Effectiveness of alternative listening devices to conventional hearing aids for adults with hearing loss: A systematic review protocol

© BMJ Publishing Group Limited 2016. Introduction: Hearing loss is a major public health concern, affecting over 11 million people in the UK. While hearing aids are the most common clinical intervention for hearing loss, the majority of people that would benefit from using hearing aids do not take them up. Recent technological advances have led to a rapid increase of alternative listening devices to conventional hearing aids. These include hearing aids that can be customised using a smartphone, smartphone-based 'hearing aid' apps, personal sound amplification products and wireless hearing products. However, no systematic review has been published evaluating whether alternative listening devices are an effective management strategy for people with hearing loss. Methods and analysis: The objective of this systematic review is to assess whether alternative listening devices are an effective intervention for adults with hearing loss. Methods are reported according to the Preferred Reporting Items for Systematic reviews and Meta-analyses Protocols (PRISMA-P) 2015 checklist. Retrospective or prospective studies, randomised controlled trials, non-randomised controlled trials, and before-after comparison studies will be eligible for inclusion. We will include studies with adult participants (≥18 years) with a mild or moderate hearing loss. The intervention should be an alternative listening device to a conventional hearing aid (comparison). Studies will be restricted to outcomes associated with the consequences of hearing loss. We will search relevant databases to identify published, completed but unpublished and ongoing trials. The overall quality of included evidence will be evaluated using the GRADE system, and meta-analysis performed if appropriate. Ethics and dissemination: No ethical issues are foreseen. The findings will be reported at national and international conferences, primarily audiology, and ear, nose and throat, and in a peer-reviewed journal using the PRISMA guidelines

Systematic review of topical diclofenac for the treatment of acute and chronic musculoskeletal pain

Aim: The objective was to systematically review the efficacy and safety of topical diclofenac in both acute and chronic musculoskeletal pain in adults. Methods: We used standard Cochrane methods. Searches were conducted in MEDLINE, EMBASE and The Cochrane Register of Studies; date of the final search was November 2018. Included studies were randomized, double blinded, with ten or more participants per treatment arm. The primary outcome of “clinical success” was defined as participant-reported reduction in pain of at least 50%. Details of adverse events (AEs) were recorded. Results: For acute pain, 23 studies (5170 participants) were included. Compared to placebo, number needed to treat (NNT) for different formulations were as follows: diclofenac plaster, 4.7 (95% CI 3.7–6.5); diclofenac plaster with heparin, 7.4 (95% CI 4.6–19); and diclofenac Emulgel, 1.8 (95% CI 1.5–2.1). 4.1% (78/1919) reported a local AE. For chronic pain, 21 studies (26 publications) with 5995 participants were included. Formulations included gel, solution with or without DMSO, emulsion and plaster. A clinical success rate of ∼60% (NNT 9.5 [95% CI 7–14.7]) was achieved with a variety of formulations. Local AEs (∼14%) were similar for both diclofenac and placebo. Conclusion: This systematic review of 11,000+ participants demonstrates that topical diclofenac is effective for acute pain, such as sprains, with minimal AEs. The effectiveness of topical diclofenac was also demonstrated in chronic musculoskeletal pain but with a higher NNT (worse) compared with acute pain. Formulation does play a part in effectiveness but needs further studies.</p

Schematic representation of the superhydrophobic states.

<p>Image (a) indicates the case on single micro scale frame and (b) presents the state on our 3D hierarchical dune-like ZnO architectures.</p

FE-SEM images of the ZnO film constructed on alumina substrate.

<p>The magnifications of these images are (a)×160 (b)×1600 (c)×3000 respectively.</p

Droplet shapes on the prepared samples.

<p>Image (a) indicates the case before Teflon treatment and (b) indicates the case after Teflon treatment.</p

The energy dispersive X-ray (EDX) spectra of the sample.

<p>The energy dispersive X-ray (EDX) spectra of the sample.</p

Visualization 1: Speckleless holographic display by complex modulation based on double-phase method

Optical results of multi-plane holographic display based on proposed method Originally published in Optics Express on 26 December 2016 (oe-24-26-30368

Structures and luminescent properties of two heterotrimetallic Ln(III)–Sr(II)–K(I) complexes

<div><p>Eu(III)–Sr(II)–K(I) and Tb(III)–Sr(II)–K(I) heterotrimetallic metal-organic frameworks with 2,4,6-pyridinetricarboxylic acid have been synthesized under hydrothermal conditions. The complexes are isomorphic and both in triclinic space group <i>P-1</i>. The ligands bond with three metal ions with two coordination modes. One connects seven metal ions and the other connects eight metal ions. IR spectra, thermal analysis, and photoluminescent properties have been studied. The results display strong characteristic emissions of Eu(III) or Tb(III) ions with excitation of ultraviolet radiation.</p></div

FE-SEM images of the ZnO films constructed on glass substrate with a magnification of (a) ×800, (b) ×20000, (c) ×40000, (d) ×80000.

<p>FE-SEM images of the ZnO films constructed on glass substrate with a magnification of (a) ×800, (b) ×20000, (c) ×40000, (d) ×80000.</p

Different water droplet configurations.

<p>(a) Water droplet spread on the superhydrophilic ZnO film, and (b) a water bead standing on a Teflon-modified ZnO surface.</p