The impact of the diagnosis and the reality of being hearing impaired could trigger uncomfortable feelings at different times in the client's life. With the cochlear implant, these feelings will still be a reality, as the implant does not heal the hearing impairment. Psychological interventions could assist the client during this healing process. The process of cochlear implants could also bring other challenges into the client's life. Expectations of quick healing play a major role and should be addressed throughout the process of implantation and rehabilitation. This is another opportunity for the psychologist to intervene. This research shows that the role of the psychologist could be expanded not only to evaluate but also to bring about change. The treatment model gives a logical and workable explanation of how and where the psychologist may intervene in the process of cochlear implantation. This model was tested and adapted by the cochlear implant team at the University of Pretoria over a period of ten years. The model may be used as a template for new teams. Intervening as described in the model presents the opportunity to address various different needs as they occur. The qualitative research design proved to be a fitting method to explore the experiences of the participants from their own viewpoints. The qualitative research is also congruent with a systemic perspective and emphasises social context, multiple perspectives, complexity, recursion and holism. This study aims to develop a complementary psychological treatment programme and create awareness within professionals working with hearing impairment of the complexity of systems. The study shows that one can only understand the behaviour of any given system by tracking changes that occur within that system and its subsystems and by tracking changes between that system and the larger whole. In this study three different therapeutic interventions are used on three different case studies, two children from different age groups and an adult, to accommodate the multiple realities of the different systems. The aim of the study with cochlear implantees and their families is to stimulate new leads and avenues of enquiry that may be used as a basis for further research. / Psychology / Thesis (D.Litt. et Phil. (Psychology))

Com o objetivo de analisar o efeito de supressão das emissões otoacústicas transientes com a apresentação de ruído branco contralateral, foram avaliadas 51 crianças de 7 a 11 anos, sendo 15 sem queixas auditivas (grupo controle) e 36 com distúrbio de processamento auditivo (divididas em dois grupos experimentais). Foram determinados, para cada grupo, a média e o desvio padrão dos valores de supressão em cada condição de estímulo: clique linear e clique não linear. Verificou-se que a proporção de ausência do efeito de supressão foi significativamente maior nos grupos de crianças com distúrbio de processamento auditivo, comparados ao grupo controle / This study concerns the suppression of transient evoked otoacoustic emissions by contralateral white noise in children with auditory processing disorder. Fifty-one children between 7 and 11 years old were assessed, being 15 children without auditory complaints (control group) and 36 with auditory processing disorder (divided in two experimental groups). The mean suppression of otoacoustic emissions and standard deviation were determined for each group, both in linear and nonlinear acquisition mode. The results provided evidence that proportion of absence of otoacoustic emissions suppression was significantly higher in auditory processing disorder groups, when compared to control group

Doctorat en sciences psychologiques / info:eu-repo/semantics/nonPublished

MPH / Department of Public Health / Hearing Conservation Programme (HCP) has been reported to be effective in protecting the hearing of South African workers who are exposed to occupational noise. In order to reduce Noise Induced Hearing Loss (NIHL) among these workers, a team work that includes an Occupational Audiologist in the proper implementation of hearing conservation programme is needed. The aim of this study was to assess the implementation of hearing conservation programme amongst farm workers in Vhembe District, Limpopo Province in South Africa.A quantitative research approach using cross sectional survey design was used to assess the implementation of the programme among farm workers in Vhembe District, Limpopo Province in South Africa. A self administered questionnaire with both open and closed ended questions was administered to both males and female respondents aged between 19 and 50 years. A total population of 260 farm workers were systematically selected and a sample size of 76 respondents were randomly selected and participated in the study. Permission to conduct the study was obtained from the Ethics Committee of the University of Venda and the office in charge of royal macadamia. The data collected was analyzed using the Statistical package of Social Sciences (SPSS) version 23,0 software. A test-retest method was used to ensure reliability and findings of the study and formed the basis of recommendations. The results of the study indicate that 82,9% of the workers who were exposed to noise for more than 14hours were not using hearing protection devices even though they were supplied. The training on the effects of noise on hearing was received by a quarter (25%) of the farm workers leaving out a large portion of 75% of workers not knowledgeable about the hearing conservation programme. A very small percentage of 3,9% indicated that they had a documented hearing loss against a large number of 96,1%. The findings show that only engineering noise controls are available and there were no provision of noise maps as part of monitoring hearing conservation programme.The farm workers need to be motivated to wear hearing protection devices in order to conserve their hearing. The management of the farm may organize an in-service training regarding the proper implementation of hearing conservation programme.Dermacation of noise zones would remind workers to put on their ear protectors before entering the noise area as part of monitoring the hearing conservation programme.

