Understanding the Low Vision Patient

ABSTRACT Over the past decade, the role of optometry in low vision care has steadily increased. Unfortunately many optometrists feel they lack the skills to fully service these patients. A functional classification of the visual losses and the aids prescribed for low vision patients has been prepared to encourage and assist the practitioner dealing with such patients.     

Rehabilitation: An Essential Component of Low Vision Care*

ABSTRACT This paper reviews the concept of rehabilitation in the delivery of care to the low vision patient. It defines low vision in functional terms and suggests that a multidisciplinary approach to management is necessary. The personal, psychological, educational and vocational factors in the successful management of a patient are discussed. Improvements in the delivery of future care are suggested.     

Geriatric Optometry

ABSTRACT Geriatric optometry differs from the more usual form of optometric care in that the geriatric patient suffers specific and characteristic visual symptoms and problems on the one hand, and has a reduced capacity for dealing with them on the other. This paper presents the origin and nature of the important problems of visual functioning for the geriatric patient and the presently available means of coping with them. There is a great need and a great scope for these services.     

乌鲁木齐市城市济困医院医疗服务状况调查

目的通过对乌鲁木齐市12家济困医院医疗现状的调查和研究，了解目前济困医院的发展情况，并针对存在的问题提出相应的改进意见。方法对乌鲁木齐市12家济困医院的医疗服务情况进行现状研究，并对获得的资料进行统计描述。结果对济困医院的医疗服务现状、人力资源、业务收入、医疗设施、对贫困人群的优惠情况进行描述，从中发现一些存在的优点和存在的问题。结论济困医院虽然对解决贫困人群，“五保户”人群“看病贵，看病难”的问题具有较好的实际意义。但是他们目前急需解决的就是人才问题与医疗设备的改进和增加的问题。     

语前聋儿童佩戴助听器后塞音发音特点

目的分析听力障碍患儿佩戴助听器后塞音的发音特点。方法以佩戴助听器的语前聋患儿30例(助听器组)和健听儿童30例(健听组)为研究对象,年龄3~6岁(分为3~、4~、5~6岁组,每组2类儿童各10例),日常均使用汉语普通话交流,具备一定的发音能力。以塞音词表进行测试,分析两组儿童塞音(/b/、/d/、/g/、/p/、/t/、/k/)的发音正确率和错误类型,分析不同生理年龄、助听时间与发音正确率的关系。结果助听器组儿童塞音发音的正确率从高到低为/b/>/d/>/g/>/k/>/t/>/p/,健听组儿童塞音发音的正确率从高到低依次为/b/>/g/>/k/>/p/>/d/>/t/;健听组儿童塞音/b/、/g/、/k/、/t/、/p/的正确率显著高于助听器组儿童(P<0.05)。助听组儿童发音错误规律包括:①发音方法相同的音互相替代,如不送气塞音的互相替代和送气塞音的互相替代;②发音部位相同的音互相替代;③发音方法和发音部位不同的替代,如:塞音擦音化,塞音塞擦音化,不送气化。4~、5~6岁组听障儿童塞音/g/、/p/、/k/发音的正确率明显高于3~岁组(P<0.05),助听器佩戴时间大于2年的听障儿童塞音/p/、/t/发音的正确率明显高于小于2年的儿童(P<0.05)。结论听障儿童塞音发音清晰度落后于健听组儿童,生理年龄、听觉干预的时间对听障儿童部分塞音发音的正确率有影响,需进行积极的干预和有针对性的康复训练。     

Smoking cessation with and without assistance: a population-based analysis

OBJECTIVE: To examine usage rates of smoking-cessation assistance and to compare the success rate of those who used assistance with the success rate of those who did not. METHODS: The data come from the 1996 California Tobacco Survey, a random sample of 4480 individuals (18 years or older) who tried to quit smoking in the 12 months before the survey. We calculated population estimates for demographics, smoking histories, rate of using assistance, and abstinence rates. RESULTS: One fifth (19.9%) of those who attempted to quit smoking used one or more forms of assistance: self-help, counseling, and/or nicotine replacement therapy (NRT). Heavy smokers were more likely to use assistance than were light smokers. Women were more likely to use assistance than were men, and usage increased with age. Whites were more likely to use NRT than were other ethnic groups. Overall, those who used assistance had a higher success rate than those who did not; the 12-month abstinence rates were 15.2% and 7.0%, respectively. CONCLUSIONS: Use of assistance for smoking cessation has increased over recent years, from 7.9% in 1986 to 19.9% in 1996. The use of assistance is associated with a greater success rate. Anti-tobacco campaigns in California and increased availability of multiple forms of assistance probably facilitated the use of assistance and successful quitting for those using assistance.     

