Measuring motivation using the transtheoretical (stages of change) model: A follow-up study of people who failed an online hearing screening.

Measuring motivation using the transtheoretical (stages of change) model: A follow-up study of people who failed an online hearing screening.

Int J Audiol. 2016 May 20;:1-7

Authors: Ingo E, Brännström KJ, Andersson G, Lunner T, Laplante-Lévesque A

Abstract
OBJECTIVE: Acceptance and readiness to seek professional help have shown to be important factors for favourable audiological rehabilitation outcomes. Theories from health psychology such as the transtheoretical (stages-of-change) model could help understand behavioural change in people with hearing impairment. In recent studies, the University of Rhode Island change assessment (URICA) has been found to have good predictive validity.
DESIGN: In a previous study, 224 Swedish adults who had failed an online hearing screening completed URICA and two other measures of stages of change. This follow-up aimed to: (1) determine prevalence of help-seeking at a hearing clinic and hearing aid uptake, and (2) explore the predictive validity of the stages of change measures by a follow-up on the 224 participants who had failed a hearing screening 18 months previously.
STUDY SAMPLE: A total of 122 people (54%) completed the follow-up online questionnaire, including the three measures and questions regarding experience with hearing help-seeking and hearing aid uptake.
RESULTS: Since failing the online hearing screening, 61% of participants had sought help. A good predictive validity for a one-item measure of stages of change was reported.
CONCLUSIONS: The Staging algorithm was the stages of change measure with the best ability to predict help-seeking 18 months later.

PMID: 27206679 [PubMed - as supplied by publisher]

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Clinical validation of automated audiometry with continuous noise-monitoring in a clinically heterogeneous population outside a sound-treated environment.

Clinical validation of automated audiometry with continuous noise-monitoring in a clinically heterogeneous population outside a sound-treated environment.

Int J Audiol. 2016 May 20;:1-7

Authors: Brennan-Jones CG, Eikelboom RH, Swanepoel W, Friedland PL, Atlas MD

Abstract
OBJECTIVE: Examine the accuracy of automated audiometry in a clinically heterogeneous population of adults using the KUDUwave automated audiometer.
DESIGN: Prospective accuracy study. Manual audiometry was performed in a sound-treated room and automated audiometry was not conducted in a sound-treated environment.
STUDY SAMPLE: 42 consecutively recruited participants from a tertiary otolaryngology department in Western Australia.
RESULTS: Absolute mean differences ranged between 5.12-9.68 dB (air-conduction) and 8.26-15 dB (bone-conduction). A total of 86.5% of manual and automated 4FAs were within 10 dB (i.e. ±5 dB); 94.8% were within 15 dB. However, there were significant (p < 0.05) differences between automated and manual audiometry at 250, 500, 1000, and 2000 Hz (air-conduction) and 500 and 1000 Hz (bone-conduction). The effect of age (≥55 years) on accuracy (p = 0.014) was not significant on linear regression (p > 0.05; R(2) =( ) 0.11). The presence of a hearing loss (better ear ≥26 dB) did not significantly affect accuracy (p = 0.604; air-conduction), (p = 0.218; bone-conduction).
CONCLUSIONS: This study provides clinical validation of automated audiometry using the KUDUwave in a clinically heterogeneous population, without the use of a sound-treated environment. Whilst threshold variations were statistically significant, future research is needed to ascertain the clinical significance of such variation.

PMID: 27206551 [PubMed - as supplied by publisher]

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Etiological factors associated with chronic suppurative otitis media in a population of Han adults in China.

Etiological factors associated with chronic suppurative otitis media in a population of Han adults in China.

Acta Otolaryngol. 2016 May 20;:1-5

Authors: Wang J, Chen B, Xu M, Wu J, Wang T, Zhao J, Zhang Q, Zhang Y

Abstract
OBJECTIVE: Risk factors for chronic suppurative otitis media (CSOM) were not clearly established. The study was to investigate the etiological factors for CSOM from a population of Han adults in China.
METHODS: A case-control study was conducted at Second Affiliated Hospital of Xi'an Jiaotong University, School of Medicine in China. A total of 416 individuals participated in this study, which included 206 cases and 210 controls.
RESULTS: Multivariate logistic regression analysis revealed male (OR = 0.42; 95% CI: 0.21-0.83), BMI increasing (OR = 0.85; 95% CI: 0.77-0.93), URTI (OR = 152.85; 95% CI: 34.11-684.93), smoke/passive smoke (OR = 7.11; 95% CI: 3.36-15.07), residential location (urban area) (OR = 0.27; 95% CI: 0.13-0.56), serum calcium increasing (OR = 0.09; 95% CI: 0.01-0.71) were prime risk factors for CSOM. Univariate analysis revealed that low socioeconomic status (OR= 2.33; 95% CI: 1.57-3.45) and hepatitis B (OR = 4.90; 95% CI: 1.82-13.21) were risk factors together with the above variables.
CONCLUSION: This study has identified several variables as risk factors for CSOM, suggesting better healthcare, living condition, as well as better nutrition might decrease the development of CSOM. Further studies are necessary to assess the outcome of CSOM after interventions in the etiological factors.

