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Background: Balance disorders impact people in all stages of their life. Individuals can experience unsteadiness, fear of movement, dizziness, nausea, and vertigo. Assessments are completed by medical professionals to determine the cause of the balance disorder, then treatments are prescribed. For peripheral balance disorders, rehabilitation can include physical therapy and movements performed by the individual at home to allow for the brain to compensate for the disorder. Adherence to such rehabilitation programs is not high, therefore other rehabilitation options must be explored. Dance is a movement form that utilizes and strengthens aspects of balance.Methods: A literature review was conducted to determine how dance has been used as a rehabilitation method for movement disorders. The search included various combinations of the following terms: “dance”, “rehabilitation”, “adults”, “therapy”, “treatment” and “balance”. Research articles that have been published in the last 25 years were included. Results: 35 articles remained following the literature search. The articles discussed various dance styles used for rehabilitation, various lengths and intensities of programs, and improvements in balance and movement measures. The articles were reviewed to determine if similarities exist between the movement disorders discussed and peripheral balance disorders. Conclusion: While no direct similarities were found between the movement disorders and balance disorders, it is hypothesized that aspects of dance can be incorporated into peripheral balance disorder rehabilitation methods to improve balance and movement measures for individuals. Further research must be conducted to determine the impacts of a dance-based rehabilitation specifically on peripheral balance disorders.

Background: Hearing healthcare is not accessible. These issues can, at least in part, stem from the traditional service-delivery model in which audiologists overly rely on third-party manufacturers to create and supply custom hearing health components. The advancement of technology is rapidly shifting the landscape of healthcare, empowering clinicians to be more autonomous and deliver better care for their patients. Yet, not all technology is successfully adopted and implemented into practice. This study seeks to establish an evidence-base that explores the performance, perceptions, and experiences of novel technologies through the lens of three-dimensional (3D) printing technology in the fabrication of custom earmolds. Methods: A total of four studies were conducted. In the first study, a scoping review was undertaken to evaluate adoption and implementation of three-dimensional printing technology in hearing healthcare research. Secondly, audiologists' perspectives of technology adoption and implementation were explored using a qualitative semi-structured interview approach. Thirdly, a feasibility study was conducted to compare custom earmolds made using the traditional service-delivery pathway versus a proposed service-delivery pathway using in-house three-dimensional printers. The study design included a repeated-measures, crossover trial, in which 30 normal hearing individuals were recruited. Each individual was made, wore, and compared three custom earmolds: one that was professionally-made with acrylic and served as the control, and the other two 3D printed in-house using polylactic acid (PLA) and a photopolymer resin. Main measures included production time, production costs, physical dimensions, objective acoustic measures, and subjective perceptual measures. Lastly, a pilot study was completed to evaluate protocol and resource feasibility for a future clinical trial that seeks to establish a non-inferiority criteria to better compare in-house 3D printed earm

Background and Aims Cochlear implantation has emerged as a leading hearing intervention for infants born with severe to profound hearing loss. Research has shown that early intervention with a cochlear implant (CI) can significantly improve speech perception and oral language development in infants, providing them with access to the sounds that are critical for language acquisition. However, studies investigating the relationship between initial electrophysiological hearing thresholds and subsequent behavioural thresholds have demonstrated uncertainty as to whether initial results are able to provide an accurate estimation of an infant’s functional hearing. This estimation must be accurate if a CI is to be considered before behavioural audiometry has been obtained, as CI surgery is likely to remove any remaining natural hearing. This study aims to explore the variance between initial electrophysiological thresholds and subsequent behavioural hearing thresholds in young infants with suspected severe to profound hearing loss in a clinical setting, to determine under which conditions initial electrophysiological results can be used to support a CI recommendation in the absence of behavioural audiology. It also aims to propose evidence-based recommendations for implementation of a paediatric CI candidacy pathway for cases in which reliance on behavioural audiometry can be reduced. Method A prospective cohort study of 63 infants with suspected severe to profound hearing loss, referred to the Cochlear Implant Clinic, Melbourne, before 12 months of age. Assessment protocol included auditory brainstem response, auditory steady-state response, otoacoustic emissions, tympanometry, cortical auditory evoked response, and behavioural audiometry. Data was explored using correlational analysis, linear regression, and clinical decision analysis. Results 90.8% of all individuals who met CI candidacy criteria with initial electrophysiological testing (3FAHL>85dB) also met cr

Cholesteatoma is a soft-looking, compressible mass mainly associated with hypoacusis. Its diagnosis is made by otoscopy, but if the physical examination is not conclusive, radiological studies should be performed. Its presentation is infrequent; thus, the incidence of acquired cholesteatoma per year in Colombia is 3/100000 children and 9.2/100000 adults. It is important in the evaluations that each health personnel can recognize it and refer it, allowing early surgical intervention to avoid invasive clinical pictures that can increase the possibility of complications. Our objective was to describe the importance of cholesteatoma with its clinical implications in different patients with auditory pathology, which allows to understand the importance of timely diagnosis. A literature search was performed in PubMed and Scielo databases, oriented towards updated and relevant articles in English and Spanish, published in the last 5 years. The relationship between hypoacusis and cholesteatoma, its medical importance, implications and therapeutic approach were analyzed. Different studies show the presence of cholesteatoma and unilateral hypoacusis, in some cases the clinical presentation is associated to syndromic pathologies. In this pathology the treatment is surgical, with a previous evaluation that establishes the type of intervention, additionally, the post-surgical follow-up is mandatory in all patients. In conclusion, cholesteatoma is a cause of hypoacusis, especially in the pediatric population, which must be diagnosed in a timely manner in order to allow a specialized assessment that ffers a surgical treatment according to the anatomical compromise and individualization of the patient., O colesteatoma é uma massa macia e compressiva associada principalmente à perda auditiva. É diagnosticado por otoscopia, mas se o exame físico for inconclusivo, estudos radiológicos devem ser realizados. Sua apresentação é pouco freqüente; assim, a incidência de colesteatoma adquirido por ano na Colômbia é de 3/100000 crianças e 9,2/100000 adultos. É importante que todo o pessoal de saúde seja capaz de reconhecê-lo e encaminhá-lo, permitindo que oÉ importante que cada equipe de saúde possa reconhecer e encaminhar, permitindo uma intervenção cirúrgica precoce para evitar quadros clínicos invasivos que possam aumentar a possibilidade de complicações. Nosso objetivo foi descrever a importância do colesteatoma com suas implicações clínicas em diferentes pacientes com patologia auditiva, o que nos permite compreender a importância de um diagnóstico oportuno. Foi realizada uma pesquisa bibliográfica nas bases de dados do PubMed e Scielo.As bases de dados da PubMed e Scielo, orientadas para artigos atualizados e relevantes em inglês e espanhol, foram publicadas nos últimos 5 anos. Analisamos a relação entre hipoacusia e colesteatoma, sua importância médica, implicações e abordagem terapêutica. Diferentes estudos mostram a presença do colesteatoma e da hipoacusia unilateral, em alguns casos a apresentação clínica está associada a patologias sindrômicas. Nesta patologia, o tratamento é cirúrgico, com uma avaliação prévia que estabelece o tipo de intervenção; além disso, o acompanhamento pós-cirúrgico é obrigatório em todos os pacientes. Em conclusão,O colesteatoma é uma causa de hipoacusia, especialmente na população pediátrica, que deve ser diagnosticada em tempo hábil a fim de permitir uma avaliação especializada que ofereça um tratamento cirúrgico de acordo com o compromisso anatômico e a individualização do paciente., El colesteatoma es una masa de apariencia blanda, comprimible y asociada principalmente a la hipoacusia. Su diagnóstico se realiza mediante otoscopia, pero si el examen físico no es concluyente se deben realizar estudios radiológicos. Su presentación es infrecuente; así, la incidencia de colesteatoma adquirido por cada año en Colombia es de 3/100000 niños y 9,2/100000 adultos. Es importante en las valoraciones que cada personal de salud lo pueda reconocer y derivar, permitiendo realizar de forma temprana la intervención quirúrgica que eviten cuadros clínicos invasivos que pueden aumentar la posibilidad de complicaciones. Nuestro objetivo fue describir la importancia del colesteatoma con sus implicaciones clínicas en los diferentes pacientes con patología auditiva, lo que permite hacer entender la importancia del diagnóstico oportuno. Se realizó una búsqueda de literatura en las bases de datos de PubMed y Scielo, orientada hacia artículos actualizados y relevantes en inglés y español, publicados en los últimos 5 años. Se analizó la relación entre hipoacusia y colesteatoma, su importancia médica, implicaciones y abordaje terapéutico. Los diferentes estudios evidencian la presencia de colesteatoma e hipoacusia unilateral, en algunos casos la presentación clínica se asociada a patologías sindrómicas. En esta patología el tratamiento es quirúrgico, con una previa valoración que establezca el tipo de intervención, adicionalmente, el seguimiento postquirúrgico es obligatorio en todos los pacientes. En conclusión, el colesteatoma es una causa de la hipoacusia, especialmente entre la población pediátrica, la cual debe ser diagnosticada de forma oportuna con el objeto de permitir una valoración especializada que ofrezca un tratamiento quirúrgico de acuerdo al compromiso anatómico y la individualización del paciente.

Speech-in-noise testing has been proposed as a useful part of the audiometric test battery dating back to the earliest years of the field of audiology. Many speech-in-noise tests have been developed and used to varying degrees. However, multiple barriers have prevented speech-in-noise testing from being used widely in the clinic. The purpose of this article is to provide a resource to audiologists and other hearing health professionals who want to know (1) what tests are available for use, (2) the rationale behind specific tests, and (3) important considerations when selecting one or more tests to use clinically. In addition, data are presented for four speech-in-noise tests with the purpose of comparing outcomes as a function of age and hearing status. The four tests (QuickSIN, Words in Noise [WIN], Listening in Spatialized Noise-Sentences [LiSN-S], and Coordinate Response Measure [CRM]) were completed by 30 individuals from three groups: 10 young adults with normal hearing, 10 older adults with normal hearing, and 10 older adults with hearing loss. The results suggest that, despite significant differences in performance between groups, group overlap was present such that some individuals from one group performed similar to some individuals of other groups; therefore, individual performance was more important than associated group. When selecting an appropriate speech-in-noise test to use clinically, audiologists should carefully consider the purpose of their testing and the type of information they desire as an outcome. A quick-resource table and appendix is provided to aid audiologists and other health professionals in their selection of an appropriate speech-in-noise test.

Purpose The purpose of this study was to develop and administer a survey to the University of Arizona College of Science to assess students, faculty, and staff’s awareness of the profession of audiology and hearing healthcare. Method A survey was administered in 2023 to the University of Arizona’s College of Science students, faculty, and staff. Survey questions included questions asking participants to describe what an audiologist does. In addition, participants were asked to describe other healthcare professions, including podiatry, optometry, neuropsychology, speech language pathology, and teacher of the deaf. Participants were also asked questions related to hearing loss and hearing healthcare. Results Participants within the speech language and hearing sciences department had more awareness of the profession of audiology than those outside of the department. Furthermore, individuals outside of the speech language and hearing sciences department were surer of their knowledge of other healthcare professions, such as podiatry and optometry, than audiology. Conclusion Data from this survey may serve as a baseline for knowledge related to audiology and hearing healthcare among a university population. This data may be used to create a targeted hearing healthcare program for this niche population. A secondary aim of this study was to explore student’s knowledge of the profession of audiology to inform future avenues for recruitment into the profession.

