Current practice, accuracy, effectiveness and cost-effectiveness of the school entry hearing screen.

PubMed

Bamford, J; Fortnum, H; Bristow, K; Smith, J; Vamvakas, G; Davies, L; Taylor, R; Watkin, P; Fonseca, S; Davis, A; Hind, S

2007-08-01

To describe and analyse in detail current practice of school entry hearing screening (SES) in the UK. Main electronic databases were searched up to May 2005. A national postal questionnaire survey was addressed to all leads for SES in the UK, considering current practice in terms of implementation, protocols, target population and performance data. Primary data from cohort studies in one area of London were examined. A systematic review of alternative SES tests, test performance and impact on outcomes was carried out. Finally, a review of published studies on costs, plus economic modelling of current and alternative programmes was prepared. The survey suggested that SES is used in most of England, Wales and Scotland; just over 10% of respondents have abandoned the screen; others are awaiting national guidance. Coverage of SES is variable, but is often over 90% for children in state schools. Referral rates are variable, with a median of about 8%. The test used for the screen is the pure tone sweep test but with wide variation in implementation, with differing frequencies, pass criteria and retest protocols; written examples of protocols were often poor and ambiguous. There is no national approach to data collection, audit and quality assurance, and there are variable approaches at local level. The screen is performed in less than ideal test conditions and resources are often limited, which has an impact on the quality of the screen. The primary cohort studies show that the prevalence of permanent childhood hearing loss continues to increase through infancy. Of the 3.47 in 1000 children with a permanent hearing loss at school screen age, 1.89 in 1000 required identification after the newborn screen. Newborn hearing screening is likely to reduce significantly the yield of SES for permanent bilateral and unilateral hearing impairments; yield had fallen from about 1.11 in 1000 before newborn screening to about 0.34 in 1000 for cohorts that had had newborn screening, of which only 0.07 in 1000 were unilateral impairments. Just under 20% of permanent moderate or greater bilateral, mild bilateral and unilateral impairments, known to services as 6-year-olds or older, remained to be identified around the time of school entry. No good-quality published comparative trials of alternative screens or tests for SES were identified and studies concerned with the relative accuracy of alternative tests are difficult to compare and often flawed by differing referral criteria and case definitions; with full pure tone audiometry as the reference test, the pure tone sweep test appears to have high sensitivity and high specificity for minimal, mild and greater hearing impairments, better than alternative tests for which evidence was identified. There is insufficient evidence regarding possible harm of the screen. There were no published studies identified that examined the possible effects of SES on longer term outcomes. No good-quality published economic evaluations of SES were identified and a universal SES based on pure tone sweep tests was associated with higher costs and slightly higher quality-adjusted life-years (QALYs) compared with no screen and other screen alternatives; the incremental cost-effectiveness ratio for such a screen is around 2500 pounds per QALY gained; the range of expected costs, QALYs and net benefits was broad, indicating a considerable degree of uncertainty. Targeted screening could be more cost-effective than universal school entry screening; however, the lack of primary data and the wide limits for variables in the modelling mean that any conclusions must be considered indicative and exploratory only. A national screening programme for permanent hearing impairment at school entry meets all but three of the criteria for a screening programme, but at least six criteria are not met for screening for temporary hearing impairment. The lack of good-quality evidence in this area remains a serious problem. Services should improve quality and audit screen performance for identification of previously unknown permanent hearing impairment, pending evidence-based policy decisions based on the research recommendations. Further research is needed into a number of important areas including the evaluation of an agreed national protocol for services delivering SES to make future studies and audits of screen performance more directly comparable.

Perceptions of public primary school teachers regarding noise-induced hearing loss in South Africa

PubMed Central

2017-01-01

Background Noise-induced hearing loss (NIHL) is an increasingly growing problem in young children. This is attributed to recreational noise being the most common cause of this problem. In young children, hearing problems can delay language development and reduce academic achievements. South Africa, in particular, has limited information and protective measures regarding the conservation of hearing in school-aged children. Objectives The main aim of the study was to determine the perception of primary school teachers regarding NIHL. The study also aimed to determine if any hearing conservation programmes are being implemented in schools and the need for training of primary school teachers regarding NIHL. Method A survey was conducted. In order to cover the population of interest, the sampled schools in Pretoria were clustered into urban, semi-urban and rural areas. Results The majority of the teachers included in this study are aware of NIHL and its effects. They, however, lack the necessary resources and knowledge to effectively use this information. Most (67.5%) of the teachers indicated that they have never been exposed to children with NIHL in a school setting. It was also found that the majority (84%) of the schools included in the study do not implement hearing screening and conservation programmes. Conclusion Although the sample size was limited, the results correlate with other research in this field indicating a need for planning and implementation of hearing conservation programmes in schools, including training of teachers in order for these programmes to be effective. PMID:28397520

Congenital hearing loss

PubMed Central

Korver, Anna M. H.; Smith, Richard J. H.; Van Camp, Guy; Schleiss, Mark R.; Bitner-Glindzicz, Maria A. K.; Lustig, Lawrence R.; Usami, Shin-ichi; Boudewyns, An N.

2017-01-01

Congenital hearing loss (hearing loss present at birth) is one of the most prevalent chronic conditions in children. In the majority of developed countries, neonatal hearing-screening programmes enable early detection; early intervention will prevent delays in speech and language development and have long-lasting beneficial effects on social and emotional development and quality of life. A hearing loss diagnosis is usually followed by a search for an underlying aetiology. Congenital hearing loss might be attributed to environmental and prenatal factors, which prevail in low-income settings; congenital infections, particularly cytomegalovirus, are also a common risk factor for hearing loss. Genetic causes probably account for the majority of cases in developed countries; mutations can affect any component of the hearing pathway, in particular inner ear homeostasis (endolymph production and maintenance) and mechano-electrical transduction (conversion of a mechanical stimulus into electrochemical activity). Once the underlying cause of hearing loss is established, it might direct therapeutic decision-making and guide prevention and (genetic) counseling. Management options include specific antimicrobial therapies, surgical treatment of cranio-facial abnormalities and hearing aids. An improved understanding of the pathophysiology and molecular mechanisms underlying hearing loss and increased awareness of recent advances in genetic testing will promote the development of new treatment and screening strategies. PMID:28079113

[Incidence of hypoacusia secondary to hyperbilirubinaemia in a universal neonatal auditory screening programme based on otoacoustic emissions and evoked auditory potentials].

PubMed

Núñez-Batalla, Faustino; Carro-Fernández, Pilar; Antuña-León, María Eva; González-Trelles, Teresa

2008-03-01

Hyperbilirubinaemia is a neonatal risk factor that has been proved to be associated with sensorineural hearing loss. A high concentration of unconjugated bilirubin place newborn children at risk of suffering toxic effects, including hypoacusia. Review of the newborn screening results with a diagnosis of pathological hyperbilirubinaemia as part of a hearing-loss early detection protocol in the general population based on otoemissions and evoked potentials. Retrospective study of 21 590 newborn children screened between 2002 and 2006. The selection criteria for defining pathological hyperbilirubinaemia were bilirubin concentrations in excess of 14 mg/dL in pre-term infants and 20 mg/dL in full-term babies. The Universal Neonatal Hearing Screening Programme is a two-phase protocol in which all children are initially subjected to a transient otoacoustic emissions test (TOAE). Children presenting risk factors associated with auditory neuropathy were always given brainstem auditory evoked potentials (BAEP). The patients identified as having severe hyperbilirubinaemia in the neonatal period numbered 109 (0.5 %) and 96 of these (88.07 %) passed the otoacoustic emissions test at the first attempt and 13 (11.93 %) did not; 11 of the 13 children in whom the otoacoustic emissions test was repeated passed it successfully. The 2 children who failed to pass the otoacoustic emissions test has normal BAEP results; 3 (2.75 %) of the newborn infants who passed the TOAE test did not pass the BAEP. Hyperbilirubinaemia values previously considered safe may harm the hearing system and give rise to isolated problems in auditory processing without being associated with other signs of classical kernicterus. Our results show that hyperbilirubinaemia-related auditory neuropathy reveals changes over time in the audiometric outcomes.

Six year effectiveness of a population based two tier infant hearing screening programme.

PubMed

Russ, S A; Rickards, F; Poulakis, Z; Barker, M; Saunders, K; Wake, M

2002-04-01

To determine whether a two tier universal infant hearing screening programme (population based risk factor ascertainment and universal distraction testing) lowered median age of diagnosis of bilateral congenital hearing impairment (CHI) >40 dB HL in Victoria, Australia. Comparison of whole population birth cohorts pre and post introduction of the Victorian Infant Hearing Screening Program (VIHSP). All babies surviving the neonatal period born in Victoria in 1989 (pre-VIHSP) and 1993 (post-VIHSP) were studied. (1) Pre-1992: distraction test at 7-9 months. (2) Post-1992: infants with risk factors for CHI referred for auditory brain stem evoked response (ABR) assessment; all others screened by modified distraction test at 7-9 months. Of the 1989 cohort (n = 63 454), 1.65/1000 were fitted with hearing aids for CHI by end 1995, compared with 2.09/1000 of the 1993 cohort (n = 64 116) by end 1999. Of these, 79 cases from the 1989 cohort (1.24/1000) and 72 cases from the 1993 cohort (1.12/1000) had CHI >40 dB HL. Median age at diagnosis of CHI >40 dB HL for the 1989 birth cohort was 20.3 months, and for the 1993 cohort was 14.2 months. Median age at diagnosis fell significantly for severe CHI but not for moderate or profound CHI. Significantly more babies with CHI >40 dB HL were diagnosed by 6 months of age in 1993 than in 1989 (21.7% v 6.3%). Compared to the six years pre-VIHSP, numbers aided by six months were consistently higher in the six years post-VIHSP (1.05 per 100 000 births versus 13.4 per 100 000 births per year). VIHSP resulted in very early diagnosis for more infants and lowered median age of diagnosis of severe CHI. However, overall results were disappointing.

Six year effectiveness of a population based two tier infant hearing screening programme

PubMed Central

Russ, S; Rickards, F; Poulakis, Z; Barker, M; Saunders, K; Wake, M

2002-01-01

Aims: To determine whether a two tier universal infant hearing screening programme (population based risk factor ascertainment and universal distraction testing) lowered median age of diagnosis of bilateral congenital hearing impairment (CHI) >40 dB HL in Victoria, Australia. Methods: Comparison of whole population birth cohorts pre and post introduction of the Victorian Infant Hearing Screening Program (VIHSP). All babies surviving the neonatal period born in Victoria in 1989 (pre-VIHSP) and 1993 (post-VIHSP) were studied. (1) Pre-1992: distraction test at 7–9 months. (2) Post-1992: infants with risk factors for CHI referred for auditory brain stem evoked response (ABR) assessment; all others screened by modified distraction test at 7–9 months. Results: Of the 1989 cohort (n = 63 454), 1.65/1000 were fitted with hearing aids for CHI by end 1995, compared with 2.09/1000 of the 1993 cohort (n = 64 116) by end 1999. Of these, 79 cases from the 1989 cohort (1.24/1000) and 72 cases from the 1993 cohort (1.12/1000) had CHI >40 dB HL. Median age at diagnosis of CHI >40 dB HL for the 1989 birth cohort was 20.3 months, and for the 1993 cohort was 14.2 months. Median age at diagnosis fell significantly for severe CHI but not for moderate or profound CHI. Significantly more babies with CHI >40 dB HL were diagnosed by 6 months of age in 1993 than in 1989 (21.7% v 6.3%). Compared to the six years pre-VIHSP, numbers aided by six months were consistently higher in the six years post-VIHSP (1.05 per 100 000 births versus 13.4 per 100 000 births per year). Conclusions: VIHSP resulted in very early diagnosis for more infants and lowered median age of diagnosis of severe CHI. However, overall results were disappointing. PMID:11919095

The challenges of starting a cochlear implant programme in a developing country.

PubMed

Krishnamoorthy, Kumaresh; Samy, Ravi N; Shoman, Nael

2014-10-01

Deafness is indeed a silent disability in many parts of the world, and the majority of people who have hearing impairment live in developing countries. With rising economy and developing nations becoming hub of industrialization, hearing loss may increase in these countries. In this review, the authors have elected to focus the discussion on India to frame the challenges of cochlear implants in a developing country. This article reviews the common causes of hearing loss, the challenges faced by those with hearing impairment and why the penetration of these devices is low and also reviews some reasons for the inability of the government to support the implant programme in India. Early identification of hearing is crucial towards ensuring appropriate hearing rehabilitation; it is, however, challenged by various factors, including public awareness, absence of a national new born screening programme, accessibility to diagnostic centres, availability of trained personnel and equipment and patient affordability. Cochlear implants are a proven auditory rehabilitative option for individuals with severe to profound sensorineural hearing loss, who otherwise do not benefiting from hearing aids. Nevertheless, only a small percentage of these individuals receive cochlear implants, and cost remains a leading prohibitive factor, particularly in developing countries. For example, in India, the personal average annual income is well below US $2000, whereas these devices cost between $12,000 and $25,000, exclusive of hospital and staff fees. Hence, the technology is virtually unavailable to the masses. To overcome the cost limitation of those who would benefit from cochlear implants countries such as India and China have started to develop their own indigenous implants.

Hearing loss in children with very low birth weight: current review of epidemiology and pathophysiology

PubMed Central

Cristobal, R; Oghalai, J S

2013-01-01

An association between birth weight <1500 g (very low birth weight (VLBW)) and hearing loss has been long recognised. As universal hearing screening programmes have become widely implemented and the survival rate of VLBW babies in modern intensive care units has increased, we have gained a substantially better understanding of the nature of this problem. However, many gaps in our knowledge base exist. This review describes recent data on hearing loss in the VLBW population and explains the current level of understanding about the physiological basis underlying the auditory deficits in these patients. Although VLBW alone may not have a severe impact on hearing, it is commonly associated with multiple other risk factors that can alter hearing in a synergistic fashion. Therefore, the risk of hearing loss is substantially higher than in the general newborn population. Also, it is important to perform a more comprehensive audiometric evaluation than standard otoacoustic emission screening for infants who are in the neonatal intensive care unit in order not to miss hearing loss due to retrocochlear pathology. Furthermore, children with VLBW are also at increased risk of experiencing progressive or delayed-onset hearing loss, and thus should continue to have serial hearing evaluations after discharge from the neonatal intensive care unit. PMID:18941031

Socio-demographic determinants of hearing impairment studied in 103,835 term babies.

PubMed

Van Kerschaver, Erwin; Boudewyns, An N; Declau, Frank; Van de Heyning, Paul H; Wuyts, Floris L

2013-02-01

Serious hearing problems appear in approximately one in 1000 newborns. In 2000, the Joint Committee on Infant Hearing defined a list of risk factors for neonatal hearing impairment relating to health, physical characteristics and family history. The aim of this study is to determine which personal, environmental and social factors are associated with the prevalence of congenital hearing impairment (CHI). The entire population of 103,835 term newborns in Flanders, Belgium, was tested by a universal neonatal hearing screening (UNHS) programme using automated auditory brainstem responses (AABR). In the case of a positive result, a CHI diagnosis was verified in specialized referral centres. Socio-demographic risk factors were investigated across the entire population to study any relationship with CHI. The prevalence of bilateral CHI of 35 dB nHL (normal hearing level) or more was 0.87/1000 newborns. The sensitivity and specificity of the screening test were 94.02 and 99.96%, respectively. The socio-demographic factors of gender, birth order, birth length, feeding type, level of education and origin of the mother were found to be independent predictors of CHI. The socio-demographic factors found to be associated with CHI extend the list of classic risk factors as defined by the American Academy of Pediatrics (AAP). Assessment of these additional factors may alert the treating physician to the increased risk of newborn hearing impairment and urge the need for accurate follow-up. Moreover, this extended assessment may improve decision making in medical practice and screening policy.

An analysis of the costs of implementing the National Newborn Hearing Screening Programme in England.

PubMed

Uus, K; Bamford, J; Taylor, R

2006-01-01

The primary aim of this analysis was to prospectively assess the full economic costs associated with implementing Newborn Hearing Screening Programme (NHSP) based on a two-stage screen, transient evoked otoacoustic emissions followed, if there is no clear response, by automated auditory brainstem response. Economic data were also collected from the Infant Distraction Test Screening (IDTS) service performed by health visitors at around eight months of age, which was being phased out. A comparison of costs and outcomes associated with NHSP and IDTS was conducted. 20 NHSP sites were invited to provide detailed cost data on NHSP implementation and 14 of these sites were selected to provide costs on the IDTS service that was being supplanted. There was marked variability in the costs. Given the higher yield of NHSP sites, the average cost per case detected across NHSP sites (31,410 pounds/case) was approximately half that of IDTS sites (69,919 pounds/case). Including family costs, the average total cost per case of NHSP (34,826 pounds/case) was almost a quarter of IDTS (117,942 pounds/case). Family costs and cost per case associated with NHSP are considerably less than that with IDTS. These findings support the policy of implementation of NHSP and the phasing out of the IDTS.

Maternal and neonatal factors associated with mode of delivery under a universal newborn hearing screening programme in Lagos, Nigeria

PubMed Central

Olusanya, Bolajoko O; Solanke, Olumuyiwa A

2009-01-01

Background Emerging evidence from a recent pilot universal newborn hearing screening (UNHS) programme suggests that the burden of obstetric complications associated with mode of delivery is not limited to maternal and perinatal mortality but may also include outcomes that undermine optimal early childhood development of the surviving newborns. However, the potential pathways for this association have not been reported particularly in the context of a resource-poor setting. This study therefore set out to establish the pattern of delivery and the associated neonatal outcomes under a UNHS programme. Methods A cross-sectional study in which all consenting mothers who delivered in an inner-city tertiary maternity hospital in Lagos, Nigeria from May 2005 to December 2007 were enrolled during the UNHS programme. Socio-demographic, obstetric and neonatal factors independently associated with vaginal, elective and emergency caesarean deliveries were determined using multinomial logistic regression analyses. Results Of the 4615 mothers enrolled, 2584 (56.0%) deliveries were vaginal, 1590 (34.4%) emergency caesarean and 441 (9.6%) elective caesarean section. Maternal age, parity, social class and all obstetric factors including lack of antenatal care, maternal HIV and multiple gestations were associated with increased risk of emergency caesarean delivery compared with vaginal delivery. Only parity, lack of antenatal care and prolonged/obstructed labour were associated with increased risk of emergency compared with elective caesarean delivery. Infants delivered by vaginal method or by emergency caesarean section were more likely to be associated with the risk of sensorineural hearing loss but less likely to be associated with hyperbilirubinaemia compared with infants delivered by elective caesarean section. Emergency caesarean delivery was also associated with male gender, low five-minute Apgar scores and admission into special care baby unit compared with vaginal or elective caesarean delivery. Conclusions The vast majority of caesarean delivery in this population occur as emergencies and are associated with socio-demographic factors as well as several obstetric complications. Mode of delivery is also associated with the risk of sensorineural hearing loss and other adverse birth outcomes that lie on the causal pathways for potential developmental deficits. PMID:19732443

Barriers to timely diagnosis and treatment for children with hearing impairment in a southern Indian city: a qualitative study of parents and clinic staff.

PubMed

Merugumala, Sri Vamshi; Pothula, Vijay; Cooper, Max

2017-10-01

In low income countries, deaf children are identified late due to the absence of a universal screening. Hearing impairment is a common yet neglected disability in India that leads to loss of speech and language. This qualitative study explored barriers to accessing appropriate hearing services in one city in southern India. To identify the barriers in timely management of deafness, 25 semi-structured interviews were conducted. Data were examined using Applied Thematic Analysis. Seventeen mothers of deaf children, primarily from low socioeconomic backgrounds, and eight staff members at a charitable hearing centre in Hyderabad. Barriers to accessing hearing services included failure to recognise deafness, the dominant role of elders in household decisions, belief that deafness would resolve, reassurance from a child's overall good health, lack of funds and transportation barriers to reach the centre particularly from rural areas. Parents frequently learned about services through word of mouth. The challenges to accessing appropriate services for deafness operate prior to presentation and include educational, cultural, navigational and financial barriers especially for those of lower socioeconomic status and residents of rural areas. The findings highlighted the need to raise awareness and implement wider screening programmes for early interventions.

How to motivate newborn hearing screening in the absence of a national programme: a collaboration between parents and professionals.

PubMed

Cutler, Jodi; Lenzi, Giovanni; Berrettini, Stefano; Martini, Alessandro; Martinelli, Stefano

2012-10-01

The establishment of the Italian Pediatric Federation Newborn Hearing Screening Network and the Italian Society of Neonatology Infant Hearing Study Group is the result of an international collaboration between Parents and Medical Professionals in order to promote an effective model in developing Early Hearing Detection Intervention Programs that recognize the role of parents as partners in the process. Among other factors, one important component frequently underestimated in most early intervention programs, both in the USA and other countries, involves the role of parental involvement within the Early Hearing Detection Intervention (EHDI) process. When a parent receives the news of their child's hearing loss, reactions may include, but are not limited to denial, grief, guilt, shame, fear and impotency. A parent may begin to ask certain questions: How do we know if the professionals in our children's lives are capable, educated, trained, up to date in their chosen fields of expertise? Do they respect our children and us as parents? Do they understand the needs of children who are deaf or hard of hearing? A life-long health professional - parental collaboration begins at the moment of the diagnosis of that child. When analyzing the habilitation process of a deaf child, the relationship between health professionals and the crucial role of parents in raising that child is a 50-50 shared responsibility. An objective of EHDI programs must be to empower parents by providing support from the beginning of the process. Distributing informative literature regarding the newborn hearing screening process and providing parents with access to resources such as parental support groups upon diagnosis equips parents with the tools necessary to immediately begin advocating for their children. The Italian Federation Pediatric Audiology Network was created by combining the parental perspective and medical protocols in order to establish the roots for stronger EHDI programs.

[Auditory rehabilitation programmes for adults: what do we know about their effectiveness?].

PubMed

Cardemil, Felipe; Aguayo, Lorena; Fuente, Adrian

2014-01-01

Hearing loss ranks third among the health conditions that involve disability-adjusted life years. Hearing aids are the most commonly used treatment option in people with hearing loss. However, a number of auditory rehabilitation programmes have been developed with the aim of improving communicative abilities in people with hearing loss. The objective of this review was to determine the effectiveness of auditory rehabilitation programmes focused on communication strategies. This was a narrative revision. A literature search using PUBMED was carried out. This search included systematic reviews investigating the effectiveness of auditory training and individual and group auditory rehabilitation programmes with the main focus on counselling and communicative strategies for adults with hearing loss. Each study was analysed in terms of the type of intervention used and the results obtained. Three articles were identified: one article about the effectiveness of auditory training programmes and 2 systematic reviews that investigated the effectiveness of communicative programmes in adults with hearing loss. The "Active Communication Education" programme appears to be an effective group programme of auditory rehabilitation that may be used with older Spanish-speaking adults. The utility of hearing aid fitting and communicative programmes as rehabilitation options are associated with improvements in social participation and quality of life in patients with hearing loss, especially group auditory rehabilitation programmes, which seem to have good potential for reducing activity limitations and social participation restrictions, and thus for improving patient quality of life. Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

PubMed Central

GIUNTINI, G.; NICASTRO, R.; CIABOTTI, A.; BRUSCHINI, L.; BERRETTINI, S.

2016-01-01

SUMMARY The implementation of regional protocols for newborn hearing screening and early audiologic diagnosis represent the first step of the entire diagnostic, rehabilitative and prosthetic programme for children with permanent hearing impairment. The maximum benefit of early diagnosis can indeed be obtained only by prompt rehabilitation aimed at fostering the child's communicative, linguistic and cognitive development. Within the framework of the CMM 2013 project of the Ministry of Health entitled "Preventing Communication Disorders: a Regional Program for Early Identification, Intervention and Care of Hearing Impaired Children", the problems concerning the promotion of the global development of children with PHI throughan early rehabilitation project based on shared knowledge and scientific evidence. In this project, our specific aim was to define the features and modes of access to a precise and specialised rehabilitation project for the small hearing-impaired child within three months from audiologic diagnosis. Three main recommendations relative to assessment and rehabilitation aspects of early care emerged from the study. PMID:27054391

PubMed Central

GALLUS, R.; DE CARLINI, M.; PICCIOTTI, P.M.; MUZZI, E.; CICIRIELLO, E.; ORZAN, E.; CONTI, G.

2016-01-01

SUMMARY Diagnosis of child permanent hearing impairment (PHI) can be made with extreme timeliness compared to the past thanks to improvements in PHI identification through newborn hearing screening programmes. It now becomes essential to provide an effective amplification as quickly as possible in order to restore auditory function and favour speech and language development. The early fitting of hearing aids and possible later cochlear implantation indeed prompts the development of central auditory pathways, connections with secondary sensory brain areas, as well as with motor and articulatory cortex. The aim of this paper is to report the results of a strategic analysis that involves identification of strengths, weaknesses, opportunities and threats regarding the process of achieving early amplification in all cases of significant childhood PHI. The analysis is focused on the Italian situation and is part of the Italian Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for Early Identification, Intervention and Care of Hearing Impaired Children". PMID:27054389

Achieving effective hearing aid fitting within one month after identification of childhood permanent hearing impairment.

PubMed

Bastanza, G; Gallus, R; De Carlini, M; Picciotti, P M; Muzzi, E; Ciciriello, E; Orzan, E; Conti, G

2016-02-01

Diagnosis of child permanent hearing impairment (PHI) can be made with extreme timeliness compared to the past thanks to improvements in PHI identification through newborn hearing screening programmes. It now becomes essential to provide an effective amplification as quickly as possible in order to restore auditory function and favour speech and language development. The early fitting of hearing aids and possible later cochlear implantation indeed prompts the development of central auditory pathways, connections with secondary sensory brain areas, as well as with motor and articulatory cortex. The aim of this paper is to report the results of a strategic analysis that involves identification of strengths, weaknesses, opportunities and threats regarding the process of achieving early amplification in all cases of significant childhood PHI. The analysis is focused on the Italian situation and is part of the Italian Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for Early Identification, Intervention and Care of Hearing Impaired Children". © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale.

Clinical Validity of hearScreen™ Smartphone Hearing Screening for School Children.

PubMed

Mahomed-Asmail, Faheema; Swanepoel, De Wet; Eikelboom, Robert H; Myburgh, Hermanus C; Hall, James

2016-01-01

The study aimed to determine the validity of a smartphone hearing screening technology (hearScreen™) compared with conventional screening audiometry in terms of (1) sensitivity and specificity, (2) referral rate, and (3) test time. One thousand and seventy school-age children in grades 1 to 3 (8 ± 1.1 average years) were recruited from five public schools. Children were screened twice, once using conventional audiometry and once with the smartphone hearing screening. Screening was conducted in a counterbalanced sequence, alternating initial screen between conventional or smartphone hearing screening. No statistically significant difference in performance between techniques was noted, with smartphone screening demonstrating equivalent sensitivity (75.0%) and specificity (98.5%) to conventional screening audiometry. While referral rates were lower with the smartphone screening (3.2 vs. 4.6%), it was not significantly different (p > 0.05). Smartphone screening (hearScreen™) was 12.3% faster than conventional screening. Smartphone hearing screening using the hearScreen™ application is accurate and time efficient.

Muenster Parental Programme empowers parents in communicating with their infant with hearing loss.

PubMed

Glanemann, Reinhild; Reichmuth, Karen; Matulat, Peter; Zehnhoff-Dinnesen, Antoinette Am

2013-12-01

With the implementation of the Universal Newborn Hearing Screening (UNHS), the age of diagnosis of children with hearing loss (HL) has been steadily declining in the past years. Consequently, there is a need for early educational intervention methods that are suitable for infants at the preverbal level. To meet this need we have developed and evaluated the Muenster Parental Programme (MPP), a responsive parenting programme for parents of children with HL aged 3-18 months. It aims at enhancing the parents' communicative skills towards their child. The MPP is introduced following confirmation of a HL. Flanked by two individual counselling sessions, the programme comprises six group sessions and two single training sessions with video feedback. The focus of the programme lies in enhancing parents' responsive behaviour and in reducing inappropriate initiative behaviour. The present study involved 29 parents of 24 children aged 6.6 (mean, range: 3-12) months at the outset of the MPP. The children's degree of HL ranged from moderate to profound. Parents of children with unilateral HL and/or risk for an additional developmental delay were included. The prospective study compared parent communication skills of a trained (N = 15) versus a control group (N = 14) before and after the MPP. For this purpose, instances of responsive behaviour to the signals of the child and total time of initiative behaviour within a 4-min video-sample were measured before and after completion of the study in both groups. Trained parents could enhance their responsiveness to vocal and preverbal signals of the child (Wilcoxon test, p = .002) and also their responsiveness to non-verbal signals (Wilcoxon test, p < .001). Moreover, parents reduced their inappropriate initiative behaviour (related t-test, p < .001). Pre-post comparisons in the control group were non-significant. The increased parental responsiveness to infants with HL is of great importance as these early behaviours underlie later acquisition of speech, language, hearing and social communication skills. The MPP constitutes the first evaluated group concept for parents of infants with HL in the German-speaking countries and equally meets the needs of parents and professionals. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

The HI HOPES data set of deaf children under the age of 6 in South Africa: maternal suspicion, age of identification and newborn hearing screening.

PubMed

Störbeck, Claudine; Young, Alys

2016-03-22

Identification of deafness before 3 months of age substantially improves the socio-linguistic and cognitive development of deaf children. Existing studies demonstrating the feasibility of newborn hearing screening in South Africa have used small samples unrepresentative of general population characteristics. This study establishes the characteristics of the largest data set of deaf infants and their families in South Africa on which there is baseline and longitudinal data (n = 532); explores its representativeness in terms of socio-demographic features and reports on access to and quality of newborn hearing screening within the sample. It examines specifically the relationship between age of maternal suspicion of childhood deafness and age of identification of deafness by cohort characteristics. Secondary analysis, using descriptive and inferential statistics, of a pre-existing longitudinal data set (n = 532) of deaf infants under 6 years of age, and their families, collected as routine monitoring of the HI HOPES (HH) early intervention programme. The HH cohort is representative in terms of racial profile and private/public health care use but displays slightly higher level of maternal education and slightly lower socio-economic status than national comparators. 102 out of 532 infants had undergone newborn hearing screening, resulting in 29 true positives, 15 of whom would have met the criteria for targeted screening. Later onset deafness does not account for the 73 false negatives. The median age of maternal suspicion (n = 247) of infant deafness was 18 months; the median age of identification of 28 months. Age of identification was unrelated to private/public health care status. The median delay between age of suspicion and age of identification was significantly longer in the public sector (7 m; IQR 0-15 m) compared to the private sector (2 m; IQR 0-8.5 m) (p = 0.035). Age of suspicion was unrelated to level of maternal education. Earlier age of suspicion did not predict earlier identification. Targeted screening as timely response to maternal suspicion offers a viable means to reduce substantially the age of identification of deafness in South Africa until implementation of newborn hearing screening on a population-wide basis can be justified.

Evaluation of very low birth weight (≤ 1,500 g) as a risk indicator for sensorineural hearing loss.

PubMed

Borkoski-Barreiro, Silvia A; Falcón-González, Juan C; Limiñana-Cañal, José M; Ramos-Macías, Angel

2013-01-01

Hearing plays an essential role in the acquisition, development and maintenance of the properties of the speech and language. Birth weight is an indicator of biological maturation of the newborn. Premature newborns with very low birth weight (VLBW<1,500 g) constitute a group with the highest risk of sensorineural hearing loss. Our objective was to ascertain the degree of hearing loss, sensorineural hearing loss and presence of the association to other risk factors for hearing loss in VLBW infants included in the Universal Hearing Loss Screening Programme at the University Mother-Child Hospital of Gran Canaria (Spain) in the 2007-2010 period. This was a retrospective study of 364 infants with VLBW, measured by transient evoked otoacoustic emissions and auditory brainstem response. There were 112 newborn (30.8%) referred for auditory brainstem response. A diagnosis of hearing loss was given to 22 newborns (2.2%), 14 had conductive hearing loss and 8, sensorineural hearing loss (SNHL), of which 2 had bilateral profound hearing loss. The VLBW newborn presented the association to another risk factor in more than a quarter of the sample studied. All those diagnosed with SNHL were premature. The percentage of VLBW newborns diagnosed with hearing loss is higher than expected in the general population. All those diagnosed with SNHL were premature and presented one or 2 hearing risk factors associated with VLBW. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Smartphone-Based Hearing Screening in Noisy Environments

PubMed Central

Na, Youngmin; Joo, Hyo Sung; Yang, Hyejin; Kang, Soojin; Hong, Sung Hwa; Woo, Jihwan

2014-01-01

It is important and recommended to detect hearing loss as soon as possible. If it is found early, proper treatment may help improve hearing and reduce the negative consequences of hearing loss. In this study, we developed smartphone-based hearing screening methods that can ubiquitously test hearing. However, environmental noise generally results in the loss of ear sensitivity, which causes a hearing threshold shift (HTS). To overcome this limitation in the hearing screening location, we developed a correction algorithm to reduce the HTS effect. A built-in microphone and headphone were calibrated to provide the standard units of measure. The HTSs in the presence of either white or babble noise were systematically investigated to determine the mean HTS as a function of noise level. When the hearing screening application runs, the smartphone automatically measures the environmental noise and provides the HTS value to correct the hearing threshold. A comparison to pure tone audiometry shows that this hearing screening method in the presence of noise could closely estimate the hearing threshold. We expect that the proposed ubiquitous hearing test method could be used as a simple hearing screening tool and could alert the user if they suffer from hearing loss. PMID:24926692

Screening for hearing loss versus parental concern regarding hearing problems: Subsequent referral and treatment for otitis media in the Netherlands

PubMed Central

Lok, Willeke; Anteunis, Lucien J. C.; Chenault, Michelene N.; Meesters, Cor; Haggard, Mark P.

2012-01-01

Objective The present study investigates whether general practitioner (GP) consultation initiated by failing the population hearing screening at age nine months or GP consultation because of parental concern over ear/hearing problems was more important in deciding on referral and/or surgical treatment of otitis media (OM). Design A questionnaire covering the history between birth and 21 months of age was used to obtain information on referral after failing the hearing screening, GP consultations for ear/hearing problems, and subsequent referral to a specialist and possible surgical treatment at an ENT department. Setting The province of Limburg, the Netherlands. Subjects Healthy infants invited for the hearing screening at age nine months, who responded in an earlier study called PEPPER (Persistent Ear Problems, Providing Evidence for Referral, response rate 58%). Main outcome measures The odds of a child being surgically treated for OM. Results The response rate for the present questionnaire was 72%. Of all children tested, 3.9% failed the hearing screening and were referred to their GP. Of all 2619 children in this study, 18.6% visited their GP with ear/hearing problems. Children failing the hearing screening without GP consultation for ear/hearing problems were significantly more often treated surgically for OM than children passing the hearing screening but with GP consultation for ear/hearing problems. Conclusion Objectified hearing loss, i.e. failing the hearing screening, was important in the decision for surgical treatment in infants in the Netherlands. PMID:22794165

Assessment of the efficacy of a hearing screening program for college students.

PubMed

Taylor, Emily J; Emanuel, Diana C

2013-01-01

The Towson University (TU) Speech-Language-Hearing Center (SLHC) conducts annual hearing screenings for college students entering education or health-care professions. Hearing is screened in therapy rooms, and students who fail the screening are rescreened in a sound-treated booth. Students who fail the rescreening are referred for a comprehensive audiological assessment, which is offered at no cost to students at the SLHC. The purpose of this study was to examine the efficacy of the hearing screening program, to report trends in hearing screening statistics for the college student population, and to make recommendations regarding ways universities can optimize hearing screening programs. The study included retrospective and prospective portions. Hearing screening records were reviewed from 1999 to 2011. The prospective study involved recruiting students to participate in diagnostic testing following the hearing screening and measuring background noise levels in the therapy rooms. Hearing screening records from 1999 to 2011 were reviewed. In addition, during the three-day fall 2011 hearing screenings, 80 students were selected to participate in diagnostic testing. Data from the retrospective review were used to determine positive predictive value (PPV) between screening and rescreening. Return rates were also examined. For the prospective study, pure tone threshold results were compared to screening results to determine sensitivity, specificity, and PPV. The retrospective file review indicated that the hearing screening in the therapy room had poor PPV compared with the rescreening in the sound booth. Specifically, if a student failed the screening, they had only a 49% chance of failing the rescreening. This may have been due to background noise, as the prospective study found noise levels were higher than allowed by American National Standards Institute (ANSI) standard. Only a third of students referred for diagnostic testing from 1999 to 2010 returned for recommended diagnostic testing. For the prospective study, specificity and sensitivity were good when considering hearing loss present at the same frequencies as those screened (1000, 2000, 4000 Hz) but poor in comparison to hearing loss overall. The screening missed many students with a high frequency notch, which was most prevalent at 6000 Hz. The prevalence of a high frequency notch was 21 and 51%, using two different criteria for establishing the presence of a notch. If college hearing screenings are conducted in rooms that are not sound treated, poor PPV should be expected; thus, an immediate second stage rescreening for failures should be conducted in a sound booth. Hearing screenings limited to 1000, 2000, and 4000 Hz will miss many cases of hearing loss in the college-age population. College hearing screening program directors should carefully consider the purpose of the screening and adjust screening protocol, such as adding 6000 Hz and a question about noise exposure, in order to identify early signs of noise-induced hearing loss in college students. Programs should focus on ways to promote high return for follow-up rates. Estimates of prevalence of a high-frequency audiometric notch are highly dependent on the criteria used to define a notch. American Academy of Audiology.

An ecological approach to hearing-health promotion in workplaces.

PubMed

Reddy, Ravi; Welch, David; Ameratunga, Shanthi; Thorne, Peter

2017-05-01

To develop and assess use, acceptability and feasibility of an ecological hearing conservation programme for workplaces. A school-based public health hearing preservation education programme (Dangerous Decibels®) was adapted for workplaces using the Multi-level Approach to Community Health (MATCH) Model. The programme was delivered in small manufacturing companies and evaluated using a questionnaire before the training and at one week and two-months after training. Workers (n = 56) from five small manufacturing companies were recruited. There was a significant improvement in knowledge, attitudes and behaviour of workers at the intrapersonal level; in behaviour motivation and safety culture at the interpersonal and organisational levels; and an overall improvement in hearing-health behaviour after two months post-intervention. The developed programme offers a simple, interactive and theory-based intervention that is well accepted and effective in promoting positive hearing-health behaviour in workplaces.

A comparison of an audiometric screening survey with an in-depth research questionnaire for hearing loss and hearing loss risk factors

PubMed Central

Mosites, Emily; Neitzel, Richard; Galusha, Deron; Trufan, Sally; Dixon-Ernst, Christine; Rabinowitz, Peter

2017-01-01

Objective We assessed the reliability of a hearing risk factor screening survey used by hearing conservation programs for noise-exposed workers. Design We compared workers’ answers from the screening survey to their answers to a confidential research questionnaire regarding hearing loss risk factors. We calculated kappa statistics to test the correlation between yes/no questions in the research questionnaire compared to answers from one and five years of screening surveys. Study Sample We compared the screening survey and research questionnaire answers of 274 aluminum plant workers. Results Most of the questions in the in-company screening survey showed fair to moderate agreement with the research questionnaire (kappa range: −0.02, 0.57). Workers’ answers to the screening survey had better correlation with the research questionnaire when we compared five years of screening answers. For nearly all questions, workers were more likely to respond affirmatively on the research questionnaire than the screening survey. Conclusions Hearing conservation programs should be aware that workers may underreport hearing loss risk factors and functional hearing status on an audiometric screening survey. Validating company screening tools could help provide more accurate information on hearing loss and risk factors. PMID:27609310

Distortion product otoacoustic emissions: comparison of sequential vs. simultaneous presentation of primary tones.

PubMed

Kumar, U Ajith; Maruthy, Sandeep; Chandrakant, Vishwakarma

2009-03-01

Distortion product otoacoustic emissions are one form of evoked otoacoustic emissions. DPOAEs provide the frequency specific information about the hearing status in mid and high frequency regions. But in most screening protocols TEOAEs are preferred as it requires less time compared to DPOAE. This is because, in DPOAE each stimulus is presented one after the other and responses are analyzed. Grason and Stadler Incorporation 60 (GSI-60) offer simultaneous presentation of four sets of primary tones at a time and checks for the DPOAE. In this mode of presentation, all the pairs are presented at a time and following that response is extracted separately whereas, in sequential mode primaries are presented in orderly fashion one after the other. In this article simultaneous and sequential protocols were used to compare the Distortion product otoacoustic emission amplitude, noise floor and administration time in individuals with normal hearing and mild sensori-neural (SN) hearing loss. In simultaneous protocols four sets of primary tones (i.e. 8 tones) were presented together whereas, in sequential presentation mode one set of primary tones was presented each time. Simultaneous protocol was completed in less than half the time required for the completion of sequential protocol. Two techniques yielded similar results at frequencies above 1000 Hz only in normal hearing group. In SN hearing loss group simultaneous presentation yielded signifi cantly higher noise floors and distortion product amplitudes. This result challenges the use of simultaneous presentation technique in neonatal hearing screening programmes and on other pathologies. This discrepancy between two protocols may be due to some changes in biomechanical process in the cochlear and/or due to higher distortion/noise produced by the system during the simultaneous presentation mode.

Consequences of a screening programme on the prevalence of congenital hereditary sensorineural deafness in the Australian Cattle Dog.

PubMed

Sommerlad, S F; Morton, J M; Johnstone, I; O'Leary, C A; Seddon, J M

2014-12-01

Genetic disease testing programmes are used in domestic animal breeds to guide selective breeding with the aim of reducing disease prevalence. We assessed the change in the prevalence of canine congenital hereditary sensorineural deafness (CHSD) in litters of Australian Cattle Dogs following the introduction of a brainstem auditory evoked response (BAER) testing programme. We studied 608 pups from 122 litters from 10 breeding kennels. Despite 10 years of testing (1998-2008), no substantial reduction in prevalence of CHSD was evident in these 10 breeding kennels. Even for the subset of litters in which both parents were BAER tested as normal hearing (305 pups from 58 litters), there was no evidence of substantial reduction in prevalence. Odds ratios for CHSD in pups for each extra year since testing in the kennel commenced were 1.01 (95% CI, 0.88-1.17) and 1.03 (95% CI, 0.82-1.30) respectively for these populations. Amongst 284 dogs from 54 litters with extended pedigrees and both parents BAER-tested normal hearing, observed prevalences of CHSD were highest in pups with no BAER-tested normal grandparents (17% or 5/29) and lowest in pups with all four grandparents tested normal (0% or 0/9). In pups for which one, two and three grandparents tested negative, prevalences of CHSD were 12% (9/74), 9% (9/101) and 8% (6/71) respectively. Hence, testing programmes based on phenotypic screening may not lead to a substantial reduction in recessive genetic disease prevalence over the medium term, even when only tested normal parents are used. Exclusive breeding of litters in which both parents and all four grandparents are BAER-tested normal is expected to reduce CHSD prevalence in pups to the greatest extent over the long term. © 2014 Stichting International Foundation for Animal Genetics.

“Targeted” Screening for Cytomegalovirus (CMV)-Related Hearing Loss: It’s Time for Universal CMV Screening in the NICU!

PubMed Central

Medoro, Alexandra; Malhotra, Prashant; Shimamura, Masako; Hounam, Gina; Findlen, Ursula; Wozniak, Phillip; Foor, Nicholas; Adunka, Oliver; Sanchez, Pablo J

2017-01-01

Abstract Background Congenital CMV infection is the leading cause of non-genetic sensorineural hearing loss in infancy. Antiviral therapy has been shown to improve hearing outcomes, and thus “targeted” CMV screening for newborns who do not pass the hearing screen has been recommended. Diagnosis of congenital CMV infection requires that the infant be tested for CMV in the first 3 weeks of age. Our objective was to determine when infants in the neonatal intensive care unit (NICU) have their first hearing screen performed and thus inform the practice of targeted screening for determination of CMV-related hearing loss. Methods Retrospective review of the electronic health records of all infants admitted to the Level 4 outborn NICU at Nationwide Children’s Hospital, Columbus, OH from August 2016 to May 2017. Demographic and clinical data were obtained, and the age that the first hearing screen was performed was assessed. Results During the 10 month study period, 362 infants were admitted to the NICU and had a first hearing screen performed. The majority of neonates (204, 56%) had a first hearing screen performed in the first 3 weeks of age. However, 158 (44%; median birth weight [IQR], 1072 g [747–1766]; median gestational age [IQR], 28 weeks [25–32]) infants received the first hearing screen at >3 weeks of age when a positive CMV PCR or culture cannot distinguish congenital infection from intrapartum/postnatal acquisition of CMV. Of the 158 infants, 20 (13%) did not pass the first hearing screen (13, unilateral; 7, bilateral), and subsequently, 9 of them did pass a second hearing screen. However, 11 of the 20 infants did not pass a second hearing screen and had urine CMV PCR testing, and 1 (9%) was positive. This latter infant’s newborn dried blood spot CMV DNA PCR was negative so a diagnosis of congenital CMV infection was not possible. Conclusion Targeted screening in the NICU for CMV-related hearing loss is problematic as a substantial number of infants do not have a hearing screen performed until after 21 days of age, thus representing a missed opportunity for diagnosis of congenital CMV infection and institution of antiviral therapy if indicated. Our findings support universal CMV screening of neonates on admission to the NICU. Disclosures O. Adunka, MED-EL Corporation: Consultant, Consulting fee, Educational grant and Research support; Advanced Bionics: Consultant, Consulting fee and Licensing agreement or royalty; Advanced Cochlear Diagnostics: President, Ownership interest; AGTC Corporation: Consultant, Consulting fee

An analysis of hearing screening test results in 2291 premature infants of Chinese population.

PubMed

Huang, Lili; Xiong, Fei; Li, Jinrong; Yang, Fan

2017-04-01

The aim of this study was to analyze the hearing screening program among preterm infants as well as to identify risk factors associated with failing primary newborn hearing screening. The retrospectively selected population included all preterm infants who had primary hearing screening in a neonatal ward from January 1st, 2013 to December 31st, 2015 at West China Second University Hospital, Sichuan University. The newborn hearing screening (NHS) procedure was performed in all preterm infants by automated auditory brainstem response (AABR). Infants who failed the primary hearing screening received a second screening at 42 days after birth. Infants who failed both tests were referred to a tertiary audiology center for diagnostic confirmation and management before 6 months of age. The final diagnosis for referred infants was obtained by telephone follow-up. The risk factors associated with failure to pass the primary hearing screen were evaluated and analyzed for preterm infants. Among 2291 preterm infants recruited, 155 infants (6.8%) failed the primary hearing screening with an abnormal AABR. Of these 155 infants, 113 (72.9%) passed the secondary screening. At the end of the follow-up, 1 infant (0.04%) was diagnosed with hearing loss, 3 infants had delayed language development, and 40 infants were lost to follow up. Multivariate regression analysis revealed that gestational age ≤32 weeks (Odds ratio [OR] = 2.093, 95% confidence interval [CI] 1.370-3.196), super hyperbilirubinemia (≥25 mg/dl) (OR = 3.560, 95% CI 1.009-12.560), and respiratory failure (OR = 1.971, 95% CI 1.188-3.265) were associated with failure to pass newborn hearing screening. The prevalence of failure to pass primary hearing screening among preterm infants was 6.8% in our study, and we found a relatively low prevalence of hearing loss (0.04%). Super hyperbilirubinemia, gestational age ≤32weeks, and respiratory failure were risk factors associated with failure of preterm infants to pass the primary hearing screening. Our results suggest that preterm infants with hyperbilirubinemia, gestational age ≤32 weeks, and respiratory failure should be closely followed. Copyright © 2017 Elsevier B.V. All rights reserved.

Prevalence and associated factors of hearing aid use among older adults in Chile.

PubMed

Fuentes-López, Eduardo; Fuente, Adrian; Cardemil, Felipe; Valdivia, Gonzalo; Albala, Cecilia

2017-11-01

The aim of this study was to determine the prevalence of use of hearing aids by older adults in Chile and the influence of some variables such as education level, income level and geographic area of residence on the prevalence of hearing aids. A national cross-sectional survey which was carried out in 2009. A representative sample of 4766 Chilean older adults aged 60 years and above. The percentage of older adults in Chile who self-reported hearing problems and used hearing aids was 8.9%. Such prevalence increased for adults living in urban areas and for those who knew about the new Chilean programme of universal access to health services (AUGE). For older adults who did not know about this programme, significant associations between the use of hearing aids and the variables of age, geographic area of residence, and income level were found. People's knowledge about AUGE programme may positively influence the use of hearing aids, although a direct effect cannot be attributed.

Hearing Screening Follow-Up: Completing the Process to Identify Hearing Health Needs

ERIC Educational Resources Information Center

Eiserman, William; Shisler, Lenore; Hoffman, Jeff

2015-01-01

Hearing is at the heart of language development and school readiness; increasing numbers of Early Head Start programs have come to rely on otoacoustic emissions (OAE) technology to screen all infants and toddlers for hearing loss. Successful identification of hearing health needs is dependent not only on an appropriate screening method, but also…

Identifying congenital hearing impairment. Personal experience based on selective hearing screening.

PubMed

Molini, E; Ricci, G; Baroni, S; Ciorba, A; Bellocci, A; Simoncelli, C

2004-06-01

If all degrees of permanent uni- or bilateral hypoacusis are taken into consideration, hearing impairment is the most common congenital disease. Early detection of permanent infantile hearing impairment has become extremely important in preventive medicine, since steps can be taken with hearing aids and rehabilitation to ensure better development of language and higher cognitive functions. Aim of this study is to provide a critical review of the time of diagnosis of hypoacusis at our audiology laboratory, where two methods were used to screen hearing of children with/without risk indicators. Results of approximately 10 years' work were re-examined during which time outpatient screening was conducted on children referred by colleagues in neonatology and paediatrics. All were carriers of congenital risk indicators associated with sensorineural and/or conductive hearing loss, based on the Joint Committee on Infant Hearing findings, or were suspected of being hypoacusic even if they had no known congenital risk factors. Hearing screening was conducted in hospital on newborns with no risk factors, within the first few days of birth. Results of the present study showed that when selective hearing screening was performed, the mean age of high-risk patients diagnosed with hypoacusis was slightly higher than that in international guidelines. Moreover, these patients represent approximately half the hypoacusic population identified in the study period. The other half of congenital hypoacusic subjects identified had no risk indicators and there was a significant delay in diagnosis due to later manifestation of symptoms indicating hypoacusis, and thus, in turn, delayed referral for hearing tests. In contrast, subjects without risk indicators who underwent in-hospital hearing screening and proved to be hypoacusic, were diagnosed early. In our experience, however, universal screening has considerable disadvantages, such as difficulty in covering the entire population, difficulty in follow-up after discharge from hospital, and last, but by no means least, significant organisational and professional commitments, making it impossible to perform in all hospitals. In order to ensure effective hearing screening for congenital hearing loss and, thus permit prompt identification of hypoacusic children, use of hearing aids and rehabilitation screening should incorporate two aspects. First, selection should be compulsory, thereby reducing waiting time between collecting case histories and performing outpatient tests; second, hospital screening of children without risk factors should be performed whenever possible. Integrating these two aspects would make it possible to approach the "utopia" of universal hearing screening.

Hearing screening in children with skeletal dysplasia.

PubMed

Tunkel, David E; Kerbavaz, Richard; Smith, Beth; Rose-Hardison, Danielle; Alade, Yewande; Hoover-Fong, Julie

2011-12-01

To determine the prevalence of hearing loss and abnormal tympanometry in children with skeletal dysplasia. Clinical screening program. National convention of the Little People of America. Convenience sample of volunteers aged 18 years or younger with skeletal dysplasias. Hearing screening with behavioral testing and/or otoacoustic emissions, otoscopy, and tympanometry. A failed hearing screen was defined as hearing 35 dB HL (hearing level) or greater at 1 or more tested frequencies or by a "fail" otoacoustic emissions response. Types B and C tympanograms were considered abnormal. A total of 58 children (aged ≤18 years) with skeletal dysplasia enrolled, and 56 completed hearing screening. Forty-one children had normal hearing (71%); 9 failed in 1 ear (16%); and 6 failed in both ears (10%). Forty-four children had achondroplasia, and 31 had normal hearing in both ears (71%); 8 failed hearing screening in 1 ear (18%), and 3 in both ears (7%). Tympanometry was performed in 45 children, with normal tympanograms found in 21 (47%), bilateral abnormal tympanograms in 15 (33%), and unilateral abnormal tympanograms in 9 (20%). Fourteen children with achondroplasia had normal tympanograms (42%); 11 had bilateral abnormal tympanograms (33%); and 8 had unilateral abnormal tympanograms (24%). For those children without functioning tympanostomy tubes, there was a 9.5 times greater odds of hearing loss if there was abnormal tympanometry (P = .03). Hearing loss and middle-ear disease are both highly prevalent in children with skeletal dysplasias. Abnormal tympanometry is highly associated with the presence of hearing loss, as expected in children with eustachian tube dysfunction. Hearing screening with medical intervention is recommended for these children.

Hear here: children with hearing loss learn words by listening.

PubMed

Lew, Joyce; Purcell, Alison A; Doble, Maree; Lim, Lynne H

2014-10-01

Early use of hearing devices and family participation in auditory-verbal therapy has been associated with age-appropriate verbal communication outcomes for children with hearing loss. However, there continues to be great variability in outcomes across different oral intervention programmes and little consensus on how therapists should prioritise goals at each therapy session for positive clinical outcomes. This pilot intervention study aimed to determine whether therapy goals that concentrate on teaching preschool children with hearing loss how to distinguish between words in a structured listening programme is effective, and whether gains in speech perception skills impact on vocabulary and speech development without them having to be worked on directly in therapy. A multiple baseline across subjects design was used in this within-subject controlled study. 3 children aged between 2:6 and 3:1 with moderate-severe to severe-profound hearing loss were recruited for a 6-week intervention programme. Each participant commenced at different stages of the 10-staged listening programme depending on their individual listening skills at recruitment. Speech development and vocabulary assessments were conducted before and after the training programme in addition to speech perception assessments and probes conducted throughout the intervention programme. All participants made gains in speech perception skills as well as vocabulary and speech development. Speech perception skills acquired were noted to be maintained a week after intervention. In addition, all participants were able to generalise speech perception skills learnt to words that had not been used in the intervention programme. This pilot study found that therapy directed at listening alone is promising and that it may have positive impact on speech and vocabulary development without these goals having to be incorporated into a therapy programme. Although a larger study is necessary for more conclusive findings, the results from this preliminary study are promising in support of emphasise on listening skills within auditory-verbal therapy programmes. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.

Results of a neonatal hearing screening program in Maceió.

PubMed

Dantas, Margareth Barbosa de Souza; Anjos, César Antônio Lira Dos; Camboim, Elizângela Dias; Pimentel, Marcella de Carvalho Ramos

2009-01-01

Since 1998, after we started the support group for neonatal hearing screening, many other hearing screening programs were held in Brazil. In Alagoas, the first program started in 2003, but none of its results were published. Hearing is paramount for human communication; therefore, childhood hearing loss can impair speech acquisition, emotional, educational and social development. to present the results achieved in a neonatal hearing screening program in Maceió. a retrospective analytical study was carried out in order to study the results from tests carried out from September 2003 to December 2006 in a private hospital of Maceió. from a total of 2002 newborns, 1,626 fitted the inclusion criteria, 835 (51.4%) males. The hearing screening was considered appropriate in 1416 cases (87.1%), and the most frequently found age was between 16 and 30 days. Finally, 163 (10.0%) children presented risk indicators for hearing loss, and hyperbilirubinemia was the most common indicator. statistical results obtained from this hearing screening program show the importance of holding such programs. This study is important because it contributes to further regional or multinational studies.

The Sensitivity of Adolescent Hearing Screens Significantly Improves by Adding High Frequencies.

PubMed

Sekhar, Deepa L; Zalewski, Thomas R; Beiler, Jessica S; Czarnecki, Beth; Barr, Ashley L; King, Tonya S; Paul, Ian M

2016-09-01

One in 6 US adolescents has high-frequency hearing loss, often related to hazardous noise. Yet, the American Academy of Pediatrics (AAP) hearing screen (500, 1,000, 2,000, 4,000 Hertz) primarily includes low frequencies (<3,000 Hertz). Study objectives were to determine (1) sensitivity and specificity of the AAP hearing screen for adolescent hearing loss and (2) if adding high frequencies increases sensitivity, while repeat screening of initial referrals reduces false positive results (maintaining acceptable specificity). Eleventh graders (n = 134) participated in hearing screening (2013-2014) including "gold-standard" sound-treated booth testing to calculate sensitivity and specificity. Of the 43 referrals, 27 (63%) had high-frequency hearing loss. AAP screen sensitivity and specificity were 58.1% (95% confidence interval 42.1%-73.0%) and 91.2% (95% confidence interval 83.4-96.1), respectively. Adding high frequencies (6,000, 8,000 Hertz) significantly increased sensitivity to 79.1% (64.0%-90.0%; p = .003). Specificity with repeat screening was 81.3% (71.8%-88.7%; p = .003). Adolescent hearing screen sensitivity improves with high frequencies. Repeat testing maintains acceptable specificity. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Newborn hearing screening in Queensland 2009-2011: Comparison of hearing screening and diagnostic audiological assessment between term and preterm infants.

PubMed

Calcutt, Trent L; Dornan, Dimity; Beswick, Rachael; Tudehope, David I

2016-08-13

This study compares rates and timing of newborn hearing screening outcomes, audiological assessment and hearing loss diagnosis between infants of different gestational age groups. Early identification and management of sensorineural hearing loss (SNHL), ideally by 3-6 months of age, facilitates speech and language optimisation. Literature stratifying hearing screening and diagnostic audiology assessment by gestational age groups is lacking. Subjects were infants with recorded gestational ages receiving newborn hearing screening in Queensland between 2009 and 2011. Data were provided through the Queensland Healthy Hearing database. Infants were analysed in <34 weeks, 34-36 +6 weeks, 37-38 +6 weeks and ≥39 weeks gestational age groups. Infants (175 911) were eligible for analysis, 7.9% being preterm. Per 1000 infants analysed, bilateral SNHL of >40 dB occurred in 2.4 for <34, 1.4 for 34-36 +6 , 0.7 for 37-38 +6 and 0.7 for ≥39 weeks gestation. Diagnoses attributable to newborn hearing screening direct referral were 93.1% for bilateral >40 dB SNHL and 88.2% for other hearing loss. Relative to term, preterm infants had a higher incidence of direct and targeted surveillance referrals, audiology assessment and hearing loss diagnosis. Preterm infants were screened later after birth. Specific hearing screening and diagnosis characteristics differed between preterm infants <34 and 34-36 +6 weeks gestation, and term infants. Consideration of unique gestational age strata characteristics supports care individualisation. Preterm infants represent a diagnostic challenge, with higher rates of bilateral >40 dB SNHL than term but correspondingly higher false positive results on screening, justifying vigilant monitoring. Focused research into specific risk factors in preterm infants is warranted. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

[Hearing screening at nursery schools: results of an evaluation study].

PubMed

Weichbold, Viktor; Rohrer, Monika; Winkler, Cornelia; Welzl-Müller, Kunigunde

2004-07-31

This study aimed to evaluate the hearing screening of pre-school children at nursery schools in Tyrol, Austria. 47 nursery schools with a total of 2199 enrolled children participated in the study. At the screening, the children were presented a series of tones at frequencies 0.5 kHz (25dB), 1 kHz, 2 kHz, 3 kHz, and 4 kHz (20 dB each) from portable audiometers. The tones were presented over headphones for each ear separately and at irregular intervals. Failure to respond to any of the frequencies was considered failure of the screening. Parents were then advised in written form to have the child examined by an ENT-specialist. 1832 individuals were screened (coverage: 83% of nursery school children; corresponding to at least 63% of all Tyrolean children aged 3 to 5 years). Of these, 390 failed the test (referral rate: 21% of all screened). Examination through an ENT-specialist occurred with 217 children, and this confirmed the positive test in 139 children (hit rate: 64%). In most cases, a temporary conductive hearing loss due to external or middle ear problems (glue ear, tube dysfunction, cerumen, otitis media) was diagnosed. A sensorineural hearing loss was found in 4 children (in 3 of them bilateral). The need for therapy was recognized in 81 children (4% of all screened). Pre-school hearing screening identifies children with ear and hearing problems that need therapeutical intervention. Although the hearing problems are mostly of a temporary nature, some may require monitoring over some period. Also some children with permanent sensorineural hearing loss may be detected through this measure. Hearing screening is an efficient means of assessing ear and hearing problems in pre-school children. However, the follow-up rate needs to be improved for optimizing the efficacy.

Risk factors and prevalence of newborn hearing loss in a private health care system of Porto Velho, Northern Brazil

PubMed Central

de Oliveira, Juliana Santos; Rodrigues, Liliane Barbosa; Aurélio, Fernanda Soares; da Silva, Virgínia Braz

2013-01-01

OBJECTIVE: To determine the prevalence of hearing loss and to analyze the results of newborn hearing screening and audiological diagnosis in private health care systems. METHODS Cross-sectional and retrospective study in a database of newborn hearing screening performed by a private clinic in neonates born in private hospitals of Porto Velho, Rondônia, Northern Brazil. The screening results, the risk for hearing loss, the risk indicators for hearing loss and the diagnosis were descriptively analyzed. Newborns cared in rooming in with their mothers were compared to those admitted to the Intensive Care Unit regarding risk factors for hearing loss. RESULTS: Among 1,146 (100%) enrolled newborns, 1,064 (92.8%) passed and 82 (7.2%) failed the hearing screening. Among all screened neonates, 1,063 (92.8%) were cared in rooming and 83 (7.2%) needed intensive care; 986 (86.0%) were considered at low risk and 160 (14.0%) at high risk for hearing problems. Of the 160 patients identified as having high risk for hearing loss, 83 (37.7%) were admitted to an hospitalized in the Intensive Care Unit, 76 (34.5%) used ototoxic drugs and 38 (17.2%) had a family history of hearing loss in childhood. Hearing loss was diagnosed in two patients (0.2% of the screened sample). CONCLUSIONS: The prevalence of hearing loss in newborns from private hospitals was two cases per 1,000 evaluated patients. The use of ototoxic drugs, admission to Intensive Care Unit and family history of hearing loss were the most common risk factors for hearing loss in the studied population. PMID:24142311

The importance of retesting the hearing screening as an indicator of the real early hearing disorder.

PubMed

Silva, Daniela Polo Camargo da; Lopez, Priscila Suman; Ribeiro, Georgea Espíndola; Luna, Marcos Otávio de Mesquita; Lyra, João César; Montovani, Jair Cortez

2015-01-01

Early diagnosis of hearing loss minimizes its impact on child development. We studied factors that influence the effectiveness of screening programs. To investigate the relationship between gender, weight at birth, gestational age, risk factors for hearing loss, venue for newborn hearing screening and "pass" and "fail" results in the retest. Prospective cohort study was carried out in a tertiary referral hospital. The screening was performed in 565 newborns through transient evoked otoacoustic emissions in three admission units before hospital discharge and retest in the outpatient clinic. Gender, weight at birth, gestational age, presence of risk indicators for hearing loss and venue for newborn hearing screening were considered. Full-term infants comprised 86% of the cases, preterm 14%, and risk factors for hearing loss were identified in 11%. Considering the 165 newborns retested, only the venue for screening, Intermediate Care Unit, was related to "fail" result in the retest. Gender, weight at birth, gestational age and presence of risk factors for hearing loss were not related to "pass" and/or "fail" results in the retest. The screening performed in intermediate care units increases the chance of continued "fail" result in the Transient Otoacoustic Evoked Emissions test. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Targeting regional pediatric congenital hearing loss using a spatial scan statistic.

PubMed

Bush, Matthew L; Christian, Warren Jay; Bianchi, Kristin; Lester, Cathy; Schoenberg, Nancy

2015-01-01

Congenital hearing loss is a common problem, and timely identification and intervention are paramount for language development. Patients from rural regions may have many barriers to timely diagnosis and intervention. The purpose of this study was to examine the spatial and hospital-based distribution of failed infant hearing screening testing and pediatric congenital hearing loss throughout Kentucky. Data on live births and audiological reporting of infant hearing loss results in Kentucky from 2009 to 2011 were analyzed. The authors used spatial scan statistics to identify high-rate clusters of failed newborn screening tests and permanent congenital hearing loss (PCHL), based on the total number of live births per county. The authors conducted further analyses on PCHL and failed newborn hearing screening tests, based on birth hospital data and method of screening. The authors observed four statistically significant (p < 0.05) high-rate clusters with failed newborn hearing screenings in Kentucky, including two in the Appalachian region. Hospitals using two-stage otoacoustic emission testing demonstrated higher rates of failed screening (p = 0.009) than those using two-stage automated auditory brainstem response testing. A significant cluster of high rate of PCHL was observed in Western Kentucky. Five of the 54 birthing hospitals were found to have higher relative risk of PCHL, and two of those hospitals are located in a very rural region of Western Kentucky within the cluster. This spatial analysis in children in Kentucky has identified specific regions throughout the state with high rates of congenital hearing loss and failed newborn hearing screening tests. Further investigation regarding causative factors is warranted. This method of analysis can be useful in the setting of hearing health disparities to focus efforts on regions facing high incidence of congenital hearing loss.

The Sensitivity of Adolescent School-Based Hearing Screens Is Significantly Improved by Adding High Frequencies

ERIC Educational Resources Information Center

Sekhar, Deepa L.; Zalewski, Thomas R.; Beiler, Jessica S.; Czarnecki, Beth; Barr, Ashley L.; King, Tonya S.; Paul, Ian M.

2016-01-01

High frequency hearing loss (HFHL), often related to hazardous noise, affects one in six U.S. adolescents. Yet, only 20 states include school-based hearing screens for adolescents. Only six states test multiple high frequencies. Study objectives were to (1) compare the sensitivity of state school-based hearing screens for adolescents to gold…

Hearing Screening in a Tertiary Care Hospital in India

PubMed Central

Shah, Neha; Patel, Kalpesh B.; Vishwakarma, Rajesh

2015-01-01

Introduction: To study the incidence of hearing loss among children and to determine and confirm the distribution of common risk factors in children with hearing loss presenting at a tertiary care hospital in India. Materials and Methods: Babies underwent hearing screening using Transient Evoked Otoacoustic Emission (TEOAE) and Automated Auditory Brainstem Response (AABR) from November 2009 to September 2011. It was a cross-sectional study carried out at our institute involving 500 babies (≤2 y). To identify the high risk babies, Joint Committee on Infant Hearing (2007) High risk registry was used. Results: In our study 110 (22%) babies belonged to high risk category and 11(2.2%) of total screened babies had significant hearing loss. Total number of babies who passed the initial screening with TEOAE was 284 (56.8%). On diagnostic AABR screening of TEOAE REFERRED babies, the babies with no risk factor showed normal AABR tracings whereas from among those with one or multiple risk factors (110 babies), 11(10%) showed different levels of hearing impairment. Hearing loss was highly associated with Neonatal Intensive Care Unit (NICU) admission i.e. 8/11(72.7%), followed by Low Birth Weight (LBW) and hypoxia (6/11 i.e. 54.5% each). Conclusion: Hearing loss is more common in those babies with risk factors (majority being NICU admission, LBW and hypoxia). OAE and ABR screening of infants at risk for significant hearing loss is a clinically efficient and cost effective approach for early detection of significant hearing loss. PMID:25954639

Hearing Screening

ERIC Educational Resources Information Center

Johnson-Curiskis, Nanette

2012-01-01

Hearing levels are threatened by modern life--headsets for music, rock concerts, traffic noises, etc. It is crucial we know our hearing levels so that we can draw attention to potential problems. This exercise requires that students receive a hearing screening for their benefit as well as for making the connection of hearing to listening.

Hearing impairment in premature newborns—Analysis based on the national hearing screening database in Poland

PubMed Central

Greczka, Grazyna; Dabrowski, Piotr; Szyfter-Harris, Joanna; Mazela, Jan

2017-01-01

Objectives The incidence of sensorineural hearing loss is between 1 and 3 per 1000 in healthy neonates and 2–4 per 100 in high-risk infants. The national universal neonatal hearing screening carried out in Poland since 2002 enables selection of infants with suspicion and/or risk factors of hearing loss. In this study, we assessed the incidence and risk factors of hearing impairment in infants ≤33 weeks’ gestational age (wga). Methods We analyzed the database of the Polish Universal Newborns Hearing Screening Program from 2010 to 2013. The study group involved 11438 infants born before 33 wga, the control group—1487730 infants. Screening was performed by means of transient evoked otoacoustic emissions. The risk factors of hearing loss were recorded. Infants who failed the screening test and/or had risk factors were referred for further audiological evaluation. Results Hearing deficit was diagnosed in 11% of infants ≤25 wga, 5% at 26–27 wga, 3.46% at 28 wga and 2–3% at 29–32 wga. In the control group the incidence of hearing deficit was 0.2% (2.87% with risk factors). The most important risk factors were craniofacial malformations, very low birth weight, low Apgar score and mechanical ventilation. Hearing screening was positive in 22.42% newborns ≤28 wga and 10% at 29–32 wga and in the control group. Conclusions Hearing impairment is a severe consequence of prematurity. Its prevalence is inversely related to the maturity of the baby. Premature infants have many concomitant risk factors which influence the occurrence of hearing deficit. PMID:28910311

Language ENvironment Analysis Language and Autism Screen and the Child Development Inventory Social Subscale as a possible autism screen for children who are deaf or hard of hearing.

PubMed

Carr, Jason; Xu, Dongxin; Yoshinaga-Itano, Christine

2014-11-01

The Language ENvironment Analysis Language and Autism Screen (LLAS) is an automated vocal production analysis that has been shown to be a valid screener for autism in hearing children between the ages of 24 to 48 months of age. Although there is reportedly a higher incidence of autism among children who are deaf or hard of hearing, the diagnosis of autism is usually later than that in children with hearing. None of the traditional screening instruments have been used with children with hearing loss. Data about the utility of LLAS with children who are deaf or hard of hearing will be presented and discussed. Though more data will be needed, an LLAS at-risk flag in conjunction with the Social Quotient from the Child Development Inventory holds significant promise for a screen for children who are deaf or hard of hearing. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Development of a computer-based automated pure tone hearing screening device: a preliminary clinical trial.

PubMed

Gan, Kok Beng; Azeez, Dhifaf; Umat, Cila; Ali, Mohd Alauddin Mohd; Wahab, Noor Alaudin Abdul; Mukari, Siti Zamratol Mai-Sarah

2012-10-01

Hearing screening is important for the early detection of hearing loss. The requirements of specialized equipment, skilled personnel, and quiet environments for valid screening results limit its application in schools and health clinics. This study aimed to develop an automated hearing screening kit (auto-kit) with the capability of realtime noise level monitoring to ensure that the screening is performed in an environment that conforms to the standard. The auto-kit consists of a laptop, a 24-bit resolution sound card, headphones, a microphone, and a graphical user interface, which is calibrated according to the American National Standards Institute S3.6-2004 standard. The auto-kit can present four test tones (500, 1000, 2000, and 4000 Hz) at 25 or 40 dB HL screening cut-off level. The clinical results at 40 dB HL screening cut-off level showed that the auto-kit has a sensitivity of 92.5% and a specificity of 75.0%. Because the 500 Hz test tone is not included in the standard hearing screening procedure, it can be excluded from the auto-kit test procedure. The exclusion of 500 Hz test tone improved the specificity of the auto-kit from 75.0% to 92.3%, which suggests that the auto-kit could be a valid hearing screening device. In conclusion, the auto-kit may be a valuable hearing screening tool, especially in countries where resources are limited.

How should hearing screening tests be offered?

PubMed

Koopman, Jan; Davey, Elizabeth; Thomas, Neil; Wittkop, Thomas; Verschuure, Hans

2008-05-01

This paper deals with the question of how the general public should be addressed when offering hearing screening. Postal-based questionnaires in the United Kingdom, Germany, and The Netherlands were sent to users of hearing devices, those that are in the process of obtaining one, or those that have indicated that they have special interest in hearing. Results of the survey indicated that respondents were enthusiastic about the idea of being able to carry out hearing self-screening tests via the internet, telephone, or questionnaires. A questionnaire as a method to screen on hearing was generally preferred above using the internet, which was preferred over using the telephone for the test. About 27% of the respondents indicated to use exclusively one method. Most respondents indicated that either method provided would be of interest (41%), 17% indicated not to be interested in conducting screening tests using the internet.

Polish universal neonatal hearing screening program-4-year experience (2003-2006).

PubMed

Szyfter, Witold; Wróbel, Maciej; Radziszewska-Konopka, Marzanna; Szyfter-Harris, Joanna; Karlik, Michał

2008-12-01

The aim of this paper is to share our experience and observations in running the Universal Neonatal Hearing Screening Program on a national level, present results and indicate some problems that have arisen during these 4 years. Polish Universal Neonatal Hearing Screening Program started back in 2002 in all neonatal units in Poland. Implemented testing methods consisted of test of transient evoked otoacoustic emission (TEOAE) performed in all new born children in their first 2-3 days of life and auditory brainstem response testing (ABR) conducted on children, who did not meet the TEOAE pass criteria. Additional questionnaire registered information on ototoxic drugs and family history of hearing impairment in every newborn. Diagnosed children were further referred for treatment and rehabilitation. After 4 years of running the program (between 2003 and 2006) a total number of 1,392,427 children were screened for hearing impairment, what stands for 96.3% of all delivered babies, registered in Poland. The screening program enabled to identify and refer for further treatment 2485 children with various types of hearing loss, 312 with profound (0.02% of population) and 145 with severe sensorineural hearing loss (0.11% of population). Our results indicate the accuracy of newborn hearing screening which remain an issue. Although improvement is needed in both intervention systems and diagnostic follow-up of hospitals, the Polish Universal Neonatal Hearing Program fully has achieved the main goal, the identification and treatment of hearing impaired children.

Screening Procedures Used to Identify Children with Hearing Loss.

ERIC Educational Resources Information Center

Barringer, Donald G.; And Others

1993-01-01

Analysis of data on 1,404 young children with hearing losses indicated that 80% of the children were identified via informal hearing-screening procedures, such as parental suspicion and referral. Auditory brainstem response technology provided the lowest mean identification age. The study concludes that formal screening programs are not locating…

Mismatch between aspects of hearing impairment and hearing disability/handicap in adult/elderly Cantonese speakers: some hypotheses concerning cultural and linguistic influences.

PubMed

Doyle, J; Wong, L L

1996-12-01

This paper addresses the observation that some Cantonese-speaking adults do not perceive a hearing problem even when hearing screening identifies hearing loss. A sample of 49 Cantonese speakers was surveyed about their self-perceptions of hearing prior to a 25 dB HTL pure-tone screening test. All 49 persons failed the screening test, yet 34 (69.4%) reported that they had no problems hearing during conversations. Persons who admitted hearing difficulties tended to have mean hearing levels in excess of 45 dB HTL. A number of hypotheses concerning cultural and linguistic influences are proposed as explanations for the apparent lack of significance of auditory sensitivity loss for some Cantonese speakers. Ways in which these hypotheses might be tested are suggested.

Antenatal factors modulate hearing screen failure risk in preterm infants.

PubMed

Leung, Jocelyn C; Cifra, Christina L; Agthe, Alexander G; Sun, Chen-Chih J; Viscardi, Rose M

2016-01-01

The objective of this study was to characterise the effects of antenatal inflammatory factors and maternal therapies on neonatal hearing screen outcomes in very low birthweight infants. We conducted a retrospective study of a cohort of infants <33 weeks' gestational age and <1501 g birth weight prospectively enrolled between 1999 and 2003 for whom placental pathology, cord blood interleukin (IL) 6, IL-1ß, tumour necrosis factor-α and neonatal hearing screen results were available. Of 289 infants with documented hearing screen results, 244 (84%) passed and 45 (16%) failed the hearing screen (unilateral, N=25 (56%); bilateral, N=20 (44%)). In the final logistic model, the fetal inflammatory response syndrome defined as the presence of fetal vasculitis and/or cord serum IL-6>18.2 pg/mL was the factor with greatest risk for hearing screen failure (OR 3.62, 95% CI 1.38 to 9.5). A patent ductus arteriosus treated with indomethacin significantly increased the risk (OR 3.3, 95% CI 1.3 to 8.26), while combined maternal steroid and magnesium sulfate exposure (0.37, 95% CI 0.11 to 0.81) reduced the risk for hearing screen failure. Intrauterine infection with a fetal inflammatory response is a risk factor for neonatal hearing loss while maternal therapies significantly reduced the risk of neonatal hearing loss in very low birthweight infants. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Results of a Targeted Screening Program for Congenital Cytomegalovirus Infection in Infants Who Fail Newborn Hearing Screening.

PubMed

Vancor, Emily; Shapiro, Eugene D; Loyal, Jaspreet

2018-01-24

Congenital cytomegalovirus (CMV) infection is a major cause of sensorineural hearing loss. By law, newborns in Connecticut who fail newborn hearing screening are tested for infection with CMV. This targeted screening is controversial, because most children with congenital CMV infection are asymptomatic, and CMV-related hearing loss can have a delayed onset. Our hospital uses a saliva polymerase chain reaction (PCR) assay (confirmed by a urine PCR assay) to detect CMV. Here, we report the results of the first year of our screening program. We reviewed the medical records of newborns in the Yale New Haven Health System who failed the newborn hearing screening test between January 1 and December 31, 2016. Of 10964 newborns, 171 failed newborn hearing screening, and 3 of these newborns had positive saliva CMV PCR test results. Of these 3 newborns, 2 had positive results on the confirmatory test (for 1 of them the confirmatory test was not performed until the infant was 10 weeks old), and 1 had a negative result on the confirmatory test. Three additional newborns with congenital CMV infection were tested because of clinical indications (1 for ventriculomegaly on prenatal ultrasound and 2 for CMV infection of the mother). Results of audiology follow-up were available for 149 (87.1%) of the 171 newborns who failed newborn hearing screening; 127 (85.2%) had normal results. Our targeted screening program for congenital CMV infection had a low yield. Consideration should be given to other strategies for identifying children at risk of hearing loss as a result of congenital CMV infection. © The Author(s) 2018. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[Validation of the Spanish parent satisfaction questionnaire with neonatal hearing screening programs].

