Biomedical subjects

Viktor Weichbold

Publications and source records attributed to Viktor Weichbold.

12 recordsLinked to original sources

PubMed2006

Social stigmatization in patients with cranial and cervical dystonia.

Patients with cranial and cervical dystonia (CCD) suffer from visible involuntary facial, head, and neck movements. Therefore, the social appearance of patients with CCD may be seriously affected and self-perceived stigma can be a major source of disability. The present study investigated enacted social stigmatization of patients with CCD. In a pilot study, a semantic differential scale for assessment of stigma was constructed and validated. The final scale contained eight items representing personality traits to be rated on a seven-point scale (-3 negative extreme to 3 positive extreme). Short video sequences (15 seconds) of patients with various types of CCD and age- and sex-matched healthy controls were presented to a sample of 80 biology students (mean age, 19.8 +/- 2.3 years). Immediately after presentation of each video sequence, the students were asked to perform stigma ratings. Significant differences between CCD patients and controls were found on all eight items (P < 0.001 for each). CCD patients were rated as less accountable for their actions, less likeable, less trustworthy, less attractive, less self-confident, more odd and different, more reserved, and more piteous than controls. CCD patients are subject to serious prejudice and enacted stigmatization. There is a need for informing the public about the nature and symptoms of this disorder and a need to support patients to cope with stigmatization.

Adult↗

PubMed2006

Universal newborn hearing screening and postnatal hearing loss.

OBJECTIVE: The goal of this study was to determine the percentage of children who have a postnatal permanent childhood hearing impairment (PCHI) and the percentage thereof who have risk indicators for a postnatal hearing loss. METHODS: Data were drawn retrospectively from the clinical charts of children who had bilateral PCHI (>40 dB hearing level, better ear, unaided) and had undergone universal newborn hearing screening (UNHS) between 1995 and 2000 in various Austrian hospitals. A hearing loss was recognized as postnatal when a child passed UNHS but was later found to have a hearing impairment. The presence of risk indicators, as suggested by the Year 2000 Statement of the American Joint Committee on Infant Hearing (JCIH), was assessed by reviewing the children's clinical charts. RESULTS: Of a total of 105 children with bilateral PCHI, 23 (22%) showed postnatal impairment. After correction of this number for underascertainment, postnatal impairment was estimated to account for 25% of all bilateral PCHI at age 9 years. Risk indicators were found in 17 children but did not fully correspond to those proposed by the JCIH. The risk factors found were a family history of hearing loss (3 children), meningitis (2), craniofacial malformation (2), persistent pulmonary hypertension (1), congenital cytomegaly infection (1), extracorporeal membrane oxygenation (1), recurrent otitis media with effusion (1), and, in addition to the JCIH list, ototoxic therapy (5), and birth before 33rd gestational week (2) (1 child had a combination of the last 2). Six children showed no risk indicators for the postnatal hearing loss. CONCLUSIONS: Our findings suggest that approximately 25% of bilateral childhood hearing loss is postnatal, which supports the leading role of UNHS in detecting PCHI. Provisions for also identifying postnatal cases nevertheless are justified. Because in some of these children no risk indicators are detectable and in others the hearing deterioration starts after age 3 years, audiologic monitoring of at-risk children up to this age may not be sufficient. Additional methods, such as hearing screening at nursery schools or schools, are recommended.

Child↗

PubMed2005

Ten-year outcome of newborn hearing screening in Austria.

OBJECTIVE: Current health care standards recommend that congenital hearing loss be confirmed before age three months and intervened for before age six months. This study evaluated to what extent the Austrian universal neonatal hearing screening (UNHS) program achieves this goal. The Austrian UNHS program is a hospital-based, two-stage screen based on transient oto-acoustic emissions, as promoted in 1995 in a position paper of the Austrian ENT Society. METHODS: Retrospective chart review and data analysis. All Austrian institutions engaged in the diagnosis and treatment of childhood hearing loss were requested to provide their data on children with permanent congenital sensorineural hearing impairment registered since 1990. Children who had undergone hearing screening, were compared to those who had not. Main outcome measures were age at confirmation of and age at intervention for the hearing loss. In each group, the percentage of children, whose hearing loss was confirmed by age three months, and intervened for by age six months, was determined. RESULTS: Data from 321 hearing-impaired children were useable. Of these children, 167 were screened and 154 were not. At age three months, a hearing loss was diagnosed in 35% of screened children, but in only 2% of unscreened. These percentages rose to 69% and 6%, respectively, at age six months and to 81% and 12%, respectively, at age one year. Intervention mostly started within less than one month after diagnosis. At age six months, 61% of screened children, but only 4% of unscreened children, had undergone intervention. CONCLUSIONS: Hearing screening enormously increases the number of early-detected children. However, in quite a few screened children hearing loss is neither confirmed within three months after birth, nor intervened for within six months after birth. Reasons for the delay must be paid attention in order to warrant that UNHS can be as effective as possible.

Austria↗

PubMed2005

[Evaluation of the Austrian Newborn Hearing Screening Program].