Access to healthcare services for children in Mexico and in Arizona communities that border Mexico can be limited. There are several humanitarian clinics that offer audiologic services in this area that were presumably developed from a need in the community. A common audiologic occurrence seen in pediatric patients is otitis media. When otitis media does not resolve or when it is recurrent, it can negatively affect a child’s speech, language, and overall development. This audiology doctoral project aims to examine the population of patients with conductive hearing loss due to middle ear disorders, such as otitis media, who receive care at a humanitarian clinic on the Arizona-Mexico border and provide recommendations about what additional resources could be used for these children and their families. Fifty-seven charts for children who received care at St. Andrew’s Children’s Clinic, located in Nogales, Arizona, between February 2017 and March 2020 were reviewed to determine the number of children with conductive (or probable conductive) hearing loss. Additionally, patients who were at an increased risk for developmental delays due to conductive hearing loss were categorized into an action group, or those who require timely intervention for hearing loss to avoid further delays. Overall, there were sixteen children who were noted to have a conductive component to their hearing loss, fourteen for whom the conductive loss was likely due to a treatable middle ear condition. Most of these children fell within the action group. The information gathered from this study can lead to a number of recommendations to address additional needs for children seen at St. Andrew’s Children’s Clinic who have middle ear dysfunction and fall within the action group.

Music has a remarkable power to arouse the feelings of those who listen to it. What features of music imbue it with such emotional resonance? A prevailing notion in music theory is that musical scale has a central role in giving meaning to music. Indeed, many studies find that, according to listeners' average ratings, music of the major scale sounds happy, and music of the minor scale sounds sad. However, recent discoveries involving “tone-scramble” stimuli complicate our understanding of these results and suggest that sensitivity to scale is not universal. This thesis details a series of experiments designed to investigate (1) the generalizability of the findings of laboratory-based tone-scramble experiments and (2) the musical nature of a latent cognitive resource that is theorized to underlie performance in tone-scramble tasks. Chapter 1 reports that the same bimodal distribution in performance repeatedly observed in laboratory-based tone-scramble experiments is observed in a large, linguistically diverse web-based sample. Chapter 2 considers whether low-performing listeners are limited by some of the non-musical qualities inherent to tone-scrambles; data are provided to show that changes in presentation rate, frequency height, and timbre that yield tone-scrambles akin to actual music do not provide low-performing listeners any advantage over ordinary tone-scrambles. In Chapter 3, the latent cognitive resource theorized to underlie performance on tone-scramble tasks is shown to operate on musical scale and not individual frequencies, drawing a clear relationship between performance in tone-scramble tasks and sensitivity to musical scale.

For many people, the sense of hearing provides a connection with others and the world around them. Losing one’s hearing can have a deleterious impact on many psychological and social aspects of life. Hearing loss can compromise psychological wellbeing, resulting in an increase in loneliness or reduced self-esteem, and it can also increase the odds of experiencing psychological symptoms, such as depression and anxiety. Given this association, audiologists are likely to encounter clients with psychological concerns on a regular basis. Understanding how these clients experience audiological rehabilitation may be an important way for audiologists to provide relevant and optimal services. Psychological factors, including mental health and illness, can also significantly influence the initiation, adherence, and success of audiological rehabilitation. Despite this, psychological factors are not adequately considered within hearing healthcare, so the recommended approach of person-centred care may need to be further extended to better address these factors. Psychologically informed practice (PIP) may provide a suitable framework that can be used to extend upon person-centred care, especially for clients with comorbid psychological symptoms. A PIP framework recognises the role of psychological factors in chronic health conditions and addresses these using psychological theories and frameworks. PIP has shown success in other rehabilitation settings and may therefore provide benefits within hearing healthcare. The aim of this thesis was therefore to explore the nature of mental illness, mental health, and psychological symptoms within audiological rehabilitation, from the perspective of clients and audiologists, and to provide a foundation of support for the implementation of PIP into hearing healthcare. Four studies were conducted to achieve the aims of this thesis. The first study included in-depth, semi-structured qualitative interviews to understand the experience of heari

Functional hearing – for practical purposes – consists of the possibility of awakening precise sensations in specific regions of the brain from the processing and extraction of hidden messages in changes in the pressure of the molecules of the air that surrounds us. Measuring the functionality of hearing in a human being becomes a titanic challenge that implies that our professional life is spent analyzing both subjective and objective information from our patients, both with an undeniable diagnostic value: as for the first, the clinical history, observations of the patient's listening behavior, reports from home, school and therapy, or studies such as pure tone audiometry and speech audiometry, are essential not only for diagnosis but also for the follow-up of our patients. However, in the case of smaller patients, or when faced with the need to evaluate aspects such as middle ear pressure, hair cell function, or the presence of cochlear microphonics; The usefulness of these subjective tools is limited and therefore the records, traces, curves and figures related to intensities, pressures, latencies, frequencies, amplitudes and other data obtained through objective studies are the resources we use to diagnose and start the investigation. rehabilitation or rehabilitation of our patients., La audición funcional –para fines prácticos– consiste en la posibilidad de despertar sensaciones precisas en regiones específicas del cerebro, a partir del procesamiento y extracción de mensajes ocultos en los cambios en la presión de las moléculas del aire que nos rodea. Medir la funcionalidad de la audición en un ser humano se convierte en un reto titánico que implica que nuestra vida profesional transcurra analizando información tanto subjetiva como objetiva de nuestros pacientes, ambas con un valor diagnóstico innegable. En cuanto a la primera, la historia clínica, las observaciones de la conducta auditiva del paciente, los reportes de la casa, la escuela y la terapia, o de estudios como la audiometría tonal y la logoaudiometría, resultan fundamentales no solo para el diagnóstico, sino para el seguimiento de nuestros pacientes. Sin embargo, en el caso de los pacientes más pequeños, o ante la necesidad de evaluar aspectos como la presión del oído medio, la función de las células ciliadas, o la presencia de microfónica coclear, la utilidad de esas herramientas subjetivas se encuentra limitada y entonces los registros, trazos, curvas y cifras relativas a intensidades, presiones, latencias, frecuencias, amplitudes y demás datos obtenidos a través de estudios objetivos, son los recursos que usamos para diagnosticar e iniciar la habilitación o rehabilitación de nuestros pacientes.

Introduction. The pre-lingual deafness or hearing loss are of genetic cause in between 60% and 68% of cases, among these, between 20% and 40% are malformation of the inner ear. From the non-syndromic hearing loss cases that are linked to the X chromosome, seven types have been described. Among these inner ear malformations, incomplete cochlear partition type III is the less frequent. Objective. Present the clinical genetical report of a Mexican family, with male individuals affected by congenital neurosensory deafness with inner ear malformation. Materials and methodology. A study on a family in which nine members were affected by deafness was done. Four of them, plus a mother without manifestation, were studied through a general clinical study by a geneticist, an audiological study (otoscopy and audiometry) by an audiologist, and a computed tomography (CT) scan by a radiologist. Results. The studied patients presented congenital neurosensory deafness, from severe to deep bilateral. Via the CT, the inner ear malformation was made clear. Three of the patients presented incomplete cochlear partition type III and one patient incomplete cochlear partition type I. Due to the clinical study and the family tree, it was diagnosed non-syndromic neurosensory deafness linked to X. The CT of the mother without manifestation did not show evidence of inner ear malformations. Conclusion. The study by image is fundamental to define whether there is or not a presence of inner ear malformations in any patient with heading loss to be able to guide the therapeutics and the genetic counseling, as well as to make more accurate molecular studies., Introducción. Las sorderas o hipoacusias prelinguales son de etiología genética entre el 60 y el 68% de los casos; de éstos, del 20 al 40% son malformaciones del oído interno. De los casos de hipoacusia no sindrómica ligada al X se han descrito siete tipos. De las malformaciones de oído interno, la partición coclear incompleta tipo III es la menos frecuente. Objetivo. Presentar el reporte clínico-genético de una familia mexicana, con individuos varones afectados por sordera neurosensorial congénita con malformación de oído interno. Material y Métodos. Se realizó estudio de una familia en la que nueve miembros presentaban sordera. Se estudiaron cuatro de ellos y una madre sin manifestaciones, a través del estudio clínico general por médico genetista, el estudio audiológico (otoscopía y audiometría) por médico audiólogo y el estudio de tomografía computada (TC) por médico radiólogo. Resultados. Los pacientes estudiados presentaron sordera neurosensorial congénita, de severa a profunda bilateral. A través de la TC, se evidenció malformación de oído interno. Tres pacientes presentaron partición coclear incompleta tipo III y un paciente partición incompleta tipo I. Debido al estudio clínico y al árbol genealógico, se definió diagnóstico de hipoacusia neurosensorial no sindrómica ligada al X. La TC de la madre sin manifestaciones no presentó evidencia de malformaciones en oído interno (MOI). Conclusión. El estudio de imagen es fundamental para definir presencia o no de MOI en todos los pacientes con hipoacusia y así poder guiar la terapéutica y el asesoramiento genético, así como realizar los estudios moleculares más adecuados.

Objective: This study aimed to evaluate the audiology students' opinions regarding their occupational perspective and their future expectations during the COVID-19 pandemic.Methods: The study included 608 participants consisting of undergraduate and graduate students. Two question forms were used in the study. "Audiology students' opinions regarding their occupational perspective during the COVID-19 pandemic" containing 10 questions and "Audiology students' opinions regarding their future expectations" containing 8 questions were assessed.Results: While the COVID-19 pandemic did not affect employment opportunities in the field of audiology, it significantly contributed to the increase of professional risks. Online education did not contribute to the learning process and professional competencies. More graduate students stated that the COVID-19 did not affect employment opportunities and increased professional risks but facilitated access to information compared to undergraduate students (p < .05). Undergraduate students stated that COVID-19 contributed more to the reconsideration of career plans and opinions about the profession compared to graduate students (p < .05). COVID-19 pandemic had a more negative effect on graduate students' future expectations compared to undergraduate students (p < .05).Conclusion: To our view, the COVID-19 pandemic negatively influenced the occupational perspective of audiology students but did not affect their future expectations. While this process affected the career plan and perspective on the audiology profession of undergraduate students, it negatively impacted the professional risk perception and future expectations of graduate students.

Introduction: Hearing screening is a detection method, its objective is to provide an early intervention that allows reducing the negative consequences of an eventual hearing impairment, in the integral development of the infant. Costa Rica has implemented a universal neonatal hearing screening program in the public health system, where the hearing of every child born in the country is examined before the first month of life. Although multiple benefits have been perceived, it is important to demonstrate with scientific evidence if it accomplishes its objectives. Methodology: the effectiveness of the Universal Newborn Hearing Screening Program in Costa Rica was analyzed, based on the information recorded from 37,656 children evaluated since 2016 to 2018, through empirical contrast using both descriptive techniques: frequency distribution of variables, as well as the use of inferential tests: chi square and analysis of variance (ANOVA). Results: 71 % of the sample was between 0 and 3 days old at the moment of being examined. Its performance over time and extension to different health centers has been satisfactory, likewise, the number of infants evaluated has been up to 98 % of the population. Conclusions: the TANU program is effective in most of the aspects analyzed, the identification of risk factors and the early detection of hearing disorders are outstanding, however, improvements are proposed in relation to the handling of information., Introducción: el tamizaje auditivo es un método de detección y su propósito es intervenir de forma temprana para reducir las consecuencias negativas de una eventual afección auditiva en el desarrollo integral del infante. Costa Rica ha implementado en el sistema de salud público un programa de tamizaje auditivo neonatal universal, donde se examina todo niño o niña antes del primer mes de vida. Aunque se han percibido múltiples beneficios, es importante demostrar con evidencia científica si cumple sus objetivos. Metodología: se analizó la eficacia del «Programa de tamizaje auditivo neonatal universal» (TANU) de la Caja Costarricense de Seguro Social, a partir de la información registrada de 37 656 infantes evaluados entre los años 2016 y 2018, mediante el contraste empírico con las técnicas descriptivas de distribución de frecuencias de variables, y las pruebas inferenciales chi cuadrado y análisis de varianza (ANOVA). Resultados: en cuanto a la edad al momento del examen, el 71 % de la muestra tenía entre 0 y 3 días. Su desempeño a través del tiempo y la extensión a distintos centros de salud ha sido satisfactorio, así mismo, la cantidad de infantes valorados ha sido hasta del 98 % de la población. Conclusiones: el programa TANU es eficaz en la mayoría de aspectos analizados, destaca la identificación de factores de riesgo y la detección temprana de afecciones auditivas, sin embargo, se proponen mejoras en relación con el manejo de la información.

