a range of remote technologies along the hearing health journey. This includes qualitative, as well as quantitative, methods to ensure the end-users' voice is at the core of the research, thereby promoting person-centered principles. Most of these remote technologies are available and some are already in use, albeit not widespread. Finally, whenever new technologies or processes are implemented into services, be they clinical, hybrid, or consumer, careful consideration needs to be given to the required behavior change of the key people (e.g., clients and service providers) to facilitate and optimize implementation.
Publisher: Informa UK Limited
Date: 25-05-2016
DOI: 10.1080/14992027.2016.1185169
Abstract: To evaluate whether clinician continuity is associated with successful hearing aid outcomes. A prospective cohort study. Clinician continuity was defined as occurring when a patient was cared for by the same clinician for the hearing assessment, hearing aid selection process, hearing aid fitting and programming, and subsequent hearing aid fine tuning appointments. The hearing aid outcome measures included self-reported hearing aid use, benefit and satisfaction as well as self-reported handling skills and problems experienced with hearing aids. Four hundred and sixty-eight adult hearing aid users (mean age 73.9 years ±10.9) and 26 qualified audiologists (mean age 34 years ±6.34) recruited from a single hearing clinic in Perth, Western Australia. There were no significant differences in hearing aid outcomes between participants who experienced clinician continuity and those who did not. Within a controlled practice setting, hearing aid outcomes may not be adversely effected if services are provided by more than one clinician.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2009
DOI: 10.1097/MAO.0B013E31819D895E
Abstract: To understand the presenting auditory signs and symptoms and to examine the relationship between the auditory manifestations and audiometric parameters in superior semicircular canal dehiscence (SSCD). Twenty consecutive patients with unilateral SSCD without a history of previous ontologic surgery. Relationship between presenting symptoms and the bone-conduction thresholds and air-bone gap (ABG) on pure-tone audiometry. All 20 patients presented with typical vestibular symptoms of SSCD. Seventeen (85%) patients also had auditory symptoms, including autophony (40%), hyperacusis to bodily sounds (65%), hearing loss (40%), aural pressure (45%), and tinnitus (35%). Of the 17 patients, 14 (82%) patients had an ABG on audiometry, but only 7 (41%) patients demonstrated negative bone conduction thresholds. Of 8 patients, 5 who underwent surgical repair experienced resolution of autophony and/or hyperacusis postoperatively. Auditory symptoms are common in SSCD patients. These symptoms do not show any relationship to the presence of negative bone-conduction thresholds on pure-tone audiometry. No firm conclusion could be drawn regarding the association between symptoms and ABG. Different pathways or mechanisms may exist in SSCD for bone-conducted sounds arising from different sources. Surgical repair of the dehiscence results in resolution of auditory symptoms in most patients.
Publisher: SAGE Publications
Date: 2018
Abstract: Objective: To evaluate the performance of self-reported hearing loss alone and in combination with pure tone audiometry screening in primary health care clinics in South Africa. Design: Nonprobability purposive s ling was used at 2 primary health care clinics. A total of 1084 participants (mean age 41.2 years SD 15.5 years range 16-97 years, 74.0% female) were screened using self-report and audiometry screening. Those failing audiometric screening and a s le of those who passed audiometric screening were also assessed by diagnostic pure time audiometry, to confirm or negate the finding of a hearing loss. Results: Four hundred and thirty-six participants (40.2%) self-reported a hearing loss with no significant association with gender or race. One hundred and thirty-six participant (12.5%) self-reported hearing loss and failed audiometry screening (35 dB HL at 1, 2, and 4 kHz). Combining self-report with a second stage audiometry screening revealed a high test accuracy (81.0%) for hearing loss, being most accurate (86.1%) to identify high-frequency hearing loss. Conclusion: While self-report of hearing loss is an easy and time-efficient screening method to use at primary health care clinics, its accuracy may be limited when used in isolation and it may not be sufficiently sensitive to detect hearing loss. Combining a simple audiometry screening as a second-stage screen can significantly improve overall performance and efficiency of the screening protocol.
Publisher: Informa UK Limited
Date: 31-05-2016
DOI: 10.1080/14992027.2016.1185168
Abstract: To systematically review and analyse experimental outcomes of studies exploring the impact of tinnitus upon cognitive function and their implications for clinical management of invasive tinnitus. A systematic and descriptive review. Eighteen studies were identified investigating the impact of tinnitus on cognitive function. The 18 studies evaluated cognitive function using 24 different objective behavioural tests, nine electrophysiological recordings, one oculomotor test, and one self-report questionnaire. The studies spanned 18 years and revealed numerous interactions potentially contributing to the cognitive difficulties frequently reported by people with invasive tinnitus. The studies indicate a clear association between tinnitus and aspects of cognitive function, specifically the executive control of attention. Tinnitus impairs cognitive function by way of impact upon executive control of attention. Clinical management of patients reporting tinnitus and cognitive difficulties requires an understanding of the reciprocal relationship between tinnitus and cognitive function, with additive effects of anxiety, depression, and somatic cognitive bias. Further study is required to establish the impact of advancing age, hearing loss, anxiety, depression tinnitus duration, and distress upon cognitive function in people with invasive tinnitus.
Publisher: Springer Science and Business Media LLC
Date: 12-11-2021
DOI: 10.1186/S13063-021-05714-7
Abstract: There is an urgent need to develop new therapies to improve cognitive function in adults following cochlear implant surgery. This study aims to determine if completing at-home computer-based brain training activities improve memory and thinking skills in adults following their first cochlear implant. This study will be conducted as a single-blind, head-to-head, randomised controlled trial (RCT). It will determine whether auditory training combined with adaptive computerised cognitive training will elicit greater improvement in cognition, sound and speech perception, mood, and quality of life outcomes in adult cochlear implant recipients, when compared to auditory training combined with non-adaptive (i.e. placebo) computerised cognitive training. Participants 18 years or older who meet the clinical criteria for a cochlear implant will be recruited into the study. The results of this trial will clarify whether the auditory training combined with cognitive training will improve cognition, sound and speech perception, mood, and quality of life outcomes in adult cochlear implant recipients. We anticipate that our findings will have implications for clinical practice in the treatment of adult cochlear implant recipients. Australian New Zealand Clinical Trials Registry ACTRN12619000609156 . Registered on April 23 2019.
Publisher: Wiley
Date: 09-10-2015
DOI: 10.1111/JPC.12741
Abstract: To describe the prevalence and risk factors of recurrent otitis media (rOM) in an urban Australian population at 3 years of age. Cross-sectional examination of prevalence and risk factors of rOM in 2280 participants from the Raine Study enrolled from public and private hospitals in Perth, Western Australia, between 1989 and 1991. Parental report questionnaires at 3 years of age were used for rOM identification, with secondary confirmation by otoscopic examination at 1, 2 or 3 years of age. The prevalence of parent-reported rOM was 26.8% (611/2280) and 5.5% (125/2280) for severe rOM in the Study. Independent associations were found between rOM and the presence of older siblings, attendance at day care and the introduction of other milk products at ≤4 months of age. Independent associations for severe rOM were the presence of allergies and attendance at day care. Prevalence rates of rOM within the Raine Study children are similar to a number of other known cohorts. Parity, presence of allergies, attendance at day care and introduction of other milk products at ≤4 months are highlighted as specific risk factors for rOM in this population and presence of allergies and attendance at day care being risk factors for severe rOM. Diagnosis of rOM by parent report and the delay between data collection and reporting are limitations of this study. However, as there is very limited data on OM in urban, non-Indigenous Australian children, this study improves our understanding of OM for this group.
Publisher: Springer Science and Business Media LLC
Date: 23-10-2010
DOI: 10.1007/S10735-010-9287-1
Abstract: Epidermal Growth Factor (EGF) has been identified as playing a critical role in the wound healing process. The objective of this study is to investigate the role that EGF plays in rat tympanic membrane (TM) wound healing using two techniques, microarray and immunohistochemistry. The tympanic membranes of rats were perforated using a sterile needle and sacrificed at time points during 2 weeks following perforation. The normalized signal intensities at the time points for EGF and associated genes are presented. The rat EGF mRNA did not change significantly between time points. Five associated proteins, including heparin-binding EGF-like growth factor were found to be differentially expressed above a two fold threshold at 12 h following perforation. EGF staining was found at low levels in the uninjured TM. Levels of EGF staining increased at 24 h in the basal keratinocyte layer, became diffusely elevated in the specimen at 36 h, before a second peak in staining of the keratinocyte layer at Day 4. The staining of EGF corresponds to its multiple roles in TM wound healing.
