Guidelines for Best Practice in the Audiological Management of Adults with Severe and Profound Hearing Loss

Individuals with severe to profound hearing loss are likely to present with complex listening needs that require evidence-based solutions. This document is intended to inform the practice of hearing care professionals who are involved in the audiological management of adults with a severe to profound degree of hearing loss and will highlight the special considerations and practices required to optimize outcomes for these individuals.     

Maternal personality traits,antenatal depressive symptoms and the postpartum mother–infant relationship: a prospective observational study

Social Psychiatry and Psychiatric Epidemiology - Maternal depression has been associated with bonding difficulties and lower maternal sensitivity in observed mother–infant interactions....     

Debate: What if it’s not just a phase?

In order to support children and young people who are exploring their gender, we need to develop a shared understanding of gender identities and enhance the evidence base relating to long-term outcomes. All professionals working with children and young people should be trained in gender diversity. Health-care systems must be adapted to enable us to record gender identity; outcome measures should be developed that accommodate different gender identities. In doing so, we will develop clearer information about the number of children and young people who are exploring their gender and the way that gender identities develop throughout childhood. We will also start to demystify gender and work to enhance understanding and acceptance of diversity.     

The measurement of pupil cycling time

Purpose: To assess the influence of pupil size on pupil cycling time (PCT), a measure which may be elongated in cases of neurological disease. Method: Clinically, pupil ”cycling” is produced by focusing a slit-lamp beam on the pupil margin. A rhythmic contraction and dilation of the pupil is produced, as changes in pupil size alternately prevent and allow the light beam to reach the retina. In this study, however, the light beam was controlled electronically so that cycling could be produced around different pupil sizes. Measurements of the variation of PCT with pupil size were taken from 22 young normal subjects. Results: PCT was seen to depend upon pupil size, increasing monotonically but non-linearly as size increased. The waveform of pupil cycling is typically sawtooth, contraction being much faster than dilation. There was considerable variation amongst subjects in the range of pupil sizes where pupil cycling could be elicited. Conclusions: The results point to the need for a standardised procedure for the measurement of cycling time, because differences in clinical conditions will themselves influence pupil size, as will other external variables such as ambient light level. The results also bring into question neurological explanations for increased PCT in those diseases where pupil size is affected, because normal subjects have PCTs well beyond the accepted limits of normality when their pupils are enlarged. Received: 13 September 1999 Revised: 18 April 2000 Accepted: 3 May 2000