Afrikaans text / Die doel van die studie is om buffer- en risikofaktore te verken wat ‟n rol in die ontwikkeling van gehoorgestremde kleuters kan speel. Gehoorgestremde kleuters presenteer met ‟n gehoorverlies, wat hul van normaalhorende kleuters onderskei. Tog beskik alle kleuters oor primêre behoeftes. Lewenskwaliteit word verbeter deur behoeftevervulling, wat die ontwikkelingsproses beïnvloed. Hierdie behoeftes word vervul deur die kleuter, asook faktore vanuit die omgewing. ‟n Literatuurstudie is onderneem as teoretiese raamwerk, wat teorieë omtrent die omgewing en behoeftes, buffer- en risikofaktore en kleuterontwikkeling insluit. Data is vanuit ‟n kwalitatiewe benadering ingesamel deur semi-gestruktureerde onderhoude en ekokaarte saamgestel deur ouers van gehoorgestremde kleuters. Kontrolering en integrering van data het deur triangulering geskied. Buffer- en risikofaktore binne kleuters self, die gesin en die breër gemeenskap is verken. Die studie is verkennend en beskrywend, en toegepaste navorsing is gebruik. So is gevolgtrekkinge en aanbevelings gemaak om toepaslike ondersteuning aan ouers van gehoorgestremde kleuters te bewerkstellig. / The aim of the study is to explore the protective and risk factors that may contribute to the development of hearing-impaired toddlers. Hearing impaired toddlers present with a hearing loss, which distinguish them from toddlers with normal hearing. However, all toddlers have primary needs. Quality of life is improved by the fulfilment of needs, which influences the developmental process. These needs are fulfilled by the toddler, as well as by factors from the environment. A literature study was conducted as theoretical framework. This included theories regarding the environment and needs, protective and risk factors, and toddler development. In this qualitative study, data collection was conducted by semi-structured interviews and the compilation of ecomaps by parents of hearing impaired toddlers. Triangulation was used to verify and integrate data. Protective and risk factors were explored within the toddler, the family and the wider community. This study is exploratory and descriptive and applied research was used. In this way conclusions and recommendations were made to provide appropriate support to parents of hearing impaired toddlers. / Social Work / M. Diac. (Spelterapie)

Made available in DSpace on 2016-01-26T12:51:55Z (GMT). No. of bitstreams: 1 vaniapiatto_tese.pdf: 1479841 bytes, checksum: 96e04c84851d635167398b1a4196d2fe (MD5) Previous issue date: 2003-11-28 / Mutações no gene que codifica a proteína conexina 26 têm contribuído para a maioria das deficiências auditivas pré-lingual, sensorioneural não-sindrômicas recessivas. Uma mutação específica, a 35delG, é a mais freqüente das mutações detectadas no gene GJB2 nos vários grupos étnicos estudados. O objetivo foi determinar a prevalência de mutações no gene GJB2 em pacientes com deficiência auditiva sensorioneural não sindrômica, do Serviço de Otorrinolaringologia da FAMERP, em São José do Rio Preto, SP. Trinta e três casos-índice foram avaliados por exames fisico e complementares para excluir formas sindrômicas e causas ambientais da deficiência auditiva e, pela reação em cadeia da polimerase alelo-específico (AS-PCR) para a detecção da mutação 35delG. Os pacientes heterozigotos para a mutação 35delG e aqueles que não tiveram a mutação detectada foram submetidos, posteriormente, ao PCR para detecção da mutação A(GJB6-D 1381830) e ao sequenciamento automático direto para análise da região codificante do gene GJB2. A mutação 35delG foi detectada em 27,3% dos casos-índice (9/3 3) ou em 2 1,2% dos alelos (14/66). A mutação A(GJB6-DI3SI 830) foi encontrada em um (3,0%) caso-índice heterozigoto 35delG. O seqüenciamento direto nos casos-índice heterozigotos identificou um paciente (3,0%) com as mutações 35delG/V3 71. As mutações no gene GJB2 são responsáveis por mais de um quarto das deficiências auditivas sensorioneural não-sindrômica na população do estudo e, o teste PCR alelo-específico (AS-PCR) é um método fácil para rastreamento da mutação 35delG e os resultados positivos podem estabelecer o diagnóstico etiológico e aconselhamento genético nos pacientes afetados.

