Prognosticating Speech Performance in Multichannel Cochlear Implant Patients

1989 ◽  
Vol 101 (3) ◽  
pp. 314-319 ◽  
Author(s):  
James L. Parkin ◽  
Bruce E. Stewart ◽  
Korine Dankowski ◽  
Leonard J. Haas
Keyword(s):  
Cochlear Implants ◽  
Hearing Aids ◽  
Reading Ability ◽  
Medical Center ◽  
Statistical Significance ◽  
Ct Scanning ◽  
University Of Utah ◽  
Lip Reading ◽  
Speech Performance ◽  
The University

Twenty patients received multichannel cochlear implants between April 1984 and May 1986 at the University of Utah Medical Center. All patients have been followed for at least 1 year postimplant. Preimplant screening included audiometric testing, electronystagmogram (ENG), promontory stimulation, computed tomography (CT) scanning, and psychological evaluation. Based on postimplant audio-only CID sentence discrimination scores, these patients were divided into three groups: good (CID > 79%), Intermediate (CID, 21% to 79%), and poor (CID < 21%). Preimplant factors that correlated with CID scores were hearing loss duration, previous use of hearing aids, lip-reading ability, tinnitus, positive ENG calorics, preimplant pure-tone average, promontory stimulation threshold, and understanding of the project. Only previous hearing aid usage approached statistical significance ( p = 0.05). A larger patient sample is needed to verify these results.

Acquired and Congenital Subglottic Stenosis in the Infant

1976 ◽  
Vol 85 (5) ◽  
pp. 573-581 ◽  
Author(s):  
James L. Parkin ◽  
Michael H. Stevens ◽  
August L. Jung
Keyword(s):  
Medical Center ◽  
Care Center ◽  
Subglottic Stenosis ◽  
University Of Utah ◽  
Newborn Intensive Care ◽  
Tracheostomy Tubes ◽  
The University ◽  
Stenotic Lesions ◽  
Stenotic Area ◽  
Overall Mortality

During the calendar year of 1974, the Intermountain Newborn Intensive Care Center at the University of Utah Medical Center had 603 admissions. A representative group of 293 charts were reviewed which indicated that 44% of these children were intubated from hours to weeks. The overall mortality rate for the 293 children was 29%. Eighteen of the 603 children were diagnosed as having subglottic stenosis. Fifteen of these children appeared to have acquired subglottic stenosis secondary to endotracheal intubation. Three children had congenital subglottic stenosis. Tracheostomy was necessary in the management of 15 patients. Ten of the 18 patients have survived and two of these patients still have tracheostomy tubes in place. The survival and thickness of the stenotic area are inversely proportional to the birth weight and the duration of intubation. Endoscopic excision, dilatation and stenting were techniques utilized in the treatment of these stenotic lesions. The extubation technique utilized is described. The factors involved in the production of acquired subglottic stenosis are presented along with suggestions to decrease the incidence of this problem in the intubated child.

scholarly journals Pautas orientativas para la asistencia a la diversidad y la inclusión de personas sordas

2021 ◽  
Vol 2 (5) ◽  
pp. 6441-6452
Author(s):  
Roberto García Sánchez ◽  
Justo Pedro Hernández González
Keyword(s):  
Continuing Education ◽  
Sign Language ◽  
Cochlear Implants ◽  
Hearing Aids ◽  
Deaf People ◽  
Deaf Students ◽  
Sign Languages ◽  
Sign Language Interpreters ◽  
The World ◽  
The University

