Tinnitus and hearing survey: cultural adaptation to Brazilian Portuguese

IntroductionHearing loss is associated with several comorbidities and may be frequently associated with tinnitus. When patients complain of both tinnitus and hearing difficulties in audiology and otolaryngology clinics, there, is often great difficulty separating the two complaints. The tinnitus and hearing survey was specially developed for this purpose to identify the main complaint and help direct the choice of appropriate intervention.ObjectiveTo translate and culturally adapt the tinnitus and hearing survey for the Brazilian-Portuguese.MethodsSeventy patients who had previously completed a battery of audiological diagnostic exams were invited to complete the tinnitus and hearing survey and were categorized into four groups: normal hearing without tinnitus, normal hearing with tinnitus, hearing loss without tinnitus, and hearing loss with tinnitus. Cultural adaptation of tinnitus and hearing survey followed the steps indicated by Guillemin et al. (1993), including assessment of inter-researchers’ reproducibility, internal consistency, and reliability of the instrument.ResultsThere were no substantial changes to the content of the tinnitus and hearing survey questions, although a few adaptations were made to two-item sound tolerance section to facilitate participants’ understanding. Internal consistency and reliability tested by Cronbach’s α was considered good for all domains. The reproducibility of the tinnitus and hearing survey was measured by the Kappa coefficient at two different moments and agreement between evaluators 1 and 2 was considered almost perfect, indicating good reproducibility.ConclusionThe tinnitus and hearing survey was culturally adapted to Brazilian Portuguese and analyzed for internal consistency, reliability, and reproducibility. Results support this questionnaire as a useful tool to help professionals differentiate the main complaint of the individual, allowing the choice of a more appropriate intervention.     

Newborn hearing screening and genetic testing in 8974 Brazilian neonates

Objective

An early diagnosis has been a priority in the audiological practice. Identifying hearing loss until 3 months old through Universal Newborn Hearing Screening and intervention before 6 months old, minimize the impact of auditory loss in the health and communication development of these children. However, in the clinical practice, despite the help of the risk indicators in the audiological and etiological diagnosis, the integrated services have come up against the challenge of determining the causes of auditory loss, bearing in mind that approximately 50% of the subjects who have congenital loss do not show risk factors in their clinical history. The current research aims introduce together etiologic and audiological diagnosis of newborns.

Methods

We eluted dried blood spots from paper and performed genetic testing for 35delG mutation in 8974 newborns that were also screened for transient otoacoustic emissions (TOAE). In addition, the A1555G and A827G mutations in the MTRNR1 mitochondrial gene were screened in all newborns.

Results

We have found 17 individuals who failed in TOAE. Among them, we detected 4 homozygous newborns for 35delG mutation and 3 individuals with A827G mutation in the MTRNR1 mitochondrial gene. The frequency of 35delG carriers was 0.94% [84/8974]. In all 17 individuals who failed in OAE no other mutation besides those mentioned above was found.

Conclusions

The results greatly contribute to the public health area indicating the etiologic diagnosis, allowing family counseling as well as the early rehabilitation treatment or surgical intervention. Over time that will help to reduce the costs of rehabilitation considerably.     

Cognitive hearing science: the legacy of Stuart Gatehouse

Stuart Gatehouse was one of the pioneers of cognitive hearing science. The ease of language understanding (ELU) model (R?nnberg) is one example of a cognitive hearing science model where the interplay between memory systems and signal processing is emphasized. The mismatch notion is central to ELU and concerns how phonological information derived from the signal, matches/mismatches phonological representations in lexical and semantic long-term memory (LTM). When signals match, processing is rapid, automatic and implicit, and lexical activation proceeds smoothly. Given a mismatch, lexical activation fails, and working or short-term memory (WM/STM) is assumed to be invoked to engage in explicit repair strategies to disambiguate what was said in the conversation. In a recent study, negative long-term consequences of mismatch were found by means of relating hearing loss to episodic LTM in a sample of old hearing-aid wearers. STM was intact (R?nnberg et al.). Beneficial short-term consequences of a binary masking noise reduction scheme on STM was obtained in 4-talker babble for individuals with high WM capacity, but not in stationary noise backgrounds (Ng et al.). This suggests that individuals high on WM capacity inhibit semantic auditory distraction in 4-talker babble while exploiting the phonological benefits in terms of speech quality provided by binary masking (Wang). Both long-term and short-term mismatch effects, apparent in data sets including behavioral as well as subjective (Rudner et al.) data, need to be taken into account in the design of future hearing instruments.     

Self citations and impact factors in otolaryngology journals

Self citation of a journal may affect its impact factor. Self citations during 1997 and 1998 were investigated in six 'general' otolaryngology journals. The citations each journal gave to other journals, including itself, and the citations each journal received from the other journals, differed significantly among the six journals (chi2= 2794, d.f. = 25, P < 0.0001). Acta Otolaryngologica and Laryngoscope had the highest self-citing rates (11.9% and 10.02%). Clinical Otolaryngology had the lowest self-citing rate (4%). There was no significant correlation between self-citing rates and impact factors for the six otolaryngology journals (r = -0.3143, P = 0.56).     

