hearing

听证
  • 文章类型: Journal Article
    目的:从随机对照试验(RCT)中评估氧氟沙星滴耳液与不干预治疗外伤性鼓膜(TM)穿孔的有效性。数据来源:Medline/PubMed,中部,临床试验。政府,谷歌学者。研究选择:纳入标准:(1)英语;(2)RCT研究;(3)报告了氧氟沙星应用的结果和自发愈合的结果。排除标准:(1)没有对照组的研究;(2)患有严重耳科疾病的患者,如慢性化脓性中耳炎或听骨破裂或颅脑损伤的患者;(3)没有治疗前价值的研究或单臂临床研究。数据提取:国家/地区,出版年份,每个手臂的参与者数量,患者特征,如年龄,性别,干预细节,偏侧性,TM穿孔的原因,穿孔位置,随访时间,听力增益,TM闭合率,和关闭时间。结果:共分析6项RCTs研究。共有502名参与者被纳入;氧氟沙星治疗的闭合率的相对风险为1.18[95%置信区间(CI),1.08至1.28,P<.001],愈合时间的平均差异(MD)为-18.4(95%CI,-19.96至-16.82,P<.001),表明氧氟沙星对TM穿孔的闭合有显着影响。然而,氧氟沙星组的听力无临床显著影响(SMD:0.21,95%CI,0.02~0.40,P=.03).此外,氧氟沙星组患者与观察组患者相比感染风险降低13%,但这一估计没有统计学意义。结论:氧氟沙星用于外伤性TM穿孔患者可有效缩短愈合时间,提高TM穿孔闭合率。当向患有创伤性TM穿孔的患者开具氧氟沙星时,没有证据表明听力损失或感染率增加。
    Objectives: To evaluate the effectiveness of ofloxacin ear drops versus no intervention in the repair of traumatic tympanic membrane (TM) perforations from randomized controlled trials (RCTs). Data Sources: Medline/PubMed, CENTRAL, Clinical Trials.Gov, and Google Scholar. Study Selection: Inclusion criteria: (1) English language; (2) RCT studies; (3) reported the outcomes on the application of ofloxacin and outcomes of spontaneous healing. Exclusion criteria: (1) studies without a control group; (2) patient with severe otologic disease such as chronic suppurative otitis media or ossicular disruption or patients with craniocerebral injury; (3) studies with no pretreatment values or single-arm clinical studies. Data Extraction: Country, year of publication, number of participants in each arm, patient characteristics such as age, sex, intervention details, laterality, cause of TM perforation, position of perforation, follow-up time, hearing gain, rate of TM closure, and closure time. Results: A total of 6 RCTs studies were analyzed. A total of 502 participants were included; the relative risk for closure rate of ofloxacin treatment was 1.18 [95% confidence interval (CI), 1.08 to 1.28, P < .001] and the mean difference (MD) for healing time was -18.4 (95% CI, -19.96 to -16.82, P < .001), suggesting ofloxacin has a significant effect on closure of TM perforations. However, no clinically significant effect in hearing (SMD: 0.21, 95% CI, 0.02 to 0.40, P = .03) was seen in ofloxacin group. Also, patients in the ofloxacin group were associated with a 13% reduction in the risk of infections compared to their observation-assigned counterparts, but this estimate was not statistically significant. Conclusion: Ofloxacin use in patients with traumatic TM perforation is effective in reducing healing time and increasing rate of TM perforation closure. No evidence of increased risk of hearing loss or infection rates are encountered when ofloxacin is prescribed to patients with traumatic TM perforation.
