Magister Chirurgiae Dentium (MChD) / Hearing impairment contributes significantly to the global burden of disabilities and has reported to be a prevalent disability in South Africa. The hearing impaired population has been associated with low levels of oral health due to numerous factors concomitant with reduced oral health care and knowledge. This predisposes these persons to oral disease including periodontal disease. Aim: To determine the prevalence of periodontal disease and the associated factors in adults with hearing impairment in designated facilities in the Western Cape, South Africa. Objectives: 1. To determine the oral health care practices in adults with hearing impairment. 2. To determine oral health knowledge of adults with hearing impairment. 3. To determine the frequency of dental visits of adults with hearing impairment and identify any associated barriers. 4. To determine the prevalence of periodontal disease in adults with hearing impairment in designated facilities in the Western Cape, South Africa. 5. To determine the relationship between the prevalence of periodontal disease and associated factors including; sociodemographic factors, oral health care practices, oral health knowledge and frequency of dental visits in adults with hearing impairment. Methodology: A quantitative, analytical cross-sectional study design was employed. A research questionnaire was used to evaluate oral health care practices, oral health knowledge, frequency of dental visits and related barriers to access oral health care. An intra-oral examination was conducted to determine the plaque index (PI), gingival index (GI) and clinical attachment loss (CAL) using the Ramjford six teeth. Data was analysed in Microsoft Excel and StataCorp using frequencies, means, standard deviations, confidence intervals, Chi-square and Fishers exact tests. Results: The prevalence of gingivitis was 100% and the prevalence of periodontitis was 26.09% amongst hearing impaired adults. The mean gingival index score (GI) was 1.24 (STD±0.49; 95% CI: 1.14-1.35) and the mean plaque index score (PI) was 1.3 (STD±0.5; 95% CI: 1.2-1.4). Periodontitis prevalence was established for those participants presenting with an average clinical attachment loss (CAL) of >3mm and the mean clinical attachment loss was 4.47mm (STD ±1.41; 95% CI: 4.18-4.76mm) for those presenting with evidence of periodontitis. Age was statistically significant (p<0.05). Prevalence of periodontitis was evident amongst participants over the age of 35 years with a mean age of 48years (STD±13). Oral health care showed a lack of the use of dental floss and regular dental visits. Access to dental care was compromised primarily due to communication barriers, dental fear and a low priority of oral health. Conclusion: The necessity of oral health care and oral health knowledge in hearing impaired adults such as education and motivation for the need of dental flossing, the use of fluoridated toothpastes and the benefits of regular dental visits, must be emphasized. Oral health care workers should strive to intensify efforts to facilitate a favourable periodontal health status amongst hearing impaired adults.

<p>Objective: From the patient’s perspective describe communication difficulties, which can arise, and how they are handled in their contact with public health care and illustrate their needs of communication.</p><p>Method: A study of literature was carried out to receive a background and an insight in previous research concerning the subject area. Twelve women with hearing loss was asked to complete a questionnaire, with open questions, regarding communication difficulties in health care situations.</p><p>Sample: For the literature review, scientific papers were selected via the database, PubMed using relevant keywords. Seven were selected for closer review. For the survey study twelve women were asked to participate which ten of those responded.</p><p>Results: The study of literature shows that communication difficulties occur in public health care between patients with hearing loss and the nursing staff. These are mainly due to lack of information, lack of knowledge and comprehension regarding hearing disorders. Also, there is a lack of knowledge about methods in communication and factors regarding environment and surrounding. This affects the patients with a not sufficient quality of the care in comparison with the care for hearing patients. The causes of communication problems above are confirmed by the questionnaire study. Most of the participants experienced insecurity in their contact with public health care due to communication difficulties and they expressed that they often meet unsympathetic nursing staff. This can create dejectedness among the patients. The results from both literature review and the survey shows that education to all nursing staff, regarding communication and meeting of patient with hearing loss, can solve the problems.</p><p>Conclusions: Special education efforts to nursing staff regarding communication with patients with hearing loss are needed. That can give conditions to the health care service to achieve the goal about a good and high qualitative care.</p>