Publisher: Wiley
Date: 10-08-2017
DOI: 10.1111/COA.12713
Abstract: A self-administered device management survey was developed and validated to investigate the ability of cochlear implant recipients to self-report physical handling and care for their hearing implant device(s) and to identify factors that may influence self-reported management skills. Survey development and validation. A prospective convenience cohort design study. Specialist hearing implant clinic. Forty-nine post-lingually hearing impaired, adult cochlear implant recipients, at least 12 months postoperative. Survey test-retest reliability, responsiveness, criterion validity and sensitivity and specificity compared to clinician evaluation of device management skills. Correlations between self-reported management skills and participant demographic, audiometric, cognitive function, clinical outcomes and device factors. The self-administered Cochlear Implant Management Skills survey was developed, demonstrating high test-retest reliability (ICC = 0.884, P < 0.001 CI 95%: 0.721-0.952), responsiveness to intervention (management skills training) [t(20) = -3.245, P = 0.004], criterion validity (ICC = 0.765, P < 0.001 CI 95%: 0.584-0.868) and sensitivity (0.89). No associations were found between self-reported management skills and participant factors. This study demonstrated that a self-report survey is an effective method for the evaluation of skills required for cochlear implant device management.
Publisher: Frontiers Media SA
Date: 19-05-2022
DOI: 10.3389/FNAGI.2022.868673
Abstract: Age-related hearing loss is one of the leading causes of disability in older adults. This cross-sectional study investigated the association between untreated hearing loss, social (perception of quality and quantity of social network) and emotional loneliness (perception of limited emotional support), social isolation (size of the social network), social support (actual or perceived availability of resources from the social network) and psychological discomfort (depression, anxiety, and stress) in older adults. Cross-sectional study design. A total of 202 community derived s le of volunteers, age range 40–89 years, mean age (M) = 65.3 ± 11.0 years were recruited. Of these 115 were females ( M = 63.2 ± 12.0 years) and 87 were males ( M = 68.2 ± 8.9 years). All participants completed a hearing assessment, social interaction and support questionnaire and a social and emotional loneliness questionnaire. Hearing loss significantly contributed to both moderate [ P & 0.001, B (95% CI): 0.01 (0.99–1.02)] and intense levels [ P & 0.001, 0.02 (1.00–1.04)] of emotional loneliness. Depression was significantly associated with satisfaction with social support [ P & 0.001 −0.17 (−0.23 to −0.11), social interaction [ P = 0.01 −0.07 (−0.12 to −0.01)], and moderate [ P & 0.001 0.31 (1.22–1.53)] and intense [ P & 0.001 0.29 (1.20–1.50)] levels of emotional loneliness and intense levels of social loneliness [ P = 0.01 0.12 (1.05–1.21)]. Untreated hearing loss significantly increases the odds of being emotionally lonely. Depression significantly contributes to social and emotional loneliness, satisfaction with social support and social loneliness. Given the higher prevalence of loneliness and psychological discomfort and their associations with untreated hearing loss, hearing-impaired older adults are at significant risk of developing loneliness and psychological discomfort. Therefore, hearing health professionals should be aware of the psychosocial burden that may accompany hearing loss, in order to provide appropriate advice and support.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2016
Publisher: IEEE
Date: 07-2016
Publisher: JMIR Publications Inc.
Date: 27-01-2023
Abstract: he most common management option for hearing loss is hearing aids. In addition to devices, patients require information and support, including maintenance and troubleshooting. Mobile health (mHealth) technologies can support hearing aid management, acclimatization, and use. This study developed an mHealth acclimatization and support program for first-time hearing aid users and subsequently implemented and pilot-tested the feasibility of the program. The program was facilitated by community health workers (CHWs) in low-income communities in South Africa. his study aimed to evaluate the feasibility of an mHealth acclimatization and support program supported by CHWs in low-income communities. n application-based acclimatization and support was adapted and translated for use in low- and middle-income countries. This program was delivered in the form of 20 different voice notes accompanied by graphical illustrations via WhatsApp or 20 different SMS text messages. The program was provided to first-time hearing aid users immediately after a community-based hearing aid fitting in March 2021 in 2 low-income communities in the Western Cape, South Africa. The 20 messages were sent over a period of 45 days. Participants were contacted telephonically on days 8, 20, and 43 of the program and via open-ended paper-based questionnaires translated to isiXhosa 45 days and 6 months after the program started to obtain information on their experiences, perceptions, and accessibility of the program. Their responses were analyzed using inductive thematic analysis. total of 19 participants fitted with hearing aids received the mHealth acclimatization and support program. Most participants (15/19, 79%) received the program via WhatsApp, with 21% (4/19) of them receiving it via SMS text message. Participants described the program as helpful, supportive, informative, sufficient, and clear at both follow-ups. A total of 14 participants reported that they were still using their hearing aids at the 6-month follow-up. Three participants indicated that not all their questions about hearing aids were answered, and 5 others had minor hearing aid issues. This included feedback (n=1), battery performance (n=1), physical fit (n=2), and issues with hearing aid accessories (n=1). However, CHWs successfully addressed all these issues. There were no notable differences in responses between the participants who received the program via WhatsApp compared with those who received it through SMS text message. Most participants receiving WhatsApp messages reported that the voice notes were easier to understand, but the graphical illustrations supplemented the voice notes well. n mHealth acclimatization and support program is feasible and potentially assists hearing aid acclimatization and use for first-time users in low-income communities. Scalable mHealth support options can facilitate increased access and improve outcomes of hearing care. >
Publisher: Informa UK Limited
Date: 12-08-2022
Publisher: Wiley
Date: 06-2000
DOI: 10.1046/J.1442-9071.2000.00298.X
Abstract: The neuroretinal rims of a set of glaucoma patients were measured using digitized stereo photographs, to determine the reproducibility of computerized stereo measurements of the neuroretinal rim. Each rim was measured five times at 18 locations, with measurement error (ME) defined as the mean of standard deviations of each set of measurements. The following ME were determined: (i) inter-sessional variability (n = 27 right and 24 left eyes, at t1 and t2) (ii) inter-assessor variability (n = 9, 2 assessors) and (iii) variability after colour adjustment algorithms were applied (n = 15). The results were as follows: (i) inter-sessional variability was 3.41+/-1.08 for t1 and 3.22+/-0.84 for t2 (ii) there was a significant difference between the two assessors, although the ME was still low and (iii) there was no significant differences between the ME of unadjusted and adjusted images. With a measurement error of up to 11% of rim width, these results show that lowcost rim measurements can be made using PC-based software.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 25-02-2020
DOI: 10.1097/MAO.0000000000002628
Abstract: To investigate the effectiveness of basic fibroblast growth factor (bFGF) versus placebo or no intervention in the treatment of tympanic membrane (TM) perforations from randomized controlled trials (RCTs), prospective and retrospective studies. PubMed, EMBASE, and Cochrane databases were screened from their inceptions to June 2019. Inclusion criteria: 1) English language 2) observational (retrospective or prospective) or treatment (RCT) studies 3) reported the outcomes on the application of bFGF in adult or pediatric population. Exclusion criteria: 1) studies without a control group 2) animal studies, in vitro studies, review studies, and case reports. Number of patients, cause of TM perforation, perforation size, treatment, mean age, follow-up time, sex, closure rate, healing time, mean air-bone gap improvement. A total of 14 studies were included, including seven RCTs and seven non-RCTs with a total of 1,072 participants. The odds ratio for closure rate of bFGF treatment was 7.33 (95% confidence interval [CI], 4.65 to 11.53 p 0.01 I 2 = 44%) and the standardized mean difference (SMD) for healing time was –5.89 (95% CI: –7.85 to –3.93, p 0.01, I 2 = 98%), suggesting bFGF application has a significant effect on closure of TM perforations. However, no significant change in hearing (SMD: 0.08, 95% CI: –0.11 to 0.27, p = 0.39, I 2 = 0%) was seen as a result of bFGF treatment. Our meta-analysis has revealed that the application of bFGF can significantly enhance the closure rate as well as shorten the healing time for TM perforations. In terms of hearing, there is as yet no evidence that bFGF has a significant effect. Given its ease, availability, and safety, bFGF can be used effectively for TM repair.
