South Africa's speech-language therapy (SLT) and audiology professions face challenges in achieving linguistic and cultural integration (i.e., the meaningful incorporation of diverse linguistic and cultural perspectives into training and practice), a critical aspect for effectively serving the country's diverse population. Limited curriculum content on indigenous languages and cultural competence, along with low diversity of academic and clinical training staff (staff), may hinder students' preparedness for multilingual and multicultural clinical practice. This study explored undergraduate students' views and self-reported practices regarding linguistic and cultural integration during their professional training. To explore the views and practices of South African SLT and audiology undergraduate students concerning linguistic and cultural integration in their training. A cross-sectional convergent mixed-methods survey design was used to gather quantitative and qualitative data from a purposive sample of 48 third- and fourth-year SLT and audiology students across four South African universities. Data were collected using a structured online questionnaire, including Likert-scale items and open-ended questions. Quantitative data were analysed using descriptive and inferential statistics, while thematic analysis was applied to qualitative responses. Within this sample, participants recognised the importance of linguistic and cultural competence but report feeling inadequately prepared to implement these skills in clinical settings. Key barriers included insufficient curriculum coverage of cultural topics, reliance on untrained interpreters, and a lack of bilingual resources. Students from indigenous language backgrounds reported higher ratings of the importance of linguistic integration than their English-speaking peers (p < .05). Qualitative themes suggested a perceived need for greater curriculum responsiveness, increased staff diversity, and enhanced institutional support to facilitate culturally competent practice. These exploratory findings suggest that curriculum responsiveness, institutional support, and staff diversity may warrant further consideration within ongoing efforts aimed at improving student preparedness for practice in South Africa's multilingual and multicultural healthcare environment. These findings point to the need for ongoing educational transformation efforts to better serve the diverse needs of the South African population.
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Work time management is an important aspect in organizing medical care. Current regulations do not establish recommended time limits for audiologists. To determine the time spent on audiologist's appointments and performing various diagnostic and rehabilitation procedures. At the City Audiology Center for Adults (St Petersburg), a time estimate was conducted for 10 audiologists who performed various medical diagnostic and rehabilitation audiology services. The advisability of standardizing audiologist's appointment duration to 30 minutes was established (for adult patients, without an instrumental audiological assessment or 60 minutes if an assessment (pure tone audiometry, acoustic impedance, otoacoustic emissions) is included). The results of medical appointments for diagnostic tests (acoustic impedance, speech audiometry, nasopharyngeal endoscopy, otoacoustic emissions, auditory brainstem response (ABR), ASSR, central auditory processing disorders tests, and vestibular tests) and rehabilitation interventions (hearing aid issuance, selection, or fitting of hearing aids) are determined. The obtained data can be used for inclusion in specialized regulatory documents governing the activities of audiologists and otolaryngologists. Нормирование труда является важным аспектом при организации оказания медицинской помощи. Действующими нормативно-правовыми актами не установлены рекомендованные нормы приема врача — сурдолога-оториноларинголога. Определить временные затраты на прием врача — сурдолога-оториноларинголога и выполнение различных диагностических и реабилитационных мероприятий. На базе Городского сурдологического центра для взрослых СПб ГБУЗ «Городской гериатрический медико-социальный центр» проведен хронометраж рабочего времени 10 врачей — сурдологов-оториноларингологов, которые оказывали различные медицинские диагностические и реабилитационные услуги сурдологического профиля. Целесообразно установить нормированное время базового приема врачом — сурдологом-оториноларингологом взрослого пациента без проведения инструментального аудиологического обследования в объеме 30 мин, а с проведением обследования (тональная пороговая аудиометрия, акустическая импедансометрия и регистрация отоакустической эмиссии) — 60 мин. Представлены результаты хронометража врачебных приемов по проведению диагностических исследований (акустической импедансометрии, речевой аудиометрии, эндоскопии носоглотки, регистрации отоакустической эмиссии и коротколатентных слуховых вызванных потенциалов (КСВП, ASSR-тест), проведения тестов для диагностики центральных слуховых расстройств, исследования вестибулярного анализатора) и реабилитационных мероприятий (выдача слуховых аппаратов, подбор или настройка имеющихся слуховых аппаратов). Полученные данные могут быть использованы для включения в профильные нормативные документы, регулирующие деятельность врача — сурдолога-оториноларинголога.