Objective: From the patient’s perspective describe communication difficulties, which can arise, and how they are handled in their contact with public health care and illustrate their needs of communication. Method: A study of literature was carried out to receive a background and an insight in previous research concerning the subject area. Twelve women with hearing loss was asked to complete a questionnaire, with open questions, regarding communication difficulties in health care situations. Sample: For the literature review, scientific papers were selected via the database, PubMed using relevant keywords. Seven were selected for closer review. For the survey study twelve women were asked to participate which ten of those responded. Results: The study of literature shows that communication difficulties occur in public health care between patients with hearing loss and the nursing staff. These are mainly due to lack of information, lack of knowledge and comprehension regarding hearing disorders. Also, there is a lack of knowledge about methods in communication and factors regarding environment and surrounding. This affects the patients with a not sufficient quality of the care in comparison with the care for hearing patients. The causes of communication problems above are confirmed by the questionnaire study. Most of the participants experienced insecurity in their contact with public health care due to communication difficulties and they expressed that they often meet unsympathetic nursing staff. This can create dejectedness among the patients. The results from both literature review and the survey shows that education to all nursing staff, regarding communication and meeting of patient with hearing loss, can solve the problems. Conclusions: Special education efforts to nursing staff regarding communication with patients with hearing loss are needed. That can give conditions to the health care service to achieve the goal about a good and high qualitative care.

A hearing impairment is one of the three leading causes of disability worldwide. It is estimated that 600 million people around the world have a hearing impairment, which affects their communication abilities, causes them to feel isolated and depressed, and impacts their economic situation. Because a decrease in the ability to hear is associated with getting older and life expectancy is increasing, the number of hearing impaired individuals is expected to increase. Much of the current research on adults with a hearing impairment focusses on a disabling hearing impairment, which is a loss of at least 40 dB HL or worse in the better ear. The research on a mild hearing impairment is predominantly focussed on children, specifically on educational effects. The aims of this study were to identify demographic, audiometric and quality of life differences between adults with a mild hearing impairment who adopt hearing aids and those who choose not to adopt hearing aids, and to measure clinical outcomes for adults with a mild hearing impairment who adopt hearing aids. Two groups of clients with a mild hearing impairment were compared. One group consisted of hearing aid adopters whilst the other group consisted of non-adopters. There was no significant difference between the groups in terms of demographic variables, such as age, gender or working status, or objective audiometric variables. We found a statistically significant difference between the groups in terms of subjective audiometric variables. Hearing aid adopters rated their hearing impairment worse than the non-adopters and were more inclined to change their current situation than the non-adopters. In addition, the adopters showed significant clinical improvement after wearing their hearing aids for an extended period of time.

Objective: The purpose of this current study was to develop an audiovisual speech perception test for New Zealand English (NZE) speaking children by adapting the American version of the Children’s-Build-A-Sentence (Ch-BAS) test. Three hypotheses were formulated for this study. First, it was predicted that the New Zealand version of the Ch-BAS test would show list equivalency. A second hypothesis was that all children would perform significantly better on the auditory-visual (AV) condition of the test in comparison to the vision-only (V-only condition). A third hypothesis was that older children would perform significantly better than younger children on both test conditions. Design: The American version of the Children’s-Build-A-Sentence test was adapted for use with NZ children and an audiovisual recording was made of an adult NZE speaker saying the sentence stimuli. This was then edited into a picture response matrix format to make up the NZ Ch-BAS test which is comprised of three lists made up of mono, bi, and tri-syllabic words. Equal numbers of sentences were allocated to the three test conditions: auditory-only (A-only), V-only, and AV conditions. The NZ Ch-BAS test was then administered to 30 normal hearing (NH) NZE-speaking children aged between 7-11 years with equal numbers (n=6) in each age group. All testing was conducted in the presence of multi-talker babble noise, set individually for each child to obtain approximately equivalent performance for the A-only condition. Results: Results revealed that the NZ Ch-BAS test lists were equivalent for both the V-only and AV test conditions when testing NH children. A significant age effect was also found, where older children showed superior speech reading performance in comparison to younger children. A stronger age effect was seen for the V-only condition in comparison to the AV condition. All children performed significantly better on the AV condition in comparison to the V-only condition. Conclusions: The three Ch-BAS test lists demonstrate list equivalency and therefore can be used to develop a reliable test for NZ-English speaking children. As anticipated, there was an age effect in regard to speech reading performance; however this effect was only found for the V-only condition. All children performed significantly better on the AV condition in comparison to the V-only condition. A number of possible explanations for superior performance are provided and clinical uses for the NZ Ch-BAS test are discussed.

