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Biomedical subjects

A Parving

Publications and source records attributed to A Parving.

At least 37 records · Page 2Linked to original sources
PubMed1997

Profound permanent hearing impairment in childhood: causative factors in two European countries.

A collaboration between Denmark and Wales was established in order to evaluate any differences between countries in factors causing permanent childhood hearing impairment (PCHI). Two identical 6-year birth-cohorts from 1975-1980 suffering from a permanent hearing loss > or = 90 dB HL in the better hearing ear, averaged across 0.5-4 kHz (BEHL), were included in the analysis. The overall estimated prevalence of children with this loss was 0.41/live births in Wales (n = 59). In Denmark the overall prevalence was 0.45/1,000 live births (n = 34), there being no significant differences in prevalence between the two countries. Both cohorts were subjected to a multidisciplinary investigation protocol. No significant differences were found between countries in the proportion of hearing impairment caused by the various factors, when based on uniform criteria and identical birth-cohorts. The proportion of inherited hearing loss is 47-50% in the two countries. Within inheritance the proportion of non-syndromal/syndromal inheritance differs slightly, as non-syndromal inheritance comprises 50% in Wales, and 76% in Denmark. The reported proportion of 16-34% of unknown factors causing profound PCHI emphasises the need for appropriate protocols for aetiological evaluation.

Child↗
PubMed1997

Hearing instruments and health technology--an evaluation.

This contribution compares a currently worn hearing instrument (i.e. R-HI) with a programmable multiband full-dynamic range compression behind-the-ear HI (i.e. T-HI), based on subject preference for HI, and, in addition, compares the preference for a linear/ non-linear amplification-mode (i.e. L-mode/C-mode). Finally, it evaluates some health technology aspects related to the devices. N = 34 experienced HI-users at a median age of 72 years (range 22-84) completed the trial, n = 5 being monaurally, and n = 29 being binaurally fitted. The trial comprises an unblinded comparative study of the R-HI and T-HI, in either C-mode or L-mode amplification, and a double-blind crossover study evaluating the C-mode versus the L-mode amplification. The results of the unblinded study showed that 94% (n = 32/34) preferred the T-HI, whereas two subjects preferred their current HI. The double-blind crossover study concerning the preference for the C-mode and L-mode, respectively, in the T-HI, showed that 72% (n = 23/32) had a significant preference for the non-linear amplification, whereas 28% (n = 9/32) preferred the linear amplification. Provided that the price of the T-HI is kept unchanged, a health technology evaluation may imply an estimate of 30 mill. DKR added costs on a national basis, which should be taken into account within the national hearing services.

Adult↗
PubMed1997

The Valby Project: a survey of hearing in the elderly > or = 80 years of age not provided with hearing aids.

This contribution forms part of an epidemiological study of hearing in the elderly > or = 80 years of age, living in an urban area. The study concentrates on the prevalence of self-reported hearing problems in a sample of subjects not provided with hearing aids (HAs), hearing level, and knowledge of and attitudes to HAs. Among the total population of 2915 > or = 80 years of age, an age- and sex-matched sample of 565 subjects was invited to attend an extensive audiological evaluation, including a questionnaire, giving information on knowledge about and attitudes to HAs. Forty-one percent (n = 231) attended, and dividing the attenders into 5 or 10 year age bands showed that the better and worse ear hearing levels, averaged across 0.5-4 kHz (BEHL/ WEHL0.5-4 kHz), deteriorate significantly with increasing age, and that no differences as a function of gender could be found. The prevalence of self-reported hearing problems was 44% (n = 101), and among these 30% (n = 30) indicated the potential need for a HA. A significantly poorer BEHL0.5-4 kHz was found in these subjects compared to those without hearing problems and/or need of a HA. In the total sample, 63% reported that a HA can ameliorate a hearing problem; however, 62% indicated that the HA should be invisible, and 28% that a HA 'makes you old'.

Age Factors↗
PubMed1997

Hearing in the elderly > or = 80 years of age. Prevalence of problems and sensitivity.

This article is part of an epidemiological study on hearing in an urban population > or = 80 years of age, and concentrates on the prevalence of hearing problems and hearing sensitivity as a function of age and gender. Prior to the study, 2915 residents aged 80+ from the Valby area in Copenhagen were selected for investigation and subdivided into two groups. The first group, comprising n = 859 subjects previously provided with HA, and the second group, resulting from an invitation mailed to n = 565 subjects, were matched according to the age and gender distribution of the population, i.e. 24% males and 76% females. Among these, only 41% at a median age of 84 years, range 80-96, accepted the invitation, being significantly younger than the non-attenders. The estimated prevalence of self, reported hearing problems ranged between 33 and 66%, increasing with increasing age. Significant differences were found in the hearing sensitivity as a function of gender, i.e. the hearing in the low-frequency area < 1 kHz is better, whereas the hearing sensitivity at > 2 kHz is significantly worse in males compared with females. The speech recognition score (SRS) was significantly higher in females compared with males, and a comparison between ears supports the finding that the right ear speech recognition score is better than the left. The study demonstrates the difficulties in obtaining reliable epidemiological data on the hearing in the elderly > or = 80 years, which represents an obstacle for the planning of appropriate hearing health services directed towards this age group, and collaborative studies are suggested in order to accumulate more knowledge.