Afrikaans text / Die doel van die studie is om buffer- en risikofaktore te verken wat ‟n rol in die ontwikkeling van gehoorgestremde kleuters kan speel. Gehoorgestremde kleuters presenteer met ‟n gehoorverlies, wat hul van normaalhorende kleuters onderskei. Tog beskik alle kleuters oor primêre behoeftes. Lewenskwaliteit word verbeter deur behoeftevervulling, wat die ontwikkelingsproses beïnvloed. Hierdie behoeftes word vervul deur die kleuter, asook faktore vanuit die omgewing. ‟n Literatuurstudie is onderneem as teoretiese raamwerk, wat teorieë omtrent die omgewing en behoeftes, buffer- en risikofaktore en kleuterontwikkeling insluit. Data is vanuit ‟n kwalitatiewe benadering ingesamel deur semi-gestruktureerde onderhoude en ekokaarte saamgestel deur ouers van gehoorgestremde kleuters. Kontrolering en integrering van data het deur triangulering geskied. Buffer- en risikofaktore binne kleuters self, die gesin en die breër gemeenskap is verken. Die studie is verkennend en beskrywend, en toegepaste navorsing is gebruik. So is gevolgtrekkinge en aanbevelings gemaak om toepaslike ondersteuning aan ouers van gehoorgestremde kleuters te bewerkstellig. / The aim of the study is to explore the protective and risk factors that may contribute to the development of hearing-impaired toddlers. Hearing impaired toddlers present with a hearing loss, which distinguish them from toddlers with normal hearing. However, all toddlers have primary needs. Quality of life is improved by the fulfilment of needs, which influences the developmental process. These needs are fulfilled by the toddler, as well as by factors from the environment. A literature study was conducted as theoretical framework. This included theories regarding the environment and needs, protective and risk factors, and toddler development. In this qualitative study, data collection was conducted by semi-structured interviews and the compilation of ecomaps by parents of hearing impaired toddlers. Triangulation was used to verify and integrate data. Protective and risk factors were explored within the toddler, the family and the wider community. This study is exploratory and descriptive and applied research was used. In this way conclusions and recommendations were made to provide appropriate support to parents of hearing impaired toddlers. / Social Work / M. Diac. (Spelterapie)

Indiana University-Purdue University Indianapolis (IUPUI) / The inner ear contains specialized sensory epithelia that detect head movements, gravity and sound. Hearing loss and imbalance are primarily caused by degeneration of the mechanosensitive hair cells in sensory epithelia or the sensory neurons that connect the inner ear to the brain. The controlled derivation of inner ear sensory epithelia and neurons from pluripotent stem cells will be essential for generating in vitro models of inner ear disorders or developing cell-based therapies. Despite some recent success in deriving hair cells from mouse embryonic stem (ES) cells, it is currently unclear how to derive inner ear sensory cells in a fully defined and reproducible manner. Progress has likely been hindered by what is known about induction of the nonneural and preplacodal ectoderm, two critical precursors during inner ear development. The studies presented here report the step-wise differentiation of inner ear sensory epithelia from mouse ES cells in three-dimensional culture. We show that nonneural, preplacodal and pre-otic epithelia can be generated from ES cell aggregates by precise temporal control of BMP, TGFβ and FGF signaling, mimicking in vivo development. Later, in a self-guided process, vesicles containing supporting cells emerge from the presumptive otic epithelium and give rise to hair cells with stereocilia bundles and kinocilium. Remarkably, the vesicles developed into large cysts with sensory epithelia reminiscent of vestibular sense organs (i.e. the utricle, saccule and crista), which sense head movements and gravity in the animal. We have designated these stem cell-derived structures inner ear organoids. In addition, we discovered that sensory-like neurons develop alongside the organoids and form putative synapses with hair cells in a similar fashion to the hair cell-to-neuron circuit that forms in the developing embryo. Our data thus establish a novel in vitro model of inner ear organogenesis that can be used to gain deeper insight into inner ear development and disorder.