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  • 文章类型: Journal Article
    在使用洗脱电极的人类和动物中植入耳蜗后,建立听力学和其他结果。
    系统回顾和叙事综合。搜索的数据库(2023年4月):MEDLINE,EMBASE,中部,ClinicalTrials.gov,和WebofScience。包括报告使用药物洗脱电极植入人工耳蜗后人类或动物结果的研究。对语言或出版年份没有限制。使用Brazzelli或实验室动物实验系统审查中心(SYRCLE)评估工具对所有纳入研究进行偏倚风险评估。审查是根据2020年系统审查和荟萃分析(PRISMA)声明的首选报告项目进行的。
    搜索确定了146篇摘要和108篇全文。其中,18项研究符合纳入标准,报告523只动物(17项研究)和24人(1项研究)的结果。洗脱电极包括地塞米松(16项研究),阿拉克辛(1项研究),烟酰胺腺嘌呤二核苷酸(1项研究),生长因子胰岛素样生长因子1(IGF1)和肝细胞生长因子(HGF)(1项研究),和神经营养蛋白-3(1项研究)。所有纳入的研究比较了洗脱电极和对照非洗脱电极植入后的结果。在大多数研究中,听力学结果(例如,与标准电极相比,植入洗脱电极后听觉脑干反应阈值)更好。大多数研究植入后阻抗的研究报告在用洗脱电极植入后阻抗较低。在纳入的研究中,洗脱电极对其他报告结果(包括植入后耳蜗纤维化以及毛细胞和螺旋神经节神经元的存活)的影响差异更大。
    洗脱电极在动物研究中显示出在保留人工耳蜗植入后的残余听力和降低阻抗方面的前景。尽管人类研究的数据仍然缺乏。将需要进一步的人体研究来确定药物洗脱耳蜗植入物作为未来治疗感音神经性听力损失的临床实用性。
    UNASSIGNED: To establish audiological and other outcomes following cochlear implantation in humans and animals with eluting electrodes.
    UNASSIGNED: Systematic review and narrative synthesis. Databases searched (April 2023): MEDLINE, EMBASE, CENTRAL, ClinicalTrials.gov, and Web of Science. Studies reporting outcomes in either humans or animals following cochlear implantation with a drug-eluting electrode were included. No limits were placed on language or year of publication. Risk of bias assessment was performed on all included studies using either the Brazzelli or Systematic Review Centre for Laboratory animal Experimentation (SYRCLE) assessment tools. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement.
    UNASSIGNED: Searches identified 146 abstracts and 108 full texts. Of these, 18 studies met the inclusion criteria, reporting outcomes in 523 animals (17 studies) and 24 humans (1 study). Eluting electrodes included dexamethasone (16 studies), aracytine (1 study), nicotinamide adenine dinucleotide (1 study), the growth factors insulin-like growth factor 1 (IGF1) and hepatocyte growth factor (HGF) (1 study), and neurotrophin-3 (1 study). All included studies compare outcomes following implantation with an eluting electrode with a control non-eluting electrode. In the majority of studies, audiological outcomes (e.g., auditory brainstem response threshold) were superior following implantation with an eluting electrode compared with a standard electrode. Most studies which investigated post-implantation impedance reported lower impedance following implantation with an eluting electrode. The influence of eluting electrodes on other reported outcomes (including post-implantation cochlear fibrosis and the survival of hair cells and spiral ganglion neurons) was more varied across the included studies.
    UNASSIGNED: Eluting electrodes have shown promise in animal studies in preserving residual hearing following cochlear implantation and in reducing impedance, though data from human studies remain lacking. Further in-human studies will be required to determine the clinical usefulness of drug-eluting cochlear implants as a future treatment for sensorineural hearing loss.
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  • 文章类型: Systematic Review
    目的:分析听觉刺激对听力正常和听力损失健康个体心率变异性(HRV)指数的影响,无论类型和/或等级,通过系统审查。
    方法:这是一项具有荟萃分析的系统评价,旨在解决以下问题:在听力正常和/或听力损失的健康个体中,与沉默相比,听觉刺激对HRV指数的影响是什么?我们咨询了Cochrane图书馆,Embase,LILACS,PubMed,WebofScience,和Scopus数据库和灰色文献(谷歌学者,OpenGrey,和ProQuest)。
    方法:对于发表的时间或语言没有限制。
    方法:我们确定了451条记录,灰色文献中的另外261个,以及通过参考文献搜索的五项研究,共产生717条记录,有171条重复的记录。在筛选了546项研究的标题和摘要后,我们排除了490项研究,并对56项研究进行了全面评估.
    结果:其中9项研究纳入了系统评价,其中8个适用于荟萃分析。
    结论:建议听觉刺激可能会影响RMSSD,pNN50,SDNN,听力正常的健康成人HRV的RRTri和SD2指数。
    OBJECTIVE: To analyze the effects of auditory stimulation on heart rate variability (HRV) indices in healthy individuals with normal hearing and with hearing loss, regardless of type and/or grade, by means of a systematic review.
    METHODS: This is a systematic review with a meta-analysis that addresses the following question: in healthy individuals with normal hearing and/or with hearing loss, what are the effects of auditory stimulation on HRV indices in comparison to silence? We consulted the Cochrane Library, Embase, LILACS, PubMed, Web of Science, and Scopus databases and the gray literature (Google Scholar, OpenGrey, and ProQuest).
    METHODS: There were no restrictions as to period or language of publication.
    METHODS: We identified 451 records, an additional 261 in the gray literature, and five studies in a search through the references, resulting in a total of 717 records, with 171 duplicate records. After screening the titles and abstracts of 546 studies, we excluded 490 and considered 56 studies in full to assess their eligibility.
    RESULTS: Nine of these studies were included in the systematic review, eight of which were suitable for the meta-analysis.
    CONCLUSIONS: It is suggested that auditory stimulation may influence the RMSSD, pNN50, SDNN, RRTri and SD2 indices of HRV in healthy adults with normal hearing.
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  • 文章类型: Systematic Review
    耳聋对视觉注意力的影响在先前的研究中已经被广泛讨论。人们注意到,以前研究的不足和优势可以归因于注意力的时间或空间方面,以及发展和临床特征的变化。视觉注意力分为三个网络:定向(外源和内源),警报(阶段性和补品),和执行控制。这项研究旨在提供支持这一假设的新神经科学证据。本文对过去15年中有关聋人视觉注意力的国际文献进行了系统的回顾。最终审查包括24篇文章。发现定向网络的功能在聋人和儿童中得到增强,主要在没有人工耳蜗的原生签名者中观察到,虽然内源性定向仅在儿童的凝视线索中观察到,在成年人中没有发现差异。有关警报和执行功能的结果取决于所使用的临床特征和范例。讨论了对聋人视觉注意的未来研究的意义。
    The impact of deafness on visual attention has been widely discussed in previous research. It has been noted that deficiencies and strengths of previous research can be attributed to temporal or spatial aspects of attention, as well as variations in development and clinical characteristics. Visual attention is categorized into three networks: orienting (exogenous and endogenous), alerting (phasic and tonic), and executive control. This study aims to contribute new neuroscientific evidence supporting this hypothesis. This paper presents a systematic review of the international literature from the past 15 years focused on visual attention in the deaf population. The final review included 24 articles. The function of the orienting network is found to be enhanced in deaf adults and children, primarily observed in native signers without cochlear implants, while endogenous orienting is observed only in the context of gaze cues in children, with no differences found in adults. Results regarding alerting and executive function vary depending on clinical characteristics and paradigms used. Implications for future research on visual attention in the deaf population are discussed.