Aged↗
PubMed1996

[Hearing problems--what do general practitioners do?].

Surveys have shown that the overall prevalence of hearing problems in the adult population is approximately 20% with an increasing prevalence as a function of age, i.e. a prevalence of 40-70% in the population at an age of 70+ years. This survey describes the role of general practitioners (GP) in audiology based on questionnaire evaluations mailed to all GPs in the Copenhagen City and to GPs offering services to persons > or = 80 years of age in the Valby health authority subdistrict. Additionally, an evaluation of hearing-impaired persons referred to the Audiological Department has been performed. Only 10% of GPs indicated that they knew the structure and organization of the hearing health services, resulting in a delay in rehabilitation. Forty-five percent of GPs always refer their elderly patients > or = 80 years of age with hearing problems to otologists in the primary health care sector, which represents unnecessary and additional costs within the local health authority. Among the hearing-impaired only 29% had gone to their GP due to hearing problems. The attitude to hearing aids among the GPs is positive, and 95% consider a hearing aid capable of improving the quality of life. It is suggested that GPs receive training and education within the audiological field before entering general practice, and that postgraduate courses directed towards GPs are established.

Adult↗
PubMed1996

Epidemiology of permanent hearing impairment in children in relation to costs of a hearing health surveillance program.

The objective of this investigation was to estimate the prevalence of any permanent hearing impairment (PHI) in the right and or left ear based on children included into a surveillance program in the local pediatric hearing health services (PHHS), and to analyze the costs, generated by the children. The study is a cross-sectional study, which is part of a major prospective study directed towards delineation of all aspects of pediatric audiology. The present sample comprises 228 children, 115 males and 113 females, at a median age of 13 years, range 0-24, and involves all children living in the health district of the City of Copenhagen, who are or have been included in a local surveillance program with one (school children) or two (pre-school children) annual visits for children with PHI > 20 dB HL at any frequency in either the left or the right ear. The prevalence of PHI increases with increasing age, reaching its peak in the age band 10-14 years exhibiting a rate of 5.32 1000 (95% confidence intervals: 4.27 to 6.64 per 1000). The estimated incidence of PHI in a ten year cohort born 1977-1986 is 325 100 000 children born (95% confidence intervals: 277 to 382 per 100 000). The most frequent factor causing PHI is inheritance, showing an increase from 20% in 1977-1981 cohorts, to 37% in 1982-1986 cohorts. The costs involved in the PHHS concerning PHI varies considerably from approximately 345 000 to 990 000 DKr.. depending on the model used for the economical analysis. No data on cost-benefit or cost-effectiveness can be given in this context, and it is concluded that the documented changes in the prevalence and causes of PHI in children emphasize the need for a continuous monitoring and evaluation of the epidemiological figures.

Adolescent↗
PubMed1996

A syndrome with retinitis pigmentosa, progressive hearing impairment, vestibular dysfunction, and congenital cataract.

A family with an unusual association of retinitis pigmentosa, progressive and severe hearing impairment, vestibular dysfunction, and congenital zonular cataract is described. The disease had a rather uniform appearance in five affected individuals. Parental consanguinity was documented in all cases and a common ancestor born in 1702 was identified. Consequently, autosomal recessive inheritance seems to be the most likely mode of transmission. This disorder possibly represents a new clinical entity among combined retinal dystrophy and hearing impairment syndromes.

Adult↗
PubMed1996

The Valby Project. A survey of the hearing in the elderly > or = 80 years of age-provided with hearing aids.

This contribution forms part of an epidemiological study of the hearing in the elderly > or = 80 years of age and describes some of the rehabilitative aspects. The sample is defined according to an age > or = 80 years of age, living in the Valby district at the time of data collection (November 1993), and provided with a hearing aid (HA) during this period 1988-1993. All information in this part of the survey is obtained from the records in the Department. The overall prevalence of HA provision was 30% (n = 859/2915) with no differences as a function of gender. The prevalence of HA provision indicated an increase from 20% at the age of 80-84 to 61% at an age of > or = 95 years of age. Among the sample, 42% were first-time applicants, whereas 58% were experienced users. The better and worse ear hearing level, averaged across 0.5-4 kHz, showed significantly poorer hearing in the experienced users compared to the inexperienced users; however, there were no significant differences as a function of 5-year age bands. In the inexperienced users a moderate hearing loss of 43-49 dB was found in the better ear hearing, averaged across 0.5-4 kHz. The average across 4-8 kHz showed significantly poorer hearing in males compared to females, which is compatible with the poorer speech recognition score in background noise (S/N = 10 dB) (SRSN) in males. An immediate benefit of HA provision was found in these elderly subjects, the majority obtained a benefit of 12-32%, measured by SRSN. It is concluded that the prevalence of 30% of HA provision is incompatible with the high prevalence of about 50% of hearing problems, indicated at the defined age, and that additional epidemiological data are needed.