Publisher: Wiley
Date: 06-2000
DOI: 10.1046/J.1442-9071.2000.00309.X
Abstract: The purpose of this study was to explore progress, in the adaptation to community screening for blinding eye disease, of digital imaging devices and technology for storage and transmission. Available imaging systems were compared to gold standard clinical photography in terms of sensitivity and specificity for diagnosis of common blinding eye conditions. Since the use of expensive non-portable imaging devices is likely to be limited for widespread community screening purposes, a portable fundus camera (Nidek, Chiyoda-ku, Japan) and a prototype monocular digital indirect ophthalmoscope constructed at the Lions Eye Institute (LEI) were selected for comparative trials for the screening of optic disc cupping, glaucoma and clinical signs of diabetic retinopathy. Fifty-one eyes of 27 consecutive patients being assessed at the LEI clinic for glaucoma were dilated and photographed with a Zeiss retinal camera, and digital images were taken with the portable Nidek NM100 fundus camera (Carl Zeiss, Oberkochen, Germany) or with a prototype digital monocular indirect ophthalmoscope. Vertical cup: disc ratios (VCDR) were measured on the disc photographs by one ophthalmologist while three other clinicians were presented with compressed digital images in random order to estimate VCDR. Field trials were also carried out to demonstrate the practicality of compression, local storage and then transmission by mobile telephone ISDN lines and satellite, of optic discs and fundus images of patients with diabetes in either rural Western Australia or Surabaya, Indonesia. Kappa values of correlations of measurement of agreement between measured and estimated VCDR were 0.87, 0.45 and 0.84, respectively, for the three observers, corresponding to a specificity of 79-97% and a sensitivity of 70-95%. The portable Nidek fundus camera was also assessed for specificity and sensitivity in the diagnosis of diabetic retinopathy in comparison to standard Zeiss fundus camera photographs. Of 49 eyes in 25 consecutive patients attending the LEI clinic for assessment of diabetic retinopathy, three ophthalmologists assessed photographs and images in random order. When used for screening diabetic retinopathy, the digital images of the Nidek camera were graded as adequate quality in only 56% of eyes compared to 93% of the photographs. The kappa value of agreement in analysis of diabetic retinopathy was only 0.30. The prototype digital monocular indirect ophthalmoscope compared favourably with the Nidek camera. At 1:5 compression, images of size 36 kB transmitted from Surabaya to Perth took 29 s on the mobile telephone, while uncompressed images took 170 s. Images compressed 1:5 were transmitted in 60 s using the satellite telephone, while the uncompressed images took 240 s. Satellite transmission was more expensive but the lines were more stable than telephone connections from Indonesia. Digital imaging is becoming a powerful tool for ophthalmology in clinical records, teaching and research, and interoffice diagnostic opinions. It also has enormous potential for community screening for blinding eye diseases, such as glaucoma and diabetic retinopathy. Inexpensive portable imaging devices that are easy to use, and on which local health workers might be trained, must be developed and validated in terms of sensitivity and specificity of performance. The technology of image capture, image compression, transmission, data base storage and analysis is rapidly evolving and becoming less expensive.
Publisher: Informa UK Limited
Date: 05-02-2016
DOI: 10.1080/14670100.2015.1114220
Abstract: To evaluate the clinical utility of the City University of New York sentence test in a cohort of post-lingually deafened cochlear implants recipients over time. 117 post-lingually deafened, Australian English-speaking CI recipients aged between 23 and 98 years (M = 66 years SD = 15.09) were recruited. CUNY sentence test scores in quiet were collated and analysed at two cut-offs, 95% and 100%, as ceiling scores. CUNY sentence scores ranged from 4% to 100% (M = 86.75 SD = 20.65), with 38.8% of participants scoring 95% and 16.5% of participants reaching the 100% scores. The percentage of participants reaching the 95% and 100% ceiling scores increased over time (6 and 12 months post-implantation). The distribution of all post-operative CUNY test scores skewed to the right with 82% of test scores reaching above 90%. This study demonstrates that the CUNY test cannot be used as a valid tool to measure the speech perception skills of post-lingually deafened CI recipients over time. This may be overcome by using adaptive test protocols or linguistically, cognitively or contextually demanding test materials. The high percentage of CI recipients achieving ceiling scores for the CUNY sentence test in quiet at 3 months post-implantation, questions the validity of using CUNY in CI assessment test battery and limits its application for use in longitudinal studies evaluating CI outcomes. Further studies are required to examine different methods to overcome this problem.
Publisher: Wiley
Date: 22-07-2021
DOI: 10.1002/LARY.29768
Abstract: The prevalence of hyperacusis and its relationship with mental and general health is unknown in a nonclinical s le. Therefore, we aimed to determine the prevalence of hyperacusis and its relation with hearing, general and mental health in a population‐based study. Prospective population‐based study. This study uses data from the Busselton Healthy Ageing Study (BHAS). A s le of 5,107 eligible inhabitants aged 45 to 70 years completed a detailed questionnaire and a clinical assessment. A positive answer to “ Do you consider yourself sensitive or intolerant to everyday sounds ” was used to indicate hyperacusis. Logistic regression was used to examine the association between hearing, mental and general health factors, and hyperacusis. Of 5,107 participants, 775 (15.2%) reported hyperacusis. The majority of participants with hyperacusis reported an occasional effect on daily life (72.0%). Being female, older in age, having a lower income, physical or mental health difficulties, more severe hearing loss, and tinnitus were all associated with the presence of hyperacusis. In iduals who experience hearing impairment, poorer general or mental health have a higher possibility of hyperacusis having an effect on their daily life. In this community population‐based cohort study, we found a prevalence of hyperacusis of 15.2%. In iduals with hearing loss, mental health problems, and lower physical health have a higher possibility of experiencing effects on their daily life associated with their hyperacusis. Unravelling the relationship between hyperacusis hearing, general and mental health can be of major importance for a better understanding of the condition and its consequences. 2 Laryngoscope , 131:E2887–E2896, 2021
Publisher: Springer Science and Business Media LLC
Date: 2001
Abstract: Oximetry may be useful for understanding pathologies of the eye. We use a prototype scanning laser ophthalmoscope capable of simultaneous multiple wavelength imaging to record fundus images. The system is run under non-confocal conditions in using slit apertures with a width of up to 600 microm. The laser lines launched into the SLO were the 633 nm line of a HeNe-laser, and the 815 nm line from a tunable (700 to 900 nm) cw Ti:Sapphire-laser. These wavelengths were selected because of their availability and absorption characteristics. The difference in absorption at these two wavelengths is used to assess blood oxygen content. Images were averaged to improve the signal to noise ratio. This simultaneous method of measuring oxygen content may be preferred to other techniques such as sequential SLO imaging at different wavelengths, or spot analysis using a modified fundus camera. The advantages of this technique are that image registration is not required, and a large area of the retina can be assessed concurrently.
Publisher: BMJ
Date: 04-2022
DOI: 10.1136/BMJOPEN-2022-060901
Abstract: Existing research on the potential association between age-related hearing loss (ARHL) and cognitive decline and dementia in tonal language-speaking populations is limited and inconsistent. There is psychophysiological evidence suggesting a tonal language background may be linked to enhanced general cognitive functions. We aim to systematically review the current evidence on the association between hearing loss and cognitive impairment/decline and dementia in older adults who speak a Sinitic tonal language, the most commonly spoken tonal language. This systematic review will consider peer-reviewed articles that employ objective or subjective hearing measurement and cognitive impairment or diagnosis of dementia. All relevant research publications in English or Chinese and published up to March 2022 will be considered for inclusion. Embase, MEDLINE, Web of Science, PsycINFO Google Scholar, SinoMed and Chinese Biomedical Database will be used, using both medical subject heading terms and keywords. The quality of evidence of an association between ARHL and cognitive impairment and/or dementia will be evaluated by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. A random-effects meta-analysis will be carried out with the Comprehensive Meta-Analysis software. Ethical approval will not be required for this systematic review. The results will be disseminated through peer-reviewed publications and conferences. CRD42021235310.