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  • 文章类型: Journal Article
    背景:冈比亚按蚊复合体的蚊子是撒哈拉以南非洲疟疾的主要传播媒介之一。它们传播这种具有重大公共卫生重要性的疾病的能力取决于它们的丰度,咬人行为,易感性和它们存活足够长的能力来传播疟疾寄生虫。可以利用对这种行为的更深入了解来改善病媒监测和疟疾控制。
    结果:成年蚊子在黄昏时从水生栖息地出现。经过24小时的长期,角质层变硬,成年人成熟,它们可能会随机散开,迎风寻找伴侣或觅食。交配通常发生在黄昏时,成群形成于特定物种的“标记”上。营养充足的雌性可能在喂血之前交配,但营养不良的昆虫则相反。雌性是一夫一妻制,雄性只交配一次,只吃花蜜,每晚蜂拥而至,可能会交配四次。雌性能够通过遵循其二氧化碳和气味梯度来定位宿主。当靠近主机时,视觉线索,还使用温度和相对湿度。大多数血液喂养发生在晚上,室内,蚊子主要通过屋顶和墙壁之间的缝隙进入房屋。除了第一个饲料,雌性在性腺上是一致的,血粉会产生完整的卵。鸡蛋发育需要两到三天,取决于温度。重力雌性在黄昏时离开它们的休息场所。它们被水梯度和挥发性化学物质所吸引,这些化学物质为产卵提供了合适的水生栖息地。
    结论:虽然传统干预措施,使用杀虫剂,瞄准室内蚊子,可以在户外使用空间驱虫剂来实现额外的保护,引诱剂陷阱或房屋改造,以防止蚊子进入。关于物种特定行为变异性的未来研究,蚊子在整个景观中移动,光和视觉的重要性,基因流动的生殖障碍,雄性蚊子的行为和蚊子行为的进化变化可能会导致疟疾监测的改善和更好的控制方法,从而减少目前对室内使用杀虫剂的过度依赖。
    BACKGROUND: Mosquitoes of the Anopheles gambiae complex are one of the major vectors of malaria in sub-Saharan Africa. Their ability to transmit this disease of major public health importance is dependent on their abundance, biting behaviour, susceptibility and their ability to survive long enough to transmit malaria parasites. A deeper understanding of this behaviour can be exploited for improving vector surveillance and malaria control.
    RESULTS: Adult mosquitoes emerge from aquatic habitats at dusk. After a 24 h teneral period, in which the cuticle hardens and the adult matures, they may disperse at random and search upwind for a mate or to feed. Mating generally takes place at dusk in swarms that form over species-specific \'markers\'. Well-nourished females may mate before blood-feeding, but the reverse is true for poorly-nourished insects. Females are monogamous and only mate once whilst males, that only feed on nectar, swarm nightly and can potentially mate up to four times. Females are able to locate hosts by following their carbon dioxide and odour gradients. When in close proximity to the host, visual cues, temperature and relative humidity are also used. Most blood-feeding occurs at night, indoors, with mosquitoes entering houses mainly through gaps between the roof and the walls. With the exception of the first feed, females are gonotrophically concordant and a blood meal gives rise to a complete egg batch. Egg development takes two or three days depending on temperature. Gravid females leave their resting sites at dusk. They are attracted by water gradients and volatile chemicals that provide a suitable aquatic habitat in which to lay their eggs.
    CONCLUSIONS: Whilst traditional interventions, using insecticides, target mosquitoes indoors, additional protection can be achieved using spatial repellents outdoors, attractant traps or house modifications to prevent mosquito entry. Future research on the variability of species-specific behaviour, movement of mosquitoes across the landscape, the importance of light and vision, reproductive barriers to gene flow, male mosquito behaviour and evolutionary changes in mosquito behaviour could lead to an improvement in malaria surveillance and better methods of control reducing the current over-reliance on the indoor application of insecticides.
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  • 文章类型: Journal Article
    目的:这项研究的目的是全面回顾动物和人类研究,这些研究探索了omega-3PUFA在维持所有生命阶段听觉器官健康中的作用。
    方法:这篇叙述性综述涉及搜索Scopus,PubMed,谷歌学者,和Cochrane图书馆数据库提供1980年12月至2023年7月的相关文章。
    结果:一些动物和人类研究表明,缺乏和过量摄入长链omega-3PUFA,特别是二十二碳六烯酸(DHA),从胎儿发育到老年(老年性耳聋)可导致听觉神经传导障碍和听力下降。这些效果可能取决于剂量。一些研究表明,过量摄入欧米茄-3,而不是缺乏,会导致营养毒性和听力障碍。动物研究强调了高DHA含量的omega-3补充剂在解决听力损伤方面的积极影响。但是人类对这个问题的研究是有限的。此外,某些研究表明,omega-3PUFA可以预防或延迟与年龄相关的听力损失,血浆omega-3浓度高,特别是长链omega-3PUFA,与听力损失减少有关。此外,每周吃两次以上的鱼可能与成年后听力损失的风险较低有关。这些影响可能受年龄和性别的影响。然而,大多数研究都是在动物身上进行的,临床试验很少。关于ω-3PUFA对外周和中央前庭系统的影响的研究仍然有限。
    结论:本文探讨了ω-3对听觉前庭系统的影响,探索其对神经发育的影响,保护,和治疗。它不仅突出了具体的研究差距,而且为潜在的未来研究提供了有价值的见解。
    OBJECTIVE: The purpose of this study was to comprehensively review animal and human studies that explore the role of omega-3 PUFAs in maintaining the health of the auditory organ across all life stages.