软带骨桥在双侧小耳畸形患者中的应用

目的 探讨佩戴软带骨桥在双侧小耳畸形患者中的临床应用效果。 方法 选取36例双侧小耳畸形患者,每例患者分别佩戴软带骨桥与软带骨锚式助听器(BAHA),佩戴前后分别测量声场纯音测听,并随访观察佩戴软带骨桥后患者的日常交流及对声音的反应情况。 结果 36例双侧小耳畸形患者佩戴软带骨桥后行声场纯音测听结果显示,平均气导听力提高38.8 dB,佩戴软带BAHA后行声场纯音测听结果显示,平均气导听力提高34.5 dB,二者比较差异无统计学意义(P>0.05),患者日常生活交流情况明显改善。 结论 对于先天性双侧小耳畸形患者,佩戴软带骨桥后,听力提高显著,效果良好。     

The use of nicotine patches with minimal intervention

BACKGROUND: This paper describes a natural, prospective, open-label study designed to evaluate the impact of free nicotine patches with minimal support for smoking cessation. METHODS: Surveys were administered to 223 participants who received nicotine patches from the American Lung Association. All participants received a 6-week supply of 15-mg/16-h transdermal nicotine patches, a self-help book Freedom from Smoking, and information about area smoking cessation classes. Follow-up telephone surveys were administered 6 weeks after the patches were distributed. Abstinence was measured through self-report exclusively. RESULTS: The overall quit rate at 6-weeks was 21% (47/223). Among nonquitters, the mean number of cigarettes smoked per day dropped from 25 at baseline to 14 at 6 weeks. There was a significant difference in the average number of patches used by quitters and nonquitters (26 versus 11, P < 0.001). CONCLUSIONS: Nicotine patches with minimal support can be effective in smoking cessation and smoking reduction. The availability of patches may have motivated participants to quit. Efforts to increase access to and use of nicotine patches may result in increased attempts to quit and successful quitting.     

Systematic Review of Factors Associated With Hearing Aid Use in People Living in the Community With Dementia and Age-Related Hearing Loss

ObjectivesTo investigate factors that influence hearing aid use according to the Theoretical Domains Framework (TDF). The TDF is a behavioral science framework that aids understanding of factors that influence behavior.DesignSystematic review.Setting and ParticipantsPeople living in the community with dementia and age-related hearing loss who have air conduction hearing aids.MethodsSystematic literature review following PRISMA guidelines. We searched for studies in 9 databases, including Ovid MEDLINE, Scopus, and OpenGrey. We undertook an interpretive data synthesis by mapping findings onto the TDF. We assessed confidence in the findings according to the GRADE-CERQual approach.ResultsTwelve studies (6 quantitative, 3 qualitative, and 3 mixed methods) were included in the review. The majority of these were rated low-moderate quality. We identified 27 component constructs (facilitators, barriers, or noncorrelates of hearing aid use) nested within the 14 domains of the TDF framework. Our GRADE-CERQual confidence rating was high for 5 findings. These suggest that hearing aid use for people living in the community with dementia and hearing loss is influenced by (1) degree of hearing aid handling proficiency, (2) positive experiential consequences, (3) degree of hearing aid comfort or fit, (4) person-environment interactions, and (5) social reinforcement.Conclusions and ImplicationsHearing aid interventions should adopt a multifaceted approach that optimizes the capabilities of people with dementia to handle and use hearing aids; addresses or capitalizes on their motivation; and ensures their primary support network is supportive and encouraging of hearing aid use. The findings also emphasize the need for further high-quality research that investigates optimal hearing aid use, influencing factors, and interventions that support hearing aid use.