Publisher: Springer Science and Business Media LLC
Date: 08-10-2013
Publisher: Wiley
Date: 04-2010
Publisher: SAGE Publications
Date: 2022
DOI: 10.1177/23312165221128431
Abstract: The aim of this study was to estimate the prevalence and distress of tinnitus pre- and post-cochlear implantation in patients with bilateral severe to profound hearing loss. In this retrospective study, we included patients from a cochlear implant clinic in Perth, Western Australia. Pre- and post-cochlear implantation data from 300 implant recipients were collected on self-reported presence of tinnitus, tinnitus distress using the Tinnitus Reaction Questionnaire (TRQ), hearing-related quality of life using the Abbreviated Profile of Hearing Aid Benefit (APHAB), and consonant-nucleus vowel-consonant (CNC) word recognition test scores. Retrospectively, patients were grouped into those with or without tinnitus, and the grade of tinnitus distress. The potential factors associated with post-implantation changes in the presence of tinnitus and its distress were evaluated. Tinnitus prevalence was 55.8% pre-operatively and 44.3% post-implantation with a median TRQ score respectively of 12.0 (IQR: 1.0–28.0) and 3.5 (IQR: 0.0–16.2) points. Among the 96 patients experiencing tinnitus pre-implantation, 14.6% patients experienced moderate to catastrophic tinnitus distress pre-implantation compared to 6.3% post-implantation. To conclude, the pre- and post-implantation median TRQ score for the cohort population showed that tinnitus was a “slight” handicap. Tinnitus prevalence and its associated tinnitus distress decreased post-implantation. Patients with tinnitus post-implantation were significantly younger and had less severe pre-implantation hearing loss in the non-implanted ear than patients without tinnitus. Further research is needed to understand the factors influencing changes in tinnitus.
Publisher: Wiley
Date: 20-10-2005
DOI: 10.1002/JBM.B.30165
Abstract: The limitations of manual prosthesis crimping in hearing restoration surgery for otosclerosis are thought to have a key role in the occurrence of incomplete postoperative elimination of conductive hearing loss and postoperative recurrences of conductive hearing loss. To eliminate manual crimping, the self-crimping, shape-memory alloy Nitinol stapes piston was introduced in nine otosclerosis patients. The results were compared with those in a database of surgeries performed with conventional titanium pistons. The effects of the self-crimping Nitinol prosthesis on the postoperative elimination of conductive hearing loss and its postoperative variations were investigated. The variations of postoperative residual conductive hearing loss were significantly smaller and the extent of conductive hearing-loss elimination greater in the Nitinol group. The mean postoperative residual conductive hearing loss was smaller in the Nitinol group. The postoperative stability of conductive hearing loss elimination was similar in both patient groups. Preliminary results suggest that the self-crimping shape-memory alloy Nitinol stapes piston overcomes the drawbacks of manual crimping in hearing restoration surgery for otosclerosis.
Publisher: Elsevier BV
Date: 11-2020
Publisher: Informa UK Limited
Date: 19-04-2023
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2018
DOI: 10.1097/AUD.0000000000000477
Abstract: To gather perspectives of hearing aid owners and hearing healthcare clinicians with regard to problems that arise after hearing aid fitting and use these perspectives to generate a conceptual framework to gain a better understanding of these problems. Participants included a group of 17 hearing aid owners and a group of 21 hearing healthcare clinicians data collection occurred separately for each group. Participants each attended two group sessions in Perth, Western Australia, wherein they: (1) generated statements describing the problems associated with hearing aids and (2) grouped and rated the statements to identify key themes. Concept mapping was used to generate a conceptual framework. Participants identified four concepts regarding hearing aid problems as follows: (1) hearing aid management (2) hearing aid sound quality and performance (3) feelings, thoughts, and behaviors and (4) information and training. While hearing aid owners and clinicians generated similar results regarding the concepts derived, the clinicians reported that the problems identified had a greater negative impact on hearing aid success than did hearing aid owners. The magnitude and ersity of hearing aid problems identified in this study highlight the ongoing challenges that hearing aid owners face and suggest that current processes for hearing aid fitting can be improved. Problems relating to hearing aid management were most often deemed to have the greatest impact on hearing aid success and be the most preventable/solvable, and thus are a good starting point when addressing hearing aid–related problems.
Publisher: Mary Ann Liebert Inc
Date: 11-2015
Abstract: This study determined the accuracy of pure tone air conduction (AC) thresholds obtained using a synchronous telemedicine approach without a sound booth in a rural South African community. The global need for increased hearing healthcare currently far exceeds the capacity for delivering these services, especially in developing countries. A tele-audiology approach using a portable diagnostic audiometer could provide the solution, enabling hearing assessments to be conducted remotely and without a sound booth. Hearing thresholds in a sound booth and natural environment were obtained from an initial s le of 20 adults (age range, 19-63 years mean age, 50±13 years 55% female), recruited from a rural agricultural community. A subgroup of 10 adults (20 ears) volunteered for the telemedicine threshold testing. AC thresholds (250-8,000 Hz) were determined and subsequently compared in these environments. Typical threshold variability was determined using test-retest correspondence as a reference for the threshold correspondence using a telemedicine mode. Test-retest threshold correspondence in the booth and natural environments was within±5 dB in 96.7% and 97.5% of comparisons, respectively. No significant differences were obtained in AC hearing thresholds determined in the telemedicine configuration compared with those recorded in the gold standard booth environment. Threshold correspondence between the telemedicine compared with booth and natural environments were within±5 dB in 82% and 85% of comparisons, respectively. The current study demonstrates the validity of using synchronous telemedicine for conducting hearing assessments in a remote rural agricultural community without a sound booth.
Publisher: Wiley
Date: 26-03-2014
Publisher: Wiley
Date: 05-1998
DOI: 10.1111/J.1442-9071.1998.TB01385.X
Abstract: Digital imaging systems provide immediate, magnified images that can easily be analysed, enhanced, archived, printed on near photographic-quality paper and transferred electronically to remote computers. We have assembled a digital ophthalmic system and tested it on patients with some common causes of blindness: corneal scarring and cataract, diabetic retinopathy, macular degeneration and glaucoma. Digital images were obtained using a variety of ophthalmic imaging devices ranging from slit-l , fundus camera, indirect ophthalmoscope and scanning laser ophthalmoscope. These images were compressed in order to concentrate image information (image size reduced by 90-95%) and minimize transmission time (reduced by 97-98%). Standard or mobile telephone lines were used to transmit images to remote terminals. Transmission time was reduced from 15-20min to 20-30s and the image size was reduced from 1.3 MB to 20-30 kB by compressing the images before transmission. Image quality is still excellent.
Publisher: Georg Thieme Verlag KG
Date: 11-2014
DOI: 10.3766/JAAA.25.10.2
Abstract: Background: Despite its value as a diagnostic measure of middle-ear function, recommendations for tympanometry as a screening test for middle-ear disorders have been tentative. This is primarily due to concerns related to over-referrals, cost-effectiveness, variability in referral criteria and protocols, variable reported screen performance, and influence of demographic and environmental factors. Purpose: The current study assessed tympanometry in a large population of children between 5–7 yr old in terms of normative ranges, performance of current recommended referral criteria, and associations with independent demographic and environmental variables. Research Design: Retrospective cohort study. Study S le: A total of 2868 children and their families were originally enrolled in the Raine Cohort Study in Western Australia. Of these, 1469 children between 5–7 yr old (average age = 5.97 yr, SD = 0.17 yr) were evaluated with tympanometry and pure-tone audiometry screening. Data Collection and Analysis: Tympanometry was conducted using a 226 Hz probe tone with screening ipsilateral acoustic reflexes recorded using a 1000 Hz stimulus. Hearing screening was conducted using pure tones at 20 dB HL for 1000, 2000, and 4000 Hz. Relationships among normative ranges (90% and 95% ranges) for tympanometric indices, age, gender, and month of test were determined. Associations were also explored between tympanometry referrals and month of test, gender, and absence of acoustic reflexes. Results: Normative 90% ranges for tympanometric peak pressure was –275 to 15 daPa, 60–150 daPa for peak compensated tympanometric width, 0.2 and 1.0 mmho for peak compensated static admittance, and 0.7–1.3 cm3 for ear canal volume. Current screening guidelines result in high referral rates for children 5–7 yr old (13.3% and 11.5% using the American Speech-Language-Hearing Association [ASHA] and American Academy of Audiology [AAA] guidelines, respectively). The subgroup of children 6–7 yr old had referral rates (for ears tested) of only 3.3% and 2.7%, respectively, according to ASHA and AAA guidelines. The prevalence of middle-ear effusion (admittance .1 mmho) was significantly different across seasons, with the highest (13.5%) in September and lowest (3.8%) in January. Month of test was associated with a general decrease in tympanometric peak pressure across the population. Conclusions: An 80% reduction in tympanometry referrals for children ages 6 and 7 yr compared with children age 5 yr argues for tympanometry as a first-tier screening method in older children only. The impact of regional seasonal influences, representing an increase in referrals as high as 3.5 times from one month to another, should also inform and direct pediatric screening programs for middle-ear functioning and/or hearing loss.