The primary objective of this dissertation was to assess four consonants, /t/, /k/, /s/, and /ʃ/, produced by young children with cochlear implants (CIs). These consonants were chosen because they comprise two place-of-articulation contrasts, which are cued auditorily by spectral information in English, and they cover both early-acquired (/t/, /k/) and late-acquired (/s/, /ʃ/) manners of articulation. Thus, the auditory-perceptual limitations imposed by CIs is likely to impact acquisition of these sounds: because spectral information is particularly distorted, children have limited access to the cues that differentiate these sounds.Twenty-eight children with CIs and a group of peers with normal hearing (NH) who were matched in terms of age, sex, and maternal education levels participated in this project. The experiment required children to repeat familiar words with initial /t/, /k/, /s/, or /ʃ/ following an auditory model and picture prompt. To create in-depth speech profiles and examine variability both within and across children, target consonants were elicited many times in front-vowel and back-vowel contexts. Patterns of accuracy and errors were analyzed based on transcriptions. Acoustic robustness of contrast was analyzed based on correct productions. Centroid frequencies were calculated from the release-burst spectra for /t/ and /k/ and the fricative noise spectra for /s/ and /ʃ/. Results showed that children with CIs demonstrated patterns not observed in children with NH. Findings provide evidence that for children with CIs, speech acquisition is not simply delayed due to a period of auditory deprivation prior to implantation. Idiosyncratic patterns in speech production are explained in-part by the limitations of CI’s speech-processing algorithms. The first chapter of this dissertation provides a general introduction. The second chapter includes a validation study for a measure to differentiate /t/ and /k/ in adults’ productions. The third chapter analyzes a

South Africa is a low to middle income country (LMIC) with a population of 60 million people. The public health sector serves more than 80% of the population. Chris Hani Baragwanath Academic Hospital is a central level public health care facility situated in Gauteng. The Speech Therapy and Audiology Department provides insight into their telepractice services through a qualitative approach. The onset of the COVID-19 pandemic resulted in therapists exploring telepractice as a sustainable model of service delivery. Therapists and patients encountered many challenges to the implementation of telepractice, however, the commitment of therapists ensured that creative solutions were developed. A comprehensive needs analysis at public health institutions is required to ensure the sustainability of telepractice. A hybrid model (telepractice and in-person consults) holds the potential to reduce the financial burden on patients and increase access to quality patient- centered care.

(1) Background: To improve hearing-aid rehabilitation, the Danish ‘Better hEAring Rehabilitation’ (BEAR) project recently developed methods for individual hearing loss characterization and hearing-aid fitting. Four auditory profiles differing in terms of audiometric hearing loss and supra-threshold hearing abilities were identified. To enable auditory profile-based hearing-aid treatment, a fitting rationale leveraging differences in gain prescription and signal-to-noise (SNR) improvement was developed. This report describes the translation of this rationale to clinical devices supplied by three industrial partners. (2) Methods: Regarding the SNR improvement, advanced feature settings were proposed and verified based on free-field measurements made with an acoustic mannikin fitted with the different hearing aids. Regarding the gain prescription, a clinically feasible fitting tool and procedure based on real-ear gain adjustments were developed. (3) Results: Analyses of the collected real-ear gain and SNR improvement data confirmed the feasibility of the clinical implementation. Differences between the auditory profile-based fitting strategy and a current ‘best practice’ procedure based on the NAL-NL2 fitting rule were verified and are discussed in terms of limitations and future perspectives. (4) Conclusion: Based on a joint effort from academic and industrial partners, the BEAR fitting rationale was transferred to commercially available hearing aids.

Introduction A growing body of evidence suggests that hearing loss is a significant and potentially modifiable risk factor for cognitive impairment. Although the mechanisms underlying the associations between cognitive decline and hearing loss are unclear, listening effort has been posited as one of the mechanisms involved with cognitive decline in older age. To date, there has been a lack of research investigating this association, particularly among adults with mild cognitive impairment (MCI). Methods and analysis 15-25 cognitively healthy participants and 15-25 patients with MCI (age 40-85 years) will be recruited to participate in an exploratory study investigating the association between cognitive functioning and listening effort. Both behavioural and objective measures of listening effort will be investigated. The sentence-final word identification and recall (SWIR) test will be administered with single talker non-intelligible speech background noise while monitoring pupil dilation. Evaluation of cognitive function will be carried out in a clinical setting using a battery of neuropsychological tests. This study is considered exploratory and proof of concept, with information taken to help decide the validity of larger-scale trials. Ethics and dissemination Written approval exemption was obtained by the Scientific Ethics Committee in the central region of Denmark (De Videnskabsetiske Komiteer i Region Hovedstaden), reference 19042404, and the project is registered pre-results at clinicaltrials.gov, reference NCT04593290, Protocol ID 19042404. Study results will be disseminated in peer-reviewed journals and conferences.

Introduction A growing body of evidence suggests that hearing loss is a significant and potentially modifiable risk factor for cognitive impairment. Although the mechanisms underlying the associations between cognitive decline and hearing loss are unclear, listening effort has been posited as one of the mechanisms involved with cognitive decline in older age. To date, there has been a lack of research investigating this association, particularly among adults with mild cognitive impairment (MCI). Methods and analysis 15-25 cognitively healthy participants and 15-25 patients with MCI (age 40-85 years) will be recruited to participate in an exploratory study investigating the association between cognitive functioning and listening effort. Both behavioural and objective measures of listening effort will be investigated. The sentence-final word identification and recall (SWIR) test will be administered with single talker non-intelligible speech background noise while monitoring pupil dilation. Evaluation of cognitive function will be carried out in a clinical setting using a battery of neuropsychological tests. This study is considered exploratory and proof of concept, with information taken to help decide the validity of larger-scale trials. Ethics and dissemination Written approval exemption was obtained by the Scientific Ethics Committee in the central region of Denmark (De Videnskabsetiske Komiteer i Region Hovedstaden), reference 19042404, and the project is registered pre-results at clinicaltrials.gov, reference NCT04593290, Protocol ID 19042404. Study results will be disseminated in peer-reviewed journals and conferences.

Audiologists are recognized in Spain and most countries in Latin America and have practised in various fields for more than 40 years. Despite this, a paucity of information exists regarding audiologists’ engagement with scientific journals both as readers and authors alike. The aim of this paper was to describe the scientific-disciplinary reader profile of Spanish-speaking audiology professionals. A questionnaire was distributed online with 16 questions grouped into two sections: 1) General and demographic data and 2) Readership profile. A total of 200 questionnaires were completed. With the results, a qualitative analysis was performed and a summary was written for each question. General audiology and hearing aids/amplification systems were found to be the areas of greatest interest among respondents (74% and 71%, respectively). In the readership profile section, 66% of respondents reported consulting scientific journals (at least once a month). The most common reason, given by 51% in this group, was to keep up to date. However, 81% of respondents reported never having published in a peer-reviewed journal. The main reason for not publishing was lack of confidence to write an article (51%). Despite audiologists showing a keen interest in reading audiology journals, only a small proportion submits articles for publication., El profesional audiólogo se encuentra reconocido en la mayoría de los países de Iberoamérica desempeñando sus funciones en diversas áreas desde hace más de 40 años. A pesar esto aún existe escasa información en relación a la vinculación con revistas científicas, ya sea como lectores y/o autores.  El objetivo del presente trabajo fue la caracterización del profesional del área de la audiología en Iberoamérica como lector de una revista científica de audiología en Castellano. Un total de 200 cuestionarios fueron respondidos. En relación al perfil del lector, se reporta que un 66% de los participantes consulta revistas científicas (una o más veces al mes), siendo la actualización (51%) el motivo más frecuente dentro de este grupo. Sin embargo, un 81% de los participantes refiere no tener experiencia publicando en una revista revisada por pares, siendo inseguridad para escribir un artículo (51%) como la razón principal.

Audiologists are recognized in Spain and most countries in Latin America and have practised in various fields for more than 40 years. Despite this, a paucity of information exists regarding audiologists’ engagement with scientific journals both as readers and authors alike. The aim of this paper was to describe the scientific-disciplinary reader profile of Spanish-speaking audiology professionals. A questionnaire was distributed online with 16 questions grouped into two sections: 1) General and demographic data and 2) Readership profile. A total of 200 questionnaires were completed. With the results, a qualitative analysis was performed and a summary was written for each question. General audiology and hearing aids/amplification systems were found to be the areas of greatest interest among respondents (74% and 71%, respectively). In the readership profile section, 66% of respondents reported consulting scientific journals (at least once a month). The most common reason, given by 51% in this group, was to keep up to date. However, 81% of respondents reported never having published in a peer-reviewed journal. The main reason for not publishing was lack of confidence to write an article (51%). Despite audiologists showing a keen interest in reading audiology journals, only a small proportion submits articles for publication., El profesional audiólogo se encuentra reconocido en la mayoría de los países de Iberoamérica desempeñando sus funciones en diversas áreas desde hace más de 40 años. A pesar esto aún existe escasa información en relación a la vinculación con revistas científicas, ya sea como lectores y/o autores.  El objetivo del presente trabajo fue la caracterización del profesional del área de la audiología en Iberoamérica como lector de una revista científica de audiología en Castellano. Un total de 200 cuestionarios fueron respondidos. En relación al perfil del lector, se reporta que un 66% de los participantes consulta revistas científicas (una o más veces al mes), siendo la actualización (51%) el motivo más frecuente dentro de este grupo. Sin embargo, un 81% de los participantes refiere no tener experiencia publicando en una revista revisada por pares, siendo inseguridad para escribir un artículo (51%) como la razón principal.

Audiologists are recognized in Spain and most countries in Latin America and have practised in various fields for more than 40 years. Despite this, a paucity of information exists regarding audiologists’ engagement with scientific journals both as readers and authors alike. The aim of this paper was to describe the scientific-disciplinary reader profile of Spanish-speaking audiology professionals. A questionnaire was distributed online with 16 questions grouped into two sections: 1) General and demographic data and 2) Readership profile. A total of 200 questionnaires were completed. With the results, a qualitative analysis was performed and a summary was written for each question. General audiology and hearing aids/amplification systems were found to be the areas of greatest interest among respondents (74% and 71%, respectively). In the readership profile section, 66% of respondents reported consulting scientific journals (at least once a month). The most common reason, given by 51% in this group, was to keep up to date. However, 81% of respondents reported never having published in a peer-reviewed journal. The main reason for not publishing was lack of confidence to write an article (51%). Despite audiologists showing a keen interest in reading audiology journals, only a small proportion submits articles for publication., El profesional audiólogo se encuentra reconocido en la mayoría de los países de Iberoamérica desempeñando sus funciones en diversas áreas desde hace más de 40 años. A pesar esto aún existe escasa información en relación a la vinculación con revistas científicas, ya sea como lectores y/o autores.  El objetivo del presente trabajo fue la caracterización del profesional del área de la audiología en Iberoamérica como lector de una revista científica de audiología en Castellano. Un total de 200 cuestionarios fueron respondidos. En relación al perfil del lector, se reporta que un 66% de los participantes consulta revistas científicas (una o más veces al mes), siendo la actualización (51%) el motivo más frecuente dentro de este grupo. Sin embargo, un 81% de los participantes refiere no tener experiencia publicando en una revista revisada por pares, siendo inseguridad para escribir un artículo (51%) como la razón principal.