    METHODS: This narrative review involved searching Scopus, PubMed, Google Scholar, and Cochrane Library databases for relevant articles from December 1980 to July 2023.
    RESULTS: some animal and human studies suggest that both deficiency and excessive intake of long-chain omega-3 PUFAs, particularly docosahexaenoic acid (DHA), can lead to auditory neural conduction impairment and reduced hearing acuity from fetal development to old age (presbycusis). These effects are likely to be dependent on the dosage. Some research indicates that an excessive intake of omega-3, rather than a deficiency, can result in nutritional toxicity and hearing impairments. Animal studies highlight the positive impact of omega-3 supplements with high DHA content in addressing hearing damage, but human research on this subject is limited. Furthermore, certain studies propose that omega-3 PUFAs may prevent or delay age-related hearing loss, with high plasma omega-3 concentration, particularly long-chain omega-3 PUFA, linked to reduced hearing loss. Additionally, consuming fish more than twice a week may be associated with a lower risk of hearing loss in adulthood, with these effects potentially influenced by age and gender. However, the majority of studies have been conducted on animals, and clinical trials are scarce. Research on the influence of omega-3 PUFAs on the peripheral and central vestibular systems remains limited.
    CONCLUSIONS: This article delves into the impact of omega-3 on the auditory-vestibular system, exploring its influence on neurodevelopment, protection, and treatment. It not only highlights specific research gaps but also offers valuable insights for potential future studies.
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  • 文章类型: Journal Article
    背景:前庭神经鞘瘤(VS)是由前庭神经的雪旺细胞引起的良性肿瘤。手术切除通过乙状窦后(RS)或中窝(MF)是标准的,但最佳方法仍存在争议。这项荟萃分析评估了RS和MF方法的VS管理,强调听力保留和颅神经七(CNVII)结局按肿瘤大小分层。
    方法:整个PubMed的系统搜索,科克伦,WebofScience,Embase确定了相关研究。听力和CNVII结果使用美国耳鼻咽喉头颈外科学会进行测量。加德纳·罗伯逊,和House-Brackmann得分.
    结果:在7228名患者中,56%接受RS和44%MF。对于囊内肿瘤,MF记录了38%的听力损失,与RS的54%相比。在小肿瘤(<1.5厘米),MF显示41%的听力损失,相比之下,RS较低15%。中型肿瘤(1.5cm-2.9cm)在MF中显示68%的听力损失,在RS中显示55%的听力损失。仅在RS中报告了大肿瘤(>3cm),听力损失率为62%。
    结论:最后,而MF可能更适合于小管内肿瘤,RS对中小型肿瘤表现出优异的听力保护。这项研究强调了肿瘤大小分层结果的重要性,指导手术决策并提高患者预后。
    BACKGROUND: Vestibular schwannomas (VS) are benign tumors arising from vestibular nerve\'s Schwann cells. Surgical resection via retrosigmoid (RS) or middle fossa (MF) is standard, but the optimal approach remains debated. This meta-analysis evaluated RS and MF approaches for VS management, emphasizing hearing preservation and Cranial nerve seven (CN VII) outcomes stratified by tumor size.
    METHODS: Systematic searches across PubMed, Cochrane, Web of Science, and Embase identified relevant studies. Hearing and CN VII outcomes were gauged using the American Academy of Otolaryngology-Head and Neck Surgery, Gardner Robertson, and House-Brackmann scores.
    RESULTS: Among 7228 patients, 56 % underwent RS and 44 % MF. For intracanalicular tumors, MF recorded 38 % hearing loss, compared to RS\'s 54 %. In small tumors (<1.5 cm), MF showed 41 % hearing loss, contrasting RS\'s lower 15 %. Medium-sized tumors (1.5 cm-2.9 cm) revealed 68 % hearing loss in MF and 55 % in RS. Large tumors (>3cm) were only reported in RS with a hearing loss rate of 62 %.