Aged↗
PubMed1996

Primary physicians and the elderly hearing-impaired. Actions and attitudes.

This study was undertaken in the Valby health district in Copenhagen in order to evaluate the activities and attitudes of GPs concerning hearing problems in their elderly patients. Among 55 GPs offering health services to the 2915 residents > or = 80 years of age in the district, 76% (n = 42) responded to a structured questionnaire or personal interview, evaluating their line of action concerning hearing problems, and their knowledge and attitudes towards hearing aids (HAs). Among the responding GPs, 7% always seek information on the hearing ability of their elderly patients at the defined age, whereas 14% never focus on the hearing; 45% of the GPs always refer to an ENT specialist when hearing problems are present, which causes further delay in the rehabilitation process and increases costs within the primary health care sector. GPs' attitudes to HAs seem to be changing in a positive way, 91% of them revealing a positive attitude to HAs, and 86% indicating that a HA is capable of ameliorating a hearing problem in the elderly. Irrespective of this positive attitude, the knowledge of types of HAs among GPs seems limited. The study cannot support the idea of making HAs prescribable by GPs unless they are first offered intensive courses on audiology.

Aged↗
PubMed1995

Regional cerebral activation during auditory stimulation in patients with cochlear implants.

OBJECTIVE: To evaluate a possible change in the regional cerebral blood flow (rCBF) in the language-related cortical areas of the brain during stimulation of a cochlear implant. METHODS: The rCBF was measured by single-photon emission tomography and inhalation of Xenon Xe 133, providing information on the regional functional level of the brain. A supplementary single-photon emission tomographic scan was also performed, using technetium Tc 99m hexamethylpropyleneamineoxime as a flow marker. The rCBF was measured during rest (baseline) and during auditory stimulation by presenting white noise and running speech to the ear with the implant. PATIENTS: Five deaf patients who had undergone intracochlear or extracochlear implantation surgery. RESULTS: As in subjects with normal hearing, notable activation was not found in the relevant primary auditory cortex on stimulation with white noise. Two of the patients with implants had an increase in the rCBF in the relevant contralateral hemisphere on stimulation with running speech, but in the other three patients, a notable increase was not detected. This lack of increase in the rCBF on speech stimulation was consistent with the lack of speech recognition experienced by the subjects when using the implant. In one subject, the implant had a beneficial effect on speech understanding that was associated with a significant increase in the cerebral blood flow in the Broca's speech area and Wernicke's second speech area. CONCLUSIONS: Although the results are preliminary, the single-photon emission tomographic technique may be useful when evaluating the function of a cochlear implant. The method may also help select patients and/or ears for cochlear implantation. Four of five patients had functional defects of auditory relevant cortical areas, suggesting that their deafness might be associated with central impairment in addition to their cochlear defects.

Acoustic Stimulation↗
PubMed1995

An audit of hearing rehabilitation within the health service--past and present.

The present contribution can be considered as an audit of the hearing aid rehabilitation programme as performed in Copenhagen, based on an ongoing quality assurance. A comparative analysis was performed in outcome measures between two 3-month periods in which the only change had been a transfer of the preliminary instruction in manipulation and management of hearing aid (HA) from the educational to the health sector. The data analysis was based on a questionnaire including three samples (sample A, n = 800 evaluated before the change; sample B,n = 779 after the change; and sample C, n = 73 with no change, acting as a reference). The comparison demonstrated no significant differences in the ability to manage or manipulate HA between samples A and B, and no changes were found in the reference sample, C. A significant decrease in the frequency of hearing-impaired subjects needing additional appointments in the health sector was found in sample B. Those subjects who at the HA fitting had made no request for additional educational services demonstrated a significantly higher frequency of 97% capability to manage HA at the follow-up in comparison to only 84% among those who had requested services compatible with the distribution of experienced/unexperienced HA users. The additional data analyses render no support for any effect of the educational services on the ability to manipulate and manage HA.

Adult↗
PubMed1995

A clinical comparative investigation of a non-linear versus linear hearing aid.

