Changes in Locus-of-Control Attitudes about Drug Misuse in a Self-Help Group in a Methadone Maintenance Clinic

Clients of a methadone-maintenance clinic in Brooklyn, New York participating in a clinically-guided self-help (CGSH) program plus standard treatment (methadone maintenance plus individual counseling) demonstrated statistically significant changes in locus-of-control beliefs, from external to internal causation, about personal responsibility for drug misuse. Members of two control groups—one participating in a didactic lecture program plus standard treatment and the other receiving only standard treatment—failed to demonstrate similar changes. This increase in internal locus of control in the CGSH group suggests the potential efficacy of CGSH as a relapse-prevention therapeutic technique.     

助视器对年龄相关性黄斑变性患者视功能恢复和阅读速度的影响

目的:评估助视器对年龄相关性黄斑变性(AMD)患者视功能恢复和阅读速度的影响。方法:对低视力门诊44名AMD患者进行评估。收集并分析使用助视器前和使用助视器时裸眼视力、最佳矫正视力、屈光状态、助视器类型(LVAs)以及阅读速度的相关数据。结果:共44例AMD患者,平均年龄为73±10.8岁,男性36例(82%)。其中,29例(67%)受试者视力较好的眼远视力(DVA)为1.0~1.6 LogMAR,而36例(82%)受试者近视力(NVA)小于3.2 m。使用助视器时平均DVA提高0.67±0.27 LogMAR(P=0.000)。使用LVAs时,42例患者NVA达到1 m甚至更佳,仅有2例(4.5%)没有使用LVAs的患者NVA为1 m。在使用一定时间的助视器后,有阅读能力的患者平均阅读速度从每分钟2.9±4.78字提高到每分钟71.31±29.96字(P<0.001)。15名受试者远距离视觉使用单目望远镜,而戴高倍单目镜片眼镜作为最常用的阅读辅助工具。结论:LVAs对AMD患者的视功能恢复和阅读能力的提高有一定的作用。对于AMD患者而言,接受低视力护理服务是有必要的。     

Variable Venting Valve for Earmolds

The frequency response and loudness reduction characteristics of earmolds with variable venting valves (VVV) were investigated. Both side-branch and laterally vented earmolds were employed. Sound pressures were measured at 44 frequencies from 100 to 4 000 Hz in a modified HA-2 coupler with the VVV in four stages of opening: closed; ? open; ? open and 3/3 open

The effect of venting is primarily in the low frequencies. Little or no reduction in intensity is observed in the ‘speech frequency’ range and a modest amount is noted in the higher frequencies. The side-branch vented earmolds were more effective than the laterally vented earmolds. Calculated loudness reductions in phons were small. The effectiveness of the VVV, whether assessed by the frequency response or loudness reduction characteristics, is achieved within the first ? of opening: further opening has little effect. The utility of the VVV, especially to the geriatric hearing aid user, is questionable     

Surgical management of pelvic organ prolapse

Pelvic organ prolapse is a common condition which can have a profound effect on health-related quality of life. The lifetime risk of surgery for pelvic organ prolapse for all women is around 10–12%, making prolapse surgery one of the most commonly performed operations of all. Surgery is generally offered only to women to do not respond to conservative measures such as physiotherapy and/or vaginal pessaries. It is very important to ensure excellent clinical governance around the decision-making process for this elective surgical problem, and this may include the use of written information, face to face and telephone consultations, patient reported outcome measures and patient decision aids. This chapter will cover all the different techniques for prolapse surgery including conventional approaches using native tissue, uterus conserving prolapse surgery and surgery for post-hysterectomy vault prolapse. This will also include laparoscopic prolapse surgery. The role of mesh in prolapse surgery will also be discussed and this chapter will cover important topics including patient selection and preparation for prolapse surgery, shared decision making and how best to facilitate this, patient preparation before prolapse surgery and follow-up post operation.     