Cognitive hearing science and ease of language understanding

Objective: The current update of the Ease of Language Understanding (ELU) model evaluates the predictive and postdictive aspects of speech understanding and communication.

Design: The aspects scrutinised concern: (1) Signal distortion and working memory capacity (WMC), (2) WMC and early attention mechanisms, (3) WMC and use of phonological and semantic information, (4) hearing loss, WMC and long-term memory (LTM), (5) WMC and effort, and (6) the ELU model and sign language.

Study Samples: Relevant literature based on own or others’ data was used.

Results: Expectations 1–4 are supported whereas 5–6 are constrained by conceptual issues and empirical data. Further strands of research were addressed, focussing on WMC and contextual use, and on WMC deployment in relation to hearing status. A wider discussion of task demands, concerning, for example, inference-making and priming, is also introduced and related to the overarching ELU functions of prediction and postdiction. Finally, some new concepts and models that have been inspired by the ELU-framework are presented and discussed.

Conclusions: The ELU model has been productive in generating empirical predictions/expectations, the majority of which have been confirmed. Nevertheless, new insights and boundary conditions need to be experimentally tested to further shape the model.     

Overview of newborn hearing screening programs in Brazilian maternity hospitals

IntroductionNewborn hearing screening has as its main objective the early identification of hearing loss in newborns and infants. In order to guarantee good results, quality indicators for newborn hearing screening programs are used as benchmarks.ObjectiveTo observe and describe the reality of national newborn hearing screening programs in Brazil, and to evaluate if they can be referred to as having quality indicators.MethodsIntegrative literature review in databases such as MEDLINE, LILACS, SciELO, and Google.Results22 articles were analyzed in relation to newborn hearing screening coverage, the place and period newborn hearing screening was performed, initial results, referral to diagnostic procedures, loss to follow-up, and occurrence of hearing loss.ConclusionTransient otoacoustic emissions were the most often used screening methodology. Coverage varied widely, and only a few maternity wards achieved 95% of the cases screened. Referral to diagnostic procedures was under 4%, but lack of adherence can be considered a barrier to successful follow-up. The occurrence of hearing loss ranged from 0% to 1.09%. The involvement of government, physicians, and society is necessary, so that the goals of newborn hearing screening can be achieved.     

Non-organic hearing loss in young persons: transient episode or indicator of deep-seated difficulty.

Depressed auditory thresholds without evidence of organic hearing loss are observed in a small percentage of children and young adults. Several studies suggest that non-organic hearing loss (NOHL) is a manifestation of, or reaction to stress. Proposed treatments range from ignoring the apparent hearing loss through the use of psychotherapy and/or counselling to confronting the individual with evidence to prove that there is no real loss of function. Few studies report on long-term outcome. Thirty-eight subjects who had been diagnosed more than six and up to twenty-seven years ago as having NOHL were identified from records. Efforts were made to determine if there was any evidence of longer term effects. Nine were untraceable. Of those reviewed one was established as a malingerer; five had concurrent speech problems; one was possibly dyslexic; five were or had been under psychiatric care. These findings suggest that NOHL may, in some individuals, indicate underlying problems that merit detailed investigation and treatment.     

Pediatric hearing impairment caregiver experience: impact of duration of hearing loss on parental stress

OBJECTIVES: Caregivers of children who are deaf/hard of hearing have been reported to have greater stress than caregivers of children with normal hearing. The time of diagnosis is a particularly stressful time and stress levels may change over time based on varying needs at different life events. Thus, we hypothesized that stress experienced by caregivers evolves over time and is impacted by the duration since the diagnosis of hearing loss. METHODS: The 68-item pediatric hearing impairment caregiver experience (PHICE) is a validated questionnaire used to measure stress. The PHICE was administered to 152 caregivers of children with permanent hearing loss. Domain scores were converted into z-scores for analysis of trends of stress over time. RESULTS: Parents of children whose hearing loss was identified more than 60 months ago reported higher stress levels regarding educational aspects of their child's needs as compared to parents of children with less than 24 months or 24-60 months duration since diagnosis. Parents of children diagnosed with hearing loss within the preceding 24 months reported higher stress levels in the area of healthcare than parents of children diagnosed greater than 24 months ago. CONCLUSIONS: Parental stressors change over time with respect to the time of diagnosis of hearing impairment. This phenomenon was observed irrespective of the age of diagnosis of hearing loss. As professionals serving families of children with hearing loss, we should be aware of changing stressors over time and identify the appropriate support services for families to meet those changing needs. By addressing those evolving stressors, the families' ability to support and improve the outcomes for their children who are deaf or hard of hearing may be enhanced.     

The impact of hearing impairment: a global health problem

Hearing impairment is a substantial worldwide problem mainly affecting the adult population. The prevalence of permanent childhood hearing impairment (PCHI) is relatively small (1 in 752) but the effects of PCHI are substantial. Children with PCHI (aged 4-12 years; n = 100) who use spoken English as their first language were assessed for cognitive and behaviour performance (controls included hearing children and children with otitis media with effusion). There was a trend in performance across severity for all assessments, with about a 2 SD difference for IQ between hearing controls and PCHI, causing concern for the pervasiveness and impact of even moderate PCHI.