BACKGROUND: Universal Neonatal Hearing Screening (UNHS) has been gradually implemented since the mid-nineties in Austrian maternity wards and neonatal intensive care units. This study evaluated the effect of UNHS on reducing age at identification as well as age of intervention for children with congenital and perinatal sensorineural hearing impairment. METHODS: This was a retrospective analysis of clinical data of 394 Austrian children diagnosed with an at least mild degree (> 20 dB hearing level) of permanent sensorineural hearing loss. Age at identification and age at intervention were compared between children who underwent UNHS ('with UNHS') and those who did not undergo UNHS ('without UNHS'). RESULTS: The median of age of identification was 37.6 months in children without UNHS, and 3.9 months in children with UNHS. By six months of age, 69% of hearing-impaired children who underwent UNHS, were identified but only 6% of those without UNHS. At one year, the corresponding percentages are 80% and 12%, respectively. In children without UNHS, the degree of hearing loss was the most predictive factor of age at identification (median of age at diagnosis for profound hearing loss: 15 months; severe: 26 months; moderate: 52 months; mild: 73 months). In children with UNHS, age of identification was unrelated to degree of hearing loss (medians between 3.7 and 4.4 months). In the majority of children intervention began within one month after diagnosis, regardless of whether or not the child was identified by UNHS. DISCUSSION: UNHS greatly increases the proportion of children whose hearing impairment is diagnosed before six months of age. However, in some 20% of children, hearing impairment was diagnosed later than one year of age, despite having failed the screening. Additionally, data from this study suggest that about 15% of childhood hearing losses manifest themselves after the hearing screening period. Efforts are thus required for the early detection of these children as well.

Age Distribution↗

PubMed2004

[Hearing screening at nursery schools: results of an evaluation study].

OBJECTIVE: This study aimed to evaluate the hearing screening of pre-school children at nursery schools in Tyrol, Austria. METHODS AND SAMPLE: 47 nursery schools with a total of 2199 enrolled children participated in the study. At the screening, the children were presented a series of tones at frequencies 0.5 kHz (25dB), 1 kHz, 2 kHz, 3 kHz, and 4 kHz (20 dB each) from portable audiometers. The tones were presented over headphones for each ear separately and at irregular intervals. Failure to respond to any of the frequencies was considered failure of the screening. Parents were then advised in written form to have the child examined by an ENT-specialist. RESULTS: 1832 individuals were screened (coverage: 83% of nursery school children; corresponding to at least 63% of all Tyrolean children aged 3 to 5 years). Of these, 390 failed the test (referral rate: 21% of all screened). Examination through an ENT-specialist occurred with 217 children, and this confirmed the positive test in 139 children (hit rate: 64%). In most cases, a temporary conductive hearing loss due to external or middle ear problems (glue ear, tube dysfunction, cerumen, otitis media) was diagnosed. A sensorineural hearing loss was found in 4 children (in 3 of them bilateral). The need for therapy was recognized in 81 children (4% of all screened). CONCLUSION: Pre-school hearing screening identifies children with ear and hearing problems that need therapeutical intervention. Although the hearing problems are mostly of a temporary nature, some may require monitoring over some period. Also some children with permanent sensorineural hearing loss may be detected through this measure. Hearing screening is an efficient means of assessing ear and hearing problems in pre-school children. However, the follow-up rate needs to be improved for optimizing the efficacy.

Audiometry, Pure-Tone↗

PubMed2004

Cochlear implantation in children under the age of two--what do the outcomes show us?

OBJECTIVES: Literature that discusses the benefits of cochlear implantation (CI) in children under the age of two is limited. Previous concerns about surgical risk have been raised and addressed; however, actual benefit in terms of outcomes needs to be clearly defined. This study evaluates outcomes of children implanted under the age of two and compares them to children implanted at a later age. METHODS: Data were reviewed from the MED-EL International Children's study database. Thirty-seven children enrolled in the study have received cochlear implants before the age of two. Outcomes were assessed using the LiP and MTP tests and the MAIS and MUSS questionnaires pre-operatively and then at initial fitting, 1, 3, 6 and 12 months after first fitting and then annually thereafter. RESULTS: Statistical analysis demonstrated that these children's scores improved significantly over time. Improvement was shown to occur at a quicker rate than for children implanted at an older age with the MTP and MUSS, but not with the LiP and the MAIS. Scores may be limited by sample size and the fact that children reached ceiling on some tests. CONCLUSIONS: Results suggest a distinct advantage early implantation may have for severe to profoundly hearing impaired children. This may be particularly the case for skills necessary for development of receptive and expressive language skills.

Age Factors↗

PubMed2004

Validation of three adaptations of the Meaningful Auditory Integration Scale (MAIS) to German, English and Polish.

