医护合作型健康教育路径在儿童耳蜗植入术的应用

目的探讨医护合作型健康教育路径在儿童人工耳蜗植入术的应用及临床效果。方法将168例人工耳蜗植入患儿,随机分为观察组82例和对照组86例,对照组按传统的方法进行健康教育,观察组按医护合作型健康教育路径进行健康教育,比较两组患儿检查前镇静成功率、术后敷料包扎松脱率、术后并发症发生率,家长对健康教育知识的知晓率。结果观察组患儿检查前镇静成功率、家长对健康教育知识的知晓率均明显优于对照组(P<0.05);观察组的敷料包扎松脱率、术后并发症发生率均低于对照组(P<0.05)。结论医护合作健康教育路径可帮助家长提高疾病认知,促进健康行为,降低术后并发症的发生,提高医疗护理服务质量。     

Hearables as a Gateway to Hearing Health Care

The market for hearing technology is evolving—with the emergence of hearables, it now extends beyond hearing aids and includes any ear-level devices with wireless connectivity (i.e., wireless earbuds). However, will this evolving marketplace bring forth opportunities or challenges to individuals’ hearing health care and the profession of audiology and otolaryngology? The debate has been ongoing. This study explores the wide spectrum of hearables available in the market and discusses the necessity of high-quality clinical evidence prior to the implementation of over-the-counter devices into clinical practice.     

防治小学教师咽喉慢性炎症性疾病及健康教育效果评价

目的评价小学教师咽喉慢性炎症性疾病防治及健康教育的效果.方法采用自行设计健康教育与保健方案在某市郊区小学教师中进行调查研究.结果干预3年后,小学教师对咽喉慢性炎症性疾病的防治知识掌握程度提高,患病率下降,两项评价指标比较差异有显著性意义.结论健康教育对提高小学教师防治咽喉慢性炎症性疾病的意识及降低发病率有着十分重要的意义.     

Barriers to Cochlear Implant Access: Acknowledging the Challenges,Changing the Future: Barriers to Adult Cochlear Implant Care in the United States: An Analysis of Health Care Delivery

Persistent underutilization of cochlear implants (CIs) in the United States is in part a reflection of a lack of hearing health knowledge and the complexities of care delivery in the treatment of sensorineural hearing loss. An evaluation of the patient experience through the CI health care delivery process systematically exposes barriers that must be overcome to undergo treatment for moderate-to-severe hearing loss. This review analyzes patient-facing obstacles including diagnosis of hearing loss, CI candidate identification and referral to surgeon, CI evaluation and candidacy criteria interpretation, and lastly CI surgery and rehabilitation. Pervasive throughout the process are several themes which demand attention in addressing inequities in hearing health disparities in the United States.     

Letters of recommendation to an otolaryngology/head and neck surgery residency program: their function and the role of gender

Objectives/Hypothesis: To ascertain common features and gender differences in letters of recommendation (LORs) for applicants to an otolaryngology/head and neck surgery (OHNS) residency program. Study Design: Retrospective review. Methods: Seven hundred sixty‐three LORs submitted to one OHNS residency program in 2006 were reviewed. Results: All 763 letters “recommended” the applicant for OHNS residency. Ninety‐one percent of letters were written by men, 68.4% by male otolaryngologists (OTOs), 4.2% by female OTOs, and 33% by OHNS department chairs or division chiefs (100% men). A comparison of female and male letter writers revealed five categories with significant differences: female letter writers were more likely to call an applicant a “team player” (P = .000), “compassionate,” (P = .001) and use strings of adjectives (P = .024). In contrast, they were less likely when compared with male letter writers, to mention an applicant's personal life (P = .003), or write “letters of minimal assurance” (P = .035). Evaluation of the letters by applicant gender revealed two findings: letter writers were more likely to use a gender term in letters for male applicants (P = .004), and male letter writers were more likely to make reference to a female candidate's physical appearance (P = .040). Conclusions: LORs for OHNS residency universally advocate for the applicant. The letters are writtenpredominately by the highest‐ranking male OTOs in academic medicine. In the LORs, male and female applicants are described similarly. Male and female letter writers, however, often describe applicants in different ways regardless of applicant gender.     