Hearing loss is a common human sensory disorder affecting millions globally, and many cases are due to a genetic etiology. Genetic testing for hearing loss is evolving as new genetic tests and genes related to hearing loss emerge; however, there has been limited research on how testing for hearing loss is impacting individuals. The purpose of this study was to assess how genetic testing for hearing loss influences decision making regarding medical management, language development, education, family planning and spouse selection by deaf adults and parents of deaf children as well as the impact on their emotional well-being. An anonymous online survey was created to assess experiences with genetic counseling and genetic testing for hearing loss. Study participants were recruited through online national organizations and social media advocacy groups, and 84 responses were analyzed. Hearing parents of deaf children were more likely to make post-genetic testing decisions regarding their children’s medical care and language development than deaf parents did for their children or themselves. Family planning decisions were made less frequently, but there were still 31% of deaf adults and 36% of parents of deaf children whose family planning was influenced by their test results. Individuals with, and parents of children with syndromic deafness were significantly more likely to make medical and family planning decisions after genetic testing than were participants or parents of children without a syndrome. Genetic testing revealed a diagnosis more frequently in deaf children than deaf adults, and deaf children also received genetic counseling more often than deaf adults. Respondents were more likely to have an overall positive affect than a negative or neutral affect post-genetic testing on the Positive and Negative Affect Schedule (PANAS). The results of this study illustrate the diversity of impact that genetic testing for hearing loss has on individuals and families and hi

Hearing loss is a common human sensory disorder affecting millions globally, and many cases are due to a genetic etiology. Genetic testing for hearing loss is evolving as new genetic tests and genes related to hearing loss emerge; however, there has been limited research on how testing for hearing loss is impacting individuals. The purpose of this study was to assess how genetic testing for hearing loss influences decision making regarding medical management, language development, education, family planning and spouse selection by deaf adults and parents of deaf children as well as the impact on their emotional well-being. An anonymous online survey was created to assess experiences with genetic counseling and genetic testing for hearing loss. Study participants were recruited through online national organizations and social media advocacy groups, and 84 responses were analyzed. Hearing parents of deaf children were more likely to make post-genetic testing decisions regarding their children’s medical care and language development than deaf parents did for their children or themselves. Family planning decisions were made less frequently, but there were still 31% of deaf adults and 36% of parents of deaf children whose family planning was influenced by their test results. Individuals with, and parents of children with syndromic deafness were significantly more likely to make medical and family planning decisions after genetic testing than were participants or parents of children without a syndrome. Genetic testing revealed a diagnosis more frequently in deaf children than deaf adults, and deaf children also received genetic counseling more often than deaf adults. Respondents were more likely to have an overall positive affect than a negative or neutral affect post-genetic testing on the Positive and Negative Affect Schedule (PANAS). The results of this study illustrate the diversity of impact that genetic testing for hearing loss has on individuals and families and hi

Background: Percutaneous bone conduction implants are an alternative to alleviate unilateral transmission, mixed and neurosensory hearing loss in patients unable to carry conventional hearing aids. Through this study we analyzed the indications of the osseointegrated systems in the Lozano Blesa Hospital (Zaragoza, Spain), among other aspects. Method: An observational study was carried out based on medical records, including patients who had been implanted with a percutaneous osseointegrated system since 2010. The collected data included demographic information, clinical and analytical data concerning his hearing loss and post-implant complications, among others. Results: 59 percutaneous implants were analyzed; 44.1% Baha type and 55.9% Ponto type. Regarding the audiological indication of the implant, mixed hearing loss was the most frequent cause (64,40%). The most frequent clinical diagnosis was chronic otitis media (83%). The functional hearing gain of the implanted patients due to transmission hearing loss was 26,92 ± 7,65 dB. The most used surgical technique was the U flap carried out in 42.40% patients. It has been observed a tendency between the relationship in the number of complications and the fact of performing a reduction of subcutaneous tissue surrounding the implant (p = 0,051). Discussion and conclusions: Although no significant differences were found, the demographic results, as well as the indication of implantation, functional gain and complications are similar to the data found in the medical literature. However, future studies with a larger number of patients would be convenient., Introducción: Los implantes de conducción de vía ósea percutáneos son una alternativa a los audífonos convencionales en hipoacusias de transmisión, mixtas y neurosensoriales unilaterales, en pacientes con imposibilidad de usar los primeros. Mediante este estudio analizamos diferentes aspectos de los sistemas osteointegrados en el Hospital Clínico Universitario Lozano Blesa de Zaragoza (España). Método: Se ha realizado un estudio observacional basado en historias clínicas, incluyendo a los pacientes que han sido implantados con un sistema osteointegrado de tipo percutáneo desde el año 2010. Entre los datos recogidos se valoraron datos demográficos, datos clínicos y analíticos referentes su hipoacusia y complicaciones post-implante entre otros. Resultados: Se han analizado 59 implantes percutáneos; un 44,1% tipo Baha y un 55,9 % tipo Ponto. La indicación audiológica mas frecuente fue la hipoacusia mixta (64,40%). El diagnóstico clínico más frecuente fue la otitis media crónica (83%). La ganancia auditiva funcional de los pacientes implantados debido a hipoacusia de transmisión fue de 26,92 ± 7,65 dB. La técnica quirúrgica más empleada fue el colgajo en U llevada a cabo en el 42,40% pacientes. Se ha objetivado cierta tendencia a la relación en el número de complicaciones y el hecho de realizar una reducción de tejido subcutáneo circundante al implante (p=0,051). Conclusiones: Aunque no se hayan encontrado diferencias significativas, los resultados tanto demográficos, como de indicación de la implantación, la ganancia funcional y las complicaciones son similares a los datos encontrados en la literatura médica.

Older listeners, particularly those with age-related hearing loss, report a high level of difficulty in perception of non-native speech when queried in clinical settings. In an increasingly global society, addressing these challenges is an important component of providing auditory care and rehabilitation to this population. Prior literature shows that younger listeners can quickly adapt to both unfamiliar and challenging auditory stimuli, improving their perception over a short period of exposure. Prior work has suggested that a protocol including higher variability of the speech materials may be most beneficial for learning; variability within the stimuli may serve to provide listeners with a larger range of acoustic information to map onto higher level lexical representations. However, there is also evidence that increased acoustic variability is not beneficial for all listeners. Listeners also benefit from the presence of semantic context during speech recognition tasks. It is less clear, however, whether older listeners derive more benefit than younger listeners from supportive context; some studies find increased benefit for older listeners, while others find that the context benefit is similar in magnitude across age groups.This project comprises a series of experiments utilizing behavioral and electrophysiologic measures designed to examine the contributions of acoustic variability and semantic context in relation to speech recognition during the course of rapid adaptation to non-native English speech. Experiment 1 examined the effects of increasing stimulus variability on behavioral measures of rapid adaptation. The results of the study indicated that stimulus variability impacted overall levels of recognition, but did not affect rate of adaptation. This was confirmed in Experiment 2, which also showed that degree of semantic context influenced rate of adaptation, but not overall performance levels. In Experiment 3, younger and older normal-hearing adults sh

The creation of the term and concept of Audiology is attributed to different authors, Schier, Nowak, Canfield, Hargrave. In 1946, Carhart et al. Defined Audiology as the science that deals with hearing disorders in both normal and pathological ears. The term Audiology, even today, lacks a precise definition, it still does not have a reference in the dictionary of the Royal Academy of the Spanish Language, which reflects the complexity of this science to be able to reference it in a specific area of ​​knowledge. Audiology is the branch of science that studies and analyzes the physiological processes that allow, through the mechanism of hearing, to interpret “what is heard”, being able to differentiate into “how and how much is heard”. This differentiation of how much and how it is heard makes Audiology a quantifiable science allowing to determine the degree of hearing loss, which facilitates intervention, treatment and prosthetic adaptation in order to replace and restore any hearing impairment. The progress of knowledge in Audiology like any other clinical branch of Health Sciences is based on basic research. The evolution of basic research in Audiology has not stopped progressing and contributing knowledge about the nature of the structural elements at the peripheral level and the central nervous system. The complex functioning of these structural elements not only related to the auditory process but also the close relationship of hearing with the interpretation of oral language, with other sensory organs such as sight, smell, balance, memory, are allowing that in this 21st century , Audiology has become a shared discipline, analyzed and used by different professionals, thus being a multidisciplinary science. The period between the years 1960-1970 where Audiology is mainly clinical and is defined as a branch of Otology, related to other clinical specialties of Health Sciences such as Phoniatrics, Geriatrics, Pediatrics, Neurology, Psychiatry . From the years 1980-2, La creación del término y concepto de Audiología se atribuye a diferentes autores, Schier, Nowak, Canfield, Hargrave. En 1946, Carhart y colaboradores definieron la Audiología como la ciencia que se ocupa de las alteraciones auditivas tanto en oído normal como patológico. El termino Audiología, aun hoy, carece de definición precisa, sigue sin tener una referencia en el diccionario de la Real Academia de la Lengua Española, lo que refleja la complejidad de esta ciencia para poder referenciarla en una parcela concreta del conocimiento. La Audiología es la rama de la ciencia estudia y analiza los procesos fisiológicos que permiten a través del mecanismo de la audición, interpretar “lo que se oye” pudiendo diferenciar en “como y cuanto se oye”. Esta diferenciación del cuanto y como se oye hace de la Audiología una ciencia cuantificable permitiendo determinar el grado de pérdida auditiva, lo que facilita la intervención, tratamiento y adaptación protésica con el fin de suplir y restaurar cualquier deficiencia auditiva. El progreso del conocimiento en Audiología como cualquier otra rama clínica de Ciencias de la Salud se sustenta en la investigación básica. La evolución de la investigación básica en Audiología no ha dejado de progresar y aportar conocimiento sobre la naturaleza de los elementos estructurales a nivel periférico y sistema nervioso central. El complejo funcionamiento de estos elementos estructurales no solo relacionados con le proceso auditivo sino la estrecha relación de audición con la interpretación del lenguaje oral, con otros órganos sensoriales como la vista el olfato, el equilibrio, la memoria, están permitiendo que en este siglo XXI, la Audiología se haya convertido en una disciplina compartida, analizada y utilizada por diferentes profesionales, siendo por tanto una ciencia multidisciplinar. El periodo comprendido entre los años 1960-1970 donde la Audiología es principalmente clínica y se la define como rama de la Otología, relacionada con otras esp

The vocational training certificate in Hearing-Aid Specialist (HAS) was created in Spain in 2001. During this time, university programs in audiology have emerged in the form of university-specific postgraduate degrees. However, the undergraduate program in general audiology does not exist in Spain yet. The objective of this study was to examine the workplaces, services offered and the self-perceived quality of training of HAS with and without a additional university studies and to explore whether any of these professional profiles conduct activities of the "general audiologist" role that was proposed by the European Federation of Audiological Societies (EFAS). An online questionnaire was completed by 255 HAS. Analysis of variance was used to compare responses between HAS, HAS with an undergraduate degree in audiology-related discipline, HAS postgraduate qualifications in audiology, and HAS with both additional qualifications. Regardless of their level of education, most HAS indicated that they work in hearing aid centers fitting hearing aids to adult patients, for which they perceived themselves as sufficiently trained. The most educated HAS indicated working in specialized centers and providing services to pediatric patients more often. Highly educated HAS also reported a better self-perceived training on cochlear implants than HAS. In general, HAS do not receive training or offer services in areas within the competencies of the general audiologist according to the model proposed by EFAS, such as cochlear implant programming or diagnosis of vestibular disorders. Future studies focus on exploring the training received by professionals who offer this type of audiological services in Spain., La titulación de Técnico Superior en Audiología Protésica (TSAP) nació en España en el año 2001. Desde entonces, han surgido títulos propios de posgrado en audiología. Sin embargo, no existe aún en España el grado universitario de audiología general. El objetivo de este estudio fue examinar los lugares de trabajo, los servicios ofrecidos y la percepción de la formación de los TSAP con y sin formación universitaria y si éstos ejercían labores propias del audiólogo general propuesto por la Federación Europea de Sociedades Audiológicas (EFAS). Un cuestionario en línea fue completado por 255 TSAP. Se utilizaron análisis de varianza para comparar las respuestas entre TSAP sin formación complementaria, TSAP con grado de una disciplina afín a la audiología, TSAP con posgrado en audiología, y TSAP con ambos complementos. Independientemente de su nivel educativo, la mayoría de los TSAP indicaron desempeñar su labor profesional en centros auditivos adaptando audífonos a pacientes adultos, para lo cual percibieron estar suficientemente formados. Los TSAP con mayor nivel educativo indicaron trabajar en centros más especializados, así como atender a pacientes pediátricos con más frecuencia, y percibieron que su formación en implantes cocleares era mejor que los TSAP. En general, los TSAP no reciben formación ni ofrecen servicios en áreas que están dentro de las competencias del audiólogo general, tales como la programación de implantes cocleares o el diagnóstico de problemas vestibulares. Los estudios futuros deberán enfocarse en conocer la formación que reciben los profesionales que ofrecen este tipo de servicios audiológicos en España.