The Meaningful Auditory Integration Scale (MAIS) is a parent-report questionnaire for assessing auditory behaviour in aurally habilitated children. This study addressed the reliability and convergent validity of three different language versions of the MAIS: English, German, and Polish. In total, 114 parents (English, n = 27: Polish, n = 37; German, n = 50) completed the MAIS preoperatively and at 6 months after cochlear implantation. Internal reliability (Cronbach's alpha) ranged from 0.92 to 0.95 preoperatively, and from 0.87 to 0.93 at 6 months. Split-half reliability was at least 0.90 preoperatively, and ranged from 0.76 to 0.89 at 6 months. Corrected item-total correlation coefficients were significant (p < 0.05) for all items except for item 1, which showed poor correlations in the Polish version. Correlation of the MAIS with the Listening Progress Profile (LP), as a measure for convergent validity, yielded coefficients between 0.81 and 0.73 preoperatively, and between 0.79 and 0.61 at 6 months. These findings demonstrate high reliability and convergent validity of the three MAIS versions.

Adult↗

PubMed2004

Analysis of ceiling effects occurring with speech recognition tests in adult cochlear-implanted patients.

This article presents a simple method of analysing speech test scores which are biased through ceiling effects. Eighty postlingually deafened adults implanted with a MED-EL COMBI 40/40+ cochlear implant (CI) were administered a numbers test and a sentence test at initial device activation and at 1, 3, 6, 12 and 24 months thereafter. As a measure for speech recognition performance, the number of patients who scored at the 'ceiling level' (i.e. at least 95% correct answers) was counted at each test interval. Results showed a quick increase in this number soon after device activation as well as a continuous improvement over time (numbers test: 1 month: 51%; 6 months: 73%; 24 months: 88%; sentence test: 1 month: 33%; 6 months: 49%; 24 months: 64%). The new method allows for the detection of speech recognition progress in CI patient samples even at late test intervals, where improvement curves based on averaged scores are usually assuming a flat shape.

Adult↗

PubMed2003

Performance of hearing impaired children on Raven's Coloured Progressive Matrices Test.

OBJECTIVE: Hearing impairment (HI) is presumed to influence the visual skills of affected children, possibly biasing their performance on tests requiring visual analyzing skills. We investigated whether such a bias would occur on Raven's Coloured Progressive Matrices (CPM); a set of three subtests (labeled A, AB and B) for measurement of non-verbal intelligence. METHOD: A sample of 62 children presenting with various degrees of HI were administered the test. Raw scores were controlled for age, and correlated to degree of HI. RESULTS: The correlation between degree of HI and overall test score missed significance (r=0.23, P=0.07), but scores from subtest B showed a significant positive correlation with HI (r=0.37, P=0.003). CONCLUSIONS: We conclude that severe or profound HI may lead to increased competence for task solution on subtest B. However, despite the biasing effect on this subtest, the CPM overall test score is only slightly affected.

Child↗

PubMed2003

Effects of a hearing protection campaign on the discotheque attendance habits of high-school students.

This study investigated whether a hearing education campaign would prompt adolescents to display hearing-protective behaviour when attending a discotheque. A sample of 169 high-school students participated in the campaign. A questionnaire was administered to them before and 1 year after the campaign, asking for the frequency of discotheque attendance within the past 6 months, and whether they used earplugs in the discotheque. The percentage of subjects who went to discotheques more than 10 times within 6 months decreased from 34% to 24% after the campaign. The overall difference between pre- and post-campaign frequencies of discotheque attendance, however, was not significant. The percentage of subjects using earplugs in the discotheque rose from 0% before to 3.7% after the campaign. In essence, the campaign had little effect in inducing hearing-protective behaviour in adolescents when attending discotheques. The need for sound level limitations in discotheques is highlighted.

Adolescent↗

PubMed2002

Recent results with the MED-EL COMBI 40+ cochlear implant and TEMPO+ behind-the-ear processor.

Cochlear implantation is a viable treatment for patients with severe to profound hearing loss. We report the results of speech perception tests (numbers, monosyllables, and sentence tests) achieved with MED-EL's COMBI40+ (C40+) cochlear implant after 12 months of use. These findings, which were taken from a larger German study, were similar to those of other studies of the C40+ implant. We also compared the differences in speech perception observed with the CIS PRO+ body-worn speech processor and the newer TEMPO+ behind-the-ear speech processor. Although these results were similar with respect to most of the measured parameters, the TEMPO+ processor had a distinct advantage during tests in noise.

Adult↗

PubMedDate not supplied

[Suitability of the Munich List of Quality of Life Dimensions (MLDL) for use in logopedic therapy research].

Public health policy increasingly focuses on criteria of cost and cost-effectiveness for health care financing. However, tools for assessing the effects of logopedic therapy are largely missing. This study investigated the suitability of the Munich List of Quality-of-Life-Dimensions (MLDL) for use with patients with dysphonia. Twenty-five adults with voice disorders were administered the MLDL at the beginning and at the end of therapy (about 20 sessions). Results were that, although most patients expressed high satisfaction with the therapy received, MLDL scores did not reflect this. Only 2 out of 19 items of the scale indicated a significant improvement in the quality of life after therapy ("ability to relax", p < 0.05, and "satisfaction with the treatment of the disorder", p < 0.01). The MLDL is not sensitive enough to detect all effects of logopedic therapy. The development of specific scales for the detection of effects of logopedic intervention is discussed.

Humans↗