Hearing aid fitting at SUS (Brazilian Public Health Care System) compared with a compact fitting model

In the present days it is critical to identify the factors that contribute to the quality of the audiologic care provided. The hearing aid fitting model proposed by the Brazilian Unified Health System (SUS) implies multidisciplinary care. This leads to some relevant and current questions.ObjectiveTo evaluate and compare the results of the hearing aid fitting model proposed by the SUS with a more compact and streamlined care.MethodWe conducted a prospective longitudinal study with 174 participants randomly assigned to two groups: SUS group and Streamline group. For both groups we assessed key areas related to hearing aid fitting through the International Outcome Inventory for Hearing Aids (IOI-HA) questionnaire, in addition to evaluating the results of Speech Recognition Index (SRI) 3 and 9 months after fitting.ResultsBoth groups had the same improvement related to the speech recognition after nine months of AASI use, and the IOI-HA didn't show any statically significant difference on three and nine months.ConclusionThe two strategies of care did not differ, from the clinical point of view, as regards the hearing aid fitting results obtained upon the evaluation of patients in the short and medium term, thus changes in the current model of care should be considered.     

Expanding and Enhancing Care with Tele-Audiology: Tinnitus Management: The Utilization of a Hybrid Telehealth and In-Person Delivery Model

Telehealth, or the delivery of healthcare services from a distance, has historically been used to provide care to underserved populations and to those unable to visit a healthcare center. During the ongoing global COVID-19 pandemic, some providers of tinnitus healthcare services incorporated telehealth into their clinical protocols to allow for continued care for their patients while adhering to social distancing guidelines and safety measures. Bothersome tinnitus can negatively impact one''s quality of life. Telehealth has been instrumental in treating this debilitating problem in a time when in-person care has not been easily available. The case of a patient with tinnitus is examined to demonstrate the use of a hybrid delivery model utilizing telehealth and in-person interactions to assess and manage her bothersome tinnitus. In-person services were used for audiological assessments and fitting of treatment devices, while telehealth was utilized for counseling, education, and remote programming of her treatment devices. This combined approach, which has allowed the patient to continue receiving care safely during the pandemic, can be continued for future care. Telehealth offers several advantages to patients and providers alike. While the COVID-19 pandemic will hopefully come to an end, telehealth services for tinnitus management may be here to stay.     

Attitude and knowledge of hearing loss among medical doctors selected to initiate a residency in Mexico

Early diagnosis and intervention of hearing loss are directly influenced by the knowledge and attitude towards this condition among medical personnel, particularly in countries where screening is not performed routinely. The objective of this paper was to evaluate the attitude and knowledge of hearing loss in a group of physicians. A questionnaire with five Likert-type items and five multiple choice and fill-in-the-blank items was completed by 2727 physicians selected to start a medical residency. Results suggested that physicians’ knowledge level on the matter is deficient and their attitude is far from the ideal; however, physicians selected for a residency in audiology showed slightly better results.     

Public Health Perspectives on Hearing Loss and Aging Outcomes: Preventive Care Utilization among Adults with Hearing Loss in the United States

Hearing loss (HL) can negatively impact patient–provider communication and limit access to health promotion information, which may lead to decreased preventive care utilization. Using data from the 2015 and 2018 National Health Interview Survey, we examined the association between perceived HL with and without hearing aid use with self-reported age-appropriate uptake of breast and colon cancer screening, and influenza and pneumococcal vaccination. In models adjusted for sociodemographic characteristics, access to care, and health status, people with HL had lower odds of receiving breast cancer screening (odds ratio [OR] = 0.83, 95% confidence interval [CI] = 0.72–0.96) and higher odds of receiving pneumococcal vaccination (OR = 1.11, 95% CI = 1.00–1.24) relative to those without HL. There were no differences in their colon cancer or influenza vaccination uptake. Compared with those without HL, people with HL who used hearing aids had increased odds of colon cancer screening and influenza and pneumococcal vaccination, while people with HL who did not use hearing aids were less likely to report cancer screening. Overall, Americans with untreated HL were less likely to report completing cancer screening. Hearing aid use may modify the association between HL and preventive care uptake. Screening for HL in primary care settings and communication trainings for providers may help reduce cancer screening disparities.     