The vocational training certificate in Hearing-Aid Specialist (HAS) was created in Spain in 2001. During this time, university programs in audiology have emerged in the form of university-specific postgraduate degrees. However, the undergraduate program in general audiology does not exist in Spain yet. The objective of this study was to examine the workplaces, services offered and the self-perceived quality of training of HAS with and without a additional university studies and to explore whether any of these professional profiles conduct activities of the "general audiologist" role that was proposed by the European Federation of Audiological Societies (EFAS). An online questionnaire was completed by 255 HAS. Analysis of variance was used to compare responses between HAS, HAS with an undergraduate degree in audiology-related discipline, HAS postgraduate qualifications in audiology, and HAS with both additional qualifications. Regardless of their level of education, most HAS indicated that they work in hearing aid centers fitting hearing aids to adult patients, for which they perceived themselves as sufficiently trained. The most educated HAS indicated working in specialized centers and providing services to pediatric patients more often. Highly educated HAS also reported a better self-perceived training on cochlear implants than HAS. In general, HAS do not receive training or offer services in areas within the competencies of the general audiologist according to the model proposed by EFAS, such as cochlear implant programming or diagnosis of vestibular disorders. Future studies focus on exploring the training received by professionals who offer this type of audiological services in Spain., La titulación de Técnico Superior en Audiología Protésica (TSAP) nació en España en el año 2001. Desde entonces, han surgido títulos propios de posgrado en audiología. Sin embargo, no existe aún en España el grado universitario de audiología general. El objetivo de este estudio fue examinar los lugares de trabajo, los servicios ofrecidos y la percepción de la formación de los TSAP con y sin formación universitaria y si éstos ejercían labores propias del audiólogo general propuesto por la Federación Europea de Sociedades Audiológicas (EFAS). Un cuestionario en línea fue completado por 255 TSAP. Se utilizaron análisis de varianza para comparar las respuestas entre TSAP sin formación complementaria, TSAP con grado de una disciplina afín a la audiología, TSAP con posgrado en audiología, y TSAP con ambos complementos. Independientemente de su nivel educativo, la mayoría de los TSAP indicaron desempeñar su labor profesional en centros auditivos adaptando audífonos a pacientes adultos, para lo cual percibieron estar suficientemente formados. Los TSAP con mayor nivel educativo indicaron trabajar en centros más especializados, así como atender a pacientes pediátricos con más frecuencia, y percibieron que su formación en implantes cocleares era mejor que los TSAP. En general, los TSAP no reciben formación ni ofrecen servicios en áreas que están dentro de las competencias del audiólogo general, tales como la programación de implantes cocleares o el diagnóstico de problemas vestibulares. Los estudios futuros deberán enfocarse en conocer la formación que reciben los profesionales que ofrecen este tipo de servicios audiológicos en España.

The vocational training certificate in Hearing-Aid Specialist (HAS) was created in Spain in 2001. During this time, university programs in audiology have emerged in the form of university-specific postgraduate degrees. However, the undergraduate program in general audiology does not exist in Spain yet. The objective of this study was to examine the workplaces, services offered and the self-perceived quality of training of HAS with and without a additional university studies and to explore whether any of these professional profiles conduct activities of the "general audiologist" role that was proposed by the European Federation of Audiological Societies (EFAS). An online questionnaire was completed by 255 HAS. Analysis of variance was used to compare responses between HAS, HAS with an undergraduate degree in audiology-related discipline, HAS postgraduate qualifications in audiology, and HAS with both additional qualifications. Regardless of their level of education, most HAS indicated that they work in hearing aid centers fitting hearing aids to adult patients, for which they perceived themselves as sufficiently trained. The most educated HAS indicated working in specialized centers and providing services to pediatric patients more often. Highly educated HAS also reported a better self-perceived training on cochlear implants than HAS. In general, HAS do not receive training or offer services in areas within the competencies of the general audiologist according to the model proposed by EFAS, such as cochlear implant programming or diagnosis of vestibular disorders. Future studies focus on exploring the training received by professionals who offer this type of audiological services in Spain., La titulación de Técnico Superior en Audiología Protésica (TSAP) nació en España en el año 2001. Desde entonces, han surgido títulos propios de posgrado en audiología. Sin embargo, no existe aún en España el grado universitario de audiología general. El objetivo de este estudio fue examinar los lugares de trabajo, los servicios ofrecidos y la percepción de la formación de los TSAP con y sin formación universitaria y si éstos ejercían labores propias del audiólogo general propuesto por la Federación Europea de Sociedades Audiológicas (EFAS). Un cuestionario en línea fue completado por 255 TSAP. Se utilizaron análisis de varianza para comparar las respuestas entre TSAP sin formación complementaria, TSAP con grado de una disciplina afín a la audiología, TSAP con posgrado en audiología, y TSAP con ambos complementos. Independientemente de su nivel educativo, la mayoría de los TSAP indicaron desempeñar su labor profesional en centros auditivos adaptando audífonos a pacientes adultos, para lo cual percibieron estar suficientemente formados. Los TSAP con mayor nivel educativo indicaron trabajar en centros más especializados, así como atender a pacientes pediátricos con más frecuencia, y percibieron que su formación en implantes cocleares era mejor que los TSAP. En general, los TSAP no reciben formación ni ofrecen servicios en áreas que están dentro de las competencias del audiólogo general, tales como la programación de implantes cocleares o el diagnóstico de problemas vestibulares. Los estudios futuros deberán enfocarse en conocer la formación que reciben los profesionales que ofrecen este tipo de servicios audiológicos en España.

The Better hEAring Rehabilitation (BEAR) project aims to provide a new clinical profiling tool—a test battery—for hearing loss characterization. Although the loss of sensitivity can be efficiently measured using pure-tone audiometry, the assessment of supra-threshold hearing deficits remains a challenge. In contrast to the classical “attenuation-distortion” model, the proposed BEAR approach is based on the hypothesis that the hearing abilities of a given listener can be characterized along two dimensions, reflecting independent types of perceptual deficits (distortions). A data-driven approach provided evidence for the existence of different auditory profiles with different degrees of distortions. Ten tests were included in a test battery, based on their clinical feasibility, time efficiency, and related evidence from the literature. The tests were divided into six categories: audibility, speech perception, binaural processing abilities, loudness perception, spectro-temporal modulation sensitivity, and spectro-temporal resolution. Seventy-five listeners with symmetric, mild-to-severe sensorineural hearing loss were selected from a clinical population. The analysis of the results showed interrelations among outcomes related to high-frequency processing and outcome measures related to low-frequency processing abilities. The results showed the ability of the tests to reveal differences among individuals and their potential use in clinical settings.

TRT is being widely established in different centers and providing the best results in the relief of patients with tinnitus. In Brazil, two facts contribute to a "resistance" to this method: the delay in the beginning to perceive the "long-awaited" improvement and the lack of knowledge about TRT. Our objective is to describe the experience with TRT in Brazil, showing some adaptations of the official method. We reviewed 161 files of tinnitus patients who have started TRT. The analysis of the results was carried out 12 months after the indication of TRT, separating the patients into 3 groups according to the category and mode of treatment: a) categories 1, 3 and 4 treated with 'more advice sessions'. broadband noise generators' (n = 38): tinnitus has improved in 73.3%; b) categories 1, 3 and 4 that have rejected the noise generators and have received 'advice sessions plus soft ambient sounds' (n = 74): tinnitus has improved by 80%; c) category 2 treated with 'advice sessions, hearing aids and soft ambient sounds' (n = 49): only 23 agreed to wear hearing aids, however 16 of them automatically presented tinnitus masking and were excluded from the result of TRT. In this study, patients have shown great restriction in wearing headphones or noise generators, so the principles of TRT had to be reinforced through the use of soft ambient sounds. Those who have followed the TRT protocol have shown excellent tinnitus improvement rates., El TRT se está instaurando ampliamente en distintos centros y proporcionando los mejores resultados en el alivio de los pacientes con acúfeno. En Brasil, dos hechos contribuyen a una “resistencia” a este método: la demora a que se empiece a percibir la ‘tan esperada’ mejora y la falta de conocimiento sobre el TRT. Nuestro objetivo es describir la experiencia con el TRT en Brasil, mostrando algunas adaptaciones del método oficial. Revisamos 161 archivos de pacientes con acúfeno que han empezado el TRT. El aná- lisis de los resultados se llevó acabo 12 meses después de la indicación del TRT separando a los pacientes en 3 grupos de acuerdo con la categoría y modo de tratamiento: a) categorías 1, 3 y 4 tratados con ‘sesiones de consejos más generadores de ruido de banda ancha’ (n=38): el acúfeno ha mejorado en el 73,3%; b) categorías 1, 3 y 4 que han rechazado los generadores de ruido y han recibido ‘sesiones de consejos más sonidos ambientales suaves’ (n=74): el acúfeno ha mejorado en el 80%; c) categoría 2 tratados con ‘sesiones de consejos, audífonos y sonidos ambientales suaves’ (n=49): solo 23 han estado de acuerdo en llevar audífonos, sin embargo 16 de ellos han presentado automáticamente enmascaramiento del acúfeno y han sido excluidos del resultado del TRT. En este estudio, los pacientes han demostrado una gran restricción en usar audífonos o generadores de ruido, así que los principios del TRT tuvieron que ser reforzados a través del uso de sonidos ambientales suaves. Aquellos que han seguido el protocolo del TRT han mostrado excelentes tasas de mejora del acúfeno.

Clinical bone conduction during a routine audiological evaluation is a vital tool for audiologists to differentiate a sensorineural hearing loss from a conductive hearing loss. However, the mechanisms that give rise to responses during bone conduction stimulation are poorly understood. This paper will cover the results of a review of the literature regarding the mechanisms of bone conduction to attempt to aid in the understanding of the mechanisms underlying bone conduction testing. Various proposed mechanisms of bone conduction are discussed, including mechanisms involving the outer ear, middle ear, and inner ear, along with newly proposed mechanisms such as soft tissue conduction and cerebrospinal fluid conduction. The evidence found in the literature supporting the existence of each mechanism is also reviewed.

