A National Survey of Pediatric Otolaryngologists and Early Hearing Detection and Intervention Programs

2006 ◽  
Vol 17 (10) ◽  
pp. 708-721 ◽  
Author(s):  
Jeffrey L. Danhauer ◽  
Carole E. Johnson ◽  
Dan Finnegan ◽  
Marilene Lamb ◽  
Ilian Priscilla Lopez ◽  
...  
Keyword(s):  
The United States ◽  
Vital Role ◽  
Postal Survey ◽  
Intervention Programs ◽  
National Study ◽  
Screening Programs ◽  
Additional Information ◽  
Adequate Knowledge ◽  
Newborn Hearing

Follow-up rates for babies identified for hearing loss from early hearing detection and intervention programs (EHDIPs) and newborn hearing screening programs (NHSPs) in the United States do not meet the goals posited by the Centers for Disease Control. Pediatric otolaryngologists (PED-ENTs) play a vital role in EHDIPs and can positively influence parents' compliance with professionals' recommendations for their babies. This national study used a 19-item questionnaire and postal survey to assess PED-ENTs' knowledge about, experience with, and attitudes toward NHSPs. Of 565 surveys mailed (36 were undeliverable), 233 were returned for a 44% response rate. Most of these PED-ENTs had adequate knowledge about, participated in, and expressed positive attitudes toward NHSPs; however, some could benefit from additional information about national EHDI benchmarks and poor follow-up rates. Audiologists should ally with PED-ENTs locally and nationally to strengthen EHDIPs and prevent loss of children with hearing impairment to follow-up.

Consistent Infection Prevention: Vital During Routine and Emerging Infectious Diseases Care

2017 ◽  
Vol 22 (1) ◽  
Author(s):  
Terri Rebmann ◽  
Ruth Carrico
Keyword(s):  
Infectious Diseases ◽  
Disease Transmission ◽  
Infection Prevention ◽  
Healthcare Providers ◽  
Emerging Infectious Diseases ◽  
Occupational Exposures ◽  
The United States ◽  
Vital Role ◽  
Routine Practice ◽  
Adequate Knowledge

Emerging infectious diseases impact healthcare providers in the United States and globally. Nurses play a vital role in protecting the health of patients, visitors, and fellow staff members during routine practice and biological disasters, such as bioterrorism, pandemics, or outbreaks of emerging infectious diseases. One vital nursing practice is proper infection prevention procedures. Failure to practice correctly and consistently can result in occupational exposures or disease transmission. This article reviews occupational health risks, and pharmacological and nonpharmacological interventions for nurses who provide care to patients with new or re-emerging infectious diseases. Infection prevention education based on existing infection prevention competencies is critical to ensure adequate knowledge and safe practice both every day and in times of limited resources. Challenges specific to infectious disease disasters are discussed, as well as the role of microorganisms and nurse education for infection prevention.

Echocardiography of coarctation of the aorta, aortic arch hypoplasia, and arch interruption: strategies for evaluation of the aortic arch

2016 ◽  
Vol 26 (8) ◽  
pp. 1553-1562 ◽  
Author(s):  
Suma P. Goudar ◽  
Sanket S. Shah ◽  
Girish S. Shirali
Keyword(s):  
Aortic Arch ◽  
Coarctation Of The Aorta ◽  
The United States ◽  
Interrupted Aortic Arch ◽  
Hypoplastic Left Heart ◽  
Live Births ◽  
Additional Information ◽  
Non Invasive ◽  
Aortic Arch Hypoplasia

AimEchocardiography is the modality of choice for the diagnosis and serial follow-up of aortic arch pathology. In this article, we review the types of obstruction of the aortic arch, various classification schemes of coarctation of the aorta and interrupted aortic arch, methodology for optimal echocardiographic imaging of the aortic arch, and key echocardiographic measurements for accurate diagnosis of obstruction and hypoplasia of the aortic arch. Finally, we will discuss the limitations of echocardiography in optimal imaging of the aortic arch and the use of other non-invasive imaging modalities such as CT or MRI to provide additional information in these cases.BackgroundCoarctation of the aorta is the more common lesion of the two, with an estimated incidence of four in every 10,000 live births in the United States of America. Interrupted aortic arch is rarer, with an incidence of 19 per one million live births.1 There is a spectrum of pathology of obstruction of the aortic arch, ranging from coarctation of the aorta with and without hypoplasia of the arch to interrupted aortic arch. Both these lesions are frequently encountered in congenital cardiology practice, and will be discussed in the remainder of this article. Obstruction of the aortic arch in the setting of hypoplastic left heart structures or atresia of the aortic valve is beyond the scope of this review and will not be discussed further.