An evaluation of the inflammatory response of lipopolysaccharide-treated primary dental pulp cells with regard to calcium silicate-based cements

This study compared the biological changes of lipopolysaccharide （LPS）-treated dental pulp （DP） cells directly cultured on mineral trioxide aggregate （MTA） and calcium silicate （CS） cements. DP cells were treated with LPS for 24 h. Then, the LPS-treated DP cells were cultured on MTA or CS cements. Cell viability, cell death mechanism and interleukin （IL）-1β expressions were analysed. A one-way analysis of variance was used to evaluate the significance of the differences between the means. A significantly higher IL-1β expression （2.9-fold） was found for LPS-treated cells （P〈0.05） compared with DP cells without LPS treatment at 24 h. Absorbance values of LPS-treated cells cultured on CS cement were higher than a tissue culture plate. A significant difference （P〈0.05） in cell viability was observed between cells on CS and MTA cements 24 h after seeding. At 48 h, a high concentration of Si （5 mM） was released from MTA, which induced LPS-treated DP cell apoptosis. The present study demonstrates that CS cement is biocompatible with cultured LPS-treated DP cells. MTA stimulates inflammation in LPS-treated DP cells, which leads to greater IL-1β expression and apoptosis.     

Improving resident familiarity with the translabyrinthine approach to the internal auditory canal

Objective

To increase otolaryngology resident experience with drilling and dissection of the internal auditory canal (IAC) via a translabyrinthine approach.

实施聋儿全纳教育实验项目的几点思考—对联合国儿童基金会聋儿双语双文化全纳教育实验项目的研究（Ⅱ）

本文是对联合国儿童基金会聋儿双语双文化全纳教育实验项目的研究报告。文章主要探讨了手语翻译师、各科教师、健听学生和学校行政人员在聋童全纳教育实验项目中的作用。并对实验项目的意义及推广建议进行了阐述。     

Expanding and Enhancing Care with Tele-Audiology: Case Study Comparison: Limitations in Telehealth Relating to Poverty and Family Support

Telehealth appointments have grown in popularity due to the COVID-19 global pandemic. Three cases presented in this article show several different perspectives where telehealth was utilized. For the first patient, appointments were successfully completed via telehealth; however, the patient''s family opted to continue with an unsecure internet connection at a local laundromat. For the second patient, a stable internet connection could not be obtained in his home, thus making telehealth appointments unavailable. The caregiver of this patient ended up driving to the clinic to have adjustments made in person. For the third patient, telehealth appointments were unavailable due to unstable internet connections as well as difficulty setting up video interpreting services. These cases highlight the idea that telehealth can be incredibly beneficial, when used correctly. For some, the option to attend appointments virtually gives them access to specialists that otherwise may not be available. For other patients, aspects such as access to smart devices and steady internet access must be considered to ensure a successful connection. The hope is that this article sheds light on some of the potential setbacks that can come from the use of telehealth appointments in a practice and provides discussion regarding for whom telehealth may be appropriate, even in pediatric patients. After reading this article, readers should be able to discuss ways in which there could be solutions for these barriers that may prevent some patients from utilizing these types of virtual appointments.     

实施聋儿全纳教育的课堂教学模式初探——对联合国儿童基金会聋儿双语双文化全纳教育实验项目的研究（Ⅰ）

本文是对联合国儿童基金会聋儿双语双文化全纳教育实验项目的研究报告。研究采用资料分析、录像分析、测试分析等方法，对参加该项目聋童的学习和学校生活情况进行了考察。结果表明：聋童双语双文化全纳教育实验提高了聋童的社会交往能力、发掘了聋童的学习潜力、促进了聋童学业的发展；聋童的汉语书面语和口语能力明显提高。