PMID: 27206699 [PubMed - as supplied by publisher]

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Subjective hearing-related quality-of-life is a major factor in the decision to continue using hearing aids among older persons.

Subjective hearing-related quality-of-life is a major factor in the decision to continue using hearing aids among older persons.

Acta Otolaryngol. 2016 May 20;:1-4

Authors: Maeda Y, Sugaya A, Nagayasu R, Nakagawa A, Nishizaki K

Abstract
CONCLUSION: Audiological parameters alone do not determine the choice to use hearing aids (HA). Subjective hearing-related QoL is a major factor that determines whether or not an older person will continue to wear HA.
OBJECTIVE: This study aimed to identify which audiological parameters and quality-of-life (QoL) measures determine whether or not older persons will continue wearing HA.
METHODS: Charts of 157 patients aged ≥65 years who attended the HA service unit at the Otolaryngology Department were retrospectively reviewed. After HA fitting and a trial, the patients were divided into groups, depending upon whether or not they wanted to continue wearing the HA (users, 58.2%; non-users, 41.8%) and then audiological parameters were compared between them. At least 4 months after the HA fitting, the self-reported QoL questionnaire, Hearing Handicap Inventory for the Elderly (HHIE), was mailed to all 157 patients and HHIE scores were compared between HA users and non-users.
RESULT: Speech discrimination score and dynamic range did not significantly differ between HA users and non-users. A difference in the average hearing threshold was marginally significant. The response rate to the HHIE was 65.2%. Total HHIE and emotional scores were higher (more impaired) among HA users than non-users.

PMID: 27206537 [PubMed - as supplied by publisher]

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Measuring motivation using the transtheoretical (stages of change) model: A follow-up study of people who failed an online hearing screening.

Measuring motivation using the transtheoretical (stages of change) model: A follow-up study of people who failed an online hearing screening.

Int J Audiol. 2016 May 20;:1-7

Authors: Ingo E, Brännström KJ, Andersson G, Lunner T, Laplante-Lévesque A

Abstract
OBJECTIVE: Acceptance and readiness to seek professional help have shown to be important factors for favourable audiological rehabilitation outcomes. Theories from health psychology such as the transtheoretical (stages-of-change) model could help understand behavioural change in people with hearing impairment. In recent studies, the University of Rhode Island change assessment (URICA) has been found to have good predictive validity.
DESIGN: In a previous study, 224 Swedish adults who had failed an online hearing screening completed URICA and two other measures of stages of change. This follow-up aimed to: (1) determine prevalence of help-seeking at a hearing clinic and hearing aid uptake, and (2) explore the predictive validity of the stages of change measures by a follow-up on the 224 participants who had failed a hearing screening 18 months previously.
STUDY SAMPLE: A total of 122 people (54%) completed the follow-up online questionnaire, including the three measures and questions regarding experience with hearing help-seeking and hearing aid uptake.
RESULTS: Since failing the online hearing screening, 61% of participants had sought help. A good predictive validity for a one-item measure of stages of change was reported.
CONCLUSIONS: The Staging algorithm was the stages of change measure with the best ability to predict help-seeking 18 months later.

PMID: 27206679 [PubMed - as supplied by publisher]

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Clinical validation of automated audiometry with continuous noise-monitoring in a clinically heterogeneous population outside a sound-treated environment.

Clinical validation of automated audiometry with continuous noise-monitoring in a clinically heterogeneous population outside a sound-treated environment.