PubMed

Núñez-Batalla, Faustino; Antuña-León, Eva; González-Trelles, Teresa; Carro-Fernández, Pilar

2009-01-01

Although measuring parent satisfaction has been recommended as one of the important outcome measures in assessing the effectiveness of neonatal hearing screening programs, there are few published studies investigating this issue. To validate the Spanish version of the Parent Satisfaction Questionnaire with Neonatal Hearing Screening Program (PSQ-NHSP). 112 parents whose children had received hearing screening participated in this study. High levels of satisfaction were reported with more than 90% of parents satisfied with all aspects of the program. The psychometric properties of the Spanish version of the PSQ-NHSP were analyzed and demonstrated good internal consistency (alpha=0.75). Construct validity was indicated by a significant positive relationship between overall satisfaction and the three specific dimensions in the questionnaire. The development of a valid and reliable parent satisfaction questionnaire is important for improving hearing screening programs.

The performance of an automatic acoustic-based program classifier compared to hearing aid users' manual selection of listening programs.

PubMed

Searchfield, Grant D; Linford, Tania; Kobayashi, Kei; Crowhen, David; Latzel, Matthias

2018-03-01

To compare preference for and performance of manually selected programmes to an automatic sound classifier, the Phonak AutoSense OS. A single blind repeated measures study. Participants were fit with Phonak Virto V90 ITE aids; preferences for different listening programmes were compared across four different sound scenarios (speech in: quiet, noise, loud noise and a car). Following a 4-week trial preferences were reassessed and the users preferred programme was compared to the automatic classifier for sound quality and hearing in noise (HINT test) using a 12 loudspeaker array. Twenty-five participants with symmetrical moderate-severe sensorineural hearing loss. Participant preferences of manual programme for scenarios varied considerably between and within sessions. A HINT Speech Reception Threshold (SRT) advantage was observed for the automatic classifier over participant's manual selection for speech in quiet, loud noise and car noise. Sound quality ratings were similar for both manual and automatic selections. The use of a sound classifier is a viable alternative to manual programme selection.

Conference on Newborn Hearing Screening; Proceedings Summary and Recommendations.

ERIC Educational Resources Information Center

Alexander Graham Bell Association for the Deaf, Inc., Washington, DC.

Presented in the conference proceedings are schedule and list of participants, seven major papers, and the newborn hearing screening recommendations of the interdisciplinary conference on newborn hearing and early identification of hearing impairment. Neonatal auditory testing is reviewed by Sanford E. Gerber, and Sheldon B. Korones gives a…

Screening for Vision Problems in Children with Hearing Impairments.

ERIC Educational Resources Information Center

Demchak, MaryAnn; Elquist, Marty

Vision problems occur at higher rates in the deaf and hearing impaired population than in the general population. When an individual has a hearing impairment, vision becomes more significant in the instructional and learning process, as well as in social and communicative exchanges. Regular comprehensive visual screening of hearing impaired…

Risk factors for hearing loss in infants under universal hearing screening program in Northern Thailand

PubMed Central

Poonual, Watcharapol; Navacharoen, Niramon; Kangsanarak, Jaran; Namwongprom, Sirianong

2016-01-01

Objective To define the risk factors for hearing loss in infants (aged 3 months) under universal hearing screening program. Materials and methods A total of 3,120 infants (aged 3 months) who underwent hearing screening using a universal hearing screening program using automated otoacoustic emission test between November 1, 2010 and May 31, 2012 in Uttaradit Hospital, Buddhachinaraj Hospital, and Sawanpracharuk Hospital (tertiary hospitals) located in Northern Thailand were included in this prospective cohort study. Results Of the 3,120 infants, 135 (4.3%) were confirmed to have hearing loss with the conventional otoacoustic emission test. Five of these 135 infants (3.7%) with hearing loss showed test results consistent with auditory brainstem responses. From the univariable analysis, there were eleven potential risk factors associated with hearing deterioration. On multivariable analysis, the risk factors independently associated with hearing loss at 3 months were birth weight 1,500–2,500 g (risk ratio [RR] 1.6, 95% confidence interval [CI] 1.1–2.6), APGAR score <6 at 5 minutes (RR 2.2, 95% CI 1.1–4.4), craniofacial anomalies (RR 2.5, 95% CI 1.6–4.2), sepsis (RR 1.8, 95% CI 1.0–3.2), and ototoxic exposure (RR 4.1, 95% CI 1.9–8.6). Conclusion This study concluded that low birth weight, APGAR score <6 at 5 minutes, craniofacial anomalies, sepsis, and ototoxic exposure are the risk factors for bilateral hearing loss in infants (aged 3 months) and proper tests should be performed to identify these risk factors. As an outcome, under the present circumstances, it is suggested that infirmary/physicians/general practitioners/health action centers/polyclinics should carry out universal hearing screening in all infants before 36 weeks. The public health policy of Thailand regarding a universal hearing screening program is important for the prevention of disability and to enhance people’s quality of life. PMID:26766912

Feasibility of a low-cost hearing screening in rural Indiana.

PubMed

Khan, Khalid M; Bielko, Sylvanna L; Barnes, Priscilla A; Evans, Sydney S; Main, Anna L K

2017-09-18

Hearing loss remains a neglected public health issue in the rural and agricultural communities in the United States and therefore, promotion of a low-cost hearing screening may be important for these underserved populations. The major objectives of our study were to assess feasibility of a low-cost telephone-administered hearing test in rural Indiana and to identify the challenges, barriers and viable implementation strategies associated with this test. Also, we evaluated whether a focus group session could change the hearing health attitude of rural residents. We recruited 126 adults from six rural Indiana counties who participated in study activities in the following order: 1) a pre-focus group demographic, knowledge and attitude survey, 2) a focus group for discussing the feasibility of a telephone-administered hearing screening, 3) a post focus group attitude survey and 4) hearing was screened using an audiometer and self-assessment scale. These activities generated both qualitative and quantitative data, which were subsequently analyzed. Hearing impairment was perceived as an important public health issue. Many participants expressed interests to try the low-cost National Hearing Test (NHT). However, participants recommended NHT to be facilitated by community organizations to provide access to landline phones. The focus group turned out to be an excellent awareness building activity producing significant improvement in hearing health attitudes. Comparison of self and audiometric evaluations indicated underestimation of hearing handicap in our rural study population. The study results underscore the urgent need for an effective strategy to promote low-cost hearing screening in rural US communities.

Development of a test of suprathreshold acuity in noise in Brazilian Portuguese: a new method for hearing screening and surveillance.

PubMed

Vaez, Nara; Desgualdo-Pereira, Liliane; Paglialonga, Alessia

2014-01-01

This paper describes the development of a speech-in-noise test for hearing screening and surveillance in Brazilian Portuguese based on the evaluation of suprathreshold acuity performances. The SUN test (Speech Understanding in Noise) consists of a list of intervocalic consonants in noise presented in a multiple-choice paradigm by means of a touch screen. The test provides one out of three possible results: "a hearing check is recommended" (red light), "a hearing check would be advisable" (yellow light), and "no hearing difficulties" (green light) (Paglialonga et al., Comput. Biol. Med. 2014). This novel test was developed in a population of 30 normal hearing young adults and 101 adults with varying degrees of hearing impairment and handicap, including normal hearing. The test had 84% sensitivity and 76% specificity compared to conventional pure-tone screening and 83% sensitivity and 86% specificity to detect disabling hearing impairment. The test outcomes were in line with the degree of self-perceived hearing handicap. The results found here paralleled those reported in the literature for the SUN test and for conventional speech-in-noise measures. This study showed that the proposed test might be a viable method to identify individuals with hearing problems to be referred to further audiological assessment and intervention.

The economics of screening infants at risk of hearing impairment: an international analysis.

PubMed

Burke, Martyn J; Shenton, Ruth C; Taylor, Matthew J

2012-02-01

Hearing impairment in children across the world constitutes a particularly serious obstacle to their optimal development and education, including language acquisition. Around 0.5-6 in every 1000 neonates and infants have congenital or early childhood onset sensorineural deafness or severe-to-profound hearing impairment, with significant consequences. Therefore, early detection is a vitally important element in providing appropriate support for deaf and hearing-impaired babies that will help them enjoy equal opportunities in society alongside all other children. This analysis estimates the costs and effectiveness of various interventions to screen infants at risk of hearing impairment. The economic analysis used a decision tree approach to determine the cost-effectiveness of newborn hearing screening strategies. Two unique models were built to capture different strategic screening decisions. Firstly, the cost-effectiveness of universal newborn hearing screening (UNHS) was compared to selective screening of newborns with risk factors. Secondly, the cost-effectiveness of providing a one-stage screening process vs. a two-stage screening process was investigated. Two countries, the United Kingdom and India, were used as case studies to illustrate the likely cost outcomes associated with the various strategies to diagnose hearing loss in infants. In the UK, the universal strategy incurs a further cost of approximately £2.3 million but detected an extra 63 cases. An incremental cost per case detected of £36,181 was estimated. The estimated economic burden was substantially higher in India when adopting a universal strategy due to the higher baseline prevalence of hearing loss. The one-stage screening strategy accumulated an additional 13,480 and 13,432 extra cases of false-positives, in the UK and India respectively when compared to a two-stage screening strategy. This represented increased costs by approximately £1.3 million and INR 34.6 million. The cost-effectiveness of a screening intervention was largely dependent upon two key factors. As would be expected, the cost (per patient) of the intervention drives the model substantially, with higher costs leading to higher cost-effectiveness ratios. Likewise, the baseline prevalence (risk) of hearing impairment also affected the results. In scenarios where the baseline risk was low, the intervention was less likely to be cost-effective compared to when the baseline risk was high. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Screening Newborns | NIH MedlinePlus the Magazine

MedlinePlus

... signed the Newborn and Infant Hearing Screening and Intervention Act, authorizing the coordination and funding of statewide ... hearing loss before they leave the hospital. → Early interventions and treatments (hearing aids, cochlear implants, sign language, ...

Parents' preferences for services for children with hearing loss: a conjoint analysis study.

PubMed

Fitzpatrick, Elizabeth; Coyle, Douglas E; Durieux-Smith, Andrée; Graham, Ian D; Angus, Douglas E; Gaboury, Isabelle

2007-12-01

Early identification of permanent childhood hearing loss through universal newborn hearing screening is rapidly becoming a standard of care. However, it is well recognized that hearing screening must be embedded within a comprehensive system of rehabilitation and parent support services. This study was undertaken with parents of young children with permanent hearing loss to examine their preferences for characteristics associated with intervention services. A secondary goal was to explore whether preferences may differ according to patient subgroups. Conjoint analysis, a preference-based economic technique, was used to investigate parents' strength of preferences. A cross-sectional survey that consisted of hypothetical clinic scenarios was developed based on information from qualitative interviews with parents. The questionnaire was administered to parents receiving intervention services in the province of Ontario, Canada, shortly after the implementation of a universal hearing screening program. The sample was recruited from three different clinical programs. A total of 48 of 75 respondents completed the questionnaire, a response rate of 64%. The participants varied by screening status of the child (25 screened, 23 not screened), type of device (23 hearing aids, 25 cochlear implants), and region. All five characteristics of care that were selected for inclusion in the survey were found to be statistically significant attributes of services: coordinated services, access to parent support, access to information, frequency of services, and location of services. Parents showed a preference for clinic-based rather than home-based services. Preferences toward once a week therapy services rather than services two to three times weekly were also found. In particular, parents valued service models that consisted of well-coordinated care with access to support from other parents. Differences in respondents according to hearing screening status (screened or unscreened), type of hearing device (hearing aid or cochlear implant), or region (Ottawa or Toronto) did not seem to affect parents' preferences for attributes of care. Conjoint analysis is a useful technique for quantifying parents' preferences for care. The values expressed by parents provide insights into the aspects of a service model that should receive consideration in the development of programs for young children with hearing loss and their families.

Certified School Nurse Perspectives on State-Mandated Hearing Screens

ERIC Educational Resources Information Center

Sekhar, Deepa L.; Beiler, Jessica S.; Schaefer, Eric W.; Henning, Antoinette; Dillon, Judith F.; Czarnecki, Beth; Zalewski, Thomas R.

2016-01-01

Background: Approximately 15% of children in the United States 6-19 years of age have hearing loss. Even mild, unilateral hearing loss may adversely affect educational success. In 2014, the Pennsylvania Department of Health (PA DOH) began updating the 2001 regulations on state-mandated school hearing screens. To inform the updates, a needs…

The carrier rate and mutation spectrum of genes associated with hearing loss in South China hearing female population of childbearing age

PubMed Central

2013-01-01

Background Given that hearing loss occurs in 1 to 3 of 1,000 live births and approximately 90 to 95 percent of them are born into hearing families, it is of importance and necessity to get better understanding about the carrier rate and mutation spectrum of genes associated with hearing impairment in the general population. Methods 7,263 unrelated women of childbearing age with normal hearing and without family history of hearing loss were tested with allele-specific PCR-based universal array. Further genetic testing were provided to the spouses of the screened carriers. For those couples at risk, multiple choices were provided, including prenatal diagnosis. Results Among the 7,263 normal hearing participants, 303 subjects carried pathogenic mutations included in the screening chip, which made the carrier rate 4.17%. Of the 303 screened carriers, 282 harbored heterozygous mutated genes associated with autosomal recessive hearing loss, and 95 spouses took further genetic tests. 8 out of the 9 couples harbored deafness-causing mutations in the same gene received prenatal diagnosis. Conclusions Given that nearly 90 to 95 percent of deaf and hard-of-hearing babies are born into hearing families, better understanding about the carrier rate and mutation spectrum of genes associated with hearing impairment in the female population of childbearing age may be of importance in carrier screening and genetic counseling. PMID:23718755

The carrier rate and mutation spectrum of genes associated with hearing loss in South China hearing female population of childbearing age.

PubMed

Yin, Aihua; Liu, Chang; Zhang, Yan; Wu, Jing; Mai, Mingqin; Ding, Hongke; Yang, Jiexia; Zhang, Xiaozhuang

2013-05-29

Given that hearing loss occurs in 1 to 3 of 1,000 live births and approximately 90 to 95 percent of them are born into hearing families, it is of importance and necessity to get better understanding about the carrier rate and mutation spectrum of genes associated with hearing impairment in the general population. 7,263 unrelated women of childbearing age with normal hearing and without family history of hearing loss were tested with allele-specific PCR-based universal array. Further genetic testing were provided to the spouses of the screened carriers. For those couples at risk, multiple choices were provided, including prenatal diagnosis. Among the 7,263 normal hearing participants, 303 subjects carried pathogenic mutations included in the screening chip, which made the carrier rate 4.17%. Of the 303 screened carriers, 282 harbored heterozygous mutated genes associated with autosomal recessive hearing loss, and 95 spouses took further genetic tests. 8 out of the 9 couples harbored deafness-causing mutations in the same gene received prenatal diagnosis. Given that nearly 90 to 95 percent of deaf and hard-of-hearing babies are born into hearing families, better understanding about the carrier rate and mutation spectrum of genes associated with hearing impairment in the female population of childbearing age may be of importance in carrier screening and genetic counseling.

Prediction of permanent hearing loss in high-risk preterm infants at term age.

PubMed

Valkama, A M; Laitakari, K T; Tolonen, E U; Väyrynen, M R; Vainionpää, L K; Koivisto, M E

2000-06-01

The aim of this series was to assess hearing screenings; auditory brainstem responses (ABR), transient evoked otoacoustic emissions (TEOAE) and free field auditory responses (FF) for the prediction of permanent bilateral hearing loss in high-risk preterm infants at term post-conceptional age. A total of 51 preterm infants (gestational age < 34 weeks, birth weight < 1500 g) underwent examinations at term and hearing, speech and neurological development were followed up until a corrected age of 18 months. Significant hearing defects were verified by broader ABR examinations under sedation and by clinical ward observation including responsiveness to sounds and enhancement of hearing using an amplification device. Seven bilateral fails in ABR were found, together with nine bilateral fails in TEOAE and four fails in FF screening at term age. Six preterm infants were later confirmed to have a significant permanent bilateral hearing loss, four of whom had also cerebral palsy. Bilateral failure in ABR screening predicted hearing loss with a sensitivity of 100% and a specificity of 98%, TEOAE with a sensitivity of 50% and a specificity of 84% and in the FF examination at the levels of 50% and 98%, respectively. Transient evoked otoacoustic emissions alone seem not to be so applicable to the neonatal screening of hearing in high-risk preterm infants as shown earlier in full-term infants, possibly because a hearing defect may be due to retrocochlear damage. Consequently, auditory brainstem response screening seems to be more suitable for very low birth weight preterm infants.

The occurrence of high-risk factors for hearing loss in very-low-birth-weight neonates: a retrospective exploratory study of targeted hearing screening.

PubMed

Kanji, Amisha; Khoza-Shangase, Katijah

2012-12-01

The current study aimed at determining the type and frequency of high-risk factors for hearing loss in a group of very-low-birth-weight (VLBW) neonates in a tertiary hospital in South Africa with the objective of collating evidence that could be used in arguing for or against revisiting targeted hearing screening in developing countries. Furthermore, the study aimed at investigating the relationship between the identified high-risk factors and hearing screening results. In a retrospective data review design, data were collated from files from the VLBW project; this included hearing screening records, as well as records from participant medical and audiology files. Records of 86 neonates with birth weights ranging between 680 g and 1500 g were reviewed. Findings indicated that neonatal jaundice, exposure to human immunodeficiency virus (HIV), mechanical or assisted ventilation, and neonatal intensive care unit stay greater than 48 hours were the most frequently occurring high-risk factors for hearing loss in the current sample. These factors are consistent with those listed in the high-risk register of the Health Professions Council of South Africa for the South African context. Findings confirm the complexity of risk factors, and the influence that a variety of factors such as poor follow-up or return rate might have on the implementation of early hearing detection and intervention. The importance of establishing context-specific risk factors for effective implementation of targeted screening protocols where niversal newborn hearing screening is not yet a reality was highlighted by the current study.

Impact of Co-Occurring Birth Defects on the Timing of Newborn Hearing Screening and Diagnosis

PubMed Central

Chapman, Derek A.; Stampfel, Caroline C.; Bodurtha, Joann N.; Dodson, Kelley M.; Pandya, Arti; Lynch, Kathleen B.; Kirby, Russell S.

2016-01-01

Purpose Early detection of hearing loss in all newborns and timely intervention are critical to children's cognitive, verbal, behavioral, and social development. The initiation of appropriate early intervention services before 6 months of age can prevent or reduce negative developmental consequences. The purpose of this study was to assess, using large, population-based registries, the effect of co-occurring birth defects (CBDs) on the timing and overall rate of hearing screening and diagnosis. Method The authors linked statewide data from newborn hearing screenings, a birth defects registry, and birth certificates to assess the timeliness of newborn hearing screening and diagnosis of hearing loss (HL) for infants with and without CBDs in 485 children with confirmed HL. Results Nearly one third (31.5%) of children with HL had 1 or more CBDs. The presence of CBDs prolonged the time of the initial infant hearing screening, which contributed to further delays in the subsequent diagnosis of HL. Conclusions Better coordination of HL assessment into treatment plans for children with CBDs may enable earlier diagnosis of HL and provide opportunities for intervention that will affect long-term developmental outcomes for these children. PMID:21940980

Consensus Statement of the Indian Academy of Pediatrics on Newborn Hearing Screening.

PubMed

Paul, Abraham; Prasad, Chhaya; Kamath, S S; Dalwai, Samir; C Nair, M K; Pagarkar, Waheeda

2017-08-15

Hearing impairment is one of the most critical sensory impairments with significant social and psychological consequences. Evidence-based, standardized national guidelines are needed for professionals to screen for hearing impairment during the neonatal period. The meeting on formulation of national consensus guidelines on developmental disorders was organized by Indian Academy of Pediatrics in Mumbai, on 18th and 19th December, 2015. The invited experts included Pediatricians, Developmental Pediatricians, Pediatric Neurologists and Clinical Psychologists. The participants framed guidelines after extensive discussions. To provide guidelines on newborn hearing screening in India. The first screening should be conducted before the neonate's discharge from the hospital - if it 'fails', then it should be repeated after four weeks, or at first immunization visit. If it 'fails' again, then Auditory Brainstem Response (ABR) audiometry should be conducted. All babies admitted to intensive care unit should be screened via ABR. All babies with abnormal ABR should undergo detailed evaluation, hearing aid fitting and auditory rehabilitation, before six months of age. The goal is to screen newborn babies before one month of age, diagnose hearing loss before three months of age and start intervention before six months of age.

Automatic classification of transiently evoked otoacoustic emissions using an artificial neural network.

PubMed

Buller, G; Lutman, M E

1998-08-01

The increasing use of transiently evoked otoacoustic emissions (TEOAE) in large neonatal hearing screening programmes makes a standardized method of response classification desirable. Until now methods have been either subjective or based on arbitrary response characteristics. This study takes an expert system approach to standardize the subjective judgements of an experienced scorer. The method that is developed comprises three stages. First, it transforms TEOAEs from waveforms in the time domain into a simplified parameter set. Second, the parameter set is classified by an artificial neural network that has been taught on a large database TEOAE waveforms and corresponding expert scores. Third, additional fuzzy logic rules automatically detect probable artefacts in the waveforms and synchronized spontaneous emission components. In this way, the knowledge of the experienced scorer is encapsulated in the expert system software and thereafter can be accessed by non-experts. Teaching and evaluation of the neural network was based on TEOAEs from a database totalling 2190 neonatal hearing screening tests. The database was divided into learning and test groups with 820 and 1370 waveforms respectively. From each recorded waveform a set of 12 parameters was calculated, representing signal static and dynamic properties. The artifical network was taught with parameter sets of only the learning groups. Reproduction of the human scorer classification by the neural net in the learning group showed a sensitivity for detecting screen fails of 99.3% (299 from 301 failed results on subjective scoring) and a specificity for detecting screen passes of 81.1% (421 of 519 pass results). To quantify the post hoc performance of the net (generalization), the test group was then presented to the network input. Sensitivity was 99.4% (474 from 477) and specificity was 87.3% (780 from 893). To check the efficiency of the classification method, a second learning group was selected out of the previous test group, and the previous learning group was used as the test group. Repeating learning and test procedures yielded 99.3% sensitivity and 80.7% specificity for reproduction, and 99.4% sensitivity and 86.7% specificity for generalization. In all respects, performance was better than for a previously optimized method based simply on cross-correlation between replicate non-linear waveforms. It is concluded that classification methods based on neural networks show promise for application to large neonatal screening programmes utilizing TEOAEs.

Cognition and screening for hearing loss in nursing home residents.

PubMed

Jupiter, Tina

2012-10-01

To compare hearing screening results using pure tones and distortion product otoacoustic emissions (DPOAEs) with nursing home residents who have dementia and explore the relationship of hearing impairment and cognitive function using the Mini- Mental Status Evaluation (MMSE). A correlational design was implemented to evaluate residents in a large inner city nursing home. One hundred one nursing home residents 65-108 years. DPOAEs and pure tone screenings were conducted at 30 dB HL and 40 dB HL at 1, 2, and 3 kHz. Pure tone thresholds at 1, 2, and 3 kHz were obtained. The MMSE was administered to all participants. Results showed that all residents failed the DPOAE screen, 97.1% failed at 30 dB HL, and 90.0% failed at 40 dB HL. Kendall's tau, phi correlation, linear by linear association, and χ(2) results indicated no significant relationship for any of the screening protocols and cognitive status other than a significant finding with left ear screening at 40 dB HL. Logistic regression analysis indicated that individuals who passed the screen had better MMSE scores. Results of the t test and Mann-Whitney U test revealed a significant difference in cognitive function for residents with a mild hearing loss compared with those with a more significant hearing loss. For screening nursing home residents, 40 dB HL screening level or DPOAEs can be used. The significant finding that residents with greater than a mild hearing loss have poorer cognitive function reinforces the importance of identifying residents with a hearing loss and providing rehabilitation and follow-up. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Development of a Test of Suprathreshold Acuity in Noise in Brazilian Portuguese: A New Method for Hearing Screening and Surveillance

PubMed Central

Vaez, Nara; Desgualdo-Pereira, Liliane; Paglialonga, Alessia

2014-01-01

This paper describes the development of a speech-in-noise test for hearing screening and surveillance in Brazilian Portuguese based on the evaluation of suprathreshold acuity performances. The SUN test (Speech Understanding in Noise) consists of a list of intervocalic consonants in noise presented in a multiple-choice paradigm by means of a touch screen. The test provides one out of three possible results: “a hearing check is recommended” (red light), “a hearing check would be advisable” (yellow light), and “no hearing difficulties” (green light) (Paglialonga et al., Comput. Biol. Med. 2014). This novel test was developed in a population of 30 normal hearing young adults and 101 adults with varying degrees of hearing impairment and handicap, including normal hearing. The test had 84% sensitivity and 76% specificity compared to conventional pure-tone screening and 83% sensitivity and 86% specificity to detect disabling hearing impairment. The test outcomes were in line with the degree of self-perceived hearing handicap. The results found here paralleled those reported in the literature for the SUN test and for conventional speech-in-noise measures. This study showed that the proposed test might be a viable method to identify individuals with hearing problems to be referred to further audiological assessment and intervention. PMID:25247181

A multidisciplinary approach to paediatric hearing loss: programme at the centre for hearing intervention and language development, National University Hospital, Singapore.

PubMed

Lim, Lynne H Y

2008-12-01

The objective is to describe the multidisciplinary management programme at the National University Hospital (NUH) in Singapore for children with hearing impairment (HI). Over 99.95% of babies born at NUH have hearing tested with both otoacoustic emission and automated auditory brainstem response tests by 6 weeks of age. The referral rate to Otolaryngology is 0.5%. Acquired causes of congenital HI are decreasing. Thirty percent of patients at NUH with idiopathic congenital sensorineural HI have DFNB1/ GJB6 Connexin 26 HI. CT scan or MRI imaging has a higher diagnostic yield when there is unilateral, fluctuating or non-Connexin 26 related HI. Routine electrocardiogram and Opthalmology evaluations will exclude associations of fatal cardiac rhythm anomaly and retinopathy. Other investigations are directed by history and clinical examination. There is now a very wide range of increasingly sophisticated medication, neuro-otologic external, middle and inner ear surgery, hearing aids, middle ear implants and cochlear implants available to improve hearing. A multidisciplinary team from neonatology, paediatrics, otolaryngology, audiology, auditory verbal and speech therapy, ophthalmology, radiology, and psychology working closely with the child, family and schools is needed to develop a cost-effective and comprehensive management programme for paediatric HI.

Effects of ventilation on hearing loss in preterm neonates: Nasal continuous positive pressure does not increase the risk of hearing loss in ventilated neonates.

PubMed

Rastogi, Shantanu; Mikhael, Michel; Filipov, Panayot; Rastogi, Deepa

2013-03-01

There is increased risk of hearing loss in preterm neonates. This risk is further increased by environmental noise exposure especially from life support equipment such as ventilation. Nasal continuous positive airway pressure (NCPAP) used for respiratory support of preterm neonates is known to be associated with prolonged exposure to high levels of noise. However, there is paucity of information on the effect of NCPAP as compared to mechanical ventilation on hearing loss among preterm neonates. A retrospective chart review was performed on neonates with birth weight (BW) <1500g. Association of clinical factors including the use of NCPAP and mechanical ventilation with failure of hearing screen were studied. Those who failed hearing screen were followed for 2 years to observe long term effects of NCPAP on the hearing loss. Of 344 neonates included in the study, 61 failed hearing screen. Gestational age (p=0.008), BW (p=0.03), ventilation (p=0.02), intrauterine growth retardation (p=0.02), necrotizing enterocolitis (NEC) (p=0.02), apnea (p<0.001), use of vancomycin (p=0.01) and furosemide (p=0.01) were associated with failure of hearing screen. On multivariate analysis, ventilation (OR 4.56, p=0.02), apnea (OR 2.2, p<0.001) and NEC (OR 2.4, p=0.02) were predictors of failed hearing screen. As compared to those not ventilated, the odds of failing hearing screen was 4.53 (p<0.01) and 4.59 (p<0.01) for those treated with NCPAP and mechanical ventilation respectively, with there being no difference between these two ventilatory modalities. Of the 61 neonates, 42 were followed for 2 years, of which 19 had confirmed hearing loss. Among these 19 neonates, there was no difference (p=0.12) between those who were treated with NCPAP or with mechanical ventilation. There is no increase in the hearing loss in preterm neonates treated with NCPAP as compared to mechanical ventilation despite being exposed to higher environmental noise generated by the NCPAP. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Conductive hearing loss and middle ear pathology in young infants referred through a newborn universal hearing screening program in Australia.

PubMed

Aithal, Sreedevi; Aithal, Venkatesh; Kei, Joseph; Driscoll, Carlie

2012-10-01

Although newborn hearing screening programs have been introduced in most states in Australia, the prevalence of conductive hearing loss and middle ear pathology in the infants referred through these programs is not known. This study was designed to (1) evaluate the prevalence of conductive hearing loss and middle ear pathology in infants referred by a newborn hearing screening program in north Queensland, (2) compare prevalence rates of conductive hearing loss and middle ear pathology in indigenous and nonindigenous infants, and (3) review the outcomes of those infants diagnosed with conductive hearing loss and middle ear pathology. Retrospective chart review of infants referred to the Audiology Department of The Townsville Hospital was conducted. Chart review of 234 infants referred for one or both ears from a newborn hearing screening program in north Queensland was conducted. A total of 211 infants attended the diagnostic appointment. Review appointments to monitor hearing status were completed for 46 infants with middle ear pathology or conductive hearing loss. Diagnosis of hearing impairment was made using an age-appropriate battery of audiological tests. Results were analyzed for both initial and review appointments. Mean age at initial diagnostic assessment was 47.5 days (SD = 31.3). Of the 69 infants with middle ear pathology during initial diagnostic assessment, 18 had middle ear pathology with normal hearing, 47 had conductive hearing loss, and 4 had mixed hearing loss. Prevalence of conductive hearing loss in the newborns was 2.97 per 1,000 while prevalence of middle ear pathology (with or without conductive hearing loss) was 4.36 per 1,000. Indigenous Australians or Aboriginal and Torres Strait Islander (ATSI) infants had a significantly higher prevalence of conductive hearing loss and middle ear pathology than non-ATSI infants (35.19 and 44.45% vs 17.83 and 28.66%, respectively). ATSI infants also showed poor resolution of conductive hearing loss over time with 66.67% of ATSI infants reviewed showing persistent conductive hearing loss compared to 17.86% of non-ATSI infants. Medical management of 17 infants with persistent conductive hearing loss included monitoring, antibiotic treatment, examination under anesthesia, and grommet insertion. Conductive hearing loss was found to be a common diagnosis among infants referred through screening. ATSI infants had significantly higher rates of middle ear pathology and conductive hearing loss at birth and showed poor resolution of middle ear pathology over time compared to non-ATSI infants. Future research using a direct measure of middle ear function as an adjunct to the automated auditory brainstem response screening tool to distinguish conductive from sensorineural hearing loss may facilitate prioritization of infants for assessment, thus reducing parental anxiety and streamlining the management strategies for the respective types of hearing loss. American Academy of Audiology.

Hearing Screening of High-Risk Newborns with Brainstem Auditory Evoked Potentials: A Follow-Up Study.

ERIC Educational Resources Information Center

Shannon, Dorothy A.; And Others

1984-01-01

The brainstem auditory evoked potential (BAEP) was evaluated as a hearing screening test in 168 high-risk newborns. The BAEP was found to be a sensitive procedure for the early identification of hearing-impaired newborns. However, the yield of significant hearing abnormalities was less than predicted in other studies using BAEP. (Author/CL)

Mitochondrial mutation m.1555A>G as a risk factor for failed newborn hearing screening in a large cohort of preterm infants.

PubMed

Göpel, Wolfgang; Berkowski, Sandra; Preuss, Michael; Ziegler, Andreas; Küster, Helmut; Felderhoff-Müser, Ursula; Gortner, Ludwig; Mögel, Michael; Härtel, Christoph; Herting, Egbert

2014-08-26

The mitochondrial m.1555A>G mutation is associated with a high rate of permanent hearing loss, if aminoglycosides are given. Preterm infants have an increased risk of permanent hearing loss and are frequently treated with aminoglycoside antibiotics. We genotyped preterm infants with a birth weight below 1500 grams who were prospectively enrolled in a large cohort study for the m.1555A>G mutation. Treatment with aminoglycoside antibiotics in combination with mitochondrial m.1555A>G mutation was tested as a predictor for failed hearing screening at discharge in a multivariate logistic regression analysis. 7056 infants were genotyped and analysed. Low birth weight was the most significant predictor of failed hearing screening (p = 7.3 × 10-10). 12 infants (0.2%) had the m.1555A>G-mutation. In a multivariable logistic regression analysis, the combination of aminoglycoside treatment with m.1555A>G-carrier status was associated with failed hearing screening (p = 0.0058). However, only 3 out of 10 preterm m.1555A>G-carriers who were exposed to aminoglycosides failed hearing screening. The m.1555A>G-mutation was detected in all mothers of m.1555A>G-positive children, but in none of 2993 maternal DNA-samples of m.1555A>G-negative infants. Antenatal screening for the m.1555A>G mutation by maternal genotyping of pregnant women with preterm labour might be a reasonable approach to identify infants who are at increased risk for permanent hearing loss. Additional studies are needed to estimate the relevance of cofactors like aminoglycoside plasma levels and birth weight and the amount of preterm m.1555A>G-carriers with permanent hearing loss.

Mitochondrial mutation m.1555A>G as a risk factor for failed newborn hearing screening in a large cohort of preterm infants

PubMed Central

2014-01-01

Background The mitochondrial m.1555A>G mutation is associated with a high rate of permanent hearing loss, if aminoglycosides are given. Preterm infants have an increased risk of permanent hearing loss and are frequently treated with aminoglycoside antibiotics. Methods We genotyped preterm infants with a birth weight below 1500 grams who were prospectively enrolled in a large cohort study for the m.1555A>G mutation. Treatment with aminoglycoside antibiotics in combination with mitochondrial m.1555A>G mutation was tested as a predictor for failed hearing screening at discharge in a multivariate logistic regression analysis. Results 7056 infants were genotyped and analysed. Low birth weight was the most significant predictor of failed hearing screening (p = 7.3 × 10-10). 12 infants (0.2%) had the m.1555A>G-mutation. In a multivariable logistic regression analysis, the combination of aminoglycoside treatment with m.1555A>G-carrier status was associated with failed hearing screening (p = 0.0058). However, only 3 out of 10 preterm m.1555A>G-carriers who were exposed to aminoglycosides failed hearing screening. The m.1555A>G-mutation was detected in all mothers of m.1555A>G-positive children, but in none of 2993 maternal DNA-samples of m.1555A>G-negative infants. Conclusion Antenatal screening for the m.1555A>G mutation by maternal genotyping of pregnant women with preterm labour might be a reasonable approach to identify infants who are at increased risk for permanent hearing loss. Additional studies are needed to estimate the relevance of cofactors like aminoglycoside plasma levels and birth weight and the amount of preterm m.1555A>G-carriers with permanent hearing loss. PMID:25155176

Enhancing Ear and Hearing Health Access for Children With Technology and Connectivity.

PubMed

Swanepoel, De Wet

2017-10-12

Technology and connectivity advances are demonstrating increasing potential to improve access of service delivery to persons with hearing loss. This article demonstrates use cases from community-based hearing screening and automated diagnosis of ear disease. This brief report reviews recent evidence for school- and home-based hearing testing in underserved communities using smartphone technologies paired with calibrated headphones. Another area of potential impact facilitated by technology and connectivity is the use of feature extraction algorithms to facilitate automated diagnosis of most common ear conditions from video-otoscopic images. Smartphone hearing screening using calibrated headphones demonstrated equivalent sensitivity and specificity for school-based hearing screening. Automating test sequences with a forced-choice response paradigm allowed persons with minimal training to offer screening in underserved communities. The automated image analysis and diagnosis system for ear disease demonstrated an overall accuracy of 80.6%, which is up to par and exceeds accuracy rates previously reported for general practitioners and pediatricians. The emergence of these tools that capitalize on technology and connectivity advances enables affordable and accessible models of service delivery for community-based ear and hearing care.

Measuring motivation using the transtheoretical (stages of change) model: A follow-up study of people who failed an online hearing screening.

PubMed

Ingo, Elisabeth; Brännström, K Jonas; Andersson, Gerhard; Lunner, Thomas; Laplante-Lévesque, Ariane

2016-07-01

Acceptance and readiness to seek professional help have shown to be important factors for favourable audiological rehabilitation outcomes. Theories from health psychology such as the transtheoretical (stages-of-change) model could help understand behavioural change in people with hearing impairment. In recent studies, the University of Rhode Island change assessment (URICA) has been found to have good predictive validity. In a previous study, 224 Swedish adults who had failed an online hearing screening completed URICA and two other measures of stages of change. This follow-up aimed to: (1) determine prevalence of help-seeking at a hearing clinic and hearing aid uptake, and (2) explore the predictive validity of the stages of change measures by a follow-up on the 224 participants who had failed a hearing screening 18 months previously. A total of 122 people (54%) completed the follow-up online questionnaire, including the three measures and questions regarding experience with hearing help-seeking and hearing aid uptake. Since failing the online hearing screening, 61% of participants had sought help. A good predictive validity for a one-item measure of stages of change was reported. The Staging algorithm was the stages of change measure with the best ability to predict help-seeking 18 months later.

The effect of ice skating on psychological well-being and sleep quality of children with visual or hearing impairment.

PubMed

Dursun, Onur Burak; Erhan, Süleyman Erim; Ibiş, Esra Özhan; Esin, Ibrahim Selcuk; Keleş, Sadullah; Şirinkan, Ahmet; Yörük, Özgür; Acar, Ethem; Beyhun, Nazim Ercument

2015-01-01

Physical exercise and sports have a key role in preventing physical and psychiatric problems in children. However, children with a disability often experience difficulty participating in physical activity due to a lack of suitable opportunities. Participation in an accessible sport is particularly important for these children, but studies examining which sports are beneficial for which disability groups are rare. In this study, we assessed the effects of ice skating on the psychological well-being, self-concept, and sleep quality of children with hearing or visual impairment. Forty students (20 visually impaired and 20 hearing impaired) aged 8-16 were included in a regular ice skating programme for three months. We examined the sleep quality, self-concept, and behavioural and emotional states of the children before and after participating in the programme. There was a significant improvement in self-concept, behavioural and emotional problems, and sleep quality (p < 0.05 for each) of the children with hearing impairment. Although the sleep quality (p = 0.019) and emotional problem scores (p = 0.000) of the visually impaired children improved; self-concept, peer relations and hyperactivity scores of these children worsened (p < 0.05 for each). Ice skating is one of the popular sport alternatives that gives children the opportunity to exercise and have fun together. The results of this study revealed that regular ice skating programmes may have positive effects on the psychological well-being of children with hearing impairment. Despite some positive effects, caution must be use when including visually impaired children in ice skating programmes. Generalization of the study's outcomes is limited as the study group were residential students enrolled in special education institutions for children who are blind or deaf. Ice skating is a community-based sport and a popular leisure activity that can also have benefits for people with disabilities. Ice skating and children with hearing impairment: Self-concept, behavioural and emotional problems, and sleep quality of the children with hearing impairment significantly improved after ice skating. Ice skating programmes may be considered as a rehabilitation alternative for children with hearing impairment. Ice skating and children with visual impairment: Caution must be use when including children with visual impairment in ice skating programmes because of possible negative psychological outcomes. Balance exercises before starting the practices on ice should be considered for preventing some possible negative outcomes in children with visual impairment.

Screening an elderly hearing impaired population for mild cognitive impairment using Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA).

PubMed

Lim, Magdalene Yeok Leng; Loo, Jenny Hooi Yin

2018-07-01

To determine if there is an association between hearing loss and poorer cognitive scores on Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) and to determine if poor hearing acuity affects scoring on the cognitive screening tests of MMSE and MoCA. One hundred fourteen elderly patients (Singapore residents) aged between 55 and 86 years were sampled. Participants completed a brief history questionnaire, pure tone audiometry, and 2 cognitive screening tests-the MMSE and MoCA. Average hearing thresholds of the better ear in the frequencies of 0.5, 1, 2, and 4 kHz were used for data analysis. Hearing loss was significantly associated with poorer cognitive scores in Poisson regression models adjusted for age. Mini-Mental State Examination scores were shown to decrease by 2.8% (P = .029), and MoCA scores by 3.5% (P = .013) for every 10 dB of hearing loss. Analysis of hearing-sensitive components of "Registration" and "Recall" in MMSE and MoCA using chi-square tests showed significantly poorer performance in the hearing loss group as compared to the normal hearing group. Phonetic analysis of target words with high error rates shows that the poor performance was likely contributed by decreased hearing acuity, on top of a possible true deficit in cognition in the hearing impaired. Hearing loss is associated with poorer cognitive scores on MMSE and MoCA, and cognitive scoring is likely confounded by poor hearing ability. This highlights an important, often overlooked aspect of sensory impairment during cognitive screening. Provisions should be made when testing for cognition in the hearing-impaired population to avoid over-referral and subsequent misdiagnoses of cognitive impairment. Copyright © 2018 John Wiley & Sons, Ltd.

Periodic Early Childhood Hearing Screening: The EHDI Perspective

ERIC Educational Resources Information Center

Hoffman, Jeff; Houston, K. Todd; Munoz, Karen F.; Bradham, Tamala S.

2011-01-01

State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that examined 12 areas within state EHDI programs. Concerning periodic early childhood hearing screening, 47 coordinators listed 241 items and themes were identified within each SWOT…

A Hearing Aid Primer 1

ERIC Educational Resources Information Center

Yetter, Carol J.

2009-01-01

This hearing aid primer is designed to define the differences among the three levels of hearing instrument technology: conventional analog circuit technology (most basic), digitally programmable/analog circuit technology (moderately advanced), and fully digital technology (most advanced). Both moderate and advanced technologies mean that hearing…

Screening for hearing, visual and dual sensory impairment in older adults using behavioural cues: a validation study.

PubMed

Roets-Merken, Lieve M; Zuidema, Sytse U; Vernooij-Dassen, Myrra J F J; Kempen, Gertrudis I J M

2014-11-01

This study investigated the psychometric properties of the Severe Dual Sensory Loss screening tool, a tool designed to help nurses and care assistants to identify hearing, visual and dual sensory impairment in older adults. Construct validity of the Severe Dual Sensory Loss screening tool was evaluated using Crohnbach's alpha and factor analysis. Interrater reliability was calculated using Kappa statistics. To evaluate the predictive validity, sensitivity and specificity were calculated by comparison with the criterion standard assessment for hearing and vision. The criterion used for hearing impairment was a hearing loss of ≥40 decibel measured by pure-tone audiometry, and the criterion for visual impairment was a visual acuity of ≤0.3 diopter or a visual field of ≤0.3°. Feasibility was evaluated by the time needed to fill in the screening tool and the clarity of the instruction and items. Prevalence of dual sensory impairment was calculated. A total of 56 older adults receiving aged care and 12 of their nurses and care assistants participated in the study. Crohnbach's alpha was 0.81 for the hearing subscale and 0.84 for the visual subscale. Factor analysis showed two constructs for hearing and two for vision. Kappa was 0.71 for the hearing subscale and 0.74 for the visual subscale. The predictive validity showed a sensitivity of 0.71 and a specificity of 0.72 for the hearing subscale; and a sensitivity of 0.69 and a specificity of 0.78 for the visual subscale. The optimum cut-off point for each subscale was score 1. The nurses and care assistants reported that the Severe Dual Sensory Loss screening tool was easy to use. The prevalence of hearing and vision impairment was 55% and 29%, respectively, and that of dual sensory impairment was 20%. The Severe Dual Sensory Loss screening tool was compared with the criterion standards for hearing and visual impairment and was found a valid and reliable tool, enabling nurses and care assistants to identify hearing, visual and dual sensory impairment among older adults. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Newborn hearing screening program: association between hearing loss and risk factors].

PubMed

Pereira, Priscila Karla Santana; Martins, Adriana de Souza; Vieira, Márcia Ribeiro; Azevedo, Marisa Frasson de

2007-01-01

Hearing loss in newborns. To verify the prevalence of auditory alterations in newborns of Hospital São Paulo (hospital), observing if there are any correlations with the following variables: birth weight, gestational age, relation weight/gestational age and risk factors for hearing loss. A retrospective analysis of the hospital records of 1696 newborns; 648 records of preterm infants and 1048 records of infants born at term. All of the infants had been submitted to an auditory evaluation consisting of: Transient Otoacoustic Emissions, investigation of the cochleal-palpebral reflexes and acoustic imittance tests, identifying the type and level of hearing loss. Sensorineural hearing loss was identified in .82% of the infants who were born at term and in 3.1% of the preterm infants -- with a statistically significant difference. Conductive hearing loss was the most frequent type of hearing loss in both groups, occurring in 14.6% of the term infants and in 16.3% of the preterm infants. Alteration of the central auditory system was considered as a possible diagnosis for 5.8% of the preterm infants and for 3.3% of the term infants. For the group of infants who were born at term, a significant correlation was observed between failure in the hearing screening test and the presence of risk factors such as family history and presence of a syndrome -- the child who presented a syndrome had 37 times more chances of failing in the hearing screening test and seven times more chances of failing in the right ear when there was a family history for hearing loss. The lower the gestational age (< 30 weeks) and birth weight (< 1500 g), the higher the chances of failing in the hearing screening test (3 times more). Hearing loss had a higher occurrence in preterm infants who remained in the ICU. Gestational age and birth weight were important variables related to the possibility of failure in the hearing screening test. A correlation was observed between the presence of a syndrome and sensorineural hearing loss in infants who were born at term.

High Prevalence of Hearing Loss at the Special Olympics: Is This Representative of People with Intellectual Disability?

ERIC Educational Resources Information Center

Hey, C.; Fessler, S.; Hafner, N.; Lange, B. P.; Euler, H. A.; Neumann, K.

2014-01-01

Background: The Healthy Hearing (HH) programme at the Special Olympics (SO) revealed hearing disorders in between 16 and 40% of athletes. However, it is not clear whether these prevalence represents the entire population with intellectual disability. Therefore, this study compares the hearing status of SO athletes with an intellectual disability…

Stages of change in adults who have failed an online hearing screening.

PubMed

Laplante-Lévesque, Ariane; Brännström, K Jonas; Ingo, Elisabeth; Andersson, Gerhard; Lunner, Thomas

2015-01-01

Hearing screening has been proposed to promote help-seeking and rehabilitation in adults with hearing impairment. However, some longitudinal studies point to low help-seeking and subsequent rehabilitation after a failed hearing screening (positive screening result). Some barriers to help-seeking and rehabilitation could be intrinsic to the profiles and needs of people who have failed a hearing screening. Theories of health behavior change could help to understand this population. One of these theories is the transtheoretical (stages-of-change) model of health behavior change, which describes profiles and needs of people facing behavior changes such as seeking help and taking up rehabilitation. According to this model, people go through distinct stages toward health behavior change: precontemplation, contemplation, action, and finally, maintenance. The present study describes the psychometric properties (construct validity) of the stages of change in adults who have failed an online hearing screening. Stages of change were measured with the University of Rhode Island Change Assessment (URICA). Principal component analysis is presented, along with cluster analysis. Internal consistency was investigated. Finally, relationships between URICA scores and speech-in-noise recognition threshold, self-reported hearing disability, and self-reported duration of hearing disability are presented. In total, 224 adults who had failed a Swedish online hearing screening test (measure of speech-in-noise recognition) completed further questionnaires online, including the URICA. A principal component analysis identified the stages of precontemplation, contemplation, and action, plus an additional stage, termed preparation (between contemplation and action). According to the URICA, half (50%) of the participants were in the preparation stage of change. The contemplation stage was represented by 38% of participants, while 9% were in the precontemplation stage. Finally, the action stage was represented by approximately 3% of the participants. Cluster analysis identified four stages-of-change clusters: they were named decision making (44% of sample), participation (28% of sample), indecision (16% of sample), and reluctance (12% of sample). The construct validity of the model was good. Participants who reported a more advanced stage of change had significantly greater self-reported hearing disability. However, participants who reported a more advanced stage of change did not have a significantly worse speech-in-noise recognition threshold or reported a significantly longer duration of hearing impairment. The additional stage this study uncovered, and which other studies have also uncovered, preparation, highlights the need for adequate guidance for adults who are yet to seek help for their hearing. The fact that very few people were in the action stage (approximately 3% of the sample) signals that screening alone is unlikely to be enough to improve help-seeking and rehabilitation rates. As expected, people in the later stages of change reported significantly greater hearing disability. The lack of significant relationships between stages-of-change measures and speech-in-noise recognition threshold and self-reported duration of hearing disability highlights the complex interplay between impairment, disability, and behaviors in adults who have failed an online hearing screening and who are yet to seek help.

Screening Newborns' Hearing Now Standard | NIH MedlinePlus the Magazine

MedlinePlus

... Possible Hearing Problem Your Baby's Hearing and Communicative Development Checklist Communication Considerations —for parents of children with hearing loss Cochlear Implants —surgically implanted hearing ...

Newborn Hearing Screening: An Analysis of Current Practices

ERIC Educational Resources Information Center

Houston, K. Todd; Bradham, Tamala S.; Munoz, Karen F.; Guignard, Gayla Hutsell

2011-01-01

State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that consisted of 12 evaluative areas of EHDI programs. For the newborn hearing screening area, a total of 293 items were listed by 49 EHDI coordinators, and themes were identified within…

Acceptance of internet-based hearing healthcare among adults who fail a hearing screening.

PubMed

Rothpletz, Ann M; Moore, Ashley N; Preminger, Jill E

2016-09-01

This study measured help-seeking readiness and acceptance of existing internet-based hearing healthcare (IHHC) websites among a group of older adults who failed a hearing screening (Phase 1). It also explored the effects of brief training on participants' acceptance of IHHC (Phase 2). Twenty-seven adults (age 55+) who failed a hearing screening participated. During Phase 1 participants were administered the University of Rhode Island Change Assessment (URICA) and patient technology acceptance model (PTAM) Questionnaire. During Phase 2 participants were randomly assigned to a training or control group. Training group participants attended an instructional class on existing IHHC websites. The control group received no training. The PTAM questionnaire was re-administered to both groups 4-6 weeks following the initial assessment. The majority of participants were either considering or preparing to do something about their hearing loss, and were generally accepting of IHHC websites (Phase 1). The participants who underwent brief IHHC training reported increases in hearing healthcare knowledge and slight improvements in computer self-efficacy (Phase 2). Older adults who fail hearing screenings may be good candidates for IHHC. The incorporation of a simple user-interface and short-term training may optimize the usability of future IHHC programs for this population.

Evidence-based occupational hearing screening II: validation of a screening methodology using measures of functional hearing ability.

PubMed

Soli, Sigfrid D; Amano-Kusumoto, Akiko; Clavier, Odile; Wilbur, Jed; Casto, Kristen; Freed, Daniel; Laroche, Chantal; Vaillancourt, Véronique; Giguère, Christian; Dreschler, Wouter A; Rhebergen, Koenraad S

2018-05-01

Validate use of the Extended Speech Intelligibility Index (ESII) for prediction of speech intelligibility in non-stationary real-world noise environments. Define a means of using these predictions for objective occupational hearing screening for hearing-critical public safety and law enforcement jobs. Analyses of predicted and measured speech intelligibility in recordings of real-world noise environments were performed in two studies using speech recognition thresholds (SRTs) and intelligibility measures. ESII analyses of the recordings were used to predict intelligibility. Noise recordings were made in prison environments and at US Army facilities for training ground and airborne forces. Speech materials included full bandwidth sentences and bandpass filtered sentences that simulated radio transmissions. A total of 22 adults with normal hearing (NH) and 15 with mild-moderate hearing impairment (HI) participated in the two studies. Average intelligibility predictions for individual NH and HI subjects were accurate in both studies (r 2  ≥ 0.94). Pooled predictions were slightly less accurate (0.78 ≤ r 2  ≤ 0.92). An individual's SRT and audiogram can accurately predict the likelihood of effective speech communication in noise environments with known ESII characteristics, where essential hearing-critical tasks are performed. These predictions provide an objective means of occupational hearing screening.

Systematic review of knowledge of, attitudes towards, and practices for newborn hearing screening among healthcare professionals.

PubMed

Ravi, Rohit; Gunjawate, Dhanshree R; Yerraguntla, Krishna; Rajashekhar, Bellur

2018-01-01

The success of newborn hearing screening programs lies in the timely identification, diagnosis, and management of children with hearing loss accomplished via a multidisciplinary newborn hearing screening (NHS) team. The team is typically comprised of various healthcare professionals who act as decision makers as well as facilitators for different stages in the screening process. Team members' knowledge of, attitudes towards, and practices for early hearing detection and intervention programs are critical for success and prevention of loss to follow up. In this context, it becomes crucial to understand their knowledge of, attitudes towards, and practices for towards newborn hearing screening. A systematic review was conducted on the following databases; PubMed/Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Web of Science, Science Direct and Cochrane Library. This search was carried out using various keywords such as practitioners, newborn hearing screening, knowledge, attitudes, and practices in different combinations. The review was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-analyses statement guidelines. A total of 271 hits were obtained of which 20 articles were found suitable for inclusion in the final review. Overall, similar results were found regarding team members' knowledge of NHS programs, regardless of country of origin. Similarly, attitudes toward NHS programs were positive. Team members' experiences with NHS programs varied from country-to-country and across healthcare professionals. Results consistently showed gaps in team members' knowledge suggesting the need for outreach and professional education programs on NHS. NHS teams members from different countries, healthcare systems, and early hearing detection and intervention programs show gaps in critical knowledge warranting outreach and educational programs. Copyright © 2017 Elsevier B.V. All rights reserved.

Newborn hearing screening update for midwifery practice.

PubMed

Narrigan, D

2000-01-01

Neonatal identification of congenital hearing impairment allows interventions during the first 3 years, the critical period for language and speech development. Two recently developed biophysical testing methods offer simple, accurate, and relatively inexpensive means to identify the one to three in 1,000 healthy newborns with hearing loss. Universal screening for auditory system integrity is advocated, because almost half of all newborns with hearing impairment have no risk factors associated with this impairment. Critics of universal screening cite the high rate of false positive tests (up to 7%), which increases program costs from follow-up and re-testing large numbers of infants to ensure identifying the few affected infants. As of early 2000, 24 states had introduced some type of auditory screening program, and the U.S. Congress had passed legislation with appropriations mandating state-based auditory screening for all newborns. Midwives practicing in states already mandating biophysical screening need to comply with their local requirements; those in other states may voluntarily incorporate new auditory test methods into practice.

Maternal knowledge and attitudes to universal newborn hearing screening: Reviewing an established program.

PubMed

Lam, Maggie Yee Yan; Wong, Eddie Chi Ming; Law, Chi Wai; Lee, Helena Hui Ling; McPherson, Bradley

2018-02-01

To facilitate early diagnosis of infants with hearing loss, a universal newborn hearing screening program (UNHS) has been implemented in Hong Kong's public hospitals for over a decade. However, there have been no known studies investigating parent attitudes to, and satisfaction with, UNHS since its launch in Hong Kong. The present study aimed to investigate knowledge of UNHS as well as infant hearing development, and attitudes and satisfaction with UNHS, in Hong Kong mothers with newborns. The study was designed to help evaluate and improve an established UNHS public hospital program, based on the perspectives of service users. A researcher-developed questionnaire was administered to 102 mothers whose newborn had received UNHS in the postnatal wards of a large public hospital in Hong Kong. The questionnaire considered parental knowledge of UNHS and infant hearing development, attitudes and satisfaction toward public hospital UNHS. In the knowledge dimension, parents' preferred time and location for pre-test information delivery, interpretation of screening results, and knowledge of hearing developmental milestones were surveyed. In addition, maternal attitudes to and satisfaction with UNHS screening services, the potential impact of UNHS on parent emotions and parent-baby bonding, attitudes toward informed consent, and willingness to comply with diagnostic assessment referral were also be surveyed. Mean participant scores on knowledge of infant hearing development were relatively low (M = 2.59/6.0, SD = 0.90). Many mothers also underestimated the potential ongoing risks of hearing impairment in babies. Around 80% of mothers thought an infant could not have hearing impairment after passing the screening. In addition, one-third of mothers thought a baby could not later develop hearing impairment in infancy or childhood. In terms of attitudes and satisfaction, participants gave somewhat negative ratings for questions regarding receiving sufficient information about the screening (M = 2.90/5.0, SD = 1.27), screening procedure (M = 2.20/5.0, SD = 1.08), and sufficiency of information about results (M = 2.87/5.0, SD = 1.14). Nonetheless, participants gave positive ratings concerning whether screening could lead to early diagnosis (M = 4.61/5.0, SD = 0.57) and over 95% of mothers supported UNHS despite potential for false positive results. Mothers reported a high willingness to bring their baby to follow-up assessments if required (M = 4.53/5.0, SD = 0.56). Participants gave positive ratings for their level of satisfaction with the time and location of first UNHS information provision (M = 4.34/5.0, SD = 0.80) and the way permission was asked for screening the baby (M = 4.04/5.0, SD = 0.97) but alternative procedures were also recommended. Most recommendations focused on providing more information about the test and a more detailed explanation of screening results. The survey results highlighted the need to provide more information to parents about infant hearing development to support home monitoring for signs of hearing loss after UNHS, as well as more detailed explanation and information regarding hearing screening and the implications of results to parents. Regardless of location, surveys of this type may provide valuable support for UNHS program quality assurance. Copyright © 2017. Published by Elsevier B.V.

Genetics of Hearing Loss

MedlinePlus

... Hearing Loss Homepage Basics Noise-Induced Hearing Loss Genetics of Hearing Loss Screening & Diagnosis Types of Hearing Loss About Sound Treatment & Intervention Services Learning Language Bacterial Meningitis Studies Data & Statistics EHDI Annual Data 2016 2015 2014 2013 ...

Hearing Loss in Children

MedlinePlus

... Hearing Loss Homepage Basics Noise-Induced Hearing Loss Genetics of Hearing Loss Screening & Diagnosis Types of Hearing Loss About Sound Treatment & Intervention Services Learning Language Bacterial Meningitis Studies Data & Statistics EHDI Annual Data 2016 2015 2014 2013 ...

Should patients with asymmetrical noise-induced hearing loss be screened for vestibular schwannomas?

PubMed

Baker, R; Stevens-King, A; Bhat, N; Leong, P

2003-08-01

The Peterborough ENT department receives many referrals for MoD personnel who have suffered hearing loss from occupational noise exposure. Those patients with asymmetrical sensorineural hearing loss are routinely screened for vestibular schwannomas by MRI scanning. Scan reports from the past 5 years have been reviewed and out of 152 scans, four revealed vestibular schwannomas giving a pick-up rate of 2.5%, which compares favourably with other published pick-up rates. Review of the audiograms in these cases suggests that they can be misleading in this context. The conclusion is that patients with noise-induced asymmetrical hearing loss should be screened for acoustic neuromas.

Hearing loss screening tool (COBRA score) for newborns in primary care setting

PubMed Central

Poonual, Watcharapol; Navacharoen, Niramon; Kangsanarak, Jaran; Namwongprom, Sirianong

2017-01-01

Purpose To develop and evaluate a simple screening tool to assess hearing loss in newborns. A derived score was compared with the standard clinical practice tool. Methods This cohort study was designed to screen the hearing of newborns using transiently evoked otoacoustic emission and auditory brain stem response, and to determine the risk factors associated with hearing loss of newborns in 3 tertiary hospitals in Northern Thailand. Data were prospectively collected from November 1, 2010 to May 31, 2012. To develop the risk score, clinical-risk indicators were measured by Poisson risk regression. The regression coefficients were transformed into item scores dividing each regression-coefficient with the smallest coefficient in the model, rounding the number to its nearest integer, and adding up to a total score. Results Five clinical risk factors (Craniofacial anomaly, Ototoxicity, Birth weight, family history [Relative] of congenital sensorineural hearing loss, and Apgar score) were included in our COBRA score. The screening tool detected, by area under the receiver operating characteristic curve, more than 80% of existing hearing loss. The positive-likelihood ratio of hearing loss in patients with scores of 4, 6, and 8 were 25.21 (95% confidence interval [CI], 14.69–43.26), 58.52 (95% CI, 36.26–94.44), and 51.56 (95% CI, 33.74–78.82), respectively. This result was similar to the standard tool (The Joint Committee on Infant Hearing) of 26.72 (95% CI, 20.59–34.66). Conclusion A simple screening tool of five predictors provides good prediction indices for newborn hearing loss, which may motivate parents to bring children for further appropriate testing and investigations. PMID:29234358

Research on Hearing and Balance--Current and Future Developments.

ERIC Educational Resources Information Center

Snow, James B., Jr.

1997-01-01

This article reviews current research that has located disease genes causing hearing impairments, discovered the ability of sensory cells of the inner ear to regenerate, developed vaccines to prevent otitis media, developed programmable hearing aids, improved cochlear implants, and demonstrated the positive effects of physical therapy with balance…

Risk factors for sensorineural hearing loss in children.

PubMed

Núñez-Batalla, Faustino; Trinidad-Ramos, Germán; Sequí-Canet, José Miguel; Alzina De Aguilar, Valentín; Jáudenes-Casaubón, Carmen

2012-01-01

In the last decade, tremendous progress has been made very rapidly in the development of Early Hearing Detection and Intervention (EHDI) systems as a major public health initiative. The percentage of infants screened annually in Spain has increased significantly since the EHDI systems have expanded to all autonomic regions. Historically, high risk indicators have been used for the identification of infants who should receive audiological evaluation but who live in geographic locations where universal hearing screening is not yet available, to help identify infants who pass neonatal screening but are at risk of developing delayed-onset hearing loss and to identify infants who may have passed neonatal screening but have mild forms of permanent hearing loss. In this review, the standard risk factors for hearing loss are analysed and the risk factors known to be associated with late onset or progressive hearing loss are identified. The recommendation for infants with a risk factor that may be considered as low risk is to perform at least one audiology assessment by 24-30 months. In contrast, for an infant with risk factors known to be associated with late onset or progressive hearing loss (such as cytomegalovirus infection or family history), early and more frequent assessment is appropriate. All infants should have an objective standardised screening of global development with a validated assessment tool at 9, 18 and 24-30 months of age or at any time if the health care professional or the family is concerned. Copyright © 2011 Elsevier España, S.L. All rights reserved.

Prevalence and referral rates in neonatal hearing screening program using two step hearing screening protocol in Chennai - A prospective study.

PubMed

Vignesh, S S; Jaya, V; Sasireka, B I; Sarathy, Kamala; Vanthana, M

2015-10-01

To estimate the prevalence and referral rates in well born and high risk babies using two step hearing screening protocol with Distortion Product Otoacoustic Emissions (DPOAE) and Automated Auditory Brainstem Response (AABR). A prospective study was carried out on 1405 neonates (983 well born babies and 422 high risk babies) who were screened during May 2013 to January 2015 at Institute of Obstetrics and Gynecology, Madras Medical College, Chennai. All neonates were screened using two step screening protocol. They were initially tested with DPOAE. Referred babies in DPOAE were screened with AABR subsequently. Among 1405 (100%) neonates 983 (69.96%) were well born babies and 422 (30.03%) were high risk babies. Total referral rate in DPOAE was found to be 311 (22.13%) among which 195 (13.87%) were well born babies and 116 (8.25%) were high risk babies. Out of 311 babies 31 (2.20%) babies were referred in AABR screening. In 31 babies referred in AABR 11(0.78%) were from well born group and 20 (1.42%) were from the high risk group. Further diagnostic evaluation of these babies, 2 (0.14%) were confirmed to have hearing loss. This study reveals, the prevalence of congenital hearing loss in our population is 1.42 per 1000 babies. Using two step protocol especially AABR along with DPOAE at the initial level of testing significantly reduces referral rates in new born screening programs. Also AABR decreases the false positive responses hence increasing the efficiency of screening program. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Invitation strategies and coverage in the population-based cancer screening programmes in the European Union.

PubMed

Vale, Diama B; Anttila, Ahti; Ponti, Antonio; Senore, Carlo; Sankaranaryanan, Rengaswamy; Ronco, Guglielmo; Segnan, Nereo; Tomatis, Mariano; Žakelj, Maja P; Elfström, Klara M; Lönnberg, Stefan; Dillner, Joakim; Basu, Partha

2018-03-21

The aim of this study was to describe the compliance of the population-based cancer screening programmes in the European Union Member States to the invitation strategies enumerated in the European Guidelines and the impact of such strategies on the invitational coverage. Experts in screening programme monitoring from the respective countries provided data. Coverage by invitation was calculated as the proportion of individuals in the target age range receiving a screening invitation over the total number of annualized eligible population. The invitation strategies of 30 breasts, 25 cervical and 27 colorectal national or regional population-based screening programmes are described. Individual mail invitations are sent by 28 breasts, 20 cervical and 25 colorectal screening programmes. Faecal occult blood test kits are sent by post in 17 of the colorectal cancer screening programmes. The majority of programmes claimed to have a population registry, although some use health insurance data as the database for sending invitations. At least 95% invitation coverage was reached by 16 breast, six cervical and five colorectal screening programmes. Majority of the programmes comply with the invitation strategies enumerated in the European guidelines, although there is still scope for improvements. Coverage by invitation is below the desirable level in many population-based cancer screening programmes in European Union.

Hearing loss among high-risk newborns admitted to a tertiary Neonatal Intensive Care Unit.

PubMed

Khairy, May Ahmed; Abuelhamed, Walaa Alsharany; Ahmed, Radwa Sayed; El Fouly, Hedayet El Sayed; Elhawary, Ismail Mohamed

2018-07-01

The aim of this work is to identify the most significant risk factors for hearing impairment in high risk neonates hospitalized at our Neonatal Intensive Care Unit (NICU) and to assess the sensitivity of hearing screening tests. This study involved 260 neonates admitted to a tertiary NICU; they were classified into two groups; 150 preterm and 110 full terms with risk factors for hearing loss. The hearing screening tests performed were transient evoked otoacoustic emissions (TEOAEs) and the automated auditory brainstem response (AABR). Forty-eight preterm neonates (32%) and 30 full term neonates (27.3%) had pathological AABR. In preterm group, mechanical ventilation more than five days, sepsis, usage of aminoglycosides, loop diuretics, vancomycin alone or in combination with aminoglycosides and prolonged duration of admission were considered risk factors of hearing affection whereas in full term group mechanical ventilation more than five days was the risk factor of hearing affection (p<.05). The prevalence of hearing loss is highest among high risk neonates and TEOAE and AABR were found to be reliable screening tools. Use of ototoxic drugs and mechanical ventilation for more than five days were significant risk factors for hearing loss in our study population.

Genetics Evaluation Guidelines for the Etiologic Diagnosis of Congenital Hearing Loss

PubMed Central

2002-01-01

The advent of hearing screening in newborns in many states has led to an increase in the use of genetic testing and related genetic services in the follow-up of infants with hearing loss. A significant proportion of those with congenital hearing loss have genetic etiologies underlying their hearing loss. To ensure that those identified with congenital hearing loss receive the genetic services appropriate to their conditions, the Maternal and Child Health Bureau of the Health Resources and Services Administration funded the American College of Medical Genetics to convene an expert panel to develop guidelines for the genetic evaluation of congential hearing loss. After a brief overview of the current knowledge of hearing loss, newborn screening, and newborn hearing screening, we provide an overview of genetic services and a guideline that describes how best to ensure that patients receive appropriate genetic services. The significant contribution of genetic factors to these conditions combined with the rapid evolution of knowledge about the genetics of these conditions overlaid with the inherently multidisciplinary nature of genetic services provides an example of a condition for which a well-integrated multidisciplinary approach to care is clearly needed. PMID:12180152

Noise exposure and hearing loss prevention programmes after 20 years of regulations in the United States

PubMed Central

Daniell, W E; Swan, S S; McDaniel, M M; Camp, J E; Cohen, M A; Stebbins, J G

2006-01-01

Objectives To evaluate noise exposures and hearing loss prevention efforts in industries with relatively high rates of workers' compensation claims for hearing loss. Methods Washington State workers' compensation records were used to identify up to 10 companies in each of eight industries. Each company (n = 76) was evaluated by a management interview, employee personal noise dosimetry (n = 983), and employee interviews (n = 1557). Results Full‐shift average exposures were ⩾85 dBA for 50% of monitored employees, using Occupational Safety and Health Administration (OSHA) parameters with a 5 dB exchange rate (Lave), but 74% were ⩾85 dBA using a 3 dB exchange rate (Leq). Only 14% had Lave ⩾90 dBA, but 42% had Leq ⩾90 dBA. Most companies conducted noise measurements, but most kept no records, and consideration of noise controls was low in all industries. Hearing loss prevention programmes were commonly incomplete. Management interview scores (higher score = more complete programme) showed significant associations with percentage of employees having Lave ⩾85 dBA and presence of a union (multiple linear regression; R2 = 0.24). Overall, 62% of interviewed employees reported always using hearing protection when exposed. Protector use showed significant associations with percentage of employees specifically required to use protection, management score, and average employee time spent ⩾95 dBA (R2 = 0.65). Conclusions The findings raise serious concerns about the adequacy of prevention, regulation, and enforcement strategies in the United States. The percentage of workers with excessive exposure was 1.5–3 times higher using a 3 dB exchange rate instead of the OSHA specified 5 dB exchange rate. Most companies gave limited or no attention to noise controls and relied primarily on hearing protection to prevent hearing loss; yet 38% of employees did not use protectors routinely. Protector use was highest when hearing loss prevention programmes were most complete, indicating that under‐use of protection was, in some substantial part, attributable to incomplete or inadequate company efforts. PMID:16551755

Association between language and hearing disorders – risk identification

PubMed Central

Samelli, Alessandra Giannella; Rondon-Melo, Silmara; Rabelo, Camila Maia; Molini-Avejonas, Daniela Regina

2017-01-01

OBJECTIVE: To identify children at risk for hearing and/or language disorders and to investigate the association between these risks by conducting pre-validated hearing and language screenings. METHODS: The study was conducted during a polio vaccination campaign in August of 2013 in basic health units in western São Paulo. Parents of children between 2 and 5 years of age were asked to complete two screening tools: a hearing questionnaire (regarding hearing development) and a language production and comprehension scale (including the major language development milestones). The screening tools were administered by different researchers. We compared the risk of having language disorders among children at risk for hearing loss versus children not at risk, as well as the attributable risk and odds ratios. Chi-squared tests and logistic regression analyses were used. RESULTS: The study included 479 children with a mean age of three and one-half years, of whom 26.9% were identified as at risk for deficits in language production, 8.6% were at risk for deficits in language comprehension and 14% were at risk for hearing disorders. The children at risk for hearing disorders were twice as likely as those not at risk to exhibit language production and comprehension deficits. CONCLUSION: The results of this study highlight the importance of establishing and adopting low-cost procedures such as screenings to identify children at risk of developing language and/or hearing disorders in early childhood. PMID:28492720

Otoacoustic Emissions in Rural Nicaragua: Cost Analysis and Implications for Newborn Hearing Screening.

PubMed

Wong, Lye-Yeng; Espinoza, Francisca; Alvarez, Karen Mojica; Molter, Dave; Saunders, James E

2017-05-01

Objective (1) Determine the incidence and risk factors for congenital hearing loss. (2) Perform cost analysis of screening programs. Study Design Proportionally distributed cross-sectional survey. Setting Jinotega, Nicaragua. Subjects and Methods Otoacoustic emissions (OAEs) were used to screen 640 infants <6 months of age from neonatal intensive care unit, institutional, and home birth settings. Data on 15 risk factors were analyzed. Cost of 4 implementation strategies was studied: universal screening, screening at the regional health center (RHC), targeted screening, and screening at the RHC plus targeted screening. Cost-effectiveness analysis over 10 years was based on disability-adjusted life year estimates, with the World Health Organization standard of cost-effectiveness ratio (CER) / gross domestic product (GDP) <3, with GDP set at $4884.15. Results Thirty-eight infants failed the initial OAE (5.94%). In terms of births, 325 (50.8%) were in the RHC, 69 (10.8%) in the neonatal intensive care unit, and 29 (4.5%) at home. Family history and birth defect were significant in univariate analysis; birth defect was significant in multivariate analysis. Cost-effectiveness analysis demonstrated that OAE screening is cost-effective without treatment (CER/GDP = 0.06-2.00) and with treatment (CER/GDP = 0.58-2.52). Conclusions Our rate of OAE failures was comparable to those of developed countries and lower than hearing loss rates noted among Nicaraguan schoolchildren, suggesting acquired or progressive etiology in the latter. Birth defects and familial hearing loss correlated with OAE failure. OAE screening of infants is feasible and cost-effective in rural Nicaragua, although highly influenced by estimated hearing loss severity in identified infants and the high travel costs incurred in a targeted screening strategy.

Utility of genetic testing for the detection of late-onset hearing loss in neonates.

PubMed

Lim, B Gail; Clark, Reese H; Kelleher, Amy S; Lin, Zhili; Spitzer, Alan R

2013-12-01

The purpose of this study was to demonstrate the utility of molecular testing in the detection of potentially important causes of delayed hearing loss missed by current audiometric screening at birth. We enrolled infants who had received a newborn audiometric hearing screen and a filter paper blood collection for state newborn screening. A central laboratory ran the SoundGene® panel. Of 3,681 infants studied, 35 (0.95%) had a positive SoundGene panel, 16 had mitochondrial mutations, 9 had Pendred mutations, 5 were cytomegalovirus (CMV) DNA positive, 2 had connexin mutations, and 3 had a combination of different mutations. Infants with an abnormal SoundGene panel were at increased risk for hearing loss compared to neonates without mutations. Three (8.6%) of the 35 subjects had persistent hearing loss compared to 5 (0.21%) of 2,398 subjects with no report of mutation (p < .01). Of 3,681 infants studied, 8 (0.22%) had persistent hearing loss: 5 (62.5%) had abnormal newborn audiometric screens, 2 (25%) had an abnormal SoundGene panel (1 was CMV positive, 1 had a mitochondrial mutation), and 1 (12.5%) had no identifiable risk factors. A positive SoundGene panel identifies infants who are not identified by audiometric testing and may be at risk for hearing loss.

Item Response Theory Applied to Factors Affecting the Patient Journey Towards Hearing Rehabilitation

PubMed Central

Chenault, Michelene; Berger, Martijn; Kremer, Bernd; Anteunis, Lucien

2016-01-01

To develop a tool for use in hearing screening and to evaluate the patient journey towards hearing rehabilitation, responses to the hearing aid rehabilitation questionnaire scales aid stigma, pressure, and aid unwanted addressing respectively hearing aid stigma, experienced pressure from others; perceived hearing aid benefit were evaluated with item response theory. The sample was comprised of 212 persons aged 55 years or more; 63 were hearing aid users, 64 with and 85 persons without hearing impairment according to guidelines for hearing aid reimbursement in the Netherlands. Bias was investigated relative to hearing aid use and hearing impairment within the differential test functioning framework. Items compromising model fit or demonstrating differential item functioning were dropped. The aid stigma scale was reduced from 6 to 4, the pressure scale from 7 to 4, and the aid unwanted scale from 5 to 4 items. This procedure resulted in bias-free scales ready for screening purposes and application to further understand the help-seeking process of the hearing impaired. PMID:28028428

Electroacoustic Evaluation of Frequency-Modulated Receivers Interfaced with Personal Hearing Aids

ERIC Educational Resources Information Center

Schafer, Erin C.; Thibodeau, Linda M.; Whalen, Holly S.; Overson, Gary J.

2007-01-01

Purpose: The purpose of this study was to compare the electroacoustic outputs of frequency-modulated (FM) systems coupled to hearing aids. Method: Electroacoustic performance of FM systems coupled to hearing aids was determined for 3 FM receivers: body-worn with neck loop, ear-level nonprogrammable, and ear-level programmable. Systems were…

Educating teenagers about hearing health by training them to educate children.

PubMed

Welch, David; Reddy, Ravi; Hand, Jennifer; Devine, Irina May

2016-09-01

We investigated the change in hearing-health behaviour amongst teenagers trained to deliver the Dangerous Decibels programme to younger children. The Dangerous Decibels programme uses a two-stage process to train 8-12 year-old children to protect their hearing from noise: (1) a team of experts train 'Educators' who (2) give classroom training to children in schools. Training teenagers as Educators may add a second level of benefit if teenagers internalize the hearing-health messages that they present and thus protect their own hearing better. They were assessed before training, immediately after, and three months later (after all had presented the classroom training) using a questionnaire. In addition, a focus group was conducted with a subgroup of the Educators to assess their subjective experience. We trained 44 Educators aged 14-17 years. Results were generally positive: there were significant and sustained improvements in knowledge, self-reported behaviour, and perceived supports towards protecting hearing, and trends but not significant changes in attitudes or perceived barriers to hearing protection. Providing training to teenagers had benefits beyond the delivery of training to younger children, but improvements in the delivery model may increase the uptake and impact on the teenagers.

Using singing to nurture children's hearing? A pilot study.