A adequação do peso ao nascimento é um fator de risco para atrasos de desenvolvimento. Dentre outras causas de morbidade e mortalidade, encontra-se a prematuridade e a Restrição de Crescimento Intrauterino (RCIU). O termo \"Pequeno para a Idade Gestacional\" (PIG) é utilizado muitas vezes, como indicador de RCIU, cujo feto pode ter sido submetido a agravos em diferentes momentos da gestação. A literatura aponta o PIG como risco para atraso no desenvolvimento neuropsicomotor, incluindo a linguagem. Objetivo: Acompanhar a maturação da via auditiva em lactentes nascidos PIG, comparando-os aos lactentes nascidos Adequados para Idade Gestacional (AIG) a termo e pré-termo, por meio do estudo das respostas do PEATE por estímulo click e tone burst (TB) nos seis primeiros meses de vida. Método: Estudo longitudinal, observacional de caráter multicêntrico. Foram avaliados 172 lactentes nascidos PIG e AIG, a termo e pré-termo, nos períodos neonatal, aos três e aos seis meses, por meio do PEATE com estímulo tipo click e tone burst em 0,5 kHz e 1 kHz, a 80dBnNA. Resultados: no período neonatal, os RN T/PIG não se diferenciaram dos RN T/AIG quanto às respostas do PEATE, o mesmo ocorrendo entre PT/PIG e PT/AIG. Ao se comparar o grupo T e PT/PIG, observou-se diferença entre as latências das ondas III, V e intervalos interpicos (Itpc) I-III e I-V, com latências maiores nos PT/PIG; não foram evidenciadas diferenças com TB nas frequências avaliadas. Na comparação do grupo T e PT/AIG, observou-se diferença entre as latências das ondas III, V e nos Itpc III-V e I-V e latências maiores nos PT/AIG. Não houve diferenças no TB nas frequências avaliadas. Aos três meses, não houve diferenças entre os T/PIG e T/AIG; na comparação PT/PIG e PT/AIG, houve diferenças no Itpc III-V, com latência menor no grupo PT/PIG. Não houve diferenças entre T/PIG e PT/PIG; o grupo AIG mostrou diferença entre T e PT nas latências da onda V e Itpc I-V. Na terceira coleta, aos seis meses, os T/PIG e T/AIG evidenciaram diferenças significativas entre as latências da onda III e Itpc I-III, o mesmo não ocorrendo quando se comparou PT/PIG e PT/AIG, os quais se diferenciaram somente no Itpc III-V. Ao se comparar T/PIG e PT/PIG, verificou-se diferenças relevantes somente no TB 0,5 kHz. Conclusão: Os achados do presente estudo permitiram concluir que o processo maturacional da via auditiva em lactentes nascidos PIG ocorre em diferente velocidade quando comparado ao de lactentes AIG; os PIG têm maturação acelerada, principalmente nos três primeiros meses, caracterizando desta forma um período de recuperação do ponto de vista da audição; a prematuridade influencia mais a maturação do sistema nervoso auditivo central que o fator peso ao nascer no período neonatal; a maturação ocorreu no sentido caudo-rostral nos dois grupos. O PEATE com TB em 0,5 kHz e em 1 kHz evidenciou o processo maturacional, porém não de modo tão detalhado quanto o fez com o estímulo tipo click. As crianças PIG devem ser monitoradas até pelo menos os três anos de idade / The appropriateness of weight at birth is a risk factor for developmental delays. Prematurity and intrauterine growth restriction (IUGR) are among other causes of morbidity and mortality. The term \"small for gestational age\" (SGA) is often used as an indicator of IUGR, when the fetus may have been subjected to restrictions at different periods of pregnancy. The literature points SGA as a risk for neuropsychological developmental delay, including language. Objective: to monitor the maturation of the auditory pathway in SGA infants, comparing to term and preterm appropriate for gestational age (AGA) infants, through the analysis of the ABR responses to click and tone burst stimulus in the first six months of life. Method: A longitudinal, observational and multicenter study was conducted. A total of 172 SGA and AGA infants, term and preterm, were evaluated in the neonatal period and at three and six months of age through the ABR with click and tone burst stimulus with 0.5 kHz and 1 kHz at 80dBHL. Results: in the neonatal period, the term SGA infants did not differ from term AGA infants for ABR responses. The same was observed between preterm SGA and preterm AGA infants. When comparing the term and preterm SGA groups, there was a difference between the latencies of waves III, V and interpeak intervals (lTPI) I-III and I-V, with longer latencies in preterm SGA; there were no differences with the tone burst stimuli in the analyzed frequencies. When comparing the AGA term and preterm groups, differences were observed on latencies of waves III, V and ITPI III-V and I-V, with longer latencies for preterm infants. There were no differences in the frequencies evaluated with the tone burst stimuli. At three months of age, there were no differences between the term SGA and AGA; when comparing preterm SGA and AGA, differences were found for ITPI III-V, with shorter latencies in preterm SGA. SGA term and preterm infants did not differ; there were differences between term and preterm AGA in latencies of wave V and ITPI I-V. In the third data collection, at six months of age, term SGA and AGA infants significantly differed on latencies of wave III and ITPI I-III, which did not occur when comparing preterm SGA and AGA infants, who differed only regarding ITPI III-V. Significant differences were only observed when comparing term and preterm SGA infants regarding the tone burst stimuli at 0.5 kHz. Conclusion: The findings of this study showed that the maturational process of the auditory pathway in SGA infants occurs at different speed when compared to AGA infants; SGA infants have accelerated maturation, especially in the first three months of age, thus characterizing a recovery period from the hearing standpoint; in the neonatal period, the maturation of the central auditory nervous system is more influenced by prematurity than birth weight; maturation occurred in caudo-rostral direction in the two groups. The ABR with tone burst at 0.5 kHz and 1 kHz evidenced maturational process, but not in such detail as with the click stimuli. The SGA infants should be monitored until at least three years of age

A adequação do peso ao nascimento é um fator de risco para atrasos de desenvolvimento. Dentre outras causas de morbidade e mortalidade, encontra-se a prematuridade e a Restrição de Crescimento Intrauterino (RCIU). O termo \"Pequeno para a Idade Gestacional\" (PIG) é utilizado muitas vezes, como indicador de RCIU, cujo feto pode ter sido submetido a agravos em diferentes momentos da gestação. A literatura aponta o PIG como risco para atraso no desenvolvimento neuropsicomotor, incluindo a linguagem. Objetivo: Acompanhar a maturação da via auditiva em lactentes nascidos PIG, comparando-os aos lactentes nascidos Adequados para Idade Gestacional (AIG) a termo e pré-termo, por meio do estudo das respostas do PEATE por estímulo click e tone burst (TB) nos seis primeiros meses de vida. Método: Estudo longitudinal, observacional de caráter multicêntrico. Foram avaliados 172 lactentes nascidos PIG e AIG, a termo e pré-termo, nos períodos neonatal, aos três e aos seis meses, por meio do PEATE com estímulo tipo click e tone burst em 0,5 kHz e 1 kHz, a 80dBnNA. Resultados: no período neonatal, os RN T/PIG não se diferenciaram dos RN T/AIG quanto às respostas do PEATE, o mesmo ocorrendo entre PT/PIG e PT/AIG. Ao se comparar o grupo T e PT/PIG, observou-se diferença entre as latências das ondas III, V e intervalos interpicos (Itpc) I-III e I-V, com latências maiores nos PT/PIG; não foram evidenciadas diferenças com TB nas frequências avaliadas. Na comparação do grupo T e PT/AIG, observou-se diferença entre as latências das ondas III, V e nos Itpc III-V e I-V e latências maiores nos PT/AIG. Não houve diferenças no TB nas frequências avaliadas. Aos três meses, não houve diferenças entre os T/PIG e T/AIG; na comparação PT/PIG e PT/AIG, houve diferenças no Itpc III-V, com latência menor no grupo PT/PIG. Não houve diferenças entre T/PIG e PT/PIG; o grupo AIG mostrou diferença entre T e PT nas latências da onda V e Itpc I-V. Na terceira coleta, aos seis meses, os T/PIG e T/AIG evidenciaram diferenças significativas entre as latências da onda