Clinical care for patients who report substantial hearing difficulties despite having little or no hearing loss is a topic of great debate within and beyond audiology. Building on our previous retrospective review of veterans evaluated for auditory processing disorders across the Veterans Health Administration (VHA), the current work presents five such case studies. The goal is to work toward improved patient care by providing a more in-depth view highlighting both strengths and weaknesses of approaches to care for veterans whose hearing difficulties are not explained by hearing loss. Five case studies were selected for review with the goal of identifying individuals with a wide range of etiologies and experiences receiving care for auditory complaints across the VHA. All information provided is taken directly from chart notes available from VHA and Defense Health Agency sources. Etiologies included traumatic brain injury, jet fuel exposure, and nonspecific origins. Some patients experienced well-coordinated care across medical departments, while others experienced repeated barriers and high burdens of self-advocacy while trying to navigate the health care system. Furthermore, differences in the approach of audiologists and speech-language pathologists are highlighted, including differing emphasis on diagnostic tests versus self-report measures and use of top-down versus bottom-up rehabilitation tools. This work highlights several options likely to improve care for veterans with auditory processing deficits, including greater emphasis on addressing patient-specific needs and goals, improved communication and collaboration between audiology and other medical disciplines, and the potential role for auditory device-based rehabilitation options, even among patients with minimal hearing loss.
The problem of hearing impairment in children remains of high medical and social significance, as it negatively affects speech development, social adaptation, and quality of life. Early rehabilitation plays a crucial role, and parental involvement is a key factor in success. In the Russian Federation, ear diseases account for 5% of the structure of childhood disability, necessitating the development of accessible regional rehabilitation programs with active family involvement. To present a comprehensive regional rehabilitation program for children with hearing impairments in the Ivanovo region, developed with the support of the National Medical Research Center for Otorhinolaryngology of the FMBA of Russia, and to describe its main modules aimed at actively involving parents in the process of hearing restoration, speech development, and social adaptation of the child. This work is based on an analysis of the experience of implementing the regional program at the audiology department of the Ivanovo Regional Clinical Hospital with the participation of the Department of Otorhinolaryngology of Ivanovo State Medical University. The description is based on program documentation, session protocols, and interviews with participants (specialists and parents). A qualitative and descriptive analysis was conducted, identifying key modules, rehabilitation stages, and the roles of specialists. The program includes comprehensive diagnostics (audiological, speech therapy, psychological), an individualized rehabilitation plan, and a differentiated approach for users of hearing aids and cochlear implants. Educational modules for parents have been developed: psychological education, training in device handling, communication strategies, parental coaching, psychological support, social navigation, monitoring, and supervision. Innovative components include theater therapy and vocal lessons, which contribute to the development of prosody and strengthen parent-child relationships. The program is implemented by a multidisciplinary team (audiologist, ENT physician, speech-language pathologist, psychologist, social worker, coordinator) in accordance with a calendar model (0-1 month, 1-6 months, 6-24 months, preschool and school stages). Distance learning formats are provided for families from remote areas. The regional program of the Ivanovo region represents an example of a comprehensive family-centered approach that integrates modern evidence-based rehabilitation methods. This experience can serve as a model for the development of similar programs in other regions. Further research will be aimed at quantitative evaluation of the effectiveness of the described modules. Нарушения слуха у детей имеют большое социально-медицинское значение, поскольку негативно влияют на речевое развитие, социальную адаптацию и качество жизни. Ранняя реабилитация играет решающую роль, а участие родителей является ключевым фактором успеха. В Российской Федерации заболевания уха составляют 5% в структуре детской инвалидности, что обусловливает необходимость создания доступных региональных программ реабилитации с активным вовлечением семьи. Представить комплексную региональную программу реабилитации детей с нарушениями слуха в Ивановской области, разработанную при поддержке НМИЦО ФМБА России, и описать ее основные модули, направленные на активное вовлечение родителей в процесс восстановления слуха, развития речи и социальной адаптации ребенка. В основу работы положен анализ опыта реализации региональной программы на базе сурдологического кабинета Ивановской областной