Rohit Ravi

Follow-up in newborn hearing screening – A systematic review

INTRODUCTION The quality and efficiency of newborn hearing screening programs (NHS) rely heavily on appropriate follow-up. The Joint Committee on Infant Hearing recommends a follow-up rate of more than 95% of infants who fail the initial hearing screening. However, a 70% benchmark is considered to be more feasible. This high loss to follow-up (LTF) rate acts as a threat to the overall success of NHS programs. The objective of the study was to identify and examine the reported rates of LTF, attributed reasons for LTF and strategies undertaken to reduce LTF. METHODS Using a systematic search, articles published between 2005 to December 2015 were identified from PubMed/Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Educational Resources Information Center (ERIC), Scopus, Ovid, ProQuest, and Cochrane Library. To be included in the review, the study should be exploring the loss to follow-up or drop-out rate in newborn hearing screening programs and be published in an indexed peer-reviewed journal in the English language. The main outcome measures were overall rate of LTF, factors leading to LTF and measures adopted to overcome LTF. RESULTS 53 articles were short-listed for data extraction. Out of these, 27 were single-centre studies, 19 were multi-centre, 3 compared multiple databases, and 4 used survey-based methods. Overall LTF rates of 20% in single-centre and 21% in multiple-centre studies were observed. Educational disparity and lack of adequate knowledge among parents were associated with LTF. The most commonly used strategy to overcome LTF suggested by studies was the use of an adequate data management system. CONCLUSION This review is a novel attempt to explore the LTF among NHS studies, reasons for LTF and strategies to reduce LTF. This review can act as a basis for planning and execution of effective NHS programs.

Knowledge and attitude (KA) survey regarding infant hearing loss in Karnataka, India

INTRODUCTION The support provided and the decisions taken by mothers determine the success of Universal Newborn Hearing Screening (UNHS). Attempts at exploring the existing knowledge-attitude among mothers is crucial to create/modify the existing screening programs. The present study attempts to explore the knowledge and attitude toward infant hearing loss (HL) among mothers of newborns in the Indian state of Karnataka. METHOD A cross-sectional survey was conducted among 219 mothers of newborns in Karnataka, India. The questionnaire was framed from existing literature and consisted of 19 questions assessing knowledge and attitude toward infant HL to be rated on a three-point scale (no, not sure, yes). Descriptive statistics and Cronbachs α were used to analyze the data. RESULTS Mothers exhibited good knowledge of risk factors; noise (70.3%) and ear discharge (54.3%). More than 75% agreed that treatment for HL is available and that these children can attend school. The questions of superstitions and cultural beliefs yielded mixed responses. A large number of mothers expressed desire to have their children tested at birth (84.9%) and were concerned about their childrens hearing (87.7%). Yet only 54.3% stated that they would allow their children to wear hearing aids. SUMMARY AND CONCLUSION The present study is an attempt to understand the knowledge and attitude of mothers toward infant HL in Karnataka and facilitate identification of potential areas of less knowledge as a reference for endeavors of enhancement. It further highlights the need for implementing public awareness programs to improve knowledge and attitude of mothers toward infant HL for better implementation of UNHS.

A national survey of knowledge, attitude and practices among pediatricians towards newborn hearing screening in India

INTRODUCTION Pediatricians have a key role in ensuring that infant has undergone hearing screening and required follow-up. Attempts in various countries and centers have been made at exploring their knowledge, attitude and practices towards universal newborn hearing screening. In India, such a program is at its preliminary stage, and hence a need was felt to study this aspect in pediatricians working in India. METHOD A cross-sectional online survey was carried out among 112 pediatricians working in India. The questionnaire was framed after reviewing the existing questionnaires. Descriptive statistics was used to summarize the findings. RESULTS A response rate of 7.99% (112/1402) was obtained of which only 20.5% reported of availability of screening program in their work set-up. The majority of the pediatricians (95%) were aware of the newborn hearing screening while 98.3% were affirmative about the importance of screening of all infants. Very few pediatricians reported of a screening program in their set-up or in their close locality. Overall the pediatricians were confident about their knowledge on this topic yet expressed a need to know more about several intricacies about hearing screening. The pediatricians also provided an input on the most preferred method of receiving more information. SUMMARY AND CONCLUSION The success of the universal newborn hearing screening program lies in the support and cooperation of health care providers such as pediatricians. The present study draws attention to the positive attitude and practices exhibited by them. It also sheds light on the knowledge gaps that are present and need the due attention of the policy makers. Further, it highlights the need for having more continuing medical education program and awareness drives for ensuring a better implementation of UNHS.

Knowledge and attitude of parents/caregivers towards hearing loss and screening in newborns – a systematic review

Abstract Objective: The parents/caregivers of a newborn play a pivotal role in the process of hearing screening and intervention. The decisions taken by them depend on their knowledge and attitude. The purpose of this study was to review the literature systematically on knowledge and attitude of parents/caregivers towards infant hearing loss and newborn hearing screening. Design: A systematic search was conducted using electronic databases for the periods from 1990 to March 2016. Two authors scrutinized the studies and extracted the data based on predetermined criteria. Study sample: Ten studies. Results: Ear discharge was correctly identified as a risk factor for hearing loss along with measles, drugs/medication, family history, congenital causes and noise exposure. The studies revealed mixed results for knowledge about newborn hearing screening. Overall, the parents/caregivers showed positive attitudes towards hearing screening and intervention options. However, due to heterogeneity in the studies, it’s hard to derive a conclusion. Conclusions: The present review sheds light on the common areas of misconception among parents/caregivers about risk factors of infant hearing loss and newborn hearing screening. The review also draws attention to the need to have more studies exploring this knowledge and attitude of parents/caregivers among diverse populations.

