人工耳蜗植入和助听器配戴儿童声调识别的对比实验研究

目的探讨人工耳蜗植入儿童和助昕器配戴儿童在声调识别方面是否存在差异；考查人工耳蜗开机时间、入园康复时间，儿童的年龄、性别等因素对声调识别是否有影响。方法采用《言语听觉反应评估》（evaluation of auditory responses to speech，EARS）中的“封闭式声调测试”作为测试材料．对61名3～6岁聋儿（其中人工耳蜗植入儿童31名，助昕器配戴儿童30名）进行声调识别的测试，利用SPSS软件对结果进行统计分析。结果助昕器配戴儿童在声调识别的精确性上优于人工耳蜗植入聋儿；人工耳蜗开机时间对声调测试成绩没有明显的影响；康复时间、聋儿的年龄和声调测试成绩呈正比；聋儿的性别和声调测试成绩无关。结论助昕设备类型、康复时间、年龄等对声调识别的成绩有一定影响，这些因素之间可能存在相互作用，有待进一步探讨。     

Implementing breast cancer decision aids in community sites: barriers and resources

Objective To assess the feasibility of implementing four patient decision aids (PtDAs) for early stage breast cancer treatment decisions into routine clinical care in community settings. Background There is very limited information available about implementing decision aids into routine clinical practice and most of this information is based on academic centres; more information is needed about implementing them into routine clinical practice in community settings. Design Structured individual interviews. Setting and participants Providers from 12 sites, including nine community hospitals, a community oncology centre and two academic centres. Main outcome measures Usage data, barriers to and resources for implementing the PtDAs. Results Nine of the 12 sites were using the PtDAs with patients. All of the sites were lending the PtDAs to patients, usually without a formal sign‐out system. The keys to successful implementation included nurses’ and social workers’ interest in distributing the PtDAs and the success of the lending model. Barriers that limited or prevented sites from using the PtDA included a lack of physician support, a lack of an organized system for distributing the PtDAs and nurses’ perceptions about patients’ attitude towards participation in decision making. Conclusions It is feasible to implement PtDAs for early stage breast cancer into routine clinical care in community settings, even with few resources available.     

助听器助听效果的客观评价

目的 评价助听器的助听效果。方法 所采用的客观测试包括,声场情况下助听与未助听的由短声引起民的听性脑干反应（ＡＢＲ）测试及由短纯音引起的颅顶慢反应（ＳＶＲ）测试。结果与结论 ＳＶＲ阈值与声场纯音测试阈值间有高度的相关性,两种测试方法所测得的听力补偿间无显著性差异。     

Effects of Synthetic Speech Output and Orthographic Feedback on Spelling in a Student with Autism: A Preliminary Study

The effects of speech output and orthographic feedback on spelling performance were evaluated in this preliminary study. A nonspeaking student with autism was taught to spell words under three feedback conditions using a voice output communication aid. In the auditory-visual condition, the participant received speech output and orthographic feedback. In the visual condition, the participant received only the orthographic feedback. In the auditory condition, the student received only speech output. An adapted alternating treatments design was used to evaluate the effects of the three feedback conditions. Although the participant reached criterion and maintained performance in each of the conditions, the provision of speech output alone and in combination with orthographic feedback resulted in more efficient spelling than the provision of orthographic feedback alone. Although replications with other subjects are necessary, findings suggest that speech output contributes to efficient spelling.     

602例农村听力语言障碍儿童的调查分析与对策

目的通过对在基层语训点参加训练的602例农村听力语言障碍儿童的现状调查。进一步了解农村儿童听力语言康复的现状及存在的问题。结果听力损失80％为重度,极重度耳聋。83％配戴助听器均为大功率,超大功率的传统模拟助听器,集中式的听力语言训练对他们都有不同程度的帮助,但是参与训练的年龄偏大。农村普通家庭年收入低,父母文化低,生养小儿多。家庭训练有一定的困难。结论依托社会各模式集中训练对目前农村的听力语言障碍儿童的康复还是必要的。     

Effects of caffeine ingestion on rating of perceived exertion during and after exercise: a meta-analysis

The purpose of this study was to use the meta-analytic approach to examine the effects of caffeine ingestion on ratings of perceived exertion (RPE). Twenty-one studies with 109 effect sizes (ESs) met the inclusion criteria. Coding incorporated RPE scores obtained both during constant load exercise (n=89) and upon termination of exhausting exercise (n=20). In addition, when reported, the exercise performance ES was also computed (n=16). In comparison to placebo, caffeine reduced RPE during exercise by 5.6% (95% CI (confidence interval), -4.5% to -6.7%), with an equivalent RPE ES of -0.47 (95% CI, -0.35 to -0.59). These values were significantly greater (P<0.05) than RPE obtained at the end of exercise (RPE % change, 0.01%; 95% CI, -1.9 to 2.0%; RPE ES, 0.00, 95% CI, -0.17 to 0.17). In addition, caffeine improved exercise performance by 11.2% (95% CI; 4.6-17.8%). Regression analysis revealed that RPE obtained during exercise could account for approximately 29% of the variance in the improvement in exercise performance. The results demonstrate that caffeine reduces RPE during exercise and this may partly explain the subsequent ergogenic effects of caffeine on performance.     