Comunidad  Sorda es aquella que participa de unos valores culturales y lingüísticos construidos en torno a la lengua de signos y a una concepción visual del mundo. Entre las personas sordas usuarias de la lengua de signos algunas aprendieron a signar en su infancia y otras siendo ya adultas; hay quienes son usuarias de audífonos o implantes cocleares y, entre ellas, hay quienes usan la lengua de signos y quienes no. También debemos mencionar a aquellas personas sordas que, a causa de un sistema educativo no inclusivo, tienen problemas de expresión y comprensión de textos escritos. Al igual que en el resto de la población, entre las personas sordas encontraremos niños, jóvenes, mayores, personas sordas con otra(s) discapacidad(es)... Todas y cada una de ellas con sus necesidades y demandas concretas. Es importante saber que, aun tratándose de un colectivo heterogéneo, todas las personas sordas, cualquiera que sea su tipo o grado de sordera, situación individual e independientemente de que sean o no usuarias de las lenguas de signos, comparten la necesidad de acceder a la comunicación e información del entorno sin barreras de ningún tipo. Por ese motivo es necesario desarrollar un servicio de orientación, asesoramiento y acción tutorial específico para el alumnado sordo que tenga en cuenta sus necesidades y dificultades y que evite cualquier tipo de discriminación o falta de accesibilidad al contenido universitario del tipo que sea. Por lo tanto, es necesario proporcionar este servicio con los recursos audiovisuales necesarios, intérpretes de lengua de signos española y formación continua a la comunidad universitaria. Es fundamental coordinarse con las asociaciones de personas sordas para cumplir los requisitos básicos que garanticen su inclusión, puesto que éstas son las que conocen mejor sus necesidades por la lucha de sus derechos, y orientar a la universidad para la consecución de dicha finalidad.   A Deaf Community is one that participates in cultural and linguistic values built around sign language and a visual conception of the world. Among the deaf people who used sign language, some learned to sign in their childhood and others when they were adults; there are those who use hearing aids or cochlear implants and, among them, there are those who use sign language and those who do not. We will also find deaf people who, because of a non-inclusive educational system, have problems of expression and comprehension of written texts. As in the rest of the population, among the deaf people we will find children, young people, elderly, deaf people with other disability(ies). . . Each and every one of them with their specific needs and demands. It is important to know that, even if it is a heterogeneous collective, all deaf people, whatever their type or degree of deafness, individual situation and regardless of whether or not they are users of sign languages, share the need to access the communication and information of the environment without barriers of any kind. For this reason it is necessary to develop a service of guidance, advice and specific tutorial action for deaf students that takes into account their needs and difficulties and avoids any type of discrimination or lack of accessibility to university content of any kind. Therefore, it is necessary to provide this service with the necessary audiovisual resources, Spanish sign language interpreters and continuing education to the university community. It is essential to coordinate with associations of deaf people to meet the basic requirements to ensure their inclusion, since they are the ones who best know their needs by fighting for their rights, and guide the university to achieve that goal.

Building a Cochlear Implant Practice: Five Lessons Learned

2013 ◽  
Vol 20 (1) ◽  
pp. 14-21
Author(s):  
Anne M. Lobdell ◽  
Joseph E. Dansie ◽  
Sarah Hargus Ferguson
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implants ◽  
Lessons Learned ◽  
Clinical Aspects ◽  
University Of Utah ◽  
The Third ◽  
The Past ◽  
Speech Science ◽  
The University ◽  
First Time

Cochlear implants are becoming available to an increasing proportion of the deaf and hard-of-hearing population. As interest in and success with cochlear implants has grown, more and more private practice clinics are incorporating them into their scopes of practice. Over the past 2 years, the first 2 authors of this article have been heavily involved in developing cochlear implant programs in separate otolaryngology private practices. A recent conversation about this process revealed several common experiences and lessons learned. During these same 2 years, the third author began teaching the cochlear implant course at the University of Utah. Although her audiology and speech science background gave her extensive knowledge of the science behind cochlear implants, she had no clinical experience with them. The first author took this course the first time the third author taught it, and the experiences and insights she shared with the third author during and since the course have been an important component of the third author’s personal education in the clinical aspects of cochlear implants. In this article, the first 2 authors share 5 things we wish we had known when first beginning their work with cochlear implants.