Publisher: SAGE Publications
Date: 12-2005
DOI: 10.1258/135763305775124920
Abstract: We studied the willingness of patients to use telemedicine for ear- and hearing-related appointments, and the factors that influenced their decision to participate in telemedicine. A survey was designed with questions about patient appointments, perceived advantages and barriers to telemedicine, and prior use of the Internet for health-related matters. A total of 116 patients in four audiology centres were surveyed from December 2004 to May 2005. There were 54 male and 62 female respondents 46% of the participants were aged over 66 years. In all, 75% had not previously heard of telemedicine. The most common reasons for willingness to use telemedicine were to reduce the time waiting for an appointment and cost. The most common barrier to using telemedicine was a preference for face-to-face visits. Of those surveyed, 32% were willing to use telemedicine, 10% would sometimes be willing, 28% were unsure, and 30% were not willing. There was no relationship between willingness and age or gender, except that women over the age of 55 years were less willing. Patients who had previously heard of telemedicine and used the Internet for health-related matters, especially men, were more inclined to have a telemedicine appointment.
Publisher: Georg Thieme Verlag KG
Date: 06-2019
DOI: 10.3766/JAAA.17129
Abstract: Clinical studies have found up to 90% of hearing aid owners demonstrate difficulty with basic hearing aid management tasks and almost 50% of hearing aid owners self-report not receiving enough practical help from their clinician regarding how to use their hearing aid. Although studies have highlighted the overwhelming amount of information and training required to learn how to use a hearing aid appropriately, a gap remains in the literature regarding the range of methods by which hearing aid owners acquire the knowledge and skills for hearing aid use, and whether these approaches are considered beneficial. To gain insight into how both hearing aid owners and hearing health clinicians view the acquisition of hearing aid management skills and the efficacy of currently used methods of hearing aid training. Concept mapping techniques were used to identify key themes, wherein participants generated, sorted, and rated the importance of statements in response to the question “How do hearing aid owners learn the skills required to use, handle, manage, maintain, and care for their hearing aids?” Twenty-four hearing aid owners (aged 56–91 years 54.2% male) and 22 clinicians (aged 32–69 years 9.1% male). Participant perspectives were collected via group concept mapping sessions in October 2015. Hierarchical cluster analysis was used to identify themes and develop a framework for understanding how skill acquisition occurs. Participants rated each method of hearing aid skill acquisition as to how beneficial it was and how often it was used. Participants identified 75 unique items describing how hearing aid management skills are acquired within six concepts: (1) Relationship with the clinician, (2) clinician as a source of knowledge and support, (3) hands-on experience, (4) seeking additional information, (5) asking support people for help, and (6) external resources. The results of this study highlight the erse methods and sources by which hearing aid owners learn the skills necessary to use, manage, and maintain their hearing aids. Significant emphasis was placed on the role of the hearing health clinician to provide training, support, and an ongoing professional relationship, with lesser roles played by family, friends, and other health professionals.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2019
DOI: 10.1097/AUD.0000000000000595
Abstract: Although hearing aids can improve hearing and communication, problems that arise following the acquisition of hearing aids can result in their disuse. This study aimed to gather perspectives of hearing aid owners and hearing health care clinicians about how hearing aid owners respond to problems that arise following hearing aid fitting, and then use these perspectives to generate a conceptual framework to better understand these responses. Seventeen hearing aid owners and 21 hearing health care clinicians generated, sorted, and rated statements regarding how hearing aid owners respond to problems associated with hearing aid use. Concept mapping was used to identify key themes and to develop a conceptual framework. Participants identified four concepts regarding how hearing aid owners respond to problems associated with hearing aids: (1) Seeking External Help (2) Problem Solving (3) Putting Up with Problems and (4) Negative Emotional Response. Participants described behaviors of the clinician and significant others that influenced their decision to seek help for hearing aid problems. Participants recognized that these behaviors could either have a helpful or unhelpful impact. Despite the ongoing support offered to clients after they acquire hearing aids, they are hesitant to seek help from their clinician and instead engage in a myriad of helpful and unhelpful behaviors in response to problems that arise with their hearing aid. Previous positive or negative experiences with the clinic, clinician, or significant other influenced these actions, highlighting the influential role of these in iduals’ in the success of the rehabilitation program. The data generated from this study suggests that clinicians could improve hearing aid problem resolution by providing technical and emotional support, including to significant others, and promoting client empowerment and self-management.
Publisher: Informa UK Limited
Date: 09-08-2022
DOI: 10.1080/14992027.2021.1957160
Abstract: To determine the attitudes of audiologists towards telehealth and use of telehealth for the delivery of ear and hearing services pre-, during- and post- the COVID-19 pandemic, and to identify the perceived effects of telehealth on services and barriers to telehealth. An online survey distributed through the International Society of Audiology and member societies. A total of 337 audiologists completing the survey between 23 June and 13 August 2020. There was a significant increase in the perceived importance of telehealth from before (44.3%) to during COVID-19 (87.1%), and the use of telehealth previous (41.3%), current (61.9%) and expected use of telehealth (80.4%). Telehealth was considered adequate for many audiology services, although hearing assessment and device fitting by telehealth received least support. Matters related to timeliness of services and reduction of travel were reported as the main advantages, but relationships between practitioners and clients may suffer with telehealth. Important barriers were technologies related to the client or remote site clinic-related items were moderate barriers, although more clinician training was a common theme provided through open-ended responses. The COVID-19 pandemic has resulted in audiologists having a more positive attitude towards and greater use of telehealth, but with some reservations.
Publisher: Informa UK Limited
Date: 27-02-2020
Publisher: AME Publishing Company
Date: 03-2020
Publisher: SAGE Publications
Date: 12-2002
DOI: 10.1258/13576330260440718
Abstract: The view of the tympanic membrane of the ear provides the specialist with important information for the assessment of ear disease and for treatment planning. In rural and remote areas, the incidence of ear disease is high but access to ear specialists is limited. As part of a project to deliver tele-otoscopy services to remote Western Australia, we have investigated various aspects of a tele-otoscopy system. We found that the MedRX video-otoscope is relatively safe to use and produces images of very good quality. A confident diagnosis could be made from still images compressed to 20 kByte. Video sequences could be compressed to a ratio of 1:300. Furthermore, a software package has been developed, and we are developing a training course for health-care workers in remote areas.
Publisher: Informa UK Limited
Date: 04-05-2015
Publisher: Informa UK Limited
Date: 2006
DOI: 10.1080/00016480500312596
Abstract: The results of this study have demonstrated for the first time that tympanic membrane (TM) structure is preserved following removal of fresh, normal tissue from patients undergoing surgery. Greater clarity has been demonstrated using resin sections than in previous studies on paraffin sections. Of particular note, cytokeratin (CK) immunocytochemistry was successfully performed on resin sections, which has not been previously reported. This may have potential applications for future work involving tissues that express CKs. To analyse the structure of normal, fresh human TM specimens after surgical removal and to evaluate their CK immunocytochemistry using resin techniques, neither of which have been demonstrated previously. Seven TM specimens were removed during surgery and then preserved in a modified Karnovsky's fixative. Semi-thin and thin sections were examined by means of light and electron microscopy, respectively. For comparison purposes, paraffin block-embedded specimens were also sectioned. CK immunocytochemistry was performed on semi-thin sections using standard immunoperoxidase techniques, with expression being demonstrated using light microscopy. The three-layer architecture of the TM was preserved. The morphology of the TM was vastly superior in the semi-thin resin sections than in the thicker paraffin sections. The outer, middle and inner layers were clearly demonstrated. The integrity of the outer epithelial layer was maintained, with an outer keratinizing stratum corneum and underlying stratum granulosum, stratum spinosum and stratum basale layers resting on the basal lamina. The thin inner mucosal layer was also viable, consisting of simple squamous or cuboidal cells. Preservation of the middle lamina propria was achieved, with demonstration of the outer radial and inner circular fibres. CK immunocytochemistry utilizing resin techniques provided excellent staining of CK 7 and 8 in the inner layer, with positive staining of CK 5 and 10 in the outer layer.
