Silvana Maria Sobral Griz

Newborn hearing screening: an outpatient model.

OBJECTIVE The purpose of this study was to assess the feasibility of implementing an outpatient model of a newborn hearing screening program with a particular focus on determining how compliance with the follow-up appointment related to specific socio-economic and demographic factors associated with the mother. METHOD Mothers who delivered their babies in public hospitals in Recife, northeast Brazil, were invited to participate in a two-step program. In Step 1 they were interviewed with regard to specific socio-economic and demographic factors, and then scheduled for a hearing screening test for their baby 1 month after discharge. In Step 2, the babys hearing was screened using transient otoacoustic emissions. RESULTS A total of 1035 mothers consented to participate in Step 1, but only 149 returned to participate in Step 2 (14.3%). Analysis of the socio-economic and demographic factors indicated that mothers who did not comply with the scheduled newborn hearing screening (NHS) test generally had less than a high school education and came from primarily lower income families who lived in rural areas outside of Recife. CONCLUSION The results of this study highlight some socio-economic and demographic factors of the population of northeast Brazil that contribute to a low compliance rate for an outpatient model of a newborn hearing screening program. Possible solutions to the low compliance rate are considered.

Indicadores de risco para perda auditiva em neonatos e lactentes atendidos em um programa de triagem auditiva neonatal

OBJETIVO: descrever os indicadores de risco para perda auditiva presentes em neonatos e lactentes que realizaram a Triagem Auditiva Neonatal no Hospital das Clinicas da Universidade Federal de Pernambuco, nascidos em 2008. METODOS: foram pesquisados os 787 neonatos e lactentes que realizaram a Triagem Auditiva Neonatal no citado Hospital, nascidos em 2008. Foi montado um banco de dados com informacoes do formulario com historico familiar e clinico dos pesquisados e resultado da triagem, para analise dos indicadores de risco. RESULTADOS: os indicadores de risco mais prevalentes na populacao estudada foram presenca de hiperbilirrubinemia, nascimento pre-termo, baixo peso ao nascimento, uso de medicamento durante o periodo gestacional, permanencia em Unidade de Terapia intensiva e presenca de infeccoes intra-uterinas durante a gestacao. Os indicadores de risco para perda auditiva com associacao estatisticamente significante com o resultado falha na triagem foram nascimento pre-termo, baixo peso, permanencia em Unidade de Terapia Intensiva, uso de ventilacao mecânica e uso de medicamento ototoxicos. CONCLUSAO: houve ocorrencia de indicadores de risco pre, peri e pos-natais, porem apenas foi encontrada significância estatistica entre alguns indicadores peri e pos-natais e a falha na triagem.

Triagem auditiva: perfil socioeconômico de mãe

PURPOSE: to describe the socio-economic and demographic aspects of mothers related to a newborn hearing screening program in Recife. METHODS: this study was developed in public hospitals in Recife, through interviews carried out with the mothers. After each interview, the mothers were invited to carry out hearing screening in their babies in audiological clinics at the Universities, with no any burden. RESULTS: 1,021 mothers took part in this study, with the following features: age varying from 13 to 50 years, with the majority (69.5%) between 20 and 35 years-old, 59.4% were married or had formal consented union, 39.1% were single, and the majority of mothers (34.1%) did not finished high school, 3.4% completed university graduation, the majority of the mothers (72.8%) earned less than one minimal wage per month, 90.3% had goods such as TV (83.6%), their self-owned house (56.7%), and telephone (40.7%). CONCLUSION: the results showed the socio-economic and demographic aspects of the mother involved in the newborn hearing screening program were married young adults, with low educational level and low income. They mostly had no outside job and owned a TV set. Therefore, from de findings we can better substantiate programs direct towards mothers with the indicated socioeconomic features. However, for reaching all mothers, the study also provided indications of minority groups that deserve, certainly, new sequential studies.