The objective of this study was to compare the effect and performance of a hearing aid (HA) having a non-linear amplification below 1600 Hz (test HA) with a linear amplifying HA (control HA), aiming towards identical target groups of hearing-disabled people. The investigation was designed as a single-blind crossover interview study, i.e. the interviewer was blind. Thirty-two experienced HA users at a median age of 74 years participated. The observation period was 6-8 weeks for both HAs. For several evaluation parameters the participants found the test HA superior to the control HA, and a significantly better effect of the test HA was indicated in person-to-person conversation in quiet surroundings. Also, quality of sound was significantly better in the test HA, and thus these parameters support the test HA, being preferred by 75%. No significant differences were found in the objectively evaluated parameter, i.e. speech recognition score in background noise (SRSN: S/N = 0) between the two aids. A one-year follow-up examination of those preferring the test HA demonstrated continuously frequent use and satisfaction with the automatic volume control. It is concluded that skilled HA users with a wide range of hearing impairment at an age of 60-80 years prefer a non-linear HA to their current linear HA when fitted monaurally--however, a certain bias in the unblinded test subjects cannot be excluded.

Aged↗
PubMed1995

Factors causing hearing impairment: some perspectives from Europe.

This review concentrates on factors causing permanent hearing impairment in childhood, described in some European studies. The emphasis is on comparative studies, based on strict criteria and terminology upon which longitudinal changes in the pattern of factors causing hearing impairment can be demonstrated in well-defined cohorts of children. The high proportion of 20-39 percent of unknown causes of permanent hearing impairment in childhood reflects a general lack of knowledge about causative factors and systematic etiologic evaluation within pediatric audiology. Future surveillance programs, including examination procedures directed towards causative factors, may see a reduction of the "unknown" category and ultimately may result in prevention of permanent hearing impairment in childhood. Some factors causing hearing impairment in adults are mentioned, including recent studies that show organic toxic solvents as a factor. As well, some controversial findings concerning the relationship between hearing impairment and endocrine disorders such as hypothyroidism and diabetes mellitus are briefly reported. It is concluded that future developments and research in the etiologic field within pediatric and adult audiology may contribute to the delineation of yet unknown damaging factors or reduction of the effect of factors causing hearing impairment--a disorder that ultimately results in adverse effects on the quality of life in all age groups.

Adult↗
PubMed1994

Is there a relationship between the acoustic occlusion effect and the sensation of occlusion?

The objective of the present investigation was to examine the relationship between the acoustic occlusion effect and the subjective occlusion sensation when using ear moulds. The material comprises 45 subjects (19M and 26F, at a median age of 76 years, range 38-88 years) subgrouped according to the classification of their hearing disorder into two group: N = 22 subjects with conductive hearing loss (1); N = 21 subjects with sensorineural hearing loss (2). The side effects caused by an ear mould were evaluated at an interview, based on a structured questionnaire, two months after the hearing aid fitting. The comparative investigation showed that when the outer ear canal was occluded with an ear mould there were no significant differences between the two groups of subjects in the frequency of sensation of occlusion, in the sound quality of environmental sound or own voice, in hearing problems when chewing, or in ventilation problems. Neither were significant differences in the magnitude of the acoustic occlusion effect present between those answering yes and those answering yes and those answering no to a change in the sound quality of own voice in the group with sensorineural hearing loss. Although the number of subjects is limited, it is concluded that no relationship exists between the acoustic occlusion effect and the perceived sound quality, thus leaving no physical basis for the claim that this side effect is caused by an ear mould.

Adult↗
PubMed1994

The causes of profound hearing impairment in a school for the deaf--a longitudinal study.

The study was aimed towards an evaluation of the causes of hearing loss in children attending the School for the 'Deaf' in Copenhagen in 1993-4 in comparison to causes evaluated 10 and 40 years previously (Arnvig, 1953; Holten and Parving, 1985). The 124 children attending the school in 1993 represent 0.04% of the age-matched target population of 312,715. A more detailed evaluation of two comparable cohorts born in 1969-77 and 1979-87 demonstrates a significant increase of children attending this type of school from 0.03% to 0.05% within a 10-year period, while a comparison between 1953 and 1993 demonstrates a reduction from 0.07% to 0.04%. The longitudinal evaluation of the causes of hearing loss showed a significant increase in the frequency of congenital inherited hearing impairment from 29% (1953) through 33% (1983) to 43% (1993), whereas a significant reduction of about 17% in the frequency of acquired deafness due to chronic otitis media was found. Between 1953 and 1993 a minor reduction (2%) in post-meningitic acquired hearing impairment was found, between 1953 and 1983 there was a significant increase in prenatal infections, compared with a decrease of 6% between 1983 and 1993. It is concluded that significant changes are found both in the prevalence of children referred to the school and in the factors causing severe to profound hearing impairment in children. Continuous recording of, and improvement in, diagnostic classification is necessary to obtain preventive measures.

Adolescent↗