    CONCLUSIONS: Conclusively, while MF may be preferable for intracanalicular tumors, RS demonstrated superior hearing preservation for small to medium-sized tumors. This research underlines the significance of stratified outcomes by tumor size, guiding surgical decisions and enhancing patient outcomes.
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  • 文章类型: Journal Article
    双侧人工耳蜗(BiCIs)可带来多种益处,包括改善噪声和声源定位中的语音理解。然而,双侧植入物在接受者之间提供的益处因个体而异。在这里,我们考虑这种可变性的原因之一:两只耳朵之间的听力功能差异,也就是说,耳间不对称。到目前为止,在各种研究领域中,对耳间不对称的调查已经高度专业化。这篇综述的目的是将这些研究整合在一个地方,激励未来在耳间不对称领域的研究。我们首先考虑自下而上的处理,其中双耳提示使用来自左耳和右耳的信号的激励-抑制来表示,随着声音在空间中的位置而变化,以听觉脑干的外侧上橄榄为代表。然后我们考虑通过预测编码进行自上而下的处理,假设感知源于基于上下文和先前感官经验的期望,以级联系列皮层电路为代表。一个内部的,感知模型根据传入的感官输入进行维护和更新。一起,我们希望这种生理的融合,行为,和建模研究将有助于弥合双耳听力领域的差距,并促进对耳间不对称对未来最佳患者干预研究的影响的更清晰的理解。
    Bilateral cochlear implants (BiCIs) result in several benefits, including improvements in speech understanding in noise and sound source localization. However, the benefit bilateral implants provide among recipients varies considerably across individuals. Here we consider one of the reasons for this variability: difference in hearing function between the two ears, that is, interaural asymmetry. Thus far, investigations of interaural asymmetry have been highly specialized within various research areas. The goal of this review is to integrate these studies in one place, motivating future research in the area of interaural asymmetry. We first consider bottom-up processing, where binaural cues are represented using excitation-inhibition of signals from the left ear and right ear, varying with the location of the sound in space, and represented by the lateral superior olive in the auditory brainstem. We then consider top-down processing via predictive coding, which assumes that perception stems from expectations based on context and prior sensory experience, represented by cascading series of cortical circuits. An internal, perceptual model is maintained and updated in light of incoming sensory input. Together, we hope that this amalgamation of physiological, behavioral, and modeling studies will help bridge gaps in the field of binaural hearing and promote a clearer understanding of the implications of interaural asymmetry for future research on optimal patient interventions.
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  • 文章类型: Review
    听力损失影响着全球16亿人,尤其影响着低收入和中等收入国家的人。尽管在很大程度上是可以预防或治疗的,耳朵和听力条件导致严重的和终身的发病率,如延迟的语言发展,教育程度降低,减少社会福祉。有必要加强预防,早期识别,治疗,以及这些条件的康复。扩大了听力筛查的机会,听力健康劳动力的增长,耳朵和听力护理系统的创新是需要的变化之一。为此,世界卫生组织已将耳部和听力保健列为全民健康覆盖的优先事项,和最近的出版物提出了耳朵和听力护理的优先事项。世界各地的国家一级正在努力,赞比亚和尼日利亚等国已将耳部和听力保健纳入国家卫生战略。虽然在改善获取方面取得了重大进展,仍然迫切需要更多的研究,倡导,和干预,以确保没有人在实现普遍获得耳朵和听力保健的目标上落在后面。
    Hearing loss affects 1.6 billion people worldwide and disproportionately affects those in low- and middle-income countries. Despite being largely preventable or treatable, ear and hearing conditions result in significant and lifelong morbidity such as delayed language development, reduced educational attainment, and diminished social well-being. There is a need to augment prevention, early identification, treatment, and rehabilitation for these conditions. Expanded access to hearing screening, growth of the hearing health workforce, and innovations in ear and hearing care delivery systems are among the changes that are needed. To that end, the World Health Organization has prioritized ear and hearing care as a component of Universal Health Coverage, and recent publications have advanced the priority for ear and hearing care. Efforts are underway at the national levels around the world, as evidenced by countries like Zambia and Nigeria that have integrated ear and hearing care within national health strategies. While significant strides have been made in improving access, a critical need remains for additional research, advocacy, and intervention to ensure that no one is left behind in the goal to achieve universal access to ear and hearing care.