Speech perception outcomes for people with a prelingual hearing loss, implanted with a cochlear implant in adolescence or adulthood, are characterized by a large degree of variability. Research findings indicate that some recipients do very well and gain significant open set speech perception skills, whilst a large percentage show little or no change in open set speech results, post implant. In studies to-date, mean speech perception scores were typically substantially poorer than those recorded for implant recipients with a postlingual hearing loss. Despite this, the majority of recipients with a prelingual hearing loss implanted with a cochlear implant in adolescence or adulthood reported satisfaction with their implant and used it regularly. Although there have been a number of studies in the area, none has taken a holistic approach and investigated both objective and subjective outcomes for a large group of participants. In addition, no study has employed a multiple regression analysis to investigate which characteristics were associated with speech perception outcomes in people with a prelingual hearing loss implanted with a cochlear implant in adolescence or adulthood. The objectives of the study were to examine speech perception and other outcomes in people with a bilateral prelingual or perilingual hearing loss, implanted with a cochlear implant as an adolescent or adult, and to investigate prognostic factors associated with positive outcomes. The design consisted of a retrospective review of both speech perception outcomes and other outcomes for 38 recipients, diagnosed with a bilateral hearing loss before age 3, and implanted with a cochlear implant at 14 years or older. There were 24 females and 14 males and the average age at initial stimulation was 33 years. All participants were implanted with a Nucleus device at a private audiology clinic (Attune). Four questionnaires were completed by approximately half of the participants – Glasgow Benefit Inventory (GBI); International Outcome Inventory (IOI-CI); Study Questionnaire; and the Hearing Abilities and Quality of Life Scale. The Study Questionnaire was developed specifically for this project and investigated satisfaction, benefit and advantages/disadvantages of the implant. The Hearing Abilities and Quality of Life Scale was developed by Attune and was completed by recipients pre and post implant. It evaluated the ability to understand conversation in different situations, environmental awareness, safety concerns, involvement in social activities and impact of the hearing loss on relationships. Approximately one third of participants scored between 30 and 90% on the CID/ CUNY test administered via CD post implant and approximately one fifth scored over 90%. The mean score on the CID/CUNY test administered via CD was 8% pre implant and 48% post implant. Over 80% of recipients used their device more than 8 hours a day and all recipients reported being satisfied with it. Three factors accounted for 65% of the variance on the open set sentence test score, post implant. These were stable versus progressive loss, mode of communication in childhood and time without a hearing aid on the implant ear. For the purposes of this research, a ‘stable’ loss was defined as a bilateral severe to profound hearing loss at diagnosis and a ‘progressive’ loss was one that deteriorated to this degree at some point after diagnosis. The findings from this study reveal that a cochlear implant is a viable option for adults and adolescents with a prelingual hearing loss. The majority of participants gained benefit from the device and were satisfied with it. In addition, a substantial number gained good open set speech perception ability, post implant. Consistent with previous studies, there was large intersubject variability in speech scores. The recipients who had a progressive loss, used oral communication in childhood and wore a hearing aid on the implant ear up to the time of surgery were more likely to obtain better speech perception outcomes.