Int J Audiol. 2016 May 20;:1-7

Authors: Brennan-Jones CG, Eikelboom RH, Swanepoel W, Friedland PL, Atlas MD

Abstract
OBJECTIVE: Examine the accuracy of automated audiometry in a clinically heterogeneous population of adults using the KUDUwave automated audiometer.
DESIGN: Prospective accuracy study. Manual audiometry was performed in a sound-treated room and automated audiometry was not conducted in a sound-treated environment.
STUDY SAMPLE: 42 consecutively recruited participants from a tertiary otolaryngology department in Western Australia.
RESULTS: Absolute mean differences ranged between 5.12-9.68 dB (air-conduction) and 8.26-15 dB (bone-conduction). A total of 86.5% of manual and automated 4FAs were within 10 dB (i.e. ±5 dB); 94.8% were within 15 dB. However, there were significant (p < 0.05) differences between automated and manual audiometry at 250, 500, 1000, and 2000 Hz (air-conduction) and 500 and 1000 Hz (bone-conduction). The effect of age (≥55 years) on accuracy (p = 0.014) was not significant on linear regression (p > 0.05; R(2) =( ) 0.11). The presence of a hearing loss (better ear ≥26 dB) did not significantly affect accuracy (p = 0.604; air-conduction), (p = 0.218; bone-conduction).
CONCLUSIONS: This study provides clinical validation of automated audiometry using the KUDUwave in a clinically heterogeneous population, without the use of a sound-treated environment. Whilst threshold variations were statistically significant, future research is needed to ascertain the clinical significance of such variation.

PMID: 27206551 [PubMed - as supplied by publisher]

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Development of a Low-Cost, Noninvasive, Portable Visual Speech Recognition Program.

Development of a Low-Cost, Noninvasive, Portable Visual Speech Recognition Program.

Ann Otol Rhinol Laryngol. 2016 May 19;

Authors: Kohlberg GD, Gal YK, Lalwani AK

Abstract
OBJECTIVES: Loss of speech following tracheostomy and laryngectomy severely limits communication to simple gestures and facial expressions that are largely ineffective. To facilitate communication in these patients, we seek to develop a low-cost, noninvasive, portable, and simple visual speech recognition program (VSRP) to convert articulatory facial movements into speech.
METHODS: A Microsoft Kinect-based VSRP was developed to capture spatial coordinates of lip movements and translate them into speech. The articulatory speech movements associated with 12 sentences were used to train an artificial neural network classifier. The accuracy of the classifier was then evaluated on a separate, previously unseen set of articulatory speech movements.
RESULTS: The VSRP was successfully implemented and tested in 5 subjects. It achieved an accuracy rate of 77.2% (65.0%-87.6% for the 5 speakers) on a 12-sentence data set. The mean time to classify an individual sentence was 2.03 milliseconds (1.91-2.16).
CONCLUSION: We have demonstrated the feasibility of a low-cost, noninvasive, portable VSRP based on Kinect to accurately predict speech from articulation movements in clinically trivial time. This VSRP could be used as a novel communication device for aphonic patients.

PMID: 27208007 [PubMed - as supplied by publisher]

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Systemic inflammation in patients with compromised upper airway anatomy and primary snoring or mild obstructive sleep apnea.

Systemic inflammation in patients with compromised upper airway anatomy and primary snoring or mild obstructive sleep apnea.

Eur Arch Otorhinolaryngol. 2016 May 20;

Authors: Jahn C, Gouveris H, Matthias C

Abstract
Our aim was to study associations between serum fibrinogen and C-reactive protein (CRP) levels and respiratory parameters on polysomnography (PSG) in patients with snoring as their main complaint and compromised upper airway anatomy. In this retrospective study, consecutive patients (43 female and 132 male; age range 11-82 years, respiratory distress index-RDI range 0.1-94.4/h) with snoring as their main complaint and compromised upper airway anatomy who underwent PSG were assessed. Spearman's Rho coefficients between RDI, AI (apnea index), hypopnea index (HI), average and lowest SpO2 (in %) and CRP- and fibrinogen serum levels were calculated. Comparisons between groups were made using Wilcoxon-W test. Patients with CRP > 5 mg/dl (22 % of the cohort) had significantly increased RDI, AI, average and lowest SpO2 than patients with CRP < 5 mg/dl. Increased correlation coefficients were observed for average SpO2 (-0.386), RDI (0.355), lowest SpO2 (-0.323) and AI (0.309). Patients with fibrinogen >350 mg/dl (in 33 %) had significantly increased RDI, HI, AI, average and lowest SpO2 than patients with fibrinogen <350 mg/dl. Increased correlation coefficients were found for average (-0.340) and lowest (-0.268) SpO2, RDI (0.236) and AI (0.229). Even patients with RDI < 15/h had increased serum CRP-(in 11 %) and/or fibrinogen-(in 19 %) levels. Simultaneous elevation of both CRP and fibrinogen levels occurred only in patients with RDI > 5/h. Systemic inflammation is strongly associated with average and lowest SpO2, RDI and AI (and with HI) in snorers with compromised upper airway anatomy and is present even in patients with primary snoring and mild obstructive sleep apnea.

