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Hearing Preservation CI Surgery and Hybrid Hearing : From Anatomical Aspects to Patient SatisfactionErixon, Elsa January 2014 (has links)
A common cause of profound deafness is hair cell dysfunction in the cochlea. Cochlear implants (CI) bypass the hair cells via an electrode and stimulate the cochlear nerve directly. Nowadays, it is possible to preserve residual hair cell function and hearing through flexible electrodes and a-traumatic CI surgery techniques; called hearing preservation CI surgery. This may suit partially deaf patients who can use natural low frequency hearing in combination with electric high frequency hearing; so-called hybrid hearing. The aim of this thesis was to elucidate the effectiveness of hearing preservation CI surgery. The thesis demonstrates human cochlear anatomy in relation to CI and evaluates hearing and patient satisfaction after hearing preservation CI surgery. Analyses of human cochlear moulds belonging to the Uppsala collection showed large variations in dimensions and coiling characteristics of the cochlea. Each cochlea was individually shaped. The size and shape of the cochlea influences the position of the electrode. The diameter of the basal cochlear turn could predict insertion depth of the electrode, which is crucial for hearing preservation. The first 21 patients operated with hearing preservation CI surgery in Uppsala, showed preserved hearing. Nine-teen partially deaf patients receiving implants intended for hybrid hearing, were evaluated concerning pure tone audiometry, monosyllables (MS) and hearing in noise test (HINT). They also responded to a questionnaire, consisting of the IOI-HA, EQ-5D VAS and nine questions about residual hearing. The questionnaire results indicated a high degree of patient satisfaction with improved speech perception in silence and noise. This was also reflected by improved results in MS and HINT. Hearing was preserved in all patients, but there was an on-going deterioration of the residual hearing in the operated ear which surpassed the contralateral ear. There were no correlations between the amount of residual hearing and patient satisfaction or speech perception results. Electric stimulation provides a major contribution to speech comprehension in partially deaf patients. All the patients showed a high degree of satisfaction with their CI, regardless of varying hearing preservation.
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Hidden In Plain Sight: Development And Testing Of A Model To Evaluate Political Leadership TacticsCitron, Albert 01 January 2013 (has links)
This thesis analyzes the kinds of verbal and nonverbal signals elites manifest to show leadership qualities. Launching from Max Weber’s conceptual framework of charisma as a power term and Harold Lasswell’s study of propaganda, this study takes a multidisciplinary approach to studying political leadership with elements of communication methodology and an ontological basis in evolutionary psychology. The study’s goal is to offer a framework for defining and evaluating the diverse signal patterns employed by political elites in three real-life situations. These are the Malta Summit, the 1992 Virginia Presidential Debate, and the 2012 South Carolina Republican Presidential Primary. The cases were chosen because they display a diverse set of signal variations during different types of interactions. The three case studies are evaluated by measuring frequency and patterns of occurrence of the five different interaction constructs (indicator of interest, indicator of disinterest, demonstration of high value, demonstration of low value, and compliance testing) to explain different interaction patterns. A simple frequency distribution of the different signals during a given interaction is used to display the empirical findings and to compare patterns across the case studies. This study reveals that the presence of DLV (demonstration of low value) signals weaken an elite’s position in relation to other elites and the public while the presence of DHV (demonstration of high value) signals strengthen an elite’s position. It is largely the presence, absence, and frequency of these two signals that determines who conveys leadership qualities effectively regardless of leadership style. Studying the signaling patterns of political elites would allow scholars to understand better the kinds of signal patterns and signal frequencies that are used in different types of leadership styles and norm ranges for signals including for political elites belonging to different cultures and subcultures
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