Dissertation (MCommunication Pathology)--University of Pretoria, 2013. / Speech-Language Pathology and Audiology / Unrestricted

O presente estudo teve como objetivo descrever e analisar a visão dos professores de ensino regular a respeito da inclusão da criança deficiente auditiva em classe comum das escolas da rede de ensino estadual, municipal e particular. Participaram, respondendo um questionário, professores de educação infantil e primeiras séries do ensino fundamental (1ª a 4ª série), selecionados aleatoriamente, num total de 196, sendo 73 de rede estadual, 54 da particular e 69 da municipal. Realizou-se intervenção no ensino fundamental buscando a formação de professores e a inclusão escolar da criança deficiente auditiva. Dos 196 (15,4% do universo) professores questionados, 83,16% (163) são a favor da inclusão da criança deficiente auditiva no ensino regular. A maioria, 56,63% (111), é formada em curso superior, sendo 55,85% (62) destes formados em Pedagogia. Dos professores participantes, 81,62% (160) sentem-se despreparados para atuar com criança deficiente auditiva, apesar de 45,91% (90) já terem atuado com as mesmas. Concluiu-se que os cursos de formação de professores não os preparam devidamente, para o exercício do Magistério conforme as exigências impostas pelo movimento de inclusão escolar; mas, mesmo assim a maioria dos professores é a favor da inclusão da criança deficiente auditiva no ensino regular, desde que sejam tomadas providências para sua real efetivação. / The present study aimed at describing and analyzing the viewpoint of the teacher of regular school regarding the inclusion of the hearing impaired child in regular classes of state, municipal and private schools. Teachers from nursery schools and the first years of primary school (1st to 4 th years) were randomly selected to answer to the questionnaire, adding up to 196 teachers, being 73 from state schools, 54 from private schools and 69 from municipal schools. An attempt was made to interfere with primary education, aiming at preparation of the teachers and school inclusion of the hearing impaired child. Among the 196 interviewed teachers (representing 15,4% of the entire population), 83,16% (163) are for the inclusion of the hearing impaired child in regular school. Most teachers, namely 56,63% (111), attended university, and that 55,85% (62) of these have a degree in Pedagogy. A total of 81,62% (160) of the interviewed teachers feel themselves unprepared to deal with a hearing impaired child, even though 45,91 (90) have already worked with them. It was concluded that the courses directed to training of teachers do not provide them proper skills to develop their professorship according to the demands of the school inclusion concept, yet most teachers are in favor of the inclusion of the hearing impaired child in regular school, since proper measures are provided for its actual establishment.

To date the management of state-maintained special schools for children with hearing impairment (SMSSCHI) in Ghana has not been extensively researched. As a result, the way such schools are managed is inadequately understood. This research sought to address that lack of understanding. The aim of the research was to examine the nature of the day-to-day management activities in SMSSCHI to refine our current understanding of such schools. Research questions focused on the nature of the day-to-day management; the organisational challenges; the relationships between the SMSSCHI and stakeholders including, the private sector, parents and the Ghana Education Service (GES); the way educational policies influence the management of SMSSCHI; and the boundary issues in the day-to-day management of SSMCHI in Ghana. The research began with an analysis of the relevant literature. The empirical research was in two phases: Phase 1 involved visits to seven out of the 12 SMSSCHI in Ghana to understand day-to-day management practices. Phase 2 explored the relationships between schools and stakeholders in the day-to-day management of SMSSCHI in three schools. The data were analysed using the planning, organising, staffing, coordinating, reporting, budgeting (POSDCoRB) framework. The key findings were that day-to-day management practices were homogenous across study schools. This homogeneity stemmed from the use of centralized planning emanating from the GES to ensure conformity to set policies. This practice led to a limited adoption of strategic plans to address local needs. Organisational boundary issues emerged as significant in relation to the involvement of stakeholders in school management portrayed by the profound influence of the GES and very minimal involvement of other stakeholders as enshrined in the decentralisation policy of the GES. Societal conceptions of disability and the location of special schools influenced stakeholders' involvement in school management. The implications of the findings for policy and practice are discussed.

