The feasibility of hospital-based universal newborn hearing screening in the United Kingdom

Current hearing screening programmes in the United Kingdom are performing unacceptably poorly. Davies et al. (1997) suggested that universal newborn hearing screening (UNHS) would be more effective and cheaper to run. However, there is concern that hospital-based UNHS would not be feasible because of early postnatal discharge, and thus babies not staying in hospital long enough to be screened. Two studies were designed to determine the viability of hospital-based UNHS in a district general hospital in the United Kingdom. Study 1 retrospectively determined the discharge age and time of discharge of all 3021 well babies born at St Helier hospital, Carshalton, and the number of babies born at home in the area, from 19 October 1997-18 October 1998. Most well babies were found to pass through hospital at a convenient time for predischarge hearing screening, and the optimal protocol was screening from 9 am-2 pm, 7 days a week. The predicted maximal screening coverage was 92.68%. Study 2 tested the calculated optimal protocol over 1 week. It was found that UNHS with otoacoustic emissions on the maternity ward from 9 am-2 pm, 7 days a week, achieved a coverage of 89.06%, with an acceptable false positive rate of 6.2%. It is likely that a similar protocol with slight modifications could be implemented successfully in other hospitals in the United Kingdom.

Effects of hearing impairment on use of health services among the elderly

OBJECTIVES

To assess the effects of hearing impairment on health-service use in an elderly population, controlling for factors associated with hearing difficulties known to affect utilization.

METHODS

Diagnoses of hearing impairment, depression, and chronic illnesses were used in hierarchical regression procedures to predict the volume and probability of any service use among 1,436 randomly selected 65-year-old health maintenance organization members.

RESULTS

Hearing impairment substantially increased the likelihood of making at least one visit to a health care provider (OR = 3.31, 95%; CI = 1.55-7.06). Among those who made such visits, however, hearing impairment did not lead to use of additional services despite expectations to the contrary.

DISCUSSION

Further research should explore whether underutilization of services exists, and, if so, whether it stems from clinician or patient attitudes about the seriousness of hearing impairment, from a paucity of available treatment strategies, or from some combination of these and other factors.

Hajdu--Cheney syndrome: evolution of phenotype and clinical problems

Hajdu-Cheney syndrome is a rare, autosomal dominant disorder comprising acroosteolysis of the distal phalanges with associated digital abnormalities, distinctive craniofacial and skull changes, dental anomalies, and proportionate short stature. The clinical and radiologic characteristics of Hajdu-Cheney syndrome develop and progress with age. Many of the medical problems that arise in this syndrome cluster in specific age ranges. Case reports of six affected individuals in two additional families and a summary of the English literature is presented with emphasis on the changing physical findings and medical sequelae over time.

Stress in caregivers of hospitalized oldest-old patients

BACKGROUND

Stress in caregivers of elderly patients is a well-recognized health care problem. However, little has been published about the stress in caregivers of the oldest-old patients, the most rapidly growing segment of our population.

METHODS

A prospective cohort study was conducted in four teaching hospitals. Questionnaires were administered to patients 80 years of age and older and their surrogates (the person who would make decisions if the patient were unable to-usually a family member) who identified themselves as the primary caregivers for the patients. Data were abstracted from medical records.

RESULTS

Caregivers tended to be female and 50 years of age or older. About one in five described her own health as fair or poor; nearly half of them lived with the patient. About one quarter spent at least 8 h/d caring for the patient, and they had few persons available to help them with care. Most of the caregivers reported mild-to-moderate levels of stress. After adjustment, higher stress scores were associated with female caregivers, poorer caregiver health, more hours per day spent caring for the patient, and the presence of patient depression and hearing impairment.

CONCLUSION

Stress is common in caregivers of the hospitalized oldest-old patients. Women who are in poor health and spend 8 or more hours every day caring for relatives aged 80 and over are at high risk for caregiver stress. Treatment of patient depression and hearing impairment may ameliorate caregiver stress.