PubMed

Welch, Graham F; Saunders, Jo; Edwards, Sian; Palmer, Zoe; Himonides, Evangelos; Knight, Julian; Mahon, Merle; Griffin, Susanna; Vickers, Deborah A

2015-09-01

This article reports a pilot study of the potential benefits of a sustained programme of singing activities on the musical behaviours and hearing acuity of young children with hearing impairment (HI). Twenty-nine children (n=12 HI and n=17 NH) aged between 5 and 7 years from an inner-city primary school in London participated, following appropriate ethical approval. The predominantly classroom-based programme was designed by colleagues from the UCL Institute of Education and UCL Ear Institute in collaboration with a multi-arts charity Creative Futures and delivered by an experienced early years music specialist weekly across two school terms. There was a particular emphasis on building a repertoire of simple songs with actions and allied vocal exploration. Musical learning was also supported by activities that drew on visual imagery for sound and that included simple notation and physical gesture. An overall impact assessment of the pilot programme embraced pre- and post-intervention measures of pitch discrimination, speech perception in noise and singing competency. Subsequent statistical data analyses suggest that the programme had a positive impact on participant children's singing range, particularly (but not only) for HI children with hearing aids, and also in their singing skills. HI children's pitch perception also improved measurably over time. Findings imply that all children, including those with HI, can benefit from regular and sustained access to age-appropriate musical activities.

Changing Trends within the Population of Children Who Are Deaf or Hard of Hearing in Flanders (Belgium): Effects of 12 Years of Universal Newborn Hearing Screening, Early Intervention, and Early Cochlear Implantation

ERIC Educational Resources Information Center

De Raeve, Leo; Lichtert, Guido

2012-01-01

The purpose of this study is to show the changing trends within the population of children who are deaf and hard of hearing in Belgium over the last 12 years. The combination of Universal Newborn Hearing Screening programs, early intervention, and cochlear implants have tremendously influenced the education and support of children who are deaf or…

Screening for Infectious Diseases among Newly Arrived Migrants in EU/EEA Countries—Varying Practices but Consensus on the Utility of Screening

PubMed Central

Kärki, Tommi; Napoli, Christian; Riccardo, Flavia; Fabiani, Massimo; Dente, Maria Grazia; Carballo, Manuel; Noori, Teymur; Declich, Silvia

2014-01-01

Screening is one possible tool for monitoring infectious diseases among migrants. However, there is limited information on screening programmes targeted for newly arrived migrants in EU/EEA countries. Our aim was to investigate the implementation, practices and usefulness of these programmes. We conducted a survey among country experts from EU/EEA countries and Switzerland, asking whether their countries had implemented screening programmes. We also estimated the association between the implementation of these programmes and the rate of asylum-seekers in the population. Of the countries, 16 (59%) had implemented screening programmes and 15 (56%) had national guidelines. The rate of asylum-seekers was associated with implementation of screening programmes (p = 0.014). Screening was performed most often for tuberculosis; most commonly on holding level, and was targeted to specific migrant groups in over half of the countries performing screening. Twenty-five of all the country experts (96%) considered screening among migrants useful, and 24 (92%) would welcome EU level guidelines for screening. The implementation of screening programmes varied, and the practices were different among countries. Our survey suggests, that establishing EU level guidelines for screening would be useful, although they would have to take into account differences between individual countries. PMID:25337945

Economic evaluation of long-term impacts of universal newborn hearing screening.

PubMed

Chiou, Shu-Ti; Lung, Hou-Ling; Chen, Li-Sheng; Yen, Amy Ming-Fang; Fann, Jean Ching-Yuan; Chiu, Sherry Yueh-Hsia; Chen, Hsiu-Hsi

2017-01-01

Little is known about the long-term efficacious and economic impacts of universal newborn hearing screening (UNHS). An analytical Markov decision model was framed with two screening strategies: UNHS with transient evoked otoacoustic emission (TEOAE) test and automatic acoustic brainstem response (aABR) test against no screening. By estimating intervention and long-term costs on treatment and productivity losses and the utility of life years determined by the status of hearing loss, we computed base-case estimates of the incremental cost-utility ratios (ICURs). The scattered plot of ICUR and acceptability curve was used to assess the economic results of aABR versus TEOAE or both versus no screening. A hypothetical cohort of 200,000 Taiwanese newborns. TEOAE and aABR dominated over no screening strategy (ICUR = $-4800.89 and $-4111.23, indicating less cost and more utility). Given $20,000 of willingness to pay (WTP), the probability of being cost-effective of aABR against TEOAE was up to 90%. UNHS for hearing loss with aABR is the most economic option and supported by economically evidence-based evaluation from societal perspective.

Comparison of Newborn Hearing Screening in Well-Baby Nursery and NICU: A Study Applied to Reduce Referral Rate in NICU

PubMed Central

Li, Pei-Chun; Chen, Wei-I; Huang, Chih-Ming; Liu, Ching-Ju; Chang, Hsiu-wen; Lin, Hung-Ching

2016-01-01

Objectives To determine whether newborn hearing screening in a well-baby nursery (WBN) and neonatal intensive care unit (NICU) nursery: 1) meet three targeted, screening, referral, and diagnostic follow-up rates; 2) compare the average age of diagnosis for infants admitted to the WIN and NICU; and 3) determine prevalence of hearing loss in neonatal population; and 4) try to find a practical newborn hearing screening time algorithm to reduce refer rate in NICU Materials and Methods It examined 15,624 newborns in the WBN (13,676) and NICU (1948) screened for congenital HL using AABR. The variables analyzed in it were the screening rate, referral rate, follow-up rate, diagnostic rate and diagnostic age, prevalence rate, degrees of congenital bilateral HL. The study was approved by the hospital’s institutional review board (13MMHISO23). Results The screening rates were 99.8% and 99.6% in the WBN and NICU groups, respectively, without significant difference. The referral rates were 0.7% and 2.8% in the WBN and NICU groups, with significant difference. Furthermore, the diagnostic follow-up rates were 76.7% and 89.1% in the WBN and NICU groups, without significant difference. The average initial diagnostic ages were 1.9 months and 3.8 months in the WBN and NICU groups, with significant difference. The prevalence of congenital bilateral hearing loss were 0.27% and 1.6% in the WBN and NICU groups, with significant difference. Conclusion The screening, referral and follow-up rate in the WBN and NICU groups were equivalent to the quality indicators. For NICU group, screening and diagnostic follow up were performed later than those in WBN group; however the lower referral rate in our NICU group was successfully achieved in this study and can be applied clinically. The prevalence of congenital bilateral hearing loss was higher in the NICU group than in the WBN group. PMID:27023324

Comparison of Newborn Hearing Screening in Well-Baby Nursery and NICU: A Study Applied to Reduce Referral Rate in NICU.

PubMed

Li, Pei-Chun; Chen, Wei-I; Huang, Chih-Ming; Liu, Ching-Ju; Chang, Hsiu-wen; Lin, Hung-Ching

2016-01-01

To determine whether newborn hearing screening in a well-baby nursery (WBN) and neonatal intensive care unit (NICU) nursery: 1) meet three targeted, screening, referral, and diagnostic follow-up rates; 2) compare the average age of diagnosis for infants admitted to the WIN and NICU; and 3) determine prevalence of hearing loss in neonatal population; and 4) try to find a practical newborn hearing screening time algorithm to reduce refer rate in NICU. It examined 15,624 newborns in the WBN (13,676) and NICU (1948) screened for congenital HL using AABR. The variables analyzed in it were the screening rate, referral rate, follow-up rate, diagnostic rate and diagnostic age, prevalence rate, degrees of congenital bilateral HL. The study was approved by the hospital's institutional review board (13MMHISO23). The screening rates were 99.8% and 99.6% in the WBN and NICU groups, respectively, without significant difference. The referral rates were 0.7% and 2.8% in the WBN and NICU groups, with significant difference. Furthermore, the diagnostic follow-up rates were 76.7% and 89.1% in the WBN and NICU groups, without significant difference. The average initial diagnostic ages were 1.9 months and 3.8 months in the WBN and NICU groups, with significant difference. The prevalence of congenital bilateral hearing loss were 0.27% and 1.6% in the WBN and NICU groups, with significant difference. The screening, referral and follow-up rate in the WBN and NICU groups were equivalent to the quality indicators. For NICU group, screening and diagnostic follow up were performed later than those in WBN group; however the lower referral rate in our NICU group was successfully achieved in this study and can be applied clinically. The prevalence of congenital bilateral hearing loss was higher in the NICU group than in the WBN group.

Two-Way Radio Modem Data Transfer for Newborn Hearing Screening Devices.

PubMed

Matulat, Peter; Lepper, Ingo; Böttcher, Peter; Parfitt, Ross; Oswald, Hans; Am Zehnhoff-Dinnesen, Antoinette; Deuster, Dirk

2017-01-01

The success of a newborn hearing screening program depends on successful tracking and follow-up to ensure that children who have had positive screening results in the first few days of life receive appropriate and timely diagnostic and intervention services. The easy availability, through a suitable infrastructure, of the data necessary for the tracking, diagnosis, and care of children concerned is a major key to enhancing the quality and efficiency of newborn hearing screening programs. Two systems for the automated two-way transmission of newborn hearing screening and configuration data, based on mobile communication technology, for the screening devices MADSEN AccuScreen ® and Natus Echo-Screen ® were developed and tested in a field study. Radio modem connections were compared with conventional analogue modem transmissions from Natus Echo-Screen devices for duration, transmission rate, number of lost connections, and frequency of use. The average session duration was significantly lower with the MADSEN AccuScreen (12 s) and Natus Echo-Screen both with radio modem (15 s) than the Natus Echo-Screen with analogue modem (108 s). The transmission rate was significantly higher (898 and 1,758 vs. 181 bytes/s) for the devices with radio modems. Both radio modem devices had significantly lower rates of broken connections after initial connection (2.1 and 0.9 vs. 5.5%). An increase in the frequency of data transmission from the clinics with mobile radio devices was found. The use of mobile communication technology in newborn hearing screening devices offers improvements in the average session duration, transmission rate, and reliability of the connection over analogue solutions. We observed a behavioral change in clinical staff using the new technology: the data exchange with the tracking center is more often used. The requirements for on-site support were reduced. These savings outweigh the small increase in costs for the Internet service provider.

When instructions fail. The effects of stimulus control training on brain injury survivors' attending and reporting during hearing screenings.

PubMed

Schlund, M W

2000-10-01

Bedside hearing screenings are routinely conducted by speech and language pathologists for brain injury survivors during rehabilitation. Cognitive deficits resulting from brain injury, however, may interfere with obtaining estimates of auditory thresholds. Poor comprehension or attention deficits often compromise patient abilities to follow procedural instructions. This article describes the effects of jointly applying behavioral methods and psychophysical methods to improve two severely brain-injured survivors' attending and reporting on auditory test stimuli presentation. Treatment consisted of stimulus control training that involved differentially reinforcing responding in the presence and absence of an auditory test tone. Subsequent hearing screenings were conducted with novel auditory test tones and a common titration procedure. Results showed that prior stimulus control training improved attending and reporting such that hearing screenings were conducted and estimates of auditory thresholds were obtained.

A Targeted Approach for Congenital Cytomegalovirus Screening Within Newborn Hearing Screening

PubMed Central

McCollister, Faye P.; Sabo, Diane L.; Shoup, Angela G.; Owen, Kris E.; Woodruff, Julie L.; Cox, Edith; Mohamed, Lisa S.; Choo, Daniel I.; Boppana, Suresh B.

2017-01-01

BACKGROUND AND OBJECTIVE: Congenital cytomegalovirus (cCMV) infection remains a leading cause of childhood hearing loss. Currently universal CMV screening at birth does not exist in the United States. An alternative approach could be testing infants who do not pass their newborn hearing screening (NHS) for cCMV. This study was undertaken to evaluate whether a targeted approach will identify infants with CMV-related sensorineural hearing loss (SNHL). METHODS: Infants born at 7 US medical centers received NHS and were also screened for cCMV while in the newborn nursery. Infants who tested positive for CMV received further diagnostic audiologic evaluations to identify or confirm hearing loss. RESULTS: Between 2007 and 2012, 99 945 newborns were screened for both hearing impairment and cCMV. Overall, 7.0% of CMV-positive infants did not pass NHS compared with 0.9% of CMV-negative infants (P < .0001). Among the cCMV infants who failed NHS, diagnostic testing confirmed that 65% had SNHL. In addition, 3.6% of CMV-infected infants who passed their NHS had SNHL confirmed by further evaluation during early infancy. NHS in this cohort identified 57% of all CMV-related SNHL that occurred in the neonatal period. CONCLUSIONS: A targeted CMV approach that tests newborns who fail their NHS identified the majority of infants with CMV-related SNHL at birth. However, 43% of the infants with CMV-related SNHL in the neonatal period and cCMV infants who are at risk for late onset SNHL were not identified by NHS. PMID:28049114

Improved Newborn Hearing Screening Follow-up Results in More Infants Identified

PubMed Central

Alam, Suhana; Gaffney, Marcus; Eichwald, John

2015-01-01

Longitudinal research suggests that efforts at the national, state, and local levels are leading to improved follow-up and data reporting. Data now support the assumption that the number of deaf or hard-of-hearing infants identified through newborn hearing screening increases with a reduction in the number of infants lost to follow-up. Documenting the receipt of services has made a noticeable impact on reducing lost to follow-up rates and early identification of infants with hearing loss; however, continued improvement and monitoring of services are still needed. PMID:23803975

Improved newborn hearing screening follow-up results in more infants identified.

PubMed

Alam, Suhana; Gaffney, Marcus; Eichwald, John

2014-01-01

Longitudinal research suggests that efforts at the national, state, and local levels are leading to improved follow-up and data reporting. Data now support the assumption that the number of deaf or hard-of-hearing infants identified through newborn hearing screening increases with a reduction in the number of infants lost to follow-up. Documenting the receipt of services has made a noticeable impact on reducing lost to follow-up rates and early identification of infants with hearing loss; however, continued improvement and monitoring of services are still needed.

Audit feedback on reading performance of screening mammograms: An international comparison.

PubMed

Hofvind, S; Bennett, R L; Brisson, J; Lee, W; Pelletier, E; Flugelman, A; Geller, B

2016-09-01

Providing feedback to mammography radiologists and facilities may improve interpretive performance. We conducted a web-based survey to investigate how and why such feedback is undertaken and used in mammographic screening programmes. The survey was sent to representatives in 30 International Cancer Screening Network member countries where mammographic screening is offered. Seventeen programmes in 14 countries responded to the survey. Audit feedback was aimed at readers in 14 programmes, and facilities in 12 programmes. Monitoring quality assurance was the most common purpose of audit feedback. Screening volume, recall rate, and rate of screen-detected cancers were typically reported performance measures. Audit reports were commonly provided annually, but more frequently when target guidelines were not reached. The purpose, target audience, performance measures included, form and frequency of the audit feedback varied amongst mammographic screening programmes. These variations may provide a basis for those developing and improving such programmes. © The Author(s) 2016.

Validated Smartphone-Based Apps for Ear and Hearing Assessments: A Review

PubMed Central

Pallawela, Danuk

2016-01-01

Background An estimated 360 million people have a disabling hearing impairment globally, the vast majority of whom live in low- and middle-income countries (LMICs). Early identification through screening is important to negate the negative effects of untreated hearing impairment. Substantial barriers exist in screening for hearing impairment in LMICs, such as the requirement for skilled hearing health care professionals and prohibitively expensive specialist equipment to measure hearing. These challenges may be overcome through utilization of increasingly available smartphone app technologies for ear and hearing assessments that are easy to use by unskilled professionals. Objective Our objective was to identify and compare available apps for ear and hearing assessments and consider the incorporation of such apps into hearing screening programs Methods In July 2015, the commercial app stores Google Play and Apple App Store were searched to identify apps for ear and hearing assessments. Thereafter, six databases (EMBASE, MEDLINE, Global Health, Web of Science, CINAHL, and mHealth Evidence) were searched to assess which of the apps identified in the commercial review had been validated against gold standard measures. A comparison was made between validated apps. Results App store search queries returned 30 apps that could be used for ear and hearing assessments, the majority of which are for performing audiometry. The literature search identified 11 eligible validity studies that examined 6 different apps. uHear, an app for self-administered audiometry, was validated in the highest number of peer reviewed studies against gold standard pure tone audiometry (n=5). However, the accuracy of uHear varied across these studies. Conclusions Very few of the available apps have been validated in peer-reviewed studies. Of the apps that have been validated, further independent research is required to fully understand their accuracy at detecting ear and hearing conditions. PMID:28582261

Performance of two hearing screening protocols in NICU in Shanghai.

PubMed

Xu, Zheng-Min; Cheng, Wen-Xia; Yang, Xiao-Lin

2011-10-01

To study the sensitivity and specificity of targeted neonatal hearing screening for the single-session distortion product otoacoustic emissions (DPOAE) technique and the combined DPOAE/automated auditory brain-stem response (AABR) technique. 3000 high-risk newborns were studied at Children's Hospital of Fudan University. They were required to take two different screening procedures separately. The first procedure consisted of DPOAE alone and the second consisted of DPOAE combined with the AABR. Based upon the etiology in high-risk babies, they were divided into four groups. In group I there were 670 very-low-birth-weight (VLBW) newborns (1340 ears), and in group II there were 890 preterm babies (1780 ears). 850 babies (1700 ears) suffered from hyperbilirubinemia in group III, whereas 790 babies (1580 ears) with asphyxia were in group IV. The babies in groups II, III, and IV came from the neonatal intensive-care unit (NICU) of our hospital. The study protocols consisted of the DPOAE alone and DPOAE combined with AABR hearing screening at an age of less than 1 month, and a diagnostic stage at the age of 2 months. With single-session DPOAE screening, the referral rate (8% of the NICU babies), the false-positive rate (4.96%) and the false-negative rate (0.8%) were higher. The different etiologies in NICU babies had significantly different referral rates (F-test, p<0.01). A 4.46% referral rate of hyperbilirubinemi babies was much lower. The combined DPOAE/AABR screening technique revealed a referral rate of 5.03%, a false-positive rate of 2% and a false-negative rate of 0.06%. The false-positive rate was well below the suggested 3% of the American Academy of Pediatric. Comparisons of the referral rate, false-positive rate and false-negative rate of two hearing screening protocols (DPOAE alone and combined DPOAE/AABR) revealed significant differences (t-test, p<0.05, p<0.01, p<0.01). 91 infants (3.03% of the NICU babies) who failed the combined DPOAE/AABR screening were confirmed on hearing impairment. Of 22 babies who passed DPOAE screening but failed the AABR screening had a severe to profound hearing loss based on classic ABR. These patients (24% of the NICU babies with hearing losses) with hyperbilirubinemia and asphyxia problems at newborn stage were diagnosed as auditory neuropathy based on evaluations of DPOAE screening passed, abnormal ABR and absent middle-ear muscle reflexes (MMR). Our study demonstrates the use of a combination of DPOAE and AABR testing ensures high sensitivity and acceptable specificity, and predict the AN profile in NICU babies. Our efforts identified 22 NICU babies with auditory neuropathy who hopefully will benefit from early remediation of their hearing deficit. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Introduction to the AJA research forum on aging and hearing: mechanisms and effects.

PubMed

Paglialonga, Alessia; Grandori, Ferdinando

2013-12-01

PURPOSE This Research Forum, "Aging and Hearing: Mechanisms and Effects," highlights 6 contributions presented at the 2nd International Conference on Adult Hearing Screening (AHS 2012), held in Cernobbio (Lake Como, Italy) in June 2012. Overall, the articles in this Research Forum give insight into the causes, mechanisms, and consequences of auditory dysfunctions in adults, with particular focus on their implications for screening, assessment, and intervention.

Measures of follow-up in early hearing detection and intervention programs: a need for standardization.

PubMed

Mason, Craig A; Gaffney, Marcus; Green, Denise R; Grosse, Scott D

2008-06-01

To demonstrate the need for standardized data definitions and reporting for early hearing detection and intervention (EHDI) programs collecting information on newborn hearing screening and follow-up, and types of information best collected in a standardized manner. A hypothetical birth cohort was used to show the potential effects of nonstandardized definitions and data classifications on rates of hearing screening, audiologic follow-up, and hearing loss. The true screening rate in this cohort was 92.4%. The calculated rate was between 90.0% and 96.5%, depending on the measure used. Among children documented as screened and referred for follow-up, 61.0% received this testing. Only 49.0% were documented to have been tested. Despite a true prevalence of 3.7 per 1,000 births, only 1.5 per 1,000 children were documented with a hearing loss. Ensuring that children receive recommended follow-up is challenging. Without complete reporting by audiologists to EHDI programs, accurate calculation of performance measures is impossible. Lack of documentation can lead to the overstatement of "loss to follow-up." Also, standardization of measures is essential for programs to evaluate how many children receive recommended services and assess progress toward national goals. A new survey has been implemented to collect more detailed and standardized information about recommended services.

Risk of Bacterial Meningitis in Children with Cochlear Implants

MedlinePlus

... Hearing Loss Homepage Basics Noise-Induced Hearing Loss Genetics of Hearing Loss Screening & Diagnosis Types of Hearing Loss About Sound Treatment & Intervention Services Learning Language Bacterial Meningitis Studies Data & Statistics EHDI Annual Data 2016 2015 2014 2013 ...

A test protocol for assessing the hearing status of students with special needs.

PubMed

Chen, Hsiao-Chuan; Wang, Nan-Mai; Chiu, Wen-Chen; Liu, Shu-Yu; Chang, Yi-Ping; Lin, Pei-Yu; Chung, King

2014-10-01

Individuals with disabilities are often reported to have a high prevalence of undetected hearing disorders/loss, but there is no standardized hearing test protocol for this population. The purposes of this study were (1) to examine the hearing status of students with special needs in Taiwan, and (2) to investigate the use of an on-site hearing test protocol that would adequately detect hearing problems in this population and reduce unnecessary referrals for off-site follow-up services. A total of 238 students enrolled in two schools for special education and one habilitation center participated in the study. Most students had intellectual disabilities and some also had additional syndromes or disorders. A hearing screening protocol including otoscopy, tympanometry, and distortion product otoacoustic emissions was administered to examine students' outer, middle, and inner ear functions, respectively. Pure tone tests were then administered as an on-site follow-up for those who failed or could not be tested using the screening protocol. Only 32.4% of students passed. When administered alone, the referral rate of otoscopy, tympanometry, and otoacoustic emissions were 38.7%, 46.0%, and 48.5%, respectively. The integration of these subtests revealed 52.1% of students needed follow-up services, 11.8% could not be tested, 2.5% had documented hearing loss, and 1.3% needed to be monitored because of negative middle ear pressure. The inclusion of pure tone audiometry increased the passing rate by 9.9% and provided information on hearing sensitivity for an additional 8.6% of students. Hearing assessments and regular hearing screening should be provided as an integral part of health care services for individuals with special needs because of high occurrences of excessive cerumen, middle ear dysfunction, and sensorineural hearing loss. The training of care-givers and teachers of students with special needs is encouraged so that they can help identify hearing problems and reduce the negative impact of hearing disorders and hearing loss. The screening protocol needs to include subtests that examine the status of different parts of their auditory system. The addition of pure tone audiometry as an on-site follow-up tool reduced the rate of off-site referrals and provided more information on hearing sensitivity. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The Development of Discourse Referencing in Cantonese of Deaf/Hard-of-Hearing Children

ERIC Educational Resources Information Center

Sze, Felix; Tang, Gladys; Lau, Tammy; Lam, Emily; Yiu, Chris

2015-01-01

This paper investigates the development of discourse referencing in spoken Cantonese of fifteen deaf/hard-of-hearing children studying in a sign bilingual and co-enrolment education programme in a mainstream setting in Hong Kong. A comparison of their elicited narratives with those of the hearing children and adults shows that, despite a delay in…

Evaluation of health benefits and harms of the breast cancer screening programme in the Basque Country using discrete event simulation.

PubMed

Arrospide, Arantzazu; Rue, Montserrat; van Ravesteyn, Nicolien T; Comas, Merce; Larrañaga, Nerea; Sarriugarte, Garbiñe; Mar, Javier

2015-10-12

Since the breast cancer screening programme in the Basque Country (BCSPBC) was started in 1996, more than 400,000 women aged 50 to 69 years have been invited to participate. Based on epidemiological observations and simulation techniques it is possible to extend observed short term data into anticipated long term results. The aim of this study was to assess the effectiveness of the programme through 2011 by quantifying the outcomes in breast cancer mortality, life-years gained, false positive results, and overdiagnosis. A discrete event simulation model was constructed to reproduce the natural history of breast cancer (disease-free, pre-clinical, symptomatic, and disease-specific death) and the actual observed characteristics of the screening programme during the evaluated period in the Basque women population. Goodness-of-fit statistics were applied for model validation. The screening effects were measured as differences in benefits and harms between the screened and unscreened populations. Breast cancer mortality reduction and life-years gained were considered as screening benefits, whereas, overdiagnosis and false positive results were assessed as harms. Results for a single cohort were also obtained. The screening programme yielded a 16 % reduction in breast cancer mortality and a 10 % increase in the incidence of breast cancer through 2011. Almost 2 % of all the women in the programme had a false positive result during the evaluation period. When a single cohort was analysed, the number of deaths decreased by 13 %, and 4 % of screen-detected cancers were overdiagnosed. Each woman with BC detected by the screening programme gained 2.5 life years due to early detection corrected by lead time. Fifteen years after the screening programme started, this study supports an important decrease in breast cancer mortality due to the screening programme, with reasonable risk of overdiagnosis and false positive results, and sustains the continuation of the breast cancer screening programme in the Basque population.

Infant hearing loss: the necessity for early identification.

PubMed

Harney, C L

2000-01-01

There has been controversy in the health professions about the necessity for newborn infant hearing screening. It is well accepted that patient history or a birth that places the infant in the high-risk registry (HHR) can identify 50% of all infants born with permanent bilateral hearing loss. Two major factors which have been cited as reasons for not screening the well-baby nursery have been poor cost effectiveness and the lack of documentation as to the benefits derived from early identification and intervention. Recent technological developments and published data are presented which indicate that economical well-baby hearing screening can be done in any setting, and that the language acquisition of the infant is permanently affected if the intervention is not done in the first six months after birth.

Do ambient noise exposure levels predict hearing loss in a modern industrial cohort?

PubMed Central

Rabinowitz, P M; Galusha, D; Dixon‐Ernst, C; Slade, M D; Cullen, M R

2007-01-01

Background Much of what is known about the exposure–response relationship between occupational noise exposures and hearing loss comes from cross‐sectional studies conducted before the widespread implementation of workplace hearing conservation programmes. Little is known about the current relationship of ambient noise exposure measurements to hearing loss risk. Aim To examine the relationship between rates of high frequency hearing loss and measured levels of noise exposure in a modern industrial workforce. Methods Ten‐year hearing loss rates were determined for 6217 employees of an aluminium manufacturing company. Industrial hygiene and human resources records allowed for reconstruction of individual noise exposures. Hearing loss rates were compared to ANSI 3.44 predictions based on age and noise exposure. Associations between hearing loss, noise exposure, and covariate risk factors were assessed using multivariate regression. Results Workers in higher ambient noise jobs tended to experience less high frequency hearing loss than co‐workers exposed at lower noise levels. This trend was also seen in stratified analyses of white males and non‐hunters. At higher noise exposure levels, the magnitude of hearing loss was less than predicted by ANSI 3.44 formulae. There was no indication that a healthy worker effect could explain these findings. The majority of 10 dB standard threshold shifts (STS) occurred in workers whose calculated ambient noise exposures were less than or equal to 85 dBA. Conclusions In this modern industrial cohort, hearing conservation efforts appear to be reducing hearing loss rates, especially at higher ambient noise levels. This could be related to differential use of hearing protection. The greatest burden of preventable occupational hearing loss was found in workers whose noise exposure averaged 85 dBA or less. To further reduce rates of occupational hearing loss, hearing conservation programmes may require innovative approaches targeting workers with noise exposures close to 85 dBA. PMID:16973736

A rapid echocardiographic screening protocol for rheumatic heart disease in Samoa: a high prevalence of advanced disease.

PubMed

Allen, Marvin; Allen, John; Naseri, Take; Gardner, Rebecca; Tolley, Dennis; Allen, Lori

2017-10-01

Echocardiography has been proposed as a method to screen children for rheumatic heart disease. The World Heart Federation has established guidelines for echocardiographic screening. In this study, we describe a rapid echocardiogram screening protocol according to the World Heart Federation guidelines in Samoa, endemic for rheumatic heart disease. We performed echocardiogram screening in schoolchildren in Samoa between 2013 and 2015. A brief screening echocardiogram was performed on all students. Children with predefined criteria suspicious for rheumatic hear diseases were referred for a more comprehensive echocardiogram. Complete echocardiograms were classified according to the World Heart Federation guidelines and severity of valve disease. Echocardiographic screening was performed on 11,434 children, with a mean age of 10.2 years; 51% of them were females. A total of 558 (4.8%) children underwent comprehensive echocardiography, including 49 students who were randomly selected as controls. Definite rheumatic heart disease was observed in 115 students (10.0 per 1000): 92 students were classified as borderline (8.0 per 1000) and 23 with CHD. Advanced disease was identified in 50 students (4.4 per 1000): 15 with severe mitral regurgitation, five with severe aortic regurgitation, 11 with mitral stenoses, and 19 with mitral and aortic valve disease. We successfully applied a rapid echocardiographic screening protocol to a large number of students over a short time period - 28 days of screening over a 3-year time period - to identify a high prevalence of rheumatic heart disease. We also reported a significantly higher rate of advanced disease compared with previously published echocardiographic screening programmes.

Effectiveness of an online SUpport PRogramme (SUPR) for older hearing aid users: study protocol for a cluster randomised controlled trial

PubMed Central

Meijerink, Janine FJ; Pronk, Marieke; Paulissen, Bernadette; Witte, Birgit I; van der Wouden, Bregje; Jansen, Vera; Kramer, Sophia E

2017-01-01

Background An educational SUpport PRogramme called SUPR has been developed for hearing aid users (HAUs) and their communication partners (CPs) offering care beyond hearing aid fitting. SUPR teaches its users communication strategies, hearing aid handling skills and personal adjustment to hearing impairment. Methods/design Using a cluster randomised controlled trial design, 70 Dutch hearing aid dispenser practices were randomised into hearing aid fitting (care as usual, 34 practices) and hearing aid fitting including SUPR (36 practices). The aim was to recruit a total of 569 older (aged 50+ years) first-time (n=258) and experienced (n=311) HAUs and their CPs. SUPR consists of a Practical Support Booklet and online material offered via email over a period of 6–7 months. The booklet provides practical information on hearing aids, advice on communication strategies and home exercises. The online material consists of educational videos on hearing aid functionality and usage, communication strategies and peer testimonials. Finally, noncommittal email contact with the dispenser is offered. Every HAU is asked to assign a CP who is advised to be involved intensively. Effect measurements for HAUs and their CPs will occur at baseline and at 6, 12 and 18 months follow-up via online questionnaires. The primary outcomes for HAUs will be the use of communication strategies as measured by the subscales of the Communication Profile for the Hearing Impaired. A process evaluation will be performed. Ethics and dissemination The study was approved by the Dutch Institutional Review Board of the VU Medical University Center Amsterdam. This intervention could contribute to lowering the hearing impairment burden in our ageing society. The results will be disseminated through peer-reviewed publications and scientific conferences. Trial registration number ISRCTN77340339; Pre-results. PMID:28634259

School scoliosis screening programme-a systematic review.

PubMed

Sabirin, J; Bakri, R; Buang, S N; Abdullah, A T; Shapie, A

2010-12-01

A systematic review on the effectiveness and cost-effectiveness of school scoliosis screening programme was carried out. A total of 248 relevant titles were identified, 117 abstracts were screened and 28 articles were included in the results. There was fair level of evidence to suggest that school scoliosis screening programme is safe, contributed to early detection and reduction of surgery. There was also evidence to suggest that school-based scoliosis screening programme is cost-effective. Based on the above review, screening for scoliosis among school children is recommended only for high risk group such as girls at twelve years of age.

Pre-market version of a commercially available hearing instrument with a tinnitus sound generator: feasibility of evaluation in a clinical trial.

PubMed

Sereda, Magdalena; Davies, Jeff; Hall, Deborah A

2017-04-01

This report considers feasibility of conducting a UK trial of combination devices for tinnitus, using data from the study which evaluated different listener programmes available within the pre-market version of Oticon Alta with Tinnitus Sound Generator. Open and closed questions addressed the following feasibility issues: (1) Participant recruitment; (2) Device acceptability; (3) Programme preferences in different self-nominated listening situations; (4) Usability; (5) Compliance; (6) Adverse events. Eight current combination hearing aid users (all males) aged between 62-72 years (mean age 67.25 years, SD = 3.8). All eight participants reported the physical aspects and noise options on the experimental device to be acceptable. Programmes with amplification and masking features were equally preferred over the basic amplification-only programme. Individual preferences for the different programme options varied widely, both across participants and across listening situations. A set of recommendations for future trials were formulated which calls for more "real world" trial design rather than tightly controlling the fitting procedure.

Identification of impaired hearing in early childhood.

PubMed Central

Wong, D; Shah, C P

1979-01-01

Although the incidence of congenital deafness is high, routine neonatal screening for this problem is not practised, and early identification of congenital or early acquired deafness is relatively rare. Delaying therapy until a child is 3 or more years old severely limits speech development, language acquisition and learning. The commonest causes of delay in diagnosis are the refusal of physicians to listen to the parents' observations, their failure to screen children for hearing and speech problems, and their reluctance to arrange prompt referral for audiologic assessment. Diagnostic delay occurs even though half the children who have impaired hearing are known to be at increased risk. A plea is made for the setting up of a register of infants known to be at risk for impaired hearing. First-contact physicians should be alert to the possibility of hearing problems, particularly in children at high risk. Screening methods for use by nonspecialist practitioners are outlined. Images p535-a p536-a p540-a PMID:387194

Subcutaneous ICD screening with the Boston Scientific ZOOM programmer versus a 12-lead ECG machine.

PubMed

Chang, Shu C; Patton, Kristen K; Robinson, Melissa R; Poole, Jeanne E; Prutkin, Jordan M

2018-02-24

The subcutaneous implantable cardioverter-defibrillator (S-ICD) requires preimplant screening to ensure appropriate sensing and reduce risk of inappropriate shocks. Screening can be performed using either an ICD programmer or a 12-lead electrocardiogram (ECG) machine. It is unclear whether differences in signal filtering and digital sampling change the screening success rate. Subjects were recruited if they had a transvenous single-lead ICD without pacing requirements or were candidates for a new ICD. Screening was performed using both a Boston Scientific ZOOM programmer (Marlborough, MA, USA) and General Electric MAC 5000 ECG machine (Fairfield, CT, USA). A pass was defined as having at least one lead that fit within the screening template in both supine and sitting positions. A total of 69 subjects were included and 27 sets of ECG leads had differing screening results between the two machines (7%). Of these sets, 22 (81%) passed using the ECG machine but failed using the programmer and five (19%) passed using the ECG machine but failed using the programmer (P < 0.001). Four subjects (6%) passed screening using the ECG machine but failed using the programmer. No subject passed screening with the programmer but failed with the ECG machine. There can be occasional disagreement in S-ICD patient screening between an ICD programmer and ECG machine, all of whom passed with the ECG machine but failed using the programmer. On a per lead basis, the ECG machine passes more subjects. It is unknown what the inappropriate shock rate would be if an S-ICD was implanted. Clinical judgment should be used in borderline cases. © 2018 Wiley Periodicals, Inc.

Universal neonatal hearing screening: applications for a developing country in the Asia-Pacific region.

PubMed

Navarro-Locsin, C Gretchen

2003-01-01

Various centers around the world have implemented and evaluated universal hearing screening programs as a response to the US National Institute of Health policy statement on early identification of hearing loss. Several well conducted clinical trials have been devised to examine and evaluate various factors relevant to establishing a UNHS program. This paper aims to describe some of these factors and analyze their applications and implications for a UNHS program for a developing country in the Asia-Pacific Region. Specifically, three main issues will be discussed: hospital vs community based programs, choice of technology, and choice of screening protocol.

[Results of audiometry screening in adolescent workers].

PubMed

Hartmann, B

1990-11-01

Results of screening audiometry of male youths aged 16 to 25 (n = 3969) in occupations from metallurgy, machine-building industry and traffic are demonstrated. Part of persons they have hearing loss between 5 to 10 percent increases from 2.8% of pupils before starting vocational training to 4.5% or 7.1% of apprentices and 9.7% of skilled workers. The incidence of persons with respective without middle ear inflammation in anamnesis only differ in stages about 20 percent hearing loss. It shows sensitivity of screening audiometry nevertheless there are possibilities of mistakes. Adolescents already may show measurable hearing loss in connection with professional and nonprofessional expositions as well as individual dispositions.

Screening protocols for the prevention of occupational noise-induced hearing loss: the role of conventional and extended high frequency audiometry may vary according to the years of employment.

PubMed

Riga, Maria; Korres, George; Balatsouras, Dimitrios; Korres, Stavros

2010-07-01

Although occupational noise-induced hearing loss (NIHL) has become a major problem in industrialized societies, there is a notable lack of effective screening protocols to ensure its early diagnosis. The aim of this study was to detect a potential role of extended high frequency (EHF) audiometry in industrial hearing screening protocols. The population consisted of 151 persons, working for 8 hours daily in a noisy environment (90-110 dBA). The changes of hearing thresholds in industrial workers were analyzed, not only with respect to their age, as has been presented by previous studies, but also with respect to the duration of their previous employment. During the first 10 years of employment, the frequencies 12500, 14000 and 16000Hz were the only ones significantly affected. For the second decade of employment, thresholds were significantly elevated only at 2000 and 4000Hz. After exceeding 20 years of employment, the affected frequencies were 250, 500 and 1000Hz. The effects of age on hearing acuity were significant at all frequencies for the first 2 groups. EHF audiometry seems able to identify the first signs of NIHL, much earlier than conventional audiometry, and therefore may need to be implemented in the screening examinations especially of workers with less than 1 decade of employment. Hearing screening protocols could become more efficient by adjusting their frequency ranges according to the frequencies "at risk", which correspond to the duration of the workers' previous employment.

Affordability of programmes to prevent spontaneous preterm birth in Austria: a budget impact analysis.

PubMed

Zechmeister-Koss, Ingrid; Piso, Brigitte

2014-02-01

Preterm birth is a rising health problem in Europe generally, and in Austria specifically. Decision makers require objective information on the effects and costs of measures to prevent preterm birth. We undertook a budget impact analysis from a public payer perspective and for a 1-year and 5-year time horizon for five prevention approaches to reduce preterm birth. These were cervix screening + progesterone application, progesterone injection, smoking cessation, fish oil supplementation and infection screening. We analysed affordability in terms of programme costs and potential cost savings. Programme costs range from below €50 000 (cervix screening in high-risk pregnancy) to €500 000 (universal infection screening). The lowest health effects have been shown for smoking cessation programmes (-10 preterm births per year), whereas infection screening demonstrated the largest effect (-230 preterm births per year). In the base-case analysis, all programmes are potentially cost saving (-€500 000 to -€13 million per year). In the sensitivity analyses, preterm birth costs, target group size and (partly) unit costs of programme components have an influence on potential cost savings. However, except for two programmes, the results are robust concerning an overall economic net benefit of the programmes analysed compared with no programme. The study is mainly limited by the quality of some cost data and choice of the reference scenario. When considering potential cost savings, the five prevention programmes analysed seem affordable, with cervix screening and infection screening likely being the most promising in Austria.

[Interval cancers and episode sensitivity in population-based screening programmes for colorectal cancer: a systematic review].

PubMed

Domènech, Xènia; Garcia, Montse; Benito, Llúcia; Binefa, Gemma; Vidal, Carmen; Milà, Núria; Moreno, Víctor

2015-01-01

To describe interval cancers (IC) and the sensitivity of colorectal cancer (CRC) screening programmes. A systematic review of the literature was conducted through a MEDLINE (PubMed) search. The search strategy combined the terms 'interval cancer', 'false negative', 'mass screening', 'screening' 'early detection of cancer', 'colorectal cancer' and 'bowel cancer'. Inclusion criteria consisted of population-based screening programmes, original articles written in English or Spanish and publication dates between 1999/01/01 and 2015/02/28. A narrative synthesis of the included articles was performed detailing the characteristics of the screening programmes, the IC rate, and the information sources used in each study. Thirteen articles were included. The episode sensitivity of CRC screening programmes ranged from 42.2% to 65.3% in programmes using the guaiac test and between 59.1% and 87.0% with the immunochemical test. We found a higher proportion of women who were diagnosed with IC and these lesions were mainly located in the proximal colon. There is wide variability in the IC rate in CRC programmes. To ensure comparability between programmes, there is a need for consensus on the working definition of IC and the methods used for their identification and quantification. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Diagnostic hearing testing of infants aged 0-36 months in 3 South African provinces - Comparison of audiology records to HPCSA guidelines.

PubMed

Moodley, Selvarani; Störbeck, Claudine

2016-12-01

Within the Early Hearing Detection and Intervention (EHDI) pathway, which includes the processes of screening, diagnosis and intervention for paediatric hearing loss, paediatric diagnostic audiology involves a battery of specific tests and procedures. International studies have highlighted a golden standard for diagnosis of paediatric hearing loss as based on the Joint Committee of Infant Hearing (2007) diagnostic guidelines, closely resembling the HPCSA diagnostic guidelines. There are limited South African studies on the processes and protocols followed in diagnostic paediatric audiology. This study aims to provide a comparison for how the tests used for diagnosis of paediatric hearing loss in South Africa (within both the public and private healthcare sectors) compare to the HPCSA recommended diagnostic guidelines. A retrospective record review of paediatric clients with hearing loss (recruited through nonprobability convenience sampling) was conducted. This study is part of a longitudinal study of 711 deaf or hard of hearing children referred to the HI HOPES early intervention programme from September 2006 to December 2011. Diagnostic data from audiology reports of 117 children between 0 and 36 months were coded and analysed. Large variation was found in the tests included in the diagnostic audiology reports. For 22 children (19%) a comprehensive test battery was used. Health Professions Council of South Africa (HPCSA) recommended guidelines for diagnostic testing were not followed in any of the records analysed. Components of the HPCSA recommended test battery most frequently omitted was bone conduction testing. For both electrophysiology and behavioural testing, there was limited frequency specificity information. This exclusion of information is evidence of deficiencies in data recording and management, as well as having an effect on accuracy of classification of degree and type of hearing loss. There are gaps in age-appropriate assessment protocols, which will have an effect on accurate differential diagnosis of paediatric hearing loss. Reasons for not including all testing components of the HPCSA recommended guidelines, as well as the possibility of developing guidelines more relevant to a developing world context, should be explored. There might be a need for. The impact of South African specific factors that have an effect on provision of accurate paediatric diagnostic audiology services should be determined. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Telephone screening tests for functionally impaired hearing: current use in seven countries and development of a US version.

PubMed

Watson, Charles S; Kidd, Gary R; Miller, James D; Smits, Cas; Humes, Larry E

2012-01-01

An estimated 36 million US citizens have impaired hearing, but nearly half of them have never had a hearing test. As noted by a recent National Institutes of Health/National Institute on Deafness and Other Communication Disorders (NIH/NIDCD) Working Group, "In the United States (in contrast to many other nations) there are no readily accessible low cost hearing screening programs…" (Donahue et al, 2010, p. 2). Since 2004, telephone administered screening tests utilizing three-digit sequences presented in noise have been developed, validated, and implemented in seven countries. Each of these tests has been based on a test protocol conceived by Smits and colleagues in The Netherlands. Investigators from Communication Disorders Technology, Inc., Indiana University, and VU University Medical Center of Amsterdam agreed to collaborate in the development and validation of a screening test for hearing impairment suitable for delivery over the telephone, for use in the United States. This test, utilizing spoken three-digit sequences (triplets), was to be based on the design of Smits and his colleagues. A version of the digits-in-noise test was developed utilizing digit triplets spoken in Middle American dialect. The stimuli were individually adjusted to speech-to-noise ratio (SNR) values yielding 50% correct identification, on the basis of data collected from a group of 10 young adult listeners with normal hearing. A final set of 64 homogeneous stimuli were selected from an original 160 recorded triplets. Each test consisted of a series of 40 triplets drawn at random, presented in a noise background. The SNR threshold for 50% correct identification of the triplets was determined by a one-down, one-up adaptive procedure. The test was implemented by telephone, and administered to listeners with varying levels of hearing impairment. The listeners were then evaluated with pure-tone tests and other audiometric measures as clinically appropriate. Ninety participants included 72 who were volunteers from the regular client population at the Indiana University Hearing Clinic, and 18 who were recruited with a newspaper ad offering a free hearing test. Of the 90 participants, 49 were later determined to have mean pure-tone thresholds greater than 20 dB hearing level (HL). The primary data analyses were correlations between telephone test thresholds and other measures, including pure-tone thresholds and speech recognition tests, collected for the same participants. The correlation between the telephone test and pure-tone thresholds (r = 0.74) was within the range of correlations observed with successful telephone screening tests in use in other countries. Thresholds based on the average of only 21 trials (trials five through 25 of the 40-trial tracking history) yielded sensitivity and specificity values of 0.80 and 0.83, respectively, using pure-tone average((0.5, 1.0, 2.0 kHz)) >20 dB HL as the criterion measure. This US version of the digits-in-noise telephone screening test is sufficiently valid to be implemented for use by the general public. Its properties are quite similar to those telephone screening tests currently in use in most European countries. Telephone tests provide efficient, easy to use, and valid screening for functional hearing impairment. The results of this test are a reasonable basis for advising those who fail to seek a comprehensive hearing evaluation by an audiologist. American Academy of Audiology.

Socio-demographic characteristics of participation in the opportunistic German cervical cancer screening programme: results from the EPIC-Heidelberg cohort.

PubMed

Seidel, David; Becker, Nikolaus; Rohrmann, Sabine; Nimptsch, Katharina; Linseisen, Jakob

2009-04-01

To analyse participation in the German cervical cancer screening programme by socio-demographic characteristics. In the EPIC-Heidelberg cohort study 13,612 women aged 35-65 years were recruited between 1994 and 1998. Follow-up questionnaires were used to analyse participation in cervical cancer screening. Subjects were categorised according to age (birth cohort), education, vocational training, employment status, marital status and household size. Associations between socio-demographic characteristics and participation in cervical cancer screening were analysed using multinomial logistic regression. Females of the oldest and middle birth cohort were less likely to be screened compared to the youngest birth cohort. Less-educated women and those with a low-level secondary school degree had a decreased likelihood of undergoing screening in comparison to better educated women. Married women and women living in households with four or more persons were more likely to participate in the screening programme than single women or women living alone. Employment status did not modify participation in cervical cancer screening. Knowledge on the characteristics of women with a lower attendance to cervical cancer screening could be used to improve the effectiveness of the current (opportunistic) programme by dedicated health promotion programmes. However, an organized screening programme with written invitation of all eligible women would be the preferred option.

Auditory maturation in premature infants: a potential pitfall for early cochlear implantation.

PubMed

Hof, Janny R; Stokroos, Robert J; Wix, Eduard; Chenault, Mickey; Gelders, Els; Brokx, Jan

2013-08-01

To describe spontaneous hearing improvement in the first years of life of a number of preterm neonates relative to cochlear implant candidacy. Retrospective case study. Hearing levels of 14 preterm neonates (mean gestational age at birth = 29 weeks) referred after newborn hearing screening were evaluated. Initial hearing thresholds ranged from 40 to 105 dBHL (mean = 85 dBHL). Hearing level improved to normal levels for four neonates and to moderate levels for five, whereas for five neonates, no improvement in hearing thresholds was observed and cochlear implantation was recommended. Three of the four neonates in whom the hearing improved to normal levels were born prior to 28 weeks gestational age. Hearing improvement was mainly observed prior to a gestational age of 80 weeks. Delayed maturation of an immature auditory pathway might be an important reason for referral after newborn hearing screening in premature infants. Caution is advised regarding early cochlear implantation in preterm born infants. Audiological follow-ups until at least 80 weeks gestational age are therefore recommended. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

[Results from ten years newborn hearing screening in a secondary hospital].

PubMed

Sequi Canet, José Miguel; Sala Langa, Maria José; Collar Del Castillo, José Ignacio

2016-10-01

A critical analysis is performed on the results of a newborn hearing screening program in a regional hospital. Screening results from 14,247 newborns in our maternity ward from 2002 to 2013. Two step recordings of bilateral otoacoustic emissions (initial and repeat, if failed, at about one month of life). Assessment by clinical brainstem responses. The first step was performed on 14,015 newborns (98.3% of the total) reaching the screening objective. The first step pass figures were 93.7%, which implies a good pass rate with a few patients to repeat. The second step is also good because it has a pass rate of 88.9% of newborns examined (only 0.63% of initial group needed brainstem responses assessment), but 10.6% were lost to follow up, and that is a major problem. In newborns, scheduled for brainstem responses, the loss to follow-up is worse, with a figure of 29.5%, despite the high accuracy of this test given that 69.4% of those assessed showed hearing loss. This figure represents a 0.31% of the initial group, and is a similar to that published for congenital hearing loss. Including patients that were lost to follow up this figure could be greater. Newborn hearing screening is useful but needs stronger control to avoid the follow up loss. In order to achieve this, it is crucial to have a good database and a screening coordinator. Copyright © 2015 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Controversies about cervical cancer screening: A qualitative study of Roma women's (non)participation in cervical cancer screening in Romania.

PubMed

Andreassen, Trude; Weiderpass, Elisabete; Nicula, Florian; Suteu, Ofelia; Itu, Andreea; Bumbu, Minodora; Tincu, Aida; Ursin, Giske; Moen, Kåre

2017-06-01

Romania has Europe's highest incidence and mortality of cervical cancer. While a free national cervical cancer-screening programme has been in operation since 2012, participation in the programme is low, particularly in minority populations. The aim of this study was to explore Roma women's (non)participation in the programme from women's own perspectives and those of healthcare providers and policy makers. We carried out fieldwork for a period of 125 days in 2015/16 involving 144 study participants in Cluj and Bucharest counties. Fieldwork entailed participant observation, qualitative interviewing and focus group discussions. A striking finding was that screening providers and Roma women had highly different takes on the national screening programme. We identified four fundamental questions about which there was considerable disagreement between them: whether a free national screening programme existed in the first place, whether Roma women were meant to be included in the programme if it did, whether Roma women wanted to take part in screening, and to what degree screening participation would really benefit women's health. On the background of insights from actor-network theory, the article discusses to what degree the programme could be said to speak to the interest of its intended Roma public, and considers the controversies in light of the literature on patient centred care and user involvement in health care. The paper contributes to the understanding of the health and health-related circumstances of the largest minority in Europe. It also problematizes the use of the concept of "barriers" in research into participation in cancer screening, and exemplifies how user involvement can potentially help transform and improve screening programmes. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Choosing options for ultrasound screening in pregnancy and comparing cost effectiveness: a decision analysis approach.

PubMed

Roberts, T; Mugford, M; Piercy, J

1998-09-01

To compare the cost effectiveness of different programmes of routine antenatal ultrasound screening to detect four key fetal anomalies: serious cardiac anomalies, spina bifida, Down's syndrome and lethal anomalies, using existing evidence. Decision analysis was used based on the best data currently available, including expert opinion from the Royal College of Obstetricians and Gynaecologists, Working Party and secondary data from the literature, to predict the likely outcomes in terms of malformations detected by each screening programme. Results applicable in clinics, hospitals or GP practices delivering antenatal screening. The number of cases with a 'target' malformation correctly detected antenatally. There was substantial overlap between the cost ranges of each screening programme demonstrating considerable uncertainty about the relative economic efficiency of alternative programmes for ultrasound screening. The cheapest, but not the most effective, screening programme consisted of one second trimester ultrasound scan. The cost per target anomaly detected (cost effectiveness) for this programme was in the range 5,000 pound silver-109,000, pound silver but in any 1000 women it will also fail to detect between 3.6 and 4.7 target anomalies. The range of uncertainty in the costs did not allow selection of any one programme as a clear choice for NHS purchasers. The results suggested that the overall allocation of resources for routine ultrasound screening in the UK is not currently economically efficient, but that certain scenarios for ultrasound screening are potentially within the range of cost effectiveness reached by other, possibly competing, screening programmes. The model highlighted the weakness of available evidence and demonstrated the need for more information both about current practice and costs.

From Screening to Care: A Qualitative Analysis of the Parental Experiences Related to Screening and (Re)habilitation Care for Children with Congenital Deafness in Flanders, Belgium

ERIC Educational Resources Information Center

Hardonk, Stefan; Desnerck, Greetje; Loots, Gerrit; Matthijs, Liesbeth; Van Hove, Geert; Van Kerschaver, Erwin; Sigurjonsdottir, Hanna Bjorg; Vanroelen, Christophe; Louckx, Fred

2011-01-01

The objective of this study is to analyze parental perspectives concerning the use of (re)habilitation services after Universal Newborn Hearing Screening (UNHS). A qualitative study design was used involving children with moderate-to-profound hearing loss who were born between 1999 and 2001 and who are registered in the UNHS program in Flanders,…

The professional quality criteria of Italian breast screening radiologists: results from a national survey comparing the programmes started in 2000-2012 versus the ones started in 1990-1999.

PubMed

Morrone, Doralba; Giordano, Livia; Artuso, Franca; Bernardi, Daniela; Fedato, Chiara; Frigerio, Alfonso; Giorgi, Daniela; Naldoni, Carlo; Saguatti, Gianni; Severi, Daniela; Taffurelli, Mario; Terribile, Daniela; Ventura, Leonardo; Bucchi, Lauro

2017-01-01

In Italy, due to increasing healthcare budget and staff shortages, the recently created regional mammography screening programmes were established under worse radiology practice quality criteria than the previously created programmes. Using available data from a national questionnaire survey conducted at the end of 2013 and involving 222 responder radiologists, we compared the main professional quality standards of radiologists working in the screening programmes established during the period 2000-2012 with those working in the screening programmes created from 1990 to 1999. The former reported more years of clinical experience in breast imaging and a greater clinical mammogram reading volume than the latter. Conversely, they dedicated less working time to breast imaging, were less likely to participate in the diagnostic assessment of screen-detected lesions, to work in large-staffed screening centres, and to have a screening and a total mammogram reading volume (SMRV and TMRV) ≥ 5000 per year. The level of most professional quality criteria of Italian mammography screening radiologists has decreased over time. As SMRV and TMRV are important predictors of diagnostic accuracy, we can expect a lower interpretation performance of radiologists working in the recently created screening programmes.

Interval cancers in a guaiac-based colorectal cancer screening programme: Consequences on sensitivity.

PubMed

Blom, Johannes; Törnberg, Sven

2017-09-01

Objective To evaluate interval cancers in the population-based colorectal cancer screening programme of Stockholm/Gotland, Sweden. Methods From 2008, individuals aged 60-69 were invited to colorectal cancer screening using biennial guaiac-based faecal occult blood test (Hemoccult®). Interval cancers, defined as colorectal cancer among participants not diagnosed by the screening programme but registered in the Swedish cancer register, were evaluated by cross-checking the screening histories for all cancers in the region 2008-2012. Results Of 203,848 individuals from nine different birth cohorts who participated (∼60%), 4530 (2.2%) tested positive. All invited individuals were followed up for 24 months after invitation. The cancer register reported 557 colorectal cancer, 219 (39.3%) screen-detected cancers and 338 (60.7%) interval cancers, generating both test- and episode sensitivities of approximately 40% and an interval cancer-rate of 17.1/10,000 tests. Among individuals with positive tests without colorectal cancer diagnosed at work-up colonoscopy, 37 interval cancers (10.9%) occurred. There was statistically significant lower sensitivity in women, ranging 22.4-32.2%, compared with 43.2-52.0% in men. Age-group and tumour location were not strongly correlated to screen-detected cancer rates. The programme sensitivity increased by year (20.3-25.0%), with successively more colorectal cancers diagnosed within the expanding programme (11.6-16.2%). Conclusion Interval cancer is a quality indicator of a screening programme. As the interval cancer-rate determined in a well-organized population-based screening programme was actually higher than the screen-detected cancer rate, a change to a more sensitive screening test is indicated. The lower screen-detected cancers among women, and compliance and quality of work-up colonoscopies also need attention.

Screening for Vision Problems, Including Usher's Syndrome, among Hearing Impaired Students.

ERIC Educational Resources Information Center

Fillman, Robyn D.; And Others

1987-01-01

A screening program for vision problems and Usher's Syndrome (a common cause of deaf-blindness) among 210 hearing-impaired students found 44 percent had significant vision problems and 1 percent had Usher's Syndrome. The program involved an interagency network of school, health care, and support personnel and utilized a dilated ophathalmological…

Is There a Silent Hearing Loss among Children in Jordan?

ERIC Educational Resources Information Center

Alaqrabawi, Wala' S.; Alshawabka, Amneh Z.; Al-Addasi, Zainab M.

2016-01-01

This study measured the prevalence of hearing loss among school children in Jordan. A random sample of 1649 children (990 males and 659 females) was collected from randomly chosen 40 schools in Amman. Screening was conducted between November 2010 and October 2014. Otoscopic examination, tympanometry, and audiometry were used for screening. Based…

Income inequality in uptake of voluntary versus organised breast cancer screening: evidence from the British Household Panel Survey.

PubMed

Carney, Patricia; O'Neill, Ciaran

2018-02-14

This paper measures income-related inequality in uptake of breast cancer screening among women before and after a policy change to extend the screening programme to women aged 65 to 70. Prior to programme expansion women aged 50 to 64 were invited for screening under the national cancer screening programme in England and Wales whereas women in the 65 to 70 age cohort could elect to be screened by personally organising a screen. This will give a deeper insight into the nature of inequality in screening and the impact of policies aimed at widening the access related to age on inequality of uptake. Taking advantage of this natural experiment, inequality is quantified across the different age cohorts and time periods with the use of concentration indices (CI). Using data from the British Household Panel Survey, information on screening attendance, equivalised household income and age was taken for the three years prior to the programme expansion and the three years immediately following the policy change. Results show that following the expansion, inequality significantly reduced for the 50-64 age group, prior to the expansion there was a pro-rich inequality in screening uptake. There is also evidence of a reduction in income inequality in screening uptake among those aged 65 to 70 and an increase in the number of women attending screening from this older age cohort. This indicates that an organised breast screening programme is likely to reduce income related inequality over a screening programme where women must organise their own screen. This is important when breast screening is one of the main methods used to detect breast cancer at an earlier stage which improves outcomes for women and reduces treatment costs.

The potential impact of a prophylactic vaccine for human papillomavirus on the current cervical screening programme in Hong Kong.

PubMed

Koljonen, Paul A

2007-08-01

To review and summarise current controversies in cervical screening in Hong Kong and discuss the potential impact of prophylactic human papillomavirus vaccination. Literature search of Medline to December 2006, the Hong Kong Cancer Registry, and Centre of Disease Control. Key words search terms were: 'human papillomavirus', 'vaccine', 'cervical cancer', 'screening programme', and 'Hong Kong'. Original articles, review papers, books, and the worldwide web. Cervical cancer is one of the most common cancers in Hong Kong, and can be prevented if detected at its pre-cancerous stage. Despite the huge disease burden this imposes on our society and robust advocacy by the academic sector, an appropriate screening programme is still not in place. Existence of a vaccine that could potentially reduce the costs of universal screening should prompt our government to re-consider subsidising such a programme. While a combined screening-vaccination programme may be more cost-effective than screening alone, the vaccine is still costly, and the government must consider all the pros and cons. The new human papillomavirus vaccine, combined with an organised screening programme, is probably a more cost-effective way of preventing morbidity and mortality due to cervical cancer than the current programme in Hong Kong. More research and cost-effectiveness analyses are needed to decide on the ideal ages for primary vaccination and the requirement for booster shots.

A user-operated test of suprathreshold acuity in noise for adult hearing screening: The SUN (Speech Understanding in Noise) test.

PubMed

Paglialonga, Alessia; Tognola, Gabriella; Grandori, Ferdinando

2014-09-01

A novel, user-operated test of suprathreshold acuity in noise for use in adult hearing screening (AHS) was developed. The Speech Understanding in Noise test (SUN) is a speech-in-noise test that makes use of a list of vowel-consonant-vowel (VCV) stimuli in background noise presented in a three-alternative forced choice (3AFC) paradigm by means of a touch sensitive screen. The test is automated, easy-to-use, and provides self-explanatory results (i.e., 'no hearing difficulties', or 'a hearing check would be advisable', or 'a hearing check is recommended'). The test was developed from its building blocks (VCVs and speech-shaped noise) through two main steps: (i) development of the test list through equalization of the intelligibility of test stimuli across the set and (ii) optimization of the test results through maximization of the test sensitivity and specificity. The test had 82.9% sensitivity and 85.9% specificity compared to conventional pure-tone screening, and 83.8% sensitivity and 83.9% specificity to identify individuals with disabling hearing impairment. Results obtained so far showed that the test could be easily performed by adults and older adults in less than one minute per ear and that its results were not influenced by ambient noise (up to 65dBA), suggesting that the test might be a viable method for AHS in clinical as well as non-clinical settings. Copyright © 2014 Elsevier Ltd. All rights reserved.

There are calls for a national screening programme for prostate cancer: what is the evidence to justify such a national screening programme?

PubMed

Green, A; Tait, C; Aboumarzouk, O; Somani, B K; Cohen, N P

2013-05-01

Prostate cancer is the commonest cancer in men and a major health issue worldwide. Screening for early disease has been available for many years, but there is still no national screening programme established in the United Kingdom. To assess the latest evidence regarding prostate cancer screening and whether it meets the necessary requirements to be established as a national programme for all men. Electronic databases and library catalogues were searched electronically and manual retrieval was performed. Only primary research results were used for the analysis. In recent years, several important randomised controlled trials have produced varied outcomes. In Europe the largest study thus far concluded that screening reduced prostate cancer mortality by 20%. On the contrary, a large American trial found no reduction in mortality after 7-10 years follow-up. Most studies comment on the adverse effects of screening - principally those of overdiagnosis and subsequent overtreatment. Further information about the natural history of prostate cancer and accuracy of screening is needed before a screening programme can be truly justified. In the interim, doctors and patients should discuss the risks, benefits and sequelae of taking part in voluntary screening for prostate cancer.

Computer Aided Lip Reading Training Tool

ERIC Educational Resources Information Center

Sarmasik, Gamze; Dalkilic, Gokhan; Kut, Alp; Cebi, Yalcin; Serbetcioglu, Bulent

2007-01-01

Worldwide auditory-verbal education is becoming widespread for deaf children. But many prelingually, late-diagnosed deaf children and adults may utilize neither hearing aids nor cochlear implants and needed the support of lip-reading. Therefore, lip-reading skill remains to be important for oral education programmes of hearing impaired. The…

Hearing Loss in Hospice and Palliative Care: A National Survey of Providers.

PubMed

Smith, Alexander K; Ritchie, Christine S; Wallhagen, Margaret L

2016-08-01

Age-related hearing loss can impair patient-provider communication about symptom management, goals of care, and end-of-life decision-making. To determine whether hospice and palliative care providers screen for or received training about hearing loss, believe it impacts patient care, and use strategies to optimize communication. This was a national survey of hospice and palliative care providers conducted via email and social media. Survey questions were pilot tested with multidisciplinary providers in San Francisco. Of 510 responses (55% age 50+ years, 65% female, 64% in practice 5+ years, 57% practiced hospital-based palliative care, 45% hospice), 315 were physicians, 50 nurses, 48 nurse practitioners, 58 social workers, and 39 chaplains. Ninety-one percent reported that hearing loss has some or great impact on the quality of care for older adults. Eighty-eight percent recalled a situation where hearing loss created a communication problem with a patient and 56% a communication problem with a caregiver. Eighty-seven percent of physicians, nurses, and nurse practitioners reported not screening for hearing loss. Although 61% felt comfortable with their communication skills for patients with hearing loss, only 21% reported having received formal training in its management, 31% were unfamiliar with resources for patients with hearing loss, and 38% had never heard of a pocket talker amplification device. Hospice and palliative medicine providers believe age-related hearing loss impacts care yet most do not screen. Although they feel they are managing well, few have formal training. Knowledge about management approaches and resources is suboptimal. Published by Elsevier Inc.

Hearing and vision screening tools for long-term care residents with dementia: protocol for a scoping review

PubMed Central

McGilton, Katherine S; Höbler, Fiona; Campos, Jennifer; Dupuis, Kate; Labreche, Tammy; Guthrie, Dawn M; Jarry, Jonathan; Singh, Gurjit; Wittich, Walter

2016-01-01

Introduction Hearing and vision loss among long-term care (LTC) residents with dementia frequently goes unnoticed and untreated. Despite negative consequences for these residents, there is little information available about their sensory abilities and care assessments and practices seldom take these abilities or accessibility needs into account. Without adequate knowledge regarding such sensory loss, it is difficult for LTC staff to determine the level of an individual's residual basic competence for communication and independent functioning. We will conduct a scoping review to identify the screening measures used in research and clinical contexts that test hearing and vision in adults aged over 65 years with dementia, aiming to: (1) provide an overview of hearing and vision screening in older adults with dementia; and (2) evaluate the sensibility of the screening tools. Methods and analysis This scoping review will be conducted using the framework by Arksey and O'Malley and furthered by methodological enhancements from cited researchers. We will conduct electronic database searches in CENTRAL, CINAHL, EMBASE, MEDLINE and PsycINFO. We will also carry out a ‘grey literature’ search for studies or materials not formally published, both online and through interview discussions with healthcare professionals and research clinicians working in the field. Our aim is to find new and existing hearing and vision screening measures used in research and by clinical professionals of optometry and audiology. Abstracts will be independently reviewed twice for acceptance by a multidisciplinary team of researchers and research clinicians. Ethics and dissemination This review will inform health professionals working with this growing population. With the review findings, we aim to develop a toolkit and an algorithmic process to select the most appropriate hearing and vision screening assessments for LTC residents with dementia that will facilitate accurate testing and can inform care planning, thereby improving residents’ quality of life. PMID:27466242

Hearing and vision screening tools for long-term care residents with dementia: protocol for a scoping review.

PubMed

McGilton, Katherine S; Höbler, Fiona; Campos, Jennifer; Dupuis, Kate; Labreche, Tammy; Guthrie, Dawn M; Jarry, Jonathan; Singh, Gurjit; Wittich, Walter

2016-07-26

Hearing and vision loss among long-term care (LTC) residents with dementia frequently goes unnoticed and untreated. Despite negative consequences for these residents, there is little information available about their sensory abilities and care assessments and practices seldom take these abilities or accessibility needs into account. Without adequate knowledge regarding such sensory loss, it is difficult for LTC staff to determine the level of an individual's residual basic competence for communication and independent functioning. We will conduct a scoping review to identify the screening measures used in research and clinical contexts that test hearing and vision in adults aged over 65 years with dementia, aiming to: (1) provide an overview of hearing and vision screening in older adults with dementia; and (2) evaluate the sensibility of the screening tools. This scoping review will be conducted using the framework by Arksey and O'Malley and furthered by methodological enhancements from cited researchers. We will conduct electronic database searches in CENTRAL, CINAHL, EMBASE, MEDLINE and PsycINFO. We will also carry out a 'grey literature' search for studies or materials not formally published, both online and through interview discussions with healthcare professionals and research clinicians working in the field. Our aim is to find new and existing hearing and vision screening measures used in research and by clinical professionals of optometry and audiology. Abstracts will be independently reviewed twice for acceptance by a multidisciplinary team of researchers and research clinicians. This review will inform health professionals working with this growing population. With the review findings, we aim to develop a toolkit and an algorithmic process to select the most appropriate hearing and vision screening assessments for LTC residents with dementia that will facilitate accurate testing and can inform care planning, thereby improving residents' quality of life. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Transient evoked oto-acoustic emission screening in newborns in Bogotá, Colombia: a retrospective study.

PubMed

Rojas, Jorge A; Bernal, Jaime E; García, Mary A; Zarante, Ignacio; Ramírez, Natalia; Bernal, Constanza; Gelvez, Nancy; Tamayo, Marta L

2014-10-01

The aim of this study was to investigate the characteristics and performance of transient evoked oto-acoustic emission (TEOAE) hearing screening in newborns in Colombia, and analyze all possible variables and factors affecting the results. An observational, descriptive and retrospective study with bivariate analysis was performed. The study population consisted of 56,822 newborns evaluated at the private institution, PREGEN. TEOAE testing was carried out as a pediatric hearing screening test from December 2003 to March 2012. The database from PREGEN was revised, and the protocol for evaluation included the same screening test performed twice. Demographic characteristics were recorded and the newborn's background was evaluated. Basic statistics of the qualitative and quantitative variables, and statistical analysis were obtained using the chi-square test. Of the 56,822 records examined, 0.28% were classed as abnormal, which corresponded to a prevalence of 1 in 350. In the screened newborns, 0.08% had a major abnormality or other clinical condition diagnosed, and 0.29% reported a family history of hearing loss. A prevalence of 6.7 in 10,000 was obtained for microtia, which is similar to the 6.4 in 10,000 previously reported in Colombia (database of the Latin-American Collaborative Study of Congenital Malformations - ECLAMC). Statistical analysis demonstrated an association between presenting with a major anomaly and a higher frequency of abnormal results on both TEOAE tests. Newborns in Colombia do not currently undergo screening for the early detection of hearing impairment. The results from this study suggest TEOAE screening tests, when performed twice, are able to detect hearing abnormalities in newborns. This highlights the need to improve the long-term evaluation and monitoring of patients in Colombia through diagnostic tests, and to provide tests that are both sensitive and specific. Furthermore, the use of TEOAE screening is justified by the favorable cost: benefit ratio demonstrated in many countries worldwide. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Bringing Text Display Digital Radio to Consumers with Hearing Loss

ERIC Educational Resources Information Center

Sheffield, Ellyn G.; Starling, Michael; Schwab, Daniel

2011-01-01

Radio is migrating to digital transmission, expanding its offerings to include captioning for individuals with hearing loss. Text display radio requires a large amount of word throughput with minimal screen display area, making good user interface design crucial to its success. In two experiments, we presented hearing, hard-of-hearing, and deaf…

Effectiveness of an online SUpport PRogramme (SUPR) for older hearing aid users: study protocol for a cluster randomised controlled trial.

PubMed

Meijerink, Janine Fj; Pronk, Marieke; Paulissen, Bernadette; Witte, Birgit I; Wouden, Bregje van der; Jansen, Vera; Kramer, Sophia E

2017-06-20

An educational SUpport PRogramme called SUPR has been developed for hearing aid users (HAUs) and their communication partners (CPs) offering care beyond hearing aid fitting. SUPR teaches its users communication strategies, hearing aid handling skills and personal adjustment to hearing impairment. Using a cluster randomised controlled trial design, 70 Dutch hearing aid dispenser practices were randomised into hearing aid fitting (care as usual, 34 practices) and hearing aid fitting including SUPR (36 practices). The aim was to recruit a total of 569 older (aged 50+ years) first-time (n=258) and experienced (n=311) HAUs and their CPs. SUPR consists of a Practical Support Booklet and online material offered via email over a period of 6-7 months. The booklet provides practical information on hearing aids, advice on communication strategies and home exercises. The online material consists of educational videos on hearing aid functionality and usage, communication strategies and peer testimonials. Finally, noncommittal email contact with the dispenser is offered. Every HAU is asked to assign a CP who is advised to be involved intensively. Effect measurements for HAUs and their CPs will occur at baseline and at 6, 12 and 18 months follow-up via online questionnaires. The primary outcomes for HAUs will be the use of communication strategies as measured by the subscales of the Communication Profile for the Hearing Impaired. A process evaluation will be performed. The study was approved by the Dutch Institutional Review Board of the VU Medical University Center Amsterdam. This intervention could contribute to lowering the hearing impairment burden in our ageing society. The results will be disseminated through peer-reviewed publications and scientific conferences. ISRCTN77340339; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effective screening programmes for cervical cancer in low- and middle-income developing countries.

PubMed

Sankaranarayanan, R; Budukh, A M; Rajkumar, R

2001-01-01

Cervical cancer is an important public health problem among adult women in developing countries in South and Central America, sub-Saharan Africa, and south and south-east Asia. Frequently repeated cytology screening programmes--either organized or opportunistic--have led to a large decline in cervical cancer incidence and mortality in developed countries. In contrast, cervical cancer remains largely uncontrolled in high-risk developing countries because of ineffective or no screening. This article briefly reviews the experience from existing screening and research initiatives in developing countries. Substantial costs are involved in providing the infrastructure, manpower, consumables, follow-up and surveillance for both organized and opportunistic screening programmes for cervical cancer. Owing to their limited health care resources, developing countries cannot afford the models of frequently repeated screening of women over a wide age range that are used in developed countries. Many low-income developing countries, including most in sub-Saharan Africa, have neither the resources nor the capacity for their health services to organize and sustain any kind of screening programme. Middle-income developing countries, which currently provide inefficient screening, should reorganize their programmes in the light of experiences from other countries and lessons from their past failures. Middle-income countries intending to organize a new screening programme should start first in a limited geographical area, before considering any expansion. It is also more realistic and effective to target the screening on high-risk women once or twice in their lifetime using a highly sensitive test, with an emphasis on high coverage (>80%) of the targeted population. Efforts to organize an effective screening programme in these developing countries will have to find adequate financial resources, develop the infrastructure, train the needed manpower, and elaborate surveillance mechanisms for screening, investigating, treating, and following up the targeted women. The findings from the large body of research on various screening approaches carried out in developing countries and from the available managerial guidelines should be taken into account when reorganizing existing programmes and when considering new screening initiatives.

Cost-effectiveness and cost utility of community screening for glaucoma in urban India.

PubMed

John, Denny; Parikh, Rajul

2017-07-01

Population-based screening for glaucoma has been demonstrated to be cost-effective if targeted at high-risk groups such as older adults and those with a family history of glaucoma, and through use of a technician for conducting initial assessment rather than a medical specialist. This study attempts to investigate the cost-effectiveness of a hypothetical community screening and subsequent treatment programme for glaucoma in comparison with current practice (i.e. with no screening programme but with some opportunistic case finding) in the urban areas of India. A hypothetical screening programme for both primary open-angle glaucoma and angle-closure disease was built for a population aged between 40 and 69 years in the urban areas of India. Screening and treatment costs were obtained from an administrator of a tertiary eye hospital in India. The probabilities for the screening pathway were derived from published literature and expert opinion. The glaucoma prevalence rates for urban areas were adapted from the Chennai Glaucoma Study findings. A decision-analytical model using TreeAge Pro 2015 was built to model events, costs and treatment pathways. One-way sensitivity analyses were conducted. The introduction of a community screening programme for glaucoma is likely to be cost-effective, the estimated incremental cost-effectiveness ratio (ICER) values being 10,668.68 when compared with no screening programme and would treat an additional 4443 cases and prevent 1790 person-years of blindness over a 10-year period in the urban areas of India. Sensitivity analyses revealed that glaucoma prevalence rates across various age groups, screening uptake rate, follow-up compliance after screening, treatment costs and utility values of health states associated with medical and surgical treatment of glaucoma had an impact on the ICER values of the screening programme. In comparison with current practice (i.e. without a screening programme but with some opportunistic case finding), the introduction of a community screening programme for glaucoma for the 40-69 years age group is likely to be relatively cost-effective if implemented in the urban areas of India. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Effective screening programmes for cervical cancer in low- and middle-income developing countries.

PubMed Central

Sankaranarayanan, R.; Budukh, A. M.; Rajkumar, R.

2001-01-01

Cervical cancer is an important public health problem among adult women in developing countries in South and Central America, sub-Saharan Africa, and south and south-east Asia. Frequently repeated cytology screening programmes--either organized or opportunistic--have led to a large decline in cervical cancer incidence and mortality in developed countries. In contrast, cervical cancer remains largely uncontrolled in high-risk developing countries because of ineffective or no screening. This article briefly reviews the experience from existing screening and research initiatives in developing countries. Substantial costs are involved in providing the infrastructure, manpower, consumables, follow-up and surveillance for both organized and opportunistic screening programmes for cervical cancer. Owing to their limited health care resources, developing countries cannot afford the models of frequently repeated screening of women over a wide age range that are used in developed countries. Many low-income developing countries, including most in sub-Saharan Africa, have neither the resources nor the capacity for their health services to organize and sustain any kind of screening programme. Middle-income developing countries, which currently provide inefficient screening, should reorganize their programmes in the light of experiences from other countries and lessons from their past failures. Middle-income countries intending to organize a new screening programme should start first in a limited geographical area, before considering any expansion. It is also more realistic and effective to target the screening on high-risk women once or twice in their lifetime using a highly sensitive test, with an emphasis on high coverage (>80%) of the targeted population. Efforts to organize an effective screening programme in these developing countries will have to find adequate financial resources, develop the infrastructure, train the needed manpower, and elaborate surveillance mechanisms for screening, investigating, treating, and following up the targeted women. The findings from the large body of research on various screening approaches carried out in developing countries and from the available managerial guidelines should be taken into account when reorganizing existing programmes and when considering new screening initiatives. PMID:11693978

Women's knowledge about cervical cancer risk factors, screening, and reasons for non-participation in cervical cancer screening programme in Estonia.

PubMed

Kivistik, Alice; Lang, Katrin; Baili, Paolo; Anttila, Ahti; Veerus, Piret

2011-09-28

The attendance rate in Estonian cervical cancer screening programme is too low therefore the programme is hardly effective. A cross-sectional population based survey was performed to identify awareness of cervical cancer risk factors, reasons why women do not want to participate in cervical screening programme and wishes for better organisation of the programme. An anonymous questionnaire with a covering letter and a prepaid envelope was sent together with the screening invitation to 2942 randomly selected women. Results are based on the analysis of 1054 (36%) returned questionnaires. Main reasons for non-participation in the national screening programme were a recent visit to a gynaecologist (42.3%), fear to give a Pap-smear (14.3%), long appointment queues (12.9%) and unsuitable reception hours (11.8%). Fear to give a Pap-smear was higher among women aged 30 and 35 than 50 and 55 (RR 1.46; 95% CI: 0.82-2.59) and women with one or no deliveries (RR 1.56, 95% CI: 0.94-2.58). In general, awareness of cervical cancer risk factors is poor and it does not depend on socio-demographic factors. Awareness of screening was higher among Estonians than Russians (RR 1.64, 95% CI: 1.46-1.86). Most women prefer to receive information about screening from personally mailed invitation letters (74.8%). Women need more information about cervical cancer risk factors and the screening programme. They prefer personally addressed information sharing. Minority groups should be addressed in their own language. A better collaboration with service providers and discouraging smears outside the programme are also required.