клинической больницы при участии кафедры оториноларингологии ФГБОУ ВО «Ивановский ГМУ» Минздрава России. Описание основано на документации программы, протоколах занятий и интервью с участниками (специалистами и родителями). Проведен качественный и описательный анализ с выделением ключевых модулей, этапов реабилитации и роли специалистов. Программа включает комплексную диагностику (аудиологическую, логопедическую, психологическую), индивидуальный план реабилитации и дифференцированный подход для пользователей слуховых аппаратов и кохлеарных имплантов. Разработаны образовательные модули для родителей: психологическое образование, обучение обращению с техникой, коммуникативные стратегии, родительский коучинг, психологическая поддержка, социальная навигация, мониторинг и супервизия. Инновационными компонентами выступают театральная терапия и вокальные занятия, способствующие развитию просодики и укреплению детско-родительских отношений. Программа реализуется мультидисциплинарной командой (аудиолог, врач-оториноларинголог, логопед-дефектолог, психолог, социальный работник, координатор) в соответствии с календарной моделью (0—1 мес, 1—6 мес, 6—24 мес, дошкольный и школьный этапы). Предусмотрены дистанционные формы работы для семей из отдаленных районов. Региональная программа Ивановской области представляет собой пример комплексного семейно-центрированного подхода, интегрирующего современные научно обоснованные методы реабилитации. Опыт может служить моделью для создания аналогичных программ в других регионах. Дальнейшие исследования будут направлены на количественную оценку эффективности описанных модулей.
Rural populations face distinctive challenges that may hinder their ability to access health services, including speech-language pathology and audiology. To address this, our speech-language pathology program partnered with local agencies and traveled to neighboring rural communities to provide speech and hearing services in central Pennsylvania for a minimal investment.
In addition to a gap detection threshold, an auditory gap detection task also provides information on response time. This study investigated the association of response time from an adaptive gap detection task with two validated measures of cognitive processing speed as well as scores from a cognitive screener, while accounting for the effects of age, peripheral hearing ability, and HIV status. Participants (age 17-45 years) were from a prospective cohort study in Dar es Salaam, Tanzania with normal hearing ability and no reported neurological diseases. The final sample included 283 unique subjects (158 living with HIV, 125 without HIV) matched on age and sex. Multiple linear regression models were employed to assess the relationship between gap response time and cognitive processing speed scores from the Tests of Variables of Attention, Cogstate test battery, and Montreal Cognitive Assessment. Regression analysis showed significant relationships between gap response time and all processing speed scores, except one. Age showed varying degrees of association with different processing speed measures, but peripheral hearing ability did not show any significant relationship with speed measures. This study identifies a link between cognitive processing speed and gap detection response times. With further validation, gap detection response times could emerge as a straightforward yet informative measure of cognitive processing speed and would expand the clinical usefulness of the gap test. In the audiology clinic, this measure may hold promise as a tool for detecting and monitoring cognitive decline.
Sodium thiosulfate (STS) has recently been approved as an otoprotectant for systemic use in pediatric cancer patients receiving cisplatin treatment for localized, nonmetastatic solid tumors by the Food and Drug Administration, European Medicines Agency, and Medicines and Healthcare Products Regulatory Agency. While incorporating STS into the current standard of care pediatric practice, questions about uniform, timely, and safe administration are raised that may benefit from additional guidance. Recognizing that advancing clinical practice presents multiple challenges, an international onco-ototoxicity prevention task force, including experts in pediatric oncology, audiology, and pharmacology, was established to identify potential barriers to the implementation of otoprotection and to offer practical solutions for clinical services for children exposed to cisplatin, based on available evidence, as well as consensus where data are less robust. This task force held several online meetings and a working group session at the annual SIOPE meeting in Milan in May 2024, where the challenges for implementing STS were outlined and addressed. Nine key challenges were identified, including, for example, the timing of both cisplatin infusion and STS administration, the optimal integration of STS into existing treatment protocols, potential drug interactions, and relevant economic considerations. In this article, we propose practical steps to address these challenges, informed by the existing literature and expert opinion, incorporating recommendation statements from the international onco-ototoxicity prevention task force on behalf of the SIOP Supportive Care Network, to facilitate the implementation of STS in children with localized, nonmetastatic disease.