Evaluating end-of-life (EOL) care at the University of Rochester Medical Center (URMC) using quality oncology practice initiative (QOPI) metrics.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 12-12
Author(s):  
Titas Banerjee ◽  
Jason Harold Mendler ◽  
Nabeel Badri ◽  
Dwight Hettler ◽  
Julie Ann Berkhof ◽  
...  
Keyword(s):  
End Of Life ◽  
Medical Center ◽  
Statistical Significance ◽  
Inpatient Mortality ◽  
Exact Test ◽  
Number Of Patients ◽  
Advanced Malignancies ◽  
Oncology Practice ◽  
The University ◽  
Eol Care

12 Background: Inpatient mortality, defined as death within 30 days of an acute hospital admission, is often used as a quality benchmark for healthcare institutions and is an important metric for evaluating quality of care of patients with advanced malignancies. In this study we aimed to utilize QOPI performance data to identify areas of weakness in our practice that may contribute to inpatient mortality. Methods: We analyzed 11 EOL measures within the QOPI database which we collected between 2015 and 2018. These included all EOL measures related to hospice enrollment (measure IDs 42-47), chemotherapy administered within the last 2 weeks of life (ID 48), percentage of patients who died from cancer with at least one emergency department (ED) visit in the last 30 days of life (ID 49ed), and the percentage of patients who died from cancer admitted to the Intensive Care Unit (ICU) in the last 30 days of life (ID 49icu). Our rate was calculated for each measure and compared against QOPI aggregate data. We used a fisher’s exact test to determine statistical significance for each metric. Results: The number of patients from our institution included in each analysis ranged from 27 to 46. Compared to our peers, patients treated at our institution were more likely to visit an ED in the last 30 days of life (68% vs. 32%; P < 0.0001), more likely to be admitted to the ICU in the last 30 days of life (29% vs. 9%; P = 0.0003), and more likely to be enrolled on hospice within the last 7 days of death (63% vs. 32%; P = 0.001). Conclusions: Analysis of QOPI EOL performance scores identified several metrics that may contribute to inpatient mortality at URMC. Ongoing participation in QOPI with a focus on EOL metrics will strengthen this analysis. We plan to use this data to guide quality improvement initiatives aimed at reducing impatient mortality and improving end of life care at our institution.

Speech Performance by Patients with Multichannel Cochlear Implants

1986 ◽  
Vol 95 (2) ◽  
pp. 205-209 ◽  
Author(s):  
James L. Parkin ◽  
M. Korine Dankowski
Keyword(s):  
Cochlear Implants ◽  
Single Channel ◽  
Word List ◽  
Open Set ◽  
Lip Reading ◽  
Speech Performance ◽  
Improved Performance ◽  
Processor Unit ◽  
Sound Processor ◽  
Channel Unit

Thirteen patients were implanted with multichannel cochlear implants between April 1,1984 and February 25,1985. The patients are fitted with the sound processor unit 4 to 6 weeks postsurgery. One patient had a single-channel unit replaced with a multichannel implant. She reported improved sound quality. All patients use their implants daily and all patients would undergo implantation again (based on their current performance). Evidence exists that continued use leads to improved performance. Patient S.S. progressed from auditory-only scores of 12% and 24% to 100% and 100% in 4 months. The average open set auditory-only performance of six patients in the first 4 months on a spondee word list was 22%. The average of eight patients—more than 4 months post sound processor—is 44%, indicating improvement with use. Patients perform better when combining auditory input with visual input than they do with lip reading alone. The multichannel implant is well tolerated and accepted, and results in speech performance improvement.

scholarly journals Cell scientist to watch – Prachee Avasthi

2021 ◽  
Vol 134 (18) ◽  
Keyword(s):  
San Francisco ◽  
Protein Trafficking ◽  
Cell Biology ◽  
Medical Center ◽  
Associate Professor ◽  
Integrative Physiology ◽  
University Of Utah ◽  
School Of Medicine ◽  
Set Up ◽  
The University

ABSTRACT Prachee Avasthi studied Molecular and Integrative Physiology at the University of Illinois at Urbana-Champaign. She received her PhD in neuroscience in 2009 from the lab of Wolfgang Baehr at the University of Utah for her work on the control of membrane protein trafficking in photoreceptors. Prachee then moved to Wallace Marshall's group at the University of California, San Francisco, for her postdoc, where she studied ciliary assembly and the regulation of ciliary length. She set up her lab at the University of Kansas Medical Center in 2015, and relocated to the Geisel School of Medicine at Dartmouth in 2020, where she is an Associate Professor of Biochemistry and Cell Biology. Her group investigates the biogenesis of cilia and the coordination of actin- and microtubule-based trafficking.