National Newborn Screening and Genetics Resource Center

MedlinePlus

... GENERAL INFORMATION Conditions Screened by US Programs General Resources Genetics Birth Defects Hearing Screening FOR PROFESSIONALS ACT Sheets(ACMG) General Resources Newborn Screening Genetics Birth Defects FOR FAMILIES FAQs ...

Evaluation of the risk of noise-induced hearing loss among unscreened male industrial workers.

PubMed

Prince, Mary M; Gilbert, Stephen J; Smith, Randall J; Stayner, Leslie T

2003-02-01

Variability in background risk and distribution of various risk factors for hearing loss may explain some of the diversity in excess risk of noise-induced hearing loss (NIHL). This paper examines the impact of various risk factors on excess risk estimates of NIHL using data from the 1968-1972 NIOSH Occupational Noise and Hearing Survey (ONHS). Previous analyses of a subset of these data focused on 1172 highly "screened" workers. In the current analysis, an additional 894 white males (609 noise-exposed and 285 controls), who were excluded for various reasons (i.e., nonoccupational noise exposure, otologic or medical conditions affecting hearing, prior occupational noise exposure) have been added 2066) to assess excess risk of noise-induced material impairment in an unscreened population. Data are analyzed by age, duration of exposure, and sound level (8-h TWA) for four different definitions of noise-induced hearing impairment, defined as the binaural pure-tone average (PTA) hearing threshold level greater than 25 dB for the following frequencies: (a) 1-4 kHz (PTA1234), (b) 1-3 kHz (PTA123), (c) 0.5, 1, and 2 kHz (PTA512), and (d) 3, 4, and 6 kHz (PTA346). Results indicate that populations with higher background risks of hearing loss may show lower excess risks attributable to noise relative to highly screened populations. Estimates of lifetime excess risk of hearing impairment were found to be significantly different between screened and unscreened population for noise levels greater than 90 dBA. Predicted age-related risk of material hearing impairment in the ONHS unscreened population was similar to that predicted from Annex B and C of ANSI S3.44 for ages less than 60 years. Results underscore the importance of understanding differential risk patterns for hearing loss and the use of appropriate reference (control) populations when evaluating risk of noise-induced hearing impairment among contemporary industrial populations.

Contralateral ear occlusion for improving the reliability of otoacoustic emission screening tests.

PubMed

Papsin, Emily; Harrison, Adrienne L; Carraro, Mattia; Harrison, Robert V

2014-01-01

Newborn hearing screening is an established healthcare standard in many countries and testing is feasible using otoacoustic emission (OAE) recording. It is well documented that OAEs can be suppressed by acoustic stimulation of the ear contralateral to the test ear. In clinical otoacoustic emission testing carried out in a sound attenuating booth, ambient noise levels are low such that the efferent system is not activated. However in newborn hearing screening, OAEs are often recorded in hospital or clinic environments, where ambient noise levels can be 60-70 dB SPL. Thus, results in the test ear can be influenced by ambient noise stimulating the opposite ear. Surprisingly, in hearing screening protocols there are no recommendations for avoiding contralateral suppression, that is, protecting the opposite ear from noise by blocking the ear canal. In the present study we have compared transient evoked and distortion product OAEs measured with and without contralateral ear plugging, in environmental settings with ambient noise levels <25 dB SPL, 45 dB SPL, and 55 dB SPL. We found out that without contralateral ear occlusion, ambient noise levels above 55 dB SPL can significantly attenuate OAE signals. We strongly suggest contralateral ear occlusion in OAE based hearing screening in noisy environments.

Screening the High-Risk Newborn for Hearing Loss: The Crib-O-Gram v the Auditory Brainstem Response.

ERIC Educational Resources Information Center

Cox, L. Clarke

1988-01-01

Presented are a rationale for identifying hearing loss in infancy and a history of screening procedures. The Crib-O-Gram and auditory brainstem response (ABR) tests are evaluated for reliability, validity, and cost-effectiveness. The ABR is recommended, and fully automated ABR instrumentation, which lowers expenses for trained personnel and…

The Need for Hearing Conservation in Our (Jos Municipality) Public Schools. Brief Research Report.

ERIC Educational Resources Information Center

Boison, Kwame Bessa

1986-01-01

Audiometric screening tests administered to students ages 5-21 in five Nigerian schools (N=2315) revealed hearing problems in 13.5% of the student population. Among findings was a high incidence of acute suppurative otitis media. Related recommendations include twice-yearly audiometric screening for children perceived to be at risk. (JW)

Social inclusion and career development--transition from upper secondary school to work or post-secondary education among hard of hearing students.

PubMed

Danermark, B; Antonson, S; Lundström, I

2001-01-01

The aim of this study was to investigate the decision process and to analyse the mechanisms involved in the transition from upper secondary education to post-secondary education or the labour market. Sixteen students with sensorioneural hearing loss were selected. Among these eight of the students continued to university and eight did not. Twenty-five per cent of the students were women and the average age was 28 years. The investigation was conducted about 5 years after graduation from the upper secondary school. Both quantitative and qualitative methods were used. The results showed that none of the students came from a family where any or both of the parents had a university or comparable education. The differences in choice between the two groups cannot be explained in terms of social inheritance. Our study indicates that given normal intellectual capacity the level of the hearing loss seems to have no predictive value regarding future educational performance and academic career. The conclusion is that it is of great importance that a hearing impaired pupil with normal intellectual capacity is encouraged and guided to choose an upper secondary educational programme which is orientated towards post-secondary education (instead of a narrow vocational programme). Additional to their hearing impairment and related educational problems, hard of hearing students have much more difficulty than normal hearing peers in coping with changes in intentions and goals regarding their educational career during their upper secondary education.

Delays in Diagnosis of Congenital Hearing Loss in Rural Children

PubMed Central

Bush, Matthew L.; Bianchi, Kristin; Lester, Cathy; Shinn, Jennifer B.; Gal, TJ; Fardo, David W.; Schoenberg, Nancy

2013-01-01

Objective To examine the incidence of pediatric congenital hearing loss and the timing of diagnosis in a rural region of hearing healthcare disparity. Study design Data from the Kentucky newborn hearing-screening program was accessed to determine the incidence of congenital hearing loss in Kentucky, both in the extremely rural region of Appalachia and non-Appalachian region of Kentucky. We also performed a retrospective review of records of children with congenital hearing loss at our institution to determine the timing of diagnostic testing. Results In Kentucky, during 2009–2011, there were 6,970 newborns who failed hearing screening; the incidence of newborn hearing loss was 1.71 per 1000 births (1.28/1000 in Appalachia and 1.87/1000 in non-Appalachia). 23.8% of Appalachian newborns compared with 17.3% of non-Appalachian children failed to obtain follow-up diagnostic testing. Children from Appalachia were significantly delayed in obtaining a final diagnosis of hearing loss compared with children from non-Appalachian regions (p=0.04). Conclusion Congenital hearing loss in children from rural regions with hearing healthcare disparities is a common problem and these children are at risk for a delay in the timing of diagnosis, which has the potential to limit language and social development. It is important to further assess the causative factors and develop interventions that can address this hearing healthcare disparity issue. PMID:24183213

[Digital vs. analog hearing aids for children. Is there a method for making an objective comparison possible?].

PubMed

Prinz, I; Nubel, K; Gross, M

2002-09-01

Until now, the assumed benefits of digital hearing aids are reflected only in subjective descriptions by patients with hearing aids, but cannot be documented adequately by routine diagnostic methods. Seventeen schoolchildren with moderate severe bilateral symmetrical sensorineural hearing loss were examined in a double-blinded crossover study. Differences in performance between a fully digital hearing aid (DigiFocus compact/Oticon) and an analogous digitally programmable two-channel hearing aid were evaluated. Of the 17 children, 13 choose the digital and 4 the analogous hearing aid. In contrast to the clear subjective preferences for the fully digital hearing aid, we could not obtain any significant results with routine diagnostic methods. Using the "virtual hearing aid," a subjective comparison and speech recognition performance task yielded significant differences. The virtual hearing aid proved to be suitable for a direct comparison of different hearing aids and can be used for double-blind testing in a pediatric population.

The value of health screening in music schools and conservatoires.

PubMed

Clark, Terry; Williamon, Aaron; Redding, Emma

2013-04-01

Interest in musicians' health and well-being is growing, reflected by increasing numbers of investigations into the physicality and psychology of musical performance. Within sport and dance, screening and profiling programmes, especially of the musculoskeletal system, have furthered understanding on not only physical and psychological capabilities and demands but also musculoskeletal injury mechanisms and susceptibility. This article engages with questions relating to the development and delivery of musician-specific health screening programmes. Effective screening can offer a variety of benefits for musicians, providing informed recommendations for sustaining performance-related fitness across educational and professional contexts. Employing an interdisciplinary approach when developing screening programmes is essential, as is the ecological appropriateness of the measures used. The implications inherent in delivering and sustaining successful screening programmes in schools and conservatoires are discussed.

Cost effectiveness analysis of screening for sight threatening diabetic eye disease

PubMed Central

James, Marilyn; Turner, David A; Broadbent, Deborah M; Vora, Jiten; Harding, Simon P

2000-01-01

Objective To measure the cost effectiveness of systematic photographic screening for sight threatening diabetic eye disease compared with existing practice. Design Cost effectiveness analysis Setting Liverpool. Subjects A target population of 5000 diabetic patients invited for screening. Main outcome measures Cost effectiveness (cost per true positive) of systematic and opportunistic programmes; incremental cost effectiveness of replacing opportunistic with systematic screening. Results Baseline prevalence of sight threatening eye disease was 14.1%. The cost effectiveness of the systematic programme was £209 (sensitivity 89%, specificity 86%, compliance 80%, annual cost £104 996) and of the opportunistic programme was £289 (combined sensitivity 63%, specificity 92%, compliance 78%, annual cost £99 981). The incremental cost effectiveness of completely replacing the opportunistic programme was £32. Absolute values of cost effectiveness were highly sensitive to varying prevalence, sensitivity and specificity, compliance, and programme size. Conclusion Replacing existing programmes with systematic screening for diabetic eye disease is justified. PMID:10856062

Children with Mild Bilateral and Unilateral Hearing Loss: Parents' Reflections on Experiences and Outcomes

ERIC Educational Resources Information Center

Fitzpatrick, Elizabeth; Grandpierre, Viviane; Durieux-Smith, Andrée; Gaboury, Isabelle; Coyle, Doug; Na, Eunjung; Sallam, Nusaiba

2016-01-01

Children with mild bilateral and unilateral hearing loss are now commonly identified early through newborn hearing screening initiatives. There remains considerable uncertainty about how to support parents and about which services to provide for children with mild bilateral and unilateral hearing loss. The goal of this study was to learn about…

Validation of the use of self-reported hearing loss and the Hearing Handicap Inventory for elderly among rural Indian elderly population.

PubMed

Deepthi, R; Kasthuri, Arvind

2012-01-01

Hearing loss is a potentially disabling problem among elderly leading to physical and social dysfunction. Though audiometric assessment of hearing loss is considered as gold standard, it is not feasible in community settings. Several questionnaires measuring hearing handicap have been developed. Knowledge regarding applicability of these questionnaires among rural elderly is limited, hence a study was planned to validate single question and Shortened Hearing Handicap Inventory for Elderly (HHIE-S) in detecting hearing loss against pure tone-audiometry among rural Indian elderly. A single question 'do you feel you have a hearing loss?' and the HHIE-S was administered to 175 elderly in two rural areas. Hearing ability was assessed using pure tone audiometry. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of both screening tools were compared with pure tone averages (PTAs) greater than 25, 40 and 55 dB hearing level (mild, moderate and severe hearing loss, respectively). The single question yielded low sensitivity (30.9%) and high specificity (93.9%) for mild hearing loss. Similarly HHIE-S yielded a sensitivity of 26.2% and specificity of 95.9%. Sensitivity with single question increased to 76.2% and specificity decreased to 83.1% with severe hearing loss. Sensitivity with HHIE-S also increased to 76.2% and specificity decreased to 87.7% with severe hearing loss. These hearing screening questionnaires will be useful in identifying more disabling hearing losses among rural elderly which helps in rehabilitation services planning. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Current State of the Curriculum in Jordanian Kindergartens for Children with Hearing Impairments

ERIC Educational Resources Information Center

Al-Zboon, Eman K.

2017-01-01

An appropriate curriculum for children with hearing impairments (HIs) is vital in establishing effective educational programmes for such children. This study aimed to describe the current status of the kindergarten (KG) curriculum for children with HIs in Jordan. Content analysis was applied to the curriculum plans and weekly schedules and…

Cost-Effectiveness Comparison of Breast Cancer Screening and Vascular Event Primary Prevention with Aspirin in Wales

ERIC Educational Resources Information Center

Morgan, Gareth

2011-01-01

Aim: For the first time, this article presents a cost-effectiveness comparison of a breast cancer screening programme with a possible health education programme with aspirin for vascular event primary prevention. Background: Breast cancer screening is a well established part of cancer control programmes yet recent evidence on this intervention has…

Screening tools for the identification of dementia for adults with age-related acquired hearing or vision impairment: a scoping review.

PubMed

Pye, Annie; Charalambous, Anna Pavlina; Leroi, Iracema; Thodi, Chrysoulla; Dawes, Piers

2017-11-01

Cognitive screening tests frequently rely on items being correctly heard or seen. We aimed to identify, describe, and evaluate the adaptation, validity, and availability of cognitive screening and assessment tools for dementia which have been developed or adapted for adults with acquired hearing and/or vision impairment. Electronic databases were searched using subject terms "hearing disorders" OR "vision disorders" AND "cognitive assessment," supplemented by exploring reference lists of included papers and via consultation with health professionals to identify additional literature. 1,551 papers were identified, of which 13 met inclusion criteria. Four papers related to tests adapted for hearing impairment; 11 papers related to tests adapted for vision impairment. Frequently adapted tests were the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MOCA). Adaptations for hearing impairment involved deleting or creating written versions for hearing-dependent items. Adaptations for vision impairment involved deleting vision-dependent items or spoken/tactile versions of visual tasks. No study reported validity of the test in relation to detection of dementia in people with hearing/vision impairment. Item deletion had a negative impact on the psychometric properties of the test. While attempts have been made to adapt cognitive tests for people with acquired hearing and/or vision impairment, the primary limitation of these adaptations is that their validity in accurately detecting dementia among those with acquired hearing or vision impairment is yet to be established. It is likely that the sensitivity and specificity of the adapted versions are poorer than the original, especially if the adaptation involved item deletion. One solution would involve item substitution in an alternative sensory modality followed by re-validation of the adapted test.

Internet-based hearing screening using speech-in-noise: validation and comparisons of self-reported hearing problems, quality of life and phonological representation

PubMed Central

Molander, Peter; Nordqvist, Peter; Öberg, Marie; Lunner, Thomas; Lyxell, Björn; Andersson, Gerhard

2013-01-01

Objectives For the last decade a host of different projects have been launched to allow persons who are concerned about their hearing status to quickly and at a low cost test their hearing ability. Most often, this is carried out without collecting complementary information that could be correlated with hearing impairment. In this two-part study we first, present the development and validation of a novel Internet-based hearing test, and second, report on the associations between this test and phonological representation, quality of life and self-reported hearing difficulties. Design Cross-sectional study. Setting An opportunity sample of participants was recruited at the Stockholm central station for the first study. All parts of the second study were conducted via the Internet, with testing and self-report forms adapted for online use. Participants The first part of the study was carried out in direct contact with the participants, and participants from the second study were recruited by means of advertisements in newspapers and on webpages. The only exclusion criterion was that participants had to be over 18 years old. Most participants were between 60 and 69 years old. There were almost an equal number of men and women (total n=316). Outcome measures 48 participants failed the Internet-based hearing screening test. The group failing the test reported more problems on the Amsterdam Inventory of Auditory Disability. In addition, they were found to have diminished phonological representational skills. However, no difference in quality of life was found. Conclusions Almost one in five participants was in need of contacting their local hearing clinic. This group had more complaints regarding tinnitus and hyperacusis, rated their own hearing as worse than those who passed, and had a poorer capability of generating accurate phonological representations. This study suggests that it is feasible to screen for hearing status online, and obtain valid data. PMID:24041846

Congenitally Deaf Children's Care Trajectories in the Context of Universal Neonatal Hearing Screening: A Qualitative Study of the Parental Experiences

ERIC Educational Resources Information Center

Hardonk, Stefan; Desnerck, Greetje; Loots, Gerrit; Van Hove, Geert; Van Kerschaver, Erwin; Sigurjonsdottir, Hanna Bjorg; Vanroelen, Christophe; Louckx, Fred

2011-01-01

The objective of this study is to examine the early care trajectories of congenitally deaf children from a parental perspective, starting with universal neonatal hearing screenings. The analysis using a three-dimensional care trajectory concept is aimed at developing a basic typology of postscreening care trajectories. Children with…

Fall risk screening protocol for older hearing clinic patients.

PubMed

Criter, Robin E; Honaker, Julie A

2017-10-01

The primary purposes of this study were (1) to describe measures that may contrast audiology patients who fall from those who do not fall and (2) to evaluate the clinical performance of measures that could be easily used for fall risk screening in a mainstream audiology hearing clinic. Cross-sectional study Study sample: Thirty-six community-dwelling audiology patient participants and 27 community-dwelling non-audiology patients over 60 years of age. The Hearing Handicap Inventory for the Elderly (HHIE) most accurately identified patients with a recent fall (sensitivity: 76.0%), while the Dizziness Handicap Inventory (DHI) most accurately identified patients without a recent fall (specificity: 90.9%). A combination of measures used in a protocol-including HHIE, DHI, number of medications, and the Timed Up and Go test-resulted in good, accurate identification of patients with or without a recent history of falls (92.0% sensitivity, 100% specificity). This study reports good sensitivity and excellent specificity for identifying patients with and without a recent history of falls when measures were combined into a screening protocol. Despite previously reported barriers, effective fall risk screenings may be performed in hearing clinic settings with measures often readily accessible to audiologists.

The importance of timely information in national cancer screening programmes.

PubMed

Droljc, Anze; Grbec, Tomaz; Orel, Andrej

2009-01-01

The Ministry of Health of Slovenia decided to support the introduction of two new organised screening programmes for cancer, one for breast and the other for colon cancer in 2005. This was an addition to the first, already running, programme for cervical cancer. Two of them are entrusted to the Institute of Oncology while the National CINDI programme takes care of the third one. Besides connection to some external public databases, cancer screening programmes require national Cancer Registry data. High quality and user friendly information support for citizens and medical professionals following doctrinal requirements and possible changes is a must.

The Effect of Integrated Hearing Protection Surround Levels on Sound Localization

DTIC Science & Technology

2015-02-01

perceived hearing loss, and tinnitus . 4 DRDC-RDDC-2015-R012 Individuals who met the telephone screening criteria were examined by...and military service: Implications for hearing loss and tinnitus . Institute of Medicine of the National Academy of Science. National Academies Press

A qualitative study to assess the potential of the human papillomavirus vaccination programme to encourage under-screened mothers to attend for cervical screening.

PubMed

Spencer, Angela M; Brabin, Loretta; Roberts, Stephen A; Patnick, Julietta; Elton, Peter; Verma, Arpana

2016-04-01

Coverage of the UK National Health Service Cervical Screening Programme is declining. Under-screened women whose daughters participate in the human papillomavirus (HPV) vaccination programme could be stimulated to attend. We investigated whether factors associated with the vaccination programme changed mothers' intentions for future screening. Questionnaires were sent to mothers of girls aged 12-13 years across two North West primary care trusts (n=2387) to assess the effect of the HPV vaccination programme on screening intentions. This identified mothers whose intentions had changed. Consent was sought to contact them for a semi-structured interview to discuss their screening intentions. Key themes were identified using framework analysis. 97/606 women responding to the questionnaire had changed their views about cervical screening. 23 women were interviewed, 10 of whom expressed a positive change and 13 no change. Most had discussed the vaccine information, including cervical screening, with their daughters. Mothers who made a positive change decision recognised their daughters' risk of cervical cancer, the need for future screening, and the importance of their own example. In this way daughters became 'significant others' in reinforcing their mothers' cervical screening motivation. A daughter's invitation for HPV vaccination instigates a reassessment of cervical screening intention in some under-screened mothers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

[Issues Related to Screening and Caring for Newborns With Hearing Impairments].

PubMed

Liou, Mei-Show; Tsao, Ying

2016-12-01

The critical period for auditory development in humans begins at around the 20th gestational week and continues until 3 years of age. Both genetic and environmental factors are known to cause impaired hearing. Without early identification and intervention, hearing-impaired children face a high risk of experiencing significant difficulties with speech and language development, social behavior, and emotional functioning. Two types of commonly used hearing screening technologies include transient evoked otoacoustic emission (TEOAE) and automated auditory brainstem response (aABR). aABR is considered to have high sensitivity and specificity, to have a relatively low referral rate, and to generate a relatively low rate of false-positive results in identifying newborn hearing impairment. The present paper outlines the psychosocial issues that are commonly experienced by parents of hearing-impaired children. Parents and other family members may benefit from medical, financial, social, and education supports in order to facilitate their adjustment to this challenging situation. The relevant literature is reviewed and recommendations for improving care for this population are provided.

Similarities Between Deaf or Hard of Hearing and Hearing Students' Awareness of Affective Words' Valence in Written Language.

PubMed

Li, Degao; Zhang, Fan; Zeng, Xihong

2016-01-01

An affective priming task was used with two cohorts of college students, one deaf or hard of hearing (D/HH), the other hearing, in two experiments. The same set of affective-word targets, preceded by "※※" in Experiment 1 but by affective-word primes of the same valence as the targets in Experiment 2, were presented vertically above or below the screen center. Stimuli that preceded the targets were shown at the screen center. D/HH participants generally performed more poorly than hearing participants, but both groups performed similarly in that both did better on the positive targets than on the negative in both experiments, and on supporting metaphorical associations between valence and vertical positions (Meier & Robinson, 2004), as indicated by reaction times, in Experiment 2. The researchers concluded that D/HH and hearing college students perform similarly in developing cognition-grounded representations of affective words in written language.

Parents' perceptions of tele-audiological testing in a rural hearing screening program in South India.

PubMed

Ramkumar, Vidya; Selvakumar, K; Vanaja, C S; Hall, James W; Nagarajan, Roopa; Neethi, J

2016-10-01

Tele-diagnostic audiological testing in a hearing screening program for infants and young children is a novel practice, and this study is the first to explore its application in a rural community. It is important to understand parental perceptions and confidence when introducing a new process such as tele-audiological diagnostic testing in rural areas. A questionnaire with 17 rater-administered items was designed to elicit comments concerning the quality of tele-hearing testing and video-conferencing, access to tele-hearing testing, and parents' attitudes regarding tele-hearing testing in the village. The questionnaire was administered by an audiologist not involved in tele-diagnostic testing to avoid bias. Parents perceived tele-hearing testing as equal in quality to in-person testing. Technical factors such as good video-conferencing quality and logistical factors such as ease of access due to reasonable travel time to testing facility could have influenced these perceptions. While these results show tele-hearing testing is an acceptable alternative, occasional poor signal quality should be addressed prior to large-scale implementation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Invitation coverage and participation in Italian cervical, breast and colorectal cancer screening programmes.

PubMed

Giorgi Rossi, Paolo; Carrozzi, Giuliano; Federici, Antonio; Mancuso, Pamela; Sampaolo, Letizia; Zappa, Marco

2018-03-01

Objectives In Italy, regional governments organize cervical, breast and colorectal cancer screening programmes, but there are difficulties in regularly inviting all the target populations and participation remains low. We analysed the determinants associated with invitation coverage of and participation in these programmes. Methods We used data on screening programmes from annual Ministry of Health surveys, 1999-2012 for cervical, 1999-2011 for breast and 2005-2011 for colorectal cancer. For recent years, we linked these data to the results of the national routine survey on preventive behaviours to evaluate the effect of spontaneous screening at Province level. Invitation and participation relative risk were calculated using Generalized Linear Models. Results There is a strong decreasing trend in invitation coverage and participation in screening programmes from North to South Italy. In metropolitan areas, both invitation coverage (rate ratio 0.35-0.96) and participation (rate ratio 0.63-0.88) are lower. An inverse association exists between spontaneous screening and both screening invitation coverage (1-3% decrease in invitation coverage per 1% spontaneous coverage increase) and participation (2% decrease in participation per 1% spontaneous coverage increase) for the three programmes. High recall rate has a negative effect on invitation coverage in the next round for breast cancer (1% decrease in invitation per 1% recall increase). Conclusions Organizational and cultural changes are needed to better implement cancer screening in southern Italy.

Customer focus in breast cancer screening services.

PubMed

Buttimer, Andreas

2009-01-01

The purpose of the paper is to demonstrate how a generic value chain and customer focused system as demonstrated by the Scottish and Irish breast screening programmes can be used to provide a high quality health service. Literature relevant to aligning the entire operating model--the companies' culture, business processes, management systems to serve one value discipline, i.e. customer intimacy, is reviewed and considered in the context of the NHS Scottish Breast Screening Programme in Edinburgh and BreastCheck--the National Breast Screening Programme in Ireland. This paper demonstrates how an emphasis on customer focus and operational excellence, as used in other service industries, can help to provide a better health service. It uses the Scottish and Irish breast screening programmes as illustrative examples. The paper applies the key requirements in the delivery of a quality service including an understanding of the characteristics of a service industry, the management of discontinuities involved in its delivery and the environment in which it operates. System failure is commonly the cause of quality failure in the health system. Breast screening programmes are designed to prevent such a failure. This paper promotes and describes the use of the generic value chain by using the knowledge gained in delivering a mammography-screening programme.

The use of transient evoked otoacoustic emissions as a hearing screen following grommet insertion.

PubMed

Dale, O T; McCann, L J; Thio, D; Wells, S C; Drysdale, A J

2011-07-01

This study aimed to evaluate the sensitivity of transient evoked otoacoustic emission testing as a screening tool for hearing loss in children, after grommet insertion. A prospective study was conducted of 48 children (91 ears) aged three to 16 years who had undergone grommet insertion for glue ear. At post-operative review, pure tone audiometry was performed followed by transient evoked otoacoustic emission testing. Outcomes for both tests, in each ear, were compared. The pure tone audiometry threshold was ≤ 20 dB in 85 ears (93.4 per cent), 25 dB in two ears (2.2 per cent) and ≥ 30 dB in four ears (4.4 per cent). Transient evoked otoacoustic emissions were detected in 69 ears (75.8 per cent). The sensitivity of transient evoked otoacoustic emission testing for detecting hearing loss was 100 per cent for ≥ 30 dB loss but only 66.7 per cent for ≥ 25 dB loss. Transient evoked otoacoustic emission testing offers a sensitive means of detecting hearing loss of ≥ 30 dB following grommet insertion in children. However, the use of such testing as a screening tool may miss some cases of mild hearing loss.

Early hearing detection and intervention: 2010 CODEPEH recommendation.

PubMed

Trinidad-Ramos, Germán; de Aguilar, Valentín Alzina; Jaudenes-Casaubón, Carmen; Núñez-Batalla, Faustino; Sequí-Canet, José Miguel

2010-01-01

Newborn hearing screening is currently performed routinely in many regional health-care systems in Spain. Despite the remarkable expansion in newborn hearing screening since 2000, its feasibility and the benefits of early identification and intervention, many major challenges still remain. In this article, the Committee for the Early Detection of Hearing Loss (Comisión para la Detección Precoz de la Hipoacusia, CODEPEH) updates the recommendations that are considered important for the future development of early hearing detection and intervention (EDHI) systems in the following points: 1. Screening protocols: Separate protocols are recommended for NICU (Neonatal Intensive Care Units) and well-infant nurseries. 2. Diagnostic audiology evaluation. Professionals with skills and expertise in evaluating newborn and young infants should provide diagnosis, selection and fitting of amplification devices. 3. Medical evaluation. Risk factors for congenital and acquired hearing loss have been combined in a single list rather than grouped by time of onset. A stepwise diagnostic paradigm is diagnostically more efficient and cost-effective than a simultaneous testing approach. 4. Early intervention and surveillance. All individuals providing services to infants with hearing loss should have specialized training and expertise in the development of audition, speech and language. Regular surveillance should be performed on developmental milestones, auditory skills, parental concerns, and middle ear status. 5. Quality control. Data management as part of an integrated system is important to monitor and improve the quality of EDHI services. 2009 Elsevier España, S.L. All rights reserved.

High Prevalence of Hearing Disorders at the Special Olympics Indicate Need to Screen Persons with Intellectual Disability

ERIC Educational Resources Information Center

Hild, U.; Hey, C.; Baumann, U.; Montgomery, J.; Euler, H. A.; Neumann, K.

2008-01-01

Background: Persons with intellectual disabilities (ID) are at increased risk for hearing impairment which often remains undetected. If left untreated, such hearing impairments may worsen the social and communicative problems of these persons. The aims of this study are to determine the prevalence of hearing impairment, to specify type and degree…

The efficacy of a neonatal screening programme in decreasing the hospitalization rate of patients with G6PD deficiency in southern Iran.

PubMed

Cohan, Nader; Karimi, Mehran; Khalili, Amir Hossein; Falahzadeh, Mohammad Hossein; Samadi, Behrang; Mahdavi, Mohammad Reza

2010-01-01

To investigate whether a neonatal screening programme for G6PD deficiency has decreased hospitalization for acute haemolytic attack in the Fars province of southern Iran. A total of 850 patients registered with G6PD deficiency were included in the study. Variables including age, sex, time and cause of hospitalization, cause of haemolytic crisis, positive history of blood transfusion, G6PD enzyme deficiency, blood urea nitrogen (BUN) and creatinine were recorded based on a standard questionnaire. All patients were analysed for G6PD enzyme level based on a quantitative test. Five hundred and fifty-three patients were hospitalized before the introduction of the neonatal screening programme (2001-2004) and 297 afterwards (2005-2008). Of those patients hospitalized after the introduction of the screening programme, 237 were wrongly classified as normal and 60 were recorded as having G6PD enzyme deficiency by the neonatal screening programme. The main causes of haemolytic crisis in G6PD-deficient patients were fava bean consumption (88.2%), underlying infection (10.9%) and drugs (0.8%). Our study showed the effectiveness of the neonatal screening programme in decreasing the hospitalization rate.

Who attends a UK diabetes screening programme? Findings from the ADDITION-Cambridge study.

PubMed

Sargeant, L A; Simmons, R K; Barling, R S; Butler, R; Williams, K M; Prevost, A T; Kinmonth, A L; Wareham, N J; Griffin, S J

2010-09-01

One of the factors influencing the cost-effectiveness of population screening for Type 2 diabetes may be uptake. We examined attendance and practice- and individual-level factors influencing uptake at each stage of a diabetes screening programme in general practice. A stepwise screening programme was undertaken among 135, 825 people aged 40-69 years without known diabetes in 49 general practices in East England. The programme included a score based on routinely available data (age, sex, body mass index and prescribed medication) to identify those at high risk, who were offered random capillary blood glucose (RBG) and glycosylated haemoglobin tests. Those screening positive were offered fasting capillary blood glucose (FBG) and confirmatory oral glucose tolerance tests (OGTT). There were 33 539 high-risk individuals invited for a RBG screening test; 24 654 (74%) attended. Ninety-four per cent attended the follow-up FBG test and 82% the diagnostic OGTT. Seventy per cent of individuals completed the screening programme. Practices with higher general practitioner staff complements and those located in more deprived areas had lower uptake for RBG and FBG tests. Male sex and a higher body mass index were associated with lower attendance for RBG testing. Older age, prescription of antihypertensive medication and a higher risk score were associated with higher attendance for FBG and RBG tests. High attendance rates can be achieved by targeted stepwise screening of individuals assessed as high risk by data routinely available in general practice. Different strategies may be required to increase initial attendance, ensure completion of the screening programme, and reduce the risk that screening increases health inequalities.

A systematic review of randomised controlled trials examining the effectiveness of breast and cervical cancer screening interventions for ethnic minority women.

PubMed

Chan, Dorothy N S; So, Winnie K W

2015-10-01

To examine the effect that breast and/or cervical cancer screening programmes for ethnic minority women have on their knowledge of and beliefs about breast or cervical cancer and screening, and on their screening intentions and uptake rates. Recommendations are also made for the format and content of such programmes, based on existing evidence. A comprehensive literature search was carried out both manually and by means of five electronic databases. The findings are summarised and synthesised in narrative fashion. The ten RCTs included here were conducted among ethnic minority women in the United States or Canada, where breast or cervical cancer screening programmes have led to improvements in screening intentions, knowledge of cervical cancer and pap test uptake. The Breast Cancer Screening Belief Scale and self-reporting were the methods commonly used to measure outcomes. The shared characteristics of both countries' programmes were that they were theory- and language-based, the instruction took place in a community setting, the materials were culturally relevant, the content highlighted key messages about breast or cervical cancer and screening measures, and there were multiple intervention strategies. Breast or cervical cancer screening programmes in Western countries have demonstrated improvements in knowledge of the disease, screening intentions and pap test uptake, although evidence on the effectiveness of the interventions has been limited. The common characteristics of programmes are identified, but a comprehensive model is still needed to link these characteristics with other factors and mediators influencing outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Strategic Planning to Improve EHDI Programs

ERIC Educational Resources Information Center

White, Karl R.; Blaiser, Kristina M.

2011-01-01

Because newborn hearing screening has become the standard of care in the United States, every state has established an early hearing detection and intervention (EHDI) program responsible for establishing, maintaining, and improving the system of services needed to serve children with hearing loss and their families. While significant developments…

Positive screening on the Modified Checklist for Autism in Toddlers (M-CHAT) in extremely low gestational age newborns.

PubMed

Kuban, Karl C K; O'Shea, T Michael; Allred, Elizabeth N; Tager-Flusberg, Helen; Goldstein, Donald J; Leviton, Alan

2009-04-01

To test the hypothesis that children born preterm are more likely to screen positive on the M-CHAT for an autism spectrum disorder. We compared the M-CHAT positive rate of those with cerebral palsy, cognitive impairment, and vision and hearing impairments to those without such deficits. Relative to children who could walk, the odds for screening positive on the M-CHAT were increased 23-fold for those unable to sit or stand independently and more than 7-fold for those requiring assistance to walk. Compared with children without a diagnosis of cerebral palsy, those with quadriparesis were 13 times more likely to screen positive, and those with hemiparesis were 4 times more likely to screen positive. Children with major vision or hearing impairments were 8 times more likely to screen positive than those without such impairments. Relative to those with a Mental Development Index (MDI) of >70, the odds for screening positive were increased 13-fold for those with an MDI of <55 and more than 4-fold for those with an MDI of 55 to 69. Major motor, cognitive, visual, and hearing impairments appear to account for more than half of the positive M-CHAT screens in extremely low gestational age newborns. Even after those with such impairments were eliminated, 10% of children--nearly double the expected rate--screened positive.

Cost-effectiveness of a vocational enablement protocol for employees with hearing impairment; design of a randomized controlled trial

PubMed Central

2012-01-01

Background Hearing impairment at the workplace, and the resulting psychosocial problems are a major health problem with substantial costs for employees, companies, and society. Therefore, it is important to develop interventions to support hearing impaired employees. The objective of this article is to describe the design of a randomized controlled trial evaluating the (cost-) effectiveness of a Vocational Enablement Protocol (VEP) compared with usual care. Methods/Design Participants will be selected with the 'Hearing and Distress Screener'. The study population will consist of 160 hearing impaired employees. The VEP intervention group will be compared with usual care. The VEP integrated care programme consists of a multidisciplinary assessment of auditory function, work demands, and personal characteristics. The goal of the intervention is to facilitate participation in work. The primary outcome measure of the study is 'need for recovery after work'. Secondary outcome measures are coping with hearing impairment, distress, self-efficacy, psychosocial workload, job control, general health status, sick leave, work productivity, and health care use. Outcome measures will be assessed by questionnaires at baseline, and 3, 6, 9, and 12 months after baseline. The economic evaluation will be performed from both a societal and a company perspective. A process evaluation will also be performed. Discussion Interventions addressing occupational difficulties of hearing impaired employees are rare but highly needed. If the VEP integrated care programme proves to be (cost-) effective, the intervention can have an impact on the well-being of hearing impaired employees, and thereby, on the costs for the company as well for the society. Trial registration Netherlands Trial Register (NTR): NTR2782 PMID:22380920

An Introduction to the Outcomes of Children with Hearing Loss Study

PubMed Central

Moeller, Mary Pat; Tomblin, J. Bruce

2015-01-01

The landscape of service provision for young children with hearing loss has shifted in recent years as a result of newborn hearing screening and the early provision of interventions, including hearing technologies. It is expected that early service provision will minimize or prevent linguistic delays that typically accompany untreated permanent childhood hearing loss. The post-newborn hearing screening era has seen a resurgence of interest in empirically examining the outcomes of children with hearing loss to determine if service innovations have resulted in expected improvements in children’s functioning. The Outcomes of Children with Hearing Loss (OCHL) project was among these recent research efforts, and this introductory article provides background in the form of literature review and theoretical discussion to support the goals of the study. The OCHL project was designed to examine the language and auditory outcomes of infants and preschool-aged children with permanent, bilateral, mild-to-severe hearing loss and to identify factors that moderate the relationship between hearing loss and longitudinal outcomes. We propose that children who are hard of hearing experience limitations in access to linguistic input, which lead to a decrease in uptake of language exposure and an overall reduction in linguistic experience. We explore this hypothesis in relation to three primary factors that are proposed to influence children’s access to linguistic input: aided audibility, duration and consistency of hearing aid (HA) use, and characteristics of caregiver input. PMID:26731159

Quality and readability of information pamphlets on hearing and paediatric hearing loss in the Gauteng Province, South Africa.

PubMed

Joubert, Karin; Githinji, Esther

2014-02-01

The implementation of early hearing detection and intervention (EHDI) programmes is necessary in order to facilitate the early identification of hearing loss. An important component of EHDI is parental education. International and national guidelines stipulating that comprehensive, unbiased and appropriate information pamphlets should be provided to parents as part of EHDI programmes, however little is known about the availability and readability of such materials in South Africa. The objectives of this study were therefore to determine the availability of information pamphlets on hearing and hearing loss in children at public hospitals in the Gauteng Province of South Africa. In addition, the quality and readability levels of these pamphlets were determined. A non-experimental, descriptive research design was employed for this study. Information on the availability of leaflets at public health hospitals was obtained through a telephonic survey. Twenty-one information pamphlets available at these hospitals were then evaluated to determine the quality and readability levels. It was found that 73% of audiology departments at public hospitals in Gauteng had information pamphlets available on hearing and hearing loss in children. Of the pamphlets evaluated, the majority were rated to 'present with serious problems' questioning the quality of the content included. In addition, it was found that on average the readability level of these pamphlets were at a sixth-grade level, much higher that the recommended fourth-grade reading level. The need for development of quality educational material focused on providing parents with unbiased, comprehensive and appropriate information on hearing and hearing loss in children has been highlighted. Proposed guidelines were recommended to assist audiologists in this endeavour. The importance of providing appropriate parental educational materials for the success of EHDI in South Africa should not be underestimated. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

New perspectives on counselling in audiological habilitation/rehabilitation.

PubMed

Borg, Erik; Borg, Birgitta

2015-01-01

To develop and apply a pedagogical method focusing on Empowerment, Empathy, Competence, and Counselling: the EC programme, and to present an initial evaluation. The EC programme was gradually developed within a study circle framework and in dialogue with study circle leaders and participants (clients) with hearing impairment (HI). An evaluation was carried out with the study circle leaders. Seventeen upper secondary school students with HI took part in the development of the programme. Eighteen study circle leaders responded to a questionnaire. The EC programme developed consisted of films, CD, and DVD productions to increase insight into one's own hearing ability, to demonstrate for others what HI means, strategies to evaluate situations, and help to act constructively in social situations. The study circle leaders found most of the course material appropriate and easy to use, as a whole or in parts. The leaders' evaluations indicated that the clients had increased their knowledge about how the HI affected themselves and others. The clients had improved their self-confidence and their empathic view of others. The EC programme can be used in its entirety or in part. Participation may lead to increased empowerment, empathy, competence and counselling ability.

Frequency of Usher syndrome in two pediatric populations: Implications for genetic screening of deaf and hard of hearing children.

PubMed

Kimberling, William J; Hildebrand, Michael S; Shearer, A Eliot; Jensen, Maren L; Halder, Jennifer A; Trzupek, Karmen; Cohn, Edward S; Weleber, Richard G; Stone, Edwin M; Smith, Richard J H

2010-08-01

Usher syndrome is a major cause of genetic deafness and blindness. The hearing loss is usually congenital and the retinitis pigmentosa is progressive and first noticed in early childhood to the middle teenage years. Its frequency may be underestimated. Newly developed molecular technologies can detect the underlying gene mutation of this disorder early in life providing estimation of its prevalence in at risk pediatric populations and laying a foundation for its incorporation as an adjunct to newborn hearing screening programs. A total of 133 children from two deaf and hard of hearing pediatric populations were genotyped first for GJB2/6 and, if negative, then for Usher syndrome. Children were scored as positive if the test revealed > or =1 pathogenic mutations in any Usher gene. Fifteen children carried pathogenic mutations in one of the Usher genes; the number of deaf and hard of hearing children carrying Usher syndrome mutations was 15/133 (11.3%). The population prevalence was estimated to be 1/6000. Usher syndrome is more prevalent than has been reported before the genome project era. Early diagnosis of Usher syndrome has important positive implications for childhood safety, educational planning, genetic counseling, and treatment. The results demonstrate that DNA testing for Usher syndrome is feasible and may be a useful addition to newborn hearing screening programs.

Frequency of Usher Syndrome in Two Pediatric Populations: Implications for genetic screening of Deaf and Hard of Hearing Children

PubMed Central

Kimberling, William J.; Hildebrand, Michael S.; Shearer, A. Eliot; Jensen, Maren L.; Halder, Jennifer A.; Cohn, Edward S.; Weleber, Richard G.; Stone, Edwin M.; Smith, Richard J. H.

2011-01-01

Purpose Usher syndrome is a major cause of genetic deafblindness. The hearing loss is usually congenital and the retinitis pigmentosa is progressive and first noticed in early childhood to the middle teenage years. Its frequency may be underestimated. Newly developed molecular technologies can detect the underlying gene mutation of this disorder early in life providing estimation of its prevalence in at risk pediatric populations and laying a foundation for its incorporation as an adjunct to newborn hearing screening programs. Methods A total of 133 children from two deaf and hard of hearing pediatric populations were genotyped first for GJB2/6 and, if negative, then for Usher syndrome. Children were scored as positive if the test revealed ≥1 pathogenic mutations in any Usher gene. Results Fifteen children carried pathogenic mutations in one of the Usher genes; the number of deaf and hard of hearing children carrying Usher syndrome mutations was 15/133 (11.3%). The population prevalence was estimated to be 1/6000. Conclusion Usher syndrome is more prevalent than has been reported prior to the genome project era. Early diagnosis of Usher syndrome has important positive implications for childhood safety, educational planning, genetic counseling, and treatment. The results demonstrate that DNA testing for Usher syndrome is feasible and may be a useful addition to newborn hearing screening programs. PMID:20613545

Programmable shunt valve interactions with osseointegrated hearing devices.

PubMed

Pierson, Matthew J; Wehrmann, Daniel; Albers, J Andrew; El Tecle, Najib E; Costa, Dary; Elbabaa, Samer K

2017-04-01

OBJECTIVE Patients with ventriculoperitoneal (VP) shunts with programmable valves who would benefit from osseointegrated hearing devices (OIHDs) represent a unique population. The aim of this study was to evaluate the magnetic field strengths of 4 OIHDs and their interactions with 5 programmable VP shunt valves. METHODS Magnetic field strength was measured as a function of distance for each hearing device (Cochlear Baha 5, Cochlear Baha BP110, Oticon Ponto Plus Power, and Medtronic Sophono) in the following modes: inactive, active in quiet, and active in 60 decibels of background noise in the sound booth. The hearing devices were introduced to each shunt valve (Aesculap proGAV, Aesculap proGAV 2.0, Codman Hakim, Codman Certas, and Medtronic Strata II) also as a function of distance in these identical 3 settings. Each trial was repeated 5 times. Between each trial, the valves were assessed for a change in setting. Finally, using a skull model, the devices were introduced to each other in standard anatomical locations and the valves were assessed for a change in settings. RESULTS The maximum magnetic field strengths generated by the Cochlear Baha 5, BP110, and Oticon OIHDs were 1.1, 36.2, and 48.7 gauss (G), respectively. The maximum strength generated by the Sophono device was > 800 G. The magnetic field strength of the hearing devices decreased markedly with increasing distance from the device. The strength of the Sophono's magnetic attachment decreased to 34.8 G at 5 mm. The Codman Hakim, Codman Certas, and Medtronic Strata II valve settings changed when rotating the valves next to the Sophono abutment. No other changes in valve settings occurred in the distance or anatomical models for any other trials. CONCLUSIONS This is the first study evaluating the interaction between OIHDs and programmable VP shunt valves. The findings suggest that it is safe to use these devices together without having to switch to a nonprogrammable valve or move the shunt valve to a more distant location. Still, care should be taken if the Sophono device is used to ensure that the valve is ≥ 5 mm away from the magnetic attachment.

The value of models in informing resource allocation in colorectal cancer screening – 1 the case of the Netherlands

PubMed Central

van Hees, Frank; Zauber, Ann G.; van Veldhuizen, Harriët; Heijnen, Marie-Louise A.; Penning, Corine; de Koning, Harry J.; van Ballegooijen, Marjolein; Lansdorp-Vogelaar, Iris

2015-01-01

In May 2011, the Dutch government decided to implement a national programme for colorectal cancer (CRC) screening using biennial faecal immunochemical test (FIT) screening between ages 55 and 75.[1] Decision modelling played an important role in informing this decision, as well as in the planning and implementation of the programme afterwards. In this overview, we illustrate the value of models in informing resource allocation in CRC screening, using the role that decision modelling has played in the Dutch CRC screening programme as an example. PMID:26063755

Impact of early hearing screening and treatment on language development and education level: evaluation of 6 years of universal newborn hearing screening (ALGO) in Flanders, Belgium.

PubMed

Verhaert, N; Willems, M; Van Kerschaver, E; Desloovere, C

2008-05-01

Early intervention in hearing-impaired children may improve language outcomes and subsequent school and occupational performance. The objective of this study was to retrospectively analyze over 6 years the educational outcome and language development of a first cohort of children, detected by the Flemish universal newborn hearing screening (UNHS) program based on automated auditory brainstem response (AABR), with the oldest children being in primary school. We studied 229 hearing-impaired children from 1998 till 2003. The following variables were considered: the age during the school year 2005-2006, the degree of hearing loss, additional impairments including presence of intellectual disability, school placement and early intervention. Analysis showed that 85.4% of the children with moderate, severe or profound hearing loss and no additional disability, older than 5.5 years, reach mainstream education. Further detailed description was provided for the outcomes of children with uni- and bilateral cochlear implants. Overall results stress that 46% of all children with a cochlear implant obtain mainstream education. Of all cochlear implant (CI) children above 5.5 years, without additional handicaps, 78.9% of children attend primary mainstream school. Data on language development show that up to 45% of the children with unilateral cochlear implant and no additional disabilities had normal to slight delay on language development. These data are fulfilling the goals stated by the JCIH and the American Academy of Pediatrics (AAP) in 2000. The role and impact of additional handicaps is discussed. The importance of early hearing loss identification and hearing therapy for appropriate language development is highlighted. Finally our preliminary results on children with bilateral cochlear implants without additional handicaps present an improved language development in comparison to unilateral CI-children. A vast majority of the children detected by the UNHS program, with moderate, severe or profound hearing loss and no additional disability, older than 5.5 years, reach mainstream education. Additional disabilities have a major influence.

[Implementation of performance indicators in the Czech Breast Cancer Screening Programme -  results of the regular monitoring].

PubMed

Májek, O; Bartoňková, H; Daneš, J; Skovajsová, M; Dušek, L

2014-01-01

The Czech organised breast cancer screening programme was initiated in 2002. Collection of data on screening mammography examinations, subsequent diagnostic procedures, and final dia-gnosis is an indispensable part of the programme. Data collection is obligatory for all accredited centres, in accordance with regulations issued by the Czech Ministry of Health. This contribution aims to demonstrate the recent results of quality monitoring of the accredited centres. Quality indicators, whose definition complies with international standards, involve the women's participation, the volume of performed examinations, the accuracy of screening mammography, the use of preoperative diagnostics, and the proportion of early detected tumours. Our evaluation documents a continuous improvement in quality of the Czech mammography screening programme, which is thereby in full agreement with international recommendations on quality assurance.

Perceived industrial deafness and hearing loss among people in a small Queensland rural community.

PubMed

Jirojwong, Sansnee; Joubert, Darren; Anastasi, Stephen

2005-07-01

This paper aims to describe chronic diseases including hearing loss reported by people in a small rural community. It will present the results of audiometric screening among a group of people in this community and their self reported risk factors of hearing loss. Different risk factors experienced by men and women will be compared. Two surveys were conducted in a small Queensland rural community. The first survey gathered information relating to chronic diseases among 604 people using a telephone interview method. The second survey assessed the level of hearing among 64 people who presented themselves for audiometric screening, their history of exposure to loud noise and their previous use of hearing protective measures. A higher rate of "industrial deafness" was reported (110.75 per 1,000 population) than the 1995 National rate (95.2 per 1,000 population). Of 64 people who attended the audiometric assessment, 60 (93.8%) had some level of hearing loss using the 2000 International Standard of hearing level (ISO 7029: 2000) taking age and gender into account. However, 15 persons (23.4%) perceived that they had good hearing. When compared to ISO 7029: 2000 standard, men and women had a similar pattern of hearing loss. Compared to men, a lower percentage of women were exposed to different sources of loud noise and were less likely to use hearing protection devices.

Early Detection and Diagnosis of Hearing Impairment: A United Kingdom Perspective.

ERIC Educational Resources Information Center

Bamford, John M.; McSporran, Eileen

1993-01-01

The incidence of congenital hearing loss in the United Kingdom is noted, and the use of a universal behavioral hearing screen at the age of seven or eight months, implemented by Health Visitors, is described. Procedures involved in identification, diagnosis, and management are discussed. (JDD)

Implementing an organised cervical screening programme in the Republic of Moldova-Stakeholder identification and engagement.

PubMed

Davies, Philip; Valuta, Diana; Cojohari, Natalia; Sancho-Garnier, Helene

2017-10-01

Successfully implementing cervical screening programmes requires them to be adapted to the local context and have broad stakeholder support. This can be achieved by actively engaging local stakeholders in planning as well as implementing the programmes. The Moldovan government started implementing an organised cervical screening programme in 2010 with the first step being stakeholder identification and engagement. This process started by contacting easily identified stakeholders with each asked to recommend others and the process continued until no new ones were identified. Stakeholders were then involved in a series of individual and group meetings over a 2-year period to build confidence and encourage progressively greater engagement. In total, 87 individuals from 46 organisations were identified. Over the 2-year process, the individual and group meetings facilitated a change in stakeholder attitudes from disinterest, to acceptance and finally to active cooperation in designing the screening programme and preparing an implementation plan that were both well adapted to the Moldovan context. Developing the broad support needed to implement cervical screening programmes required ongoing interaction with stakeholders over an extended period. This interaction allowed stakeholder concerns to be identified and addressed, progress to be demonstrated, and stakeholders to be educated about organised screening programmes so they had the knowledge to progressively take greater responsibility and ownership. Copyright © 2017 Elsevier Ltd. All rights reserved.

Measuring informed choice in population-based reproductive genetic screening: a systematic review

PubMed Central

Ames, Alice Grace; Metcalfe, Sylvia Ann; Archibald, Alison Dalton; Duncan, Rony Emily; Emery, Jon

2015-01-01

Genetic screening and health-care guidelines recommend that programmes should facilitate informed choice. It is therefore important that accurate measures of informed choice are available to evaluate such programmes. This review synthesises and appraises measures used to evaluate informed choice in population-based genetic screening programmes for reproductive risk. Databases were searched for studies offering genetic screening for the purpose of establishing reproductive risk to an adult population sample, in which aspects of informed choice were measured. Studies were included if, at a minimum, measures of uptake of screening and knowledge were used. Searches identified 1462 citations and 76 studies were reviewed in full text; 34 studies met the inclusion criteria. Over 20 different measures of informed choice were used. Many measures lacked adequate validity and reliability data. This systematic review will inform future evaluation of informed choice in population genetic screening programmes. PMID:24848746

Literacy Outcomes for Primary School Children Who Are Deaf and Hard of Hearing: A Cohort Comparison Study

ERIC Educational Resources Information Center

Harris, Margaret; Terlektsi, Emmanouela; Kyle, Fiona E.

2017-01-01

Purpose: In this study, we compared the language and literacy of two cohorts of children with severe-profound hearing loss, recruited 10 years apart, to determine if outcomes had improved in line with the introduction of newborn hearing screening and access to improved hearing aid technology. Method: Forty-two children with deafness, aged 5-7…

Washington University School of Medicine: A Distinctive Program in Deaf Education Studies at the Program in Audiology and Communication Sciences (PACS)

ERIC Educational Resources Information Center

Hayes, Heather

2010-01-01

Developments in universal newborn hearing screening programs and assistive hearing technology have had considerable effects on the speech, language, and educational success of children who are deaf or hard of hearing. Several recent research studies of children who are deaf or hard of hearing and who use spoken language as their primary method of…

Breast cancer in European Union: an update of screening programmes as of March 2014 (review).

PubMed

Altobelli, E; Lattanzi, A

2014-11-01

Breast cancer, a major cause of female morbidity and mortality, is a global health problem; 2008 data show an incidence of ~450,000 new cases and 140,000 deaths (mean incidence rate 70.7 and mortality rate 16.7, world age-standardized rate per 100,000 women) in European Union Member States. Incidence rates in Western Europe are among the highest in the world. We review the situation of BC screening programmes in European Union. Up to date information on active BC screening programmes was obtained by reviewing the literature and searching national health ministries and cancer service websites. Although BC screening programmes are in place in nearly all European Union countries there are still considerable differences in target population coverage and age and in the techniques deployed. Screening is a mainstay of early BC detection whose main weakness is the rate of participation of the target population. National policies and healthcare planning should aim at maximizing participation in controlled organized screening programmes by identifying and lowering any barriers to adhesion, also with a view to reducing healthcare costs.

Hearing Loss in the Elderly: Is the Hearing Handicap Inventory for the Elderly - Screening Version Effective in Diagnosis When Compared to the Audiometric Test?

PubMed Central

Servidoni, Alexandre Barbosa; Conterno, Lucieni de Oliveira

2018-01-01

Introduction  Hearing losses inherent to the natural process of aging represent today a major public health issue, despite the little attention that their adequate care still receives. Early recognition and proper management of these shortcomings can significantly improve hearing, as well as the patient's general quality of life, reducing the overall impact of this important and prevalent condition of the aging process. Objective  The aim of this research was to evaluate the accuracy of the Hearing Handicap Inventory for the Elderly - Screening Version (HHIE-S) in the diagnosis of hearing loss in the elderly when compared with the audiometric test. Methods  Through a cross-sectional study, our target population was composed of 138 individuals, aged over 60 and with any otorhinolaryngological complaints, recruited at the Clinic of Otorhinolaryngology and Speech Therapy of the Faculdade de Medicina de Marília (Famema), in the city of Marília, SP, Brazil. Patients already in the process of auditory rehabilitation were excluded, as well as those who did not demonstrate the minimum level of oral understanding necessary to allow the interview. Results  The prevalence of hearing loss according to the questionnaire was of 76.1%, while audiometry showed 79.7%. We found the diagnostic accuracy of the instrument to be of 86.2%, with a sensitivity of 89.1% and a specificity of 75.0%, regardless of gender. Conclusion  Thereby, we conclude that the standardized questionnaire under rating is suitable for the screening of hearing loss in the elderly, given its high accuracy and user-friendly quality. PMID:29371892

Nurses with Undiagnosed Hearing Loss: Implications for Practice.

PubMed

Spencer, Cara S; Pennington, Karen

2015-01-05

Hearing loss affects 36 million people in the United States of America, including 17% of the adult population. This suggests some nurses will have hearing losses that affect their communication skills and their ability to perform auscultation assessments, potentially compromising patient care and safety. In this article, the authors begin by reviewing the hearing process, describing various types of hearing loss, and discussing noise-induced hearing loss and noise levels in hospitals. Next, they consider the role of hearing in nursing practice, review resources for hearing-impaired nurses, identify the many costs associated with untreated hearing loss, and note nurses' responsibility for maintaining their hearing health. The authors conclude that nurses need to be aware of their risk for hearing loss and have their hearing screened every five years.

Participants, Physicians or Programmes: Participants' educational level and initiative in cancer screening.

PubMed

Willems, Barbara; Bracke, Piet

2018-04-01

This study is an in-depth examination of at whose initiative (participant, physician or screening programme) individuals participate in cervical, breast and colorectal cancer screening across the EU-28. Special attention is paid to (1) the association with educational attainment and (2) the country's cancer screening strategy (organised, pilot/regional or opportunistic) for each type of cancer screened. Data were obtained from Eurobarometer 66.2 'Health in the European Union' (2006). Final samples consisted of 10,186; 5443 and 9851 individuals for cervical, breast, and colorectal cancer, respectively. Multinomial logistic regressions were performed. Surprisingly, even in countries with organised screening programmes, participation in screenings for cervical, breast and colorectal cancer was most likely to be initiated by the general practitioner (GP) or the participant. In general, GPs were found to play a crucial role in making referrals to screenings, regardless of the country's screening strategy. The results also revealed differences between educational groups with regard to their incentive to participate in cervical and breast cancer screening and, to a lesser extent, in colorectal cancer screening. People with high education are more likely to participate in cancer screening at their own initiative, while people with less education are more likely to participate at the initiative of a physician or a screening programme. Albeit, the results varied according to type of cancer screening and national screening strategy. Copyright © 2018 Elsevier B.V. All rights reserved.

An Alternative to Impedance Screening: Unoccluded Frontal Bone Conduction Screening.

ERIC Educational Resources Information Center

Square, Regina; And Others

1985-01-01

A bone conduction hearing screening test using frontal bone oscillator placement was compared with pure-tone air-conduction screening and impedance audiometry with 114 preschoolers. Unoccluded frontal bone conduction testing produced screening results not significantly different from results obtained by impedance audiometry. (CL)!

Screening for hearing loss in the elderly using distortion product otoacoustic emissions, pure tones, and a self-assessment tool.

PubMed

Jupiter, Tina

2009-12-01

To determine whether distortion product otoacoustic emissions (DPOAEs) could be used as a hearing screening tool with elderly individuals living independently, and to compare the utility of different screening protocols: (a) 3 pure-tone screening protocols consisting of 30 dB HL at 1, 2, and 3 kHz; 40 dB HL at 1, 2, and 3 kHz; or 40 dB HL at 1 and 2 kHz; (b) the Hearing Handicap Inventory for the Elderly-Screening version (HHIE-S); (c) pure tones at 40 dB HL at 1 and 2 kHz plus the HHIE-S; and (d) DPOAEs. A total of 106 elderly individuals age 65-91 years were screened using the above protocols. Pass/fail results showed that most individuals failed at 30 dB HL, followed by DPOAEs, the 40-dB HL protocols, the HHIE-S alone, and the combined pure-tone/HHIE-S protocol. All screening results were associated except the HHIE-S and 30 dB HL and the HHIE-S and DPOAEs. A McNemar analysis revealed that the differences between the correlated pass/fail results were significant except for the HHIE-S and 40 dB at 1 and 2 kHz. DPOAEs can be used to screen the elderly, with the advantage that individuals do not have to voluntarily respond to the test.

Exploring Maori health worker perspectives on colorectal cancer and screening.

PubMed

Pitama, Suzanne; Cave, Tami; Huria, Tania; Lacey, Cameron; Cuddy, Jessica; Frizelle, Frank

2012-06-08

To explore Maori health worker perspectives on colorectal screening and identify factors that may influence Maori participation in a colorectal screening programme. Thirty Maori health workers were interviewed to explore their experience with screening programmes, knowledge of colorectal cancer and their perspective on a potential colorectal screening programme. Health workers shared their perspective informed by both their own whanau and whanau they encountered professionally through their health work. Participants were largely positive about potential colorectal screening; however, various access barriers were identified. These included patient-clinician engagement and communication, lack of provision for patient's privacy during screening and patients feeling discouraged to take part in screening. Factors enabling screening included having an established relationship with their General Practitioner, screening clinicians taking time to build rapport, answer questions and share information, screening practices that were inclusive of Maori cultural norms and possessing high health literacy. Evidence points to growing disparity between the colorectal cancer incidence rates of Maori and non-Maori; disparities in colorectal cancer survival rates are already marked. Participants in the current pilot could provide valuable information to help ensure that the health education, promotion, and clinical practice surrounding a national colorectal screening programme are effective for Maori in reducing disparity and improving health outcomes.

Cost-effectiveness and budget impact analyses of a colorectal cancer screening programme in a high adenoma prevalence scenario using MISCAN-Colon microsimulation model.

PubMed

Arrospide, Arantzazu; Idigoras, Isabel; Mar, Javier; de Koning, Harry; van der Meulen, Miriam; Soto-Gordoa, Myriam; Martinez-Llorente, Jose Miguel; Portillo, Isabel; Arana-Arri, Eunate; Ibarrondo, Oliver; Lansdorp-Vogelaar, Iris

2018-04-25

The Basque Colorectal Cancer Screening Programme began in 2009 and the implementation has been complete since 2013. Faecal immunological testing was used for screening in individuals between 50 and 69 years old. Colorectal Cancer in Basque country is characterized by unusual epidemiological features given that Colorectal Cancer incidence is similar to other European countries while adenoma prevalence is higher. The object of our study was to economically evaluate the programme via cost-effectiveness and budget impact analyses with microsimulation models. We applied the Microsimulation Screening Analysis (MISCAN)-Colon model to predict trends in Colorectal Cancer incidence and mortality and to quantify the short- and long-term effects and costs of the Basque Colorectal Cancer Screening Programme. The model was calibrated to the Basque demographics in 2008 and age-specific Colorectal Cancer incidence data in the Basque Cancer Registry from 2005 to 2008 before the screening begun. The model was also calibrated to the high adenoma prevalence observed for the Basque population in a previously published study. The multi-cohort approach used in the model included all the cohorts in the programme during 30 years of implementation, with lifetime follow-up. Unit costs were obtained from the Basque Health Service and both cost-effectiveness analysis and budget impact analysis were carried out. The goodness-of-fit of the model adaptation to observed programme data was evidence of validation. In the cost-effectiveness analysis, the savings from treatment were larger than the added costs due to screening. Thus, the Basque programme was dominant compared to no screening, as life expectancy increased by 29.3 days per person. The savings in the budget analysis appeared 10 years after the complete implementation of the programme. The average annual budget was €73.4 million from year 2023 onwards. This economic evaluation showed a screening intervention with a major health gain that also produced net savings when a long follow-up was used to capture the late economic benefit. The number of colonoscopies required was high but remain within the capacity of the Basque Health Service. So far in Europe, no other population Colorectal Cancer screening programme has been evaluated by budget impact analysis.

Genetics of non syndromic hearing loss.

PubMed

Venkatesh, M D; Moorchung, Nikhil; Puri, Bipin

2015-10-01

Non Syndromic Hearing Loss is an important cause for hearing loss. One in 1000 newborns have some hearing impairment. Over 400 genetic syndromes have been described. Non Syndromic Hearing Loss (NSHL) can be inherited in an Autosomal Dominant, Autosomal Recessive or a Sex Linked fashion. There are several reasons why genetic testing should be done in cases of NSHL, the main reasons being for genetic screening and for planning treatment. This review describes the genes involved in NSHL and the genetic mechanisms involved in the pathogenesis of the disease.

Two faces of patient advocacy: the current controversy in newborn screening.

PubMed

Arnold, Cosby G

2014-08-01

Newborn screening programmes began in the 1960s, have traditionally been conducted without parental permission and have grown dramatically in the last decade. Whether these programmes serve patients' best interests has recently become a point of controversy. Privacy advocates, concerned that newborn screening infringes upon individual liberties, are demanding fundamental changes to these programmes. These include parental permission and limiting the research on the blood samples obtained, an agenda at odds with the viewpoints of newborn screening advocates. This essay presents the history of newborn screening in the USA, with attention to factors that have contributed to concerns about these programmes. The essay suggests that the rapid increase in the number of disorders screened for and the addition of research without either public knowledge or informed consent were critical to the development of resistance to mandatory newborn screening and research. Future newborn screening initiatives should include public education and comment to ensure continued support. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

[The model of aged-hearing monitoring under the hospital information system].

PubMed

Bao, Xiao-lin; Xu, Hua; Sun, Qiang; Liu, Ji-hong; Guo, Jia-liang

2013-03-01

To study the oldly people's hearing screening and dynamic monitoring mode, and to discuss the new diseases and health management mode in current information network era. To establish the network connection between the hospital and the communities in the internet through the function expansion of the Hospital Information Systems and to realize "dual systems, double platforms" integrated management modes and establish the audiology workstation. The routine physical examination, pure tone hearing threshold tests and middle ear analysis were performed on four hundred and twenty elderly people from the fourteen communities every three months, and the changes of hearing and related symptoms were observed. Resources sharing was established between the hospital and these fourteen communities. Health records were established for all the aged people, the hearing screening lasted only half a day each time. Fourteen hearing loss cases were found during one year. A statistically significant difference (P < 0.01) were found, the ratio of hearing loss with diabetes, high blood pressure and other diseases were much higher than people without concomitant. The advantage of disease management mode under the Hospital Information System is convenient, the work efficiency and qualities are improved, which is worthy of popularizing.

PubMed Central

PALUDETTI, G.; CONTI, G.; DI NARDO, W.; DE CORSO, E.; ROLESI, R.; PICCIOTTI, P.M.; FETONI, A.R.

2012-01-01

SUMMARY Hearing loss is one of the most common disabilities and has lifelong consequences for affected children and their families. Both conductive and sensorineural hearing loss (SNHL) may be caused by a wide variety of congenital and acquired factors. Its early detection, together with appropriate intervention, is critical to speech, language and cognitive development in hearing-impaired children. In the last two decades, the application of universal neonatal hearing screening has improved identification of hearing loss early in life and facilitates early intervention. Developments in molecular medicine, genetics and neuroscience have improved the aetiological classification of hearing loss. Once deafness is established, a systematic approach to determining the cause is best undertaken within a dedicated multidisciplinary setting. This review addresses the innovative evidences on aetiology and management of deafness in children, including universal neonatal screening, advances in genetic diagnosis and the contribution of neuroimaging. Finally, therapy remains a major challenge in management of paediatric SNHL. Current approaches are represented by hearing aids and cochlear implants. However, recent advances in basic medicine which are identifying the mechanisms of cochlear damage and defective genes causing deafness, may represent the basis for novel therapeutic targets including implantable devices, auditory brainstem implants and cell therapy. PMID:23349554

[How to assess and reduce social inequalities in cancer screening programmes].

PubMed

Binefa, Gemma; García, Montse; Peiró, Rosana; Molina-Barceló, Ana; Ibáñez, Raquel

2016-01-01

This field note presents the conclusions and recommendations made at the meeting 'How to reduce social inequalities in cancer screening programmes?' held at the XXVI School of Public Health of Mahon (Menorca, Spain). Participants developed recommendations based on experiences of population-based screening programmes (breast and colorectal) and opportunistic screening (cervical). The conclusions and recommendations focused on four main areas (information systems, evaluation and quality, research, and interventions): the inclusion of social variables at an individual level in health information systems; the establishment of minimum standards for gathering information regarding inequalities in access to preventive services; the performance of actions in vulnerable populations; and the promotion of the exchange of experiences and best practices through the Cancer Screening Programmes Network and working groups of the scientific societies. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

[Evaluation of the usefulness for neonatal mass screening in light of 35 years personal experience].

PubMed

Bozkowa, K; Cabalska, B; Radomyska, B; Ołtarzewski, M; Lenartowska, I

1999-01-01

The results and the significance of neonatal mass-screening programmes for inborn errors of metabolism, conducted by the National Research Institute of Mother and Child (NRIMC), are discussed. As the first in Poland, in 1964, mass-screening for phenylketonuria (PKU) was introduced. The BIA-Guthrie test was used. Other Guthrie tests (GBIA) were applied in homocystinuria, tyrosinemia, histidinemia and leucinosis (Maple Syrup Urine Disease-MSUD). In the middle of the 60. the Beutler and Baluda test was introduced for galactosaemia, as well as the Efron urine test in infant screening for different inborn errors of metabolism. In the middle of the 70., neonatal mass-screening for cystic fibrosis (CF, mucoviscidosis) was started. Meconium tests and the sweat test with ion selective chloride electrode were used. Apart from inborn errors of metabolism, we also introduced a screening programme for neuroblastoma in which vaniline mandelic acid (VMA) in urine was estimated and for congenital hypothyroidism were TSH level was assessed. The results of screening are shown in the tables and in the figures. In our opinion the best clinical results are obtained with screening for congenital hypothyroidism and for PKU, since very early detection and treatment in these diseases prevents severe mental retardation. We therefore consider that both these screening programmes should be treated as obligatory examinations in all neonates. Taking into consideration the fact that there are different types of hyperhenylalaninemias, the principles of differential diagnosis are discussed. Molecular genetic investigations, carried out in the NRIMC Department of Genetics proved to be a very important procedure in the verification of diagnosis of different mutations. The authors also discuss the problem of dietary treatment duration in PKU. In our opinion the hypophenyloalanine diet regimen in girls, should not be discontinued during adolescence, since there is the problem of maternal PKU and the possibility of foetal damage. The results of our own investigations of maternal PKU are discussed. The significance of mass-screening for galactosemia is still under discussion. In our opinion, mass-screening for galactosemia is not useful and we have discontinued it. Selective screening has been started combined with molecular genetic studies in high risk families. In the future, we plan to prepare guidelines on the principles of diagnosis and treatment of galactosemia in children and women in the reproductive age. Mass-screening for cystic fibrosis is also still under discussion. The results of the early screening programmes were not satisfactory and the tests were discontinued. In 1998, after reorganisation of the whole system, CF screening, using tripsin-radioimmune assays, was started again. The new screening programme is combined with molecular genetic investigation of different mutations. It is still too early to assess the importance and success of this CF mass-screening programme. We decided to discontinue the screening for homocystinuria, histidinemia, tyrosinemia, leucinosis and for neuroblastoma, since these programmes did not comply with criteria of mass-screening. In 1997, major reorganisation of screening programmes for inborn errors of metabolism, at NRIMC, was undertaken. The Guthrie test for PKU was changed to a quantitative colorimetric method. The immuno-luminometric method is used for TSH estimation. The whole system is based on complete computer control of all the steps of screening, from blood sampling on filter paper until the final diagnosis. The advantages of this modern system of organisation of the screening programme are discussed.

Software intelligent system for effective solutions for hearing impaired subjects.

PubMed

S, Rajkumar; S, Muttan; V, Sapthagirivasan; V, Jaya; S S, Vignesh

2017-01-01

The anatomy and physiology of the ear is complex in nature, which makes it a challenge for audiologists to prescribe solutions for varied hearing-impaired subjects. There is a need to increase the satisfaction level of hearing-aid users by adopting better strategies that involve modern technological advancements. To design and develop a decision support Software Intelligent System (SIS) that performs audiological investigations to assess the degree of hearing loss and to suggest appropriate hearing-aid gain values. SIS is developed based on the study conducted in the Government General Hospital, Chennai, India, between 2013 and 2015. In the study period, audiological investigations were performed on 368 subjects, using the clinical audiometer (Inventis-Piano, Italy) and the SIS. Gain suggestions were recommended for hearing-aid users (Siemens Intuis life & Intuis-SP) using standard prescriptive procedures, alterations made by the audiologists, and by the SIS. It was developed with artificial neural network-based gain predictions. Of the tested subjects, 256 were identified as hearing-impaired. The calculated sensitivity, specificity and accuracy of the computerised audiometer incorporated in the SIS are 93%, 85% and 90% respectively. Furthermore, 86% of the hearing-impaired subjects were satisfied during their first hearing-aid trial with the gain recommendations from SIS. The findings suggest that the proposed SIS could be used to perform audiological screening tests and to recommend appropriate hearing-aid gain values to the hearing-impaired subjects. This could eventually be helpful for audiologists in the areas where routine mass audiological screening and fast hearing-aid solution is required. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Mild and Unilateral Hearing Loss: Implications for Early Intervention

ERIC Educational Resources Information Center

Holstrum, W. June; Biernath, Krista; McKay, Sarah; Ross, Danielle S.

2009-01-01

Newborn hearing screening has become a standard practice in most birthing hospitals in the United States. Historically, the primary target for the identification of hearing loss has been infants with permanent bilateral loss of moderate degree or greater (i.e., greater than 40 dB). However, research indicates that without early identification and…

Early Hearing Detection and Intervention in Developing Countries: Current Status and Prospects

ERIC Educational Resources Information Center

Olusanya, Bolajoko O.

2006-01-01

Infant hearing screening is emerging rapidly as a silent global revolution for the early detection of children with congenital or early onset hearing loss to ensure timely enrollment in family-oriented intervention programs for the development of spoken language. This article examines the overriding and interrelated scientific, ethical and…

Improving access to screening for people with learning disabilities.

PubMed

Marriott, Anna; Turner, Sue; Giraud-Saunders, Alison

2014-11-04

People with learning disabilities have poorer health than their non-disabled peers, and are less likely to access screening services than the general population. The National Development Team for Inclusion and the Norah Fry Research Centre developed a toolkit and guidance to improve uptake of five national (English) screening programmes (one of which is delivered through local programmes), based on work to improve access by people with learning disabilities in the south west peninsula of the UK. This article describes the findings in relation to the five English screening programmes and suggests ways to improve uptake of cancer screening by people with learning disabilities.

Genetic basis of hearing loss in Spanish, Hispanic and Latino populations.

PubMed

Mittal, Rahul; Patel, Amit P; Nguyen, Desiree; Pan, Debbie R; Jhaveri, Vasanti M; Rudman, Jason R; Dharmaraja, Arjuna; Yan, Denise; Feng, Yong; Chapagain, Prem; Lee, David J; Blanton, Susan H; Liu, Xue Zhong

2018-03-20

Hearing loss (HL) is the most common neurosensory disorder affecting humans. The screening, prevention and treatment of HL require a better understanding of the underlying molecular mechanisms. Genetic predisposition is one of the most common factors that leads to HL. Most HL studies include few Spanish, Hispanic and Latino participants, leaving a critical gap in our understanding about the prevalence, impact, unmet health care needs, and genetic factors associated with hearing impairment among Spanish, Hispanic and Latino populations. The few studies which have been performed show that the gene variants commonly associated with HL in non-Spanish and non-Hispanic populations are infrequently responsible for hearing impairment in Spanish as well as Hispanic and Latino populations (hereafter referred to as Hispanic). To design effective screening tools to detect HL in Spanish and Hispanic populations, studies must be conducted to determine the gene variants that are most commonly associated with hearing impairment in this racial/ethnic group. In this review article, we summarize gene variants and loci associated with HL in Spanish and Hispanic populations. Identifying new genetic variants associated with HL in Spanish and Hispanic populations will pave the way to develop effective screening tools and therapeutic strategies for HL. Copyright © 2018 Elsevier B.V. All rights reserved.

Breast cancer screening in the Czech Republic: time trends in performance indicators during the first seven years of the organised programme

PubMed Central

2011-01-01

Background The Czech Breast Cancer Screening Programme (CBCSP) was initiated in September 2002 by establishing a network of accredited centres. The aim of this article is to describe progress in the programme quality over time after the inception of the organised programme. Methods The CBCSP is monitored using an information system consisting of three principal components: 1) the national cancer registry, 2) a screening registry collecting data on all screening examinations, further assessments and final diagnoses at accredited programme centres, and 3) administrative databases of healthcare payers. Key performance indicators from the European Guidelines have been adopted for continuous monitoring. Results Breast cancer incidence in the Czech Republic has steadily been increasing, however with a growing proportion of less advanced stages. The mortality rate has recently stabilised. The screening registry includes 2,083,285 records on screening episodes between 2002 and 2008. In 2007-2008, 51% of eligible women aged 45-69 were screened. In 2008, the detection rates were 6.1 and 3.7 per 1,000 women in initial and subsequent screening respectively. Corresponding recall rates are 3.9% and 2.2%, however, it is necessary to pay attention to further assessment performed during the screening visits. Benign to malignant open biopsy ratio was 0.1. Of invasive cases detected in screening, 35.6% was less than 10 mm in diameter. Values of early performance indicators, as measured by both crude and standardized estimates, are generally improving and fulfil desirable targets set by European Guidelines. Conclusions Mammography screening in the Czech Republic underwent successful transformation from opportunistic prevention to an organised programme. Values of early indicators confirm continuous improvement in different aspects of process quality. Further stimulation of participation through invitation system is necessary to exploit the full potential of screening mammography at the population level. PMID:21554747

Disability and participation in breast and bowel cancer screening in England: a large prospective study.

PubMed

Floud, S; Barnes, I; Verfürden, M; Kuper, H; Gathani, T; Blanks, R G; Alison, R; Patnick, J; Beral, V; Green, J; Reeves, G K

2017-11-21

There is limited information about participation in organised population-wide screening programmes by people with disabilities. Data from the National Health Service routine screening programmes in England were linked to information on disability reported by the Million Women Study cohort participants. Of the 473 185 women offered routine breast or bowel cancer screening, 23% reported some disability. Women with disabilities were less likely than other women to participate in breast cancer screening (RR=0.64, 95% CI: 0.62-0.65) and in bowel cancer screening (RR=0.75, 0.73-0.76). Difficulties with self-care or vision were associated with the greatest reduction in screening participation. Participation in routine cancer screening programmes in England is reduced in people with disabilities and participation varies by type of disability.