Tele-talk: a communication device for the persons with hearing disabilities

Tele-Talk is a device designed to allow a person with hearing disabilities to communicate using the telephone, with a minimum of effort and without requiring a multitude of special equipment. This device provides a previously unavailable link for the hearing disabled to communicate directly over telephone lines. Tele-Talk has the extra capability of operating in live conference situations using microphone input. Today, most devices designed for the hearing-impaired are dependent on both communicants' owning/operating identical set-ups. If an accessory item is missing or misplaced, communication breaks down. Tele-Talk answers the need to permit transparent hearing assistance via the telephone.

Hereditary congenital deafness in uniovular twins

A deaf-mute boy of 14 years, who was examined owing to his poor progress in the special school for the deaf-mute, proved to be one of a twin. Both boys were born 6 weeks before the normal term by breach presentation at the end of an uncomplicated pregnancy. There was one placenta. The mother had noticed A's deafness when he was 11 weeks old, as he did not react to street noises as his brother did. The twin brother B is deaf in the right ear; he attends the secondary school and his performance is average.

Approaches to studying in people with hearing loss

BACKGROUND

There has been little research on the experiences of students with hearing loss in higher education. It has, however, been suggested that children with hearing loss adopt different strategies and styles and that this leads to differences in their academic performance.

AIMS

This investigation compared students in higher education with and without hearing loss in terms of their approaches to studying.

SAMPLES

We compared 382 students with hearing loss taking courses by distance learning with the Open University and a comparison group of 190 students taking the same courses with no declared form of disablement.

METHODS

A questionnaire containing a shortened and adapted version of the Approaches to Studying Inventory was distributed in a postal survey.

RESULTS

Students with postvocational hearing loss obtained higher scores than the comparison group on deep approach, and those with postvocational deafness also obtained higher scores on the use of evidence and logic. Students with prevocational deafness obtained higher scores on reproducing orientation than the comparison group, and in particular on improvidence. All of the subgroups of students with hearing loss obtained higher scores than the comparison group on fear of failure.

CONCLUSIONS

The impact of hearing loss on cognitive aspects of studying appears to be relatively slight. Future research might focus instead upon its affective consequences and its effects upon a student's self-concept.

[Driver's licence: responsibility, ethics and deontology]

The new law enacted on march 23rd 1998 regarding driving-licence, which became effective on october 1st 1998, modifies the method for obtaining the different types of driving-licences. Its 6th annex enumerates a list of physical impairments and pathologies implying the denial, the limitation or the withdrawal of the driving-licence; it determines if a medical advice, and if the case which kind of medical advice, is required. This leads to new situations, for which no jurisprudence has been established to date, where not only the responsibility of the licence's applicant but also that of the examining physician could be suspected. The physicians are also confronted to ethical an deontological problems on which the medical authorities have not always given an opinion. This paper examines them in order to give some bases for reflexion and discussion.

Hearing health services in nursing homes: perceptions of administrators and audiologists

A recent survey found that many residents lack adequate audiological services despite a high prevalence of hearing loss. Upgrading hearing health services is one way to dramatically improve quality of life.

Anatomy of an ADA case. Chatoff v. City of New York

This article addresses plaintiff and defense strategies in the context of an ADA case and is intended to serve as a ready reference to employer's counsel when faced with ADA litigation. In an ADA case, it is essential that counsel humanize the employer by keeping the "Our Business Supports Diversity" theme before the trier of facts at all times. This theme should be accompanied by the proposition that plaintiff's demands are not reasonable because they impose an undue burden on the employer or a risk to the safety of the employee or others in the workplace. It is also crucial for defense counsel to become familiar with the plaintiff's attorney's strategic considerations. ADA litigation strategy is illustrated by reference to Chatoff v. City of New York, a landmark ADA case instituted on behalf of the approximately 200,000 hearing-impaired residents of the City of New York, demanding equal and direct access to Emergency 911 services.

An examination of two coteaching classrooms

The present study presents data on two classrooms that used a coteaching approach to provide services to students who were deaf, hard of hearing, and hearing. The author conducted extensive observations, as well as interviews with teachers, students, administrators, and parents. The resulting qualitative data supported coteaching's effectiveness as a service delivery model. However, the research also identified important and specific challenges. Seven subthemes about coteaching are presented, and quotes from various stakeholders are provided to support and illustrate the information reported. Suggestions for future research are provided. The author makes recommendations on how to establish coteaching teams and describes issues surrounding communication, staff development, and family involvement.