scholarly journals Timeliness of Service Delivery for Children With Later-Identified Mild-to-Severe Hearing Loss

2014 ◽  
Vol 23 (1) ◽  
pp. 116-128 ◽  
Author(s):  
Elizabeth A. Walker ◽  
Lenore Holte ◽  
Meredith Spratford ◽  
Jacob Oleson ◽  
Anne Welhaven ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Early Intervention ◽  
Service Delivery ◽  
Regression Models ◽  
Neonatal Period ◽  
Intervention Programs ◽  
Newborn Period ◽  
Dependent Variables ◽  
Newborn Hearing

Purpose In this study, the authors examined diagnostic and intervention services for children identified with hearing loss (HL) after the newborn period. Method The authors compared ages at service delivery and length of delays between service delivery steps for 57 later-identified children with HL and 193 children who referred for assessment from the newborn hearing screen (NHS). For only later-identified children, regression models were used to investigate relationships among predictor variables and dependent variables related to service delivery. Results Children who referred from the NHS received follow-up services at younger ages than later-identified children. Later-identified children had significantly longer delays from HL confirmation to entry into early intervention, compared to children who referred from the NHS. For later-identified children, degree of HL predicted ages at follow-up clinical services. Children with more severe HL received services at younger ages compared to children with milder HL. Gender predicted the length of the delay from confirmation to entry into early intervention, with girls demonstrating shorter delays. Conclusions The current results lend support to the need for ongoing hearing monitoring programs after the neonatal period, particularly when children enter early intervention programs because of language/developmental delays.

Cost and Cost-effectiveness of Universal Screening for Hearing Loss in Newborns

2001 ◽  
Vol 124 (4) ◽  
pp. 359-367 ◽  
Author(s):  
Eric J. Kezirian ◽  
Karl R. White ◽  
Bevan Yueh ◽  
Sean D. Sullivan
Keyword(s):  
Hearing Loss ◽  
Cost Effectiveness ◽  
Otoacoustic Emissions ◽  
Universal Screening ◽  
Newborn Hearing Screening ◽  
Cost Effectiveness Ratio ◽  
Screening Programs ◽  
Universal Newborn Hearing Screening ◽  
Newborn Hearing

OBJECTIVE: To estimate the cost and cost-effectiveness of universal newborn hearing screening. STUDY DESIGN AND SETTING: Decision analysis model utilizing the hospital perspective. This model evaluated 4 distinct protocols for screening a fixed and defined hypothetical cohort of newborn infants. OUTCOME MEASURES: Cost of screening and the number of infants with hearing loss identified through universal screening. RESULTS: Otoacoustic emissions testing at birth followed by repeat testing at follow up demonstrated the lowest cost ($13 per infant) and had the lowest cost-effectiveness ratio ($5100 per infant with hearing loss identified). Screening auditory brainstem evoked response testing at birth with no screening test at follow-up was the only protocol with greater effectiveness, but it also demonstrated the highest cost ($25 per infant) and highest cost-effectiveness ratio ($9500 per infant with hearing loss identified). These findings were robust to sensitivity analysis, including best-case and worst-case estimation. The prevalence of hearing loss and the fraction of infants returned for follow-up testing had a large impact on the absolute level, but not relative level of protocol cost and cost-effectiveness. CONCLUSION: The otoacoustic emissions testing protocol should be selected by screening programs concerned with cost and cost-effectiveness, although there are certain caveats to consider. SIGNIFICANCE: The most significant barriers to implementation of universal newborn hearing screening programs have been financial, and this study compares the most common protocols currently in use. This study can assist program directors not only in the decision to initiate universal screening but also in their choice of screening protocol.

scholarly journals Nationwide population genetic screening improves outcomes of newborn screening for hearing loss in China

2018 ◽  
Author(s):  
Qiuju Wang ◽  
Jiale Xiang ◽  
Jun Sun ◽  
Yun Yang ◽  
Jing Guan ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Genetic Screening ◽  
Outcome Data ◽  
Convincing Evidence ◽  
Hearing Screening ◽  
Loss To Follow Up ◽  
Screening Programs ◽  
Universal Newborn Hearing Screening ◽  
Newborn Hearing

