Otoacoustic emissions as a screening test for hearing impairment in children recovering from acute bacterial meningitis

OBJECTIVES: To study the efficacy of otoacoustic emissions (OAEs) as a screening test for hearing impairment in children with acute bacterial meningitis. Hearing tests were performed before discharge from the hospital in an attempt to improve coverage and avoid delays in the diagnosis of postmeningitic hearing loss. METHODS: Children with bacterial meningitis were recruited from 21 centers. In the 48 hours before discharge from the hospital, all patients underwent a thorough audiologic assessment consisting of transient evoked OAEs, auditory brainstem responses (ABRs), otoscopy, and tympanometry. Hearing loss was defined as ABR threshold >/=30 dB. The results of OAE screening were compared with the gold standard of ABR threshold. RESULTS: Of 124 children recruited, we were able to perform both OAEs and ABRs on 110 children. Seven (6.3%) of the 110 children had ABR threshold >/=30 dB; 2 had sensorineural hearing loss and 5 had conductive hearing loss. At follow-up, hearing loss persisted in both cases of sensorineural hearing loss and no new cases were identified. All 7 children with hearing loss failed the OAE screening test. Ninety-four children with normal hearing thresholds passed the test, and 9 failed. Thus, the screening test had a sensitivity of 1.00 (95% confidence interval, 0.59 to 1.00), a specificity of 0.91 (0.85 to 0.97), a positive predictive value of 0. 44 (0.20 to 0.70), and a negative predictive value of 1.00 (0.96 to 1.00). CONCLUSIONS: OAE screening in children recovering from meningitis was found to be feasible and effective. The test was highly sensitive and reasonably specific. Inpatient OAE screening should allow early diagnosis of postmeningitic hearing loss and prompt auditory rehabilitation.     

Pretreatment of coir lignocellulose for preparation of a porous coir–polyurethane composite with high oil adsorption capacity

In this present work, different treatment methods of coir biomass were investigated to improve the oil sorption capacity. The treated coir material was then used to fabricate an efficient porous coir–polyurethane composite sorbent by incorporating coir into a polyurethane matrix. The new composite possessed an open cell structure with high porosity and high oil sorption efficiency. The suitable technical parameters of the coir treatment process were selected as: hot water treatment at 170 °C for 120 minutes. After treatment under this suitable condition, treated coconut fiber exhibited an oil adsorption capacity of 4.1 g g⁻¹, with an increase of 78.3% compared to that of the original coconut fiber. Furthermore, the application of the as-fabricated porous composite sorbent for oil treatment was examined under various conditions. It was observed that the oil uptake capacity of the new composite sorbent was high, up to 15.2 g g⁻¹ when 20% treated coir material with a particle size of 1 mm was added into the polyurethane matrix. Several advantages of the new porous composite sorbent obtained from coir biomass and polyurethane such as low cost, being eco-friendly, ready availability and high buoyancy make it an efficient sorbent material for oil spill treatment.

An efficient porous coir–polyurethane composite with high porosity and high oil sorption efficiency has been successfully prepared by incorporating coir into a polyurethane matrix.     

Satisfaction with rehabilitation in relation to self‐perceived quality of life and function among patients with stroke – a 12 month follow‐up

Scand J Caring Sci; 2013; 27; 373–379 Satisfaction with rehabilitation in relation to self‐perceived quality of life and function among patients with stroke – a 12 month follow‐up Background and Purpose: Stroke causes complex disability and function, and perceived quality of life has been shown to correlate with satisfaction with care as well as with life in general among stroke patients. The aim of this study was to study the relation of satisfaction with how rehabilitation was provided with self‐perceived quality of life, self‐perceived function and rehabilitation received, 12 months after the incidence. Method: The subjects were assessed 12 months after the onset of stroke. The Barthel index was used to measure function, and the EuroQol‐5D to measure quality of life. To measure satisfaction with how rehabilitation was provided, a questionnaire from the Swedish Stroke Register was used. Results: Two hundred and eighty‐three patients participated in the follow‐up, 137 women and 146 men, aged between 42 and 95 years (mean age 75.2, SD 11.8). For the majority of patients rehabilitation was initiated at in‐hospital care (directly after onset). One hundred and sixty‐eight patients considered that rehabilitation was well provided for. Sixty‐six regarded that the rehabilitation was only partly provided for and 35 that it was not provided for at all. High value on Barthel Index was associated with satisfaction with how rehabilitation was provided for (OR 2.81). Also, rehabilitation on three or more levels was negatively associated with satisfaction with rehabilitation provision (OR 0.24) and so was being male (OR 0.49). Conclusion: In this study, patients with higher values on Barthel Index were more satisfied with how rehabilitation was provided for. However, male patients and patients who received rehabilitation on three or more levels of care were less satisfied. Given the assumption that patients with more severe dysfunction after stroke are being rehabilitated on more levels, this might imply that it is not the amount of rehabilitation that gives satisfaction but the patients self‐perceived function after rehabilitation.