Publisher: Springer Science and Business Media LLC
Date: 02-05-2023
DOI: 10.1186/S43058-023-00427-1
Abstract: This study describes the development of an intervention to increase the frequency of audiologists’ asking about and providing information regarding mental wellbeing within adult audiology services. The Behaviour Change Wheel (BCW), an eight-step systematic process, was followed to develop the intervention. Reports describing the first four steps are published elsewhere. This report describes the final four steps and details the intervention developed. A multifaceted intervention was developed to change audiologists’ behaviours relating to providing mental wellbeing support to adults with hearing loss. Specifically, three behaviours were targeted: (1) asking clients about their mental wellbeing, (2) providing general information on the mental wellbeing impacts of hearing loss, and (3) providing personalised information on managing the mental wellbeing impacts of hearing loss. A variety of intervention functions and behaviour change techniques were incorporated into the intervention, including instruction and demonstration, information about others approval, adding objects to the environment, use of prompts/cues, and endorsement from credible sources. This study is the first to use the Behaviour Change Wheel to develop an intervention targeting mental wellbeing support behaviours in audiologists and confirms the usability and usefulness of the approach in a complex area of clinical care. The systematic development of the Ask, Inform, Manage, Encourage, Refer (AIMER) intervention will facilitate a thorough evaluation of its effectiveness in the next phase of this work.
Publisher: Frontiers Media SA
Date: 12-2022
DOI: 10.3389/FPSYG.2022.917276
Abstract: Age-related hearing loss, mental health conditions, and loneliness commonly affect older adults. This study aimed to determine whether untreated hearing loss is independently associated with depression, anxiety, stress, and loneliness in tonal language-speaking older adults in China. Observational, cross-sectional study. 293 older adults (111 males, M = 70.33 ± 4.90 years 182 females, M = 69.02 ± 4.08 years) were recruited. All participants completed a pure tone audiometric hearing assessment, and provided information on living arrangements, marital status, leisure activities, tobacco and alcohol use, and medical history. The Mandarin version of the De Jong Gierveld Loneliness Scale was used to measure loneliness, and the Mandarin version of the 21-item Depression Anxiety Stress Scale (DASS-21) was used to assess a range of symptoms common to depression, stress, and anxiety of the participants. The analysis focused on determining the predictors of depression, anxiety, and stress, and the predictors of measures of loneliness. Multiple stepwise regression analyses revealed that the emotional loneliness ( β = 0.303 , p & 0.001) and living status ( β = 0.110, p = 0.048) significantly predicted DASS depression scores emotional loneliness ( β = 0.276, p & 0.001) and a history of vascular disease ( β = 0.148, p = 0.009) were significantly related to DASS anxiety scores emotional loneliness ( β = 0.341, p & 0.001) and a history of vascular disease ( β = 0.129, p = 0.019) significantly predicted DASS stress scores. Furthermore, multiple stepwise regression analyses showed that DASS stress scores ( β = 0.333, p & 0.001), education years ( β = −0.126, p = 0.020), marriage status ( β = 0.122, p = 0.024), and a history of vascular disease ( β = 0.111, p = 0.044) significantly predicted emotional loneliness four-frequency average hearing loss ( β = 0.149, p = 0.010) and DASS stress scores ( β = 0.123, p = 0.034) significantly predicted social loneliness scale and four-frequency average hearing loss ( β = 0.167, p = 0.003) and DASS stress scores ( β = 0.279, p & 0.001) also significantly predicted overall loneliness. There were no significant associations with high-frequency hearing loss. This study revealed that loneliness has a significant relationship both with hearing loss and aspects of mental health in an older adult Mandarin-speaking population. However, mental health was not significantly associated with hearing loss in this population.
Publisher: Elsevier BV
Date: 2006
DOI: 10.1016/J.PRETEYERES.2005.07.001
Abstract: As digital imaging and computing power increasingly develop, so too does the potential to use these technologies in ophthalmology. Image processing, analysis and computer vision techniques are increasing in prominence in all fields of medical science, and are especially pertinent to modern ophthalmology, as it is heavily dependent on visually oriented signs. The retinal microvasculature is unique in that it is the only part of the human circulation that can be directly visualised non-invasively in vivo, readily photographed and subject to digital image analysis. Exciting developments in image processing relevant to ophthalmology over the past 15 years includes the progress being made towards developing automated diagnostic systems for conditions, such as diabetic retinopathy, age-related macular degeneration and retinopathy of prematurity. These diagnostic systems offer the potential to be used in large-scale screening programs, with the potential for significant resource savings, as well as being free from observer bias and fatigue. In addition, quantitative measurements of retinal vascular topography using digital image analysis from retinal photography have been used as research tools to better understand the relationship between the retinal microvasculature and cardiovascular disease. Furthermore, advances in electronic media transmission increase the relevance of using image processing in 'teleophthalmology' as an aid in clinical decision-making, with particular relevance to large rural-based communities. In this review, we outline the principles upon which retinal digital image analysis is based. We discuss current techniques used to automatically detect landmark features of the fundus, such as the optic disc, fovea and blood vessels. We review the use of image analysis in the automated diagnosis of pathology (with particular reference to diabetic retinopathy). We also review its role in defining and performing quantitative measurements of vascular topography, how these entities are based on 'optimisation' principles and how they have helped to describe the relationship between systemic cardiovascular disease and retinal vascular changes. We also review the potential future use of fundal image analysis in telemedicine.
Publisher: Oxford University Press (OUP)
Date: 05-03-2020
Abstract: Studies reporting an association between hearing loss and depression in older adults are conflicting and warrant a systematic review and meta-analysis of the evidence. A search of academic databases (e.g., MEDLINE) and gray literature (e.g., OpenGrey) identified relevant articles published up to July 17, 2018. Cross-sectional or cohort designs were included. Outcome effects were computed as odds ratios (ORs) and pooled using random-effects meta-analysis (PROSPERO: CRD42018084494). A total of 147,148 participants from 35 studies met inclusion criteria. Twenty-four studies were cross-sectional and 11 were cohort designs. Overall, hearing loss was associated with statistically significantly greater odds of depression in older adults (OR = 1.47, 95% confidence interval [CI] = 1.31−1.65). When studies were stratified by design, hearing loss was associated with greater odds of depression in cross-sectional studies (OR = 1.54, 95% CI = 1.31−1.80) and cohort studies (OR = 1.39, 95% CI = 1.16 − 1.67), and there was no difference between cross-sectional or cohort effect estimates (Q = 0.64, p = .42). There was no effect of moderator variables (i.e., hearing aid use) on the association between hearing loss and depression, but these findings must be interpreted with caution. There was no presence of publication bias but certainty in the estimation of the overall effect was classified as “low.” Older adults may experience increased odds of depression associated with hearing loss, and this association may not be influenced by study or participant characteristics.
Publisher: Elsevier BV
Date: 12-2022
DOI: 10.1016/J.IJPORL.2022.111379
Abstract: To investigate the long-term impact of recurrent otitis media (rOM) and ventilation tube insertion (VTI) in early childhood on hearing outcomes and middle-ear health three to five years later, in a prospective pregnancy cohort study. Children were classified into rOM (n = 314), VTI (n = 94), and reference (n = 1735) groups, according to their otitis media (OM) history in their first three years of life. Audiometry at frequencies 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz, and tympanometry were performed when children were approximately six years of age. A binary logistic regression incorporating a range of potential confounding variables showed that hearing outcomes and middle-ear health status in children who had early childhood rOM with or without undergoing VTI were not significantly different to those in the reference group. The only significant difference was found in the VTI group for both tympanometry (OR = 2.190 95% CI = 1.123, 4.270) and audiometry outcomes at 4000 Hz (OR = 3.202 95% CI 1.341, 6.717), in the left ear only. The median score of the better ear 4FA was 20 dB in children in all groups. Children with rOM with or without undergoing VTI in the first three years of childhood had comparable hearing outcomes and middle-ear health status to those with no history of the disease, at around the age of six years. Although children who underwent VTI had an increased risk of abnormal middle-ear status and some elevation in hearing levels in their left ear only, their audiometry results were still within normal limits, indicating that the impact of VTI in early childhood is unlikely to have clinically significant adverse impact on later hearing outcomes.