III e Itpc I-III, o mesmo não ocorrendo quando se comparou PT/PIG e PT/AIG, os quais se diferenciaram somente no Itpc III-V. Ao se comparar T/PIG e PT/PIG, verificou-se diferenças relevantes somente no TB 0,5 kHz. Conclusão: Os achados do presente estudo permitiram concluir que o processo maturacional da via auditiva em lactentes nascidos PIG ocorre em diferente velocidade quando comparado ao de lactentes AIG; os PIG têm maturação acelerada, principalmente nos três primeiros meses, caracterizando desta forma um período de recuperação do ponto de vista da audição; a prematuridade influencia mais a maturação do sistema nervoso auditivo central que o fator peso ao nascer no período neonatal; a maturação ocorreu no sentido caudo-rostral nos dois grupos. O PEATE com TB em 0,5 kHz e em 1 kHz evidenciou o processo maturacional, porém não de modo tão detalhado quanto o fez com o estímulo tipo click. As crianças PIG devem ser monitoradas até pelo menos os três anos de idade / The appropriateness of weight at birth is a risk factor for developmental delays. Prematurity and intrauterine growth restriction (IUGR) are among other causes of morbidity and mortality. The term \"small for gestational age\" (SGA) is often used as an indicator of IUGR, when the fetus may have been subjected to restrictions at different periods of pregnancy. The literature points SGA as a risk for neuropsychological developmental delay, including language. Objective: to monitor the maturation of the auditory pathway in SGA infants, comparing to term and preterm appropriate for gestational age (AGA) infants, through the analysis of the ABR responses to click and tone burst stimulus in the first six months of life. Method: A longitudinal, observational and multicenter study was conducted. A total of 172 SGA and AGA infants, term and preterm, were evaluated in the neonatal period and at three and six months of age through the ABR with click and tone burst stimulus with 0.5 kHz and 1 kHz at 80dBHL. Results: in the neonatal period, the term SGA infants did not differ from term AGA infants for ABR responses. The same was observed between preterm SGA and preterm AGA infants. When comparing the term and preterm SGA groups, there was a difference between the latencies of waves III, V and interpeak intervals (lTPI) I-III and I-V, with longer latencies in preterm SGA; there were no differences with the tone burst stimuli in the analyzed frequencies. When comparing the AGA term and preterm groups, differences were observed on latencies of waves III, V and ITPI III-V and I-V, with longer latencies for preterm infants. There were no differences in the frequencies evaluated with the tone burst stimuli. At three months of age, there were no differences between the term SGA and AGA; when comparing preterm SGA and AGA, differences were found for ITPI III-V, with shorter latencies in preterm SGA. SGA term and preterm infants did not differ; there were differences between term and preterm AGA in latencies of wave V and ITPI I-V. In the third data collection, at six months of age, term SGA and AGA infants significantly differed on latencies of wave III and ITPI I-III, which did not occur when comparing preterm SGA and AGA infants, who differed only regarding ITPI III-V. Significant differences were only observed when comparing term and preterm SGA infants regarding the tone burst stimuli at 0.5 kHz. Conclusion: The findings of this study showed that the maturational process of the auditory pathway in SGA infants occurs at different speed when compared to AGA infants; SGA infants have accelerated maturation, especially in the first three months of age, thus characterizing a recovery period from the hearing standpoint; in the neonatal period, the maturation of the central auditory nervous system is more influenced by prematurity than birth weight; maturation occurred in caudo-rostral direction in the two groups. The ABR with tone burst at 0.5 kHz and 1 kHz evidenced maturational process, but not in such detail as with the click stimuli. The SGA infants should be monitored until at least three years of age