Purpose: Concurrent newborn hearing and genetic screening has been reported, but its benefits have not been statistically proven due to limited sample sizes and outcome data. To fill this gap, we analyzed outcomes of a large number of newborns with genetic screening results. Methods: Newborns in China were screened for 20 hearing-loss-related genetic variants from 2012-2017. Genetic results were categorized as positive, at-risk, inconclusive, or negative. Hearing screening results, risk factors, and up-to-date hearing status were followed-up via phone interviews. Results: We completed genetic screening on one million newborns and followed up 12,778. We found that a positive genetic result significantly indicated a higher positive predictive value of the initial hearing screening (60% vs. 5.0%, P<0.001) and a lower rate of loss-to-follow-up (5% vs. 22%, P<0.001) than an inconclusive one. Importantly, 42% of subjects in the positive group with reported or presymptomatic hearing loss were missed by conventional hearing screening. Furthermore, genetic screening identified 0.23% of subjects predisposed to preventable ototoxicity. Conclusion: Our results demonstrate that limited genetic screening identified additional cases, reduced loss-to-follow-up, and informed families of ototoxicity risks, providing convincing evidence to support integrating genetic screening into universal newborn hearing screening programs.

scholarly journals Clinical Diagnostic Testing for Human Cytomegalovirus Infections

2020 ◽  
Vol 221 (Supplement_1) ◽  
pp. S74-S85 ◽  
Author(s):  
Raymund R Razonable ◽  
Naoki Inoue ◽  
Swetha G Pinninti ◽  
Suresh B Boppana ◽  
Tiziana Lazzarotto ◽  
...  
Keyword(s):  
Human Cytomegalovirus ◽  
Screening Program ◽  
Diagnostic Testing ◽  
Congenital Infection ◽  
The United States ◽  
Diagnostic Strategies ◽  
Screening Programs ◽  
Transplant Patients ◽  
Cytomegalovirus Infections

Abstract Human cytomegalovirus (HCMV) infections are among the most common complications arising in transplant patients, elevating the risk of various complications including loss of graft and death. HCMV infections are also responsible for more congenital infections worldwide than any other agent. Congenital HCMV (cCMV) infections are the leading nongenetic cause of sensorineural hearing loss and a source of significant neurological disabilities in children. While there is overlap in the clinical and laboratory approaches to diagnosis of HCMV infections in these settings, the management, follow-up, treatment, and diagnostic strategies differ considerably. As yet, no country has implemented a universal screening program for cCMV. Here, we summarize the issues, limitations, and application of diagnostic strategies for transplant recipients and congenital infection, including examples of screening programs for congenital HCMV that have been implemented at several centers in Japan, Italy, and the United States.

scholarly journals FOR BETTER OR FOR WORSE: MARITAL TRANSITIONS AND SEXUAL LIFE IN MIDDLE AND OLDER AGE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S304-S305
Author(s):  
Jeffrey E Stokes ◽  
Elizabeth A Gallagher ◽  
Remona Kanyat ◽  
Cindy N Bui ◽  
Celeste Beaulieu
Keyword(s):  
Marital Status ◽  
Sexual Activity ◽  
Later Life ◽  
Well Being ◽  
The United States ◽  
Sexual Life ◽  
National Study ◽  
Marital Transitions ◽  
Baseline Values

Abstract Marital transitions have known implications for health and well-being. However, little research has examined the effects of such transitions on adults’ sexual lives. This study uses longitudinal data from the National Study of Midlife Development in the United States (1995–2014) to compare different marital status and transition groups’ sexual activity, satisfaction, control, and effort throughout mid-and-later life. Across all outcomes, effects of marital status/transitions were contingent upon baseline values of the outcome. Consistently married adults reported more frequent sexual activity, greater sexual satisfaction, and greater effort put into sexual life than other groups when baseline values of those outcomes were average or above-average; such group differences were reduced or reversed at below-average baseline values. Among the not-married, women reported significantly less sexual activity than men. The consistently divorced/separated, consistently widowed, newly divorced/separated, and newly widowed all reported greater control over sexual life at follow-up than the consistently married, when baseline sexual control was average and/or below-average. Lastly, women reported lesser effort put into sexual life at follow-up than men across all groups, accounting for baseline effort; these gender gaps were least pronounced among the consistently and newly married, and most pronounced among the newly widowed and newly divorced/separated. Overall, findings indicate that implications of marital transitions for midlife and older adults’ sexual lives depend upon both gender and pre-transition context. Marriage is not always beneficial for sexual life; rather, poor quality sexual lives during marriage can reduce opportunities for improvement that may arise with marital transitions, including divorce and widowhood.