With age-related hearing loss on the rise and a large bilingual (BI) population in the United States, there is an increasing need for effective assessment tools for Spanish-speaking and BI older adults. Research in this area is limited. The AzBio Sentence Test (AzBio) is used to assess speech perception in challenging listening environments. A Spanish version was recently developed to address the needs of Spanish-speaking patients, and opens new opportunities for research with BI individuals to better understand speech perception processes in both the native and the second language. This preliminary study aims to explore the characteristics of speech recognition among older BI adults by examining the performance of younger and older proficient Spanish-English BIs on the AzBio in quiet and noisy conditions. Preliminary quasi-experimental group design. Twenty-one participants were divided into three groups: eight young American English monolinguals (M = 28.12 years, range: 24-32), eight young Spanish-English BIs (M = 28.38 years, range: 23-33), and five older Spanish-English BIs (M = 58 years, range: 55-62). The AzBio was used to assess speech perception in quiet and noisy conditions in both English and Spanish, with two signal-to-noise ratios: 0 and -3 dB. Independent and paired sample statistical tests were conducted. In quiet conditions, older BIs outperformed younger ones on the Spanish version, whereas younger BIs performed better in English. However, for the older group, the linguistic advantage observed in quiet conditions disappeared in noisy environments, because performance differences with the younger group diminished when background noise was introduced. Young monolinguals and BIs showed no difference in performance on the English version. Aging poses challenges for speech recognition in noisy environments. For BIs, these difficulties extend to both languages, including the dominant one. The combined effects of bilingualism and aging negatively impact speech recognition in both languages. Understanding how individuals perform on the AzBio and other BI sentence recognition tools is essential for improving clinical assessment and intervention for those impacted by language background and age-related hearing changes.
Neural activity has been shown to track hierarchical linguistic units in connected speech, and these responses are modulated by changes in speech intelligibility resulting from spectral degradation. In this study, we manipulated prior knowledge to enhance the intelligibility of physically identical speech sentences and tested whether this improvement would strengthen neural tracking responses. Cortical magnetoencephalography responses were recorded from 23 normal-hearing participants while they listened to intelligible speech followed by either the same (matched) or different (unmatched) unintelligible speech. When prior knowledge was available, cortical coherence at higher-order linguistic rates, particularly phrase and sentence rates, was enhanced relative to the unmatched condition and was predominantly lateralized to the left hemisphere. In contrast, cortical coherence to word-level units, which aligned with acoustic onsets, was bilateral and did not show a significant modulation by contextual information. No such coherence enhancement was observed when unintelligible speech preceded intelligible speech. This dissociation suggests that cerebral tracking of linguistic information is directly influenced by intelligibility, which itself is strongly shaped by physical speech cues. These findings provide an objective and sensitive neural index of speech intelligibility and help explain why previous studies have reported no effect of prior knowledge on cortical entrainment.
Assigning individuals with hearing impairment to auditory profiles can support a better understanding of the causes and consequences of hearing loss and facilitate profile-based hearing-aid fitting. However, the factors influencing auditory profile generation remain insufficiently understood, and existing profiling frameworks have rarely been compared systematically. This study therefore investigated the impact of two key factors-the clustering method and the number of profiles-on auditory profile generation. In addition, eight established auditory profiling frameworks were systematically reviewed and compared using intrinsic statistical measures and manifold learning techniques. Frameworks were evaluated with respect to internal consistency (i.e., grouping similar individuals) and cluster separation (i.e., clear differentiation between groups). To ensure comparability, all analyses were conducted on a common open-access dataset, the extended Oldenburg Hearing Health Record (OHHR), comprising 1,127 participants (mean age = 67.2 years, SD = 12.0). Results showed that both the clustering method and the chosen number of profiles substantially influenced the resulting auditory profiles. Among purely audiogram-based approaches, the Bisgaard auditory profiles demonstrated the strongest clustering performance, whereas audiometric phenotypes performed worst. Among frameworks incorporating supra-threshold information in addition to the audiogram, the Hearing4All auditory profiles achieved the lowest normalized Davies-Bouldin (DB) score, while the BEAR auditory profiles performed better on the other intrinsic measures. In conclusion, separability should be considered a primary criterion in auditory profile generation, as it directly determines how meaningfully different profiles can be distinguished in practice. Manifold learning and intrinsic measures enable systematic comparisons of auditory profiling frameworks and identify the Hearing4All auditory profile as a promising approach for future research.