Estudo imitanciométrico em portadores da Sequência de Moebiüs

Moebius Sequence has been described as a pathology which involves the VI and VII cranial nerves, causing facial palsy. Acoustic reflexes are elicited by a high intensity stimulation of the stapedius and the tensor tympani muscles. The VII cranial nerve is responsible for innervating the stapedius muscle. No acoustic reflexes are expected for individuals with this Sequence. AIM: To describe immittance findings in a series of individuals with Moebius Sequence. MATERIALS AND METHODS: We had 17 individuals with Moebius Sequence of both gender, with age raging from 3 to 13 years, who were submitted to otoscopy and immittance measures. RESULTS: The results of this study indicated a Type A tympanometry in the majority of the analyzed ears, demonstrating normal function of the stapedius muscle. For the contralateral acoustic reflexes we observed it present in 50% of the ears. The ipsilateral acoustic reflexes were absent in the majority of the ears. CONCLUSION: The results of the acoustic reflexes suggested that this measure could help in the prognosis of VII cranial nerve lesions, since half of the individual presented those reflexes.

Masking period patterns and forward masking for speech-shaped noise: Age-related effects

Objective: The purpose of this study was to assess age-related changes in temporal resolution in listeners with relatively normal audiograms. The hypothesis was that increased susceptibility to nonsimultaneous masking contributes to the hearing difficulties experienced by older listeners in complex fluctuating backgrounds. Design: Participants included younger (n = 11), middle-age (n = 12), and older (n = 11) listeners with relatively normal audiograms. The first phase of the study measured masking period patterns for speech-shaped noise maskers and signals. From these data, temporal window shapes were derived. The second phase measured forward-masking functions and assessed how well the temporal window fits accounted for these data. Results: The masking period patterns demonstrated increased susceptibility to backward masking in the older listeners, compatible with a more symmetric temporal window in this group. The forward-masking functions exhibited an age-related decline in recovery to baseline thresholds, and there was also an increase in the variability of the temporal window fits to these data. Conclusions: This study demonstrated an age-related increase in susceptibility to nonsimultaneous masking, supporting the hypothesis that exacerbated nonsimultaneous masking contributes to age-related difficulties understanding speech in fluctuating noise. Further support for this hypothesis comes from limited speech-in-noise data, suggesting an association between susceptibility to forward masking and speech understanding in modulated noise.

Modulation masking release using the Brazilian-Portuguese HINT: psychometric functions and the effect of speech time compression.

Abstract Objective: The Brazilian-Portuguese hearing in noise test (HINT) was used to investigate the benefit to speech recognition of listening in a fluctuating background. The goal was to determine whether modulation masking release varied as a function of the speech-to-masker ratio at threshold. Speech-to-masker ratio at threshold was manipulated using the novel approach of adjusting the time-compression of the speech. Design: Experiment 1 measured performance-intensity functions in both a steady speech-shaped noise masker and a 10-Hz square-wave modulated masker. Experiment 2 measured speech-to-masker ratios at threshold as a function of time-compression of the speech (0, 33, and 50%) in both maskers. Study sample: Participants were normal-hearing adults who were native speakers of Brazilian Portuguese (Experiment 1: N = 10; Experiment 2: N = 30). Results: The slope of the performance-intensity function was shallower in the modulated masker than in the steady masker for both words and sentences. Thresholds increased with increasing time-compression in both maskers, but more markedly in the modulated masker, resulting in reduced modulation masking release with increasing time-compression. Conclusions: Speech-to-masker ratio at threshold varies with time-compression of speech. The results are relevant to the issue of whether degree of masker modulation benefit depends on speech-to-masker ratio at threshold.

Newborn and infant hearing health education for nursing professionals

UNLABELLED Hearing loss is a sensory deprivation, which can brings several consequences, among them: language development delay, emotional and social problems, and school difficulties. In such settings, we stress the role of nursing professional, who can expand their knowledge about childrens hearing health, all the way from pre-natal care. OBJECTIVE To check the knowledge of nursing professional after the educational actions on pediatric hearing. METHOD A quasi-experimental design with timeseries outline. We had 82 nursing professional participating (nurses, technicians and assistants) working in a university hospital between March and September of 2011. All of the interviewees answered a semi-structured questionnaire before and after the educational actions. RESULTS We observed a significant change in the knowledge of the nursing professionals after the educational activity in most of the variables; such as: ideal age to perform the newborn hearing screening; ideal age to diagnose hearing loss; ideal age to start intervention against hearing loss and risk indicators for hearing loss. CONCLUSION It is believed that the methodology used in educational activities, based on problems found in professional practice, education may have contributed greatly to increase knowledge about hearing health, especially concerning neonates and infants.