Universal Neonatal Hearing Screening

2001 ◽  
Vol 10 (1) ◽  
pp. 3-12 ◽  
Author(s):  
George T. Mencher ◽  
Adrian C. Davis ◽  
Shirley J. DeVoe ◽  
Dee Beresford ◽  
John M. Bamford
Keyword(s):  
Otoacoustic Emissions ◽  
Target Population ◽  
Testing Procedure ◽  
The United States ◽  
Hearing Screening ◽  
Screening Programs ◽  
Newborn Hearing ◽  
Key Issues ◽  
Universal Hearing Screening ◽  
Universal Neonatal Hearing Screening

After a brief review of the history of newborn hearing screening including the Downs behavioral testing procedure, the Crib-o-gram and similar devices, and the use of auropalpebral reflex and otoacoustic emissions, there is a discussion of key issues that need to be resolved before universal hearing screening is introduced. Included are questions regarding the target population(s) of screening programs, well baby versus NICU screening, dealing with false-positives and the effects on parent-child relationships, and finally, the availability of resources for screening and follow-up. The results of a recent study in the United Kingdom that assessed the current state of audiology services and found there is a difference between existing standards and what is actually being done in practice, are presented and considered in terms of current trends in the United States to move ahead with universal screening without a solid database of information regarding the preparedness of clinical centers to deal with the need for services that will result from the initiation of universal programs. Caution is urged.

Identification of Undiagnosed Hyperlipidemia: Do Work Site Screening Programs Work?

2016 ◽  
Vol 32 (4) ◽  
pp. 971-978 ◽  
Author(s):  
Alain K. Koyama ◽  
Vishal Bali ◽  
Irina Yermilov ◽  
Antonio P. Legorreta
Keyword(s):  
Lipid Profile ◽  
Total Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
The United States ◽  
Workplace Health ◽  
Subsequent Increase ◽  
Physician Visits ◽  
Screening Programs

Purpose: We evaluated the rate of hyperlipidemia identified during workplace screening in previously undiagnosed individuals, the association between workplace hyperlipidemia screening and use of medical care during follow-up, and changes in lipid profile among individuals with hyperlipidemia at screening. Design: Nonexperimental longitudinal study. Setting: Employees who participated in a workplace health screening. Participants: A total of 18 993 individuals from 39 self-insured employers in the United States. Measures: Total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides were measured during screening. A claims-based algorithm was used to identify hyperlipidemia cases. Analysis: Discrete-time survival analysis was used to estimate monthly rates of new hyperlipidemia diagnoses or prescriptions. Paired t tests were used to evaluate 1-year changes in lipid profile. Results: A total of 1872 (9.9%) individuals had hyperlipidemia at screening. Among all individuals, a significantly greater rate of new hyperlipidemia diagnoses was observed during the first month after screening, compared to the 3 months before screening (odds ratio [95% CI]: 2.99 [2.66-3.36]). Among the 987 individuals who were followed up 1 year later, significant improvements were observed in total cholesterol (−8.5% ± 13.6%) and LDL levels (−10.2% ± 19.3%). Conclusion: Workplace health screenings in an insured population were associated with a subsequent increase in physician visits and prescriptions for hyperlipidemia. After 1 year, significant improvements in total cholesterol and LDL levels were observed among individuals who screened positive for hyperlipidemia.

Practicality, Validity, and Cost-Efficiency of Universal Newborn Hearing Screening Using Transient Evoked Otoacoustic Emissions

1995 ◽  
Vol 17 (1) ◽  
pp. 9-14 ◽  
Author(s):  
Karl R. White ◽  
Thomas R. Behrens ◽  
Bonnie Strickland
Keyword(s):  
Hearing Loss ◽  
Otoacoustic Emissions ◽  
Screening Program ◽  
The United States ◽  
Hearing Screening ◽  
Newborn Hearing Screening ◽  
Transient Evoked Otoacoustic Emissions ◽  
Screening Programs ◽  
Universal Newborn Hearing Screening ◽  
Newborn Hearing

Although the importance of identifying significant hearing loss at an early age has long been recognized, it is generally acknowledged that newborn hearing screening programs in the United States have not been very successful. The problem has been that available techniques were impractical, too expensive, or invalid. This article summarizes the data regarding the use of transient evoked otoacoustic emissions (TEOAE) in a universal newborn hearing screening program and describes various facets of program implementation. It is concluded that available data provide clear evidence that TEOAE can be used to significantly reduce the average age of identification for hearing loss in the U.S.

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