A comparison of the efficacy of weight-shift vs. joystick control of a robotic mobility device by infants ages 5 to 10 months

The onset of crawling in infants contributes to cognitive, perceptual, social, and emotional development. Conversely, infants with motor impairment that delays or prevents autonomous mobility often have associated developmental delays. Evidence suggests that providing mobility may have positive developmental outcomes, however powered wheelchairs may not be recommended for very young children, due to safety concerns and the child’s level of cognitive maturity. The WeeBot is a mobility device controlled by infant weight shifting while seated; infants as young as 5 months have learned to use it. This study compares the efficacy of using the WeeBot vs. using the traditional manual joystick to control a robotic mobility device. Participants were 20 typically developing infants between 5 and 10 months who had not yet achieved independent mobility. A quasi-experimental two-group design was used: The first 10 participants recruited used the WeeBot (weight-shift); the next 10 used the joystick. Results showed that infants learned to use weight-shift control more easily and more skilfully than did infants using the joystick. The ability of infants to use the WeeBot suggests that an intuitive alternative control might allow very early powered mobility for children with disabilities, which might have implications for various aspects of their development.     

Hearing impairment and hearing aid usage in Singapore

Objective: To examine the epidemiological and audiological profile, pattern of hearing aid (HA) fitting and usage among HA users in Singapore. Design: Retrospective cross-sectional study. Study sample: Cohort of 1068 subjects issued with HAs at a tertiary hospital between 2001 and 2013. Results: Mean age was 70?years with 50.8% male. Mean hearing loss (HL) was 63.1?dB and 69.5% had at least moderate-severe HL. Sensorineural HL was present in 66.4% and 69.8% had symmetrical HL. “Behind-the-Ear” HAs were cheaper than “In-Ear” HAs. Standard “Behind-The-Ear” HAs were also cheaper than “Receiver-in-Canal” HAs. Among In-Ear HAs, “In-the-Canal” and “Completely-in-Canal” were more popular than “In-the-Ear” HAs despite costing more. HA was used ≥4?days/week by 85.6% but >7?h per day by only 35.7%. Only 18% received bilateral first HA fitting. In multivariate analysis, younger age and symmetrical HL were predictors of bilateral HA uptake while better Pure-Tone-Audiometry of aided ear and >7?h of daily HA usage were predictors of successive HA fitting. Conclusions: HA users in Singapore were elderly and presented with advanced HL. Bilateral HA adoption and average daily use were low compared to other developed countries. Future research on understanding the suboptimal HA usage should explore patients' motivation, hearing disability, and HA effectiveness.     

Contemporary Health-Related Decision Aids: Tools for Social Work Practice

The escalating complexity in health-related decisions that people face have important implications for social work interventions. This article explores the nature of these implications within the context of decisional conflict, shared decision making, and the use of decision aids. In addition, the authors present the findings of a content analysis of 29 contemporary health-related decision aids. Emergent categories from this analysis are presented as a resource for social workers as they encounter, adapt, and create decision aids in their work to help address the health-related needs of their clients.     

Value-based design for the elderly: An application in the field of mobility aids

In the aging society, the need for the elderly to remain mobile and independent is higher than ever. However, many aids supporting mobility often fail to target real needs and lack acceptance. The aim of this study is to demonstrate how value-based design can contribute to the design of mobility aids that address real needs and thus, lead to high acceptance. We elicited values, facilitators, and barriers of mobility of older adults via ten in-depth interviews. Next, we held co-creation sessions, resulting in several designs of innovative mobility aids, which were evaluated for acceptance via nine in-depth interviews. The interviews resulted in a myriad of key values, such as “independence from family” and “doing their own groceries.” Design sessions resulted in three designs for a wheeled walker. Their acceptance was rather low. Current mobility device users were more eager to accept the designs than non-users. The value-based approach offers designers a close look into the lives of the elderly, thereby opening up a wide range of innovation possibilities that better fit their actual needs. Product service systems seem to be a promising focus for targeting human needs in mobility device design.     

A Comparison of Hearing Aids with Amplitude Compression

Intelligibility scores with a modified rhyme test were obtained for normally hearing subjects and subjects with sensorineural hearing impairment using several commercial hearing aids. These hearing aids differed mainly in values of time constants of compression and of harmonic distortion during overshoots. In general, better performance was obtained for the shorter time constants of compression, but performance seemed also to be affected by the occurrence of higher levels of harmonic distortion and of peak-clipping during overshoots.