To compare personal listening device (PLD) listening behaviours, leisure noise exposure, audiometric outcomes, hearing protection (HP) usage and self-reported hearing loss (HL) symptoms at Time 1: 2009/2010 and Time 2: 2022/2023. Mean hearing thresholds (HTs), pure-tone average HL prevalence, PLD volume levels, durations, earbud/headphone tightness, and sex among matched pairs, at Time 1 and 2, were compared. Longitudinal design. Questionnaire evaluating PLD listening behaviours, leisure noise exposure and HL symptoms. Multivariate regression analysis used to determine relationship between variables and audiometry. 59 Participants, aged 22-30, of original cohort (n = 237, aged 10-17) were re-tested (Time 2). Over time, tinnitus following leisure noise tripled, HP doubled and higher average PLD listening time was observed (7 vs. 18 h/week); longer durations for males. High volume listening was 20% at both timepoints. Leisure noise exposure and HL prevalence were similar across time, however mean HTs were higher at Time 1. Among matched pairs, more Time 2 participants created tight-fitting earbuds/headphones and responded affirmatively to some HL symptom questions. Subtle auditory changes, such as hidden HL, may be occurring over time. Educational outreach regarding HL prevention would be beneficial. Further longitudinal research needed due to the small follow-up sample.
Measures of speech intelligibility in noise show limited correspondence with difficulties people with hearing loss report from daily life. This mismatch suggests that standard measurement conditions do not sufficiently capture aspects that are relevant for speech perception, such as dip listening and spatial release from masking. In the present study we developed and evaluated a test condition that incorporates these aspects and compared it with a standard condition. Speech intelligibility was measured in 100 participants with normal hearing (NH, N=17) and hearing loss (HL, N=83) ranging from mild to severe. Measurements were conducted using the German matrix sentence test (OLSA) in the standard condition with frontal presentation of stationary noise co-located with the target speech, and the proposed condition with fluctuating, speech-like maskers spatially separated (±60°) from the target. Stimuli were presented via headphones using virtual acoustics. Tests were performed unaided and with individualized amplification. The proposed condition revealed reduced speech intelligibility also for listeners with HL that showed close-to-normal speech intelligibility in the standard condition. With individualized amplification, more listeners with HL showed reduced speech intelligibility compared to NH listeners than in the standard condition. Benefit of amplification varied widely across individuals with similar hearing thresholds, with some listeners showing little or no benefit. The advantages of the proposed condition were driven by masker fluctuations rather than by spatial separation of sound sources. These findings demonstrate that speech intelligibility measurements incorporating fluctuating maskers provide potentially relevant information beyond standard assessments and can support a more individualized assessment of hearing loss.
Deep plane facelift surgery has gained increasing popularity owing to its ability to provide natural and long-lasting rejuvenation results. This study aimed to analyze the incidence, management, and clinical outcomes of complications following deep plane facelift surgery and assess the relationship between surgical experience and complication rates. This retrospective, single-surgeon study included 240 patients (206 women and 34 men; mean age 53.3 ± 8.2 years) who underwent extended deep plane facelift surgery between 2021 and 2025. Early (≤14 days) and late (>14 days) complications were recorded, categorized, and statistically analyzed. The learning curve was evaluated in consecutive groups of 60 cases. Complications occurred in 30 patients (12.5%). The most frequent complication was transient facial nerve dysfunction (n = 14; 5.8%), followed by skin necrosis (n = 6; 2.5%), alopecia (n = 4; 1.7%), suture reaction (n = 2; 0.8%), keloid (n = 2; 0.8%), hypertrophic scar (n = 1; 0.4%), hematoma (n = 1; 0.4%), and salivary fistula owing to Stensen's duct injury (n = 1; 0.4%). The overall complication rate declined progressively with experience: 16.7% in the first 60 cases versus 8.3% in the last 60 cases. Skin necrosis incidence similarly decreased from 6.7% to 0%. Deep plane facelift surgery is a safe and effective facial rejuvenation technique when performed by experienced surgeons. The transient nature of most complications and observed decline in complication frequency with increasing surgical experience highlight the importance of anatomical precision and operative refinement.