Presence, characteristics and equity of access to breast cancer screening programmes in 27 European countries in 2010 and 2014. Results from an international survey.

PubMed

Deandrea, S; Molina-Barceló, A; Uluturk, A; Moreno, J; Neamtiu, L; Peiró-Pérez, R; Saz-Parkinson, Z; Lopez-Alcalde, J; Lerda, D; Salas, D

2016-10-01

The European Union Council Recommendation of 2 December 2003 on cancer screening suggests the implementation of organised, population-based breast cancer screening programmes based on mammography every other year for women aged 50 to 69years, ensuring equal access to screening, taking into account potential needs for targeting particular socioeconomic groups. A European survey on coverage and participation, and key organisational and policy characteristics of the programmes, targeting years 2010 and 2014, was undertaken in 2014. Overall, 27 countries contributed to this survey, 26 of the 28 European Union member states (92.9%) plus Norway. In 2014, 25 countries reported an ongoing population-based programme, one country reported a pilot programme and another was planning a pilot. In eight countries, the target age range was broader than that proposed by the Council Recommendation, and in three countries the full range was not covered. Fifteen countries reported not reaching some vulnerable populations, such as immigrants, prisoners and people without health insurance, while 22 reported that participation was periodically monitored by socioeconomic variables (e.g. age and territory). Organised, population-based breast cancer screening programmes based on routine mammograms are in place in most EU member states. However, there are still differences in the way screening programmes are implemented, and participation by vulnerable populations should be encouraged. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Colorectal Cancer Screening Programme in Spain: Results of Key Performance Indicators After Five Rounds (2000-2012).

PubMed

Binefa, Gemma; Garcia, Montse; Milà, Núria; Fernández, Esteve; Rodríguez-Moranta, Francisco; Gonzalo, Núria; Benito, Llúcia; Clopés, Ana; Guardiola, Jordi; Moreno, Víctor

2016-01-20

Effective quality assurance is essential in any screening programme. This article provides a unique insight into key quality indicators of five rounds of the first population-based colorectal cancer screening programme implemented in Spain (2000-2012), providing the results according to the type of screening (prevalent or first screen and incident or subsequent screen) and test (guaiac or immunochemical). The total crude participation rate increased from 17.2% (11,011) in the first round to 35.9% (22,988) in the last one. Rescreening rate was very high (88.6% in the fifth round). Positivity rate was superior with the faecal immunochemical test (6.2%) than with the guaiac-based test (0.7%) (p < 0.0001) and detection rates were also better with the immunochemical test. The most significant rise in detection rate was observed for high risk adenoma in men (45.5 per 1,000 screened). Most cancers were diagnosed at an early stage (61.4%) and there was a statistically significant difference between those detected in first or subsequent screening (52.6% and 70.0% respectively; p = 0.024). The availability of these results substantially improves data comparisons and the exchange of experience between screening programmes.

To nudge or not to nudge: cancer screening programmes and the limits of libertarian paternalism.

PubMed

Ploug, Thomas; Holm, Søren; Brodersen, John

2012-12-01

'Nudging--and the underlying idea 'libertarian paternalism'--to an increasing degree influences policy thinking in the healthcare sector. This article discusses the influence exerted upon a woman's choice of participation in the Danish breast screening programme in light of 'libertarian paternalism'. The basic tenet of 'libertarian paternalism' is outlined and the relationship between 'libertarian paternalism' and informed consent investigated. Key elements in the process of enrolling women into the Danish mammography screening programme are introduced. It is shown that for several reasons the influence exerted upon women's choices of participation cannot be justified within a welfare-enhancing libertarian paternalistic framework. The article suggests that screening programmes alternatively adopt a liberty-enhancing approach and considers the practical implications of this alternative.

Public Hearing or `Hearing Public'? An Evaluation of the Participation of Local Stakeholders in Environmental Impact Assessment of Ghana's Jubilee Oil Fields

NASA Astrophysics Data System (ADS)

Bawole, Justice Nyigmah

2013-08-01

This article investigates the involvement of local stakeholders in the environmental impact assessment (EIA) processes of Ghana's first off-shore oil fields (the Jubilee fields). Adopting key informants interviews and documentary reviews, the article argues that the public hearings and the other stakeholder engagement processes were cosmetic and rhetoric with the view to meeting legal requirements rather than a purposeful interest in eliciting inputs from local stakeholders. It further argues that the operators appear to lack the social legitimacy and social license that will make them acceptable in the project communities. A rigorous community engagement along with a commitment to actively involving local stakeholders in the corporate social responsibility (CSR) programmes of the partners may enhance the image of the partners and improve their social legitimacy. Local government agencies should be capacitated to actively engage project organisers; and government must mitigate the impact of the oil projects through well-structured social support programmes.

Public hearing or 'hearing public'? an evaluation of the participation of local stakeholders in environmental impact assessment of Ghana's Jubilee oil fields.

PubMed

Bawole, Justice Nyigmah

2013-08-01

This article investigates the involvement of local stakeholders in the environmental impact assessment (EIA) processes of Ghana's first off-shore oil fields (the Jubilee fields). Adopting key informants interviews and documentary reviews, the article argues that the public hearings and the other stakeholder engagement processes were cosmetic and rhetoric with the view to meeting legal requirements rather than a purposeful interest in eliciting inputs from local stakeholders. It further argues that the operators appear to lack the social legitimacy and social license that will make them acceptable in the project communities. A rigorous community engagement along with a commitment to actively involving local stakeholders in the corporate social responsibility (CSR) programmes of the partners may enhance the image of the partners and improve their social legitimacy. Local government agencies should be capacitated to actively engage project organisers; and government must mitigate the impact of the oil projects through well-structured social support programmes.

Educational, employment, and social participation of young adult graduates from the paediatric Southern Cochlear Implant Programme, New Zealand.

PubMed

Goh, Terence; Bird, Philip; Pearson, John; Mustard, Jill

2016-01-01

The purpose of this study is to observe the education and vocational achievements and social participation of cochlear implant recipients as they graduate from a paediatric cochlear implant programme and identify any significant associations that might exist. This study identified 56 patients from the Southern Cochlear Implant Programme (SCIP) who received cochlear implants before the age of 19 (paediatric) and are now over the age of 19 (adult). A questionnaire investigated their education, employment, and identity with the hearing and deaf communities. Also included were the satisfaction with life scale and Hearing Participation Scale (HPS). Subjects ranged in age from 19 to 32. Twenty-six patients responded to the questionnaire, including one non-user. Twenty identified strongly or very strongly with the hearing community. There was weak evidence of a linear association between strong identity with the hearing community and a higher HPS score. No other statistically significant associations were detected. Interestingly, 12 out of 26 participants found employment through family. Positive outcome trends in education and employment were seen in this study although no statistical significance was achieved. There is a strong bias for those who use their cochlear implants regularly, and there are no data available for those who do not use their cochlear implants for comparison as only one non-user completed the survey, despite efforts to include this group. This study shows that there is perceived benefit in implantation for patients who use it regularly but further research is needed with a more diverse group of cochlear implant recipients.

Economic evaluation of the breast cancer screening programme in the Basque Country: retrospective cost-effectiveness and budget impact analysis.

PubMed

Arrospide, Arantzazu; Rue, Montserrat; van Ravesteyn, Nicolien T; Comas, Merce; Soto-Gordoa, Myriam; Sarriugarte, Garbiñe; Mar, Javier

2016-06-01

Breast cancer screening in the Basque Country has shown 20 % reduction of the number of BC deaths and an acceptable overdiagnosis level (4 % of screen detected BC). The aim of this study was to evaluate the breast cancer early detection programme in the Basque Country in terms of retrospective cost-effectiveness and budget impact from 1996 to 2011. A discrete event simulation model was built to reproduce the natural history of breast cancer (BC). We estimated for lifetime follow-up the total cost of BC (screening, diagnosis and treatment), as well as quality-adjusted life years (QALY), for women invited to participate in the evaluated programme during the 15-year period in the actual screening scenario and in a hypothetical unscreened scenario. An incremental cost-effectiveness ratio was calculated with the use of aggregated costs. Besides, annual costs were considered for budget impact analysis. Both population level and single-cohort analysis were performed. A probabilistic sensitivity analysis was applied to assess the impact of parameters uncertainty. The actual screening programme involved a cost of 1,127 million euros and provided 6.7 million QALYs over the lifetime of the target population, resulting in a gain of 8,666 QALYs for an additional cost of 36.4 million euros, compared with the unscreened scenario. Thus, the incremental cost-effectiveness ratio was 4,214€/QALY. All the model runs in the probabilistic sensitivity analysis resulted in an incremental cost-effectiveness ratio lower than 10,000€/QALY. The screening programme involved an increase of the annual budget of the Basque Health Service by 5.2 million euros from year 2000 onwards. The BC screening programme in the Basque Country proved to be cost-effective during the evaluated period and determined an affordable budget impact. These results confirm the epidemiological benefits related to the centralised screening system and support the continuation of the programme.

Test, episode, and programme sensitivities of screening for colorectal cancer as a public health policy in Finland: experimental design.

PubMed

Malila, Nea; Oivanen, Tiina; Malminiemi, Outi; Hakama, Matti

2008-11-20

To report the sensitivities of the faecal occult blood test, screening episode, and screening programme for colorectal cancer and the benefits of applying a randomised design at the implementation phase of a new public health policy. Experimental design incorporated in public health evaluation using randomisation at individual level in the target population. 161 of the 431 Finnish municipalities in 2004-6. 106 000 adults randomised to screening or control arms. In total, 52 998 adults aged 60-64 in the screening arm received faecal occult blood test kits. Test, episode, and programme sensitivities estimated by the incidence method and corrected for selective attendance and overdiagnosis. The response for screening was high overall (70.8%), and significantly better in women (78.1%) than in men (63.3%). The incidence of cancer in the controls was somewhat higher in men than in women (103 v 93 per 100 000 person years), which was not true for interval cancers (42 v 49 per 100 000 person years). The sensitivity of the faecal occult blood test was 54.6%. Only a few interval cancers were detected among those with positive test results, hence the episode sensitivity of 51.3% was close to the test sensitivity. At the population level the sensitivity of the programme was 37.5%. Although relatively low, the sensitivity of screening for colorectal cancer with the faecal occult blood test in Finland was adequate. An experimental design is a prerequisite for evaluation of such a screening programme because the effectiveness of preventing deaths is likely to be small and results may otherwise remain inconclusive. Thus, screening for colorectal cancer using any primary test modality should be launched in a public health programme with randomisation of the target population at the implementation phase.

Purpose of Newborn Hearing Screening

MedlinePlus

... services, babies will have trouble with speech and language development. For some babies, early intervention services may include ... baby will have the best chance for normal language development if any hearing loss is discovered and treatment ...

Hearing Loss in Children: Screening and Diagnosis

MedlinePlus

... and Statistical Hub (DASH) Articles & Key Findings Research & Tracking EHDI Funded Projects EHDI FOA 1701 Funding Map ... audiologist can do to find out if a person has a hearing loss, how much of a ...

Hearing impairment and language delay in infants: Diagnostics and genetics

PubMed Central

Lang-Roth, Ruth

2014-01-01

This overview study provides information on important phoniatric and audiological aspects of early childhood hearing and language development with the aim of presenting diagnostic and therapeutic approaches. The article first addresses the universal newborn hearing screening that has been implemented in Germany for all infants since January 2009. The process of newborn hearing screening from the maternity ward to confirmation diagnostics is presented in accordance with a decision by the Federal Joint Committee (G-BA). The second topic is pediatric audiology diagnostics. Following confirmation of a permanent early childhood hearing disorder, the search for the cause plays an important role. Hereditary hearing disorders and intrauterine cytomegalovirus (CMV) infection, probably the most common cause of an acquired hearing disorder, are discussed and compared with the most common temporary hearing disorder, otitis media with effusion, which in some cases is severe enough to be relevant for hearing and language development and therefore requires treatment. The third topic covered in this article is speech and language development in the first 3 years of life, which is known today to be crucial for later language development and learning to read and write. There is a short overview and introduction to modern terminology, followed by the abnormalities and diagnostics of early speech and language development. Only some aspects of early hearing and language development are addressed here. Important areas such as the indication for a cochlear implant in the first year of life or because of unilateral deafness are not included due to their complexity. PMID:25587365

Results of an early hearing detection program.

PubMed

Borkoski Barreiro, Silvia A; Falcón González, Juan C; Bueno Yanes, Jorge; Pérez Bermúdez, José L; López Cano, Zoraida; Ramos Macías, Ángel

2013-01-01

Neonatal hearing loss is a public health problem that meets the requirements for submission to universal screening. Our objective was to analyse the results of the early hearing detection and intervention program implemented at our centre between January 2007 and December 2010. We studied 26,717 newborns during the period mentioned, using transient otoacoustic emissions (TOAEs) for the screening. The diagnostic phase was carried out at the hearing loss department. In our area, there were 27,935 births between January 2007 and December 2010. The screening was performed on 26,717 children. Of these, 24,173 had positive TOAEs, 1,040 had no TOAEs and 1,504 presented TOAEs in 1 ear with absence of TOAEs in the contralateral ear. Risk factors associated with hearing loss were found in 4,674 infants. In a second phase of the program, TOAEs were given to 5,156 children, of whom 4,626 had positive otoacoustic emissions in both ears, 323 had no TOAEs in 1 ear and 207 failed this second phase. Of all children studied, 3.8% were referred to auditory brainstem response (ABR) testing and 26 children entered the cochlear implant program. The program reached coverage of 95.64%. The early hearing detection and intervention program at our hospital is suitable for our environment, reaching 95.64% of coverage. We consider the relationship between effectiveness and efficiency to be positive. Copyright © 2012 Elsevier España, S.L. All rights reserved.

European Guidelines for Quality Assurance in Cervical Cancer Screening. Second edition--summary document.

PubMed

Arbyn, M; Anttila, A; Jordan, J; Ronco, G; Schenck, U; Segnan, N; Wiener, H; Herbert, A; von Karsa, L

2010-03-01

European Guidelines for Quality Assurance in Cervical Cancer Screening have been initiated in the Europe Against Cancer Programme. The first edition established the principles of organised population-based screening and stimulated numerous pilot projects. The second multidisciplinary edition was published in 2008 and comprises approximately 250 pages divided into seven chapters prepared by 48 authors and contributors. Considerable attention has been devoted to organised, population-based programme policies which minimise adverse effects and maximise benefits of screening. It is hoped that this expanded guidelines edition will have a greater impact on countries in which screening programmes are still lacking and in which opportunistic screening has been preferred in the past. Other methodological aspects such as future prospects of human papillomavirus testing and vaccination in cervical cancer control have also been examined in the second edition; recommendations for integration of the latter technologies into European guidelines are currently under development in a related project supported by the European Union Health Programme. An overview of the fundamental points and principles that should support any quality-assured screening programme and key performance indicators are presented here in a summary document of the second guidelines edition in order to make these principles and standards known to a wider scientific community.

Translating evidence into practice in low resource settings: cervical cancer screening tests are only part of the solution in rural India.

PubMed

Isaac, Rita; Finkel, Madelon; Olver, Ian; Annie, I K; Prashanth, H R; Subhashini, J; Viswanathan, P N; Trevena, Lyndal J

2012-01-01

The majority of women in rural India have poor or no access to cervical cancer screening services, although one-quarter of all cervical cancers in the world occur there. Several large trials have proven the efficacy of low-tech cervical cancer screening methods in the Indian context but none have documented the necessary components and processes of implementing this evidence in a low-resource setting. This paper discusses a feasible model of implementation of cervical cancer screening programme in low-resource settings developed through a pilot research project carried out in rural Tamilnadu, India. The programme used visual inspection of cervix after acetic acid application (VIA) as a screening tool, nurses in the primary care centres as the primary screeners and peer educators within Self-Help Women groups to raise community awareness. The uptake of screening was initially low despite the access to a screening programme. However, the programme witnessed an incremental increase in the number of women accessing screening with increasing community awareness. The investigators recommend 4 key components to programme implementation in low-resource setting: 1) Evidence-based, cost-effective test and treatment available within the reach of the community; 2) Appropriate referral pathways; 3) Skilled health workers and necessary equipment; and 4) Optimisation of health literacy, beliefs, attitudes of the community.

How Are My Newborn's Screening Results Used?

MedlinePlus

... Pinterest Email Print How are my newborn’s screening results used? In most cases, parents don't hear ... for a particular condition(s). 1 Out of Range Results If the screening detects one or more conditions, ...

Drug discovery for hearing loss: Phenotypic screening of chemical compounds on primary cultures of the spiral ganglion.

PubMed

Whitlon, Donna S

2017-06-01

In the United States there are, at present, no drugs that are specifically FDA approved to treat hearing loss. Although several clinical trials are ongoing, including one testing D-methionine that is supported by the US Army, none of these trials directly address the effect of noise exposure on cochlear spiral ganglion neurons. We recently published the first report of a systematic chemical compound screen using primary, mammalian spiral ganglion cultures in which we were able to detect a compound and others in its class that increased neurite elongation, a critical step in restoring cochlear synapses after noise induced hearing loss. Here we discuss the issues, both pro and con, that influenced the development of our approach. These considerations may be useful for future compound screens that target the same or other attributes of cochlear spiral ganglion neurons. Copyright © 2016 Elsevier B.V. All rights reserved.

Performance of a subsidised mammographic screening programme in Malaysia, a middle-income Asian country.

PubMed

Lee, Marianne; Mariapun, Shivaani; Rajaram, Nadia; Teo, Soo-Hwang; Yip, Cheng-Har

2017-01-28

The incidence of breast cancer in Asia is increasing because of urbanization and lifestyle changes. In the developing countries in Asia, women present at late stages, and mortality is high. Mammographic screening is the only evidence-based screening modality that reduces breast cancer mortality. To date, only opportunistic screening is offered in the majority of Asian countries because of the lack of justification and funding. Nevertheless, there have been few reports on the effectiveness of such programmes. In this study, we describe the cancer detection rate and challenges experienced in an opportunistic mammographic screening programme in Malaysia. From October 2011 to June 2015, 1,778 asymptomatic women, aged 40-74 years, underwent subsidised mammographic screening. All patients had a clinical breast examination before mammographic screening, and women with mammographic abnormalities were referred to a surgeon. The cancer detection rate and variables associated with a recommendation for adjunct ultrasonography were determined. The mean age for screening was 50.8 years and seven cancers (0.39%) were detected. The detection rate was 0.64% in women aged 50 years and above, and 0.12% in women below 50 years old. Adjunct ultrasonography was recommended in 30.7% of women, and was significantly associated with age, menopausal status, mammographic density and radiologist's experience. The main reasons cited for recommendation of an adjunct ultrasound was dense breasts and mammographic abnormalities. The cancer detection rate is similar to population-based screening mammography programmes in high-income Asian countries. Unlike population-based screening programmes in Caucasian populations where the adjunct ultrasonography rate is 2-4%, we report that 3 out of 10 women attending screening mammography were recommended for adjunct ultrasonography. This could be because Asian women attending screening are likely premenopausal and hence have denser breasts. Radiologists who reported more than 360 mammograms were more confident in reporting a mammogram as normal without adjunct ultrasonography compared to those who reported less than 180 mammograms. Our subsidised opportunistic mammographic screening programme is able to provide equivalent cancer detection rates but the high recall for adjunct ultrasonography would make screening less cost-effective.

The serological screening of deceased tissue donors within the English Blood Service for infectious agents--a review of current outcomes and a more effective strategy for the future.

PubMed

Kitchen, A D; Gillan, H L

2010-04-01

The overall effectiveness of the NHSBT screening programme for infectious agents in deceased tissue donors is examined and evaluated in terms of current outcomes and how to improve upon these outcomes. The screening results and any subsequent confirmatory results from a total of 1659 samples from NHSBT deceased donors referred to NTMRL for screening for infectious agents were included in the analysis. Overall 1566/1659 (94.4%) of the samples were screen negative. A total of 93 were repeat reactive on screening for one or more of the mandatory markers screened for, of which only 12 (13%) were subsequently confirmed to be positive on confirmatory testing. The majority of the repeat reactive samples were demonstrating non-specific reactivity with the screening assays in use. Overall, the NHSBT screening programme for infectious agents in deceased tissue donors is very effective with a relatively low overall loss of donors because of non-specific reactivity. However, unnecessary loss of tissue products is not acceptable, and although this programme compares favourably with the outcomes of other such programmes, the confirmatory results obtained demonstrate both the need and the potential for improving the outcomes. This is particularly important as one donor may donate more than one product, and can be achieved very easily with a change to the screening algorithm followed, using the confirmatory data obtained to support and validate this change. CONTENTS SUMMARY: Critical analysis of the NHSBT screening programme for infectious agents in deceased tissue donors and a strategy involving the design and use of a different screening algorithm to improve these outcomes.

International variation in programmes for assessment of children's neurodevelopment in the community: Understanding disparate approaches to evaluation of motor, social, emotional, behavioural and cognitive function.

PubMed

Wilson, Philip; Wood, Rachael; Lykke, Kirsten; Hauskov Graungaard, Anette; Ertmann, Ruth Kirk; Andersen, Merethe Kirstine; Haavet, Ole Rikard; Lagerløv, Per; Abildsnes, Eirik; Dahli, Mina P; Mäkelä, Marjukka; Varinen, Aleksi; Hietanen, Merja

2018-05-01

Few areas of medicine demonstrate such international divergence as child development screening and surveillance. Many countries have nationally mandated surveillance policies, but the content of programmes and mechanisms for delivery vary enormously. The cost of programmes is substantial but no economic evaluations have been carried out. We have critically examined the history, underlying philosophy, content and delivery of programmes for child development assessment in five countries with comprehensive publicly funded health services (Denmark, Finland, Norway, Scotland and Sweden). The specific focus of this article is on motor, social, emotional, behavioural and global cognitive functioning including language. Variations in developmental surveillance programmes are substantially explained by historical factors and gradual evolution although Scotland has undergone radical changes in approach. No elements of universal developmental assessment programmes meet World Health Organization screening criteria, although some assessments are configured as screening activities. The roles of doctors and nurses vary greatly by country as do the timing, content and likely costs of programmes. Inter-professional communication presents challenges to all the studied health services. No programme has evidence for improved health outcomes or cost effectiveness. Developmental surveillance programmes vary greatly and their structure appears to be driven by historical factors as much as by evidence. Consensus should be reached about which surveillance activities constitute screening, and the predictive validity of these components needs to be established and judged against World Health Organization screening criteria. Costs and consequences of specific programmes should be assessed, and the issue of inter-professional communication about children at remediable developmental risk should be prioritised.

[Spatial and temporal analysis of the coverage for neonatal hearing screening in Brazil (2008-2015)].

PubMed

Paschoal, Monique Ramos; Cavalcanti, Hannalice Gottschalck; Ferreira, Maria Ângela Fernandes

2017-11-01

This article seeks to establish the coverage of neonatal hearing screening in Brazil between January 2008 and June 2015. It is an ecological study that uses the country, through the Urban Articulation Regions, as a base. To calculate the screening coverage percentage, the Live Births Information System, the Outpatient Information System and the Beneficiaries of the National Supplementary Health Agency Information System were used. An exploratory analysis of maps and spatial statistical analysis was conducted using TerraView 4.2.2 software. The coverage of neonatal hearing screening saw an increase of 9.3% to 37.2% during the study period. In 2008-2009 it was observed that the percentage of coverage ranged from 0% to 79.92%, but most areas received coverage from 0% to 20%, though in 2014-2015 coverage ranged from 0% to 171.77%, and there was a visible increase in the percentage of coverage in the country, mainly in the Southern Region. The screening coverage has increased over time, but is still low with an uneven distribution in the territory, which may be explained by local laws and policies and by the existence of different types of auditory health service in the country.

Universal newborn screening for congenital CMV infection: what is the evidence of potential benefit?†

PubMed Central

Cannon, Michael J.; Griffiths, Paul D.; Aston, Van; Rawlinson, William D.

2015-01-01

SUMMARY Congenital CMV infection is a leading cause of childhood disability. Many children born with congenital CMV infection are asymptomatic or have nonspecific symptoms and therefore are typically not diagnosed. A strategy of newborn CMV screening could allow for early detection and intervention to improve clinical outcomes. Interventions might include antiviral drugs or nonpharmaceutical therapies such as speech-language therapy or cochlear implants. Using published data from developed countries, we analyzed existing evidence of potential benefit that could result from newborn CMV screening. We first estimated the numbers of children with the most important CMV-related disabilities (i.e. hearing loss, cognitive deficit, and vision impairment), including the age at which the disabilities occur. Then, for each of the disabilities, we examined the existing evidence for the effectiveness of various interventions. We concluded that there is good evidence of potential benefit from nonpharmaceutical interventions for children with delayed hearing loss that occurs by 9 months of age. Similarly, we concluded that there is fair evidence of potential benefit from antiviral therapy for children with hearing loss at birth and from nonpharmaceutical interventions for children with delayed hearing loss occurring between 9 and 24 months of age and for children with CMV-related cognitive deficits. We found poor evidence of potential benefit for children with delayed hearing loss occurring after 24 months of age and for children with vision impairment. Overall, we estimated that in the United States, several thousand children with congenital CMV could benefit each year from newborn CMV screening, early detection, and interventions. Copyright © 2014 John Wiley & Sons, Ltd. PMID:24760655

Breast Cancer Screening Programmes across the WHO European Region: Differences among Countries Based on National Income Level.

PubMed

Altobelli, Emma; Rapacchietta, Leonardo; Angeletti, Paolo Matteo; Barbante, Luca; Profeta, Filippo Valerio; Fagnano, Roberto

2017-04-23

Breast cancer (BC) is the most frequent tumour affecting women all over the world. In low- and middle-income countries, where its incidence is expected to rise further, BC seems set to become a public health emergency. The aim of the present study is to provide a systematic review of current BC screening programmes in WHO European Region to identify possible patterns. Multiple correspondence analysis was performed to evaluate the association among: measures of occurrence; GNI level; type of BC screening programme; organization of public information and awareness campaigns regarding primary prevention of modifiable risk factors; type of BC screening services; year of screening institution; screening coverage and data quality. A key difference between High Income (HI) and Low and Middle Income (LMI) States, emerging from the present data, is that in the former screening programmes are well organized, with approved screening centres, the presence of mobile units to increase coverage, the offer of screening tests free of charge; the fairly high quality of occurrence data based on high-quality sources, and the adoption of accurate methods to estimate incidence and mortality. In conclusion, the governments of LMI countries should allocate sufficient resources to increase screening participation and they should improve the accuracy of incidence and mortality rates.

Mammographic screening: measurement of the cost in a population based programme in Victoria, Australia.

PubMed

Hurley, S F; Livingston, P M; Thane, N; Quang, L

1994-08-01

To estimate the cost per woman participating in a mammographic screening programme, and to describe methods for measuring costs. Expenditure, resource usage, and throughput were monitored over a 12 month period. Unit costs for each phase of the screening process were estimated and linked with the probabilities of each screening outcome to obtain the cost per woman screened and the cost per breast cancer detected. A pilot, population based Australian programme offering free two-view mammographic screening. A total of 5986 women aged 50-69 years who lived in the target area, were listed on the electoral roll, had no previous breast cancer, and attended the programme. Unit costs for recruitment, screening, and recall mammography were $17.54, $60.04, and $175.54, respectively. The costs of clinical assessment for women with subsequent clear, benign, malignant (palpable), and malignant (impalpable) diagnoses were $173.71, $527.29, $436.62, and $567.22, respectively. The cost per woman screened was $117.70, and the cost per breast cancer detected was $11,550. The cost per woman screened is a key variable in assessment of the cost effectiveness of mammographic screening, and is likely to vary between health care settings. Its measurement is justified if decisions about health care services are to be based on cost effectiveness criteria.

The Natural History and Rehabilitative Outcomes of Hearing Loss in Congenital Cytomegalovirus: A Systematic Review.

PubMed

Fletcher, Kyle T; Horrell, Erin M Wolf; Ayugi, John; Irungu, Catherine; Muthoka, Maria; Creel, Liza M; Lester, Cathy; Bush, Matthew L

2018-06-15

The purpose of this study was to examine the literature regarding the natural history and rehabilitative outcomes of sensorineural hearing loss from congenital cytomegalovirus infections. A systematic search was performed in PubMed, PsychINFO, CINAHL, and Web of Science to identify peer-reviewed research. Eligible studies were those containing original peer-reviewed research in English addressing either the natural history or rehabilitative outcomes of sensorineural hearing loss (SNHL) in congenital cytomegalovirus (cCMV). Two investigators independently reviewed all articles and extracted data. Bias was assessed using the Cochrane Collaboration's tool and the Newcastle-Ottawa Assessment Scale. Thirty-six articles were reviewed. Universal screening identifies 0.2 to 1% of newborns with cCMV infection. SNHL ranged from 8 to 32% of infants and was more prevalent in symptomatic versus asymptomatic cases. Nine to 68% of hearing loss occurs in a late or delayed fashion. In 7 to 71% of cases hearing loss is progressive. Cochlear implantation (CI) is a viable option for patients with cCMV associated hearing loss and leads to improvements in hearing and language. There is limited literature comparing rehabilitation outcomes in cCMV and non-cCMV CI recipients. Late onset and progressive hearing loss is seen in children who develop hearing loss from cCMV. Frequent audiologic follow-up is necessary considering the natural history of cCMV hearing loss. Universal screening should be pursued due to the number of asymptomatic children, at birth, who develop late onset/delayed hearing loss. CI is an effective means of improving speech and language in this population.

Evaluation of the colorectal cancer screening Programme in the Basque Country (Spain) and its effectiveness based on the Miscan-colon model.

PubMed

Idigoras, I; Arrospide, A; Portillo, I; Arana-Arri, E; Martínez-Indart, L; Mar, J; de Koning, H J; Lastra, R; Soto-Gordoa, M; van der Meulen, M; Lansdorp-Vogelaar, I

2017-08-01

The population-based Basque Colorectal Cancer (CRC) Screening Programme started in 2009 with a biennial immunochemical quantitative test (FIT) biennial and colonoscopy under sedation in positive cases. The population target of 586,700 residents was from 50 to 69 years old and the total coverage was reached at the beginning of 2014. The aim of our study was to determine possible scenarios in terms of incidence, mortality and reduction of Life-years-Lost (L-y-L) in the medium and long term of CRC. Invitations were sent out by the Programme from 2009 to 2014, with combined organizational strategies. Simulation was done by MISCAN-colon (Microsimulation Screening Analysis) over 30 years comparing the results of screening vs no-screening, taking the population-based Cancer Registry into account. Lifetime population and real data from the Programme were used from 2008 to 2012. The model was run differentially for men and women. 924,416 invitations were sent out from 2009 to 2014. The average participation rate was 68.4%, CRC detection rate was 3.4% and the Advanced Adenoma detection rate was 24.0‰, with differences observed in sex and age. Future scenarios showed a higher decrease of incidence (17.2% vs 14.7%), mortality (28.1% vs 22.4%) and L-y-L (22.6% vs 18.4%) in men than women in 2030. The Basque Country CRC Programme results are aligned to its strategy and comparable to other programmes. MISCAN model was found to be a useful tool to predict the benefits of the programme in the future. The effectiveness of the Programme has not been formally established as case control studies are required to determine long term benefits from the screening strategy.

Parents of Deaf Children Seeking Hearing Loss-Related Information on the Internet: The Australian Experience

ERIC Educational Resources Information Center

Porter, Ann; Edirippulige, Sisira

2007-01-01

Parents whose children are diagnosed in an infant screening program are required to make some difficult choices about the management of the hearing loss at a time when they are emotionally vulnerable. They are required to evaluate information and outcomes regarding issues such as technology for hearing impairment, communication options, education,…

School-Aged Children with Mild Bilateral and Unilateral Hearing Loss: Parents' Reflections on Services, Experiences, and Outcomes

ERIC Educational Resources Information Center

Grandpierre, Viviane; Fitzpatrick, Elizabeth M.; Na, Eunjung; Mendonca, Oreen

2018-01-01

Following the establishment of newborn hearing screening programs, age of identification and length of time before receiving interventions has been reduced for children, including those with milder degrees of hearing loss who were previously not identified until school age. This population of early-identified children requires new support programs…

First Information Parents Receive after UNHS Detection of Their Baby's Hearing Loss

ERIC Educational Resources Information Center

Matthijs, Liesbeth; Loots, Gerrit; Mouvet, Kimberley; Van Herreweghe, Mieke; Hardonk, Stefan; Van Hove, Geert; Van Puyvelde, Martine; Leigh, Greg

2012-01-01

The first information parents receive after referral through Universal Newborn Hearing Screening (UNHS) has significant consequences for later care-related decisions they take and thus for the future of the child with a hearing loss. In this study, 11 interviews were conducted with a representative sample of Flemish service providers to discover…

Music Exposure and Hearing Health Education: A Review of Knowledge, Attitude, and Behaviour in Adolescents and Young Adults

ERIC Educational Resources Information Center

Zhao, Fei; French, David; Manchaiah, Vinaya K.C.; Liang, Maojin; Price, Sharon M.

2012-01-01

Introduction: Adolescents and young adults have been shown to be the age group most at risk of music-induced hearing loss (MIHL), which is already evident and increasing among this group. Objective: The purpose of this review is to provide further insight into the effectiveness of education programmes on attitude and behaviour towards loud music…

Disability and participation in breast and bowel cancer screening in England: a large prospective study

PubMed Central

Floud, S; Barnes, I; Verfürden, M; Kuper, H; Gathani, T; Blanks, R G; Alison, R; Patnick, J; Beral, V; Green, J; Reeves, G K

2017-01-01

Background: There is limited information about participation in organised population-wide screening programmes by people with disabilities. Methods: Data from the National Health Service routine screening programmes in England were linked to information on disability reported by the Million Women Study cohort participants. Results: Of the 473 185 women offered routine breast or bowel cancer screening, 23% reported some disability. Women with disabilities were less likely than other women to participate in breast cancer screening (RR=0.64, 95% CI: 0.62–0.65) and in bowel cancer screening (RR=0.75, 0.73–0.76). Difficulties with self-care or vision were associated with the greatest reduction in screening participation. Conclusion: Participation in routine cancer screening programmes in England is reduced in people with disabilities and participation varies by type of disability. PMID:28972966

Public health genomics and personalized prevention: lessons from the COGS project.

PubMed

Pashayan, N; Hall, A; Chowdhury, S; Dent, T; Pharoah, P D P; Burton, H

2013-11-01

Using the principles of public health genomics, we examined the opportunities and challenges of implementing personalized prevention programmes for cancer at the population level. Our model-based estimates indicate that polygenic risk stratification can potentially improve the effectiveness and cost-effectiveness of screening programmes. However, compared with 'one-size-fits-all' screening programmes, personalized screening adds further layers of complexity to the organization of screening services and raises ethical, legal and social challenges. Before polygenic inheritance is translated into population screening strategy, evidence from empirical research and engagement with and education of the public and the health professionals are needed. © 2013 The Association for the Publication of the Journal of Internal Medicine.

The impact of a family history of hearing problems on those with hearing difficulties themselves: an exploratory study.

PubMed

Stephens, Dafydd; Kramer, Sophia E

2005-04-01

The objective of the study was to investigate the effects of a family history of hearing impairment on those people with the hearing impairment themselves. The subjects were 102 consecutive patients with a family history of hearing impairment, seen in an audiological rehabilitation clinic. Each was given an open-ended questionnaire asking whether such a family history had any effects on them and, if so, to list any effects. Results were qualitatively analysed. 57 subjects indicated effects. Of those listed, 57% were positive, 19% negative, and 24% neutral. The most common positive effects concerned realising the importance of hearing aids and early help-seeking. Common negative effects were concern for the future of themselves and their children. Neutral effects were a reported ignorance or denial of a family history. The results emphasize the importance of asking patients about any family history when planning their rehabilitative programme.

Age of diagnosis of congenital hearing loss: Private v. public healthcare sector.

PubMed

Butler, I R T; Ceronio, D; Swart, T; Joubert, G

2015-11-01

The age of diagnosis of congenital hearing loss is one of the most important determinants of communication outcome. A previous study by the lead author had evaluated the performance of the public health services in Bloemfontein, South Africa (SA), in this regard. This study aimed to examine whether the private health services in the same city were any better. To determine whether the age of diagnosis of congenital hearing loss (CHL) in children seen in the private healthcare sector in Bloemfontein, Free State Province, SA, was lower than that in the public healthcare system in the same city. A comparative study design was utilised and a retrospective database review conducted. Data obtained from this study in the private healthcare sector were compared with data from a previous study in the public healthcare sector using the same study design. Forty-eight children aged <6 years with disabling hearing impairment (DHI) were identified in the private healthcare sector during the study period; 33/47 (70.2%) did not undergo hearing screening at birth. The median age of diagnosis of DHI in the private healthcare sector was 2.24 years, and this was statistically significantly lower than the median age of diagnosis of 3.71 years in the public healthcare sector (p<0.0001; 95% confidence interval (CI) 0.99-2.0). The median age of diagnosis of congenital hearing loss (CHL) in the private healthcare sector was 3.01 years in children who were not screened at birth, and 1.25 years in those who were screened at birth. This difference was statistically significant (p<0.01; 95% CI 0.72-2.47). We also compared the median age of diagnosis of CHL in children from the private healthcare sector who were not screened at birth (median 3.01 years) with that in children in the public healthcare sector (median 3.71 years). This difference was statistically significant (p<0.01; 95% CI 0.41-1.56). Children in the Free State are diagnosed with CHL at a younger age in the private healthcare sector than in the public healthcare sector. With the social and economic benefits of early intervention in cases of DHI well established internationally, SA healthcare providers in both the public and private sectors need to develop screening, diagnostic and (re)habilitation services for children with hearing impairment.

What's New with Newborn Screening

ERIC Educational Resources Information Center

Exceptional Parent, 2008

2008-01-01

Newborn screening is the process of testing and screening newborns shortly after birth for certain, potentially dangerous, conditions and/or impairments--conditions that include everything from inborn errors of metabolism and other genetic disorders to hearing impairment. Early detection through newborn screening is paramount, often allowing the…

[Economic evaluation of the new national breast cancer screening programme in France: application to the Bouche-du-Rhone district].

PubMed

Giorgi, Roch; Reynaud, Julie; Wait, Suzanne; Seradour, Brigitte

2005-11-01

The purpose is to measure the costs of the new national breast cancer screening programme in France and to compare these with those of the previous programme in the Bouches-du-Rhône district. Direct screening costs and costs related to diagnosis and assessment were collected. Costs are presented by screening period, by organisms involved in the screening program and by corresponding phase within the screening process. The total cost of the screening program total cost has increased from 5587487 euros to 9345469 euros between the two campaigns. The main reasons are the investment costs in the new screening program, the increase in the target population and the increased fee for programs. This study presents a first estimate of the costs related to the new national breast cancer screening program. Results of this study may help to guide future decisions on the further development of breast cancer screening in France.

Accuracy of Mobile-Based Audiometry in the Evaluation of Hearing Loss in Quiet and Noisy Environments.

PubMed

Saliba, Joe; Al-Reefi, Mahmoud; Carriere, Junie S; Verma, Neil; Provencal, Christiane; Rappaport, Jamie M

2017-04-01

Objectives (1) To compare the accuracy of 2 previously validated mobile-based hearing tests in determining pure tone thresholds and screening for hearing loss. (2) To determine the accuracy of mobile audiometry in noisy environments through noise reduction strategies. Study Design Prospective clinical study. Setting Tertiary hospital. Subjects and Methods Thirty-three adults with or without hearing loss were tested (mean age, 49.7 years; women, 42.4%). Air conduction thresholds measured as pure tone average and at individual frequencies were assessed by conventional audiogram and by 2 audiometric applications (consumer and professional) on a tablet device. Mobile audiometry was performed in a quiet sound booth and in a noisy sound booth (50 dB of background noise) through active and passive noise reduction strategies. Results On average, 91.1% (95% confidence interval [95% CI], 89.1%-93.2%) and 95.8% (95% CI, 93.5%-97.1%) of the threshold values obtained in a quiet sound booth with the consumer and professional applications, respectively, were within 10 dB of the corresponding audiogram thresholds, as compared with 86.5% (95% CI, 82.6%-88.5%) and 91.3% (95% CI, 88.5%-92.8%) in a noisy sound booth through noise cancellation. When screening for at least moderate hearing loss (pure tone average >40 dB HL), the consumer application showed a sensitivity and specificity of 87.5% and 95.9%, respectively, and the professional application, 100% and 95.9%. Overall, patients preferred mobile audiometry over conventional audiograms. Conclusion Mobile audiometry can correctly estimate pure tone thresholds and screen for moderate hearing loss. Noise reduction strategies in mobile audiometry provide a portable effective solution for hearing assessments outside clinical settings.

Simplified risk assessment of noise induced hearing loss by means of 2 spreadsheet models.

PubMed

Lie, Arve; Engdahl, Bo; Tambs, Kristian

2016-11-18

The objective of this study has been to test 2 spreadsheet models to compare the observed with the expected hearing loss for a Norwegian reference population. The prevalence rates of the Norwegian and the National Institute for Occupational Safety and Health (NIOSH) definitions of hearing outcomes were calculated in terms of sex and age, 20-64 years old, for a screened (with no occupational noise exposure) (N = 18 858) and unscreened (N = 38 333) Norwegian reference population from the Nord-Trøndelag Hearing Loss Study (NTHLS). Based on the prevalence rates, 2 different spreadsheet models were constructed in order to compare the prevalence rates of various groups of workers with the expected rates. The spreadsheets were then tested on 10 different occupational groups with varying degrees of hearing loss as compared to a reference population. Hearing of office workers, train drivers, conductors and teachers differed little from the screened reference values based on the Norwegian and the NIOSH criterion. The construction workers, miners, farmers and military had an impaired hearing and railway maintenance workers and bus drivers had a mildly impaired hearing. The spreadsheet models give a valid assessment of the hearing loss. The use of spreadsheet models to compare hearing in occupational groups with that of a reference population is a simple and quick method. The results are in line with comparable hearing thresholds, and allow for significance testing. The method is believed to be useful for occupational health services in the assessment of risk of noise induced hearing loss (NIHL) and the preventive potential in groups of noise-exposed workers. Int J Occup Med Environ Health 2016;29(6):991-999. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Using resource modelling to inform decision making and service planning: the case of colorectal cancer screening in Ireland.

PubMed

Sharp, Linda; Tilson, Lesley; Whyte, Sophie; Ceilleachair, Alan O; Walsh, Cathal; Usher, Cara; Tappenden, Paul; Chilcott, James; Staines, Anthony; Barry, Michael; Comber, Harry

2013-03-19

Organised colorectal cancer screening is likely to be cost-effective, but cost-effectiveness results alone may not help policy makers to make decisions about programme feasibility or service providers to plan programme delivery. For these purposes, estimates of the impact on the health services of actually introducing screening in the target population would be helpful. However, these types of analyses are rarely reported. As an illustration of such an approach, we estimated annual health service resource requirements and health outcomes over the first decade of a population-based colorectal cancer screening programme in Ireland. A Markov state-transition model of colorectal neoplasia natural history was used. Three core screening scenarios were considered: (a) flexible sigmoidoscopy (FSIG) once at age 60, (b) biennial guaiac-based faecal occult blood tests (gFOBT) at 55-74 years, and (c) biennial faecal immunochemical tests (FIT) at 55-74 years. Three alternative FIT roll-out scenarios were also investigated relating to age-restricted screening (55-64 years) and staggered age-based roll-out across the 55-74 age group. Parameter estimates were derived from literature review, existing screening programmes, and expert opinion. Results were expressed in relation to the 2008 population (4.4 million people, of whom 700,800 were aged 55-74). FIT-based screening would deliver the greatest health benefits, averting 164 colorectal cancer cases and 272 deaths in year 10 of the programme. Capacity would be required for 11,095-14,820 diagnostic and surveillance colonoscopies annually, compared to 381-1,053 with FSIG-based, and 967-1,300 with gFOBT-based, screening. With FIT, in year 10, these colonoscopies would result in 62 hospital admissions for abdominal bleeding, 27 bowel perforations and one death. Resource requirements for pathology, diagnostic radiology, radiotherapy and colorectal resection were highest for FIT. Estimates depended on screening uptake. Alternative FIT roll-out scenarios had lower resource requirements. While FIT-based screening would quite quickly generate attractive health outcomes, it has heavy resource requirements. These could impact on the feasibility of a programme based on this screening modality. Staggered age-based roll-out would allow time to increase endoscopy capacity to meet programme requirements. Resource modelling of this type complements conventional cost-effectiveness analyses and can help inform policy making and service planning.

Screening of hearing in elderly people: assessment of accuracy and reproducibility of the whispered voice test.

PubMed

Labanca, Ludimila; Guimarães, Fernando Sales; Costa-Guarisco, Letícia Pimenta; Couto, Erica de Araújo Brandão; Gonçalves, Denise Utsch

2017-11-01

Given the high prevalence of presbycusis and its detrimental effect on quality of life, screening tests can be useful tools for detecting hearing loss in primary care settings. This study therefore aimed to determine the accuracy and reproducibility of the whispered voice test as a screening method for detecting hearing impairment in older people. This cross-sectional study was carried out with 210 older adults aged between 60 and 97 years who underwent the whispered voice test employing ten different phrases and using audiometry as a reference test. Sensitivity, specificity and positive and negative predictive values were calculated and accuracy was measured by calculating the area under the ROC curve. The test was repeated on 20% of the ears by a second examiner to assess inter-examiner reproducibility (IER). The words and phrases that showed the highest area under the curve (AUC) and IER values were: "shoe" (AUC = 0.918; IER = 0.877), "window" (AUC = 0.917; IER = 0.869), "it looks like it's going to rain" (AUC = 0.911; IER = 0.810), and "the bus is late" (AUC = 0.900; IER = 0.810), demonstrating that the whispered voice test is a useful screening tool for detecting hearing loss among older people. It is proposed that these words and phrases should be incorporated into the whispered voice test protocol.

Social inequalities in pure-tone hearing assessed using occupational stratification schemes.

PubMed

von Gablenz, Petra; Holube, Inga

2017-07-01

The objective of this study is to analyse the performance of two occupational stratification approaches and the impact of social position on adult hearing. The prevalence of hearing impairment, pure-tone averages (PTA) and prevalence ratios (PR) for relative hearing loss, which focuses on the position of one's PTA in the age- and gender-specific distribution, were compared in groups defined by ISCO Skill Level and the International Socio-Economic Index (ISEI). About 1571 subjects aged 30-89, including 677 highly screened adults, from the cross-sectional study HÖRSTAT. ISCO Skill Level and ISEI yielded qualitatively the same results. The prevalence difference between the socially least and most advantaged group ranges between 10 and 16%, varying with the scheme applied. Low- and high-frequency PTA and PR for relative hearing loss confirm the gradient. Screening reduced, but did not negate the social differences. The prevalence difference dropped to 6-7% in the otologically normal subsample. Social groups defined by hierarchical, occupational measures differ in their pure-tone hearing, even if the main risk factors are controlled for. This underlines the need for population-based sampling, the relevance of reporting the study group's social composition and the importance of advancing the discussion on appropriate social measures in hearing research.

Firefighter hearing health: an informatics approach to screening, measurement, and research.

PubMed

Hong, OiSaeng; Monsen, Karen A; Kerr, Madeleine J; Chin, Dal Lae; Lytton, Amy B; Martin, Karen S

2012-10-01

The purpose of this study was to evaluate the use of a standardized interface terminology, the Omaha System, with respect to noise-induced hearing loss (NIHL). A descriptive, correlational design was employed for this secondary analysis with the data from an ongoing hearing protection intervention study. A total of 346 firefighters were included. First, an evidence-based standardized care plan (EB-SCP) for hearing screening was developed and validated by clinical experts. Second, occupational health records were used to compute Omaha System Knowledge, Behavior, and Status outcomes. Third, research data were mapped to Omaha System rating scales. For Knowledge, the mean score was close to 'adequate' (3.7). For Behavior, the mean score was close to 'rarely appropriate' (2.2). For Status, the mean score was close to 'minimal sign/symptom' (4.4). Significant positive relationships were found between Knowledge and Behavior (Spearman's rho =.13, p =.01), and between Behavior and hearing Status (Spearman's rho =.12, p =.02). Findings support the validity of the new Knowledge, Behavior, and hearing Status. Informatics methods such as the standardized NIHL EB-SCP and outcome data sets will create opportunities for clinical decision support and data exchange across various health care settings, thus supporting population-based hearing health assessments and outcomes.

A RCT of three training and support strategies to encourage implementation of screening and brief alcohol intervention by general practitioners.

PubMed

Kaner, E F; Lock, C A; McAvoy, B R; Heather, N; Gilvarry, E

1999-09-01

Providing doctors with new research findings or clinical guidelines is rarely sufficient to promote changes in clinical practice. An implementation strategy is required to provide clinicians with the skills and encouragement needed to alter established routines. To evaluate the effectiveness and cost-effectiveness of different training and support strategies in promoting implementation of screening and brief alcohol intervention (SBI) by general practitioners (GPs). Subjects were 128 GPs, one per practice, from the former Northern and Yorkshire Regional Health Authority, who agreed to use the 'Drink-Less' SBI programme in an earlier dissemination trial. GPs were stratified by previous marketing conditions and randomly allocated to three intensities of training and support: controls (n = 43) received the programme with written guidelines only, trained GPs (n = 43) received the programme plus practice-based training in programme usage, trained and supported GPs (n = 42) received the programme plus practice-based training and a support telephone call every two weeks. GPs were requested to use the programme for three months. Outcome measures included proportions of GPs implementing the programme and numbers of patients screened and intervened with. Seventy-three (57%) GPs implemented the programme and screened 11,007 patients for risk drinking. Trained and supported GPs were significantly more likely to implement the programme (71%) than controls (44%) or trained GPs (56%); they also screened, and intervened with, significantly more patients. Costs per patient screened were: trained and supported GPs, 1.05 Pounds; trained GPs, 1.08 Pounds; and controls, 1.47 Pounds. Costs per patient intervened with were: trained and supported GPs, 5.43 Pounds; trained GPs, 6.02 Pounds; and controls, 8.19 Pounds. Practice-based training plus support telephone calls was the most effective and cost-effective strategy to encourage implementation of SBI by GPs.

Withdrawing low risk women from cervical screening programmes: mathematical modelling study

PubMed Central

Sherlaw-Johnson, C; Gallivan, S; Jenkins, D

1999-01-01

Objective To evaluate the impact of policies for removing women before the recommended age of 64 from screening programmes for cervical cancer in the United Kingdom. Design A mathematical model of the clinical course of precancerous lesions which accounts for the influence of infection with the human papillomavirus, the effects of screening on the progression of disease, and the accuracy of the testing procedures. Two policies are compared: one in which women are withdrawn from the programme if their current smear is negative and they have a recent history of regular, negative results and one in which women are withdrawn if their current smear test is negative and a simultaneous test is negative for exposure to high risk types of human papillomavirus. Setting United Kingdom cervical screening programme. Main outcome measures The incidence of invasive cervical cancer and the use of resources. Results Early withdrawal of selected women from the programme is predicted to give rise to resource savings of up to 25% for smear tests and 18% for colposcopies when withdrawal occurs from age 50, the youngest age considered in the study. An increase in the incidence of invasive cervical cancer, by up to 2 cases/100 000 women each year is predicted. Testing for human papillomavirus infection to determine which women should be withdrawn from the programme makes little difference to outcome. Conclusions This model systematically analyses the consequences of screening options using available data and the clinical course of precancerous lesions. If further audit studies confirm the model’s forecasts, a policy of early withdrawal might be considered. This would be likely to release substantial resources which could be channelled into other aspects of health care or may be more effectively used within the cervical screening programme to counteract the possible increase in cancer incidence that early withdrawal might bring. Key messagesIn the United Kingdom there is concern that the cervical screening programme uses a large amount of resources to screen postmenopausal women who are at low risk of cervical cancerThere may be advantages to withdrawing these women from the screening programme before they reach the recommended age of 64A mathematical modelling approach can be used to evaluate the effectiveness of different policies for early withdrawal from screening with or without an additional test for human papillomavirus DNAEarly withdrawal could lead to a substantial reduction in the resources devoted to screening which could be channelled more effectively into other aspects of health careEarly withdrawal is likely to increase the overall incidence of cervical cancer unless other steps are taken to compensate PMID:9933195

Exploring the Effectiveness of Mandatory Premarital Screening and Genetic Counselling Programmes for β-Thalassaemia in the Middle East: A Scoping Review.

PubMed

Saffi, Marwa; Howard, Natasha

2015-01-01

β-Thalassaemia is a common genetic blood disorder in the Middle Eastern region. Mandatory premarital screening and genetic counselling (PMSGC) programmes are implemented in 8 Middle East countries to reduce at-risk marriages and thus disease prevalence. A scoping review was conducted to explore the effectiveness of these programmes. The 6-stage scoping framework of Arksey and O'Malley [Int J Soc Res Methodol 2005;8:19-32] was used. Reported outcomes were analysed per country, with success defined as achieving a 65% reduction in at-risk marriages and/or thalassaemia-affected births. Emergent enablers and barriers were analysed thematically. Twenty-one sources were included from the 1,348 identified, discussing 7 country programmes, with 95% (20/21) published during 2003-2013. Five publications each were included for Iran and Saudi Arabia, 3 for Turkey, 2 each for Bahrain and Iraq (Kurdistan), and 1 for the United Arab Emirates, plus 2 multi-country evaluations. No programme achieved a 65% at-risk marriage cancellation rate. Though data on thalassaemia-affected birth reductions were minimal, programmes in Iran, Turkey and Iraq reported at least 65% reductions. A thematic analysis found that screening timing, access to prenatal detection and abortion, socio-religious issues, awareness and counselling affected decisions. This review found that PMSGC programmes were unsuccessful in discouraging at-risk marriages but successful in reducing the prevalence of affected births in countries providing prenatal detection and therapeutic abortion. A life cycle approach to prevention, incorporation of school screening, awareness campaigns, reconsideration of therapeutic abortion, and screening and counselling of couples married prior to programme inception are likely to improve the effectiveness of such programmes in the Middle Eastern region. © 2015 S. Karger AG, Basel.

A Whole New World: Technology and Its Impact on Students Who Are Deaf or Hard-of-Hearing

ERIC Educational Resources Information Center

Miller, Kevin

2015-01-01

In this article, the author describes technology used with children or students who are deaf or hard-of-hearing. Specifically, three technological developments are highlighted: cochlear implants, universal newborn infant hearing screening, and telepractice. The positive impact of each type of technology on students who are deaf or hard-of-hearing…

Adolescent Depression: Differential Symptom Presentations in Deaf and Hard-of-Hearing Youth Using the Patient Health Questionnaire-9

ERIC Educational Resources Information Center

Bozzay, Melanie L.; O'Leary, Kimberly N.; De Nadai, Alessandro S.; Gryglewicz, Kim; Romero, Gabriela; Karver, Marc S.

2017-01-01

The present study examined differences in symptom presentation in screening for pediatric depression via evaluation of the Patient Health Questionnaire-9 (PHQ-9). In particular, we examined whether PHQ-9 items function differentially among deaf and hard-of-hearing (DHH; n = 75) and hearing (n = 75) youth based on participants recruited from crisis…

Effective Identification of Functional Hearing Loss Using Behavioral Threshold Measures

ERIC Educational Resources Information Center

Schlauch, Robert S.; Koerner, Tess K.; Marshall, Lynne

2015-01-01

Purpose: Four functional hearing loss protocols were evaluated. Method: For each protocol, 30 participants feigned a hearing loss first on an audiogram and then for a screening test that began a threshold search from extreme levels (-10 or 90 dB HL). Two-tone and 3-tone protocols compared thresholds for ascending and descending tones for 2 (0.5…

Surveillance of hearing loss among older construction and trade workers at Department of Energy nuclear sites.

PubMed

Dement, John; Ringen, Knut; Welch, Laura; Bingham, Eula; Quinn, Patricia

2005-11-01

Medical screening programs at three Departments of Energy (DOE) nuclear weapons facilities (Hanford Nuclear Reservation, Oak Ridge, and the Savannah River Site) have included audiometric testing since approximately 1996. This report summarizes hearing evaluations through March 31, 2003. Occupational examinations included a medical history, limited physical examination, and tests for medical effects from specific hazards, including audiometric testing. Hearing thresholds by frequency for DOE workers were compared to age-standardized thresholds among an external comparison population of industrial workers with noise exposures <80 dBA. Multivariate analyses were used to explore the risk of hearing impairment by duration of construction trade work and self-reported noise exposure, while controlling for potential confounders such as age, race, sex, smoking, elevated serum cholesterol, hypertension, solvent exposures, and recreational noise exposures. Hearing thresholds among DOE workers were much higher than observed in a comparison population of industrial workers with low noise exposures. Overall, 59.7% of workers examined were found to have material hearing impairment by NIOSH criteria. Age, duration of construction work, smoking, and self-reported noise exposure increased the risk of hearing loss. The risk of material hearing impairment was significantly elevated for construction trade workers compared to the external comparison population (odds-ratio = 1.6, 95% CI = 1.3-2.1) and increased with the duration of trade work. These medical screening programs confirm worker concerns about risks for hearing loss and the need for hearing conservation programs for construction workers, with emphasis on the prevention of noise exposures.

Internationally comparable screening tests for listening in noise in several European languages: the German digit triplet test as an optimization prototype.

PubMed

Zokoll, Melanie A; Wagener, Kirsten C; Brand, Thomas; Buschermöhle, Michael; Kollmeier, Birger

2012-09-01

A review is given of internationally comparable speech-in-noise tests for hearing screening purposes that were part of the European HearCom project. This report describes the development, optimization, and evaluation of such tests for headphone and telephone presentation, using the example of the German digit triplet test. In order to achieve the highest possible comparability, language- and speaker-dependent factors in speech intelligibility should be compensated for. The tests comprise spoken numbers in background noise and estimate the speech reception threshold (SRT), i.e. the signal-to-noise ratio (SNR) yielding 50% speech intelligibility. The respective reference speech intelligibility functions for headphone and telephone presentation of the German version for 15 and 10 normal-hearing listeners are described by a SRT of -9.3 ± 0.2 and -6.5 ± 0.4 dB SNR, and slopes of 19.6 and 17.9%/dB, respectively. Reference speech intelligibility functions of all digit triplet tests optimized within the HearCom project allow for investigation of the comparability due to language specificities. The optimization criteria established here should be used for similar screening tests in other languages.

Predicting speech intelligibility in noise for hearing-critical jobs

NASA Astrophysics Data System (ADS)

Soli, Sigfrid D.; Laroche, Chantal; Giguere, Christian

2003-10-01

Many jobs require auditory abilities such as speech communication, sound localization, and sound detection. An employee for whom these abilities are impaired may constitute a safety risk for himself or herself, for fellow workers, and possibly for the general public. A number of methods have been used to predict these abilities from diagnostic measures of hearing (e.g., the pure-tone audiogram); however, these methods have not proved to be sufficiently accurate for predicting performance in the noise environments where hearing-critical jobs are performed. We have taken an alternative and potentially more accurate approach. A direct measure of speech intelligibility in noise, the Hearing in Noise Test (HINT), is instead used to screen individuals. The screening criteria are validated by establishing the empirical relationship between the HINT score and the auditory abilities of the individual, as measured in laboratory recreations of real-world workplace noise environments. The psychometric properties of the HINT enable screening of individuals with an acceptable amount of error. In this presentation, we will describe the predictive model and report the results of field measurements and laboratory studies used to provide empirical validation of the model. [Work supported by Fisheries and Oceans Canada.

Effects of background noise on recording of portable transient-evoked otoacoustic emission in newborn hearing screening.

PubMed

Salina, Husain; Abdullah, Asma; Mukari, Siti Zamratol Mai-sarah; Azmi, Mohd Tamil

2010-04-01

Transient-evoked otoacoustic emission (TEOAE) is a well-established screening tool for universal newborn hearing screening. The aims of this study are to measure the effects of background noise on recording of TEOAE and the duration required to complete the test at various noise levels. This study is a prospective study from June 2006 until May 2007. The study population were newborns from postnatal wards who were delivered at term pregnancy. Newborns who were more than 8-h old and passed a hearing screening testing using screening auditory brainstem response (SABRe) were further tested with TEOAE in four different test environments [isolation room in the ward during non-peak hour (E1), isolation room in the ward during peak hour (E2), maternal bedside in the ward during non-peak hour (E3) and maternal bedside in the ward during peak hour (E4)]. This study showed that test environment significantly influenced the time required to complete testing in both ears with F [534.23] = 0.945; P < 0.001 on the right ear and F [636.54] = 0.954; P < 0.001 on the left. Our study revealed that TEOAE testing was efficient in defining the presence of normal hearing in our postnatal wards at maternal bedside during non-peak hour with a specificity of 96.8%. Our study concludes that background noise levels for acceptable and accurate TEOAE recording in newborns should not exceed 65 dB A. In addition, when using TEOAE assessment in noisy environments, the time taken to obtain accurate results will greatly increase.

The expansion and performance of national newborn screening programmes for cystic fibrosis in Europe.

PubMed

Barben, Jürg; Castellani, Carlo; Dankert-Roelse, Jeannette; Gartner, Silvia; Kashirskaya, Nataliya; Linnane, Barry; Mayell, Sarah; Munck, Anne; Sands, Dorota; Sommerburg, Olaf; Pybus, Simon; Winters, Victoria; Southern, Kevin W

2017-03-01

Newborn screening (NBS) for cystic fibrosis (CF) is a well-established public health strategy with international standards. The aim of this study was to provide an update on NBS for CF in Europe and assess performance against the standards. Questionnaires were sent to key workers in each European country. In 2016, there were 17 national programmes, 4 countries with regional programmes and 25 countries not screening in Europe. All national programmes employed different protocols, with IRT-DNA the most common strategy. Five countries were not using DNA analysis. In addition, the processing and structure of programmes varied considerably. Most programmes were achieving the ECFS standards with respect to timeliness, but were less successful with respect to sensitivity and specificity. There has been a steady increase in national CF NBS programmes across Europe with variable strategies and outcomes that reflect the different approaches. Copyright © 2016 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

Narrative review of EHDI in South Africa

PubMed Central

Storbeck, Claudine

2015-01-01

Background With 17 babies born with hearing loss every day in South Africa, there is a pressing need for systematic Early Hearing Detection and Intervention (EHDI) services. Progress is being made in offering newborn hearing screening and studies have been conducted to document these processes within South Africa. However, due to the lack of a national and holistic overview of EHDI services to date, an accurate picture of the current status of EHDI within the South African context is required. Objective To document and profile what has been published within the field of EHDI in South Africa over the last two decades (Jan 1995–Sept 2014) in order to gain a comprehensive overview of the current status and practice of screening and diagnosis in the field of paediatric hearing loss. Method A narrative review of peer-reviewed articles related to EHDI in South Africa was conducted by searching the EBSCOHOST, SCOPUS and JSTOR databases for the period January 1995 to September 2014. Results Results indicate that over the last two decades research and publications in the field of EHDI have increased considerably. These publications have revealed extensive knowledge related to paediatric hearing screening and intervention services in South Africa; however, this knowledge seems to be limited primarily to the provinces of Gauteng and the Western Cape. Furthermore, studies pertaining to diagnosis have revealed that, although much has been written on the scientific aspects on tools for diagnosis of hearing loss, there is a lack of comprehensive information on diagnostic protocols and procedures. Conclusion Despite the clear progress being made in South Africa in the field of early hearing detection and intervention, there is a need for comprehensive studies on protocols and procedures in diagnosing paediatric hearing loss. Finally, the narrative review revealed a clear need to ensure that development and growth in the field of EHDI is a national priority and extends beyond the two provinces currently showing growth.

Does the evidence support population-wide screening for type 2 diabetes? No.

PubMed

Shaw, Jonathan E

2017-11-01

Large-scale, centrally-coordinated screening for undiagnosed type 2 diabetes is an attractive option to reduce the mortality and morbidity resulting from inadequately controlled diabetes. However, there is limited research examining the direct consequences of such screening programmes on outcomes such as cardiovascular disease and death. Two papers published in this edition of Diabetologia (DOIs: 10.1007/s00125-017-4323-2 and 10.1007/s00125-017-4299-y ) examine data from one of the very few trials conducted in this area. Overall, there was little benefit that could be directly related to the screening programme. In part, this was due to the high levels of opportunistic screening in the control group. Thus, when there are high levels of opportunistic screening for type 2 diabetes, there remains no clear evidence of benefit of centrally-coordinated screening programmes that approach individuals outside usual healthcare settings.

Software for math and science education for the deaf.

PubMed

Adamo-Villani, Nicoletta; Wilbur, Ronnie

2010-01-01

In this article, we describe the development of two novel approaches to teaching math and science concepts to deaf children using 3D animated interactive software. One approach, Mathsigner, is non-immersive and the other, SMILE, is a virtual reality immersive environment. The content is curriculum-based, and the animated signing characters are constructed with state-of-the art technology and design. We report preliminary development findings of usability and appeal based on programme features (e.g. 2D/3D, immersiveness, interaction type, avatar and interface design) and subject features (hearing status, gender and age). Programme features of 2D/3D, immersiveness and interaction type were very much affected by subject features. Among subject features, we find significant effects of hearing status (deaf children take longer time and make more mistakes than hearing children) and gender (girls take longer than boys; girls prefer immersive environments rather than desktop presentation; girls are more interested in content than technology compared to boys). For avatar type, we found a preference for seamless, deformable characters over segmented ones. For interface comparisons, there were no subject effects, but an animated interface resulted in reduced time to task completion compared to static interfaces with and without sound and highlighting. These findings identify numerous features that affect software design and appeal and suggest that designers must be careful in their assumptions during programme development.

Alerts in electronic medical records to promote a colorectal cancer screening programme: a cluster randomised controlled trial in primary care.

PubMed

Guiriguet, Carolina; Muñoz-Ortiz, Laura; Burón, Andrea; Rivero, Irene; Grau, Jaume; Vela-Vallespín, Carmen; Vilarrubí, Mercedes; Torres, Miquel; Hernández, Cristina; Méndez-Boo, Leonardo; Toràn, Pere; Caballeria, Llorenç; Macià, Francesc; Castells, Antoni

2016-07-01

Participation rates in colorectal cancer screening are below recommended European targets. To evaluate the effectiveness of an alert in primary care electronic medical records (EMRs) to increase individuals' participation in an organised, population-based colorectal cancer screening programme when compared with usual care. Cluster randomised controlled trial in primary care centres of Barcelona, Spain. Participants were males and females aged 50-69 years, who were invited to the first round of a screening programme based on the faecal immunochemical test (FIT) (n = 41 042), and their primary care professional. The randomisation unit was the physician cluster (n = 130) and patients were blinded to the study group. The control group followed usual care as per the colorectal cancer screening programme. In the intervention group, as well as usual care, an alert to health professionals (cluster level) to promote screening was introduced in the individual's primary care EMR for 1 year. The main outcome was colorectal cancer screening participation at individual participant level. In total, 67 physicians and 21 619 patients (intervention group) and 63 physicians and 19 423 patients (control group) were randomised. In the intention-to-treat analysis screening participation was 44.1% and 42.2% respectively (odds ratio 1.08, 95% confidence interval [CI] = 0.97 to 1.20, P = 0.146). However, in the per-protocol analysis screening uptake in the intervention group showed a statistically significant increase, after adjusting for potential confounders (OR, 1.11; 95% CI = 1.02 to 1.22; P = 0.018). The use of an alert in an individual's primary care EMR is associated with a statistically significant increased uptake of an organised, FIT-based colorectal cancer screening programme in patients attending primary care centres. © British Journal of General Practice 2016.

Community Screening for Preschool Child Inhibition to Offer the "Cool Little Kids" Anxiety Prevention Programme

ERIC Educational Resources Information Center

Beatson, Ruth M.; Bayer, Jordana K.; Perry, Alexandra; Mathers, Megan; Hiscock, Harriet; Wake, Melissa; Beesley, Kate; Rapee, Ronald M.

2014-01-01

Temperamental inhibition has been identified as a key risk factor for childhood anxiety and internalizing problems. An efficacious early prevention programme for shy/inhibited children has been developed; however, accurate, efficient and acceptable screening is needed to support wider implementation. We explore community screening options in the…

Hearing Tests Based on Biologically Calibrated Mobile Devices: Comparison With Pure-Tone Audiometry

PubMed Central

Grysiński, Tomasz; Kręcicki, Tomasz

2018-01-01

Background Hearing screening tests based on pure-tone audiometry may be conducted on mobile devices, provided that the devices are specially calibrated for the purpose. Calibration consists of determining the reference sound level and can be performed in relation to the hearing threshold of normal-hearing persons. In the case of devices provided by the manufacturer, together with bundled headphones, the reference sound level can be calculated once for all devices of the same model. Objective This study aimed to compare the hearing threshold measured by a mobile device that was calibrated using a model-specific, biologically determined reference sound level with the hearing threshold obtained in pure-tone audiometry. Methods Trial participants were recruited offline using face-to-face prompting from among Otolaryngology Clinic patients, who own Android-based mobile devices with bundled headphones. The hearing threshold was obtained on a mobile device by means of an open access app, Hearing Test, with incorporated model-specific reference sound levels. These reference sound levels were previously determined in uncontrolled conditions in relation to the hearing threshold of normal-hearing persons. An audiologist-assisted self-measurement was conducted by the participants in a sound booth, and it involved determining the lowest audible sound generated by the device within the frequency range of 250 Hz to 8 kHz. The results were compared with pure-tone audiometry. Results A total of 70 subjects, 34 men and 36 women, aged 18-71 years (mean 36, standard deviation [SD] 11) participated in the trial. The hearing threshold obtained on mobile devices was significantly different from the one determined by pure-tone audiometry with a mean difference of 2.6 dB (95% CI 2.0-3.1) and SD of 8.3 dB (95% CI 7.9-8.7). The number of differences not greater than 10 dB reached 89% (95% CI 88-91), whereas the mean absolute difference was obtained at 6.5 dB (95% CI 6.2-6.9). Sensitivity and specificity for a mobile-based screening method were calculated at 98% (95% CI 93-100.0) and 79% (95% CI 71-87), respectively. Conclusions The method of hearing self-test carried out on mobile devices with bundled headphones demonstrates high compatibility with pure-tone audiometry, which confirms its potential application in hearing monitoring, screening tests, or epidemiological examinations on a large scale. PMID:29321124

Hearing Tests Based on Biologically Calibrated Mobile Devices: Comparison With Pure-Tone Audiometry.

PubMed

Masalski, Marcin; Grysiński, Tomasz; Kręcicki, Tomasz

2018-01-10

Hearing screening tests based on pure-tone audiometry may be conducted on mobile devices, provided that the devices are specially calibrated for the purpose. Calibration consists of determining the reference sound level and can be performed in relation to the hearing threshold of normal-hearing persons. In the case of devices provided by the manufacturer, together with bundled headphones, the reference sound level can be calculated once for all devices of the same model. This study aimed to compare the hearing threshold measured by a mobile device that was calibrated using a model-specific, biologically determined reference sound level with the hearing threshold obtained in pure-tone audiometry. Trial participants were recruited offline using face-to-face prompting from among Otolaryngology Clinic patients, who own Android-based mobile devices with bundled headphones. The hearing threshold was obtained on a mobile device by means of an open access app, Hearing Test, with incorporated model-specific reference sound levels. These reference sound levels were previously determined in uncontrolled conditions in relation to the hearing threshold of normal-hearing persons. An audiologist-assisted self-measurement was conducted by the participants in a sound booth, and it involved determining the lowest audible sound generated by the device within the frequency range of 250 Hz to 8 kHz. The results were compared with pure-tone audiometry. A total of 70 subjects, 34 men and 36 women, aged 18-71 years (mean 36, standard deviation [SD] 11) participated in the trial. The hearing threshold obtained on mobile devices was significantly different from the one determined by pure-tone audiometry with a mean difference of 2.6 dB (95% CI 2.0-3.1) and SD of 8.3 dB (95% CI 7.9-8.7). The number of differences not greater than 10 dB reached 89% (95% CI 88-91), whereas the mean absolute difference was obtained at 6.5 dB (95% CI 6.2-6.9). Sensitivity and specificity for a mobile-based screening method were calculated at 98% (95% CI 93-100.0) and 79% (95% CI 71-87), respectively. The method of hearing self-test carried out on mobile devices with bundled headphones demonstrates high compatibility with pure-tone audiometry, which confirms its potential application in hearing monitoring, screening tests, or epidemiological examinations on a large scale. ©Marcin Masalski, Tomasz Grysiński, Tomasz Kręcicki. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 10.01.2018.

‘It has saved thousands of lives, so why change it?’ Content analysis of objections to cervical screening programme changes in Australia

PubMed Central

Bonner, Carissa; Jansen, Jesse; McCaffery, Kirsten

2018-01-01

Objectives The incidence and mortality of cervical cancer have halved since introduction of the Australian cervical screening programme in 1991, involving 2-yearly Pap smears from ages 18–69 years. In 2017, the programme changed to 5- yearly primary human papillomavirus (HPV) testing for women aged 25–74 years. This study investigated reasons for opposition to the renewed screening programme within the open-ended comments of an online petition, ‘Stop May 1st Changes to Pap Smears—Save Women’s Lives’, opposing the changes, which received over 70 000 signatures and almost 20 000 comments. Methods Content analysis of a random sample of 2000 comments, reflecting 10% of the 19 633 comments posted in February–March 2017. Results Nineteen codes were identified, reflecting four themes: (1) valuing women’s health and rights, (2) political statements, (3) concerns about healthcare funding cuts and (4) opposition to specific components of the new screening programme. The most prevalent codes were: placing value on women’s health (33%), concerns about increasing screening intervals (17%) and opposition to the changes related to personal experiences with cervical cancer or cervical abnormalities (15%). Concern about the key change in technology (HPV testing instead of Pap smears) was expressed in less than 3% of comments, and some opposition to the changes from health professionals was noted. Conclusions Screening changes within this selected group were perceived as threatening women’s health, as a political policy created by male decision-makers and as a cost-cutting exercise. Many commenters were concerned about increased screening intervals and later screening onset, but little opposition was expressed regarding the testing technology itself. This analysis may inform public education and communication strategies for future changes to cervical screening programmes internationally, to pre-emptively address specific concerns about the changes. PMID:29440214

Withdrawing low risk women from cervical screening programmes: mathematical modelling study.

PubMed

Sherlaw-Johnson, C; Gallivan, S; Jenkins, D

1999-02-06

To evaluate the impact of policies for removing women before the recommended age of 64 from screening programmes for cervical cancer in the United Kingdom. A mathematical model of the clinical course of precancerous lesions which accounts for the influence of infection with the human papillomavirus, the effects of screening on the progression of disease, and the accuracy of the testing procedures. Two policies are compared: one in which women are withdrawn from the programme if their current smear is negative and they have a recent history of regular, negative results and one in which women are withdrawn if their current smear test is negative and a simultaneous test is negative for exposure to high risk types of human papillomavirus. United Kingdom cervical screening programme. The incidence of invasive cervical cancer and the use of resources. Early withdrawal of selected women from the programme is predicted to give rise to resource savings of up to 25% for smear tests and 18% for colposcopies when withdrawal occurs from age 50, the youngest age considered in the study. An increase in the incidence of invasive cervical cancer, by up to 2 cases/100 000 women each year is predicted. Testing for human papillomavirus infection to determine which women should be withdrawn from the programme makes little difference to outcome. This model systematically analyses the consequences of screening options using available data and the clinical course of precancerous lesions. If further audit studies confirm the model's forecasts, a policy of early withdrawal might be considered. This would be likely to release substantial resources which could be channelled into other aspects of health care or may be more effectively used within the cervical screening programme to counteract the possible increase in cancer incidence that early withdrawal might bring.

A small molecule mitigates hearing loss in a mouse model of Usher syndrome III.

PubMed

Alagramam, Kumar N; Gopal, Suhasini R; Geng, Ruishuang; Chen, Daniel H-C; Nemet, Ina; Lee, Richard; Tian, Guilian; Miyagi, Masaru; Malagu, Karine F; Lock, Christopher J; Esmieu, William R K; Owens, Andrew P; Lindsay, Nicola A; Ouwehand, Krista; Albertus, Faywell; Fischer, David F; Bürli, Roland W; MacLeod, Angus M; Harte, William E; Palczewski, Krzysztof; Imanishi, Yoshikazu

2016-06-01

Usher syndrome type III (USH3), characterized by progressive deafness, variable balance disorder and blindness, is caused by destabilizing mutations in the gene encoding the clarin-1 (CLRN1) protein. Here we report a new strategy to mitigate hearing loss associated with a common USH3 mutation CLRN1(N48K) that involves cell-based high-throughput screening of small molecules capable of stabilizing CLRN1(N48K), followed by a secondary screening to eliminate general proteasome inhibitors, and finally an iterative process to optimize structure-activity relationships. This resulted in the identification of BioFocus 844 (BF844). To test the efficacy of BF844, we developed a mouse model that mimicked the progressive hearing loss associated with USH3. BF844 effectively attenuated progressive hearing loss and prevented deafness in this model. Because the CLRN1(N48K) mutation causes both hearing and vision loss, BF844 could in principle prevent both sensory deficiencies in patients with USH3. Moreover, the strategy described here could help identify drugs for other protein-destabilizing monogenic disorders.

Cost-effectiveness of a programme of screening and brief interventions for alcohol in primary care in Italy.