Este estudo teve por objetivo avaliar o site Curso de Sistema de Frequência Modulada para Professores, como instrumento de capacitação de professores que tenham em sala de aula alunos com deficiência auditiva usuários de Aparelho de Amplificação Sonora Individual (AASI) e/ou Implante Coclear (IC) acoplados ao Sistema de Frequência Modulada (FM). O site foi avaliado por professores da Rede Estadual e Privada da cidade de Bauru e também por professores do Colégio do Serviço Social da Indústria (SESI), quanto aos aspectos de qualidade técnica e de conteúdo. Participaram, no total, 65 professores com idade média de 40 anos e todos com curso superior em sua formação. Os professores após navegarem no site preencheram anonimamente um questionário online disponível no site com questões sobre dados demográficos, conhecimento do professor sobre o seu aluno, formação complementar e uso da internet. Também responderam às questões sobre a qualidade técnica do site por meio do questionário Emory, que compreende as subescalas precisão, autores, atualizações, público, navegação, links e estrutura e conteúdo do site. Os professores não manifestaram dificuldades para responder ao questionário, tendo como média de preenchimento do questionário 33 minutos e 14 segundos. Os mesmos também demonstraram não ter experiência com as questões da deficiência auditiva de um modo geral (perda auditiva, localização, grau da perda, acústica em sala, uso do sistema de FM, dentre outras). Foi possível verificar que 53,84% dos professores utilizam a internet frequentemente. O site obteve como pontuação geral 87,64% no questionário Emory, considerado como sendo adequado. No estudo das subescalas isoladamente foi verificado que os aspectos \"conteúdo\", \"autores\", \"atualizações\", \"público\" e \"links\" relacionados ao questionário Emory tiveram pontuação como sendo excelente (acima de 90%). As subescalas \"navegação\" e \"estrutura\" foram classificadas como sendo adequadas (pontuação 76,53% e 78,84%, respectivamente). O aspecto \"precisão\" do site obteve a pontuação de 68,2%, revelando necessidade de revisão. Os professores avaliaram o seu conhecimento prévio antes de navegar no conteúdo do site como sendo ruim e satisfeito e após navegarem no site eles avaliaram que o site ajudou muito e também estavam muito satisfeitos com o conteúdo. O site foi considerado pelos participantes como sendo uma ferramenta importante para ajudá-los no dia a dia com o aluno com a deficiência auditiva. / This study aimed to evaluate the site \"Course Frequency Modulation System for Teachers \", as a tool for teachers who have students in the classroom for hearing -impaired users Individual hearing aids (HA) and cochlear implants (CI) coupled to the Frequency Modulation (FM) System. The site was evaluated by teachers of state and private systems of Bauru city and also by teachers of the Colégio do Serviço Social da Indústria (SESI), on the aspects of technical quality and content. A total of 65 teachers, whose average age was 40 years old and all of them were college graduated, participated in the evaluation. After navigating the site, anonymously filled an online questionnaire about demographic data, teacher´s knowledge about his/her student, complementary training and internet usage. They also answered the questions about technical quality of the site through the questionnaire Emory, which includes the subscales accuracy, authors, updates, public, navigation, links and the site structure and content. The teachers did not have problems to answer the questionnaire, and the average time of filling it was 33 minutes and 14 seconds. They also demonstrated to have no experience with hearing impairment questions in general (hearing loss, location, hearing loss degree, classroom acoustics, usage of FM System, and others). It was possible to verify that 53,84% of teachers use the internet frequently. The site obtained as 87,64% general score on the questionnaire Emory, considered to be appropriate. Analyzing the subscales separately, the aspect \"content\", \"author\", \"update\", \"public\" and \"links\" related to the questionnaire Emory scored as excellent (above 90%). The subscales \"navigation\" and \"structure\" were classified appropriate (score 76.53% and 78.84%, respectively). The aspect of \"accuracy\" of the site received a score of 68.2%, revealing a need for review. Before navigating the site content, teachers rated their previous knowledge as \"poor\" and \"satisfied\"; after navigating the site, they assessed the site \"helped a lot\" and \"helped\", and they were very satisfied about the content. The site was considered by the participants as an important tool to help them in day-to-day to work with hearing-impaired students.