Publisher: OSA
Date: 1999
Publisher: Wiley
Date: 12-2009
DOI: 10.1016/J.OTOHNS.2009.08.029
Abstract: To examine the relationship between the air‐bone gap (ABG) and the size of the superior semicircular canal dehiscence (SSCD) as measured on a computed tomography (CT) scan. STUDY DESIGN : Case series with chart review. Tertiary referral center. Twenty‐three patients (28 ears) diagnosed with SSCD. The size of the dehiscence on CT scans and the ABG on pure‐tone audiometry were recorded. The size of the dehiscence ranged from 1.0 to 6.0 mm (mean, 3.5 ± 1.6 mm). Six ears with a dehiscence measuring less than 3.0 mm did not have an ABG (0 dB). The remaining 18 ears showed an average ABG at 500, 1000, and 2000 Hz (AvABG 500–2000 ) ranging from 3.3 to 27.0 dB (mean, 11.6 ± 5.7 dB). The analysis of the relationship between the dehiscence size and AvABG 500–2000 revealed a correlation of R 2 = 0.828 ( P 0.001, quadratic fit) and R 2 = 0.780 ( P 0.001, linear fit). Therefore, the larger the dehiscence, the larger the ABG at lower frequencies on pure‐tone audiometry. In SSCD patients, an ABG is consistently shown at the low frequency when the dehiscence is larger than 3 mm. The size of the average ABG correlates with the size of the dehiscence. These findings highlight the effect of the dehiscence size on conductive hearing loss in SSCD and contribute to a better understanding of the symptomatology of patients with SSCD.
Publisher: Informa UK Limited
Date: 11-11-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-08-2020
DOI: 10.1097/AUD.0000000000000887
Abstract: Emotional and psychological well-being are essential to overall health, but there is little research showing how to approach emotional and psychological concerns in the audiological setting. This study investigated audiologists’ self-reported clinical behaviors in response to emotional and psychological concerns and/or symptoms raised by audiology clients. A s le of 83 Australia-based audiologists completed a survey including vignettes presenting older adults with hearing loss and experiencing symptoms consistent with either depression or grief. Content analysis was used to explore: (1) audiologists’ self-reported usual response when clients present with emotional and psychological concerns and/or symptoms in the audiological setting (2) audiologists’ ability to identify and describe psychological symptoms and (3) audiologists’ self-reported clinical behaviors relating to client referral for psychological support. When asked to describe their usual clinical course of action in response to the vignettes, over one half the audiologists described actions that address the clients concerns related to psychological well-being. Where audiologists described how they would provide psychological support, they described modifications to the audiological rehabilitation program including involving significant others in the rehabilitation process, recommending additional support outside of the audiology setting (such as General Practitioner or psychologists), and providing emotional support and counseling. When prompted, the majority of participants recognized the two cases with depression as having a mental health condition however, 48% of participants indicated the control case as also having a mental health condition. When asked directly, the majority of audiologists indicated that they would refer the three vignettes for specialist support however, less than one third described referral to a General Practitioner and less than 5% described referral to a mental health professional as their normal course of action in the open response item. Twenty-five different professions eople were reported as potential sources for referral. These findings support the need for further training and/or resources for audiologists to enable them to appropriately detect, describe and refer for emotional and psychological concerns and/or symptoms raised by clients’ in the audiology setting.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2016
Publisher: Georg Thieme Verlag KG
Date: 2019
DOI: 10.3766/JAAA.17111
Abstract: Extended high-frequency (EHF) audiometry (8-16 kHz) has an important role in audiological assessments such as ototoxicity monitoring, and for speech recognition and localization. Accurate and reliable EHF testing with smartphone technologies has the potential to provide more affordable and accessible hearing-care services, especially in underserved contexts. To determine the accuracy and test-retest reliability of EHF audiometry with a smartphone application, using calibrated headphones. Air-conduction thresholds (8-16 kHz) and test-retest reproducibility, recorded with conventional audiometry (CA) and smartphone audiometry (SA), using audiometric (Sennheiser HDA 300 circumaural) and nonstandard audiometric (Sennheiser HD202 II supra-aural) headphones, were compared in a repeated-measures design. A total of 61 participants (122 ears) were included in the study. Of these, 24 were adults attending a tuberculosis clinic (mean age = 36.8, standard deviation [SD] = 14.2 yr 48% female) and 37 were adolescents and young adults recruited from a prospective students program (mean age = 17.6, SD = 3.2 yr 76% female). Of these, 22.3% (n = 326) of EHF thresholds were ≥25 dB HL. Threshold comparisons were made between CA and SA, with audiometric headphones and nonstandard audiometric headphones. A paired s les t-test was used for comparison of threshold correspondence between conventional and smartphone thresholds, and test-retest reproducibility of smartphone thresholds. Conventional thresholds corresponded with smartphone thresholds at the lowest intensity (10 dB HL), using audiometric and nonstandard audiometric headphones in 59.4% and 57.6% of cases, respectively. Conventional thresholds (exceeding 10 dB HL) corresponded within 10 dB or less, with smartphone thresholds in 82.9% of cases using audiometric headphones and 84.1% of cases using nonstandard audiometric headphones. There was no significant difference between CA and SA, using audiometric headphones across all frequencies (p > 0.05). Test-retest comparison also showed no significant differences between conditions (p > 0.05). Smartphone test-retest thresholds corresponded within 10 dB or less in 86.7% and 93.4% of cases using audiometric and nonstandard audiometric headphones, respectively. EHF smartphone testing with calibrated headphones can provide an accurate and reliable option for affordable mobile audiometry. The validity of EHF smartphone testing outside a sound booth as a cost-effective and readily available option to detect high-frequency hearing loss in community-based settings should be established.
Publisher: Informa UK Limited
Date: 2000
DOI: 10.1080/01405110050198591
Abstract: Photographs of the optic nerve head (optic disc) in the eye are used for the clinical assessment of the disease glaucoma. These images are usually subjectively assessed by a clinician. A case of Sturge-Weber Syndrome which includes glaucoma as a symptom, is presented here. Narrowing of the rim of the optic disc was measured using custom-made measurement software confirming glaucomatous progression. To maximize the information obtained from optic disc images, low cost software can assist with quantifying disc parameters aiding clinical interpretation.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2008
Publisher: Informa UK Limited
Date: 20-05-2016
DOI: 10.1080/14992027.2016.1178858
Abstract: Examine the accuracy of automated audiometry in a clinically heterogeneous population of adults using the KUDUwave automated audiometer. Prospective accuracy study. Manual audiometry was performed in a sound-treated room and automated audiometry was not conducted in a sound-treated environment. 42 consecutively recruited participants from a tertiary otolaryngology department in Western Australia. Absolute mean differences ranged between 5.12-9.68 dB (air-conduction) and 8.26-15 dB (bone-conduction). A total of 86.5% of manual and automated 4FAs were within 10 dB (i.e. ±5 dB) 94.8% were within 15 dB. However, there were significant (p 0.05 R(2) =( ) 0.11). The presence of a hearing loss (better ear ≥26 dB) did not significantly affect accuracy (p = 0.604 air-conduction), (p = 0.218 bone-conduction). This study provides clinical validation of automated audiometry using the KUDUwave in a clinically heterogeneous population, without the use of a sound-treated environment. Whilst threshold variations were statistically significant, future research is needed to ascertain the clinical significance of such variation.
Publisher: Springer Science and Business Media LLC
Date: 09-1993
DOI: 10.1007/BF00921116
Publisher: American Speech Language Hearing Association
Date: 10-09-2021
DOI: 10.1044/2021_AJA-20-00178
Abstract: The aim of this study was to generate a conceptual framework describing which aspects of children and adolescents' lives are affected by chronic tinnitus. Views and experiences of 32 participants from two participant groups informed this study: (a) a tinnitus group, consisting of adults who had experienced tinnitus during childhood and/or adolescence and primary carers of children/adolescents with tinnitus, and (b) a clinicians' group, consisting of clinicians who provided care for children/adolescents with tinnitus. Participants produced statements describing aspects of children/adolescents' lives that may be affected by chronic tinnitus. Key concepts were identified through the processes of sorting the statements and rating them for degree of associated impact. Participants identified 118 unique aspects of the lives of children/adolescents who may be affected by chronic tinnitus. These were clustered into four concepts: (a) emotional well-being, (b) academic performances, (c) social/relationa, and (d) auditory/cognitive processing. At a group level, participants rated the impact of tinnitus as above a slight degree but below a moderate degree of impact. However, in idual participant's ratings indicated a range of perceived impact for each statement. The experience of chronic tinnitus during childhood and adolescence extends beyond the mere perception of sound. The perception of tinnitus may impact a child's emotional well-being, academic performances, social/relational, and auditory/cognitive processing. The impact of tinnitus in one aspect of a child's life may influence other aspects of their life. While at a group level, participants regarded the impact of tinnitus as “somewhat more than mild” to “less than moderate” in idual participant's ratings indicate that the impact from chronic tinnitus may be highly in idual and highlighted the importance of in idual assessment and management. Clinically, tinnitus management during childhood and adolescence may be improved if clinicians consider the impact and manifestation of tinnitus within each child's daily life and tailor tinnitus education and management strategies accordingly.