PubMed

Angus, Colin; Scafato, Emanuele; Ghirini, Silvia; Torbica, Aleksandra; Ferre, Francesca; Struzzo, Pierluigi; Purshouse, Robin; Brennan, Alan

2014-02-06

As alcohol-related health problems continue to rise, the attention of policy-makers is increasingly turning to Screening and Brief Intervention (SBI) programmes. The effectiveness of such programmes in primary healthcare is well evidenced, but very few cost-effectiveness analyses have been conducted and none which specifically consider the Italian context. The Sheffield Alcohol Policy Model has been used to model the cost-effectiveness of government pricing and public health policies in several countries including England. This study adapts the model using Italian data to evaluate a programme of screening and brief interventions in Italy. Results are reported as Incremental Cost-Effectiveness Ratios (ICERs) of SBI programmes versus a 'do-nothing' scenario. Model results show such programmes to be highly cost-effective, with estimated ICERs of €550/Quality Adjusted Life Year (QALY) gained for a programme of SBI at next GP registration and €590/QALY for SBI at next GP consultation. A range of sensitivity analyses suggest these results are robust under all but the most pessimistic assumptions. This study provides strong support for the promotion of a policy of screening and brief interventions throughout Italy, although policy makers should be aware of the resource implications of different implementation options.

Measuring the psychosocial consequences of screening

PubMed Central

Brodersen, John; McKenna, Stephen P; Doward, Lynda C; Thorsen, Hanne

2007-01-01

The last three decades have seen a dramatic rise in the implementation of screening programmes for cancer in industrialised countries. However, in contrast to screening for infectious diseases, most cancer screening programmes only have the potential to reduce mortality; they cannot lower the incidence of cancer in a population. In fact, most cancer screening programmes have been shown to increase the incidence of the disease as a consequence of over-diagnosis. A further dilemma of cancer screening programmes is that they do not distinguish between healthy people and those with disease. Rather, they identify a continuum of disease severity. Consequently, many healthy people who have abnormal screening tests are wrongly diagnosed. Indeed, studies have demonstrated that for each screening-prevented death from cancer, at least 200 false-positive results are given. Therefore, screening has the potential to be harmful as well as beneficial. The psychosocial consequences of false-positive screening results cannot be determined by diagnostic tests or by other technical means. Instead, patient reported outcome measures must be employed. To measure the outcomes of screening accurately and comprehensively patient reported outcome measures have to capture; the nature and extent of the psychosocial consequences and how these change over time. The outcome measures used must have high content validity and their psychometric properties should be determined prior to their use in the specific population. In particular it is important to establish unidimensionality, additivity and item ordering through the application of Item Response Theory. PMID:17210071

Clinical evaluation of the vector algorithm for neonatal hearing screening using automated auditory brainstem response.

PubMed

Keohane, Bernie M; Mason, Steve M; Baguley, David M

2004-02-01

A novel auditory brainstem response (ABR) detection and scoring algorithm, entitled the Vector algorithm is described. An independent clinical evaluation of the algorithm using 464 tests (120 non-stimulated and 344 stimulated tests) on 60 infants, with a mean age of approximately 6.5 weeks, estimated test sensitivity greater than 0.99 and test specificity at 0.87 for one test. Specificity was estimated to be greater than 0.95 for a two stage screen. Test times were of the order of 1.5 minutes per ear for detection of an ABR and 4.5 minutes per ear in the absence of a clear response. The Vector algorithm is commercially available for both automated screening and threshold estimation in hearing screening devices.

Interventions to enhance informed choices among invitees of screening programmes-a systematic review.

PubMed

van Agt, Heleen M E; Korfage, Ida J; Essink-Bot, Marie-Louise

2014-10-01

Informed decision making about participation has become an explicit purpose in invitations for screening programmes in western countries. An informed choice is commonly defined as based on: (i) adequate levels of knowledge of the screening and (ii) agreement between the invitee's values towards own screening participation and actual (intention to) participation. We systematically reviewed published studies that empirically evaluated the effects of interventions aiming at enhancing informed decision making in screening programmes targeted at the general population. We focused on prenatal screening and neonatal screening for diseases of the foetus/new-born and screening for breast cancer, cervical cancer and colorectal cancer. The Medline, EMBASE and Cochrane databases were searched for studies published till April 2012, using the terms 'informed choice', 'decision making' and 'mass screening' separately and in combination and terms referring to the specific screening programmes. Of the 2238 titles identified, 15 studies were included, which evaluated decision aids (DAs), information leaflets, film, video, counselling and a specific screening visit for informed decision making in prenatal screening, breast and colorectal cancer screening. Most of the included studies evaluated DAs and showed improved knowledge and informed decision making. Due to the limited number of studies the results could not be synthesized. The empirical evidence regarding interventions to improve informed decision making in screening is limited. It is unknown which strategies to enhance informed decision making are most effective, although DAs are promising. Systematic development of interventions to enhance informed choices in screening deserves priority, especially in disadvantaged groups. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Performance indicators evaluation of the population-based breast cancer screening programme in Northern Portugal using the European Guidelines.

PubMed

Bento, Maria José; Gonçalves, Guilherme; Aguiar, Ana; Castro, Clara; Veloso, Vitor; Rodrigues, Vítor

2015-10-01

To evaluate the first 10 years of operation of the population-based breast cancer screening programme implemented in the Northern Region of Portugal, using selected recommended standard performance indicators. Data from women aged 50-69 screened with two-view mammography, biennially, in the period 2000-2009, were included. Main performance indicators were compared with the recommended levels of the European Guidelines. A total of 202,039 screening examinations were performed, 71,731 (35.5%) in the initial screening and 130,308 (64.5%) in the subsequent screening. Coverage rate by examination reached 74.3% of the target population, in the last period evaluated. Recall rates were 8.1% and 2.4% and cancer detection rates were 4.4/1000 and 2.9/1000 respectively, for initial and subsequent screenings. The breast cancer detection rate, expressed as a multiple of the background expected incidence was 3.1 in initial screen and 2.2 in subsequent screen. The incidence of invasive interval cancers met the desirable recommended levels both the first and second years since last screening examination, in the initial and subsequent screenings. Invasive tumours <15mm were 50.4% and 53.8% of the invasive cancers detected in initial and subsequent screenings. Less favourable size, grading and biomarkers expression were found in interval cancers compared to screen-detected cancers. Breast cancer screening programme in the Northern Region of Portugal was well accepted by the population. Most of the performance indicators were consistent with the desirable levels of the European Guidelines, which indicate an effective screening programme. Future research should verify the consistency of some of these results by using updated information from a larger population. Copyright © 2015 Elsevier Ltd. All rights reserved.

Screening for colorectal cancer: medical and economic aspects.

PubMed

Sanduleanu, S; Stockbrügger, R W

2003-01-01

Colorectal cancer (CRC) is the second commonest cause of cancer death in the Western world. In The Netherlands, CRC causes about 4400 deaths per year, and its diagnosis and treatment make up for a large share of health-care costs. Review and discussioN. Experts in the field presently assume that screening for CRC and its precursor lesions, colorectal adenomas (CRAs), could prevent death from colorectal neoplasia by more than 80%. Additionally, there is increasing acknowledgement that CRC screening programmes can save lives at a cost similar to, or even less than, the generally accepted breast cancer or cervical cancer screening programmes. Nonetheless, while neighbouring countries have taken vigorous measures to fight CRC, the Dutch are still hesitating in this matter. This is partly due to some yet unanswered questions concerning the acceptability of screening for CRC in the general population, the starting age and the frequency of screening, the type of screening tests to be used, and the programme organization. In this commentary, general epidemiological and pathogenetic aspects of CRC are addressed. In addition, some frequently asked questions (FAQ) and (very subjective) answers about screening for CRC are offered, as potential substrate for further in-depth discussions. The emerging message for the community is that an effective national screening programme is urgently required to reduce the substantial morbidity and mortality from this disease.

"Effects Of" and "Effects With" Captions: How Exactly Does Watching a TV Programme with Same-Language Subtitles Make a Difference to Language Learners?

ERIC Educational Resources Information Center

Vanderplank, Robert

2016-01-01

Ever since Karen Price's ground-breaking work in 1983, we have known that same-language subtitles (captions) primarily intended for the deaf and hearing-impaired can provide access to foreign language films and TV programmes which would otherwise be virtually incomprehensible to non-native-speaker viewers. Since then, researchers have steadily…

Using resource modelling to inform decision making and service planning: the case of colorectal cancer screening in Ireland

PubMed Central

2013-01-01

Background Organised colorectal cancer screening is likely to be cost-effective, but cost-effectiveness results alone may not help policy makers to make decisions about programme feasibility or service providers to plan programme delivery. For these purposes, estimates of the impact on the health services of actually introducing screening in the target population would be helpful. However, these types of analyses are rarely reported. As an illustration of such an approach, we estimated annual health service resource requirements and health outcomes over the first decade of a population-based colorectal cancer screening programme in Ireland. Methods A Markov state-transition model of colorectal neoplasia natural history was used. Three core screening scenarios were considered: (a) flexible sigmoidoscopy (FSIG) once at age 60, (b) biennial guaiac-based faecal occult blood tests (gFOBT) at 55–74 years, and (c) biennial faecal immunochemical tests (FIT) at 55–74 years. Three alternative FIT roll-out scenarios were also investigated relating to age-restricted screening (55–64 years) and staggered age-based roll-out across the 55–74 age group. Parameter estimates were derived from literature review, existing screening programmes, and expert opinion. Results were expressed in relation to the 2008 population (4.4 million people, of whom 700,800 were aged 55–74). Results FIT-based screening would deliver the greatest health benefits, averting 164 colorectal cancer cases and 272 deaths in year 10 of the programme. Capacity would be required for 11,095-14,820 diagnostic and surveillance colonoscopies annually, compared to 381–1,053 with FSIG-based, and 967–1,300 with gFOBT-based, screening. With FIT, in year 10, these colonoscopies would result in 62 hospital admissions for abdominal bleeding, 27 bowel perforations and one death. Resource requirements for pathology, diagnostic radiology, radiotherapy and colorectal resection were highest for FIT. Estimates depended on screening uptake. Alternative FIT roll-out scenarios had lower resource requirements. Conclusions While FIT-based screening would quite quickly generate attractive health outcomes, it has heavy resource requirements. These could impact on the feasibility of a programme based on this screening modality. Staggered age-based roll-out would allow time to increase endoscopy capacity to meet programme requirements. Resource modelling of this type complements conventional cost-effectiveness analyses and can help inform policy making and service planning. PMID:23510135

Follow-Up Activities for the HISD Kindergarten Screening Instrument.

ERIC Educational Resources Information Center

Perry, Pat; Cater, Margot

The Kindergarten Screening Instrument consists of five sub-scales and attempts to screen for possible difficulty in the areas of distant vision, hearing, eye-hand coordination, language learning, and gross motor performance. In response to many requests for follow-up activities after screening, this manual was prepared by Volunteers in Public…

A Comparison of Health Screenings in Rural and Urban Schools in Missouri.

ERIC Educational Resources Information Center

Waignandt, Alex; Brown, James

1991-01-01

Studied health screening methods of schools in mid-Missouri. Found significant differences between rural and urban schools in terms of number of school nurses employed and percentage of schools screening in all areas studied: physical assessment, vision, hearing, scoliosis, and dental. Recommends improved health screenings in rural schools. (KS)

Can an alert in primary care electronic medical records increase participation in a population-based screening programme for colorectal cancer? COLO-ALERT, a randomised clinical trial

PubMed Central

2014-01-01

Background Colorectal cancer is an important public health problem in Spain. Over the last decade, several regions have carried out screening programmes, but population participation rates remain below recommended European goals. Reminders on electronic medical records have been identified as a low-cost and high-reach strategy to increase participation. Further knowledge is needed about their effect in a population-based screening programme. The main aim of this study is to evaluate the effectiveness of an electronic reminder to promote the participation in a population-based colorectal cancer screening programme. Secondary aims are to learn population’s reasons for refusing to take part in the screening programme and to find out the health professionals’ opinion about the official programme implementation and on the new computerised tool. Methods/Design This is a parallel randomised trial with a cross-sectional second stage. Participants: all the invited subjects to participate in the public colorectal cancer screening programme that includes men and women aged between 50–69, allocated to the eleven primary care centres of the study and all their health professionals. The randomisation unit will be the primary care physician. The intervention will consist of activating an electronic reminder, in the patient’s electronic medical record, in order to promote colorectal cancer screening, during a synchronous medical appointment, throughout the year that the intervention takes place. A comparison of the screening rates will then take place, using the faecal occult blood test of the patients from the control and the intervention groups. We will also take a questionnaire to know the opinions of the health professionals. The main outcome is the screening status at the end of the study. Data will be analysed with an intention-to-treat approach. Discussion We expect that the introduction of specific reminders in electronic medical records, as a tool to facilitate and encourage direct referral by physicians and nurse practitioners to perform colorectal cancer screening will mean an increase in participation of the target population. The introduction of this new software tool will have good acceptance and increase compliance with recommendations from health professionals. Trial registration Clinical Trials.gov identifier NCT01877018 PMID:24685117

Differences in diagnostic activity in general practice and findings for individuals invited to the danish screening programme for colorectal cancer: a population-based cohort study.

PubMed

Juul, Jakob Søgaard; Andersen, Berit; Laurberg, Søren; Carlsen, Anders Helles; Olesen, Frede; Vedsted, Peter

2018-06-22

To investigate the diagnostic activity in general practice and the cumulative incidence of colorectal cancer (CRC) in individuals invited to the Danish national screening programme for CRC. A historical population-based cohort study. The Danish CRC screening programme and general practice. The 376,198 individuals invited to the Danish CRC screening programme from 1 March to 31 December 2014. The diagnostic activity (consultations and haemoglobin measures) in general practice in the year preceding the screening invitation and the cumulated incidence of CRC in the year following the screening invitation. Screening participants had significantly higher diagnostic activity than non-participants. Individuals with a positive faecal immunochemical test (FIT) had higher diagnostic activity compared to individuals with a negative FIT, and a small increase in the months leading up to the invitation. Individuals with a screen-detected CRC had lower diagnostic activity than individuals with no CRC. In total, 308 (25.3%) of CRCs diagnosed in the invited population were diagnosed outside the screening programme. Non-participants with CRC more often had low socio-economic status, high comorbidity and stage IV CRC than participants with CRC. There was a tendency that participants and those with a positive FIT had a higher diagnostic activity the year before the screening. This was not seen for those with CRC detected through screening. CRC must still be diagnosed in general practice in the invited population and non-participants are of special interest as they have higher risk of late stage CRC. Key Points Current awareness:Individuals with colorectal cancer (CRC) in screening may be symptomatic and CRC may still occur outside screening in the invited population. Most important points:The majority of individuals with CRC in screening cannot be expected to be diagnosed on symptomatic presentation in general practice GPs have to be aware that CRC still occurs outside screening in the invited population Non-participants with CRC are often deprived and have late stage CRC.

Effect of gentamicin and levels of ambient sound on hearing screening outcomes in the neonatal intensive care unit: A pilot study.

PubMed

Garinis, Angela C; Liao, Selena; Cross, Campbell P; Galati, Johnathan; Middaugh, Jessica L; Mace, Jess C; Wood, Anna-Marie; McEvoy, Lindsey; Moneta, Lauren; Lubianski, Troy; Coopersmith, Noe; Vigo, Nicholas; Hart, Christopher; Riddle, Artur; Ettinger, Olivia; Nold, Casey; Durham, Heather; MacArthur, Carol; McEvoy, Cynthia; Steyger, Peter S

2017-06-01

Hearing loss rates in infants admitted to neonatal intensive care units (NICU) run at 2-15%, compared to 0.3% in full-term births. The etiology of this difference remains poorly understood. We examined whether the level of ambient sound and/or cumulative gentamicin (an aminoglycoside) exposure affect NICU hearing screening results, as either exposure can cause acquired, permanent hearing loss. We hypothesized that higher levels of ambient sound in the NICU, and/or gentamicin dosing, increase the risk of referral on the distortion product otoacoustic emission (DPOAE) assessments and/or automated auditory brainstem response (AABR) screens. This was a prospective pilot outcomes study of 82 infants (<37 weeks gestational age) admitted to the NICU at Oregon Health & Science University. An ER-200D sound pressure level dosimeter was used to collect daily sound exposure in the NICU for each neonate. Gentamicin dosing was also calculated for each infant, including the total daily dose based on body mass (mg/kg/day), as well as the total number of treatment days. DPOAE and AABR assessments were conducted prior to discharge to evaluate hearing status. Exclusion criteria included congenital infections associated with hearing loss, and congenital craniofacial or otologic abnormalities. The mean level of ambient sound was 62.9 dBA (range 51.8-70.6 dBA), greatly exceeding American Academy of Pediatrics (AAP) recommendation of <45.0 dBA. More than 80% of subjects received gentamicin treatment. The referral rate for (i) AABRs, (frequency range: ∼1000-4000 Hz), was 5%; (ii) DPOAEs with a broad F2 frequency range (2063-10031 Hz) was 39%; (iii) DPOAEs with a low-frequency F2 range (<4172 Hz) was 29%, and (iv) DPOAEs with a high-frequency F2 range (>4172 Hz) was 44%. DPOAE referrals were significantly greater for infants receiving >2 days of gentamicin dosing compared to fewer doses (p = 0.004). The effect of sound exposure and gentamicin treatment on hearing could not be determined due to the low number of NICU infants without gentamicin exposure (for control comparisons). All infants were exposed to higher levels of ambient sound that substantially exceed AAP guidelines. More referrals were generated by DPOAE assessments than with AABR screens, with significantly more DPOAE referrals with a high-frequency F2 range, consistent with sound- and/or gentamicin-induced cochlear dysfunction. Adding higher frequency DPOAE assessments to existing NICU hearing screening protocols could better identify infants at-risk for ototoxicity. Copyright © 2017 Elsevier B.V. All rights reserved.

Effect of Gentamicin and Levels of Ambient Sound on Hearing Screening Outcomes in the Neonatal Intensive Care Unit: A Pilot Study

PubMed Central

Garinis, Angela C.; Liao, Selena; Cross, Campbell P.; Galati, Johnathan; Middaugh, Jessica L.; Mace, Jess C.; Wood, Anna-Marie; McEvoy, Lindsey; Moneta, Lauren; Lubianski, Troy; Coopersmith, Noe; Vigo, Nicholas; Hart, Christopher; Riddle, Artur; Ettinger, Olivia; Nold, Casey; Durham, Heather; MacArthur, Carol; McEvoy, Cynthia; Steyger, Peter S.

2017-01-01

Objective Hearing loss rates in infants admitted to neonatal intensive care units (NICU) run at 2–15%, compared to 0.3% in full-term births. The etiology of this difference remains poorly understood. We examined whether the level of ambient sound and/or cumulative gentamicin (an aminoglycoside) exposure affect NICU hearing screening results, as either exposure can cause acquired, permanent hearing loss. We hypothesized that higher levels of ambient sound in the NICU, and/or gentamicin dosing, increase the risk of referral on the distortion product otoacoustic emission (DPOAE) assessments and/or automated auditory brainstem response (AABR) screens. Methods This was a prospective pilot outcomes study of 82 infants (<37 weeks gestational age) admitted to the NICU at Oregon Health & Science University. An ER-200D sound pressure level dosimeter was used to collect daily sound exposure in the NICU for each neonate. Gentamicin dosing was also calculated for each infant, including the total daily dose based on body mass (mg/kg/day), as well as the total number of treatment days. DPOAE and AABR assessments were conducted prior to discharge to evaluate hearing status. Exclusion criteria included congenital infections associated with hearing loss, and congenital craniofacial or otologic abnormalities. Results The mean level of ambient sound was 62.9 dBA (range 51.8–70.6 dBA), greatly exceeding American Academy of Pediatrics (AAP) recommendation of <45.0 dBA. More than 80% of subjects received gentamicin treatment. The referral rate for (i) AABRs, (frequency range: ~1000–4000 Hz), was 5%; (ii) DPOAEs with a broad F2 frequency range (2063–10031 Hz) was 39%; (iii) DPOAEs with a low-frequency F2 range (<4172 Hz) was 29%, and (iv) DPOAEs with a high-frequency F2 range (>4172 Hz) was 44%. DPOAE referrals were significantly greater for infants receiving >2 days of gentamicin dosing compared to fewer doses (p= 0.004). The effect of sound exposure and gentamicin treatment on hearing could not be determined due to the low number of NICU infants without gentamicin exposure (for control comparisons). Conclusion All infants were exposed to higher levels of ambient sound that substantially exceed AAP guidelines. More referrals were generated by DPOAE assessments than with AABR screens, with significantly more DPOAE referrals with a high-frequency F2 range, consistent with sound- and/or gentamicin-induced cochlear dysfunction. Adding higher frequency DPOAE assessments to existing NICU hearing screening protocols could better identify at-risk infants to be referred for diagnostic evaluation. PMID:28483249

The Impact of Robotics on Employment. Hearing before the Subcommittee on Economic Goals and Intergovernmental Policy of the Joint Economic Committee, Congress of the United States, Ninety-Eighth Congress. First Session.

ERIC Educational Resources Information Center

Joint Economic Committee, Washington, DC.

This document is a transcript of a fact-finding hearing conducted to evaluate the prospective impact of robotics (the use of sophisticated programmable or computer-controlled robots to perform routine and repetitious tasks) on employment in this country. Testimony and prepared reports were given by John Andelin, assistant director of Science,…

A hearing self-reported survey in people over 80 years of age in China by hearing handicap inventory for the elderly-complete version vs screening version.

PubMed

Liu, Xin-Ying; Han, Ying; Yang, Shi-Ming

2016-12-01

HHIE-S can be a useful tool in investigating hearing loss among people over 80 years old, with the same validity as HHIE. To investigate the effect of hearing loss on the quality-of-life in people over 80 years of age in China, and to compare the results of the Chinese mandarin version Hearing Handicap Inventory for the Elderly (HHIE) and its screening version (HHIE-S). Eighty-four people over 80 years participated in the study. Both HHIE and HHIE-S were completed, and the hearing handicap degrees were rated according to HHIE scores and HHIE-S scores, respectively. Results obtained by HHIE and HHIE-S were compared. Multi-factor analysis of variance was used to analyze the impact of eight factors on hearing handicap in the oldest old people over 80 years of age, including age, noise exposure, ear surgery, infection, ototoxic drugs use, cardiovascular and cerebrovascular diseases, diabetes, and tumors. Both HHIE and HHIE-S revealed 48 subjects (57.1%) with no self-perceived hearing problem, and 36 subjects (42.9%) with hearing handicap. No statistical difference was found between results of the functional hearing handicap rating by HHIE and HHIE-S (Chi-square = 1.532, p = 0.465). The HHIE and HHIE-S were in agreement with each other (kappa = 0.772, p < 0.001). All the eight factors had no significance on both HHIE and HHIE-S scores (p > 0.05), except noise exposure on S-score of HHIE-S (p = 0.032), and the R-squares of these factors were less than 5%.

Auditory-steady-state response reliability in the audiological diagnosis after neonatal hearing screening.

PubMed

Núñez-Batalla, Faustino; Noriega-Iglesias, Sabel; Guntín-García, Maite; Carro-Fernández, Pilar; Llorente-Pendás, José Luis

2016-01-01

Conventional audiometry is the gold standard for quantifying and describing hearing loss. Alternative methods become necessary to assess subjects who are too young to respond reliably. Auditory evoked potentials constitute the most widely used method for determining hearing thresholds objectively; however, this stimulus is not frequency specific. The advent of the auditory steady-state response (ASSR) leads to more specific threshold determination. The current study describes and compares ASSR, auditory brainstem response (ABR) and conventional behavioural tone audiometry thresholds in a group of infants with various degrees of hearing loss. A comparison was made between ASSR, ABR and behavioural hearing thresholds in 35 infants detected in the neonatal hearing screening program. Mean difference scores (±SD) between ABR and high frequency ABR thresholds were 11.2 dB (±13) and 10.2 dB (±11). Pearson correlations between the ASSR and audiometry thresholds were 0.80 and 0.91 (500Hz); 0.84 and 0.82 (1000Hz); 0.85 and 0.84 (2000Hz); and 0.83 and 0.82 (4000Hz). The ASSR technique is a valuable extension of the clinical test battery for hearing-impaired children. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

PubMed Central

DE LUCIA, A.; PASTORE, V.; BRACCI LAUDIERO, L.; BUONISSIMO, I.; RICCI, G.

2016-01-01

SUMMARY Programmes for early childhood childhood hearing impairment identification allows to quickly start the appropriate hearing aid fitting and rehabilitation process; nevertheless, a large number of patients do not join the treatment program. The goal of this article is to present the results of a strategic review of the strengths, weaknesses, opportunities and threats connected with the audiologic/prosthetic/language follow-up process of children with bilateral permanent hearing impairment. Involving small children, the follow-up includes the involvement of specialised professionals of a multidisciplinary team and a complex and prolonged multi-faced management. Within the framework of the Italian Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for Early Identification, Intervention and Care of Hearing Impaired Children", the purpose of this analysis was to propose recommendations that can harmonise criteria for outcome evaluation and provide guidance on the most appropriate assessment methods to be used in the follow-up course of children with permanent hearing impairment. PMID:27054392

Procedures for central auditory processing screening in schoolchildren.

PubMed

Carvalho, Nádia Giulian de; Ubiali, Thalita; Amaral, Maria Isabel Ramos do; Santos, Maria Francisca Colella

2018-03-22

Central auditory processing screening in schoolchildren has led to debates in literature, both regarding the protocol to be used and the importance of actions aimed at prevention and promotion of auditory health. Defining effective screening procedures for central auditory processing is a challenge in Audiology. This study aimed to analyze the scientific research on central auditory processing screening and discuss the effectiveness of the procedures utilized. A search was performed in the SciELO and PUBMed databases by two researchers. The descriptors used in Portuguese and English were: auditory processing, screening, hearing, auditory perception, children, auditory tests and their respective terms in Portuguese. original articles involving schoolchildren, auditory screening of central auditory skills and articles in Portuguese or English. studies with adult and/or neonatal populations, peripheral auditory screening only, and duplicate articles. After applying the described criteria, 11 articles were included. At the international level, central auditory processing screening methods used were: screening test for auditory processing disorder and its revised version, screening test for auditory processing, scale of auditory behaviors, children's auditory performance scale and Feather Squadron. In the Brazilian scenario, the procedures used were the simplified auditory processing assessment and Zaidan's battery of tests. At the international level, the screening test for auditory processing and Feather Squadron batteries stand out as the most comprehensive evaluation of hearing skills. At the national level, there is a paucity of studies that use methods evaluating more than four skills, and are normalized by age group. The use of simplified auditory processing assessment and questionnaires can be complementary in the search for an easy access and low-cost alternative in the auditory screening of Brazilian schoolchildren. Interactive tools should be proposed, that allow the selection of as many hearing skills as possible, validated by comparison with the battery of tests used in the diagnosis. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Cordblood-Based High-Throughput Screening for Deafness Gene of 646 Newborns in Jinan Area of China

PubMed Central

Li, Shou-Xia; Chen, Ding-Li; Zhao, Su-Bin; Guo, Li-Li; Feng, Hai-Qin; Zhang, Xiao-Fang; Ping, Li-Li; Yang, Zhi-Ming; Sun, Cai-Xia

2015-01-01

Objectives Infants with slight/mild or late-onset hearing impairment might be missed in universal newborn hearing screening (UNHS). We identified the mutation hot spot of common deaf gene in the newborns in Jinan area population by screening the mutation spot with neonate cord blood, in order to make clear whether the neonate cord blood for screening is feasible. Methods Six hundred and forty-six newborns were subjected to both UNHS and genetic screening for deafness by using neonate cord blood. The newborn genetic screening targeted four deafness-associated genes, which were commonly found in the Chinese population including gap junction beta-2 protein (GJB2), gap junction beta-3 protein (GJB3), solute carrier family 26 member 4 (SLC26A4), and mtDNA 12S rRNA. The most common 20 spot mutations in 4 deaf genes were detected by MassARRAY iPLEX platform and mitochondrial 12S rRNA A1555G and C1494T mutations were sequenced using Sanger sequencing. Results Among the 646 newborns, 635 cases passed the UNHS and the other 11 cases (1.7%) did not. Of the 11 failures, two cases were found to carry homozygous GJB2 p.R143W pathogenic mutation, one case was found to have heterozygous GJB2 235delC mutation, and another one case carried heterozygous GJB3 p.R180X pathogenic mutation. Six hundred and thirty-five babies passed the newborn hearing screening, in which 25 babies were identified to carry pathogenic mutations, including 12 heterozygotes (1.9%) for GJB2 235delC, eight heterozygotes (1.3%) for SLC26A4 IVS7-2A>G, one heterozygote (0.2%) for p.R409H, two homozygotes (0.3%) for m.1494C>T, and two homozygotes (0.3%) for m.1555A>G. Conclusion Newborn genetic screening through the umbilical cord blood for common deafness-associated mutations may identify carriers sensitive to aminoglycoside antibiotic, and can effectively prevent or delay hearing loss occurs. PMID:26330914

Follow-up of permanent hearing impairment in childhood.

PubMed

Della Volpe, A; De Lucia, A; Pastore, V; Bracci Laudiero, L; Buonissimo, I; Ricci, G

2016-02-01

Programmes for early childhood childhood hearing impairment identification allows to quickly start the appropriate hearing aid fitting and rehabilitation process; nevertheless, a large number of patients do not join the treatment program. The goal of this article is to present the results of a strategic review of the strengths, weaknesses, opportunities and threats connected with the audiologic/prosthetic/language follow-up process of children with bilateral permanent hearing impairment. Involving small children, the follow-up includes the involvement of specialised professionals of a multidisciplinary team and a complex and prolonged multi-faced management. Within the framework of the Italian Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for Early Identification, Intervention and Care of Hearing Impaired Children", the purpose of this analysis was to propose recommendations that can harmonise criteria for outcome evaluation and provide guidance on the most appropriate assessment methods to be used in the follow-up course of children with permanent hearing impairment. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale.

Hearing Loss in HIV-Infected Children in Lilongwe, Malawi

PubMed Central

Hrapcak, Susan; Kuper, Hannah; Bartlett, Peter; Devendra, Akash; Makawa, Atupele; Kim, Maria; Kazembe, Peter; Ahmed, Saeed

2016-01-01

Introduction With improved access to antiretroviral therapy (ART), HIV infection is becoming a chronic illness. Preliminary data suggest that HIV-infected children have a higher risk of disabilities, including hearing impairment, although data are sparse. This study aimed to estimate the prevalence and types of hearing loss in HIV-infected children in Lilongwe, Malawi. Methods This was a cross-sectional survey of 380 HIV-infected children aged 4–14 years attending ART clinic in Lilongwe between December 2013-March 2014. Data was collected through pediatric quality of life and sociodemographic questionnaires, electronic medical record review, and detailed audiologic testing. Hearing loss was defined as >20 decibels hearing level (dBHL) in either ear. Predictors of hearing loss were explored by regression analysis generating age- and sex-adjusted odds ratios. Children with significant hearing loss were fitted with hearing aids. Results Of 380 patients, 24% had hearing loss: 82% conductive, 14% sensorineural, and 4% mixed. Twenty-one patients (23% of those with hearing loss) were referred for hearing aid fitting. There was a higher prevalence of hearing loss in children with history of frequent ear infections (OR 7.4, 4.2–13.0) and ear drainage (OR 6.4, 3.6–11.6). Hearing loss was linked to history of WHO Stage 3 (OR 2.4, 1.2–4.5) or Stage 4 (OR 6.4, 2.7–15.2) and history of malnutrition (OR 2.1, 1.3–3.5), but not to duration of ART or CD4. Only 40% of caregivers accurately perceived their child’s hearing loss. Children with hearing impairment were less likely to attend school and had poorer emotional (p = 0.02) and school functioning (p = 0.04). Conclusions There is an urgent need for improved screening tools, identification and treatment of hearing problems in HIV-infected children, as hearing loss was common in this group and affected school functioning and quality of life. Clear strategies were identified for prevention and treatment, since most hearing loss was conductive in nature, likely due to frequent ear infections, and many children with hearing loss qualified for hearing aids. Screening strategies need to be developed and tested since caregivers were not reliable at identifying hearing loss, and often mis-identified children with normal hearing as having hearing loss. Children with frequent ear infections, ear drainage, TB, severe HIV disease, or low BMI should receive more frequent ear assessments and hearing evaluations. PMID:27551970

Reduction in interval cancer rates following the introduction of two-view mammography in the UK breast screening programme

PubMed Central

Dibden, A; Offman, J; Parmar, D; Jenkins, J; Slater, J; Binysh, K; McSorley, J; Scorfield, S; Cumming, P; Liao, X-H; Ryan, M; Harker, D; Stevens, G; Rogers, N; Blanks, R; Sellars, S; Patnick, J; Duffy, S W

2014-01-01

Background: The introduction of two-view mammography at incident (subsequent) screens in the National Health Service Breast Screening Programme (NHSBSP) has led to an increased number of cancers detected at screen. However, the effect of two-view mammography on interval cancer rates has yet to be assessed. Methods: Routine screening and interval cancer data were collated from all screening programmes in the United Kingdom for women aged 50–64, screened between 1 April 2003 and 31 March 2005. Interval cancer rates were compared based on whether two-view mammography was in use at the last routine screen. Results: The reduction in interval cancers following screening using two-view mammography compared with one view was 0.68 per 1 000 women screened. Overall, this suggests the introduction of two-view mammography at incident screen was accompanied by a 15–20% reduction in interval cancer rates in the NHSBSP. Conclusion: The introduction of two-view mammography at incident screens is associated with a reduction in incidence of interval cancers. This is consistent with previous publications on a contemporaneous increase in screen-detected cancers. The results provide further evidence of the benefit of the use of two-view mammography at incident screens. PMID:24366303

Expanded newborn metabolic screening programme in Hong Kong: a three-year journey.

PubMed

Chong, S C; Law, L K; Hui, J; Lai, C Y; Leung, T Y; Yuen, Y P

2017-10-01

No universal expanded newborn screening service for inborn errors of metabolism is available in Hong Kong despite its long history in developed western countries and rapid development in neighbouring Asian countries. To increase the local awareness and preparedness, the Centre of Inborn Errors of Metabolism of the Chinese University of Hong Kong started a private inborn errors of metabolism screening programme in July 2013. This study aimed to describe the results and implementation of this screening programme. We retrieved the demographics of the screened newborns and the screening results from July 2013 to July 2016. These data were used to calculate quality metrics such as call-back rate and false-positive rate. Clinical details of true-positive and false-negative cases and their outcomes were described. Finally, the call-back logistics for newborns with positive screening results were reviewed. During the study period, 30 448 newborns referred from 13 private and public units were screened. Of the samples, 98.3% were collected within 7 days of life. The overall call-back rate was 0.128% (39/30 448) and the false-positive rate was 0.105% (32/30 448). Six neonates were confirmed to have inborn errors of metabolism, including two cases of medium-chain acyl-coenzyme A dehydrogenase deficiency, one case of carnitine-acylcarnitine translocase deficiency, and three milder conditions. One case of maternal carnitine uptake defect was diagnosed. All patients remained asymptomatic at their last follow-up. The Centre of Inborn Errors of Metabolism has established a comprehensive expanded newborn screening programme for selected inborn errors of metabolism. It sets a standard against which the performance of other private newborn screening tests can be compared. Our experience can also serve as a reference for policymakers when they contemplate establishing a government-funded universal expanded newborn screening programme in the future.

Promotion of early pediatric hearing detection through patient navigation: A randomized controlled clinical trial.

PubMed

Bush, Matthew L; Taylor, Zachary R; Noblitt, Bryce; Shackleford, Taylor; Gal, Thomas J; Shinn, Jennifer B; Creel, Liza M; Lester, Cathy; Westgate, Philip M; Jacobs, Julie A; Studts, Christina R

2017-11-01

To assess the efficacy of a patient navigator intervention to decrease nonadherence to obtain audiological testing following failed screening, compared to those receiving the standard of care. Using a randomized controlled design, guardian-infant dyads, in which the infants had abnormal newborn hearing screening, were recruited within the first week after birth. All participants were referred for definitive audiological diagnostic testing. Dyads were randomized into a patient navigator study arm or standard of care arm. The primary outcome was the percentage of patients with follow-up nonadherence to obtain diagnostic testing. Secondary outcomes were parental knowledge of infant hearing testing recommendations and barriers in obtaining follow-up testing. Sixty-one dyads were enrolled in the study (patient navigator arm = 27, standard of care arm = 34). The percentage of participants nonadherent to diagnostic follow-up during the first 6 months after birth was significantly lower in the patient navigator arm compared with the standard of care arm (7.4% vs. 38.2%) (P = .005). The timing of initial follow-up was significantly lower in the navigator arm compared with the standard of care arm (67.9 days after birth vs. 105.9 days, P = .010). Patient navigation increased baseline knowledge regarding infant hearing loss diagnosis recommendations compared with the standard of care (P = .004). Patient navigation decreases nonadherence rates following abnormal infant hearing screening and improves knowledge of follow-up recommendations. This intervention has the potential to improve the timeliness of delivery of infant hearing healthcare; future research is needed to assess the cost and feasibility of larger scale implementation. 1b. Laryngoscope, 127:S1-S13, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Calibration of an In-Ear Dosimeter for a Single Hearing Protection Device

DTIC Science & Technology

2014-02-01

history of ototoxic medication use, audiological history of tinnitus , etc. A total of 54 subjects were screened to participate in this study.1 subject...was excluded from this study based on a history of seizures. 18 subjects were excluded based on hearing threshold results. 15 subjects were...Military Service: Implications for hearing loss and tinnitus ”, Washington, DC, National Academies Press. 7. United States Government Accountability Office

Analysing use of the Chinese HHIE-S for hearing screening of elderly in a northeastern industrial area of China.

PubMed

Wang, Yue; Mo, Lingyan; Li, Yagang; Zheng, Zhongwei; Qi, Yu

2017-04-01

The aim of the present study was to investigate the use of Chinese version of HHIE-S as a hearing screening tool for the elderly in an industrial area in northeast China. Prevalence, sensitivity and specificity of Chinese version of HHIE-S were calculated. Factors that had impact on HHIE-S were analysed. Five hundred and seventy Mandarin speaking participants, aged from 50 to 85 years were included. They were tested with pure tone audiometry and Chinese version of HHIE-S. The prevalence of hearing handicap was 55.3%. The sensitivity and specificity of HHIE-S were 84.5% and 58.3% respectively when the pass/fail criteria were set at PTA 0.5-4kHz >40 dBHL. In general, HHIE-S total and subscale scores were significantly associated with severity of hearing impairment. After stratified by severity of hearing impairment, both the prevalence of reported handicap and the scores of HHIE-S were not significantly associated with age. Male participants had significantly higher HHIE-S scores than female participants did. The Chinese version of HHIE-S contributes useful information to identifying hearing handicap and addressing the rehabilitative needs in the elderly in an industrial city in Mainland China.

Newborn Hearing Screening and Early Diagnostic in the NICU

PubMed Central

Colella-Santos, Maria Francisca; Hein, Thaís Antonelli Diniz; de Souza, Gabriele Libano; do Amaral, Maria Isabel Ramos; Casali, Raquel Leme

2014-01-01

The aim was to describe the outcome of neonatal hearing screening (NHS) and audiological diagnosis in neonates in the NICU. The sample was divided into Group I: neonates who underwent NHS in one step and Group II: neonates who underwent a test and retest NHS. NHS procedure was automated auditory brainstem response. NHS was performed in 82.1% of surviving neonates. For GI, referral rate was 18.6% and false-positive was 62.2% (normal hearing in the diagnostic stage). In GII, with retest, referral rate dropped to 4.1% and false-positive to 12.5%. Sensorineural hearing loss was found in 13.2% of infants and conductive in 26.4% of cases. There was one case of auditory neuropathy spectrum (1.9%). Dropout rate in whole process was 21.7% for GI and 24.03% for GII. We concluded that it was not possible to perform universal NHS in the studied sample or, in many cases, to apply it within the first month of life. Retest reduced failure and false-positive rate and did not increase evasion, indicating that it is a recommendable step in NHS programs in the NICU. The incidence of hearing loss was 2.9%, considering sensorineural hearing loss (0.91%), conductive (1.83%) and auditory neuropathy spectrum (0.19%). PMID:24999481

Readability of Internet Information on Hearing: Systematic Literature Review.

PubMed

Laplante-Lévesque, Ariane; Thorén, Elisabet Sundewall

2015-09-01

This systematic literature review asks the following question: “ What is the readability of Internet information on hearing that people with hearing impairment and their significant others can access in the context of their hearing care?” Searches were completed in three databases: CINAHL, PubMed, and Scopus. Seventy-eight records were identified and systematically screened for eligibility: 8 records were included that contained data on the readability of Internet information on hearing that people with hear ing impairment and their significant others can access in the context of their hearing care. Records reported mean readability levels from 9 to over 14. In other words, people with hearing impairment and their significant others need 9 to 14 years of education to read and understand Internet information on hearing that they access in the context of their hearing care. The poor readability of Internet information on hearing has been well documented; it is time to focus on valid and sustainable initiatives that address this problem.

The impact of age on the art of mammography and how to adapt accordingly.

PubMed

Lake, B; Cielecki, L; Williams, S; Worrall, C; Metelko, M

2017-11-01

Breast cancer is increasingly a disease of the elderly, and combined with the NHS Breast Screening Extension means that more elderly patients are having mammography. Increasing age can make mammography more technically difficult. This is a technical note detailing the results of a local audit which may be of interest due to potential service implications. A retrospective audit of the first year of screening extension of The Shropshire Breast Screening Programme. Aims to collect data on patient demographics and describe the technical adaptations developed in Shropshire. Breast screening extension has increased by 2.5 times the number of women aged 70-74 screened, and doubled the overall numbers of women over 70 screened. Significantly more older patients are being screened to present technical challenges to a screening programme. Data was obtained from a month of screening showed that 29% of patients over 70 needed extra time for positioning. Reasons included 22% difficulty in obtaining adequate positioning and 15% needed a relative to aid with consent. In the Shropshire screening programme different technical adaptations have been developed and are key to ensuring adequate images. These include double appointments, two radiographers, thorough assessment, steeper angles, seated examinations, from-below imaging and pre-planning for subsequent screen. Significantly more older women are having breast screening due to the increasing incidence of breast cancer and the Breast Screening Programme extension. Increasing age can significantly increase time taken for adequate imaging and present technical challenges. Development of technical adaptations to art of mammography is key to achieve adequate images. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

Health Vulnerability Index and newborn hearing screening: urban inequality.

PubMed

Januário, Gabriela Cintra; Alves, Claudia Regina Lindgren; Lemos, Stela Maris Aguiar; Almeida, Maria Cristina de Mattos; Cruz, Ramon Costa; Friche, Amélia Augusta de Lima

To analyze the intra-urban differentials related to the outcome of the Newborn Hearing Screening (NHS) of children living in Belo Horizonte tested in a reference service using the Health Vulnerability Index (HVI). cross-sectional study with children living in Belo Horizonte evaluated by a Newborn Hearing Screening Reference Service (NHSRS) between 2010 and 2011. The HVI of the census tract of each child was obtained by the georeferencing of their respective addresses. Multivariate analysis was conducted using the decision tree technique, considering a statistical model for each response. A thematic map of points representing the geographic distribution of the children evaluated by the NHS program was also developed. The NHS failure rate for children living in areas with very high HVI, or without HVI data, was 1.5 times higher than that for children living in other census tracts. For children living in areas of low, medium, and high HVI, who underwent NHS after 30 days of life, the NHS failure rate was 2.1 times higher in children that presented Risk Indicator for Hearing Loss (RIHL) (17.2%) than in those who did not (8.1%). Uneven distribution was observed between areas for children that underwent the NHS and those who failed it. Significant intra-urban differentials were found in Belo Horizonte, indicating correlation between health vulnerability and NHS outcomes.

[Ear, nose and throat disease profile in children with Down syndrome].

PubMed

Paul D, María A; Bravo V, Alejandra; Beltrán M, Constanza; Cerda L, Jaime; Angulo M, Daniela; Lizama C, Macarena

2015-01-01

The children with Down syndrome (DS) are at increased risk of ear-nose-throat (ENT) disorders. International recommendations suggest early hearing screening and periodic specialist evaluation. Our goal was to characterize ENT disorders in children with DS, and propose recommendations for the Chilean population. Cross-sectional, descriptive study, of children with DS, between 6 months and 15 years of age. The data was obtained by a health interview to the parents and review of medical records. We analyzed 134 patients with an average age of 44.5 months. The 78.8% had ENT disorders, the most frequent ENT disorders was allergic rhinitis and otitis media with effusion. Hearing screening was abnormal in a quarter of the patients, 50% of children over 3 years of age had obstructive sleep apnea diagnosed by polysomnogram. Older children had a statistically higher frequency of ENT disorders. This series shows a high rate of ENT disorders in children with DS, which supports recommendations for hearing screening, high suspicion of obstructive sleep apnea and routine referral to an ENT specialist for prevention and aggressive therapy in order to reduce hearing loss and improve development of the child with DS. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Screening for Usher Syndrome: A Hands-On Guide for School Nurses.

ERIC Educational Resources Information Center

Houghton, Joan; Coonts, Teresa; Jordan, Beth; Schafer, Jacqueline, Ed.

This manual was written specifically to help school nurses conduct screenings for Usher syndrome, a genetic condition that involves deafness or hearing loss and the progressive loss of vision. It provides information on the step-by-step process of how to conduct a screening, the actual forms needed for a screening, and resources for referring…

Development of a multimedia educational programme for first-time hearing aid users: a participatory design.

PubMed

Ferguson, Melanie; Leighton, Paul; Brandreth, Marian; Wharrad, Heather

2018-05-02

To develop content for a series of interactive video tutorials (or reusable learning objects, RLOs) for first-time adult hearing aid users, to enhance knowledge of hearing aids and communication. RLO content was based on an electronically-delivered Delphi review, workshops, and iterative peer-review and feedback using a mixed-methods participatory approach. An expert panel of 33 hearing healthcare professionals, and workshops involving 32 hearing aid users and 11 audiologists. This ensured that social, emotional and practical experiences of the end-user alongside clinical validity were captured. Content for evidence-based, self-contained RLOs based on pedagogical principles was developed for delivery via DVD for television, PC or internet. Content was developed based on Delphi review statements about essential information that reached consensus (≥90%), visual representations of relevant concepts relating to hearing aids and communication, and iterative peer-review and feedback of content. This participatory approach recognises and involves key stakeholders in the design process to create content for a user-friendly multimedia educational intervention, to supplement the clinical management of first-time hearing aid users. We propose participatory methodologies are used in the development of content for e-learning interventions in hearing-related research and clinical practice.

Civilian law: from occupational medicine to occupational event.

PubMed

Mpotos, N; Watelet, J B

Civilian law:from occupational medicine to occupational event. Despite the growing importance of objective measurements, the health effects of many occupational risk factors are currently not fully quantified. Occupational noise, as a widespread risk factor, is illustrative in this regard; there is a strong body of evidence linking it to an important health outcome (hearing loss), but it is less decisively associated with others (such as psychological disorders). It is also distinct from environmental noise, and therefore falls under the responsibility of employers as well as individuals. Noise-induced hearing loss (NIHL) is, at present, incurable and irreversible. However, it is preventable, if effective and global hearing conservation programmes can be implemented. These programmes should not be isolated efforts, but should be integrated into the overall hazard prevention and control programme of the workplace. Belgian law encompasses a set of provisions for prevention and the protection of the health and safety of workers within the workplace, including aspects pertaining to the hygiene of the workplace and psychosocial aspects at work (stress, violence, bullying and sexual harassment, among others). In principle, combating environmental noise is fully addressed in this country. However, other levels of policy-making also play an important role in this regard. For example, the federal government is in charge of product standards, and therefore also of noise emission standards for products. The interpretation and enforcement of Belgian legislation on well-being at work converts European directives and international agreements on well-being at work into Belgian law.

Alerts in electronic medical records to promote a colorectal cancer screening programme: a cluster randomised controlled trial in primary care

PubMed Central

Guiriguet, Carolina; Muñoz-Ortiz, Laura; Burón, Andrea; Rivero, Irene; Grau, Jaume; Vela-Vallespín, Carmen; Vilarrubí, Mercedes; Torres, Miquel; Hernández, Cristina; Méndez-Boo, Leonardo; Toràn, Pere; Caballeria, Llorenç; Macià, Francesc; Castells, Antoni

2016-01-01

Background Participation rates in colorectal cancer screening are below recommended European targets. Aim To evaluate the effectiveness of an alert in primary care electronic medical records (EMRs) to increase individuals’ participation in an organised, population-based colorectal cancer screening programme when compared with usual care. Design and setting Cluster randomised controlled trial in primary care centres of Barcelona, Spain. Method Participants were males and females aged 50–69 years, who were invited to the first round of a screening programme based on the faecal immunochemical test (FIT) (n = 41 042), and their primary care professional. The randomisation unit was the physician cluster (n = 130) and patients were blinded to the study group. The control group followed usual care as per the colorectal cancer screening programme. In the intervention group, as well as usual care, an alert to health professionals (cluster level) to promote screening was introduced in the individual’s primary care EMR for 1 year. The main outcome was colorectal cancer screening participation at individual participant level. Results In total, 67 physicians and 21 619 patients (intervention group) and 63 physicians and 19 423 patients (control group) were randomised. In the intention-to-treat analysis screening participation was 44.1% and 42.2% respectively (odds ratio 1.08, 95% confidence interval [CI] = 0.97 to 1.20, P = 0.146). However, in the per-protocol analysis screening uptake in the intervention group showed a statistically significant increase, after adjusting for potential confounders (OR, 1.11; 95% CI = 1.02 to 1.22; P = 0.018). Conclusion The use of an alert in an individual’s primary care EMR is associated with a statistically significant increased uptake of an organised, FIT-based colorectal cancer screening programme in patients attending primary care centres. PMID:27266861

The factors associated with a self-perceived hearing handicap in elderly people with hearing impairment--results from a community-based study.

PubMed

Chang, Hsin-Pin; Ho, Chin-Yu; Chou, Pesus

2009-10-01

Elderly persons with a physiologic hearing deficit (hearing impairment) are not necessarily socially or emotionally disturbed by the deficit in everyday life (hearing handicap). The self-perception of a hearing handicap in elderly people is a key element in seeking consultation for a hearing impairment or using hearing aids. Thus, it is important to determine the factors associated with the self-perception of a hearing handicap. The aims of the present study were to report the relation between a hearing impairment and the self-perception of a hearing handicap, and the factors associated with a self-perceived hearing handicap among a group of randomly recruited, community-dwelling elderly persons, aged 65 yr and older, in Taipei, Taiwan. A cross-sectional survey of community-dwelling elderly persons aged 65 yr and older (N = 1220) participating in an annual general purpose geriatric health examination in 2005 in Taipei. Pure-tone audiometry and a questionnaire including the Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S) were administered, after obtaining the subject's consent to participate in the study. Demographic information, lifestyle, self-report health status, and biochemical data were also collected. There was a moderate association (gamma(s) = 0.52) between hearing impairment and self-perceived handicap. Only 21.4% of the study subjects with moderate to profound hearing impairment (M4 >or=41 dB HL, N = 555) perceived themselves as hearing-handicapped (HHIE-S total score >or=10). Besides hearing level, marital status (widowed) and self-perceived general health (bad or neutral) were factors that are significantly associated with a self-perceived hearing handicap among elderly subjects with moderate to profound hearing impairment. For study subjects with moderate to profound hearing impairment (M4 >or=41 dB HL), 5.0% of those with HHIE-S <10 and 45.4% of those with HHIE-S >or=10 used or felt that they required hearing aids (chi2 test, p < 0.001). These data suggested that a self-perceived hearing handicap (HHIE-S >or=10) is an important indicator for referral of elderly persons for hearing-aid fitting. Our study findings, consistent with those of previous studies, demonstrated that not all elderly persons with impaired hearing function (hearing impairment) perceived a hearing deficit socially or emotionally in everyday life (hearing handicap). Marital status (widowed) and bad/neutral general health were nonaudiologically associated factors with a hearing handicap in the present study. Further, those with a self-perceived hearing handicap reported a higher rate of the use of, or requirement for, hearing aids. Because hearing deterioration is a common biologic process of aging, the results of this study can be used to identify the groups among elderly people with a greater need for hearing screening and hearing rehabilitation services.

Screening of Visually Impaired Children for Health Problems.

PubMed

Açıl, Dilay; Ayaz, Sultan

2015-12-01

Disability is a significant problem and is accepted globally as a health priority in childhood. Like nonvisually impaired children, visually impaired children also need to use health services during childhood. The purpose of this study was to determine the health problems of visually impaired children. A descriptive design was used. The subjects were 74 children with visual impairment attending primary school (aged 5-14 years), who agreed to participate and whose parents gave permission. Data were collected via physical examination including questionnaires and a physical assessment form. The health screening included physical measurements for height, weight, blood pressure, dental health, hearing, and scoliosis. The mean age of children was 10.43 ± 2.9 years. When the health screening results of children were examined, it was found that 25.7% of the children were overweight or obese, 35.1% of them had dental problems, 27.0% had hearing problems, and 39.2% had scoliosis risk. Systolic and diastolic blood pressures were normal in 91.8% and 93.2% of the children, respectively. These findings showed the important role of school health nurses in performing health screenings directed at visually impaired children who constitute a special group for school health services. Health screening for height, weight, dental health, hearing, and scoliosis is suggested for visually impaired children. Copyright © 2015. Published by Elsevier B.V.

77 FR 70407 - Updated Information and Comment Sought on Review of Hearing Aid Compatibility Regulations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-26

... of display screens, wireless headsets, and simultaneous transmission capabilities in handsets. The... Communications Commission. ACTION: Proposed rule. SUMMARY: In this document, the Wireless Telecommunications... relating to hearing aid compatibility of wireless handsets. The Bureau seeks updated comment on whether, in...

76 FR 2625 - Comment Sought on 2010 Review of Hearing Aid Compatibility Regulations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-14

... compatibility, as well as the effects of display screens, wireless headsets, and simultaneous transmission.... ACTION: Proposed rule. SUMMARY: The Wireless Telecommunications Bureau (Bureau) seeks comments on the operation and effectiveness of the Commission's rules relating to hearing aid compatibility of wireless...

Survey on Infant Hearing Loss at Caritas Baby Hospital in Bethlehem-Palestine.

PubMed

Corradin, Lucia; Hindiyeh, Musa; Khaled, Rasha; Rishmawi, Fadi; Zidan, Marwan; Marzouqa, Hiyam

2014-03-06

This study describes the epidemiology of infants' hearing loss (IHL) among patients under 3 months of age at Caritas Baby Hospital, the only pediatric hospital in Palestine. It was aimed to demonstrate that IHL is a major health problem in Palestine and to assess the first available data of the newborn hearing screening program conducted between September 25, 2006 and December 31, 2011. Data was uploaded and analyzed using Microsoft Excel and the Statistical Package for the Social Sciences software (SPSS version 21). A total of 8144 infants were tested, 4812 (59%) were males and 3332 (41%) were females. As to their origin, 72% (5886) came from the Bethlehem district, 25% (2044) from the Hebron district, while 3% (214) from the other Palestinian districts (Jericho, Ramallah, Nablus, Jenin and Jerusalem). The transient evoked otoacoustic emissions (TEOAEs) and the automated auditory brainstem response were used according to the manufacturer guidelines. The results were interpreted according to the indications of the American Academy of Pediatrics, the National Institutes of Health, and the European Consensus Development Conference on Neonatal Hearing Screening. Out of the 8144 infants tested, 1507 (14.6%) did not pass the 1(st) test, 477 (32.8%) of these 1507 infants failed retesting, while 498 (33%) patients were lost to follow-up. Only 152 (31.9%) patients that failed retesting went to an audiologist. The audiologist evaluation revealed that 101 (66.4%) patients presented with a mild-moderate or profound hearing loss according to the Bureau International of Audiophonologie standards, 44 (28.9%) patients had otitis media, whereas 7 cases (4.7%) had no hearing disorders. The overall unadjusted percentage of hearing loss was 1.24%, and the adjusted overall percentage was 1.85%. The chart review showed that jaundice, sepsis, prematurity, lung disease were more common among the affected patients. The high prevalence of childhood deafness in Palestine is of utmost importance and deserves immediate attention on the part of the Palestinian government. Meanwhile, Caritas Baby Hospital undertook to set up a newborn hearing screening unit utilizing the TEOAE method.

Identifying hearing loss by means of iridology.

PubMed

Stearn, Natalie; Swanepoel, De Wet

2006-11-13

Isolated reports of hearing loss presenting as markings on the iris exist, but to date the effectiveness of iridology to identify hearing loss has not been investigated. This study therefore aimed to determine the efficacy of iridological analysis in the identification of moderate to profound sensorineural hearing loss in adolescents. A controlled trial was conducted with an iridologist, blind to the actual hearing status of participants, analyzing the irises of participants with and without hearing loss. Fifty hearing impaired and fifty normal hearing subjects, between the ages of 15 and 19 years, controlled for gender, participated in the study. An experienced iridologist analyzed the randomised set of participants' irises. A 70% correct identification of hearing status was obtained by iridological analyses with a false negative rate of 41% compared to a 19% false positive rate. The respective sensitivity and specificity rates therefore came to 59% and 81%. Iridological analysis of hearing status indicated a statistically significant relationship to actual hearing status (P < 0.05). Although statistically significant sensitivity and specificity rates for identifying hearing loss by iridology were not comparable to those of traditional audiological screening procedures.

Road Traffic Noise Exposure and Hearing Impairment Among Traffic Policemen in Surat, Western India

NASA Astrophysics Data System (ADS)

Tandel, B. N.; Macwan, J. E. M.

2017-06-01

Among all of the sources responsible for noise pollution, traffic related sources are of great environmental concern and increasing level of discomfort in urban areas with increasing traffic concentration. It will be a larger and serious problem in the future, if effective precautions are not taken addressed and attended to. Hence, a study was undertaken to measure the levels of road traffic noise at major intersections of Surat city, located in Western India and assess the hearing impairment among the exposed group of population i.e. the traffic policemen. Manual noise measurements and vehicle counts were performed at three of the busiest traffic intersections in the city for a period of 12 h. Audiometric screening was done on 46 policemen working at these intersections to determine the occurrence of hearing impairment. At all the three intersections, Leq measured was well above the permissible levels of 65 dBA for daytime. The Lmax recorded for three intersections were 84.6 dBA (07:36 pm), 87.3 dBA (06:32 pm) and 85.6 dBA (11:41 am). Audiometric screening showed that only 10 policemen (22%) had normal hearing. Slight, moderate and severe hearing impairment was recorded among 13 (28%), 18 (39%) and 5 (11%) policemen respectively. Of the total 46 policemen, none had profound impairment (deafness, hearing loss >81 dB). Of the 36 policemen having hearing impairment, 27 had bilateral impairment.

Cervical screening among migrant women: a qualitative study of Polish, Slovak and Romanian women in London, UK

PubMed Central

Jackowska, Marta; von Wagner, Christian; Wardle, Jane; Juszczyk, Dorota; Luszczynska, Aleksandra; Waller, Jo

2012-01-01

Objective To explore awareness of and participation in cervical screening services in women from Poland, Slovakia and Romania living in London, UK. Methods Three qualitative studies were carried out in London in 2008–2009: an interview study of professionals working with Central and Eastern European migrants (n=11); a focus group study including three Polish, one Slovak and one Romanian focus group; and an interview study of Polish (n=11), Slovak (n=7) and Romanian (n=2) women. Results Awareness of the cervical screening programme was good, but understanding of the purpose of screening was sometimes limited. Some women were fully engaged with the UK screening programme; others used screening both in the UK and their countries of origin; and a third group only had screening in their home countries. Women welcomed the fact that screening is free and that reminders are sent, but some were concerned about the screening interval and the age of the first invitation. Conclusions Migrant women from Poland, Slovakia and Romania living in London vary in their level of participation in the National Health Service Cervical Screening Programme. More needs to be done to address concerns regarding screening services, and to ensure that language is not a barrier to participation. PMID:22219504

American Sign Language and Early Intervention

ERIC Educational Resources Information Center

Snoddon, Kristin

2008-01-01

Since the beginning of the twenty-first century, the introduction in several countries of universal neonatal hearing screening programs has changed the landscape of education for deaf children. Due to the increasing provision of early intervention services for children identified with hearing loss, public education for deaf children often starts…

Impact of comorbid conditions on participation in an organised colorectal cancer screening programme: a cross-sectional study.

PubMed

Guiriguet, Carolina; Pera, Guillem; Castells, Antoni; Toran, Pere; Grau, Jaume; Rivero, Irene; Buron, Andrea; Macià, Francesc; Vela-Vallespín, Carmen; Vilarrubí-Estrella, Mercedes; Marzo-Castillejo, Mercedes

2017-08-07

There is controversy regarding how comorbidity impacts on colorectal cancer screening, especially in the context of organised programmes. The aim of this study is to assess the effect of comorbidities on participation in the Barcelona population-based colorectal cancer screening programme (BCCSP). Cross-sectional study carried out in ten primary care centres involved in the BCCSP. Individuals aged 50 to 69, at average risk of colorectal cancer, who were invited to participate in the first round of the faecal immunochemical test-based BCCSP were included (2011-2012). The main variable was participation in the BCCSP. Comorbidity was assessed by clinical risk group status. Other adjusting variables were age, sex, socioeconomic deprivation, visits to primary care, smoking, alcohol consumption and body mass index. Logistic regression models were used to test the association between participation in the programme and potential explanatory variables. The results were given as incidence rate ratios (IRR) and their 95% confidence intervals (CI). Of the 36,208 individuals included, 17,404 (48%) participated in the BCCSP. Participation was statistically significantly higher in women, individuals aged 60 to 64, patients with intermediate socioeconomic deprivation, and patients with more medical visits. There was a higher rate of current smoking, high-risk alcohol intake, obesity and individuals in the highest comorbidity categories in the non-participation group. In the adjusted analysis, only individuals with multiple minor chronic diseases were more likely to participate in the BCCSP (IRR 1.14; 95% CI [1.06 to 1.22]; p < 0.001). In contrast, having three or more dominant chronic diseases was associated with lower participation in the screening programme (IRR 0.76; 95% CI [0.65 to 0.89]; p = 0.001). Having three or more dominant chronic diseases, was associated with lower participation in a faecal immunochemical test-based colorectal cancer screening programme, whereas individuals with multiple minor chronic diseases were more likely to participate. Further research is needed to explore comorbidity as a cause of non-participation in colorectal cancer screening programmes and which individuals could benefit most from colorectal cancer screening.

Testing the construct validity of willingness to pay valuations using objective information about risk and health benefit.

PubMed

Philips, Zoë; Whynes, David K; Avis, Mark

2006-02-01

This paper describes an experiment to test the construct validity of contingent valuation, by eliciting women's valuations for the NHS cervical cancer screening programme. It is known that, owing to low levels of knowledge of cancer and screening in the general population, women both over-estimate the risk of disease and the efficacy of screening. The study is constructed as a randomised experiment, in which one group is provided with accurate information about cervical cancer screening, whilst the other is not. The first hypothesis supporting construct validity, that controls who perceive greater benefits from screening will offer higher valuations, is substantiated. Both groups are then provided with objective information on an improvement to the screening programme, and are asked to value the improvement as an increment to their original valuations. The second hypothesis supporting construct validity, that controls who perceive the benefits of the programme to be high already will offer lower incremental valuations, is also substantiated. Copyright 2005 John Wiley & Sons, Ltd.

The Nonmydriatic Fundus Camera in Diabetic Retinopathy Screening: A Cost-Effective Study with Evaluation for Future Large-Scale Application

PubMed Central

Scarpa, Giuseppe; Urban, Francesca; Tessarin, Michele; Gallo, Giovanni; Midena, Edoardo

2016-01-01

Aims. The study aimed to present the experience of a screening programme for early detection of diabetic retinopathy (DR) using a nonmydriatic fundus camera, evaluating the feasibility in terms of validity, resources absorption, and future advantages of a potential application, in an Italian local health authority. Methods. Diabetic patients living in the town of Ponzano, Veneto Region (Northern Italy), were invited to be enrolled in the screening programme. The “no prevention strategy” with the inclusion of the estimation of blindness related costs was compared with screening costs in order to evaluate a future extensive and feasible implementation of the procedure, through a budget impact approach. Results. Out of 498 diabetic patients eligible, 80% was enrolled in the screening programme. 115 patients (34%) were referred to an ophthalmologist and 9 cases required prompt treatment for either proliferative DR or macular edema. Based on the pilot data, it emerged that an extensive use of the investigated screening programme, within the Greater Treviso area, could prevent 6 cases of blindness every year, resulting in a saving of €271,543.32 (−13.71%). Conclusions. Fundus images obtained with a nonmydriatic fundus camera could be considered an effective, cost-sparing, and feasible screening tool for the early detection of DR, preventing blindness as a result of diabetes. PMID:27885337

Association of socioeconomic status with hearing loss in Chinese working-aged adults: A population-based study

PubMed Central

Hu, Xiangyang; Gong, Rui; Wen, Xu

2018-01-01

Hearing loss is the most common sensory impairment, but limited studies focused on the association of socioeconomic status (SES) with hearing loss among adults of working age. This paper aimed to fill this gap among Chinese adults. We obtained data from Ear and Hearing Disorder Survey conducted in four provinces of China in 2014–2015. The survey was based on WHO Ear and Hearing Disorders Survey Protocol and 25,860 adults aged 25 to 59 years were selected in this study. Trained local examiners performed pure tone audiometry to screen people with hearing loss, and those who were screened positively for hearing loss were referred to audiologists to make final diagnosis. SES was measured by occupation, education and income. Results show after adjusting for SES measures and covariates, in urban areas, compared with white-collar workers, blue-collar workers and the unemployed were more likely to have hearing loss, with an odds ratio of 1.2 (95%CI: 1.0, 1.3) and 1.2 (95%CI: 1.0, 1.4), respectively. Compared with people with education of senior high school or above, those with junior high school, primary school and illiteracy had 1.6 (95%CI: 1.4, 1.8), 2.1(95%CI: 1.7, 2.5) and 2.6 (95%CI: 1.9, 3.7) times as likely to have hearing loss, respectively. In rural areas, the unemployed had 1.5 (95%CI: 1.0, 2.3) times the risk of hearing loss compared with white-collar workers, and illiterates had 1.6 (95%CI: 1.6, 2.1) times the risk of hearing loss compared with people with education of senior high school or above, after SES variables and covariates were taken into considerations. Income was not significantly associated with hearing loss in urban and rural areas. In conclusion, SES, in the form of occupation and education, was associated with hearing loss among working-aged population, and further studies are needed to explore the mechanism of such association. PMID:29596478

[Audiological characteristics of young children with otitis media with effusion].

PubMed

Wang, Qiu-ju; Shi, Wei; Lan, Lan; Wang, Da-yong; Zhang, Ya-mei

2008-12-01

To characterize the audiological features in the infants with otitis media with effusion (OME) and to investigate the utility of variety of objective audiometry methods in diagnosis and intervention on OME. Fifty six infants (40 males and 16 females) were investigated, who were referred to our clinic at the General Hospital of Chinese People's Liberation Army by the other hospitals from December 2004 to June 2007 when the infants were diagnosed or highly suspected of OME. The ages at the initial diagnosis ranged from 42 days to three years, with an average of five months. The infants, after receiving the conventional otolaryngological exams, were subjected to the tests of auditory brainstem response (ABR), otoacoustic emission (OAE), tympanometry (226 Hz and 1000 Hz) and behaviors audiometry. Among 56 affected infants, 87 ears were diagnosed with OME, of which 31 infants were affected bilateral and 25 with monaural. For the 49 infants who received hearing screening at birth, 36 infants were referred at the initial screening. For the 52 infants who received repeated screening, all subjects were referred. Six infants without receiving hearing screening came to clinic when their parents observed their kids' hearing impairment. Among the 52 cases (104 ears) who received tympanometry test, 20 subjects (28 ears) showed B or C type tympanometry curve. Thirty-nine cases (78 ears) were given tympanometry test at 1000 Hz, of which 38 cases (55 ears) showed abnormal hearing. Among 56 infants (112 ears) with ABR test, 49 subjects (74 ears) exhibited prolonged ABR type I curve. All 56 infants (112 ears) received OAE test, of which 55 subjects (81 ears) were referred. Four infants (8 ears) accepted the behavior test and all of them showed A-B Gap. The combined tympanometry test at both 226 Hz and 1000 Hz, ABR latency or threshold test, infant's behavior test and OAE, used jointly, enable characterizing better OME in infants, thus helping early diagnosis of this hearing disorder.

Infants and Toddlers (Ages 0-3) - Raising Healthy Children

MedlinePlus

... Washing Hearing Screening Infant & Toddler Health Infant & Toddler Nutrition Maternal and Infant Health Newborn Screening Parenting Tips Perchlorate in Baby Formula Special Needs Families Test Your Knowledge about Kids’ Health Tips for Calming a Crying ...

Cost-benefit analysis of hyperphenylalaninemia due to 6-pyruvoyl-tetrahydropterin synthase (PTPS) deficiency: for consideration of expanded newborn screening in Hong Kong.

PubMed

Lee, Hencher Han-Chih; Mak, Chloe Miu; Poon, Grace Wing-Kit; Wong, Kar-Yin; Lam, Ching-Wan

2014-06-01

To evaluate the cost-benefit of implementing an expanded newborn screening programme for hyperphenylalaninemias due to 6-pyruvoyl-tetrahydropterin synthase (PTPS) deficiency in Hong Kong. Regional public hospitals in Hong Kong providing care for cases of inborn errors of metabolism. Implementational and operational costs of a new expanded mass spectrometry-based newborn screening programme were estimated. Data on various medical expenditures for the mild and severe phenotypic subtypes were gathered from a case cohort diagnosed with PTPS deficiency from 2001 to 2009. Local incidence from a previously published study was used. Implementation and operational costs of an expanded newborn screening programme in Hong Kong were estimated at HKD 10,473,848 (USD 1,342,801) annually. Assuming a birthrate of 50,000 per year and an incidence of 1 in 29,542 live births, the medical costs and adjusted loss of workforce per year would be HKD 20,773,207 (USD 2,663,232). Overall the annual savings from implementing the programme would be HKD 9,632,750 (USD 1,234,968). Our estimates show that implementation of an expanded newborn screening programme in Hong Kong is cost-effective, with a significant annual saving for public expenditure. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Can a lifestyle intervention be offered through NHS breast cancer screening? Challenges and opportunities identified in a qualitative study of women attending screening.

PubMed

Conway, Ellie; Wyke, Sally; Sugden, Jacqui; Mutrie, Nanette; Anderson, Annie S

2016-08-11

Around one third of breast cancers in post-menopausal women could be prevented by decreasing body fatness and alcohol intake and increasing physical activity. This study aimed to explore views and attitudes on lifestyle intervention approaches in order to inform the proposed content of a lifestyle intervention programme amongst women attending breast cancer screening. Women attending breast cancer screening clinics in Dundee and Glasgow, were invited to participate in focus group discussions (FGD) by clinic staff. The groups were convened out with the clinic setting and moderated by an experienced researcher who attained brief details on socio-demographic background and audio-recorded the discussions. Data analysis was guided by the framework approach. The main topics of enquiry were: Understanding of risk of breast cancer and its prevention, views on engaging with a lifestyle intervention programme offered through breast cancer screening and programme design and content. Thirty one women attended 5 focus groups. Participant ages ranged from 51 to 78 years and 38 % lived in the two most deprived quintiles of residential areas. Women were generally positive about being offered a programme at breast cancer screening but sceptical about lifestyle associated risk, citing genetics, bad luck and knowing women with breast cancer who led healthy lifestyles as reasons to query the importance of lifestyle. Engagement via clinic staff and delivery of the programme by lifestyle coaches out with the screening setting was viewed favourably. The importance of body weight, physical activity and alcohol consumption with disease was widely known although most were surprised at the association with breast cancer. They were particularly surprised about the role of alcohol and resistant to thinking about themselves having a problem. They expressed frustration that lifestyle guidance was often conflicting and divergent over time. The concept of focussing on small lifestyle changes, which were personalised, supported socially and appropriate to age and ability were welcomed. Offering access to a lifestyle programme through breast screening appears acceptable. Explaining the relevance of the target behaviours for breast cancer health, endorsing and utilising consistent messages and identifying personalised, mutually agreed, behaviour change goals provides a framework for programme development.

Impedance in School Screening Programs.

ERIC Educational Resources Information Center

Robarts, John T.

1985-01-01

This paper examines the controversy over use of impedance screening in public schools to identify students with hearing problems, including otitis media, a common ear condition in infants and young children. It cites research that questions the value of pure tone screening as a single test and raises critics' objections to the use of impedance,…

Osteoporosis: should there be a screening programme in Hong Kong?

PubMed

Hui, Y

2002-08-01

Osteoporosis is rapidly becoming a major health problem in Hong Kong with the ever-increasing population of elderly people. Its importance lies in the predisposition to fragility fractures of patients with the disease. These fractures incur morbidity and mortality to the elderly. Measures are needed to reduce the prevalence of osteoporosis and the incidence of osteoporotic fractures. A screening programme is potentially the way forward in achieving such a goal. The need for, and the feasibility of, a screening programme for osteoporosis in Hong Kong were evaluated. A comprehensive examination of the relevant issues was carried out within the framework of the World Health Organization criteria on screening of diseases. Major studies from abroad and Hong Kong were discussed and the strength of evidence was assessed. Osteoporosis satisfies some of the World Health Organization criteria for screening of diseases: it is a significant health problem, the natural history is fairly well understood, and early detection is possible. Nevertheless, there remain unresolved issues related to the screening tests, the treatments currently available, and the selection criteria for treatment. Several therapeutic options have been tested in trials. However, more work is needed to determine whether, in addition to increasing bone mass, they reduce the incidence of fracture. Moreover, the duration of therapy needed to achieve long-term benefit has yet to be established. More studies are also needed to evaluate the cost-effectiveness of such a programme. There undoubtedly needs to be a means of identifying individuals who have osteoporosis and are susceptible to fragility fractures. However, based on the currently available evidence, large-scale screening is not a valid option. Before instituting such a programme in Hong Kong, more studies are needed to determine the most appropriate and cost-effective way forward.

Relation between amniotic fluid infection or cytokine levels and hearing screen failure in infants at 32 wk gestation or less.

PubMed

Jung, Eun Young; Choi, Byung Yoon; Rhee, Jihye; Park, Jaehong; Cho, Soo-Hyun; Park, Kyo Hoon

2017-02-01

To determine whether the presence of intra-amniotic infection and elevated proinflammatory cytokine levels in amniotic fluid (AF) are associated with failure in the newborn hearing screen (NHS) test in very preterm neonates. This is a retrospective cohort study of 112 premature singleton neonates born to women with preterm labor or preterm premature rupture of membranes at ≤32 wk. AF obtained through amniocentesis was cultured, and interleukin-6 (IL-6) and IL-8 levels were determined. Fourteen (12.5%) neonates failed the NHS test. The prevalence of a positive AF culture was 40% (45/112). Multiple logistic regression analyses indicated that intra-amniotic infection was significantly associated with failure in the NHS test after adjusting for baseline covariates such as maternal white blood cell count (WBC) and periventricular leukomalacia. However, the IL-6 and IL-8 levels in AF were not significantly associated with hearing screen failure. Moreover, neither gestational age at birth nor birth weight was associated with NHS failure. The presence of intra-amniotic infection, but not elevated levels of AF IL-6 and IL-8, may contribute to the risk for failure in the NHS test in very preterm neonates. This finding suggests that intra-amniotic infection in utero might contribute to the development of congenital sensorineural hearing loss.

Secondary prevention at 360°: the important role of diagnostic imaging.

PubMed

Ciarrapico, Anna Micaela; Manenti, Guglielmo; Pistolese, Chiara; Fabiano, Sebastiano; Fiori, Roberto; Romagnoli, Andrea; Sergiacomi, Gianluigi; Stefanini, Matteo; Simonetti, Giovanni

2015-06-01

The aim of this paper is to underline the importance of the role of general practitioners (GPs) in distributing vital information about prevention to citizens, to highlight the importance of the so-called voluntary prevention programmes, both for conditions for which no organised screening programmes exist and for those for which they do exist but may well be obsolete or inefficient. Nowadays, voluntary prevention is made more effective thanks to the new sophisticated diagnostic technologies applied worldwide by diagnostic imaging. Epidemiological data about the incidence and causes of death among the Italian population have shown that screening programmes should be aimed first at fighting the following diseases: prostatic carcinoma, lung cancer, colorectal carcinoma, breast cancer, cardiovascular disease, cerebrovascular disease, aortic and peripheral vascular disease. GPs do not generally give good or adequate instructions concerning voluntary prevention programmes; GPs may not even be aware of this type of prevention which could represent a valuable option together with the existing mass screening programmes. Therefore, in the following analysis, we aim to outline the correct diagnostic pathway for the prevention of diseases having the highest incidence in our country and which represent the most frequent causes of death. If used correctly, these screening programmes may contribute to the success of secondary prevention, limiting the use of tertiary prevention and thus producing savings for the Italian National Health System.

Correction factors for self-selection when evaluating screening programmes.

PubMed

Spix, Claudia; Berthold, Frank; Hero, Barbara; Michaelis, Jörg; Schilling, Freimut H

2016-03-01

In screening programmes there is recognized bias introduced through participant self-selection (the healthy screenee bias). Methods used to evaluate screening programmes include Intention-to-screen, per-protocol, and the "post hoc" approach in which, after introducing screening for everyone, the only evaluation option is participants versus non-participants. All methods are prone to bias through self-selection. We present an overview of approaches to correct for this bias. We considered four methods to quantify and correct for self-selection bias. Simple calculations revealed that these corrections are actually all identical, and can be converted into each other. Based on this, correction factors for further situations and measures were derived. The application of these correction factors requires a number of assumptions. Using as an example the German Neuroblastoma Screening Study, no relevant reduction in mortality or stage 4 incidence due to screening was observed. The largest bias (in favour of screening) was observed when comparing participants with non-participants. Correcting for bias is particularly necessary when using the post hoc evaluation approach, however, in this situation not all required data are available. External data or further assumptions may be required for estimation. © The Author(s) 2015.