Audiology occupational stress experienced by audiologists practicing in India

Abstract Objective: The aim of the present study is to identify the levels of occupational stress across different types of setting, years of experience, and age. Design: A questionnaire-based observational research design using the audiology occupational stress questionnaire (AOSQ) was used. Study sample: The sample comprised of audiologists registered under the Indian Speech and Hearing Association. The questionnaire was sent via personal email to 400 audiologists, of which 100 responded. Results: Descriptive statistics and chi-square analysis were carried out. Participants in both the groups experienced stress to some extent, with more stress reported in private practitioners. Conclusion: This study helps to identify certain factors that contribute towards work-related stress. These in turn have an impact on the overall professional output of a professional.

Knowledge and attitude of pediatric hearing impairment among general physicians and medical interns in coastal Karnataka, India

Objective: The objectives of the present study were to investigate and compare the knowledge and attitude among general physicians in primary health-care centers and medical interns. Materials and Methods: A questionnaire-based observational study design was implemented to assess and compare the knowledge and attitude of physicians and medical interns regarding pediatric hearing impairment in setups that have speech and hearing services and that do not offer these services. Results: The general physicians and medical interns showed a positive attitude toward different issues such as importance of hearing in development of speech and language, importance of hearing as a sense, need of hearing screening in newborns, consideration of suspicion of hearing loss by parents, and need of speech therapy. Conclusion: Even though the participants showed adequate knowledge and attitude toward pediatric hearing impairment, there are certain areas that need attention and awareness development. There is also a need to introduce speech and hearing settings at all hospitals as this will ensure a better awareness about the role of the professionals and enable more referrals.

Knowledge and Perceptions of Teleaudiology Among Audiologists: A Systematic Review

Background and Objectives The knowledge and perception of teleaudiology among audiologists will determine the acceptance and success of teleaudiology practice. This systematic review was conducted to review the published literature on knowledge and perceptions of teleaudiology application among audiologists. Materials and Methods Five studies exploring knowledge and perceptions of teleaudiology application among audiologists published in the English language up to May 2017 were included. Results Positive attitudes was observed across the studies regarding acceptance towards application of teleaudiology. The most common sources of knowledge were on the job, graduate studies, and continuing education programs. The major barriers to the uptake of application of teleaudiology were in terms of limitations in infrastructure, reimbursement, and licensure. Conclusions The study sheds light on the existing knowledge and perceptions of teleaudiology applications among audiologists. This will help in improving the existing teleaudiology services as well as overcome the challenges faced.

Acoustic Analysis of Voice in Singers: A Systematic Review

Purpose Singers are vocal athletes having specific demands from their voice and require special consideration during voice evaluation. Presently, there is a lack of standards for acoustic evaluation in them. The aim of the present study was to systematically review the available literature on the acoustic analysis of voice in singers. Method A systematic review of studies on acoustic analysis of voice in singers (PubMed/MEDLINE, CINAHL, Scopus, ProQuest, Cochrane, Ovid, Science Direct, and Shodhganga) was carried out. Key words based on PIO (population-investigation-outcome) were used to develop search strings. Titles and abstracts were screened independently, and appropriate studies were read in full for data extraction. Results Of the 895 studies, 26 studies met the inclusion criteria. Great variability was noted in the instruments and task used. Different acoustic measures were employed, such as fundamental frequency, perturbation, cepstral, spectral, dysphonia severity index, singing power ratio, and so forth. Conclusion Overall, a great heterogeneity was noted regarding population, tasks, instruments, and parameters. There is a lack of standardized criteria for the evaluation of singing voice. In order to implement acoustic analysis as a part of comprehensive voice evaluation exclusively for singers, there is a certain need for methodical sound studies.

Professional Quality of Life in Audiologists and Speech Language Pathologists Working in India

ABSTRACT The study aimed to investigate professional quality of life as reported by audiologists and speech language pathologists (SLPs) working in India. Questionnaire-based cross-sectional e-mail survey design using the Professional Quality of Life scale (ProQOL) was carried out. The sample consisted of professionals registered under the Indian Speech and Hearing Association. The questionnaire was sent through the personal registered e-mail-id to 500 professionals of which 155 complete responses were obtained. Descriptive statistics were used to summarize the demographic variables. Internal consistency was checked using Cronbach’s alpha. Independent sample t test was used to check the relation of occupation, gender and work setting with the ProQOL subscales. ANOVA and post hoc Tukey HSD was performed to determine the effect of years of experience. A statistically significant difference was found between occupation and secondary traumatic stress (STS) levels and years of work experience and burnout. Post hoc analysis revealed a significant difference between 11 and 20 and more than 21 years of experience. Strong negative correlation between compassion satisfaction and burnout whereas a moderate positive correlation between burnout and STS was observed. The study identifies factors such as occupation type and years of experience have an influence on the professional quality of life.