Much of audiology education occurs in clinical settings with students working closely with aclinical instructor and with real patients. Although these pedagogical experiences are not in a traditional classroom, clinical education nonetheless can and should be intentionally designed. The scholarship of teaching and learning as a field has theoretical and evidence-based design frameworks that appear, thus far, not to have been cohesively applied to clinical education in audiology. This paper will examine the theory and research on Fink’s Taxonomy of Significant Learning along with the current research on clinical education in audiology using a critically appraised topic approach. Fink’s Taxonomy appears to be well-positioned to provide a cohesive, theoretically-ground, evidence-based framework for understanding, researching, and improving clinical audiology education. Both areas are used to inform a step-by-step guide on employing an evidence-based theory to design a clinical education experience.

BACKGROUND: Hearing loss is highly prevalent among older adults, and, when unaddressed, its impacts include social isolation, depression, and cognitive decline. Hearing aids are typically recommended to help manage hearing loss. However, there are significant disparities in the use of hearing aids by race/ethnicity, rural/urban status, and income, representing underlying access barriers. The prevailing model of hearing aid service delivery is clinic-based and private-pay, posing multiple obstacles for potentially millions of Americans. Teleaudiology is a strategy that can improve geographic access to services, yet there is a lack of research demonstrating the implementation and feasibility of this service delivery model in real-world practice settings, particularly among diverse and rural populations who may benefit most. Community Health Workers (CHWs) are non-medical public health workers from their community who help improve patient access, including by connecting patients to services and by improving the cultural-relevance of health information. CHWs may be uniquely positioned as the local, hands-on facilitators in teleaudiology to help improve patients’ access to hearing aid services, and therefore help improve their health outcomes. OBJECTIVES: The work in this dissertation addresses the following three aims: 1) synthesize past teleaudiology literature focusing on the role of patient-site facilitators; 2) describe the development and evaluation of a training program to prepare CHWs as patient-site facilitators in teleaudiology; and 3) investigate the feasibility of CHWs as patient-site facilitators in a teleaudiology intervention to improve hearing aid rehabilitation outcomes for older adults in a medically underserved, rural, US-Mexico border community. METHODS: To address Aim 1, a scoping literature review of the teleaudiology literature was conducted, in which patient-site facilitator roles, responsibilities, and background were described. Next, Aim 2 was a

OBJECTIVES: Abandonment of vision, hearing or mobility aids suggests common barriers and facilitators to ongoing device use. However, the possible interactive effects of combined hearing and vision disabilities on device use by those living with deafblindness are unclear. Here we summarise existing knowledge on variables influencing assistive technology use from the perspective of persons living with deafblindness. We used the WHO's International Classification of Functioning, Disability and Health (ICF) framework to contextualise the findings, asking 'What is currently known about variables influencing the (non-)use of assistive devices recommended for persons with deafblindness?' DESIGN: A scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews Checklist. DATA SOURCES: PubMed; ProQuest: ERIC; ProQuest Dissertation; ProQuest: Sociological Thesaurus; Web of Science; Scientific Electronic Library Online; Bielefeld Academic Search Engine; Pascal & Francis; APA PsycINFO and Ebsco for CINAHL were searched through 9 November 2020. ELIGIBILITY CRITERIA: We included peer-reviewed studies that reported on assistive technology, device abandonment/utilisation and provided data from persons living with deafblindness. DATA EXTRACTION AND SYNTHESIS: Four team members independently scored 83 studies for eligibility. RESULTS: Ten articles were chosen for data extraction. The emerging variables replicated established categories of barriers and facilitators: personal, device-related, environmental and intervention variables. The use of the ICF highlighted how an intermediate variable (eg, device acceptability) was necessary in order for a variable to become a barrier or a facilitator to device use. CONCLUSIONS: The variables influencing device use by persons with deafblindness followed the same categories described for single impairments. Usability was challenged in devices that rely on the 'other' sense. Hapti, Funding Agencies:Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal University Hospital Örebro Fonds de la Recherche en Sante du Quebec 281451

Acoustic comfort, safety and ergonomics in an environment for people with hearing dissabilities are determined by adequate accessibility conditions in it. These conditions will eliminate and / or avoid in the best possible way the presence of discriminatory conditions.The measures to be applied may vary according to the needs and degree of disability of each person, although they can also be valid and useful for the vast majority of the group and beneficial for the rest of the population, since it is based on the principle of design for all . Therefore, it is essential to take into account the conditions of the space and the environment in order to carry out an exhaustive study and implement the most appropriate measures. It is not enough only to take into account the scarce accessibility criteria established by current regulations, but also, aspects related to construction materials, the design and distribution of spaces, the conditions of furniture, lighting, etc. must be studied. This work presents all the parameters that are necessary to apply so that the conditions of an environment are the most suitable for a person with hearing impairment. These measures are endorsed and certified by the experience of users with hearing disabilities and by different studies that verify their suitability., El confort acústico, la seguridad y la ergonomía de las personas con discapacidad auditiva en un entorno vienen determinadas por unas adecuadas condiciones de accesibilidad en el mismo. Estas condiciones eliminarán y/o evitarán de la mejor forma posible la presencia de condiciones discriminatorias.Las medidas a aplicar pueden variar según las necesidades y grado de discapacidad de cada persona, aunque también pueden ser válidas y útiles para la gran mayoría del colectivo y beneficiaras para el resto de la población, puesto que se basa en el principio del diseño para todos. Por tanto, es imprescindible tener en cuenta las condiciones del espacio y el entorno para poder realizar un estudio exhaustivo e implementar las medidas más adecuadas. No basta sólo con tener en cuenta los escasos criterios de accesibilidad que recoge la normativa vigente, sino que también, se deben estudiar aspectos relativos a los materiales de construcción, el diseño y distribución de los espacios, las condiciones del mobiliario, la iluminación, etc. En este trabajo se presentan todos los parámetros que son necesarios aplicar para que las condiciones de un entorno sean las más idóneas para una persona con discapacidad auditiva. Dichas medidas están avaladas y certificadas por la experiencia de usuarios con discapacidad auditiva y por diferentes estudios que verifican la idoneidad de las mismas.

The mission of the hearing care professional does not focus solely and exclusively on the material and physical act of providing a hearing aid. The hearing care professional has a great responsibility in the educational process of the deaf child since it depends on him that the reeducation and auditory, speech and speech therapy are developed optimally. The hearing care professional must be aware that the intellectual and psychological development of the deaf child depends on him, consequently if he does not have special knowledge about the adaptation processes and methodologies, even having his rights acquired in the sale of hearing aids recognized, he should voluntarily refrain supplying hearing aids, with the consequent economic-commercial damage that this entails, but the ethical and human rights of the deaf child must be put before the economic benefits., La misión del audioprotesista no se centra solo y exclusivamente en el acto material y físico de suministrar una prótesis auditiva. El audioprotesista tiene una gran responsabilidad en el proceso educativo del niño sordo puesto que de él depende que la reeducación y rehabilitación auditiva, foniátrica y logopédica se desarrolle de forma optima. El audioprotesista tiene que ser consciente que el desarrollo intelectual, y psicológico del niño sordo depende de él, en consecuencia si no tiene conocimientos especiales sobre los procesos y metodologías de adaptación, aun teniendo reconocidos sus derechos adquiridos en la venta de audífonos debería de abstenerse voluntariamente de suministrar las prótesis auditivas, con el consiguiente perjuicio económico-comercial que ello supone, pero hay que anteponer los derechos éticos y humanos del niño sordo a los beneficios crematísticos.

Dr. Barruecos began the previous editorial by reviewing modern audiology, being this clinicaly and technically eminent. In a process of continuity, let me emphasize the lesser known part of audiology that is integrated into clear spaces of global audiology. The first thing that occurs to me is to look in the dictionary of the Royal Spanish Academy of the language ... and I can't find any meaning. Note that the term audiology does not appear, however all of us who intervene in one way or another know that it does exist. That is interesting. What should we understand by social audiology? I find some meaning in second-rate dictionaries: "Discipline that deals with the study of acoustic phenomena in relation to hearing." I keep looking for: "Discipline that deals with the study of acoustic phenomena in relation to hearing and the causes of lack of it." Well ... now I agree somewhat more. In the last congress held in May 2004 in Como, a town near Milan, one of the largest, possibly the largest, of those held in Europe in audiology, will help me to make the approach that I outline. If social audiology did not exist, how would it be understood that a good number of interventions of the fantastic event, of the hundreds that were reproduced, dealt with the intervention with parents of deaf children? Obviously, the programs or therapies influence the intervention with parents of these deaf children. And what we can call the other way of doing audiology has great relevance. Even the World Health Organization (WHO) dares to participate, developing elements that allow us to understand what happens with children with disabilities and their classification, and how they should participate in society. And he makes an important distinction between illness, disability, restrictions and handicap, because obviously those of us who work with deaf children know their difference. We intend that these services are carried out from professional services understood as the interaction of diffe, Iniciaba el Dr. Barruecos la editorial que precede haciendo una revisión de la audiología moderna, ésta eminentemente clínica y técnica. En un proceso de continuidad permítanme enfatizar la parte de la audiología menos conocida que se integra en claros espacios de audiología global. Lo primero que se me ocurre es mirar en el diccionario de la real academia española de la lengua… y no encuentro acepción alguna. Observen que no aparece el término audiología sin embargo a todos los que intervenimos de una forma u otra sabemos que sí existe. Curioso. ¿Qué debemos entender por audiología social? Encuentro algún significado en diccionarios de segunda: “Disciplina que se ocupa del estudio de los fenómenos acústicos en relación con la audición”. Sigo buscando: “Disciplina que se ocupa del estudio de los fenómenos acústicos en relación con la audición y las causas que produce la falta de ella”. Ya… ahora estoy algo más de acuerdo. En el pasado congreso celebrado en el mes de mayo de 2004 en Como, localidad próxima a Milán, uno de los mayores, posiblemente el mayor, de los celebrados en Europa en audiología, me va a servir para realizar la aproximación que les esbozo. Si no existiera la audiología social ¿Cómo se entendería que un buen numero de intervenciones del fantástico evento, de los cientos que reprodujeron, trataran sobre la intervención con padres de niños sordos? Evidentemente, los programas o terapias inciden en la intervención con padres de estos niños sordos. Y tiene gran relevancia lo que podemos llamar la otra forma de hacer audiología. Incluso la Organización Mundial de la Salud (OMS) osa participar, desarrollando elementos que nos permiten entender que pasa con los niños con discapacidad y su clasificación, y la forma cómo han de participar en la sociedad. Y realiza una importante distinción entre enfermedad, discapacidad, deficiencia y minusvalía, porque evidentemente los que trabajamos con niños sordos sabemos de su diferencia. Pretendemos que estos servic

In this review we intend to summarize the most outstanding contributions of Avicenna, included in Al-Qanun, to the field of Audiology. A review of various editions in Arabic and Persian of the fourth treatise of the third volume of Al-Qanun is made, focusing on the chapters corresponding to the study of the anatomy, physiology and pathology of the ear and trying to relate the concepts included with current knowledge . Avicenna's Al-Qanun offers a clear example of the advanced level of understanding of the anatomy, physiology and pathophysiology of the ear as perceived over a thousand years ago and of which many concepts are still valid today. The field of Audiology is a clear example of the involvement of Islamic Medicine and the contribution of Muslim doctors in the study of the anatomy, physiology and diseases of the ear. The scientific contributions of pioneering scholars like Avicenna to the field of Audiology should not be ignored., En esta revisión pretendemos resumir las aportaciones más destacadas de Avicena, incluidas en Al-Qanun, al campo de la Audiología. Se realiza una revisión de varias ediciones en árabe y en persa del cuarto tratado del tercer volumen de Al-Qanun, centrándonos en los capítulos correspondientes al estudio de la anatomía, fi siología y patología del oído e intentando relacionar los conceptos incluidos con los conocimientos actuales. Al-Qanun de Avicena ofrece un claro ejemplo del avanzado nivel de comprensión de la anatomía, la fi siología y fi siopatología del oído como fueron percibidos hace más de mil años y de lo cual muchos conceptos siguen vigentes hasta la actualidad. El campo de la Audiología es un claro ejemplo de la participación de la Medicina Islámica y de la contribución de los médicos musulmanes en el estudio de la anatomía, fi siología y enfermedades del oído. Las contribuciones científi cas de los eruditos pioneros como Avicena al campo de la Audiología no deben ser ignoradas.