PMID: 27207142 [PubMed - as supplied by publisher]

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Is the remedy temporary surgical procedures in primer snoring?

Is the remedy temporary surgical procedures in primer snoring?

Eur Arch Otorhinolaryngol. 2016 May 20;

Authors: Acar B, Dagli E

PMID: 27207141 [PubMed - as supplied by publisher]

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Better consenting for thyroidectomy: who has an increased risk of postoperative hypocalcaemia?

Better consenting for thyroidectomy: who has an increased risk of postoperative hypocalcaemia?

Eur Arch Otorhinolaryngol. 2016 May 20;

Authors: Harris AS, Prades E, Tkachuk O, Zeitoun H

Abstract
Hypocalcaemia is the most common complication following thyroidectomy. This study aimed to establish the factors associated with increased risk of hypocalcaemia on day 1 following thyroidectomy. All patients who underwent thyroidectomy under a single consultant during a 5-year period were included. A multivariate analysis was undertaken to ascertain which variables had the most effect on the risk of hypocalcaemia. A prognosis table was constructed to allow risk to be predicted for individual patients based on these factors. Included in the analysis were 210 procedures and 194 patients. Eighty-two percent of patients had no calcium derangement postoperatively. Fourteen point nine percent were categorised as early hypocalcaemia, 1 % had protracted hypocalcaemia and 2.1 % had permanent hypocalcaemia. For hemi-thyroidectomies 2.8 % had postoperative hypocalcaemia and 0.9 % had permanent hypocalcaemia. The multivariate analysis revealed total thyroidectomy (risk ratio 26.5, p < 0.0001), diabetes (risk ratio 4.8, p = 0.07) and thyrotoxicosis (risk ratio 3.1, p = 0.04) as statistically significant variables for early postoperative hypocalcaemia. Gender as an isolated factor did not reach significance but was included in the model. The p value for the model was p < 1 × 10(-12). Total thyroidectomy increases risk of early hypocalcaemia when compared to hemithyroidectomy. Gender, diabetes and thyrotoxicosis were also been found to influence the risk. All of these factors are available pre-operatively and can therefore be used to predict a more specific risk for individual patients. It is hoped that this can lead to better informed consent, prevention and better resource allocation.

PMID: 27207140 [PubMed - as supplied by publisher]

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Medial sural artery perforator flap in head and neck reconstruction.

Medial sural artery perforator flap in head and neck reconstruction.

Eur Arch Otorhinolaryngol. 2016 May 20;

Authors: Özkan HS, İrkören S, Aydın OE, Eryılmaz A, Karaca H

Abstract
Medial sural artery perforator (MSAP) flap is a relatively new flap which is a modification of medial gastrocnemius myocutaneous flap. Both radial forearm flap and MSAP has common benefits, such as thinness, long pedicle and pliability; however, MSAP has lower donor site morbidity when compared with radial forearm flap. Because of this reason, the MSAP flap has gained popularity during the last decade. The objective of this study was to determine clinical application results of this flap in reconstruction of post-oncologic defects in the head and neck region. 11 patients operated for head and neck post oncologic defects and reconstructed with MSAP between June 2014 and Dec 2015 were included in the study. Age, gender, histopathology, area of reconstruction, flap size, number of perforators were reviewed. Postoperatively recipient and donor site complications, hospital stay and additional surgical procedures were also analyzed. We had seven uncomplicated cases; one total flap failure due to arterial problem, in three cases due fistula formation and local wound healing problems additional surgeries were performed. All venous anastomosis were performed with 9/0 sutures, nine arterial anastomosis were performed with 9/0 and two arterial anastomosis were performed with 10/0 nylon sutures. Medial sural artery perforator flap is a good alternative in head and neck reconstruction, with the advantages of thin and pliable skin, a reliable vascular pedicle, straightforward intramuscular dissection. But there are certain drawbacks like tedious pedicle and perforator dissection, small arterial pedicle size which complicates anastomosis and obscurities of anatomy. Surgical team must always be ready for a difficult micro anastomosis and an alternative flap choice must be prepared and counseled with the patient in case of inadequate perforators.

PMID: 27207139 [PubMed - as supplied by publisher]

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