Developing an appropriate digital hearing aid for low-resource countries: a case study.

PubMed

Israsena, P; Isaradisaikul, S; Noymai, A; Boonyanukul, S; Hemakom, A; Chinnarat, C; Navacharoen, N; Lekagul, S

2013-01-01

This paper reviews the development process and discusses the key findings which resulted from our multidisciplinary research team's effort to develop an alternative digital hearing suitable for low-resource countries such as Thailand. A cost-effective, fully programmable digital hearing aid, with its specifications benchmarking against WHO's recommendations, was systematically designed, engineered, and tested. Clinically it had undergone a full clinical trial that employed the outcome measurement protocol adopted from the APHAB, the first time implemented in Thai language. Results indicated that using the hearing aid improves user's satisfaction in terms of ease of communication, background noises, and reverberation, with clear benefit after 3 and 6 months, confirming its efficacy. In terms of engineering, the hearing aid also proved to be robust, passing all the designated tests. As the technology has successfully been transferred to a local company for the production phase, we also discuss other challenges that may arise before the device can be introduced into the market.

Concerns, perceived need and competing priorities: a qualitative exploration of decision-making and non-participation in a population-based flexible sigmoidoscopy screening programme to prevent colorectal cancer

PubMed Central

Hall, N; Birt, L; Rees, C J; Elliot, S; Ritchie, M; Weller, D; Rubin, G

2016-01-01

Objective Optimising uptake of colorectal cancer (CRC) screening is important to achieve projected health outcomes. Population-based screening by flexible sigmoidoscopy (FS) was introduced in England in 2013 (NHS Bowel scope screening). Little is known about reactions to the invitation to participate in FS screening, as offered within the context of the Bowel scope programme. We aimed to investigate responses to the screening invitation to inform understanding of decision-making, particularly in relation to non-participation in screening. Design Qualitative analysis of semistructured in-depth interviews and written accounts. Participants and setting People from 31 general practices in the North East and East of England invited to attend FS screening as part of NHS Bowel scope screening programme were sent invitations to take part in the study. We purposively sampled interviewees to ensure a range of accounts in terms of beliefs, screening attendance, sex and geographical location. Results 20 screeners and 25 non-screeners were interviewed. Written responses describing reasons for, and circumstances surrounding, non-participation from a further 28 non-screeners were included in the analysis. Thematic analysis identified a range of reactions to the screening invitation, decision-making processes and barriers to participation. These include a perceived or actual lack of need; inability to attend; anxiety and fear about bowel preparation, procedures or hospital; inability or reluctance to self-administer an enema; beliefs about low susceptibility to bowel cancer or treatment and understanding of harm and benefits. The strength, rather than presence, of concerns about the test and perceived need for reassurance were important in the decision to participate for screeners and non-screeners. Decision-making occurs within the context of previous experiences and day-to-day life. Conclusions Understanding the reasons for non-participation in FS screening can help inform strategies to improve uptake and may be transferable to other screening programmes. PMID:27836872

Looking for fungi in all the right places: screening for cryptococcal disease and other AIDS-related mycoses among patients with advanced HIV disease.

PubMed

Greene, Greg; Sriruttan, Charlotte; Le, Thuy; Chiller, Tom; Govender, Nelesh P

2017-03-01

As HIV treatment programmes scale up to meet the UNAIDS 90-90-90 goals, care must be taken to start antiretroviral treatment safely in patients with advanced disease (CD4 counts <200 cells/μl) who are simultaneously at risk for opportunistic infections and immune reconstitution inflammatory syndrome. Invasive fungal diseases pose a great threat at this critical time point, though the development of inexpensive and highly accurate rapid diagnostic tests has changed the approach HIV programmes are taking to reduce the high mortality associated with these opportunistic infections. This article summarizes recent advances and findings in fungal opportunistic infection diagnostics with a focus on screening to prevent cryptococcal meningitis. Cryptococcal antigen (CrAg) screening using a lateral flow assay platform is cost-effective and feasible to implement as either a laboratory reflex or point-of-care test. Recent CrAg screening pilots have elucidated the varying prevalence of cryptococcal antigenemia across geographic regions, which may aid programme planning. Evidence from recently completed clinical trials provides a strong motivation for the use of CrAg titer to refine treatment options for patients with subclinical cryptococcal disease. Although several operational barriers to programme effectiveness still need to be addressed, the utility of CrAg screening using inexpensive and accurate antigen assays has been demonstrated in real-world HIV programmes, paving the way for development and testing of other fungal opportunistic infection screening strategies and for an integrated advanced HIV disease testing package to reduce AIDS mortality and ensure safe antiretroviral treatment initiation.

Delayed diagnosis of childhood deafness: the value of false negatives in the Programme for Early Detection of Neonatal Hearing Loss.

PubMed

Martínez-Pacheco, María C; Ferrán de la Cierva, Luis; García-Purriños, Francisco J

Despite its importance, the existence of false negatives (patients who are told they hear well, but they have some degree of hipacusia) is rarely evaluated in programs for early detection of hearing loss. The aim of this study is to determine the variables that can lead to a delayed diagnosis, especially the existence of false negatives and the lack of registration of risk factors. A retrospective study of prevalence has been carried out, in which the medical records of children diagnosed with sensorineural hearing loss born within 2005 and 2012 in the health centers of study have been analyzed. Of the 32 children with sensorineural hearing loss, 16 passed the OAE, 12 did not passed the OAE, and in four they were not carried out. Of the children who passed the OAE, 57% have severe hearing loss. 66% of children with hearing loss presented a risk factor for hearing loss at birth, being the most frecuent family history of hearing loss, but only 7% of those with family history of hearing loss were included in the risk group. The results of the study indicate that the late diagnosis of hearing loss is related to the presence of false negatives to the OAE and the non-registration of risk factors. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

The West Midlands breast cancer screening status algorithm - methodology and use as an audit tool.

PubMed

Lawrence, Gill; Kearins, Olive; O'Sullivan, Emma; Tappenden, Nancy; Wallis, Matthew; Walton, Jackie

2005-01-01

To illustrate the ability of the West Midlands breast screening status algorithm to assign a screening status to women with malignant breast cancer, and its uses as a quality assurance and audit tool. Breast cancers diagnosed between the introduction of the National Health Service [NHS] Breast Screening Programme and 31 March 2001 were obtained from the West Midlands Cancer Intelligence Unit (WMCIU). Screen-detected tumours were identified via breast screening units, and the remaining cancers were assigned to one of eight screening status categories. Multiple primaries and recurrences were excluded. A screening status was assigned to 14,680 women (96% of the cohort examined), 110 cancers were not registered at the WMCIU and the cohort included 120 screen-detected recurrences. The West Midlands breast screening status algorithm is a robust simple tool which can be used to derive data to evaluate the efficacy and impact of the NHS Breast Screening Programme.

Cervical cancer screening in Europe: Quality assurance and organisation of programmes.

PubMed

Elfström, K Miriam; Arnheim-Dahlström, Lisen; von Karsa, Lawrence; Dillner, Joakim

2015-05-01

Cervical screening programmes have reduced cervical cancer incidence and mortality but the level of success is highly variable between countries. Organisation of programmes is essential for equity and cost-effectiveness. However, there are differences in effectiveness, also among organised programmes. In order to identify the key organisational components that determine effectiveness, we performed a Europe-wide survey on the current status of organisation and organised quality assurance (QA) measures in cervical cancer prevention programmes, as well as organisation-associated costs. A comprehensive questionnaire was developed through systematic review of literature and existing guidelines. The survey was sent to programme organisers, Ministries of Health and experts in 34 European Union (EU) and European Free Trade Agreement (EFTA) countries. Detailed aspects of programme organisation, quality assurance, monitoring, evaluation and corresponding line-item costs were recorded. Documentation of programme guidelines, protocols and publications was requested. Twenty-nine of 34 countries responded. The results showed that organised efforts for QA, monitoring and evaluation were carried out to a differing extent and were not standardised, making it difficult to compare the cost-effectiveness of organisation and QA strategies. Most countries found it hard to estimate the costs associated with launching and operating the organised programme. To our knowledge, this is the first questionnaire to request detailed information on the actual organisation and QA of programmes. The results of this survey can be used as a basis for further development of standardised guidelines on organisation and QA of cervical cancer screening programmes in Europe. Copyright © 2015 Elsevier Ltd. All rights reserved.

Prevalence and causes of hearing impairment in Fundong Health District, North-West Cameroon.

PubMed

Ferrite, Silvia; Mactaggart, Islay; Kuper, Hannah; Oye, Joseph; Polack, Sarah

2017-04-01

To estimate the prevalence and causes of hearing impairment in Fundong Health District, North-West Cameroon. We selected 51 clusters of 80 people (all ages) through probability proportionate to size sampling. Initial hearing screening was undertaken through an otoacoustic emission (OAE) test. Participants aged 4+ years who failed this test in both ears or for whom an OAE reading could not be taken underwent a manual pure-tone audiometry (PTA) screening. Cases of hearing impairment were defined as those with pure-tone average ≥41 dBHL in adults and ≥35 dBHL in children in the better ear, or children under age 4 who failed the OAE test in both ears. Each case with hearing loss was examined by an ear, nose and throat nurse who indicated the main likely cause. We examined 3567 (86.9%) of 4104 eligible people. The overall prevalence of hearing impairment was 3.6% (95% confidence interval [CI]: 2.8-4.6). The prevalence was low in people aged 0-17 (1.1%, 0.7-1.8%) and 18-49 (1.1%, 0.5-2.6%) and then rose sharply in people aged 50+ (14.8%, 11.7-19.1%). Among cases, the majority were classified as moderate (76%), followed by severe (15%) and profound (9%). More than one-third of cases of hearing impairment were classified as unknown (37%) or conductive (37%) causes, while sensorineural causes were less common (26%). Prevalence of hearing impairment in North-West Cameroon is in line with the WHO estimate for sub-Saharan Africa. The majority of cases with known causes are treatable, with impacted wax playing a major role. © 2017 John Wiley & Sons Ltd.

Self-reported hearing loss in baby boomers from the Busselton Healthy Ageing Study: audiometric correspondence and predictive value.

PubMed

Swanepoel, De Wet; Eikelboom, Robert H; Hunter, Michael L; Friedland, Peter L; Atlas, Marcus D

2013-06-01

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. To determine the clinical value and audiometric correspondence of self-reported hearing loss as a screening tool for the baby boomer population. A population-based study, Busselton Healthy Ageing Study (BHAS), surveying baby boomers born between 1946 and 1964 from the shire of Busselton, Western Australia. A randomized sample 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 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. Of the sample, 16% self-reported hearing loss (72.1% males). Logistic regression indicated 4000 Hz as the most important individual frequency related to self-report while the four-frequency average (500, 1000, 2000, and 4000 Hz) >25 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 >25 dB in the worse ear or a high-frequency average (4000 and 8000 Hz) hearing loss greater than 35 dB in the worse ear. 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. American Academy of Audiology.

Targeted surveillance for postnatal hearing loss: a program evaluation.

PubMed

Beswick, Rachael; Driscoll, Carlie; Kei, Joseph; Glennon, Shirley

2012-07-01

The importance of monitoring hearing throughout early childhood cannot be understated. However, there is a lack of evidence available regarding the most effective method of monitoring hearing following the newborn screen. The goal of this study was to describe a targeted surveillance program using a risk factor registry to identify children with a postnatal hearing loss. All children who were born in Queensland, Australia between September 2004 and December 2009, received a bilateral 'pass' on newborn hearing screening, and had at least one risk factor, were referred for targeted surveillance and were included in this study. The cohort was assessed throughout early childhood in accordance with Queensland's diagnostic assessment protocols. During the study period, 7320 (2.8% of 261,328) children were referred for targeted surveillance, of which 56 were identified with a postnatal hearing loss (0.77%). Of these, half (50.0%) were identified with a mild hearing loss, and 64.3% were identified with a sensorineural hearing loss. In regards to risk factors, syndrome, craniofacial anomalies, and severe asphyxia had the highest yield of positive cases of postnatal hearing loss for children referred for targeted surveillance, whereas, low birth weight, bacterial meningitis, and professional concern had a particularly low yield. Limitations of the targeted surveillance program were noted and include: (1) a lost contact rate of 32.4%; (2) delays in first surveillance assessment; (3) a large number of children who required on-going monitoring; and (4) extensive diagnostic assessments were completed on children with normal hearing. Examination of the lost contact rate revealed indigenous children were more likely to be documented as lost contact. In addition, children with one risk factor only were significantly more likely to not attend a surveillance appointment. Positive cases of postnatal hearing loss were detected through the targeted surveillance program. However, the limitations of the program question the usefulness of this service delivery model. For targeted surveillance to continue, time frames for assessment, assessments performed, and discharge criteria need to be revisited. The contribution of individual and combined risk factors in detecting postnatal hearing loss should also be examined in more detail. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

Preventing type 2 diabetes: systematic review of studies of cost-effectiveness of lifestyle programmes and metformin, with and without screening, for pre-diabetes

PubMed Central

Roberts, Samantha; Barry, Eleanor; Craig, Dawn; Airoldi, Mara; Bevan, Gwyn; Greenhalgh, Trisha

2017-01-01

Objective Explore the cost-effectiveness of lifestyle interventions and metformin in reducing subsequent incidence of type 2 diabetes, both alone and in combination with a screening programme to identify high-risk individuals. Design Systematic review of economic evaluations. Data sources and eligibility criteria Database searches (Embase, Medline, PreMedline, NHS EED) and citation tracking identified economic evaluations of lifestyle interventions or metformin alone or in combination with screening programmes in people at high risk of developing diabetes. The International Society for Pharmaco-economics and Outcomes Research’s Questionnaire to Assess Relevance and Credibility of Modelling Studies for Informing Healthcare Decision Making was used to assess study quality. Results 27 studies were included; all had evaluated lifestyle interventions and 12 also evaluated metformin. Primary studies exhibited considerable heterogeneity in definitions of pre-diabetes and intensity and duration of lifestyle programmes. Lifestyle programmes and metformin appeared to be cost effective in preventing diabetes in high-risk individuals (median incremental cost-effectiveness ratios of £7490/quality-adjusted life-year (QALY) and £8428/QALY, respectively) but economic estimates varied widely between studies. Intervention-only programmes were in general more cost effective than programmes that also included a screening component. The longer the period evaluated, the more cost-effective interventions appeared. In the few studies that evaluated other economic considerations, budget impact of prevention programmes was moderate (0.13%–0.2% of total healthcare budget), financial payoffs were delayed (by 9–14 years) and impact on incident cases of diabetes was limited (0.1%–1.6% reduction). There was insufficient evidence to answer the question of (1) whether lifestyle programmes are more cost effective than metformin or (2) whether low-intensity lifestyle interventions are more cost effective than the more intensive lifestyle programmes that were tested in trials. Conclusions The economics of preventing diabetes are complex. There is some evidence that diabetes prevention programmes are cost effective, but the evidence base to date provides few clear answers regarding design of prevention programmes because of differences in denominator populations, definitions, interventions and modelling assumptions. PMID:29146638

Newborn screening: new developments, new dilemmas.

PubMed

Kerruish, N J; Robertson, S P

2005-07-01

Scientific and technological advances are lending pressure to expand the scope of newborn screening. Whereas this has great potential for improving child health, it also challenges our current perception of such programmes. Standard newborn screening programmes are clearly justified by the fact that early detection and treatment of affected individuals avoids significant morbidity and mortality. However, proposals to expand the scope and complexity of such testing are not all supported by a similar level of evidence for unequivocal benefit. We argue that screening for genetic susceptibility to complex disorders is inherently different from standard screening and, while of potential value, must be considered separately from conventional testing.

Cost effectiveness of strategies to combat vision and hearing loss in sub-Saharan Africa and South East Asia: mathematical modelling study.

PubMed

Baltussen, Rob; Smith, Andrew

2012-03-02

To determine the relative costs, effects, and cost effectiveness of selected interventions to control cataract, trachoma, refractive error, hearing loss, meningitis and chronic otitis media. Cost effectiveness analysis of or combined strategies for controlling vision and hearing loss by means of a lifetime population model. Two World Health Organization sub-regions of the world where vision and hearing loss are major burdens: sub-Saharan Africa and South East Asia. Biological and behavioural parameters from clinical and observational studies and population based surveys. Intervention effects and resource inputs based on published reports, expert opinion, and the WHO-CHOICE database. Cost per disability adjusted life year (DALY) averted, expressed in international dollars ($Int) for the year 2005. Treatment of chronic otitis media, extracapsular cataract surgery, trichiasis surgery, treatment for meningitis, and annual screening of schoolchildren for refractive error are among the most cost effective interventions to control hearing and vision impairment, with the cost per DALY averted <$Int285 in both regions. Screening of both schoolchildren (annually) and adults (every five years) for hearing loss costs around $Int1000 per DALY averted. These interventions can be considered highly cost effective. Mass treatment with azithromycin to control trachoma can be considered cost effective in the African but not the South East Asian sub-region. Vision and hearing impairment control interventions are generally cost effective. To decide whether substantial investments in these interventions is warranted, this finding should be considered in relation to the economic attractiveness of other, existing or new, interventions in health.

High-frequency Audiometry Hearing on Monitoring of Individuals Exposed to Occupational Noise: A Systematic Review.

PubMed

Antonioli, Cleonice Aparecida Silva; Momensohn-Santos, Teresa Maria; Benaglia, Tatiana Aparecida Silva

2016-07-01

The literature reports on high-frequency audiometry as one of the exams used on hearing monitoring of individuals exposed to high sound pressure in their work environment, due to the method́s greater sensitivity in early identification of hearing loss caused by noise. The frequencies that compose the exam are generally between 9 KHz and 20KHz, depending on the equipment. This study aims to perform a retrospective and secondary systematic revision of publications on high-frequency audiometry on hearing monitoring of individuals exposed to occupational noise. This systematic revision followed the methodology proposed in the Cochrane Handbook, focusing on the question: "Is High-frequency Audiometry more sensitive than Conventional Audiometry in the screening of early hearing loss individuals exposed to occupational noise?" The search was based on PubMed data, Base, Web of Science (Capes), Biblioteca Virtual em Saúde (BVS), and in the references cited in identified and selected articles. The search resulted in 6059 articles in total. Of these, only six studies were compatible with the criteria proposed in this study. The performed meta-analysis does not definitively answer the study's proposed question. It indicates that the 16 KHz high frequency audiometry (HFA) frequency is sensitive in early identification of hearing loss in the control group (medium difference (MD = 8.33)), as well as the 4 KHz frequency (CA), this one being a little less expressive (MD = 5.72). Thus, others studies are necessary to confirm the HFA importance for the early screening of hearing loss on individuals exposed to noise at the workplace.

Intelligence and Academic Achievement With Asymptomatic Congenital Cytomegalovirus Infection.

PubMed

Lopez, Adriana S; Lanzieri, Tatiana M; Claussen, Angelika H; Vinson, Sherry S; Turcich, Marie R; Iovino, Isabella R; Voigt, Robert G; Caviness, A Chantal; Miller, Jerry A; Williamson, W Daniel; Hales, Craig M; Bialek, Stephanie R; Demmler-Harrison, Gail

2017-11-01

To examine intelligence, language, and academic achievement through 18 years of age among children with congenital cytomegalovirus infection identified through hospital-based newborn screening who were asymptomatic at birth compared with uninfected infants. We used growth curve modeling to analyze trends in IQ (full-scale, verbal, and nonverbal intelligence), receptive and expressive vocabulary, and academic achievement in math and reading. Separate models were fit for each outcome, modeling the change in overall scores with increasing age for patients with normal hearing ( n = 78) or with sensorineural hearing loss (SNHL) diagnosed by 2 years of age ( n = 11) and controls ( n = 40). Patients with SNHL had full-scale intelligence and receptive vocabulary scores that were 7.0 and 13.1 points lower, respectively, compared with controls, but no significant differences were noted in these scores among patients with normal hearing and controls. No significant differences were noted in scores for verbal and nonverbal intelligence, expressive vocabulary, and academic achievement in math and reading among patients with normal hearing or with SNHL and controls. Infants with asymptomatic congenital cytomegalovirus infection identified through newborn screening with normal hearing by age 2 years do not appear to have differences in IQ, vocabulary or academic achievement scores during childhood, or adolescence compared with uninfected children. Copyright © 2017 by the American Academy of Pediatrics.

Feasibility and acceptability of training community health workers in ear and hearing care in Malawi: a cluster randomised controlled trial.

PubMed

Mulwafu, Wakisa; Kuper, Hannah; Viste, Asgaut; Goplen, Frederik K

2017-10-11

To assess the feasibility and acceptability of training community health workers (CHWs) in ear and hearing care, and their ability to identify patients with ear and hearing disorders. Cluster randomised controlled trial (RCT). Health centres in Thyolo district, Malawi. Ten health centres participated, 5 intervention (29 CHWs) and 5 control (28 CHWs). Intervention CHWs received 3 days of training in primary ear and hearing care, while among control CHWs, training was delayed for 6 months. Both groups were given a pretest that assessed knowledge about ear and hearing care, only the intervention group was given the posttest on the third day of training. The intervention group was given 1 month to identify patients with ear and hearing disorders in their communities, and these people were screened for hearing disorders by ear, nose and throat clinical specialists. Primary outcome measure was improvement in knowledge of ear and hearing care among CHWs after the training. Secondary outcome measures were number of patients with ear or hearing disorders identified by CHWs and number recorded at health centres during routine activities, and the perceived feasibility and acceptability of the intervention. The average overall correct answers increased from 55% to 68% (95% CI 65 to 71) in the intervention group (p<0.001). A total of 1739 patients with potential ear and hearing disorders were identified by CHWs and 860 patients attended the screening camps, of whom 400 had hearing loss (73 patients determined through bilateral fail on otoacoustic emissions, 327 patients through audiometry). Where cause could be determined, the most common cause of ear and hearing disorders was chronic suppurative otitis media followed by impacted wax. The intervention was perceived as feasible and acceptable to implement. Training was effective in improving the knowledge of CHW in ear and hearing care in Malawi and allowing them to identify patients with ear and hearing disorders. This intervention could be scaled up to other CHWs in low-income and middle-income countries. Pan African Clinical Trial Registry (201705002285194); Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Use of Baby Isao Simulator and Standardized Parents in Hearing Screening and Parent Counseling Education.

PubMed

Alanazi, Ahmad A; Nicholson, Nannette; Atcherson, Samuel R; Franklin, Clifford; Anders, Michael; Nagaraj, Naveen; Franklin, Jennifer; Highley, Patricia

2016-09-01

The primary purpose of this study was to test the effect of the combined use of trained standardized parents and a baby simulator on students' hearing screening and parental counseling knowledge and skills. A one-group pretest-posttest quasi-experimental study design was used to assess self-ratings of confidence in knowledge and skills and satisfaction of the educational experience with standardized parents and a baby simulator. The mean age of the 14 audiology students participating in this study was 24.79 years (SD = 1.58). Participants completed a pre- and postevent questionnaire in which they rated their level of confidence for specific knowledge and skills. Six students (2 students in each scenario) volunteered to participate in the infant hearing screening and counseling scenarios, whereas others participated as observers. All participants participated in the briefing and debriefing sessions immediately before and after each of 3 scenarios. After the last scenario, participants were asked to complete a satisfaction survey of their learning experience using simulation and standardized parents. Overall, the pre- and post-simulation event questionnaire revealed a significant improvement in the participants' self-rated confidence levels regarding knowledge and skills. The mean difference between pre- and postevent scores was 0.52 (p < .01). The mean satisfaction level was 4.71 (range = 3.91-5.00; SD = 0.30) based on a Likert scale, where 1 = not satisfied and 5 = very satisfied. The results of this novel educational activity demonstrate the value of using infant hearing screening and parental counseling simulation sessions to enhance student learning. In addition, this study demonstrates the use of simulation and standardized parents as an important pedagogical tool for audiology students. Students experienced a high level of satisfaction with the learning experience.

Neonatal hearing screening in a neonatal intensive care unit using distortion-product otoacoustic emissions.

PubMed

Chiong, Charlotte M; Llanes, Erasmo Gonzalo Dv; Tirona-Remulla, Agnes N; Calaquian, Christopher Malorre E; Reyes-Quintos, Maria-Rina T

2003-01-01

To determine pass and refer rates, and identify risk factors relating to refer responses, in neonates screened using distortion-product otoacoustic emissions (DPOAEs). A total of 435 neonates admitted to the neonatal intensive care unit (NICU) of the Philippine General Hospital between May and October 2000 were screened using DPOAEs within 48 h of admission. The male:female ratio in the sample was 1.05. In total, 56% of neonates were born preterm, the mean birthweight was 2,428.39 +/- 710.39 g and 8.9% weighed < 1,500 g. In total, 47.9% were delivered by Caesarian section and 44.9% were delivered vaginally. Almost 14% of neonates had 1-min Apgar scores of < 6, and 4% had 5-min Apgar scores of < 7. Approximately 95% of neonates had a poor perinatal history. Using pediatric aging it was noted that 46% of these neonates were born preterm. and 30.4% were small for gestational age. At least one neonatal disease was found in 42% of neonates, whilst 95.7% had to be given medication. The bilateral refer rate was 29.1%. Two-by-two analysis of risk factors for hearing loss and DPOAE measurements showed that only male sex seemed to have a significant association with a refer response. Neonates weighing < 1,500 g at birth showed a marginally significant association with a refer response (p = 0.07). All other neonates showed no crude association with DPOAE measurements. These preliminary data show that a high proportion of NICU patients may have poor outer hair cell function, and thus poor hearing. In order to develop an effective neonatal hearing screening program, further studies of prevalence and risk factors should be pursued in the same setting.

Cost-benefit analysis of targeted hearing directed early testing for congenital cytomegalovirus infection.

PubMed

Bergevin, Anna; Zick, Cathleen D; McVicar, Stephanie Browning; Park, Albert H

2015-12-01

In this study, we estimate an ex ante cost-benefit analysis of a Utah law directed at improving early cytomegalovirus (CMV) detection. We use a differential cost of treatment analysis for publicly insured CMV-infected infants detected by a statewide hearing-directed CMV screening program. Utah government administrative data and multi-hospital accounting data are used to estimate and compare costs and benefits for the Utah infant population. If antiviral treatment succeeds in mitigating hearing loss for one infant per year, the public savings will offset the public costs incurred by screening and treatment. If antiviral treatment is not successful, the program represents a net cost, but may still have non-monetary benefits such as accelerated achievement of diagnostic milestones. The CMV education and treatment program costs are modest and show potential for significant cost savings. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Fish in a Dish: Drug Discovery for Hearing Habilitation.

PubMed

Esterberg, Robert; Coffin, Allison B; Ou, Henry; Simon, Julian A; Raible, David W; Rubel, Edwin W

2013-01-01

The majority of hearing loss is caused by the permanent loss of inner ear hair cells. The identification of drugs that modulate the susceptibility to hair cell loss or spur their regeneration is often hampered by the difficulties of assaying for such complex phenomena in mammalian models. The zebrafish has emerged as a powerful animal model for chemical screening in many contexts. Several characteristics of the zebrafish, such as its small size and external location of sensory hair cells, uniquely position it as an ideal model organism for the study of hair cell toxicity, protection, and regeneration. We have used this model to screen for drugs that affect each of these aspects of hair cell biology and have identified compounds that affect each of these processes. The identification of such drugs and drug-like compounds holds promise in the future ability to stem hearing loss in the human population.

Parent educational materials regarding the newborn hearing screening process.

PubMed

Krishnan, Lata A; Lawler, Breanne; Van Hyfte, Shannon

2017-04-01

Newborn hearing screening (NHS) procedures and implementation vary from state to state in the US. The purpose of this study was to evaluate the content and nature of information provided to parents about their infant's NHS across states to answer two questions: 1) what information is included in each state's parent information brochure? and 2) do the brochures include educational information requested by parents that may help reduce parental anxiety, improve satisfaction, and decrease the potential for misunderstandings? Each state's parent brochures and educational resources provided to parents were accessed via the National Center for Hearing Assessment and Management (NCHAM) website, categorized, and reviewed for content. Results indicate that the information provided to parents varies considerably across states and many brochures do not contain important information that is desired by parents. NHS procedures may be improved by providing standardized information regarding the process to parents in all states. Copyright © 2017 Elsevier B.V. All rights reserved.

Predicting the effectiveness of the Finnish population-based colorectal cancer screening programme.

PubMed

Chiu, Sherry Yueh-Hsia; Malila, Nea; Yen, Amy Ming-Fang; Chen, Sam Li-Sheng; Fann, Jean Ching-Yuan; Hakama, Matti

2017-12-01

Objective Because colorectal cancer (CRC) has a long natural history, estimating the effectiveness of CRC screening programmes requires long-term follow-up. As an alternative, we here demonstrate the use of a temporal multi-state natural history model to predict the effectiveness of CRC screening. Methods In the Finnish population-based biennial CRC screening programme using faecal occult blood tests (FOBT), which was conducted in a randomised health services study, we estimated the pre-clinical incidence, the mean sojourn time (MST), and the sensitivity of FOBT using a Markov model to analyse data from 2004 to 2007. These estimates were applied to predict, through simulation, the effects of five rounds of screening on the relative rate of reducing advanced CRC with 6 years of follow-up, and on the reduction in mortality with 10 years of follow-up, in a cohort of 500,000 subjects aged 60 to 69. Results For localised and non-localised CRC, respectively, the MST was 2.06 and 1.36 years and the sensitivity estimates were 65.12% and 73.70%. The predicted relative risk of non-localised CRC and death from CRC in the screened compared with the control population was 0.86 (95% CI: 0.79-0.98) and 0.91 (95% CI: 0.85-1.02), respectively. Conclusion Based on the preliminary results of the Finnish CRC screening programme, our model predicted a 9% reduction in CRC mortality and a 14% reduction in advanced CRC.

Identification of Childhood Disability in Jamaica: Evaluation of the Ten Question Screen.

ERIC Educational Resources Information Center

Thorburn, Marigold; And Others

1992-01-01

This study examined the internal validity and reasons for false positives for the Ten Question Screen (with and without probes), used by community workers in developing nations to assess type and severity of disability. Results support the use of the screen but only if paired with measurements of hearing and visual impairments. (DB)

Variation in cervical and breast cancer screening coverage in England: a cross-sectional analysis to characterise districts with atypical behaviour

PubMed Central

Massat, Nathalie J; Douglas, Elaine; Waller, Jo; Wardle, Jane; Duffy, Stephen W

2015-01-01

Objectives Reducing cancer screening inequalities in England is a major focus of the 2011 Department of Health cancer outcome strategy. Screening coverage requires regular monitoring in order to implement targeted interventions where coverage is low. This study aimed to characterise districts with atypical coverage levels for cervical or breast screening. Design Observational study of district-level coverage in the English Cervical and Breast screening programmes in 2012. Setting England, UK. Participants All English women invited to participate in the cervical (age group 25–49 and 50–64) and breast (age group 50–64) screening programmes. Outcomes Risk adjustment models for coverage were developed based on district-level characteristics. Funnel plots of adjusted coverage were constructed, and atypical districts examined by correlation analysis. Results Variability in coverage was primarily explained by population factors, whereas general practice characteristics had little independent effect. Deprivation and ethnicity other than white, Asian, black or mixed were independently associated with poorer coverage in both screening programmes, with ethnicity having the strongest effect; by comparison, the influence of Asian, black or mixed ethnic minority was limited. Deprivation, ethnicity and urbanisation largely accounted for the lower cervical screening coverage in London. However, for breast screening, being located in London remained a strong negative predictor. A subset of districts was identified as having atypical coverage across programmes. Correlates of deprivation in districts with relatively low adjusted coverage were substantially different from overall correlates of deprivation. Discussion These results inform the continuing drive to reduce avoidable cancer deaths in England, and encourage implementation of targeted interventions in communities residing in districts identified as having atypically low coverage. Sequential implementation to monitor the impact of local interventions would help accrue evidence on ‘what works’. PMID:26209119

A cross-sectional survey assessing factors associated with reading cancer screening information: previous screening behaviour, demographics and decision-making style.

PubMed

Ghanouni, Alex; Renzi, Cristina; Waller, Jo

2017-04-18

There is broad agreement that cancer screening invitees should know the risks and benefits of testing before deciding whether to participate. In organised screening programmes, a primary method of relaying this information is via leaflets provided at the time of invitation. Little is known about why individuals do not engage with this information. This study assessed factors associated with reading information leaflets provided by the three cancer screening programmes in England. A cross-sectional survey asked screening-eligible members of the general population in England about the following predictor variables: uptake of previous screening invitations, demographic characteristics, and 'decision-making styles' (i.e. the extent to which participants tended to make decisions in a way that was avoidant, rational, intuitive, spontaneous, or dependent). The primary outcome measures were the amount of the leaflet that participants reported having read at their most recent invitation, for any of the three programmes for which they were eligible. Associations between these outcomes and predictor variables were assessed using binary or ordinal logistic regression. After exclusions, data from 275, 309, and 556 participants were analysed in relation to the breast, cervical, and bowel screening programmes, respectively. Notable relationships included associations between regularity of screening uptake and reading (more of) the information leaflets for all programmes (e.g. odds ratio: 0.16 for participants who never/very rarely attended breast screening vs. those who always attended previously; p = .009). Higher rational decision-making scores were associated with reading more of the cervical and bowel screening leaflets (OR: 1.13, p < .0005 and OR: 1.11, p = .045, respectively). Information engagement was also higher for White British participants compared with other ethnic groups for breast (OR: 3.28, p = .008) and bowel (OR: 2.58, p = .015) information; an opposite relationship was observed for older participants (OR: 0.96, p = .048; OR: 0.92, p = .029). Interventions that increase screening uptake may also increase subsequent engagement with information. Future research could investigate how to improve engagement at initial invitations. There may also be scope to reduce barriers to accessing non-English information and alternative communication strategies may benefit participants who are less inclined to weigh up advantages and disadvantages as part of their decision-making.

Interobserver agreement between primary graders and an expert grader in the Bristol and Weston diabetic retinopathy screening programme: a quality assurance audit.

PubMed

Patra, S; Gomm, E M W; Macipe, M; Bailey, C

2009-08-01

To assess the quality and accuracy of primary grading in the Bristol and Weston diabetic retinopathy screening programme and to set standards for future interobserver agreement reports. A prospective audit of 213 image sets from six fully trained primary graders in the Bristol and Weston diabetic retinopathy screening programme was carried out over a 4-week period. All the images graded by the primary graders were regraded by an expert grader blinded to the primary grading results and the identity of the primary grader. The interobserver agreement between primary graders and the blinded expert grader and the corresponding Kappa coefficient was determined for overall grading, referable, non-referable and ungradable disease. The audit standard was set at 80% for interobserver agreement with a Kappa coefficient of 0.7. The interobserver agreement bettered the audit standard of 80% in all the categories. The Kappa coefficient was substantial (0.7) for the overall grading results and ranged from moderate to substantial (0.59-0.65) for referable, non-referable and ungradable disease categories. The main recommendation of the audit was to provide refresher training for the primary graders with focus on ungradable disease. The audit demonstrated an acceptable level of quality and accuracy of primary grading in the Bristol and Weston diabetic retinopathy screening programme and provided a standard against which future interobserver agreement can be measured for quality assurance within a screening programme. Diabet. Med. 26, 820-823 (2009).

Making sense of listening: the IMAP test battery.

PubMed

Barry, Johanna G; Ferguson, Melanie A; Moore, David R

2010-10-11

The ability to hear is only the first step towards making sense of the range of information contained in an auditory signal. Of equal importance are the abilities to extract and use the information encoded in the auditory signal. We refer to these as listening skills (or auditory processing AP). Deficits in these skills are associated with delayed language and literacy development, though the nature of the relevant deficits and their causal connection with these delays is hotly debated. When a child is referred to a health professional with normal hearing and unexplained difficulties in listening, or associated delays in language or literacy development, they should ideally be assessed with a combination of psychoacoustic (AP) tests, suitable for children and for use in a clinic, together with cognitive tests to measure attention, working memory, IQ, and language skills. Such a detailed examination needs to be relatively short and within the technical capability of any suitably qualified professional. Current tests for the presence of AP deficits tend to be poorly constructed and inadequately validated within the normal population. They have little or no reference to the presenting symptoms of the child, and typically include a linguistic component. Poor performance may thus reflect problems with language rather than with AP. To assist in the assessment of children with listening difficulties, pediatric audiologists need a single, standardized child-appropriate test battery based on the use of language-free stimuli. We present the IMAP test battery which was developed at the MRC Institute of Hearing Research to supplement tests currently used to investigate cases of suspected AP deficits. IMAP assesses a range of relevant auditory and cognitive skills and takes about one hour to complete. It has been standardized in 1500 normally-hearing children from across the UK, aged 6-11 years. Since its development, it has been successfully used in a number of large scale studies both in the UK and the USA. IMAP provides measures for separating out sensory from cognitive contributions to hearing. It further limits confounds due to procedural effects by presenting tests in a child-friendly game-format. Stimulus-generation, management of test protocols and control of test presentation is mediated by the IHR-STAR software platform. This provides a standardized methodology for a range of applications and ensures replicable procedures across testers. IHR-STAR provides a flexible, user-programmable environment that currently has additional applications for hearing screening, mapping cochlear implant electrodes, and academic research or teaching.

Colorectal cancer screening programme by faecal occult blood test in Tuscany: first round results.

PubMed

Grazzini, G; Castiglione, G; Ciabattoni, C; Franceschini, F; Giorgi, D; Gozzi, S; Mantellini, P; Lopane, P; Perco, M; Rubeca, T; Salvadori, P; Visioli, C B; Zappa, M

2004-02-01

Screening with faecal occult blood test (FOBT) has been shown to be effective in reducing mortality from colorectal cancer. Tuscany was the first region in Italy in which a screening programme for colorectal cancer by FOBT was initiated region-wide. The aim of the paper was to describe organizational aspects, a quality control model and the results of this experience. From June 2000 to December 2001, 192583 subjects aged 50-70 were invited to undergo a 1-day immunochemical test without any dietary restriction. A total of 78505 subjects (41%) performed the screening test, of whom 4537 responders had a positive test result (5.8%). Among them, 1122 refused any form of assessment or underwent a colonoscopy outside the screening referral centres, with an overall assessment compliance of 75.3%. Malignancies were found in 193 patients and at least a high-risk adenomatous polyp in 692 patients. In about a quarter of the positive subjects who underwent assessment, cancer or high-risk adenoma was detected. In conclusion, data from this experience supported the feasibility of biennial colorectal screening programme by FOBT, particularly regarding invitation compliance and positivity rate. Further efforts are necessary to implement screening extension and to improve data collection.

The Envoy® Totally Implantable Hearing System, St. Croix Medical

PubMed Central

Kroll, Kai; Grant, Iain L.; Javel, Eric

2002-01-01

The Totally Implantable Envoy® System is currently undergoing clinical trials in both the United States and Europe. The fully implantable hearing device is intended for use in patients with sensorineural hearing loss. The device employs piezoelectric transducers to sense ossicle motion and drive the stapes. Programmable signal processing parameters include amplification, compression, and variable frequency response. The fully implantable attribute allows users to take advantage of normal external ear resonances and head-related transfer functions, while avoiding undesirable earmold effects. The high sensitivity, low power consumption, and high fidelity attributes of piezoelectric transducers minimize acoustic feedback and maximize battery life (Gyo, 1996; Yanagihara, (1987) and 2001). The surgical procedure to install the device has been accurately defined and implantation is reversible. PMID:25425915

(De)stigmatizing the silent epidemic: representations of hearing loss in entertainment television.

PubMed

Foss, Katherine A

2014-01-01

The number of adolescents, young adults, and senior citizens experiencing hearing loss has significantly increased over the last 30 years. Despite this prevalence, hearing loss receives little attention in popular and political discourse, except in its connection to aging. Thus, hearing loss and the use of hearing aids have been stigmatized, discouraging adults from seeking hearing evaluation and screening, and justifying the lack of insurance coverage for hearing devices. This research explored how and why hearing loss continues to be stigmatized through a study of media messages about hearing loss. A textual analysis was conducted on 276 television episodes that involved d/Deaf characters and/or storylines about hearing loss and deafness from 1987 through 2013 (see Table 1). Only 11 fictional programs addressed the experience of hearing loss through 47 episodes, including Criminal Minds, Switched at Birth, House, M.D., and New Girl. Contrary to the assumption that hearing loss exclusively impacts older people, characters were typically young, attractive, working professionals who held prominent roles in the programs. For most characters, hearing loss developed suddenly and was restored by the end of the episode, with only four characters using hearing aids. Hearing loss was depicted as comical, embarrassing, lonely, and threatening to one's work. The scarcity of hearing loss portrayals, combined with the negative representations of hearing loss, could help explain why hearing loss continues to be stigmatized and overlooked, even though almost half of all Americans will eventually experience difficulty hearing.

Recurrent variants in OTOF are significant contributors to prelingual nonsydromic hearing loss in Saudi patients

PubMed Central

Almontashiri, Naif A M; Alswaid, Abdulrahman; Oza, Andrea; Al-Mazrou, Khalid A; Elrehim, Omnia; Tayoun, Ahmad Abou; Rehm, Heidi L; Amr, Sami S

2018-01-01

Purpose Hearing loss is more prevalent in the Saudi Arabian population than in other populations; however, the full range of genetic etiologies in this population is unknown. We report the genetic findings from 33 Saudi hearing-loss probands of tribal ancestry, with predominantly prelingual severe to profound hearing loss. Methods Testing was performed over the course of 2012–2016, and involved initial GJB2 sequence and GJB6-D13S1830 deletion screening, with negative cases being reflexed to a next-generation sequencing panel with 70, 71, or 87 hearing-loss genes. Results A “positive” result was reached in 63% of probands, with two recurrent OTOF variants (p.Glu57* and p.Arg1792His) accountable for a third of all “positive” cases. The next most common cause was pathogenic variants in MYO7A and SLC26A4, each responsible for three “positive” cases. Interestingly, only one “positive” diagnosis had a DFNB1-related cause, due to a homozygous GJB6-D13S1830 deletion, and no sequence variants in GJB2 were detected. Conclusion Our findings implicate OTOF as a potential major contributor to hearing loss in the Saudi population, while highlighting the low contribution of GJB2, thus offering important considerations for clinical testing strategies for Saudi patients. Further screening of Saudi patients is needed to characterize the genetic spectrum in this population. PMID:29048421

Apps for Hearing Science and Care.

PubMed

Paglialonga, Alessia; Tognola, Gabriella; Pinciroli, Francesco

2015-09-01

Our research aims at the identification and assessment of applications (referred to as apps) in the hearing health care domain. This research forum article presents an overview of the current availability, affordability, and variety of hearing-related apps. The available apps were reviewed by searching on the leading platforms (iOS, Android, Windows Phone stores) using the keywords hearing, audiology, audio, auditory, speech, language, tinnitus, hearing loss, hearing aid, hearing sys tem, cochlear implant, implantable device, auditory training, hearing rehabilitation, and assistive technology/tool/device. O n the bas is of the offered services, apps were classified into 4 application domains: (a) screening and assessment, (b) intervention and rehabilitation, (c) education and information, and (d) assistive tools. A large variety of apps are available in the hearing health care domain. These cover a wide range of services for people with hearing or communication problems as well as for hearing professionals, families, or informal caregivers. This evolution can potentially bring along considerable advantages and improved outcomes in the field of hearing health care. Nevertheless, potential risks and threats (e.g., safety, quality, effectiveness, privacy, and regulation) should not be overlooked. Significant research—particularly in terms of assessment and guidance—is still needed for the informed, aware, and safe adoption of hearing-related apps by patients and professionals.

The Need for Improved Detection and Management of Adult-Onset Hearing Loss in Australia

PubMed Central

McMahon, Catherine M.; Gopinath, Bamini; Schneider, Julie; Reath, Jennifer; Hickson, Louise; Leeder, Stephen R.; Mitchell, Paul; Cowan, Robert

2013-01-01

Adult-onset hearing loss is insidious and typically diagnosed and managed several years after onset. Often, this is after the loss having led to multiple negative consequences including effects on employment, depressive symptoms, and increased risk of mortality. In contrast, the use of hearing aids is associated with reduced depression, longer life expectancy, and retention in the workplace. Despite this, several studies indicate high levels of unmet need for hearing health services in older adults and poor use of prescribed hearing aids, often leading to their abandonment. In Australia, the largest component of financial cost of hearing loss (excluding the loss of well-being) is due to lost workplace productivity. Nonetheless, the Australian public health system does not have an effective and sustainable hearing screening strategy to tackle the problem of poor detection of adult-onset hearing loss. Given the increasing prevalence and disease burden of hearing impairment in adults, two key areas are not adequately met in the Australian healthcare system: (1) early identification of persons with chronic hearing impairment; (2) appropriate and targeted referral of these patients to hearing health service providers. This paper reviews the current literature, including population-based data from the Blue Mountains Hearing Study, and suggests different models for early detection of adult-onset hearing loss. PMID:23710184

Real-Time Transliteration of Speech into Print for Hearing-Impaired Students in Regular Classes.

ERIC Educational Resources Information Center

Stuckless, E. Ross

1983-01-01

A system is described whereby a stenotypist records the classroom instructor's and students' speech which a computer then translates to words on the screen for hearing impaired postsecondary students. Initial results include a high degree of verbatim accuracy, support for real-time operation, and several technical problems including lack of…

Predictors of Early-Onset Permanent Hearing Loss in Malnourished Infants in Sub-Saharan Africa

ERIC Educational Resources Information Center

Olusanya, Bolajoko O.

2011-01-01

The objective of this study was to determine the predictors of early-onset permanent hearing loss (EPHL) among undernourished infants in a low-income country where routine screening for developmental disabilities in early childhood is currently unattainable. All infants attending four community-based clinics for routine immunization who met the…

Language Planning for the 21st Century: Revisiting Bilingual Language Policy for Deaf Children

ERIC Educational Resources Information Center

Knoors, Harry; Marschark, Marc

2012-01-01

For over 25 years in some countries and more recently in others, bilingual education involving sign language and the written/spoken vernacular has been considered an essential educational intervention for deaf children. With the recent growth in universal newborn hearing screening and technological advances such as digital hearing aids and…

Future Directions for EHDI Programs: Recommendations from a Strategic Analysis

ERIC Educational Resources Information Center

Bradham, Tamala S.; Houston, K. Todd

2011-01-01

Over the past 20 years, tremendous strides have been made in establishing and strengthening early hearing detection and intervention (EHDI) programs in all 50 states and the U.S. territories. Although EHDI programs have become more robust, considerable work remains to ensure that all children who do not pass a hearing screening receive the…

The Roller-Coaster of Experiences: Becoming the Parent of a Deaf Child

ERIC Educational Resources Information Center

Bosteels, Sigrid; Van Hove, Geert; Vandenbroeck, Michel

2012-01-01

When early testing indicates a hearing loss, parents find themselves on a roller-coaster of experiences leaving little time or space for reflection. This study is based on interviews with families in the Flemish region of Belgium, one of the earliest in the world to introduce universal neonatal screening for hearing loss. Starting from a…

[Individualised parent counselling in paediatric practices for the reduction of second-hand smoke exposure of their children: a feasibility study].

PubMed

Haug, S; Biedermann, A; Ulbricht, S; John, U

2015-05-01

The aim of this study was to test the feasibility of a web-based programme provided by paediatric practices for counselling parents to reduce second-hand smoke exposure of their children. Accompanying persons of children were systematically screened concerning tobacco smoking at their home in 2 Swiss paediatric practices. They were invited for programme participation if they or their partners smoked at home regularly. The web-based programme provided at least 1 computer-tailored counselling letter. Upto 3 additional counselling letters could be requested online by the participants over a period of 3 months. The letters were tailored according to the indoor smoking behaviour of the parents and considered individual barriers and resources for the establishment of a smoke-free home. Additionally, further information and advice could be requested on the programme website. Feasibility indicators were the participation rate, programme use, and programme evaluation by the participants. 3 055 (82.3%) of 3 712 accompanying persons of children in the paediatric practices were screened concerning tobacco smoking at their home. 96 (56.8%) of 169 eligible persons participated in the programme. 68 (70.8%) of the 96 programme participants could be reassessed at post assessment. 9 (15.0%) of 60 participants who provided a valid e-mail address requested more than one counselling letter. The counselling letters and the web-based programme were evaluated positively by the programme participants. Systematic screening combined with the provision of individually tailored counselling letters for parents to reduce second-hand smoke exposure of their children was feasible in paediatric practices. Possible strategies to in-crease the use and reach of the programme are -discussed. © Georg Thieme Verlag KG Stuttgart · New York.

Health workforce planning and service expansion during an economic crisis: A case study of the national breast screening programme in Ireland.

PubMed

McHugh, S M; Tyrrell, E; Johnson, B; Healy, O; Perry, I J; Normand, C

2015-12-01

This article aims to estimate the workforce and resource implications of the proposed age extension of the national breast screening programme, under the economic constraints of reduced health budgets and staffing levels in the Irish health system. Using a mixed method design, a purposive sample of 20 participants were interviewed and data were analysed thematically (June-September 2012). Quantitative data (programme-level activity data, screening activity, staffing levels and screening plans) were used to model potential workload and resource requirements. The analysis indicates that over 90% operational efficiency was achieved throughout the first six months of 2012. Accounting for maternity leave (10%) and sick leave (3.5%), 16.1 additional radiographers (whole time equivalent) would be required for the workload created by the age extension of the screening programme, at 90% operational efficiency. The results suggest that service expansion is possible with relatively minimal additional radiography resources if the efficiency of the skill mix and the use of equipment are improved. Investing in the appropriate skill mix should not be limited to clinical groups but should also include administrative staff to manage and support the service. Workload modelling may contribute to improved health workforce planning and service efficiency. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Screening for infectious diseases of asylum seekers upon arrival: the necessity of the moral principle of reciprocity.

PubMed

Beeres, Dorien T; Cornish, Darren; Vonk, Machiel; Ravensbergen, Sofanne J; Maeckelberghe, Els L M; Boele Van Hensbroek, Pieter; Stienstra, Ymkje

2018-03-02

With a large number of forcibly displaced people seeking safety, the EU is facing a challenge in maintaining solidarity. Europe has seen millions of asylum seekers crossing European borders, the largest number of asylum seekers since the second world war. Endemic diseases and often failing health systems in their countries of origin, and arduous conditions during transit, raise questions around how to meet the health needs of this vulnerable population on arrival in terms of screening, vaccination, and access to timely and appropriate statutory health services. This paper explores the potential role of the principle of reciprocity, defined as the disposition 'to return good in proportion to the good we receive, and to make reparations for the harm we have done', as a mid-level principle in infectious disease screening policies. More than half of the European countries implemented screening programmes for newly arrived asylum seekers. Screening may serve to avoid potential infectious disease risks in the receiving countries as well as help identify health needs of asylum seekers. But screening may infringe upon basic rights of those screened, thus creating an ethical dilemma. The use of the principle of reciprocity can contribute to the identification of potential improvements for current screening programmes and emphasizes the importance of certain rights into guidelines for screening. It may create a two way moral obligation, upon asylum seekers to actively participate in the programme, and upon authorities to reciprocate the asylum seekers' participation and the benefits for the control of public health. The authors argue that the reciprocity principle leads to a stronger ethical justification of screening programmes and help achieve a balance between justifiable rights claims of the host population and the asylum seekers. The principle deserves a further and more thorough exploration of its potential use in the field of screening, migration and infectious diseases.

Cost-effectiveness of community screening for glaucoma in rural India: a decision analytical model.

PubMed

John, D; Parikh, R

2018-02-01

Studies in several countries have demonstrated the cost-effectiveness of population-based screening for glaucoma when targeted at high-risk groups such as older adults and with familial history of disease. This study conducts a cost-effective analysis of a hypothetical community screening and subsequent treatment programme in comparison to opportunistic case finding for glaucoma in rural India. A hypothetical screening programme for both primary open-angle glaucoma and angle-closure disease was built for a population aged between 40 and 69 years in rural areas of India. A decision analytical model was built to model events, costs and treatment pathways with and without a hypothetical screening programme for glaucoma for a rural-based population aged between 40 and 69 years in India. The treatment pathway included both primary open-angle glaucoma and angle-closure disease. The data on costs of screening and treatment were provided by an administrator of a tertiary eye hospital in Eastern India. The probabilities for the screening and treatment pathway were derived from published literature and a glaucoma specialist. The glaucoma prevalence rates were adapted from the Chennai Glaucoma Study findings. An incremental cost-effectiveness ratio value of ₹7292.30 per quality-adjusted life-year was calculated for a community-screening programme for glaucoma in rural India. The community screening for glaucoma would treat an additional 2872 cases and prevent 2190 person-years of blindness over a 10-year period. Community screening for glaucoma in rural India appears to be cost-effective when judged by a ratio of willingness-to-pay thresholds as per WHO-CHOICE guidelines. For community screening to be cost-effective, adequate resources, such as trained medical personnel and equipment would need to be made available. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

A Community Jury on PSA screening: what do well-informed men want the government to do about prostate cancer screening--a qualitative analysis.

PubMed

Rychetnik, Lucie; Doust, Jenny; Thomas, Rae; Gardiner, Robert; Mackenzie, Geraldine; Glasziou, Paul

2014-04-30

Cancer screening policies and programmes should take account of public values and concerns. This study sought to determine the priorities, values and concerns of men who were 'fully informed' about the benefits and harms of prostate-specific antigen (PSA) screening; and empirically examine the value of a community jury in eliciting public values on PSA screening. Community jury was convened on the Gold Coast, Queensland (Australia) to consider PSA screening benefits and harms, and whether government campaigns on PSA screening should be conducted. 27 men (volunteers) aged 50-70 with no personal history of prostate cancer and willing to attend jury 6-7 April 2013: 12 were randomly allocated to jury (11 attended). A qualitative analysis was conducted of the jury deliberations (audio-recorded and transcribed) to elicit the jury's views and recommendations. A survey determined the impact of the jury process on participants' individual testing decisions compared with control group. The jury concluded governments should not invest in programmes focused on PSA screening directed at the public because the PSA test did not offer sufficient reassurance or benefit and could raise unnecessary alarm. It recommended an alternative programme to support general practitioners to provide patients with better quality and more consistent information about PSA screening. After the jury, participants were less likely to be tested in the future compared with the controls, but around half said they would still consider doing so. The jury's unanimous verdict about government programmes was notable in the light of their divergent views on whether or not they would be screened themselves in the future. Community juries provide valuable insights into the priorities and concerns of men weighing up the benefits and harms of PSA screening. It will be important to assess the degree to which the findings are generalisable to other settings.

Bilateral versus unilateral hearing aids for bilateral hearing impairment in adults.

PubMed

Schilder, Anne Gm; Chong, Lee Yee; Ftouh, Saoussen; Burton, Martin J

2017-12-19

Acquired hearing loss is common and its incidence increases markedly with age. In most people, 'age-related' hearing loss is sensorineural (due to the loss of cochlear hair cells) and bilateral, affecting both ears to the same degree. Hearing loss categorised as mild, moderate or severe is primarily managed with hearing aids. People with bilateral hearing loss may be offered one aid, fitted to one specific ear, or two aids fitted to both ears. There is uncertainty about the relative benefits to people with hearing loss of these different strategies. To assess the effects of bilateral versus unilateral hearing aids in adults with a bilateral hearing impairment. The Cochrane ENT Information Specialist searched the ENT Trials Register; Cochrane Register of Studies Online; PubMed; Ovid Embase; CINAHL; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 8 June 2017. Randomised controlled trials (RCTs) comparing the fitting of two versus one ear-level acoustic hearing aids in adults (over 18 years) with a bilateral hearing impairment, both ears being eligible for hearing aids. We used the standard methodological procedures expected by Cochrane. Our primary outcomes were patient preference for bilateral or unilateral aids, hearing-specific health-related quality of life and adverse effects (pain or discomfort in the ear, initiation or exacerbation of middle or outer ear infection). Secondary outcomes included: usage of hearing aids (as measured by, for example, data logging or battery consumption), generic health-related quality of life, listening ability and audiometric benefit measured as binaural loudness summation. We used GRADE to assess the quality of the evidence for each outcome; this is indicated in italics. We included four cross-over RCTs with a total of 209 participants, ranging in age from 23 to 85 and with a preponderance of men. All the studies allowed the use of hearing aids for a total period of at least eight weeks before questions on preference were asked. All studies recruited patients with bilateral hearing loss but there was considerable variation in the types and degree of sensorineural hearing loss that the participants were experiencing.Three of the studies were published before the mid-1990s whereas the fourth study was published in 2011. Therefore, only the most recent study used hearing aids incorporating technology comparable to that currently readily available in high-income settings. Of the four studies, two were conducted in the UK in National Health Service (NHS - public sector) patients: one recruited patients from primary care with hearing loss detected by a screening programme whereas the other recruited patients who had been referred by their primary care practitioner to an otolaryngology department for hearing aids. The other two studies were conducted in the United States: one study recruited only military personnel or veterans with noise-induced hearing loss whereas about half of the participants in the other study were veterans.Only one primary outcome (patient preference) was reported in all studies. The percentage of patients who preferred bilateral hearing aids varied between studies: this was 54% (51 out of 94 participants), 39% (22 out of 56), 55% (16 out of 29) and 77% (23 out of 30), respectively. We have not combined the data from these four studies. The evidence for this outcome is of very low quality.The other outcomes of interest were not reported in the included studies. This review identified only four studies comparing the use of one hearing aid with two. The studies were small and included participants of widely varying ages. There was also considerable variation in the types and degree of sensorineural hearing loss that the participants were experiencing.For the most part, the types of hearing aid evaluated would now be regarded, in high-income settings, as 'old technology', with only one study looking at 'modern' digital aids. However, the relevance of this is uncertain, as this review did not evaluate the differences in outcomes between the different types of technology.We were unable to pool data from the four studies and the very low quality of the evidence leads us to conclude that we do not know if people with hearing loss have a preference for one aid or two. Similarly, we do not know if hearing-specific health-related quality of life, or any of our other outcomes, are better with bilateral or unilateral aids.

Universal neonatal hearing screening program in Shanghai, China: An inter-regional and international comparison.

PubMed

Fang, Xingang; Li, Xi; Zhang, Qi; Wan, Jin; Sun, Mei; Chang, Fengshui; Lü, Jun; Chen, Gang

2016-11-01

By comparing the Universal Neonatal Hearing Screening (UNHS) program as implemented in Shanghai and other regions in China and countries around the world, this study makes an assessment of the Shanghai model and summarizes the experiences implementing the UNHS program, so as to provide a valuable reference for other countries or regions to carry out UNHS more effectively. Since Shanghai is one of the most developed regions in China, we also examined the relationship between economic development and the UNHS starting year and coverage rate. The study conducted a systematic review of published studies in Chinese and English on the program status of neonatal hearing screening to compare and analyze the implementation of the UNHS program in 20 cities or provinces in China and 24 regions or countries around the world. The literature search in Chinese was conducted in the three most authoritative publication databases, CNKI (China National Knowledge Infrastructure), WANFANGDATA, and CQVIP (http://www.cqvip.com/). We searched all publications in those databases with the keywords "neonatal hearing screening" (in Chinese) between 2005 and 2014. English literature was searched using the same keywords (in English). The publication database included Medline and Web of Science, and the search time period was 2000-2014. Shanghai was one of the first regions in China to implement UNHS, and its coverage rate was among the top regions by international comparison. The starting time of the UNHS program had no relationship with the Gross Domestic Product (GDP) per capita in the same year. Economic level serves as a threshold for carrying out UNHS but is not a linear contributor to the exact starting time of such a program. The screening coverage rate generally showed a rising trend with the increasing GDP per capita in China, but it had no relationship with the area's GDP per capita in selected regions and countries around the world. The system design of UNHS is the key factor influencing screening coverage. Policy makers, program administrators, and cost-sharing structures are important factors that influence the coverage rates of UNHS. When to carry out a UNHS program is determined by the willingness and preference of the local government, which is influenced by the area's social, political and cultural conditions. Mandatory hearing screening and minimal-cost to no-cost intervention are two pillars for a good coverage rate of UNHS. In terms of system design, decision-making, implementation, funding and the concrete implementation plan are all important factors affecting the implementation of the UNHS. Copyright © 2016 The Author(s). Published by Elsevier Ireland Ltd.. All rights reserved.

Screening, Education, and Rehabilitation Services for Hearing Loss Provided to Clients with Low Vision: Measured and Perceived Value Among Participants of the Vision-Hearing Project.

PubMed

McMahon, Catherine M; Schneider, Julie; Dunsmore, Moira; Gopinath, Bamini; Kifley, Annette; Mitchell, Paul; Wang, Jie-Jin; Leeder, Stephen R

Combined vision and hearing impairment, termed dual sensory impairment (DSI), is associated with poorer health outcomes compared with a single sensory loss alone. Separate systems of care exist for visual and hearing impairment which potentially limit the effectiveness of managing DSI. To address this, a Hearing Screening Education Model (HSEM) was offered to older adults attending a low-vision clinic in Australia within this pilot study. The present study aimed to evaluate the benefits of seeking help on hearing handicap, self-perceived health, and use of community services among those identified with unmet hearing needs after participation in the HSEM. Of 210 older adults (>55 years of age) who completed the HSEM and were referred for follow-up, 169 returned for a follow-up interview at least 12 months later. Of these, 68 (40.2%) sought help, and the majority were seen by a hearing healthcare provider (89.7%). Changes in hearing handicap, quality of life, and reliance on community services between the baseline and 12-month follow-up were compared between those who sought help and those who did not. In addition, the perceived value of the HSEM was assessed. Results showed that there was no significant difference in hearing handicap between those who sought help (mean change -1.02 SD = 7.97, p = 0.3) and those who did not (mean change 0.94 SD = 7.68, p = 0.3), p = 0.18. The mental component of the SF-36 worsened significantly between baseline and follow-up measures across the whole group (mean change -2.49 SD = 9.98, p = 0.002). This was largely driven by those not seeking help, rather than those seeking help, but was not significantly different between the two groups. Those who sought help showed a significant reduction in the use of community services compared with those who did not. Further, all participants positively viewed the HSEM's underlying principle of greater integration between vision and hearing services. These findings suggest a need to further develop and evaluate integrated models of healthcare for older adults with DSI. It also highlights the importance of using broader measures of benefit, other than use of hearing aids to evaluate outcomes of hearing healthcare programs.

Preschool vision screening.

PubMed Central

Jarvis, S N; Tamhne, R C; Thompson, L; Francis, P M; Anderson, J; Colver, A F

1991-01-01

Although a good case for preschool screening for vision defects can be made there is very little evidence that existing programmes are effective in practice. A comparative trial of three different methods of preschool vision screening is described. Some 7000 children initially aged 5 months (younger cohorts) and 30 months (older cohorts) in three matched areas entered the trial during 1987. During 18 months of follow up new visual and ocular defects among these children were ascertained through ophthalmology outpatients and from optician records. Screening at 35 months by an orthoptist based in the community is superior to conventional health visitor surveillance at 30 months and to an agreed programme of primary care screening for squint at 30-36 months as judged by screening sensitivity (100% v 50% v 50%) and the incidence of treated target conditions (17 v 3 v 5 per 1000 person years). A notable feature in the area served by the orthoptist is that 13 children received treatment for straight eyed visual acuity loss from among 1000 children whereas there were no such cases among 2500 in the comparison areas. In the younger cohorts (that is, screening at age 5-9 months) all three programmes showed equally poor results, only one of the eight treated target conditions arising from all 3500 younger children being screen detected. PMID:2025002

Health care screening for people with mental handicap living in the community.

PubMed Central

Wilson, D N; Haire, A

1990-01-01

OBJECTIVE--To determine what contact people with mental handicap had had with their general practitioner in the previous year; what prescribed drugs they were taking and whether these had been reviewed; when hearing and vision had last been screened; and what medical problems were found on examination. DESIGN--Case series. SETTING-Day centre for adults with mental handicap. SUBJECTS--A balanced sample of 75 of the 150 people attending the day centre. 10 Were excluded because consent was not given. RESULTS--The subjects did not consult their general practitioners more frequently than the general population but were more likely to be taking prescribed drugs, and 57% of these prescriptions had not been reviewed by a doctor. Thirty three people failed vision screening, including 13 who wore glasses. Twenty seven of the 62 who were testable had a hearing impairment. CONCLUSIONS--As only eight out of 65 people examined in the study did not have an appreciable problem brought to light, screening seems to be worth while. Whether such screening needs to be done by a medically qualified person needs further research. PMID:2148703

Evaluation of the localization auditory screening test in children 6-18 months of age.

PubMed

Tillis, C H; Grimm, W A

1978-01-01

The present paper is a report of a project to develop an automated auditory screening test for infants six to 18 months of age. The first year of the project was devoted to developing equipment and test procedures; the second year was concerned with testing the effectiveness of the equipment and procedures on an actual population of six to 18 month old infants. Two-hundred and fifty infants were screened auditorily as part of a county health department child development clinic. The pass/fail results of the screening test were evaluated in terms of physical and developmental examination following the screening and by means of a case review of the child's previous history. The results indicate that the procedure under investigation can be used to differentiate the normal hearing infant from the infant with possible hearing problems. It is shown by the test environment in which this study was conducted that the procedure reported can be successfully incorporated into a public health program, i.e., child development clinics or EPSDT programs.

[Subsidized project of hearing aid purchase for mild-moderate hearing impaired children in Akita prefecture].

PubMed

Sato, Teruyuki; Nakazawa, Misao; Takahashi, Shin; Ishikawa, Kazuo

2013-06-01

The dissemination of newborn hearing screening has detected children with mild-moderate hearing impairment at an early age. However, there is no nation-wide welfare system for children with mild-moderate hearing impairment in Japan. Under these kinds of social conditions, a subsidized project of hearing aid purchase for mild-moderate hearing impaired children has come into force from April 2010 in Akita prefecture. All 18 candidates who applied for this project were subsidized in Akita prefecture. Eighteen children purchased their hearing aids using this subsidy. The feature of this project was that every child could have access to subsidies as long as their doctor recognized the effectiveness of hearing aids because children with hearing impairment need to learn language. They contacted the hospital, prefectural government and institutes related to hearing loss before this project come into force. We recognized parents who are raising a child with mild-moderate hearing impairment have high interest in this project. Hearing aids can represent a considerable expense for young parents who are raising a child. We encountered some children who had to give up the idea of hearing aids due to their parents' economic circumstances before this project become effective. These situations were completely avoided after this project came into being. This administrative purpose was of demonstrated value in children with mild-moderate hearing impairment.

How the Kennel Club is tackling inherited disorders in the United Kingdom.

PubMed

Sampson, Jeff

2011-08-01

Health screening of potential canine breeding stock can provide invaluable information to allow breeders to select against inherited diseases in their breeding programmes. This review details the screening programmes that are currently available to UK dog breeders and evaluates their impact as selective tools for dog breeders. Copyright © 2011 Elsevier Ltd. All rights reserved.

Version 1.00 programmer`s tools used in constructing the INEL RML/analytical radiochemistry sample tracking database and its user interface

DOE Office of Scientific and Technical Information (OSTI.GOV)

Femec, D.A.

This report describes two code-generating tools used to speed design and implementation of relational databases and user interfaces: CREATE-SCHEMA and BUILD-SCREEN. CREATE-SCHEMA produces the SQL commands that actually create and define the database. BUILD-SCREEN takes templates for data entry screens and generates the screen management system routine calls to display the desired screen. Both tools also generate the related FORTRAN declaration statements and precompiled SQL calls. Included with this report is the source code for a number of FORTRAN routines and functions used by the user interface. This code is broadly applicable to a number of different databases.

Cost-Effectiveness Analysis of a National Neonatal Hearing Screening Program in China: Conditions for the Scale-Up

PubMed Central

Tobe, Ruoyan Gai; Mori, Rintaro; Huang, Lihui; Xu, Lingzhong; Han, Demin; Shibuya, Kenji

2013-01-01

Background In 2009, the Chinese Ministry of Health recommended scale-up of routine neonatal hearing screening - previously performed primarily only in select urban hospitals - throughout the entire country. Methods A decision analytical model for a simulated population of all live births in China was developed to compare the costs and health effects of five mutually exclusive interventions: 1) universal screening using Otoacoustic Emission (OAE) and Automated Auditory Brainstem Response (AABR); 2) universal OAE; 3) targeted OAE and AABR; 4) targeted OAE; and 5) no screening. Disability-Adjusted Life Years (DALYs) were calculated for health effects. Results and Discussion Based on the cost-effectiveness and potential health outcomes, the optimal path for scale-up would be to start with targeted OAE and then expand to universal OAE and universal OAE plus AABR. Accessibility of screening, diagnosis, and intervention services significantly affect decision of the options. Conclusion In conclusion, to achieve cost-effectiveness and best health outcomes of the NHS program, the accessibility of screening, diagnosis, and intervention services should be expanded to reach a larger population. The results are thus expected to be of particular benefit in terms of the ‘rolling out’ of the national plan. PMID:23341887

Pilot study on the use of data mining to identify cochlear implant candidates.

PubMed

Grisel, Jedidiah J; Schafer, Erin; Lam, Anne; Griffin, Terry

2018-05-01

The goal of this pilot study was to determine the clinical utility of data-mining software that screens for cochlear implant (CI) candidacy. The Auditory Implant Initiative developed a software module that screens for CI candidates via integration with a software system (Noah 4) that serves as a depository for hearing test data. To identify candidates, patient audiograms from one practice were exported into the screening module. Candidates were tracked to determine if any eventually underwent implantation. After loading 4836 audiograms from the Noah 4 system, the screening module identified 558 potential CI candidates. After reviewing the data for the potential candidates, 117 were targeted and invited to an educational event. Following the event, a total of six candidates were evaluated, and two were implanted. This objective approach to identifying candidates has the potential to address the gross underutilization of CIs by removing any bias or lack of knowledge regarding the management of severe to profound sensorineural hearing loss with CIs. The screening module was an effective tool for identifying potential CI candidates at one ENT practice. On a larger scale, the screening module has the potential to impact thousands of CI candidates worldwide.

Patients' experiences of screening for type 2 diabetes: prospective qualitative study embedded in the ADDITION (Cambridge) randomised controlled trial

PubMed Central

Davies, Richard; Kinmonth, Ann-Louise; Griffin, Simon; Lawton, Julia

2007-01-01

Objectives To provide insight into factors that contribute to the anxiety reported in a quantitative study of the psychological effect of screening for type 2 diabetes. To explore expectations of and reactions to the screening experience of patients with positive, negative, and intermediate results. Design Prospective qualitative interview study of patients attending a screening programme for type 2 diabetes. Setting Seven general practices in the ADDITION (Cambridge) trial in the east of England. Participants 23 participants (aged 50-69) attending different stages in the screening process. Results Participants' perceptions changed as they progressed through the screening programme; the stepwise process seemed to help them adjust psychologically. The first screening test was typically considered unimportant and was attended with no thought about its implications. By the final diagnostic test, type 2 diabetes was considered a strong possibility, albeit a “mild” form. After diagnosis, people with screen detected type 2 diabetes tended to downplay its importance and talked confidently about their plans to control it. Participants with intermediate results seemed uncertain about their diagnosis, and those who screened negative were largely unaware of their remaining high risk. Conclusions This study helps in understanding the limited psychological impact of screening for type 2 diabetes quantified previously, in particular by the quantitative substudy of ADDITION (Cambridge). The findings have implications for implementing such a screening programme in terms of timing and content. PMID:17762000

A Look into the Crystal Ball for Children Who Are Deaf or Hard of Hearing: Needs, Opportunities, and Challenges.

PubMed

Yoshinaga-Itano, Christine; Wiggin, Mallene

2016-11-01

Hearing is essential for the development of speech, spoken language, and listening skills. Children previously went undiagnosed with hearing loss until they were 2.5 or 3 years of age. The auditory deprivation during this critical period of development significantly impacted long-term listening and spoken language outcomes. Due to the advent of universal newborn hearing screening, the average age of diagnosis has dropped to the first few months of life, which sets the stage for outcomes that include children with speech, spoken language, and auditory skill testing in the normal range. However, our work is not finished. The future holds even greater possibilities for children with hearing loss. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Role of Audiologic Evaluation in Progressive Audiologic Tinnitus Management

PubMed Central

Henry, James A.; Zaugg, Tara L.; Myers, Paula J.; Schechter, Martin A.

2008-01-01

Progressive Audiologic Tinnitus Management (PATM) is based on the premise that tinnitus is managed most efficiently using a hierarchy of clinical services that address different levels of need. PATM includes five levels of management: (a) triage; (b) audiologic evaluation; (c) group education; (d) tinnitus evaluation; and (e) individualized management. This article provides an overview of PATM and focuses on the procedures that make up the Level 2 Audiologic Evaluation. The evaluation is conducted to assess the potential need for medical, audiologic (hearing loss, tinnitus, hyperacusis), and/or mental health services. The Tinnitus Handicap Inventory, Hearing Handicap Inventory, and Tinnitus and Hearing Survey are used to differentiate effects of tinnitus and hearing loss. If indicated, patients are interviewed with the Tinnitus-Impact Screening Interview. Patients requiring amplification receive hearing aids. Often, management of hearing loss at Level 2 addresses any problems that were attributed to the tinnitus, which obviates further tinnitus-specific intervention. PMID:18628281

Prevalence and degree of hearing loss among males in Beaver Dam cohort: comparison of veterans and nonveterans.

PubMed

Wilson, Richard H; Noe, Colleen M; Cruickshanks, Karen J; Wiley, Terry L; Nondahl, David M

2010-01-01

The Epidemiology of Hearing Loss Study (EHLS) conducted in Beaver Dam, Wisconsin, was a population-based study that focused on the prevalence of hearing loss among 3,753 participants between 1993 and 1995. This article reports the results of several auditory measures from 999 veteran and 590 nonveteran males 48 to 92 years of age included in the EHLS. The auditory measures included pure tone thresholds, tympanometry and acoustic reflexes, word recognition in quiet and in competing message, and the Hearing Handicap Inventory for the Elderly-Screening (HHIE-S) version. Hearing loss in the auditory domains of pure tone thresholds, word recognition in quiet, and word recognition in competing message increased with age but were not significantly different for the veterans and nonveterans. No significant differences were found between participant groups on the HHIE-S; however, regarding hearing aid usage, mixed differences were found.

Mental health and self-image among deaf and hard of hearing children.

PubMed

Mejstad, Lena; Heiling, Kerstin; Svedin, Carl Göran

2009-01-01

Mental health and self-image among deaf and hard of hearing children (ages 11-18 years) in southern Sweden was investigated. The children (N = 111) attended special schools for the deaf (n = 28), special schools for the hard of hearing (n = 23), and regular schools where hard of hearing children were mainstreamed (n = 60). The Strengths and Difficulties Questionnaire (Goodman, 1997) was used to screen mental health and the "I Think I Am" questionnaire Ouvinen-Birgerstam (1982, 1984) to measure self-esteem. The study shows that hard of hearing children seem to do as well, as a group, as other children in Swedish society. Mean SDQ and ITIA scores indicated that the mainstreamed students and the students in special schools for the hard of hearing had higher levels of rated mental health and self-image than the students in schools for the deaf.

A process evaluation of implementing a vocational enablement protocol for employees with hearing difficulties in clinical practice.

PubMed

Gussenhoven, Arjenne H M; Singh, Amika S; Goverts, S Theo; van Til, Marten; Anema, Johannes R; Kramer, Sophia E

2015-08-01

A multidisciplinary vocational rehabilitation programme, the Vocational Enablement Protocol (VEP) was developed to address the specific needs of employees with hearing difficulties. In the current study we evaluated the process of implementing the VEP in audiologic care among employees with hearing impairment. In conjunction with a randomized controlled trial, we collected and analysed data on seven process parameters: recruitment, reach, fidelity, dose delivered, dose received and implemented, satisfaction, and perceived benefit. Sixty-six employees with hearing impairment participated in the VEP. The multidisciplinary team providing the VEP comprised six professionals. The professionals performed the VEP according to the protocol. Of the recommendations delivered by the professionals, 31% were perceived as implemented by the employees. Compliance rate was highest for hearing-aid uptake (51%). Both employees and professionals were highly satisfied with the VEP. Participants rated good perceived benefit from it. Our results indicate that the VEP could be a useful treatment for employees with hearing difficulties from a process evaluation perspective. Implementation research in the audiological setting should be encouraged in order to further provide insight into parameters facilitating or hindering successful implementation of an intervention and to improve its quality and efficacy.

Intelligent hearing aids: the next revolution.

PubMed

Tao Zhang; Mustiere, Fred; Micheyl, Christophe

2016-08-01

The first revolution in hearing aids came from nonlinear amplification, which allows better compensation for both soft and loud sounds. The second revolution stemmed from the introduction of digital signal processing, which allows better programmability and more sophisticated algorithms. The third revolution in hearing aids is wireless, which allows seamless connectivity between a pair of hearing aids and with more and more external devices. Each revolution has fundamentally transformed hearing aids and pushed the entire industry forward significantly. Machine learning has received significant attention in recent years and has been applied in many other industries, e.g., robotics, speech recognition, genetics, and crowdsourcing. We argue that the next revolution in hearing aids is machine intelligence. In fact, this revolution is already quietly happening. We will review the development in at least three major areas: applications of machine learning in speech enhancement; applications of machine learning in individualization and customization of signal processing algorithms; applications of machine learning in improving the efficiency and effectiveness of clinical tests. With the advent of the internet of things, the above developments will accelerate. This revolution will bring patient satisfactions to a new level that has never been seen before.

Cancer screening in Portugal: sex differences in prevalence, awareness of organized programmes and perception of benefits and adverse effects.

