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Background: Targeted new-born hearing screening, based on high risk factors is recommended in the absence of universal new-born hearing screening in resource-constrained settings. The relevance of risk factors listed in the guidelines of high-income countries and used by low-middle income countries remains relatively unknown. Risk factors consistent with the epidemiological profile, evolution of risks and disease burden in these countries need to be considered. Objectives: This study aimed to profile the frequency of risk factors and their manifestation in hearing outcomes of young children in the KwaZulu-Natal province of South Africa. Method: A chart review of N = 1433 patients’ archival audiology records was conducted, conveniently sampled from a single tertiary hospital (n = 351), a provincial assessment and therapy centre (n = 649), a university clinic (n = 291), and two schools for the deaf (n = 142). Results: Overall, 56% of the participants presented with either a conductive, sensorineural or a mixed hearing loss; 62% of the children had between 1 and 2 risk factors present (Mean [M] = 1.1; standard deviation [s.d.] = 0.98). Admission to neonatal intensive care unit, maternal infections, bacterial and viral infections and chemotherapy, from the Joint Committee on Infant Hearing list of high risk factors were significantly associated with hearing loss (p 0.05). Known non-JCIH risks, emerging risks and other statistically significant contextually relevant risk factors were also noted. Conclusion: Understanding the profile of high risk factors in a given context has implications for prevention, early hearing identification and intervention services. Contribution: Targeted new-born hearing screening needs to be based on risk factors that are contextually relevant. This study is one of the first profiling high risk factors for hearing loss in children in KZN, the province with the second highest population in South Africa.

Background: The use of face masks and/or shields can pose a challenge during communication. They block facial expressions thus removing visual cues and affect sound transmission making it difficult to hear speech clearly. Given the widespread use of face coverings, it seems reasonable to clarify if communication in typical speakers and listeners has significantly differed. Health science students as future practitioners need to understand challenges that arise from using face coverings. Objective: This study aimed to determine health sciences students’ perception of the communicative impacts of face coverings. Method: The study employed a descriptive, self-administered online survey, obtaining information from 96 health science undergraduate students. Results: All participants changed their manner of speaking in that they spoke louder when wearing masks and focused more on eye contact when someone was wearing masks. These were statistically significant (p = 0.450 and p = 0.035 respectively). Fifty-three percent reported using more listening effort and feeling anxious when communicating. Approximately 33% indicated that it was challenging to read emotions, such as sad or unhappy, when someone wore a mask. Most, 61%, were positive or very positive about wearing masks. The level of difficulty differed depending on the listening environment. It was harder to understand the doctor, nurse, or other healthcare workers when they wore face coverings than when listening to their friends and family, which had little effect, this being statistically significant (p = 0.025). Conclusion: Challenges envisaged in practice included frequent communication breakdowns, inability to connect and build trust between patient and practitioner, and communicating in noisy environments. Coping strategies, future clinical and research implications were proposed, and limitations acknowledged.

Hardware Trojans in Integrated Circuits (ICs), that are inserted as hostile modifications in the design phase and/or the fabrication phase, are a security threat since the semiconductor manufacturing process is increasingly becoming globalized. These Trojans are devised to stay hidden during standard structural and functional testing procedures and only activate under pre-determined rare conditions (e.g., after a large number of clock cycles or the assertion of an improbable net). Once triggered, they can deliver malicious payloads (e.g., denial-of-service and information leakage attacks). Current literature identifies a collection of logic Trojans (both trigger circuits and payloads), but minimal research exists on memory Trojans despite their high feasibility. Emerging Non-Volatile Memories (NVMs), such as Resistive RAM (RRAM), have special properties such as non-volatility and gradual drift in bitcell resistance under a pulsing voltage input that make them prime targets to deploy hardware Trojans. In this paper, we present two delay-based and two voltage-based Trojan triggers using emerging NVM (ENTT) by utilizing RRAM’s resistance drift under a pulsing voltage input. Simulations show that ENTTs can be triggered by reading/writing to a specific memory address N times (N could be 2,500–3,500 or a different value for each ENTT design). Since the RRAM is non-volatile, address accesses can be intermittent and therefore stay undetected from system-level techniques that can identify continuous hammering as a possible security threat. We also present three reset techniques to de-activate the triggers. The resulting static/dynamic power overhead and maximum area overhead incurred by the proposed ENTTs are 104.24 μW/0.426 μW and 9.15 μm2, respectively in PTM 65 nm technology. ENTTs are effective against contemporary Trojan detection techniques and system level protocols. We also propose countermeasures to detect ENTT during the test phase and/or prevent fault-injection attacks during deployment.

Background: There is slow progress in early hearing detection and intervention (EHDI) services within South Africa. Audiologists are EHDI gatekeepers and can provide valuable insights into the barriers and facilitators that can progressively move EHDI towards best practice in South Africa. Objectives: The study aimed to determine the barriers and facilitators to EHDI in KwaZulu-Natal as reported by audiologists/speech therapists and audiologists (A/STAs). Method: A descriptive qualitative approach was used. Telephonic interviews were conducted with 12 A/STAs working in public and private healthcare facilities, using the strengths, weaknesses, opportunities, threats (SWOT) conceptual framework. Data was analysed using thematic analysis in conjunction with NVivo software. Results: One of the main barriers perceived by A/STAs, affecting EHDI was the lack of resources in healthcare facilities. The participants indicated that although there was a guideline in place to guide practice, it may be more suited to an urban area versus a rural area. Poor knowledge and awareness of EHDI was also identified as a barrier. Information provided from A/STAs at grassroots level, in the various provinces, may benefit in developing a more contextually relevant and practical guideline. Facilitators included; development of task teams specifically for EHDI programmes, creation of improved communication networks for collaboration and communication, training of healthcare professionals and improving data management systems. Conclusion: Strategies such as an increase in resources, further education and training, development of contextually relevant, culturally, and linguistically diverse practices and protocols need to be in place to improve EHDI implementation. Further research, clinical implications and limitations are provided emanating from the study.