Percepção da fala em presença de ruído competitivo: o efeito da taxa de modulação do ruído mascarante

ABSTRACT Purpose: To investigate the effect of modulation rate on masking release for speech. Methods: Fifteen normal hearing subjects participated in the study. They were tested on speech perception in noise using the senten-ces of the HINT-Brazil. Speech recognition thresholds were obtained in the presence of steady masking and amplitude modulated masking at rates of 4, 8, 16, 32 and 64 Hz. The magnitude of masking release was obtained for each modulation rate, and results were compared. Results: Data showed significantly lower speech thresholds when the masking noise was amplitude modulated at rates of 4, 8, 16 and 32 Hz, when compared to thresholds obtained in steady noise or noise modulated at 64 Hz. Speech-to-masker ratios (SMR) were higher in steady masking noise, followed by modulated noise at 64 Hz, and lower for modulated rates of 32, 16, 8 and 4 Hz, respectively. Conclusion: The magnitude of masking release for speech does not seem to differ significantly among modulation rates of 4 to 32 Hz. However, for a modulation rate of 64 Hz the magnitude of masking release is significantly reduced.

Potencial evocado auditivo de tronco encefálico por condução óssea: uma revisão integrativa

The aim of this study was to conduct an integrative review of the procedures used in the acquisition criteria of the Bone-Conducted Brainstem Auditory Evoked Potentials examination in order to help in the diagnosis of hearing problems. A search was conducted on the following databases: Latin American and Caribbean Literature on Health Sciences (LILACS), Medical Literature Analysis and Retrieval System Online (MEDLINE) and Scientific Electronic Library Online (SciELO). The following keywords were used: AEPs, Electrophysiology and Bone Conduction, found via Descriptors in Health Sciences Headings (MeSH). The results shown are for the 35 selected studies. Most studies opted to use click stimuli and supra-aural headphones, such as the TDH-39, as conduction transducers, and the Radioear B-71 vibrator, with a pressure of 425+/- 25g, for bone conducted stimulation. It was observed that the the bone vibrator was most frequently placed in the mastoid region. The majority of studies report using alternating polarity, with different presentation rates, the most widely used being 57.7/s, with a 30-3000 Hz filter and a window of 15 ms. Most studies used a stimulus rate of 2048, and a total of 2 stimulus recordings. The Brainstem Auditory Evoked Response exam has been studied for many years and much has been written in the literature regarding acquisition and analysis, in addition to underscoring its importance for newborns.

Educação em saúde com vistas à triagem neonatal e audição: uma revisão integrativa

O objetivo deste trabalho foi investigar estudos sobre educacao em saude e capacitacao que abordassem o tema triagem neonatal e/ou audicao. Trata-se de uma revisao integrativa, realizada em agosto de 2011, com busca na Biblioteca Virtual em Saude, a partir dos Descritores em Ciencias da Saude: “Audicao”;, “Capacitacao”;, “Educacao em Saude”; e “Triagem Neonatal”;. A amostra final constituiu-se por 10 estudos. A base de dados com maior numero de artigos foi a Medline e a maioria dos artigos (n=07) foi classificado com nivel de evidencia tres. Nesta revisao integrativa, pode-se observar o quao e interessante adotar as estrategias de educacao em saude e/ou capacitacao nos servicos de saude como uma forma de educacao permanente ou continuada. A populacao mais frequentemente estudada foi maes/pais e medicos. Acoes educativas podem empoderar a populacao em relacao a audicao, englobando aspectos sobre a Triagem Auditiva Neonatal e seus procedimentos.