The creation of the term and concept of Audiology is attributed to different authors, Schier, Nowak, Canfield, Hargrave. In 1946, Carhart et al. Defined Audiology as the science that deals with hearing disorders in both normal and pathological ears. The term Audiology, even today, lacks a precise definition, it still does not have a reference in the dictionary of the Royal Academy of the Spanish Language, which reflects the complexity of this science to be able to reference it in a specific area of ​​knowledge. Audiology is the branch of science that studies and analyzes the physiological processes that allow, through the mechanism of hearing, to interpret “what is heard”, being able to differentiate into “how and how much is heard”. This differentiation of how much and how it is heard makes Audiology a quantifiable science allowing to determine the degree of hearing loss, which facilitates intervention, treatment and prosthetic adaptation in order to replace and restore any hearing impairment. The progress of knowledge in Audiology like any other clinical branch of Health Sciences is based on basic research. The evolution of basic research in Audiology has not stopped progressing and contributing knowledge about the nature of the structural elements at the peripheral level and the central nervous system. The complex functioning of these structural elements not only related to the auditory process but also the close relationship of hearing with the interpretation of oral language, with other sensory organs such as sight, smell, balance, memory, are allowing that in this 21st century , Audiology has become a shared discipline, analyzed and used by different professionals, thus being a multidisciplinary science. The period between the years 1960-1970 where Audiology is mainly clinical and is defined as a branch of Otology, related to other clinical specialties of Health Sciences such as Phoniatrics, Geriatrics, Pediatrics, Neurology, Psychiatry . From the years 1980-2, La creación del término y concepto de Audiología se atribuye a diferentes autores, Schier, Nowak, Canfield, Hargrave. En 1946, Carhart y colaboradores definieron la Audiología como la ciencia que se ocupa de las alteraciones auditivas tanto en oído normal como patológico. El termino Audiología, aun hoy, carece de definición precisa, sigue sin tener una referencia en el diccionario de la Real Academia de la Lengua Española, lo que refleja la complejidad de esta ciencia para poder referenciarla en una parcela concreta del conocimiento. La Audiología es la rama de la ciencia estudia y analiza los procesos fisiológicos que permiten a través del mecanismo de la audición, interpretar “lo que se oye” pudiendo diferenciar en “como y cuanto se oye”. Esta diferenciación del cuanto y como se oye hace de la Audiología una ciencia cuantificable permitiendo determinar el grado de pérdida auditiva, lo que facilita la intervención, tratamiento y adaptación protésica con el fin de suplir y restaurar cualquier deficiencia auditiva. El progreso del conocimiento en Audiología como cualquier otra rama clínica de Ciencias de la Salud se sustenta en la investigación básica. La evolución de la investigación básica en Audiología no ha dejado de progresar y aportar conocimiento sobre la naturaleza de los elementos estructurales a nivel periférico y sistema nervioso central. El complejo funcionamiento de estos elementos estructurales no solo relacionados con le proceso auditivo sino la estrecha relación de audición con la interpretación del lenguaje oral, con otros órganos sensoriales como la vista el olfato, el equilibrio, la memoria, están permitiendo que en este siglo XXI, la Audiología se haya convertido en una disciplina compartida, analizada y utilizada por diferentes profesionales, siendo por tanto una ciencia multidisciplinar. El periodo comprendido entre los años 1960-1970 donde la Audiología es principalmente clínica y se la define como rama de la Otología, relacionada con otras esp

TRT is being widely established in different centers and providing the best results in the relief of patients with tinnitus. In Brazil, two facts contribute to a "resistance" to this method: the delay in the beginning to perceive the "long-awaited" improvement and the lack of knowledge about TRT. Our objective is to describe the experience with TRT in Brazil, showing some adaptations of the official method. We reviewed 161 files of tinnitus patients who have started TRT. The analysis of the results was carried out 12 months after the indication of TRT, separating the patients into 3 groups according to the category and mode of treatment: a) categories 1, 3 and 4 treated with 'more advice sessions'. broadband noise generators' (n = 38): tinnitus has improved in 73.3%; b) categories 1, 3 and 4 that have rejected the noise generators and have received 'advice sessions plus soft ambient sounds' (n = 74): tinnitus has improved by 80%; c) category 2 treated with 'advice sessions, hearing aids and soft ambient sounds' (n = 49): only 23 agreed to wear hearing aids, however 16 of them automatically presented tinnitus masking and were excluded from the result of TRT. In this study, patients have shown great restriction in wearing headphones or noise generators, so the principles of TRT had to be reinforced through the use of soft ambient sounds. Those who have followed the TRT protocol have shown excellent tinnitus improvement rates., El TRT se está instaurando ampliamente en distintos centros y proporcionando los mejores resultados en el alivio de los pacientes con acúfeno. En Brasil, dos hechos contribuyen a una “resistencia” a este método: la demora a que se empiece a percibir la ‘tan esperada’ mejora y la falta de conocimiento sobre el TRT. Nuestro objetivo es describir la experiencia con el TRT en Brasil, mostrando algunas adaptaciones del método oficial. Revisamos 161 archivos de pacientes con acúfeno que han empezado el TRT. El aná- lisis de los resultados se llevó acabo 12 meses después de la indicación del TRT separando a los pacientes en 3 grupos de acuerdo con la categoría y modo de tratamiento: a) categorías 1, 3 y 4 tratados con ‘sesiones de consejos más generadores de ruido de banda ancha’ (n=38): el acúfeno ha mejorado en el 73,3%; b) categorías 1, 3 y 4 que han rechazado los generadores de ruido y han recibido ‘sesiones de consejos más sonidos ambientales suaves’ (n=74): el acúfeno ha mejorado en el 80%; c) categoría 2 tratados con ‘sesiones de consejos, audífonos y sonidos ambientales suaves’ (n=49): solo 23 han estado de acuerdo en llevar audífonos, sin embargo 16 de ellos han presentado automáticamente enmascaramiento del acúfeno y han sido excluidos del resultado del TRT. En este estudio, los pacientes han demostrado una gran restricción en usar audífonos o generadores de ruido, así que los principios del TRT tuvieron que ser reforzados a través del uso de sonidos ambientales suaves. Aquellos que han seguido el protocolo del TRT han mostrado excelentes tasas de mejora del acúfeno.

Acoustic comfort, safety and ergonomics in an environment for people with hearing dissabilities are determined by adequate accessibility conditions in it. These conditions will eliminate and / or avoid in the best possible way the presence of discriminatory conditions.The measures to be applied may vary according to the needs and degree of disability of each person, although they can also be valid and useful for the vast majority of the group and beneficial for the rest of the population, since it is based on the principle of design for all . Therefore, it is essential to take into account the conditions of the space and the environment in order to carry out an exhaustive study and implement the most appropriate measures. It is not enough only to take into account the scarce accessibility criteria established by current regulations, but also, aspects related to construction materials, the design and distribution of spaces, the conditions of furniture, lighting, etc. must be studied. This work presents all the parameters that are necessary to apply so that the conditions of an environment are the most suitable for a person with hearing impairment. These measures are endorsed and certified by the experience of users with hearing disabilities and by different studies that verify their suitability., El confort acústico, la seguridad y la ergonomía de las personas con discapacidad auditiva en un entorno vienen determinadas por unas adecuadas condiciones de accesibilidad en el mismo. Estas condiciones eliminarán y/o evitarán de la mejor forma posible la presencia de condiciones discriminatorias.Las medidas a aplicar pueden variar según las necesidades y grado de discapacidad de cada persona, aunque también pueden ser válidas y útiles para la gran mayoría del colectivo y beneficiaras para el resto de la población, puesto que se basa en el principio del diseño para todos. Por tanto, es imprescindible tener en cuenta las condiciones del espacio y el entorno para poder realizar un estudio exhaustivo e implementar las medidas más adecuadas. No basta sólo con tener en cuenta los escasos criterios de accesibilidad que recoge la normativa vigente, sino que también, se deben estudiar aspectos relativos a los materiales de construcción, el diseño y distribución de los espacios, las condiciones del mobiliario, la iluminación, etc. En este trabajo se presentan todos los parámetros que son necesarios aplicar para que las condiciones de un entorno sean las más idóneas para una persona con discapacidad auditiva. Dichas medidas están avaladas y certificadas por la experiencia de usuarios con discapacidad auditiva y por diferentes estudios que verifican la idoneidad de las mismas.

Dr. Barruecos began the previous editorial by reviewing modern audiology, being this clinicaly and technically eminent. In a process of continuity, let me emphasize the lesser known part of audiology that is integrated into clear spaces of global audiology. The first thing that occurs to me is to look in the dictionary of the Royal Spanish Academy of the language ... and I can't find any meaning. Note that the term audiology does not appear, however all of us who intervene in one way or another know that it does exist. That is interesting. What should we understand by social audiology? I find some meaning in second-rate dictionaries: "Discipline that deals with the study of acoustic phenomena in relation to hearing." I keep looking for: "Discipline that deals with the study of acoustic phenomena in relation to hearing and the causes of lack of it." Well ... now I agree somewhat more. In the last congress held in May 2004 in Como, a town near Milan, one of the largest, possibly the largest, of those held in Europe in audiology, will help me to make the approach that I outline. If social audiology did not exist, how would it be understood that a good number of interventions of the fantastic event, of the hundreds that were reproduced, dealt with the intervention with parents of deaf children? Obviously, the programs or therapies influence the intervention with parents of these deaf children. And what we can call the other way of doing audiology has great relevance. Even the World Health Organization (WHO) dares to participate, developing elements that allow us to understand what happens with children with disabilities and their classification, and how they should participate in society. And he makes an important distinction between illness, disability, restrictions and handicap, because obviously those of us who work with deaf children know their difference. We intend that these services are carried out from professional services understood as the interaction of diffe, Iniciaba el Dr. Barruecos la editorial que precede haciendo una revisión de la audiología moderna, ésta eminentemente clínica y técnica. En un proceso de continuidad permítanme enfatizar la parte de la audiología menos conocida que se integra en claros espacios de audiología global. Lo primero que se me ocurre es mirar en el diccionario de la real academia española de la lengua… y no encuentro acepción alguna. Observen que no aparece el término audiología sin embargo a todos los que intervenimos de una forma u otra sabemos que sí existe. Curioso. ¿Qué debemos entender por audiología social? Encuentro algún significado en diccionarios de segunda: “Disciplina que se ocupa del estudio de los fenómenos acústicos en relación con la audición”. Sigo buscando: “Disciplina que se ocupa del estudio de los fenómenos acústicos en relación con la audición y las causas que produce la falta de ella”. Ya… ahora estoy algo más de acuerdo. En el pasado congreso celebrado en el mes de mayo de 2004 en Como, localidad próxima a Milán, uno de los mayores, posiblemente el mayor, de los celebrados en Europa en audiología, me va a servir para realizar la aproximación que les esbozo. Si no existiera la audiología social ¿Cómo se entendería que un buen numero de intervenciones del fantástico evento, de los cientos que reprodujeron, trataran sobre la intervención con padres de niños sordos? Evidentemente, los programas o terapias inciden en la intervención con padres de estos niños sordos. Y tiene gran relevancia lo que podemos llamar la otra forma de hacer audiología. Incluso la Organización Mundial de la Salud (OMS) osa participar, desarrollando elementos que nos permiten entender que pasa con los niños con discapacidad y su clasificación, y la forma cómo han de participar en la sociedad. Y realiza una importante distinción entre enfermedad, discapacidad, deficiencia y minusvalía, porque evidentemente los que trabajamos con niños sordos sabemos de su diferencia. Pretendemos que estos servic