'From victim to agent': the clinical and social significance of self-help group participation for people with life-threatening diseases

AIM: The main objective of the paper is to discuss the ways in which self-help groups can be useful to persons with life-threatening diseases like cancer or human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). The paper offers an outline of the central characteristics of self-help groups, highlighted by the participants themselves. BACKGROUND: Self-help groups are a growing phenomenon across national borders. New empirical sociological studies show that nurses have become important agents in self-help groups, both within and outside the public health-care system. However, research on self-help groups is a relatively new area within nursing studies yet it serves an important function in shedding light on a rather unique form of social practice organized and managed partly by the participants themselves. METHODS: Qualitative interviews designed to examine how participants evaluate their experiences with self-help groups. The study includes 53 self-help group participants suffering from cancer or HIV/AIDS. Findings: Contact with other people, forming of friendships, new networks and increased self-confidence are some of the effects indicated by the participants. Participation in a self-help group has a positive impact on the patients' ability to cope with the psychological and social consequences of living with a life-threatening disease. CONCLUSIONS: It is evident that the positive effects of self-help groups are mainly because of their inherent capacity for universalizing personal problems, which, in itself, legitimizes the scientific relevance of self-help groups. There is no evidence to indicate that self-help groups have a positive influence on the life expectancy of participants who suffer from cancer or HIV/AIDS, but it should be noted that this is not the explicit concern when groups are formed. By their very existence self-help groups indicate the need for a reevaluation of the scope and focus of the individualized care and nursing. The clinical and social significance of self-help group participation has not been sufficiently accounted for.     

A randomized controlled trial comparing internet and video to facilitate patient education for men considering the prostate specific antigen test

BACKGROUND: Little is known about the relative advantages of video versus internet-based decision aids to facilitate shared medical decision making. This study compared internet and video patient education modalities for men considering the prostate specific antigen (PSA) test. METHODS: Two hundred and twenty-six men, aged 50 years or older, and scheduled to complete a physical examination at an HMO Health Appraisal Clinic were randomly assigned to access a website (N = 114) or view a 23-minute videotape in the clinic (N = 112) prior to deciding whether they wanted to be screened for prostate cancer. RESULTS: There were no between-groups differences in participants' ratings of convenience, effort, or satisfaction following exposure to the decision aid. Participants assigned to the video group were more likely to review the materials than individuals assigned to the internet group (98.2% vs 53.5%). Participants in the video group showed significantly greater increases in PSA knowledge and were more likely to decline the PSA test than individuals assigned to the internet group. However, participants in the internet group who reviewed the entire online presentation showed similar increases in PSA knowledge as video participants. Only 5% of all participants visited other websites to inform themselves about the PSA test. CONCLUSIONS: Overall, the video was significantly more effective than the Internet in educating participants about benefits and risks of PSA screening.     

Internet-based treatment of headache: does telephone contact add anything?

OBJECTIVE: To study the contribution of therapist-initiated telephone contact in the treatment of recurrent headache via the Internet. BACKGROUND: Internet-based cognitive behavioral self-help is a promising new venue for the treatment of recurrent headache. While cost-effective, there are indications that this modality may be associated with high dropout rates. DESIGN AND METHODS: The role of therapist-initiated contact was investigated in a randomized controlled trial in which 44 self-recruited headache sufferers were randomized to either a Web-based self-help program with e-mail support or to a group receiving, in addition, weekly individual telephone calls. An additional 8 control subjects were recruited to receive similar treatment outside of the study. RESULTS: Dropout rates were 29% in the telephone support group and 35% in the control group, suggesting that the telephone calls did not affect dropout. Results showed significant reductions in headache-related disability, depression, maladaptive coping strategies, and perceived stress but little to indicate any superior performance in the Internet-only group and little improvement in the headache index. In short, therapist-initiated telephone calls did not influence the results. CONCLUSIONS: Internet-based treatment for headache is not affected by minimal therapist-initiated telephone contact.