The cochlear microphonic (CM) primarily reflects the composite receptor potential of outer hair cells (OHCs), providing an objective assessment of OHC mechanoelectrical transduction (MET) capacity. However, systematic studies on CM in basic research remain scarce, and baseline CM values for CBA/CaJ mice have not yet been established. Moreover, whether CM can functionally differentiate between auditory neuropathy (AN) and noise-induced hearing loss (NIHL) has not been systematically addressed. This study aimed to establish normative CM reference values for CBA/CaJ mice and to explore the utility of CM as an objective electrophysiological tool for assessing OHC function across different pathophysiological conditions. CM was recorded from the round window in three mouse models: wild-type (WT) CBA/CaJ mice (1, 2, and 7 months), Aifm1 p.R450Q knock-in AN mice, and NIHL models of permanent threshold shift (PTS) and temporary threshold shift (TTS). Input-output (I/O) nonlinearity and frequency-specific were analyzed. In WT mice, CM amplitude exhibited an approximately linear relationship with stimulus intensity at levels ≤90dB SPL. When the intensity exceeded 90dB SPL, the amplitude saturated and subsequently declined, demonstrating nonlinear characteristics under high-intensity stimulation. Compared to 1- and 2-month-old WT mice, CM amplitude was reduced at 7 months of age. In AN mouse models, CM waveforms remained generally normal, but amplitude increased at 1 month and declined by 7 months. In noise-exposed mice, CM amplitude significantly decreased in the PTS group, while only a slight reduction was observed in the TTS group. This study establishes normative CM values for CBA/CaJ mice and demonstrates that CM profiling provides a functional differentiation between AN and two types of NIHL. These findings support CM as a robust, objective tool for assessing OHC function in murine models and encourage broader implementation of CM testing in both preclinical research and clinical diagnostics.
Conversations are an important part of our social lives, although for people with hearing impairment (HI), conversations can pose a considerable challenge and can often lead to miscommunications. In conversations recorded from 25 groups consisting of one HI interlocutor and two normal hearing (NH) interlocutors, all miscommunications were identified to evaluate how HI, background noise level, and hearing-aid signal processing affected miscommunications. A subset of miscommunications is so-called other-initiated repairs (OIRs) where one interlocutor signals a communication breakdown, using unspecific open requests (e.g., "What?") or increasingly more specific restricted requests or offers (e.g., "Who?" or "Did you say blue?"). An "open request" signals a problem without specifying what is misheard/understood, while the restricted request specifies what part of the sentence is not heard, and finally, the most specific "restricted offer" is asking the conversation partner to confirm the supposed word/phrase. With increasing communication difficulty, open OIRs are expected to be more frequently used due to poorer speech understanding. The results showed that HI interlocutors generally had more miscommunications and that, across interlocutors, open OIRs were mostly used. At low noise levels, the HI interlocutor had fewer miscommunications and used more specific OIRs when wearing a hearing aid relative to being unaided. At the high noise level, all interlocutors had more miscommunications. When listening to directional sound processing (dir) at the high noise level, the HI interlocutor produced fewer open OIRs. It is interesting that the NH interlocutors were also affected by having more miscommunications and more open OIRs when the HI interlocutor listened to dir. The speech levels of the HI interlocutors were reduced in dir, and a relationship was found between the HI speech levels and the number of OIRs made by the NH interlocutors. Our results highlight how sensitive the number and nature of miscommunications and OIRs in conversations are, not only to the sound environment, but also to the experience of a single (HI) interlocutor, even in triadic interactions, where only two interlocutors are strictly needed to keep the conversation going.