In this review we intend to summarize the most outstanding contributions of Avicenna, included in Al-Qanun, to the field of Audiology. A review of various editions in Arabic and Persian of the fourth treatise of the third volume of Al-Qanun is made, focusing on the chapters corresponding to the study of the anatomy, physiology and pathology of the ear and trying to relate the concepts included with current knowledge . Avicenna's Al-Qanun offers a clear example of the advanced level of understanding of the anatomy, physiology and pathophysiology of the ear as perceived over a thousand years ago and of which many concepts are still valid today. The field of Audiology is a clear example of the involvement of Islamic Medicine and the contribution of Muslim doctors in the study of the anatomy, physiology and diseases of the ear. The scientific contributions of pioneering scholars like Avicenna to the field of Audiology should not be ignored., En esta revisión pretendemos resumir las aportaciones más destacadas de Avicena, incluidas en Al-Qanun, al campo de la Audiología. Se realiza una revisión de varias ediciones en árabe y en persa del cuarto tratado del tercer volumen de Al-Qanun, centrándonos en los capítulos correspondientes al estudio de la anatomía, fi siología y patología del oído e intentando relacionar los conceptos incluidos con los conocimientos actuales. Al-Qanun de Avicena ofrece un claro ejemplo del avanzado nivel de comprensión de la anatomía, la fi siología y fi siopatología del oído como fueron percibidos hace más de mil años y de lo cual muchos conceptos siguen vigentes hasta la actualidad. El campo de la Audiología es un claro ejemplo de la participación de la Medicina Islámica y de la contribución de los médicos musulmanes en el estudio de la anatomía, fi siología y enfermedades del oído. Las contribuciones científi cas de los eruditos pioneros como Avicena al campo de la Audiología no deben ser ignoradas.

A renewed AUDITIO! World Hearing Day is coming and we couldn't have chosen a better time to welcome the new AUDITIO. After many months of work, AEDA has managed to renew its journal in a unique way. A team, led by Dr. Raul Sánchez, brand new Editor-in-Chief of the journal, began to work with the aim of renovating, modernizing and adapting the journal to the needs of the 21st century. It may surprise you but AUDITIO is a pioneering journal in audiology as it was designed, by the Fundación Canaria Dr. Barajas in 2001, as a free access electronic journal. I assure you that in 2001 this format was quite a novelty and this fact has marked its existence. The distribution of AUDITIO through the internet among the Spanish-speaking community made it the most widely distributed Audiology journal in the Spanish language and therefore one of the most widely read journals. AUDITIO has always maintained its academic orientation and has successfully fulfilled its goal: the free dissemination of Audiology. So why did it have to be renewed? It was a demand from our associates and a thorn in many of us. So much so that it became a goal of my action program for the legislature of the Presidency in the 2020 elections. The reason for this demand was clear: its lack of periodicity. In the last five years AUDITIO has suffered ups and downs and a lack of regularity, due to a lower reception of publications. It has not been due to lack of work from its Editor-in-Chief, Dr. Bartolomé, who knew how to surround herself with a great team of reviewers, was able to encourage university students and masterfully handled her contacts with prestigious researchers to maintain the greatest possible regularity. We should all thank her for her effort, dedication and results, but AUDITIO was slowly getting sick and we were unable to detect it and we were unable to find solutions. And in the face of illness, renew or die. It was the cruel reality that AEDA had to face. And after delving into the reasons, ¡AUDITIO se renueva! Llega el Día Mundial de la audición y no podíamos haber elegido mejor momento para dar la bienvenida a la nueva AUDITIO. Tras muchos meses de trabajo, AEDA ha conseguido renovar de manera única su revista científica. Un equipo, liderado el Dr. Raul Sánchez, flamante Editor Jefe de la revista, empezó a trabajar con el objetivo de renovar, modernizar y adaptar la revista a las necesidades del siglo XXI. Puede que les sorprenda  pero AUDITIO es una revista pionera en audiología pues fue diseñada, por la Fundación Canaria Dr. Barajas en 2001, como una revista electrónica de acceso libre. Les aseguro que en 2001 este formato era toda una novedad y este hecho ha marcado su existencia. La distribución de AUDITIO a través de internet entre la comunidad hispanohablante la convirtió en la revista de Audiología de mayor difusión en lengua española y por tanto, una de las revistas más leídas. AUDITIO siempre ha mantenido su orientación académica y ha cumplido con éxito su objetivo: la divulgación gratuita de la Audiología. Entonces, ¿por qué tenía que ser renovada?. Era una demanda de nuestros asociados y una espina clavada en muchos de nosotros. Tanto que se convirtió en un objetivo de mi programa de actuación para la legislatura de Presidencia en las elecciones del 2020. El motivo de esa demanda era claro: su falta de periodicidad. En el último lustro AUDITIO ha sufrido altibajos y la falta de regularidad, por una menor recepción de publicaciones. No ha sido por falta de trabajo de su Editora Jefe, la Dra. Bartolomé, que supo rodearse de un gran equipo de revisores, supo incentivar a los universitarios y manejó con maestría sus contactos con prestigiosos investigadores para mantener la mayor regularidad posible. Todos debemos agradecerle su esfuerzo, dedicación y resultados pero AUDITIO enfermaba lentamente y no supimos detectarlo ni fuimos capaces de encontrar soluciones. Y ante la enfermedad, renovar o morir. Era la cruel realidad que AEDA tenía qu

The mission of the hearing care professional does not focus solely and exclusively on the material and physical act of providing a hearing aid. The hearing care professional has a great responsibility in the educational process of the deaf child since it depends on him that the reeducation and auditory, speech and speech therapy are developed optimally. The hearing care professional must be aware that the intellectual and psychological development of the deaf child depends on him, consequently if he does not have special knowledge about the adaptation processes and methodologies, even having his rights acquired in the sale of hearing aids recognized, he should voluntarily refrain supplying hearing aids, with the consequent economic-commercial damage that this entails, but the ethical and human rights of the deaf child must be put before the economic benefits., La misión del audioprotesista no se centra solo y exclusivamente en el acto material y físico de suministrar una prótesis auditiva. El audioprotesista tiene una gran responsabilidad en el proceso educativo del niño sordo puesto que de él depende que la reeducación y rehabilitación auditiva, foniátrica y logopédica se desarrolle de forma optima. El audioprotesista tiene que ser consciente que el desarrollo intelectual, y psicológico del niño sordo depende de él, en consecuencia si no tiene conocimientos especiales sobre los procesos y metodologías de adaptación, aun teniendo reconocidos sus derechos adquiridos en la venta de audífonos debería de abstenerse voluntariamente de suministrar las prótesis auditivas, con el consiguiente perjuicio económico-comercial que ello supone, pero hay que anteponer los derechos éticos y humanos del niño sordo a los beneficios crematísticos.

TRT is being widely established in different centers and providing the best results in the relief of patients with tinnitus. In Brazil, two facts contribute to a "resistance" to this method: the delay in the beginning to perceive the "long-awaited" improvement and the lack of knowledge about TRT. Our objective is to describe the experience with TRT in Brazil, showing some adaptations of the official method. We reviewed 161 files of tinnitus patients who have started TRT. The analysis of the results was carried out 12 months after the indication of TRT, separating the patients into 3 groups according to the category and mode of treatment: a) categories 1, 3 and 4 treated with 'more advice sessions'. broadband noise generators' (n = 38): tinnitus has improved in 73.3%; b) categories 1, 3 and 4 that have rejected the noise generators and have received 'advice sessions plus soft ambient sounds' (n = 74): tinnitus has improved by 80%; c) category 2 treated with 'advice sessions, hearing aids and soft ambient sounds' (n = 49): only 23 agreed to wear hearing aids, however 16 of them automatically presented tinnitus masking and were excluded from the result of TRT. In this study, patients have shown great restriction in wearing headphones or noise generators, so the principles of TRT had to be reinforced through the use of soft ambient sounds. Those who have followed the TRT protocol have shown excellent tinnitus improvement rates., El TRT se está instaurando ampliamente en distintos centros y proporcionando los mejores resultados en el alivio de los pacientes con acúfeno. En Brasil, dos hechos contribuyen a una “resistencia” a este método: la demora a que se empiece a percibir la ‘tan esperada’ mejora y la falta de conocimiento sobre el TRT. Nuestro objetivo es describir la experiencia con el TRT en Brasil, mostrando algunas adaptaciones del método oficial. Revisamos 161 archivos de pacientes con acúfeno que han empezado el TRT. El aná- lisis de los resultados se llevó acabo 12 meses después de la indicación del TRT separando a los pacientes en 3 grupos de acuerdo con la categoría y modo de tratamiento: a) categorías 1, 3 y 4 tratados con ‘sesiones de consejos más generadores de ruido de banda ancha’ (n=38): el acúfeno ha mejorado en el 73,3%; b) categorías 1, 3 y 4 que han rechazado los generadores de ruido y han recibido ‘sesiones de consejos más sonidos ambientales suaves’ (n=74): el acúfeno ha mejorado en el 80%; c) categoría 2 tratados con ‘sesiones de consejos, audífonos y sonidos ambientales suaves’ (n=49): solo 23 han estado de acuerdo en llevar audífonos, sin embargo 16 de ellos han presentado automáticamente enmascaramiento del acúfeno y han sido excluidos del resultado del TRT. En este estudio, los pacientes han demostrado una gran restricción en usar audífonos o generadores de ruido, así que los principios del TRT tuvieron que ser reforzados a través del uso de sonidos ambientales suaves. Aquellos que han seguido el protocolo del TRT han mostrado excelentes tasas de mejora del acúfeno.

Acoustic comfort, safety and ergonomics in an environment for people with hearing dissabilities are determined by adequate accessibility conditions in it. These conditions will eliminate and / or avoid in the best possible way the presence of discriminatory conditions.The measures to be applied may vary according to the needs and degree of disability of each person, although they can also be valid and useful for the vast majority of the group and beneficial for the rest of the population, since it is based on the principle of design for all . Therefore, it is essential to take into account the conditions of the space and the environment in order to carry out an exhaustive study and implement the most appropriate measures. It is not enough only to take into account the scarce accessibility criteria established by current regulations, but also, aspects related to construction materials, the design and distribution of spaces, the conditions of furniture, lighting, etc. must be studied. This work presents all the parameters that are necessary to apply so that the conditions of an environment are the most suitable for a person with hearing impairment. These measures are endorsed and certified by the experience of users with hearing disabilities and by different studies that verify their suitability., El confort acústico, la seguridad y la ergonomía de las personas con discapacidad auditiva en un entorno vienen determinadas por unas adecuadas condiciones de accesibilidad en el mismo. Estas condiciones eliminarán y/o evitarán de la mejor forma posible la presencia de condiciones discriminatorias.Las medidas a aplicar pueden variar según las necesidades y grado de discapacidad de cada persona, aunque también pueden ser válidas y útiles para la gran mayoría del colectivo y beneficiaras para el resto de la población, puesto que se basa en el principio del diseño para todos. Por tanto, es imprescindible tener en cuenta las condiciones del espacio y el entorno para poder realizar un estudio exhaustivo e implementar las medidas más adecuadas. No basta sólo con tener en cuenta los escasos criterios de accesibilidad que recoge la normativa vigente, sino que también, se deben estudiar aspectos relativos a los materiales de construcción, el diseño y distribución de los espacios, las condiciones del mobiliario, la iluminación, etc. En este trabajo se presentan todos los parámetros que son necesarios aplicar para que las condiciones de un entorno sean las más idóneas para una persona con discapacidad auditiva. Dichas medidas están avaladas y certificadas por la experiencia de usuarios con discapacidad auditiva y por diferentes estudios que verifican la idoneidad de las mismas.