scholarly journals Use of a Feedback Survey as a Part of a Wellness Champions Program to Improve Academic Faculty Satisfaction and Burnout: Implications for Burnout in Academic Health Centers

2020 ◽  
Vol 9 ◽  
pp. 216495612097363
Author(s):  
Amy Beth Locke ◽  
Katherine T Fortenberry ◽  
Erika Sullivan ◽  
Dominik Ose ◽  
Ben Tingey ◽  
...  
Keyword(s):  
Family Medicine ◽  
Effect Size ◽  
Statistical Significance ◽  
Maslach Burnout Inventory ◽  
Well Being ◽  
Medium Effect ◽  
University Of Utah ◽  
Work Related ◽  
Faculty Survey ◽  
The University

Background Faculty and trainee well-being at academic medical centers is a nationwide concern. In response, the University of Utah Health created a system-wide provider wellness program that used individual faculty champions who were empowered to 1) examine the unique needs of their department or division using a lens of quality improvement, 2) design projects to address well-being, and 3) measure impact of projects addressing well-being. One team used a feedback tool to attempt to improve the well-being of Family Medicine faculty by better understanding challenges and developing a roadmap for action. Objective Evaluate the effectiveness of an anonymous feedback tool on faculty well-being. Methods The Division of Family Medicine developed and implemented a quarterly anonymous faculty survey to facilitate an ongoing improvement process for faculty wellness in 2016. The faculty survey identified thematic concerns, which were used to develop constructive solutions and systemic changes. Results A closed loop feedback structure provided rich faculty input into impacts on burnout and professional well-being. Sense of control (good to optimal) over workload among faculty increased significantly (p = 0.011) from 10% to 42% over one year exhibiting a large effect size (Cohen’s h = 0.751). Faculty burnout, using a single item emotional exhaustion question validated to the Maslach Burnout Inventory, was reduced from 48% to 25% showing a medium effect size (Cohen’s h = 0.490 with p = 0.097). Work related stress was reduced from 72% to 50% demonstrating clinical significance (Cohen’s h = 0.465) but not statistical significance (p = 0.154)—an effect which was more noticeable when comparing means between years (Cohen's d=0.451with p = 0.068). Response rate was 100% in 2016 (29/29) and 92% (23/25) in 2017. Conclusion This faculty survey, which has since been adopted by other groups at the University of Utah, could help improve well-being in a variety of health care professions.

scholarly journals Reading Ability and Working Memory in School-Age Children Who Are Deaf and Hard of Hearing Using Cochlear Implants and/or Hearing Aids: A 3-Year Follow-Up on Computer-Based Phonics Training

2020 ◽  
Vol 5 (6) ◽  
pp. 1388-1399
Author(s):  
Cecilia Nakeva von Mentzer ◽  
Sonia Wallfelt ◽  
Elisabet Engström ◽  
Malin Wass ◽  
Birgitta Sahlén ◽  
...  
Keyword(s):  
Working Memory ◽  
Hearing Loss ◽  
Reading Comprehension ◽  
Cochlear Implants ◽  
Hearing Aids ◽  
Hard Of Hearing ◽  
Reading Ability ◽  
Computer Based ◽  
Phonics Intervention