China and India represent a large proportion of the Asian birth cohort and have produced extensive but heterogeneous evidence on neonatal hearing screening. This scoping review summarizes studies published between 2005 and 2025 on otoacoustic-emission-based neonatal hearing screening programs in these countries, with emphasis on program implementation, screening coverage, the prevalence of congenital and bilateral hearing loss, follow-up, and intervention pathways. Searches were conducted in PubMed, Scopus, and Google Scholar using predefined keywords. Studies reporting screening protocols, coverage, prevalence, or follow-up outcomes were included. The standard English language filter was used. A total of 19 papers were considered for this review. The data from the two assessed Asian states show two clearly different screening implementation profiles. In China, universal hearing screening has evolved into a large-scale and increasingly standardized system, supported by technical specifications and regional or municipal databases. The reported screening coverage was 85.8% in early rural programs, 93.6% in Shanghai, and 97.9% in Liuzhou. National institutional surveys indicate that UNHS has now been substantially implemented in many regions. Reported hearing loss prevalence estimates generally ranged from 1.66 to 3.43 per 1000 newborns, although follow-up and regional equity remain problematic, especially in rural settings. In India, the evidence is dominated by tertiary-hospital feasibility studies rather than a uniformly implemented national program. Reported hearing loss prevalence estimates varied more widely, from 0.29 to 5.60 per 1000 screened newborns, largely reflecting differences in study design, screening timing, referral completion, and population risk profile. Across both countries, OAE-based two-stage or sequential OAE + AABR protocols reduced referral rates and improved case identification, but loss to follow-up remained a recurrent limitation. China and India provide complementary models of neonatal hearing screening expansion. China demonstrates the effects of system-level scale-up, whereas India highlights the feasibility and constraints of hospital-based implementation in a highly diverse healthcare environment. Future priorities include stronger follow-up systems, harmonized reporting standards, and broader dissemination of outcome data through peer-reviewed publications.
Pastors are heavy occupational voice users both in the singing and speaking voice. This study aims to determine the prevalence of voice problems among pastors working in the Protestant Church in Germany, and to identify possible factors influencing their occurrence. A link to an electronic questionnaire consisting of 26 questions was sent to the respective member churches of the Protestant Church in Germany in the period between January and April 2020. The member churches, in turn, were asked to forward the link to their employed pastors. A total of 1022 pastors completed the questionnaire: 52.3% male, 47.7% female. The prevalence of voice disorder varied depending on which definition was used: 5.1% (diagnosed voice disorder), 7.5% (sick leave due to voice problems), 21.5% who reported two or more frequently occurring vocal symptoms. Significantly more female than male pastors had already been on sick leave due to vocal problems (P < 0.0001), had a medically diagnosed voice disorder (P = 0.0008), and had at least two voice-related symptoms (P = 0.0001). 87.5% of all participants got voice and speech training at one point during their career; mostly during the last two years of ministerial training (63.8%). However, 36.3% also took additional private lessons in voice and speech training (44.3% female vs. 29.0% male, P < 0.001). Results from a multivariable analysis indicated that individuals with high vocal strain, limited knowledge of voice care, and those who were female reported voice problems more frequently. Voice and speech training and vocal hygiene advice represent a primary tool for preventing occupational dysphonia in the pastoral profession. This training should be tailored to the professional needs of pastors and not only be included at the beginning of a career as a pastor, but also refreshed repeatedly throughout one's professional life.
The aim of this study was to examine the relationship between temporal processing and literacy performance in children with hearing aids. The study included a total of 45 children, comprising 21 with typical hearing and 24 who used hearing aids, all of whom were attending the second, third, or fourth grades of primary school. Temporal processing skills were evaluated using the Frequency Pattern Test and the Duration Pattern Test (DPT), whereas reading and writing abilities were assessed through the Literacy Assessment Battery. Children using hearing aids demonstrated statistically significantly lower performance in the DPT and in the test assessing writing skills compared to their typically hearing peers. A positive, significant correlation was found between temporal processing skills and literacy skills. Moreover, temporal processing and literacy performance were observed to be negatively correlated with the age at which the child's first amplification was provided and positively correlated with the duration of auditory rehabilitation. This study found that in children using hearing aids, performance on temporal pattern tests was significantly correlated with reading and writing skills. Furthermore, these findings suggest that early amplification and consistent auditory rehabilitation may be correlated with better temporal processing and literacy skills.