Publisher: American Speech Language Hearing Association
Date: 12-09-2018
Abstract: Although hearing health care clinicians provide training on hearing aid handling and management as part of the rehabilitation program, clinical studies suggest that the level of management skill demonstrated by hearing aid owners is low. In the absence of a comprehensive clinical survey to identify these shortfalls in clinical training, the objective of this study was to develop and report the psychometric properties of the Hearing Aid Skills and Knowledge Inventory (HASKI: a self-administered version and a clinician-administered version). The HASKI evaluates the knowledge and skills required for hearing aid management. A secondary aim was to report the prevalence of hearing aid management difficulties in an Australian population. The development of the HASKI and the investigation of its psychometric properties in a prospective convenience cohort of 518 adult hearing aid owners, ranging in age from 18 to 97 years ( M = 71 years, SD = 14), 60% male, 38% female, and 2% undisclosed, recruited from 7 hearing clinics across Australia, were used. The HASKI (both the self-administered and clinician administered) demonstrated high internal consistency, interdimensional relationships, construct validity, test–retest reliability, interobserver reliability, and criterion validity. A range of aptitudes were observed from low to full competency, with 99% of participants indicating difficulty with at least 1 item on the survey. The Hearing Aid Skills and Knowledge Inventories are valid and reliable measures of hearing aid handling and management skills with good potential for use in clinical settings. Hearing aid management is an area of difficulty for the majority of hearing aid owners, indicating the need for clinicians to improve the efficacy of hearing aid management training delivered.
Publisher: Informa UK Limited
Date: 04-06-2020
Publisher: American Speech Language Hearing Association
Date: 09-12-2021
DOI: 10.1044/2021_AJA-21-00048
Abstract: Audiology clinical guidelines recommend the use of mental health screening tools however, they remain underutilized in clinical practice. As such, psychological concerns are frequently undetected in adults with hearing loss. This study aimed to better understand audiology clinic staff's perspectives (including audiologists, audiometrists, reception staff, and clinic managers) on how to improve detection of poor mental health by (a) exploring the role of audiology clinic staff in detecting psychological concerns in adults with hearing loss and (b) investigating the appropriateness, acceptability, and usability of several screening tools in an audiology setting. Eleven audiology clinic staff ( M age = 33.9 ± 7.3, range: 25–51 years) participated in a semistructured focus group. First, participants discussed the role of audiology clinic staff in detecting psychological difficulties in adults with hearing loss, including current practices and needs for improving practices. Second, participants discussed the appropriateness, acceptability, and usability of nine standardized mental health screening tools commonly used in wider health care settings. Audiology clinic staff described their role in being aware of, and detecting, psychological difficulties, as well as their part in promoting an understanding of the link between hearing loss and mental health. Participants described the need to provide support following detection, and highlighted barriers to fulfilling these roles. The use of mental health screening tools was considered to be client and context specific. The language used within the screener was identified as an important factor for its acceptability by audiology clinic staff. Audiology clinic staff acknowledged that they have an important role to play in the detection of psychological difficulties and identified the core barriers to using screening tools. Future research may explore the possibility of developing a mental health screening tool specific to the unique experiences of adults with comorbid hearing loss and mental health concerns. 0.23641/asha.16702501
Publisher: Wiley
Date: 28-02-2016
DOI: 10.1111/COA.12607
Abstract: Hearing loss affects over 1.23 billion people globally. It has been proposed that hearing impairment negatively impacts on cognition. Some studies have demonstrated a faster rate of decline in cognition, and increased risk of incident all-cause dementia. This finding is not ubiquitous. This study used meta-analysis to examine the evidence-base regarding the relationship between hearing and cognition. A systematic review of the literature and meta-analyses of study findings were conducted. Published and grey literature was reviewed. Papers were included if they studied the relationship between hearing and cognition in adults with and without hearing impairment. Meta-analyses examined evidence for and against seven questions. Is cognition poorer in in iduals with normal hearing compared to (i) untreated or (ii) treated hearing impairment, is cognition associated with degree of hearing impairment in (iii) untreated and/or (iv) treated hearing, is cognition (v) different in untreated compared to treated hearing impairment, (vii) does cognition improve after intervention, and (vii) how is hearing impairment differentially associated with cognitive ability across six domains of cognition? The 33 included studies contributed 40 s les, with a total of 602 participants with untreated hearing impairment, 672 participants with treated hearing impairment, 176 healthy controls, and 4260 in iduals with a range of hearing impairment with/without treatment. The results demonstrated that cognition is significantly poorer in (i) in iduals with untreated hearing and remains poorer in (ii) treated hearing impairment compared to normal hearers. The degree of cognitive deficit is significantly associated with the degree of hearing impairment in both (iii) untreated and (iv) treated hearing impairment. Furthermore, (v) hearing intervention significantly improves cognition. Finally, (vii) hearing impairment impacted on all domains of cognition. This meta-analysis suggests that hearing impairment is associated with cognitive problems. However, due to ersity within studies, small s le sizes, the failure to control for premorbid and other health factors, this conclusion may be premature.
Publisher: American Speech Language Hearing Association
Date: 06-12-2018
Abstract: Hearing aid management describes the skills and knowledge required for the handling, use, care, and maintenance of the hearing aid. The importance of hearing aid management skills and knowledge is evidenced by their association with hearing aid outcomes. However, the nature of this association and the influence of participant factors on this association are unknown. Accordingly, the aims of the current study were to (a) investigate participant factors that influence hearing aid management skills and knowledge and (b) investigate the impact of hearing aid management skills and knowledge on hearing aid outcomes. Factors associated with hearing aid management skills and knowledge were investigated through an e-mail– and paper-based self-report survey, including the Hearing Aid Skills and Knowledge Inventory (Bennett, Meyer, Eikelboom, & Atlas, 2018b) and the International Outcomes Inventory for Hearing Aids (Cox & Alexander, 2002). The study s le included 518 adult hearing aid owners, ranging in age from 18 to 97 years ( M = 71 years, SD = 14 years), 61% male and 39% female, recruited from seven hearing clinics across Australia. Participant factors found to be associated with hearing aid skills and knowledge included participants' age, gender, style of hearing aid, age of current hearing aid, and total years of hearing aid ownership. Higher levels of hearing aid management skills and knowledge were found to be associated with better hearing aid outcomes, specifically higher self-reported satisfaction with hearing aids, perceived benefit from hearing aids, and overall outcome of the hearing aid fitting as evaluated by the International Outcomes Inventory for Hearing Aids. Hearing aid management difficulties were greatest for older people, women, and owners of behind-the-ear style of hearing aids, suggesting that clinicians need to be cognizant of the additional needs for these three groups. The positive association between hearing aid outcomes and hearing aid skills and knowledge emphasizes the importance of education and training on hearing aid management for successful aural rehabilitation.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2013
Publisher: Wiley
Date: 02-2005
DOI: 10.1097/01.MLG.0000154747.63561.52
Abstract: Manual piston malcrimping in stapedotomy may be the major cause of the occurrence of the significant, interin idual variations of postoperative air-bone gap (ABG), air-bone gap closures (ABGC), and postoperative recurrences of conductive hearing loss. To eliminate the effects of manual crimping on stapedotomy outcomes, the self-crimping, shape memory alloy Nitinol stapes piston was investigated and hearing evaluated. Prospective, preliminary case-control study in a tertiary care referral center. Sixteen patients with otosclerosis undergoing reversed stapedotomy using the Nitinol stapes piston were matched to reference patients out of our conventional titanium piston database. The effects of the self-crimping Nitinol piston on the postoperative ABGC, the postoperative air-bone gap (ABG) variations, and the postoperative short-term hearing results were investigated 3, 6 and 9 months postoperatively. These data were statistically compared with the results of the control patients in our titanium stapes piston database. The mean postoperative ABG and the interin idual variations of the postoperative ABG were significantly smaller in the Nitinol group, the extent of ABGC greater in the Nitinol piston group, but not significant. The postoperative short-term stability of ABGC was similar in both groups. No infections or adverse reactions occurred during follow-up. Our preliminary results suggest that the self-crimping shape memory alloy Nitinol stapes piston eliminates the limitations of manual malcrimping in stapedotomy, thus optimising the surgical procedure. This allows reliable, safe, and consistent air-bone-gap closure in patients with otosclerosis up to 1 year after surgery.
No related grants have been discovered for Robert Eikelboom.