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  • 文章类型: Systematic Review
    背景:早期发现长期,通常无症状,在初级卫生保健中常规进行耳部健康和听力检查时,年轻土著和托雷斯海峡岛民儿童中耳感染的可能性更大.证据一致表明,这种情况对儿童及其家庭的发展和福祉产生不利影响。我们的目标是开发可行的,基于证据和共识的初级医疗保健建议,涉及6岁以下原住民和托雷斯海峡岛民儿童的耳朵健康和听力检查的组成部分和时机,还不知道有,也没有积极管理,耳朵和听力问题。
    方法:由土著和托雷斯海峡岛民以及来自初级卫生保健的非土著成员组成的22人工作组,耳朵,听力,研究部门为该项目提供了指导。一项系统的范围审查研究了与原住民和托雷斯海峡岛民以及其他持续存在耳朵健康问题风险增加的人群的初级健康耳朵健康和听力检查有关的研究问题。确定并审查了1998年至2020年之间发表的12项主要研究和11项指南。完成了研究和指南的证据质量和确定性以及偏倚风险评级。在缺乏某些直接证据的情况下,使用修改后的e-Delphi程序,向79名成员的专家小组提交了研究结果和建议草案,以获得共识意见.建议是在与工作组成员协商后最后确定的,并提交给专家小组成员,以就与执行有关的考虑提出意见。
    结果:总体而言,质量,确定性,在所审查的研究和指南中,证据的直接性很低.然而,调查结果为建立共识过程中提出的建议草案提供了基础和结构。经过两次E-Delphi测试,针对初级卫生保健中针对年轻土著和托雷斯海峡岛民儿童的耳朵健康和听力检查的组成部分和时间制定了7项目标和8项建议。
    结论:系统范围审查和建立共识过程为在合理的短时间内提出强有力的建议提供了一种务实的方法,尽管证据的质量和确定性都很低,以及缺乏与初级医疗保健环境有关的研究。
    BACKGROUND: Early detection of long-term, often asymptomatic, middle ear infection in young Aboriginal and Torres Strait Islander children is more likely to be achieved when ear health and hearing checks are routinely undertaken in primary healthcare. Evidence consistently demonstrates the adverse impacts of this condition on the development and wellbeing of children and their families. We aimed to develop feasible, evidence- and consensus-based primary healthcare recommendations addressing the components and timing of ear health and hearing checks for Aboriginal and Torres Strait Islander children aged under 6 years, not already known to have, nor being actively managed for, ear and hearing problems.
    METHODS: A 22-person working group comprising Aboriginal and Torres Strait Islander and non-Indigenous members from the primary healthcare, ear, hearing, and research sectors provided guidance of the project. A systematic scoping review addressed research questions relating to primary health ear health and hearing checks for Aboriginal and Torres Strait Islander and other populations at increased risk of persistent ear health problems. Twelve primary studies and eleven guidelines published between 1998 and 2020 were identified and reviewed. Quality and certainty of evidence and risk of bias ratings were completed for studies and guidelines. In the absence of certain and direct evidence, findings and draft recommendations were presented for consensus input to a 79-member expert panel using a modified e-Delphi process. Recommendations were finalised in consultation with working group members and presented to expert panel members for input on considerations relating to implementation.
    RESULTS: Overall, the quality, certainty, and directness of evidence in the studies and guidelines reviewed was low. However, the findings provided a basis and structure for the draft recommendations presented during the consensus-building process. After two e-Delphi rounds, seven goals and eight recommendations on the components and timing of Ear Health and Hearing Checks in primary healthcare for young Aboriginal and Torres Strait Islander children were developed.
    CONCLUSIONS: The systematic scoping review and consensus-building process provided a pragmatic approach for producing strong recommendations within a reasonably short timeframe, despite the low quality and certainty of evidence, and paucity of studies pertaining to primary healthcare settings.
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