Purpose The aim of the current study was to investigate reading ability in children who are deaf and hard of hearing (DHH) using cochlear implants (CI) or hearing aids (HA) 3 years after computer-assisted phonics intervention. Reading ability was examined in relation to cognitive and audiological aspects and compared to a reference group of children with typical hearing (TH). Method Participants were 73 Swedish primary school children ( Mdn = 9 years). Fifty-five of the children were TH, and 18 children were DHH using CI ( n = 10) or HA ( n = 8). Twenty-seven of the children (all children who were DHH and nine of the children with TH) had participated in computer-based phonics intervention 3 years earlier. Children were assessed on word and nonword decoding, reading comprehension, and three working memory (WM) tasks. Age at diagnosis, age of amplification, and duration of unaided hearing loss formed the audiological variables. Results Comparable word decoding skills and reading comprehension were observed in all three groups (CI, HA, and TH). Children with CI showed strong and significant correlations between two aspects of WM capacity (phonological and complex WM) and all aspects of reading. For children with TH, similar but weaker correlations as in children with CI was observed, and correlations with visual WM were also evident. In children with HA only, complex WM correlated strongly and significantly with nonword decoding. Duration of unaided hearing loss was the single audiological variable that was significantly associated with reading. Conclusions This 3-year follow-up showed overall positive reading results at the group level in children who are DHH. However, some children still lag behind their peers with TH. Early hearing experience and intervention are stressed as crucial factors in preventing negative outcomes in these children.

Cochlear Implants in Children, Adolescents, and Prelinguistically Deafened Adults

1992 ◽  
Vol 35 (2) ◽  
pp. 401-417 ◽  
Author(s):  
Pam W. Dawson ◽  
Peter J. Blamey ◽  
Louise C. Rowland ◽  
Shani J. Dettman ◽  
Graeme M. Clark ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implants ◽  
Hearing Aids ◽  
Age At Onset ◽  
Closed Set ◽  
Open Set ◽  
Profound Deafness ◽  
Monosyllabic Words ◽  
Open Set Recognition ◽  
The University

A group of 10 children, adolescents, and prelinguistically deafened adults were implanted with the 22-electrode cochlear implant (Cochlear Pty Ltd) at the University of Melbourne Cochlear Implant Clinic and have used the prosthesis for periods from 12 to 65 months. Postoperative performance on the majority of closed-set speech perception tests was significantly greater than chance, and significantly better than preoperative performance for all of the patients. Five of the children have achieved substantial scores on open-set speech tests using hearing without lipreading. Phoneme scores in monosyllabic words ranged from 30% to 72%; word scores in sentences ranged from 26% to 74%. Four of these 5 children were implanted during preadolescence (aged 5:5 to 10:2 years) and the fifth, who had a progressive loss, was implanted during adolescence (aged 14:8 years). The duration of profound deafness before implantation varied from 2 to 8 years. Improvements were also noted over postoperative data collection times for the younger children. The remaining 5 patients who did not demonstrate open-set recognition were implanted after a longer duration of profound deafness (aged 13:11 to 20:1 years). The results are discussed with reference to variables that may affect implant performance, such as age at onset of loss, duration of profound loss, age at implantation, and duration of implantation. They are compared with results for similar groups of children using hearing aids and cochlear implants.

Speech Recognition Experience with Multichannel Cochlear Implants

1985 ◽  
Vol 93 (5) ◽  
pp. 639-645 ◽  
Author(s):  
James L. Parkin ◽  
Donald K. Eddington ◽  
Jeffrey L. Orth ◽  
Derald E. Brackmann
Keyword(s):  
Clinical Trials ◽  
Electrical Stimulation ◽  
Speech Recognition ◽  
Cochlear Implants ◽  
Single Channel ◽  
University Of Utah ◽  
Sound Coding ◽  
Coding Strategies ◽  
The University ◽  
Sound Processor

Four patients received multichannel intracochlear implants before 1978 as part of the University of Utah program. By 1983, sound coding strategies and electronic miniaturization were developed to allow production and use of a portable sound processor/cochlear stimulator unit. Approval for expanded clinical trials has allowed Implantation of five additional patients by August 1984. Data on the earlier patients demonstrate stability of electrode thresholds and impedance, low risk of the percutaneous pedestal, and the development of speech recognition scores of greater than 60% with electrical stimulation alone and greater than 90% with electrical stimulation combined with lipreading. Data on recent recipients indicate early electrode threshold stability, lower thresholds for apical electrodes, possibility of replacing single-channel with multichannel units, and low morbidity of the implantation. Return to function in a verbally communicating environment has been achieved by one earlier patient.

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