PubMed

Costa, Ana Rute; Silva, Susana; Moura-Ferreira, Pedro; Villaverde-Cabral, Manuel; Santos, Osvaldo; Carmo, Isabel do; Barros, Henrique; Lunet, Nuno

2017-04-01

Cancer screening has contributed to downward trends in cancer mortality, but is also associated with adverse effects, which highlights the importance of promoting the participation based on informed decisions. We aimed to describe the use of cancer screening (either in organized programmes or as opportunistic screening), awareness of organized programmes and perception of its potential benefits and adverse effects, depicting possible sex differences. We evaluated 1624 Portuguese-speaking dwellers, aged between 16 and 79 years, through face-to-face interviews. To quantify sex differences, adjusted prevalence ratios and respective 95% confidence intervals were computed using Poisson regression. Among eligible age groups, the lifetime prevalence of screening for breast and cervical cancers was 89.8 and 71.9%, respectively. The prevalence was 23.7% for colorectal cancer and no significant sex differences were observed. Prostate cancer screening was reported by 63.8% of men. Over half of the participants referred that cancers such as prostate, skin, lung and stomach should be screened for, in addition to those for which organized programmes are recommended. Reassurance by negative results was identified as the main potential benefit of screening by nearly one-third of men and women. Anxiety while waiting for results was the most mentioned potential adverse effect (60.4%); men refer less often this and financial costs, although statistical significance of these results was borderline. This study provides a benchmark to plan and monitor the effects of awareness-raising interventions, as well as for international comparisons across countries with different cancer prevention and control structures. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

I can't get my husband to go and have a colonoscopy: gender and screening for colorectal cancer.

PubMed

Thompson, Lee; Reeder, Tony; Abel, Gillian

2012-05-01

It is anticipated that a colorectal cancer (CRC) screening programme will be introduced in New Zealand making it the first screening programme in this country to include both males and females. In-depth interviews were carried out with 80 participants (53 females and 27 males) about their knowledge and attitudes to screening programmes in general, as well as their understanding and perceptions of CRC screening in particular. The study highlighted the perceived marginalization of men's health with a sense that women had advocated for, and therefore monopolized, screening while men's health had been left unattended. There were also perceptions of women's responsibility for ensuring men's access to health services. There are arguments that such perceptions disempower or 'infantalize' men which have no long term benefits. While health is perceived as being a feminine matter, it may be difficult to encourage men to engage in preventative behaviours, such as taking up the offer of screening. This article also highlights the heterogeneity of men, where different performances of masculinities were presented. A stereotypical 'staunch' or 'macho image' discourse was evident in some of the interviews where much emphasis was on maintaining and controlling bodily boundaries. Letting the barrier of embodied 'staunchness' down to access health services is a threat to identity. What is required for successful implementation of the CRC screening programme is a normalization of men's health help-seeking, taking into account the fact that men are not homogenous. Studies in relation to men's health need to attend to cultural diversity which is likely to present a challenge to individualism. Critical studies of men would be enhanced by more engagement with the work of black male scholars.

Cost-effectiveness of antenatal screening for neonatal alloimmune thrombocytopenia.

PubMed

Killie, M K; Kjeldsen-Kragh, J; Husebekk, A; Skogen, B; Olsen, J A; Kristiansen, I S

2007-05-01

To estimate the costs and health consequences of three different screening strategies for neonatal alloimmune thrombocytopenia (NAIT). Cost-utility analysis on the basis of a decision tree that incorporates the relevant strategies and outcomes. Three health regions in Norway encompassing a 2.78 million population. Pregnant women (n = 100,448) screened for human platelet antigen (HPA) 1a and anti-HPA 1a antibodies, and their babies. Decision tree analysis. In three branches of the decision tree, pregnant women entered a programme while in one no screening was performed. The three different screening strategies included all HPA 1a negative women, only HPA 1a negative, HLA DRB3*0101 positive women or only HPA 1a negative women with high level of anti-HPA 1a antibodies. Included women underwent ultrasound examination and elective caesarean section 2-4 weeks before term. Severely thrombocytopenic newborn were transfused immediately with compatible platelets. Quality-adjusted life years (QALYs) and costs. Compared with no screening, a programme of screening and subsequent treatment would generate between 210 and 230 additional QALYs among 100,000 pregnant women, and at the same time, reduce health care costs by approximately 1.7 million euros. The sensitivity analyses indicate that screening is cost effective or even cost saving within a wide range of probabilities and costs. Our calculations indicate that it is possible to establish an antenatal screening programme for NAIT that is cost effective.

Neonatal screening for inborn errors of metabolism: cost, yield and outcome.

PubMed

Pollitt, R J; Green, A; McCabe, C J; Booth, A; Cooper, N J; Leonard, J V; Nicholl, J; Nicholson, P; Tunaley, J R; Virdi, N K

1997-01-01

OBJECTIVES. To systematically review the literature on inborn errors of metabolism, neonatal screening technology and screening programmes in order to analyse the costs and benefits of introducing screening based on tandem mass-spectrometry (tandem MS) for a wide range of disorders of amino acid and organic acid metabolism in the UK. To evaluate screening for cystic fibrosis, Duchenne muscular dystrophy and other disorders which are tested on an individual basis. HOW THE RESEARCH WAS CONDUCTED. Systematic searches were carried out of the literature on inborn errors of metabolism, neonatal screening programmes, tandem MS-based neonatal screening technology, economic evaluations of neonatal screening programmes and psychological aspects of neonatal screening. Background material on the biology of inherited metabolic disease, the basic philosophy, and the history and current status of the UK screening programme was also collected. Relevant papers in the grey literature and recent publications were identified by hand-searching. Each paper was graded. For each disease an aggregate grade for the state of knowledge in six key areas was awarded. Additional data were prospectively collected on activity and costs in UK neonatal screening laboratories, and expert clinical opinion on current treatment modalities and outcomes. These data were used to construct a decision-analysis model of neonatal screening technologies, comparing tandem MS with the existing phenylketonuria screening methods. This model determined the cost per additional case identified and, for each disease, the additional treatment costs per case, and the cost per life-year saved. All costs and benefits were discounted at 6% per annum. One-way sensitivity analysis was performed showing the effect of varying the discount rate, the incidence rate of each disorder, the number of neonates screened and the cost of tandem MS, on the cost per life-year gained. RESEARCH FINDINGS. The UK screening programmes for phenylketonuria and congenital hypothyroidism have largely achieved the expected objectives and are cost-effective. Current concerns are the difficulty of maintaining adequate coverage, perceived organisational weaknesses, and a lack of overview. For many of the organic acid disorders it was necessary to rely on data obtained from clinically-diagnosed cases. Many of these diseases can be treated very effectively and a sensitive screening test was available for most of the diseases. Except for cystic fibrosis, there have been no randomised controlled trials of the overall effectiveness of neonatal screening. Despite the anxiety generated by the screening process, there is strong parental support for screening. The effects of diagnosis through screening on subsequent reproductive behaviour is less clear. Conflicts exist between current concepts and the traditional principles of screening. The availability of effective treatment is not an absolute prerequisite: early diagnosis is of value to the family concerned and, to the extent that is leads to increased use of prenatal diagnosis, may help to reduce the overall burden of disease. Neonatal screening is also of value in diseases which present early but with non-specific symptoms. Indeed, almost all of the diseases considered could merit neonatal screening. The majority of economic evaluations failed to incorporate the health benefits from screening, and therefore failed to address the value of the information which the screening programmes provided to parents. The marginal cost of changing from present technology to tandem MS would be approximately 0.60 pounds per baby at a workload of 100,000 samples a year, and 0.87 pounds at 50,000 samples per year. The ability to screen for a wider range of diseases would lead to the identification of some 20 additional cases per 100,000 infants screened, giving a laboratory cost per additional diagnosis of 3000 pounds at an annual workload of 100,000 babies per year.(ABSTRACT TRUNCATED)

A cross sectional study on the motivators for Asian women to attend opportunistic mammography screening in a private hospital in Malaysia: the MyMammo study.

PubMed

Hassan, Norhashimah; Ho, Weang Kee; Mariapun, Shivaani; Teo, Soo Hwang

2015-06-12

To date, because of limited budgets and lower incidence of breast cancer, the majority of Asian countries do not have population-based screening programmes, but instead offer opportunistic screening. However, there have been few studies which have assessed the motivators for women attending such programmes and the appropriateness of the programmes in terms of targeting women at risk. We conducted a prospective cross-sectional study of 1,619 women aged 40 to 74 years attending a subsidized opportunistic screening mammogram from October 2011 to October 2013 at a private hospital in Malaysia. Breast cancer risk was estimated using the Gail Model and two-step cluster analysis was used to examine the motivators of attending screening. Although Malaysia comprises 54.5% Malay, 24.5% Chinese and 7.3% Indian, the majority of women in the MyMammo Study were Chinese (70.1%) and 99.2% had a <2% ten-year risk of breast cancer. The most commonly cited barriers were the perception of not being at risk and fear of painful mammography. We found that highly educated women, cited doctors, family and friends as their main motivators. Of those with only secondary school education, their main motivators were doctors. Taken together, our results suggest the women attending opportunistic mammography screening in Asia are at low risk of breast cancer and this poses challenges to cost-effective and equitable strategies for cancer control. We propose that to improve uptake of screening mammography, awareness programmes should target both doctors and members of the public.

Inclusive Education: Programmes and Provisions

ERIC Educational Resources Information Center

Kappen, Mini Dejo

2010-01-01

Inclusive education is a practice of teaching handicapped children in regular classrooms with non-handicapped children to the fullest extent possible; such children may have orthopedic, intellectual, emotional, or visual difficulties or handicaps associated with hearing or learning. In India there are constitutional provisions for Inclusive…

[Perception of healthcare professionals on the Breast Cancer Screening Programme in Barcelona].

PubMed

Serral, G; Puigpinós-Riera, R; Maydana, E; Pons-Vigués, M; Borrell, C

2013-01-01

A good communication plan is vital for optimal results in any screening programme. The objective of this study was to assess the knowledge, involvement and opinion of health professionals regarding the Breast Cancer Screening Programme in Barcelona in 2008. A cross-sectional study using an anonymous and self-administered questionnaire. The study population (N = 960) were health professionals from Primary Health-care (PH), Programs for Sexual and Reproductive Health (PSRH), and Community Pharmacies (CP). The dependent variables were: knowledge of the Programme, professional involvement and opinion of the Programme. The independent variables were: sex, age, qualifications, employment status, and health team. A descriptive and bivariate analysis was performed. Using multivariate logistic regression models adjusted for age, an Odds Ratios (OR) were obtained along with the 95% confidence intervals (CI 95%). PSRH professionals know the target population better; 80.2% versus 26.1% PH, and 14.0% CP, respectively. Professional involvement was related to the health care team (ORCP/PH: 0.32, CI 95%: 0.22-0.43) being observed more in PH. The opinion on the Programme in reducing breast cancer mortality was similar in the three teams (61.6% PH, 59.3% PSRH, and 56.5% CP). Healthcare professionals are unaware of some aspects of Programme, such as age range or periodicity. There is great professional involvement and belief that the Programme has helped disseminate information and knowledge on the early detection of breast cancer. Copyright © 2012 SECA. Published by Elsevier Espana. All rights reserved.

A Prospective, Longitudinal Study of the Impact of GJB2/GJB6 Genetic Testing on the Beliefs and Attitudes of Parents of Deaf and Hard-of-Hearing Infants

PubMed Central

Palmer, Christina G.S.; Martinez, Ariadna; Fox, Michelle; Zhou, Jin; Shapiro, Nina; Sininger, Yvonne; Grody, Wayne W.; Schimmenti, Lisa A.

2010-01-01

There are limited data on the impact of incorporating genetic counseling and testing into the newborn hearing screening process. We report on results from a prospective, longitudinal study to determine the impact of genetic counseling and GJB2/GJB6 genetic testing on parental knowledge, attitudes, and beliefs about genetic testing. One hundred thirty culturally hearing parents of 93 deaf or hard-of-hearing children ages 0 – 3 years primarily identified through newborn hearing screening received pre- and post-test genetic counseling for GJB2 and GJB6. Parents completed questionnaires following pre-test counseling, and 1- and 6-months post-test result disclosure. Results indicate that following pre-test counseling all parents perceived benefits to genetic testing. While parents who received positive results continued to perceive benefits from testing, perceived benefit declined among parents who received inconclusive or negative results. Parents did not perceive genetic testing as harmful following pre-test counseling or receipt of test results. Parents who received positive test results performed better in understanding recurrence and causation of their child’s deafness and indicated greater interest in prenatal genetic testing than those who received inconclusive or negative test results. Parents felt that pediatricians and audiologists should inform parents of genetic testing availability; however, there was no consensus on timing of this discussion. Thus culturally hearing parents do not perceive genetic testing of their deaf or hard-of-hearing infants/toddlers as harmful; they feel that primary care providers should discuss genetic testing with them; and positive genetic test results with genetic counseling give rise to better understanding and perceived benefit than negative or inconclusive results. PMID:19449415

High-frequency Audiometry Hearing on Monitoring of Individuals Exposed to Occupational Noise: A Systematic Review

PubMed Central

Antonioli, Cleonice Aparecida Silva; Momensohn-Santos, Teresa Maria; Benaglia, Tatiana Aparecida Silva

2015-01-01

Introduction  The literature reports on high-frequency audiometry as one of the exams used on hearing monitoring of individuals exposed to high sound pressure in their work environment, due to the method́s greater sensitivity in early identification of hearing loss caused by noise. The frequencies that compose the exam are generally between 9 KHz and 20KHz, depending on the equipment. Objective  This study aims to perform a retrospective and secondary systematic revision of publications on high-frequency audiometry on hearing monitoring of individuals exposed to occupational noise. Data Synthesis  This systematic revision followed the methodology proposed in the Cochrane Handbook, focusing on the question: “Is High-frequency Audiometry more sensitive than Conventional Audiometry in the screening of early hearing loss individuals exposed to occupational noise?” The search was based on PubMed data, Base, Web of Science (Capes), Biblioteca Virtual em Saúde (BVS), and in the references cited in identified and selected articles. The search resulted in 6059 articles in total. Of these, only six studies were compatible with the criteria proposed in this study. Conclusion  The performed meta-analysis does not definitively answer the study's proposed question. It indicates that the 16 KHz high frequency audiometry (HFA) frequency is sensitive in early identification of hearing loss in the control group (medium difference (MD = 8.33)), as well as the 4 KHz frequency (CA), this one being a little less expressive (MD = 5.72). Thus, others studies are necessary to confirm the HFA importance for the early screening of hearing loss on individuals exposed to noise at the workplace. PMID:27413413

A prospective, longitudinal study of the impact of GJB2/GJB6 genetic testing on the beliefs and attitudes of parents of deaf and hard-of-hearing infants.

PubMed

Palmer, Christina G S; Martinez, Ariadna; Fox, Michelle; Zhou, Jin; Shapiro, Nina; Sininger, Yvonne; Grody, Wayne W; Schimmenti, Lisa A

2009-06-01

There are limited data on the impact of incorporating genetic counseling and testing into the newborn hearing screening process. We report on results from a prospective, longitudinal study to determine the impact of genetic counseling and GJB2/GJB6 genetic testing on parental knowledge, attitudes, and beliefs about genetic testing. One hundred thirty culturally hearing parents of 93 deaf or hard-of-hearing children ages 0-3 years primarily identified through newborn hearing screening received pre- and post-test genetic counseling for GJB2 and GJB6. Parents completed questionnaires following pre-test counseling, and 1- and 6-month post-test result disclosure. Results indicate that following pre-test counseling all parents perceived benefits to genetic testing. While parents who received positive results continued to perceive benefits from testing, perceived benefit declined among parents who received inconclusive or negative results. Parents did not perceive genetic testing as harmful following pre-test counseling or receipt of test results. Parents who received positive test results performed better in understanding recurrence and causation of their child's deafness and indicated greater interest in prenatal genetic testing than those who received inconclusive or negative test results. Parents felt that pediatricians and audiologists should inform parents of genetic testing availability; however, there was no consensus on timing of this discussion. Thus culturally hearing parents do not perceive genetic testing of their deaf or hard-of-hearing infants/toddlers as harmful; they feel that primary care providers should discuss genetic testing with them; and positive genetic test results with genetic counseling give rise to better understanding and perceived benefit than negative or inconclusive results. (c) 2009 Wiley-Liss, Inc.

Interventions to prevent occupational noise-induced hearing loss.

PubMed

Tikka, Christina; Verbeek, Jos H; Kateman, Erik; Morata, Thais C; Dreschler, Wouter A; Ferrite, Silvia

2017-07-07

This is the second update of a Cochrane Review originally published in 2009. Millions of workers worldwide are exposed to noise levels that increase their risk of hearing disorders. There is uncertainty about the effectiveness of hearing loss prevention interventions. To assess the effectiveness of non-pharmaceutical interventions for preventing occupational noise exposure or occupational hearing loss compared to no intervention or alternative interventions. We searched the CENTRAL; PubMed; Embase; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; and OSH UPDATE to 3 October 2016. We included randomised controlled trials (RCT), controlled before-after studies (CBA) and interrupted time-series (ITS) of non-clinical interventions under field conditions among workers to prevent or reduce noise exposure and hearing loss. We also collected uncontrolled case studies of engineering controls about the effect on noise exposure. Two authors independently assessed study eligibility and risk of bias and extracted data. We categorised interventions as engineering controls, administrative controls, personal hearing protection devices, and hearing surveillance. We included 29 studies. One study evaluated legislation to reduce noise exposure in a 12-year time-series analysis but there were no controlled studies on engineering controls for noise exposure. Eleven studies with 3725 participants evaluated effects of personal hearing protection devices and 17 studies with 84,028 participants evaluated effects of hearing loss prevention programmes (HLPPs). Effects on noise exposure Engineering interventions following legislationOne ITS study found that new legislation in the mining industry reduced the median personal noise exposure dose in underground coal mining by 27.7 percentage points (95% confidence interval (CI) -36.1 to -19.3 percentage points) immediately after the implementation of stricter legislation. This roughly translates to a 4.5 dB(A) decrease in noise level. The intervention was associated with a favourable but statistically non-significant downward trend in time of the noise dose of -2.1 percentage points per year (95% CI -4.9 to 0.7, 4 year follow-up, very low-quality evidence). Engineering intervention case studiesWe found 12 studies that described 107 uncontrolled case studies of immediate reductions in noise levels of machinery ranging from 11.1 to 19.7 dB(A) as a result of purchasing new equipment, segregating noise sources or installing panels or curtains around sources. However, the studies lacked long-term follow-up and dose measurements of workers, and we did not use these studies for our conclusions. Hearing protection devicesIn general hearing protection devices reduced noise exposure on average by about 20 dB(A) in one RCT and three CBAs (57 participants, low-quality evidence). Two RCTs showed that, with instructions for insertion, the attenuation of noise by earplugs was 8.59 dB better (95% CI 6.92 dB to 10.25 dB) compared to no instruction (2 RCTs, 140 participants, moderate-quality evidence). Administrative controls: information and noise exposure feedbackOn-site training sessions did not have an effect on personal noise-exposure levels compared to information only in one cluster-RCT after four months' follow-up (mean difference (MD) 0.14 dB; 95% CI -2.66 to 2.38). Another arm of the same study found that personal noise exposure information had no effect on noise levels (MD 0.30 dB(A), 95% CI -2.31 to 2.91) compared to no such information (176 participants, low-quality evidence). Effects on hearing loss Hearing protection devicesIn two studies the authors compared the effect of different devices on temporary threshold shifts at short-term follow-up but reported insufficient data for analysis. In two CBA studies the authors found no difference in hearing loss from noise exposure above 89 dB(A) between muffs and earplugs at long-term follow-up (OR 0.8, 95% CI 0.63 to 1.03 ), very low-quality evidence). Authors of another CBA study found that wearing hearing protection more often resulted in less hearing loss at very long-term follow-up (very low-quality evidence). Combination of interventions: hearing loss prevention programmesOne cluster-RCT found no difference in hearing loss at three- or 16-year follow-up between an intensive HLPP for agricultural students and audiometry only. One CBA study found no reduction of the rate of hearing loss (MD -0.82 dB per year (95% CI -1.86 to 0.22) for a HLPP that provided regular personal noise exposure information compared to a programme without this information.There was very-low-quality evidence in four very long-term studies, that better use of hearing protection devices as part of a HLPP decreased the risk of hearing loss compared to less well used hearing protection in HLPPs (OR 0.40, 95% CI 0.23 to 0.69). Other aspects of the HLPP such as training and education of workers or engineering controls did not show a similar effect.In three long-term CBA studies, workers in a HLPP had a statistically non-significant 1.8 dB (95% CI -0.6 to 4.2) greater hearing loss at 4 kHz than non-exposed workers and the confidence interval includes the 4.2 dB which is the level of hearing loss resulting from 5 years of exposure to 85 dB(A). In addition, of three other CBA studies that could not be included in the meta-analysis, two showed an increased risk of hearing loss in spite of the protection of a HLPP compared to non-exposed workers and one CBA did not. There is very low-quality evidence that implementation of stricter legislation can reduce noise levels in workplaces. Controlled studies of other engineering control interventions in the field have not been conducted. There is moderate-quality evidence that training of proper insertion of earplugs significantly reduces noise exposure at short-term follow-up but long-term follow-up is still needed.There is very low-quality evidence that the better use of hearing protection devices as part of HLPPs reduces the risk of hearing loss, whereas for other programme components of HLPPs we did not find such an effect. The absence of conclusive evidence should not be interpreted as evidence of lack of effectiveness. Rather, it means that further research is very likely to have an important impact.

Methodology for a randomised controlled trial of preschool vision screening. A new approach with the 'ALSPAC' project.

PubMed

Williams, C; Harrad, R A; Harvey, I; Frankel, S; Golding, J

1996-06-01

We present the methodology of a population-based Randomised Controlled Trial, comparing an intensive programme of primary preschool vision screening by orthoptists with the usual non-specialist screening. The aims of the trial are to compare the effectiveness and costs of intensive orthoptic screening with non-specialist measures. The orthoptic screening programme will be evaluated both as a composite package and in terms of the screening value of the individual tests at specific ages. This trial is nested within a large population-based longitudinal study. Additional demographic and developmental data on the children in the trial are therefore available. The results of the trial will be used to help clarify which methods of preschool ophthalmic population screening are best in terms of disease detection and cost efficiency.

The effects and outcomes of electrolyte disturbances and asphyxia on newborns hearing

PubMed Central

Liang, Chun; Hong, Qi; Jiang, Tao-Tao; Gao, Yan; Yao, Xiao-Fang; Luo, Xiao-Xing; Zhuo, Xiu-Hui; Shinn, Jennifer B.; Jones, Raleigh O.; Zhao, Hong-Bo; Lu, Guang-Jin

2013-01-01

Objective To determine the effect of electrolyte disturbances (ED) and asphyxia on infant hearing and hearing outcomes. Study Design We conducted newborn hearing screening with transient evoked otoacoustic emission (TEOAE) test on a large scale (>5,000 infants). The effects of ED and asphyxia on infant hearing and hearing outcomes were evaluated. Result The pass rate of TEOAE test was significantly reduced in preterm infants with ED (83.1%, multiple logistic regression analysis: P<0.01) but not in full-term infants with ED (93.6%, P=0.41). However, there was no significant reduction in the pass rate in infants with asphyxia (P=0.85). We further found that hypocalcaemia significantly reduced the pass rate of TEOAE test (86.8%, P<0.01). In the follow-up recheck at 3 months of age, the pass rate remained low (44.4%, P<0.01). Conclusion ED is a high-risk factor for preterm infant hearing. Hypocalcaemia can produce more significant impairment with a low recovery rate. PMID:23648318

Sudden onset unilateral sensorineural hearing loss after rabies vaccination.

PubMed

Okhovat, Saleh; Fox, Richard; Magill, Jennifer; Narula, Antony

2015-12-15

A 33-year-old man developed profound sudden onset right-sided hearing loss with tinnitus and vertigo, within 24 h of pretravel rabies vaccination. There was no history of upper respiratory tract infection, systemic illness, ototoxic medication or trauma, and normal otoscopic examination. Pure tone audiograms (PTA) demonstrated right-sided sensorineural hearing loss (thresholds 90-100 dB) and normal left-sided hearing. MRI internal acoustic meatus, viral serology (hepatitis B, C, HIV and cytomegalovirus) and syphilis screen were normal. Positive Epstein-Barr virus IgG, viral capsid IgG and anticochlear antibodies (anti-HSP-70) were noted. Initial treatment involved a course of high-dose oral prednisolone and acyclovir. Repeat PTAs after 12 days of treatment showed a small improvement in hearing thresholds. Salvage intratympanic steroid injections were attempted but failed to improve hearing further. Sudden onset sensorineural hearing loss (SSNHL) is an uncommon but frightening experience for patients. This is the first report of SSNHL following rabies immunisation in an adult. 2015 BMJ Publishing Group Ltd.

Concerns, perceived need and competing priorities: a qualitative exploration of decision-making and non-participation in a population-based flexible sigmoidoscopy screening programme to prevent colorectal cancer.

PubMed

Hall, N; Birt, L; Rees, C J; Walter, F M; Elliot, S; Ritchie, M; Weller, D; Rubin, G

2016-11-11

Optimising uptake of colorectal cancer (CRC) screening is important to achieve projected health outcomes. Population-based screening by flexible sigmoidoscopy (FS) was introduced in England in 2013 (NHS Bowel scope screening). Little is known about reactions to the invitation to participate in FS screening, as offered within the context of the Bowel scope programme. We aimed to investigate responses to the screening invitation to inform understanding of decision-making, particularly in relation to non-participation in screening. Qualitative analysis of semistructured in-depth interviews and written accounts. People from 31 general practices in the North East and East of England invited to attend FS screening as part of NHS Bowel scope screening programme were sent invitations to take part in the study. We purposively sampled interviewees to ensure a range of accounts in terms of beliefs, screening attendance, sex and geographical location. 20 screeners and 25 non-screeners were interviewed. Written responses describing reasons for, and circumstances surrounding, non-participation from a further 28 non-screeners were included in the analysis. Thematic analysis identified a range of reactions to the screening invitation, decision-making processes and barriers to participation. These include a perceived or actual lack of need; inability to attend; anxiety and fear about bowel preparation, procedures or hospital; inability or reluctance to self-administer an enema; beliefs about low susceptibility to bowel cancer or treatment and understanding of harm and benefits. The strength, rather than presence, of concerns about the test and perceived need for reassurance were important in the decision to participate for screeners and non-screeners. Decision-making occurs within the context of previous experiences and day-to-day life. Understanding the reasons for non-participation in FS screening can help inform strategies to improve uptake and may be transferable to other screening programmes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

A Community Jury on PSA screening: what do well-informed men want the government to do about prostate cancer screening—a qualitative analysis

PubMed Central

Rychetnik, Lucie; Doust, Jenny; Thomas, Rae; Gardiner, Robert; MacKenzie, Geraldine; Glasziou, Paul

2014-01-01

Objective Cancer screening policies and programmes should take account of public values and concerns. This study sought to determine the priorities, values and concerns of men who were ‘fully informed’ about the benefits and harms of prostate-specific antigen (PSA) screening; and empirically examine the value of a community jury in eliciting public values on PSA screening. Setting Community jury was convened on the Gold Coast, Queensland (Australia) to consider PSA screening benefits and harms, and whether government campaigns on PSA screening should be conducted. Participants 27 men (volunteers) aged 50–70 with no personal history of prostate cancer and willing to attend jury 6–7 April 2013: 12 were randomly allocated to jury (11 attended). Outcome measures A qualitative analysis was conducted of the jury deliberations (audio-recorded and transcribed) to elicit the jury's views and recommendations. A survey determined the impact of the jury process on participants’ individual testing decisions compared with control group. Results The jury concluded governments should not invest in programmes focused on PSA screening directed at the public because the PSA test did not offer sufficient reassurance or benefit and could raise unnecessary alarm. It recommended an alternative programme to support general practitioners to provide patients with better quality and more consistent information about PSA screening. After the jury, participants were less likely to be tested in the future compared with the controls, but around half said they would still consider doing so. Conclusions The jury's unanimous verdict about government programmes was notable in the light of their divergent views on whether or not they would be screened themselves in the future. Community juries provide valuable insights into the priorities and concerns of men weighing up the benefits and harms of PSA screening. It will be important to assess the degree to which the findings are generalisable to other settings. PMID:24785399

Individual decision making in relation to participation in cardiovascular screening: a study of revealed and stated preferences.

PubMed

Søgaard, Rikke; Lindholt, Jes; Gyrd-Hansen, Dorte

2013-02-01

The (cost-)effectiveness of a screening programme may be strongly influenced by the participation rate. The objective of this study was to compare participants' and non-participants' motives for the attendance decision as well as their overall preferences for participation in cardiovascular disease screening. This study sampled 1053 participants and 1006 non-participants from a screening trial and randomly allocated the participants to receive different levels of additional information about the screening programme. An ad hoc survey questionnaire about doubt and arguments in relation to the participation decision was given to participants and non-participants along with a contingent valuation task. Among participants, 5% had doubt about participation and the most frequent argument was that they did not want the test result. Among non-participants, 40% would reconsider their non-participation decision after having received additional information while the remainder 60% stood by their decision and provided explicit arguments for it. After having received additional information the participants still valued the programme significantly higher than non-participants, but the difference was relatively small. Participants and non-participants in cardiovascular screening programmes seem to have different strengths of preferences, which signals that their behavioural choice is founded in rational thinking. Furthermore, it appears that additional information and a second reflection about the participation decision may affect a substantial proportion of non-participants to reverse their decision, a finding that should receive policy interest.

Scottish Bowel Screening Programme Colonoscopy Quality - scope for improvement?

PubMed

Quyn, A J; Fraser, C G; Stanners, G; Carey, F A; Rees, C J; Moores, B; Steele, R J

2018-06-04

The delivery of the Scottish Bowel Screening Programme (SBoSP) is rooted in the provision of a high quality, effective and participant-centred service. Safe and effective colonoscopy forms an integral part of the process. Additional accreditation as part of a multi-faceted programme for participating colonoscopists, as in England, does not exist in Scotland. This study aimed to describe the quality of colonoscopy in the SBoSP and compare this to the English national screening standards. Data were collected from the SBoSP between 2007 and 2014. End-points for analysis were caecal intubation, cancer, polyp and adenoma detection, and complications. Overall results were compared with 2012 published English national standards for screening and outcomes from 2006-2009. During the study period 53,332 participants attended for colonoscopy. Colonoscopy completion rate was 95.6% overall. The mean cancer detection rate (CDR) was 7.1%, the polyp detection rate (PDR) 45.7% and the adenoma detection rate (ADR) was 35.5%.The overall complication rate was 0.47%. Colonoscopy quality in the SBoSP has exceeded the standard set for screening colonoscopy in England, despite not adopting a multi-faceted programme for screening colonoscopy. However, the overall ADR in Scotland was 9.1% lower than that in England which has implications for colonoscopy quality and may have an impact on the cancer prevention rates, a key aim of the SBoSP. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

SKI*HI Home-Based Programming for Children with Hearing Impairments: Demographics, Child Identification, and Program Effectiveness, 1979-1991.

ERIC Educational Resources Information Center

Strong, Carol J.; And Others

SKI*HI is a program designed to identify children with hearing impairments as early as possible and to provide them and their families with complete home programming that will facilitate development. The delivery model includes identification/screening services, home visit services, support services, and program management. A parent advisor makes…

Visual Attention in Deaf and Normal Hearing Adults: Effects of Stimulus Compatibility

ERIC Educational Resources Information Center

Sladen, Douglas P.; Tharpe, Anne Marie; Ashmead, Daniel H.; Grantham, D. Wesley; Chun, Marvin M.

2005-01-01

Visual perceptual skills of deaf and normal hearing adults were measured using the Eriksen flanker task. Participants were seated in front of a computer screen while a series of target letters flanked by similar or dissimilar letters was flashed in front of them. Participants were instructed to press one button when they saw an "H," and another…

A Reversed-Typicality Effect in Pictures but Not in Written Words in Deaf and Hard of Hearing Adolescents

ERIC Educational Resources Information Center

Li, Degao; Gao, Kejuan; Wu, Xueyun; Xong, Ying; Chen, Xiaojun; He, Weiwei; Li, Ling; Huang, Jingjia

2015-01-01

Two experiments investigated Chinese deaf and hard of hearing (DHH) adolescents' recognition of category names in an innovative task of semantic categorization. In each trial, the category-name target appeared briefly at the screen center followed by two words or two pictures for two basic-level exemplars of high or middle typicality, which…

Using the "Common European Framework of Reference for Languages" to Teach Sign Language to Parents of Deaf Children

ERIC Educational Resources Information Center

Snoddon, Kristin

2015-01-01

No formal Canadian curriculum presently exists for teaching American Sign Language (ASL) as a second language to parents of deaf and hard of hearing children. However, this group of ASL learners is in need of more comprehensive, research-based support, given the rapid expansion in Canada of universal neonatal hearing screening and the…

Chinese peoples' perceptions of colorectal cancer screening: a New Zealand perspective.

PubMed

Bong, Genevieve; McCool, Judith

2011-03-25

A national cancer screening programme requires a level of perceived acceptability of the procedure among the target population groups to be successful (that is, achieve a high uptake rate). In this study we explored Chinese immigrants' attitudes and perceptions towards colorectal cancer screening. A grounded theory methodology was used explore the determinants of colorectal cancer screening. In depth one-on-one interviews were conducted and subsequently analysed to develop an appreciation of the perspectives on colorectal cancer screening among Chinese people living in New Zealand. Findings indicated a high degree of perceived acceptability for the concept of a national colorectal cancer screening programme. Chinese participants valued health care and preventive health measures were highly prioritised. However, colorectal cancer suffered from the 'poor cousin' syndrome whereby other more highly publicised cancers, such breast cancer, or skin cancer, were perceived to be more relevant and serious, thus marginalising the perceived priority of colorectal cancer screening. Overall, participants paid close attention to their bodies' balance and were proactive in seeking medical advice. Patient practitioner interaction was also found to be influential in the patient's decision to seek screening. The results of the study suggest that the introduction of a colorectal cancer screening programme in New Zealand would benefit from close attention to cultural determinants of screening uptake to provide an equitable service and outcome. Chinese patients who are eligible for participating in the colorectal cancer screening would benefit from access to appropriately detailed and culturally relevant information on the risks, benefit and procedures associated with colorectal cancer screening.

Effect of Education Sessions of a Structured School Eye Screening Programme on Indian Schoolteachers' Knowledge and Responsibility for Children's Eye Health

ERIC Educational Resources Information Center

Thummalapalli, Rohit; Williams, Jachin D.; Khoshnood, Kaveh; Salchow, Daniel J.; Forster, Susan H.

2013-01-01

Objective: To evaluate the effect of education sessions on Indian schoolteacher awareness of childhood eye health issues, responsibility for children's eye health, and successful participation in a teacher-led eye screening health intervention programme in primary schools aimed at addressing avoidable childhood blindness in India. Design:…

The ethics of screening: is 'screeningitis' an incurable disease?

PubMed Central

Shickle, D; Chadwick, R

1994-01-01

Screening programmes are becoming increasingly popular since prevention is considered 'better than cure'. While earlier diagnosis may result in more effective treatment for some, there will be consequent harm for others due to anxiety, stigma, side-effects etc. A screening test cannot guarantee the detection of all 'abnormal' cases, therefore there will be false reassurance for some. A proper consideration of the potential benefit and harm arising from screening may lead to the conclusion that the programme should not be offered. A modified utilitarian approach may be used for allocation of scarce resources in health care. Ethics has an important role in this evaluation. PMID:8035433

Increased survival and decreased recurrence in colorectal cancer patients diagnosed in a screening programme.

PubMed

Mengual-Ballester, Mónica; Pellicer-Franco, Enrique; Valero-Navarro, Graciela; Soria-Aledo, Victoriano; García-Marín, José Andrés; Aguayo-Albasini, José Luis

2016-08-01

Population-based screening programmes for colorectal cancer (CRC) allow an early diagnosis, even before the onset of symptoms, but there are few studies and none in Spain on the influence they have on patient survival. The aim of the present study is to show that patients receiving surgery for CRC following diagnosis via a screening programme have a higher survival and disease-free survival rate than those diagnosed in the symptomatic stage. Prospective study of all the patients undergoing programmed surgery for CRC at the JM Morales Meseguer Hospital in Murcia (Spain) between 2004 and 2010. The patients were divided into two groups: (a) those diagnosed through screening (125 cases); and (b) those diagnosed in the symptomatic stage (565 cases). Survival and disease-free survival were analysed and compared for both groups using the Mantel method. The screen-detected CRC patients show a higher rate of survival (86.3% versus 72.1% at 5 years, p<0.05) and a lower rate of tumour recurrence (73.4% versus 88.3% at 5 years, p<0.05). Population-based screening for CRC is an effective strategic measure for reducing mortality specific to this neoplasia. Copyright © 2016. Published by Elsevier Ltd.

Testing times: do new prenatal tests signal the end of Down syndrome?

PubMed

Cole, Robert; Jones, Gareth

2013-03-01

Since 2010, prenatal screening for Down syndrome (DS) has been offered to all pregnant women in New Zealand. The programme has been criticised by several groups, on claims that screening is eugenic and discriminatory towards those with DS. Recently, tests have been developed that may one day prove more efficient than current screening methods. They are an example of 'Non-Invasive Prenatal Diagnosis' (NIPD), which enables diagnosis earlier in pregnancy with less risk of complications. If the current programme raises objections, what threats does this new and seemingly more attractive technology pose to the DS community? We argue that NIPD is simply an extension of current screening methods, raising similar ethical concerns. Presently, the programme shows little evidence of 'eugenics', demonstrated by moderate uptake rates and varying attitudes towards disability. We do not regard the offer of screening to be threatening, as women choose whether or not to be screened depending on their own personal circumstances. One day, prenatal testing may result in fewer people with DS; but past and present trends indicate these individuals will continue to be supported, irrespective of 'group size'. Care and respect for the disabled will remain essential, regardless of a woman's decision over her pregnancy.

Implementing risk-stratified screening for common cancers: a review of potential ethical, legal and social issues

PubMed Central

Hall, A.E.; Chowdhury, S.; Hallowell, N.; Pashayan, N.; Dent, T.; Pharoah, P.; Burton, H.

2014-01-01

Background The identification of common genetic variants associated with common cancers including breast, prostate and ovarian cancers would allow population stratification by genotype to effectively target screening and treatment. As scientific, clinical and economic evidence mounts there will be increasing pressure for risk-stratified screening programmes to be implemented. Methods This paper reviews some of the main ethical, legal and social issues (ELSI) raised by the introduction of genotyping into risk-stratified screening programmes, in terms of Beauchamp and Childress's four principles of biomedical ethics—respect for autonomy, non-maleficence, beneficence and justice. Two alternative approaches to data collection, storage, communication and consent are used to exemplify the ELSI issues that are likely to be raised. Results Ultimately, the provision of risk-stratified screening using genotyping raises fundamental questions about respective roles of individuals, healthcare providers and the state in organizing or mandating such programmes, and the principles, which underpin their provision, particularly the requirement for distributive justice. Conclusions The scope and breadth of these issues suggest that ELSI relating to risk-stratified screening will become increasingly important for policy-makers, healthcare professionals and a wide diversity of stakeholders. PMID:23986542

Danish method study on cervical screening in women offered HPV vaccination as girls (Trial23): a study protocol.

PubMed

Thamsborg, Lise Holst; Andersen, Berit; Larsen, Lise Grupe; Christensen, Jette; Johansen, Tonje; Hariri, Jalil; Christiansen, Sanne; Rygaard, Carsten; Lynge, Elsebeth

2018-05-26

The first birth cohorts of women offered human papillomavirus (HPV) vaccination as girls are now entering cervical screening. However, there is no international consensus on how to screen HPV vaccinated women. These women are better protected against cervical cancer and could therefore be offered less intensive screening. Primary HPV testing is more sensitive than cytology, allowing for a longer screening interval. The aim of Trial23 is to investigate if primary HPV testing with cytology triage of HPV positive samples is a reasonable screening scheme for women offered HPV vaccination as girls. Trial23 is a method study embedded in the existing cervical screening programme in four out of five Danish regions. Without affecting the screening programme, women born in 1994 are randomised to present screening with liquid-based cytology every third year (present programme arm) or present screening plus an HPV test (HPV arm). The study started 1 February 2017 and will run over three screening rounds corresponding to 7-8 years. The primary endpoint is cervical intraepithelial neoplasia grade 3 or above. The trial is undertaken as a non-inferiority study including intention-to-treat and per-protocol analyses. The potential effect of primary HPV screening with a 6-year interval will be calculated from the observed data. The study protocol has been submitted to the ethical committee and deemed a method study. All women are screened according to routine guidelines. The study will contribute new evidence on the future screening of HPV vaccinated birth cohorts of women. All results will be published in open-access journal. NCT03049553; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Prevention, screening and treatment of colorectal cancer: a global and regional generalized cost effectiveness analysis

PubMed Central

2010-01-01

Background Regional generalized cost-effectiveness estimates of prevention, screening and treatment interventions for colorectal cancer are presented. Methods Standardised WHO-CHOICE methodology was used. A colorectal cancer model was employed to provide estimates of screening and treatment effectiveness. Intervention effectiveness was determined via a population state-transition model (PopMod) that simulates the evolution of a sub-regional population accounting for births, deaths and disease epidemiology. Economic costs of procedures and treatment were estimated, including programme overhead and training costs. Results In regions characterised by high income, low mortality and high existing treatment coverage, the addition of screening to the current high treatment levels is very cost-effective, although no particular intervention stands out in cost-effectiveness terms relative to the others. In regions characterised by low income, low mortality with existing treatment coverage around 50%, expanding treatment with or without screening is cost-effective or very cost-effective. Abandoning treatment in favour of screening (no treatment scenario) would not be cost effective. In regions characterised by low income, high mortality and low treatment levels, the most cost-effective intervention is expanding treatment. Conclusions From a cost-effectiveness standpoint, screening programmes should be expanded in developed regions and treatment programmes should be established for colorectal cancer in regions with low treatment coverage. PMID:20236531

[Population screening for breast cancer: an interim assessment].

PubMed

van der Maas, P J

2000-06-03

The Dutch national breast cancer programme started in 1989 and ten years later complete coverage of the target population was realised. Screening will save the lives of 27% of all women with screen detected breast cancer. In the other 73% survival will not change, but they will know some years earlier that they have breast cancer. There are 4 lessons from the 12 year experience: (a) mortality reduction due to the present programme can only be identified in individual follow-up data of all women with breast cancer; (b) systematic improvement of the programme's performance can only be based on feedback from a detailed quality and outcome monitoring system; (c) the advice to increase the upper age limit to 75 years was based on the interpretation of trial results for younger age groups and model analysis; (d) breast cancer screening contributed to the systematic improvement of clinical procedures. Current scientific and practical challenges are mortality evaluation, optimising test properties, setting upper and lower age limits, understanding regional differences, developing optimal screening frequencies in women with an elevated breast cancer risk, digital mammography and computer assisted diagnosis.

Data integration and warehousing: coordination between newborn screening and related public health programs.

PubMed

Therrell, Bradford L

2003-01-01

At birth, patient demographic and health information begin to accumulate in varied databases. There are often multiple sources of the same or similar data. New public health programs are often created without considering data linkages. Recently, newborn hearing screening (NHS) programs and immunization programs have virtually ignored the existence of newborn dried blood spot (DBS) newborn screening databases containing similar demographic data, creating data duplication in their 'new' systems. Some progressive public health departments are developing data warehouses of basic, recurrent patient information, and linking these databases to other health program databases where programs and services can benefit from such linkages. Demographic data warehousing saves time (and money) by eliminating duplicative data entry and reducing the chances of data errors. While newborn screening data are usually the first data available, they should not be the only data source considered for early data linkage or for populating a data warehouse. Birth certificate information should also be considered along with other data sources for infants that may not have received newborn screening or who may have been born outside of the jurisdiction and not have birth certificate information locally available. This newborn screening serial number provides a convenient identification number for use in the DBS program and for linking with other systems. As a minimum, data linkages should exist between newborn dried blood spot screening, newborn hearing screening, immunizations, birth certificates and birth defect registries.

Looking Behavior and Audiovisual Speech Understanding in Children With Normal Hearing and Children With Mild Bilateral or Unilateral Hearing Loss.

PubMed

Lewis, Dawna E; Smith, Nicholas A; Spalding, Jody L; Valente, Daniel L

Visual information from talkers facilitates speech intelligibility for listeners when audibility is challenged by environmental noise and hearing loss. Less is known about how listeners actively process and attend to visual information from different talkers in complex multi-talker environments. This study tracked looking behavior in children with normal hearing (NH), mild bilateral hearing loss (MBHL), and unilateral hearing loss (UHL) in a complex multi-talker environment to examine the extent to which children look at talkers and whether looking patterns relate to performance on a speech-understanding task. It was hypothesized that performance would decrease as perceptual complexity increased and that children with hearing loss would perform more poorly than their peers with NH. Children with MBHL or UHL were expected to demonstrate greater attention to individual talkers during multi-talker exchanges, indicating that they were more likely to attempt to use visual information from talkers to assist in speech understanding in adverse acoustics. It also was of interest to examine whether MBHL, versus UHL, would differentially affect performance and looking behavior. Eighteen children with NH, eight children with MBHL, and 10 children with UHL participated (8-12 years). They followed audiovisual instructions for placing objects on a mat under three conditions: a single talker providing instructions via a video monitor, four possible talkers alternately providing instructions on separate monitors in front of the listener, and the same four talkers providing both target and nontarget information. Multi-talker background noise was presented at a 5 dB signal-to-noise ratio during testing. An eye tracker monitored looking behavior while children performed the experimental task. Behavioral task performance was higher for children with NH than for either group of children with hearing loss. There were no differences in performance between children with UHL and children with MBHL. Eye-tracker analysis revealed that children with NH looked more at the screens overall than did children with MBHL or UHL, though individual differences were greater in the groups with hearing loss. Listeners in all groups spent a small proportion of time looking at relevant screens as talkers spoke. Although looking was distributed across all screens, there was a bias toward the right side of the display. There was no relationship between overall looking behavior and performance on the task. The present study examined the processing of audiovisual speech in the context of a naturalistic task. Results demonstrated that children distributed their looking to a variety of sources during the task, but that children with NH were more likely to look at screens than were those with MBHL/UHL. However, all groups looked at the relevant talkers as they were speaking only a small proportion of the time. Despite variability in looking behavior, listeners were able to follow the audiovisual instructions and children with NH demonstrated better performance than children with MBHL/UHL. These results suggest that performance on some challenging multi-talker audiovisual tasks is not dependent on visual fixation to relevant talkers for children with NH or with MBHL/UHL.

Ensuring financial access to hearing AIDS for infants and young children.

PubMed

Limb, Stephanie J; McManus, Margaret A; Fox, Harriette B; White, Karl R; Forsman, Irene

2010-08-01

Many young children with permanent hearing loss do not receive hearing aids and related professional services, in part because of public and private financing limitations. In 2006 the Children's Audiology Financing Workgroup was convened by the National Center for Hearing Assessment and Management to evaluate and make recommendations about public and private financing of hearing aids and related professional services for 0- to 3-year-old children. The workgroup recommended 4 possible strategies for ensuring that all infants and young children with hearing loss have access to appropriate hearing aids and professional services: (1) clarify that the definition of assistive technology, which is a required service under Part C of the Individuals With Disabilities Education Act (IDEA), includes not only analog hearing aids but also digital hearing aids with appropriate features as needed by young children with hearing loss; (2) clarify for both state Medicaid and Children's Health Insurance Programs that digital hearing aids are almost always the medically necessary type of hearing aid required for infants and young children and should be covered under the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program; (3) encourage the passage of private health insurance legislative mandates to require coverage of appropriate digital hearing aids and related professional services for infants and young children; and (4) establish hearing-aid loaner programs in every state. The costs of providing hearing aids to all 0- to 3-year old children in the United States are estimated here.

Sign Language and Spoken Language for Children With Hearing Loss: A Systematic Review.

PubMed

Fitzpatrick, Elizabeth M; Hamel, Candyce; Stevens, Adrienne; Pratt, Misty; Moher, David; Doucet, Suzanne P; Neuss, Deirdre; Bernstein, Anita; Na, Eunjung

2016-01-01

Permanent hearing loss affects 1 to 3 per 1000 children and interferes with typical communication development. Early detection through newborn hearing screening and hearing technology provide most children with the option of spoken language acquisition. However, no consensus exists on optimal interventions for spoken language development. To conduct a systematic review of the effectiveness of early sign and oral language intervention compared with oral language intervention only for children with permanent hearing loss. An a priori protocol was developed. Electronic databases (eg, Medline, Embase, CINAHL) from 1995 to June 2013 and gray literature sources were searched. Studies in English and French were included. Two reviewers screened potentially relevant articles. Outcomes of interest were measures of auditory, vocabulary, language, and speech production skills. All data collection and risk of bias assessments were completed and then verified by a second person. Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) was used to judge the strength of evidence. Eleven cohort studies met inclusion criteria, of which 8 included only children with severe to profound hearing loss with cochlear implants. Language development was the most frequently reported outcome. Other reported outcomes included speech and speech perception. Several measures and metrics were reported across studies, and descriptions of interventions were sometimes unclear. Very limited, and hence insufficient, high-quality evidence exists to determine whether sign language in combination with oral language is more effective than oral language therapy alone. More research is needed to supplement the evidence base. Copyright © 2016 by the American Academy of Pediatrics.

The effect of tinnitus retraining therapy on chronic tinnitus: A controlled trial

PubMed Central

Berry, Jennifer L.; Brozoski, Thomas J.

2017-01-01

Objectives The goal of this study was to compare treatment outcomes for chronic bothersome tinnitus after Tinnitus Retraining Therapy (TRT) versus standard of care treatment (SC) and to determine the longevity of the effect over an 18‐month period. Study Design A randomized controlled trial comparing TRT to SC for chronic tinnitus. Methods Adults with subjective, stable, bothersome chronic tinnitus associated with hearing loss amenable to aural rehabilitation with hearing aids were recruited. The Tinnitus Handicap Inventory (THI) was the primary outcome measure and the Tinnitus Functional Index (TFI) the secondary outcome measure of tinnitus severity and impact. Data were collected at screening, entry (0 months), and 6, 12, and 18 months after the beginning of treatment, using an integrated digitized suite of evaluation modules. TRT consisted of directive counseling and acoustic enrichment using combination hearing aids and sound generators; SC consisted of general aural rehabilitation counseling and hearing aids. Results Significant improvement in tinnitus impact occurred after both TRT and SC therapy, with a larger treatment effect obtained in the TRT group. Lasting therapeutic benefit was evident at 18 months in both groups. THI initial scores were unstable in 10% of enrolled participants, showing moderate bidirectional fluctuation between screening and baseline (0 month) assessment. Conclusion Adults with moderate to severe tinnitus and hearing loss amenable to amplification, benefit from either TRT or SC treatment when combined with hearing aid use. TRT benefit may exceed that of SC. The global improvement in tinnitus severity that accrued over an 18‐month period appeared to be robust and clinically significant. Level of Evidence I PMID:28894836

A Comprehensive Study on the Etiology of Patients Receiving Cochlear Implantation With Special Emphasis on Genetic Epidemiology

PubMed Central

Miyagawa, Maiko; Nishio, Shin-Ya; Usami, Shin-Ichi

2016-01-01

Objective: Cochlear implantation is the most important treatment currently available for profound sensorineural hearing loss. The aim of this study was to investigate the etiology of hearing loss in patients with cochlear implantation, and to compare outcomes. Methods: Japanese hearing loss patients who received cochlear implants (CIs) or electric acoustic stimulation (EAS) in Shinshu University hospital (n = 173, prelingual onset: 92, postlingual onset: 81) participated in this study. Invader assay followed by the targeted exon-sequencing of 63 deafness genes using Massively parallel DNA sequencing (MPS) was applied. For prelingual patients, additional imaging examination, cCMV screening, and pediatric examination were performed for precise diagnosis. Results: Genetic screening successfully identified the causative mutation in 60% of patients with prelingual onset hearing loss and in 36% of those with postlingual hearing loss. Differences in the kinds of genes identified were observed between the two groups. Although there were marked variations in the outcome of cochlear implantation, patients with specific deafness gene mutations showed relatively good results. Conclusion: The present study showed genetic etiology is a major cause of hearing loss in CI/EAS patients. Patients possessing mutations in a number of deafness genes known to be expressed within inner ear have achieved satisfactory auditory performance, suggesting that the identification of the genetic background facilitates the prediction of post-CI performance. MPS is a powerful tool for the identification of causative deafness genes in patients receiving cochlear implantation. Therefore, determination of the involved region inside/outside of the cochlea by identification of the responsible gene is essential. PMID:26756145

Women's perceptions of breast cancer screening. Spanish screening programme survey.

PubMed

Baena-Cañada, José M; Rosado-Varela, Petra; Expósito-Álvarez, Inmaculada; González-Guerrero, Macarena; Nieto-Vera, Juan; Benítez-Rodríguez, Encarnación

2014-12-01

Participants in breast cancer screening programmes may benefit from early detection but may also be exposed to the risks of overdiagnosis and false positives. We surveyed a sample of Spanish women to assess knowledge, information sources, attitudes and psychosocial impact. A total of 434 breast cancer screening programme participants aged 45-69 years were administered questionnaires regarding knowledge, information sources, attitudes and psychosocial impact. Scores of 5 or more (out of 10) and 12 or less (out of 24) were established as indicating adequate knowledge and a positive attitude, respectively. Psychosocial impact was measured using the Hospital Anxiety and Depression Scale and the Cancer Worry Scale. Only 42 women (9.7%) had adequate knowledge. The mean (SD) knowledge score was 2.97 (1.16). Better educated women and women without previous false positives had higher scores. The main sources of information were television, press, Andalusian Health Service documentation and family and friends. Most participants (99.1%) had a positive attitude, with a mean (SD) score of 3.21 (2.66). Mean (SD) scores for anxiety, depression and cancer worry were 1.86 (3.26), 0.72 (1.99) and 9.4 (3.04), respectively. Women have a very positive attitude to breast cancer screening, but are poorly informed and use television as their main information source. They experience no negative psychosocial impact from participation in such programmes. Copyright © 2014 Elsevier Ltd. All rights reserved.

Evidence of hearing loss in a “normally-hearing” college-student population

PubMed Central

Le Prell, C. G.; Hensley, B.N.; Campbell, K. C. M.; Hall, J. W.; Guire, K.

2011-01-01

We report pure-tone hearing threshold findings in 56 college students. All subjects reported normal hearing during telephone interviews, yet not all subjects had normal sensitivity as defined by well-accepted criteria. At one or more test frequencies (0.25–8 kHz), 7% of ears had thresholds ≥25 dB HL and 12% had thresholds ≥20 dB HL. The proportion of ears with abnormal findings decreased when three-frequency pure-tone-averages were used. Low-frequency PTA hearing loss was detected in 2.7% of ears and high-frequency PTA hearing loss was detected in 7.1% of ears; however, there was little evidence for “notched” audiograms. There was a statistically reliable relationship in which personal music player use was correlated with decreased hearing status in male subjects. Routine screening and education regarding hearing loss risk factors are critical as college students do not always self-identify early changes in hearing. Large-scale systematic investigations of college students’ hearing status appear to be warranted; the current sample size was not adequate to precisely measure potential contributions of different sound sources to the elevated thresholds measured in some subjects. PMID:21288064

Evaluating the impacts of screening and smoking cessation programmes on lung cancer in a high-burden region of the USA: a simulation modelling study

PubMed Central

Tramontano, Angela C; Sheehan, Deirdre F; McMahon, Pamela M; Dowling, Emily C; Holford, Theodore R; Ryczak, Karen; Lesko, Samuel M; Levy, David T; Kong, Chung Yin

2016-01-01

Objective While the US Preventive Services Task Force has issued recommendations for lung cancer screening, its effectiveness at reducing lung cancer burden may vary at local levels due to regional variations in smoking behaviour. Our objective was to use an existing model to determine the impacts of lung cancer screening alone or in addition to increased smoking cessation in a US region with a relatively high smoking prevalence and lung cancer incidence. Setting Computer-based simulation model. Participants Simulated population of individuals 55 and older based on smoking prevalence and census data from Northeast Pennsylvania. Interventions Hypothetical lung cancer control from 2014 to 2050 through (1) screening with CT, (2) intensified smoking cessation or (3) a combination strategy. Primary and secondary outcome measures Primary outcomes were lung cancer mortality rates. Secondary outcomes included number of people eligible for screening and number of radiation-induced lung cancers. Results Combining lung cancer screening with increased smoking cessation would yield an estimated 8.1% reduction in cumulative lung cancer mortality by 2050. Our model estimated that the number of screening-eligible individuals would progressively decrease over time, indicating declining benefit of a screening-only programme. Lung cancer screening achieved a greater mortality reduction in earlier years, but was later surpassed by smoking cessation. Conclusions Combining smoking cessation programmes with lung cancer screening would provide the most benefit to a population, especially considering the growing proportion of patients ineligible for screening based on current recommendations. PMID:26928026

Amplitude changes in otoacoustic emissions after exposure to industrial noise.

PubMed

Baradarnfar, Mohammad Hossein; Karamifar, Kayvan; Mehrparvar, Amir Houshang; Mollasadeghi, Abolfazl; Gharavi, Marjan; Karimi, Ghasem; Vahidy, Mohammad Reza; Baradarnfar, Amin; Mostaghaci, Mehrdad

2012-01-01

Noise-induced hearing loss (NIHL) is a frequent problem in industrial settings, especially where a high noise level is present. It is permanent, and irreversible, but preventable. Routine audiometry (an objective and time consuming) test is used for NIHL screening. Otoacoustic emissions (OAEs) are recently proposed as a more sensitive test for early diagnosis of NIHL. In this study, we aimed to compare the results of pure tone audiometry (PTA) with OAE in the diagnosis of NIHL. In a cross-sectional study on 120 workers (in three groups: Not exposed to noise, exposed to noise without NIHL and exposed to noise with NIHL), we compared the results of PTA and OAE. OAE can detect some changes in the function of hearing system in subjects exposed to noise, and these changes are apparently prior to hearing loss, which is diagnosed by PTA. OAE is a more sensitive method for the early diagnosis of cochlear damage than PTA, and can be performed in industrial settings for NIHL screening.

Variation in cervical and breast cancer screening coverage in England: a cross-sectional analysis to characterise districts with atypical behaviour.

PubMed

Massat, Nathalie J; Douglas, Elaine; Waller, Jo; Wardle, Jane; Duffy, Stephen W

2015-07-24

Reducing cancer screening inequalities in England is a major focus of the 2011 Department of Health cancer outcome strategy. Screening coverage requires regular monitoring in order to implement targeted interventions where coverage is low. This study aimed to characterise districts with atypical coverage levels for cervical or breast screening. Observational study of district-level coverage in the English Cervical and Breast screening programmes in 2012. England, UK. All English women invited to participate in the cervical (age group 25-49 and 50-64) and breast (age group 50-64) screening programmes. Risk adjustment models for coverage were developed based on district-level characteristics. Funnel plots of adjusted coverage were constructed, and atypical districts examined by correlation analysis. Variability in coverage was primarily explained by population factors, whereas general practice characteristics had little independent effect. Deprivation and ethnicity other than white, Asian, black or mixed were independently associated with poorer coverage in both screening programmes, with ethnicity having the strongest effect; by comparison, the influence of Asian, black or mixed ethnic minority was limited. Deprivation, ethnicity and urbanisation largely accounted for the lower cervical screening coverage in London. However, for breast screening, being located in London remained a strong negative predictor. A subset of districts was identified as having atypical coverage across programmes. Correlates of deprivation in districts with relatively low adjusted coverage were substantially different from overall correlates of deprivation. These results inform the continuing drive to reduce avoidable cancer deaths in England, and encourage implementation of targeted interventions in communities residing in districts identified as having atypically low coverage. Sequential implementation to monitor the impact of local interventions would help accrue evidence on 'what works'. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The current screening programme for congenital transmission of Chagas disease in Catalonia, Spain.

PubMed

Basile, L; Oliveira, I; Ciruela, P; Plasencia, A

2011-09-22

Due to considerable numbers of migrants from Chagas disease-endemic countries living in Catalonia, the Catalonian Health Department has recently implemented a screening programme for preventing congenital transmission, targeting Latin American pregnant women who attend antenatal consultations. Diagnosis of Trypanosoma cruzi infection in women is based on two positive serological tests. Screening of newborns from mothers with positive serology is based on a parasitological test during the first 48 hours of life and/or conventional serological analysis at the age of nine months. If either of these tests is positive, treatment with benznidazole is started following the World Health Organization's recommendations. The epidemiological surveillance of the programme is based on the Microbiological Reporting System of Catalonia, a well established network of laboratories. Once a positive case is reported, the responsible physician is asked to complete a structured epidemiological questionnaire. Clinical and demographic data are registered in the Voluntary Case Registry of Chagas Disease, a database administered by the Catalonian Health Department. It is expected that this programme will improve the understanding of the real burden of Chagas disease in the region. Furthermore, this initiative could encourage the implementation of similar programmes in other regions of Spain and even in other European countries.

‘A morass of considerations’: exploring attitudes towards ethnicity-based haemoglobinopathy-carrier screening in primary care

PubMed Central

Henneman, L; de Jonge, A; van El, C G; van Tuyl, L H; Cornel, M C; Lagro-Janssen, A L M

2013-01-01

Background. The Netherlands does not have a national haemoglobinopathy (HbP)-carrier screening programme aimed at facilitating informed reproductive choice. HbP-carrier testing for those at risk is at best offered on the basis of anaemia. Registration of ethnicity has proved controversial and may complicate the introduction of a screening programme if based on ethnicity. However, other factors may also play a role. Objective. To explore perceived barriers and attitudes among GPs and midwives regarding the registration of ethnicity and ethnicity-based HbP-carrier screening. Methods. Six focus groups in Dutch primary care, with a total of 37 GPs (n = 9) and midwives (n = 28) were conducted, transcribed and content analysed using Atlas-ti. Results. Both GPs and midwives struggled with correctly identifying ethnicities at risk for HbP. Ethical concerns regarding privacy seemed to originate from World War II experiences, when ethnic and religious registration facilitated deportation of Jewish citizens, coupled with the political climate at the time focus groups were held. Some respondents thought the ethnicity question might undermine the relationship with their clients. Software programmes prevented GPs from registering ethnicity of patients at risk. Financial implications for patients were also a concern. Despite this, respondents seemed positive about screening and were familiar with identifying ethnicity and used this for individual patient care. Conclusions. Although health professionals are generally positive about screening, ethical, financial and practical issues surrounding ethnicity-based HbP-carrier screening need to be clarified before introducing such a programme. Primary care professionals can be targeted through professional organizations but they need national policy support. PMID:23629736

Psychometric Properties of the Strengths and Difficulties Questionnaire and Mental Health Problems among Children with Hearing Loss

ERIC Educational Resources Information Center

Niclasen, Janni; Dammeyer, Jesper

2016-01-01

More knowledge is needed about the characteristics of mental health problems among deaf or hard of hearing (D/HH) children. This study investigates the factor structure of one of the most widely used screening tools, the Strengths and Difficulties Questionnaire (SDQ), and the prevalence of mental health problems among D/HH children. Our data were…

Screening for iron deficiency and iron deficiency anaemia in pregnancy: a structured review and gap analysis against UK national screening criteria.

PubMed

Rukuni, Ruramayi; Knight, Marian; Murphy, Michael F; Roberts, David; Stanworth, Simon J

2015-10-20

Iron deficiency anaemia is a common problem in pregnancy despite national recommendations and guidelines for treatment. The aim of this study was to appraise the evidence against the UK National Screening Committee (UKNSC) criteria as to whether a national screening programme could reduce the prevalence of iron deficiency anaemia and/or iron deficiency in pregnancy and improve maternal and fetal outcomes. Search strategies were developed for the Cochrane library, Medline and Embase to identify evidence relevant to UK National Screening Committee (UKNSC) appraisal criteria which cover the natural history of iron deficiency and iron deficiency anaemia, the tests for screening, clinical management and evidence of cost effectiveness. Many studies evaluated haematological outcomes of anaemia, but few analysed clinical consequences. Haemoglobin and ferritin appeared the most suitable screening tests, although future options may follow recent advances in understanding iron homeostasis. The clinical consequences of iron deficiency without anaemia are unknown. Oral and intravenous iron are effective in improving haemoglobin and iron parameters. There have been no trials or economic evaluations of a national screening programme for iron deficiency anaemia in pregnancy. Iron deficiency in pregnancy remains an important problem although effective tests and treatment exist. A national screening programme could be of value for early detection and intervention. However, high quality studies are required to confirm whether this would reduce maternal and infant morbidity and be cost effective.

Hearing handicap predicts the development of depressive symptoms after 3 years in older community-dwelling Japanese.

PubMed

Saito, Hideyuki; Nishiwaki, Yuji; Michikawa, Takehiro; Kikuchi, Yuriko; Mizutari, Kunio; Takebayashi, Toru; Ogawa, Kaoru

2010-01-01

To examine the association between hearing handicap and depressive symptoms in older community-dwelling Japanese. Community-based cohort study. Kurabuchi Town, Gunma Prefecture, Japan. Five hundred eighty residents (261 men, 319 women) aged 65 and older without depressive symptoms. In a baseline examination performed in 2005/06, participants answered the 10-item screening version of the Hearing Handicap Inventory for Elderly (HHIE-S). They were divided into two groups according to their scores: a group with no hearing handicap (HHIE-S scores of < or =8) and a hearing handicap group (HHIE-S scores of > or =10). The Geriatric Depression Scale was used to identify depressive symptoms in face-to-face home visit interviews conducted in 2008, and the association between hearing handicap and depressive symptoms was assessed using logistic regression. The incidence of depressive symptoms was 19.6% in the group with a hearing handicap and 8.0% in the group without a hearing handicap. When compared with the subjects without hearing handicap, subjects with a hearing handicap had a multiadjusted odds ratio of depressive symptoms of 2.45 (95% confidence interval=1.26-4.77). The association remained significant even when hearing impairment measured with pure-tone audiometry was added to the multiadjusted model. A hearing handicap can predict future depressive symptoms in older community-dwelling people.

Newborn screening for cystic fibrosis: Polish 4 years' experience with CFTR sequencing strategy.

PubMed

Sobczyńska-Tomaszewska, Agnieszka; Ołtarzewski, Mariusz; Czerska, Kamila; Wertheim-Tysarowska, Katarzyna; Sands, Dorota; Walkowiak, Jarosław; Bal, Jerzy; Mazurczak, Tadeusz

2013-04-01

Newborn screening for cystic fibrosis (NBS CF) in Poland was started in September 2006. Summary from 4 years' experience is presented in this study. The immunoreactive trypsin/DNA sequencing strategy was implemented. The group of 1,212,487 newborns were screened for cystic fibrosis during the programme. We identified a total of 221 CF cases during this period, including, 4 CF cases were reported to be omitted by NBS CF. Disease incidence in Poland based on the programme results was estimated as 1/4394 and carrier frequency as 1/33. The frequency of the F508del was similar (62%) to population data previously reported. This strategy allowed us to identify 29 affected infants with rare genotypes. The frequency of some mutations (eg, 2184insA, K710X) was assessed in Poland for the first time. Thus, sequencing assay seems to be accurate method for screening programme using blood spots in the Polish population.

Graphical representations of a television series: a study with deaf and hearing adolescents.

PubMed

Cambra, Cristina; Leal, Aurora; Silvestre, Núria

2010-11-01

The understanding of a television story can be very different depending on the age of the viewer, their background knowledge, the content of the programme and the way in which they combine the information gathered from linguistic, audio and visual elements. This study explores the different ways of interpreting an audiovisual document considering that, due to a hearing impaired, visual, audio and linguistic information could be perceived very differently to the way it is by hearing people. The study involved the participation of 20 deaf and 20 hearing adolescents, aged 12 to 19 years who, after watching a fragment of a television series, were asked to draw a picture of what had happened in the story. The results show that the graphical representation of the film is similar for both groups in terms of the number of scenes, but there is greater profusion, in the deaf group, of details about the context and characters, and there are differences in their interpretations of some of the sequences in the story.

Sensitivity of fetal RHD screening for safe guidance of targeted anti-D immunoglobulin prophylaxis: prospective cohort study of a nationwide programme in the Netherlands.

PubMed

de Haas, Masja; Thurik, Florentine F; van der Ploeg, Catharina P B; Veldhuisen, Barbera; Hirschberg, Hoang; Soussan, Aicha Ait; Woortmeijer, Heleen; Abbink, Frithjofna; Page-Christiaens, Godelieve C M L; Scheffer, Peter G; Ellen van der Schoot, C

2016-11-07

 To determine the accuracy of non-invasive fetal testing for the RHD gene in week 27 of pregnancy as part of an antenatal screening programme to restrict anti-D immunoglobulin use to women carrying a child positive for RHD DESIGN:  Prospectively monitoring of fetal RHD testing accuracy compared with serological cord blood typing on introduction of the test. Fetal RHD testing was performed with a duplex real time quantitative polymerase chain reaction, with cell-free fetal DNA isolated from 1 mL of maternal plasma The study period was between 4 July 2011 and 7 October 2012. The proportion of women participating in screening was determined.  Nationwide screening programme, the Netherlands. Tests are performed in a centralised setting.  25 789 RhD negative pregnant women.  Sensitivity, specificity, false negative rate, and false positive rate of fetal RHD testing compared with serological cord blood typing; proportion of technical failures; and compliance to the screening programme.  A fetal RHD test result and serological cord blood result were available for 25 789 pregnancies. Sensitivity for detection of fetal RHD was 99.94% (95% confidence interval 99.89% to 99.97%) and specificity was 97.74% (97.43% to 98.02%). Nine false negative results for fetal RHD testing were registered (0.03%, 95% confidence interval 0.01% to 0.06%). In two cases these were due to technical failures. False positive fetal RHD testing results were registered for 225 samples (0.87%, 0.76% to 0.99%). Weak RhD expression was shown in 22 of these cases, justifying anti-D immunoglobulin use. The negative and positive predictive values were 99.91% (95% confidence interval 99.82% to 99.95%) and 98.60% (98.40% to 98.77%), respectively. More than 98% of the women participated in the screening programme.  Fetal RHD testing in week 27 of pregnancy as part of a national antenatal screening programme is highly reliable and can be used to target both antenatal and postnatal anti-D immunoglobulin use. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The Gap-Startle Paradigm for Tinnitus Screening in Animal Models: Limitations and Optimization

PubMed Central

Lobarinas, Edward; Hayes, Sarah H.; Allman, Brian L.

2012-01-01

In 2006, Turner and colleagues (Behav Neurosci, 120:188–195) introduced the gap-startle paradigm as a high-throughput method for tinnitus screening in rats. Under this paradigm, gap detection ability was assessed by determining the level of inhibition of the acoustic startle reflex produced by a short silent gap inserted in an otherwise continuous background sound prior to a loud startling stimulus. Animals with tinnitus were expected to show impaired gap detection ability (i.e., lack of inhibition of the acoustic startle reflex) if the background sound containing the gap was qualitatively similar to the tinnitus pitch. Thus, for the gap-startle paradigm to be a valid tool to screen for tinnitus, a robust startle response from which to inhibit must be present. Because recent studies have demonstrated that the acoustic startle reflex could be dramatically reduced following noise exposure, we endeavored to 1) modify the gap-startle paradigm to be more resilient in the presence of hearing loss, and 2) evaluate whether a reduction in startle reactivity could confound the interpretation of gap prepulse inhibition and lead to errors in screening for tinnitus. In the first experiment, the traditional broadband noise (BBN) startle stimulus was replaced by a bandpass noise in which the sound energy was concentrated in the lower frequencies (5–10 kHz) in order to maintain audibility of the startle stimulus after unilateral high frequency noise exposure (16 kHz). However, rats still showed a 57% reduction in startle amplitude to the bandpass noise post-noise exposure. A follow-up experiment on a separate group of rats with transiently-induced conductive hearing loss revealed that startle reactivity was better preserved when the BBN startle stimulus was replaced by a rapid airpuff to the back of the rats neck. Furthermore, it was found that transient unilateral conductive hearing loss, which was not likely to induce tinnitus, caused an impairment in gap prepulse inhibition as assessed with the traditional BBN gap-startle paradigm, resulting in a false-positive screening for tinnitus. Thus, the present study identifies significant caveats of the traditional gap-startle paradigm, and describes experimental parameters using an airpuff startle stimulus which may help to limit the negative consequences of reduced startle reactivity following noise exposure, thereby allowing researchers to better screen for tinnitus in animals with hearing loss. PMID:22728305

Controversies in colorectal cancer screening.

PubMed

Pox, Christian P

2014-01-01

Colorectal cancer (CRC) is one of the most common cancers worldwide and a good candidate for screening programmes. However, there is controversy concerning which of the available screening tests should be used. There is general agreement that screening for CRC in the asymptomatic population should begin at the age of 50. Several different screening methods are available which can be separated into those that mainly detect cancers: faecal occult blood tests [guaiac (FOBT) and immunochemical (FIT)], genetic stool tests, blood tests and the M2-pyruvate kinase (M2-PK) test. Methods that detect cancers and polyps are colonoscopy, sigmoidoscopy, CT-colonography (CT-C) and colon capsule endoscopy. The only tests for which a reduction in CRC mortality compared to no screening have been proven in randomized trials are FOBT and sigmoidoscopy. Several trials suggest that FIT are superior to FOBT in terms of detection rates of cancers and advanced adenomas and possibly compliance. There is indirect evidence suggesting efficacy of colonoscopy as a screening test. The role of CT-C is controversial. There is data suggesting a good sensitivity for neoplasia >9 mm with a lower sensitivity for smaller neoplasia. However, radiation exposure is considered a major limitation in some countries. Unresolved questions include the lesion cut-off for referral to colonoscopy and work-up of extracolonic findings. For other methods, like genetic stool testing using newer markers, blood tests, capsule endoscopy and M2-PK, there is currently insufficient data on screening of the asymptomatic population. Key Messages: Colorectal screening is recommended and should be performed in the form of an organized programme. If detection of early-stage cancers is the aim of a screening programme, FIT seem to be superior to FOBT. If detection and removal of adenomas is the aim of a screening programme, endoscopic methods seem to be good alternatives. Sigmoidoscopy is easier to perform but will likely only have an effect on distal cancers. Colonoscopy is more invasive but enables inspection of the whole colon. The role of CT-C, capsule endoscopy, genetic stool tests, blood tests and M2-PK is currently unknown. © 2014 S. Karger AG, Basel.

Cortical Auditory Evoked Potentials Reveal Changes in Audibility with Nonlinear Frequency Compression in Hearing Aids for Children: Clinical Implications

PubMed Central

Ching, Teresa Y. C.; Zhang, Vicky W.; Hou, Sanna; Van Buynder, Patricia

2016-01-01

Hearing loss in children is detected soon after birth via newborn hearing screening. Procedures for early hearing assessment and hearing aid fitting are well established, but methods for evaluating the effectiveness of amplification for young children are limited. One promising approach to validating hearing aid fittings is to measure cortical auditory evoked potentials (CAEPs). This article provides first a brief overview of reports on the use of CAEPs for evaluation of hearing aids. Second, a study that measured CAEPs to evaluate nonlinear frequency compression (NLFC) in hearing aids for 27 children (between 6.1 and 16.8 years old) who have mild to severe hearing loss is reported. There was no significant difference in aided sensation level or the detection of CAEPs for /g/ between NLFC on and off conditions. The activation of NLFC was associated with a significant increase in aided sensation levels for /t/ and /s/. It also was associated with an increase in detection of CAEPs for /t/ and /s/. The findings support the use of CAEPs for checking audibility provided by hearing aids. Based on the current data, a clinical protocol for using CAEPs to validate audibility with amplification is presented. PMID:27587920

French-Canadian translation and validation of four questionnaires assessing hearing impairment and handicap.

PubMed

Vincent, Claude; Gagné, Jean-Pierre; Leroux, Tony; Clothier, Audrey; Larivière, Marianne; Dumont, Frédéric S; Gendron, Martine

2017-04-01

Questionnaires evaluating hearing impairment are available in English but there is a need for French standardised questionnaires for researchers as well as for audiologists and other clinicians. The objective of this study is to describe the translation and validation of four questionnaires that assess different aspects of hearing impairment and handicap among elders with hearing loss, by comparing the main score and psychometric evaluation of original and French-Canadian (FC) versions of the World Health Organization Disability Assessment Scale II (WHO-DAS II), the Screening Test for Hearing Problems (STHP), the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids (MARS-HA). Vallerand method: translation and back-translation by two translators, revision by a committee of experts and pre-tested with five bilingual older participants. Participants (n = 29) were 65 years of age or older including 21 with hearing aids. The psychometric properties (internal consistency, temporal stability after four weeks) indicate good reliability for most of the translated questionnaires and their subscales, especially the WHO-DAS II. The translations in FC of two hearing loss and two hearing aid questionnaires were validated. It is recommended to pursue the demonstration for temporal stability for the STHP.

[Using an employee survey as a means of quality assurance in newborn hearing screening].

PubMed

Depenbrock, A; Matulat, P; am Zehnhoff-Dinnesen, A

2013-03-01

Studies drawing information not only from technical data but also from surveying human resources behind the universal newborn hearing screening (UNHS) appear to be a rarity. This study aims at showing how the state of both knowledge and practical skills among the screening staff are essential aspects in future quality management. A self-developed questionnaire was sent to hospital staff addressing a total of 710 nurses who were registered as having undertaken a UNHS training course. Questions were aimed at aspects of organization, personal practical skills, current problems and improvement possibilities. High rates of occupancy, lack of trained personnel, technical issues and background noise disturbances were considered to be factors that increased time pressure and slowed down procedures. Of the participants 16 % considered communicating a "refer" result to parents a difficult step and 8 % felt insecure when explaining the aims and procedures to parents. There was a high interest in further training sessions. This survey served well to reveal aspects of improvement in screening procedures and meeting staff needs. The training sessions should outline practical aspects of conducting screening and also professional, sensitive communication to parents.