“Can you hear me now?”: Insurance Coverage for Hearing Benefits in the United States

Public and private insurance coverage for hearing benefits underscores the gaps in coverage for treating hearing loss in the U.S. The commodification of the hearing benefits sector of healthcare in this country has detrimental consequences for personal health. Using three personal anecdotes to frame the issue, my paper explores the complex worlds of both public and private insurance as well as the implications of each type of insurance for both adults and children. Current regulations and laws for hearing benefits leave many people to suffer financially, physically, and emotionally. After reviewing the current regulations I propose changes to rectify some of the problems within this sector of health care

A Mimetic Strategy to Engage Voluntary Physical Activity In Interactive Entertainment

We describe the design and implementation of a vision based interactive entertainment system that makes use of both involuntary and voluntary control paradigms. Unintentional input to the system from a potential viewer is used to drive attention-getting output and encourage the transition to voluntary interactive behaviour. The iMime system consists of a character animation engine based on the interaction metaphor of a mime performer that simulates non-verbal communication strategies, without spoken dialogue, to capture and hold the attention of a viewer. The system was developed in the context of a project studying care of dementia sufferers. Care for a dementia sufferer can place unreasonable demands on the time and attentional resources of their caregivers or family members. Our study contributes to the eventual development of a system aimed at providing relief to dementia caregivers, while at the same time serving as a source of pleasant interactive entertainment for viewers. The work reported here is also aimed at a more general study of the design of interactive entertainment systems involving a mixture of voluntary and involuntary control.Comment: 6 pages, 7 figures, ECAG08 worksho

Assistive robotics: research challenges and ethics education initiatives

Assistive robotics is a fast growing field aimed at helping healthcarers in hospitals, rehabilitation centers and nursery homes, as well as empowering people with reduced mobility at home, so that they can autonomously fulfill their daily living activities. The need to function in dynamic human-centered environments poses new research challenges: robotic assistants need to have friendly interfaces, be highly adaptable and customizable, very compliant and intrinsically safe to people, as well as able to handle deformable materials. Besides technical challenges, assistive robotics raises also ethical defies, which have led to the emergence of a new discipline: Roboethics. Several institutions are developing regulations and standards, and many ethics education initiatives include contents on human-robot interaction and human dignity in assistive situations. In this paper, the state of the art in assistive robotics is briefly reviewed, and educational materials from a university course on Ethics in Social Robotics and AI focusing on the assistive context are presented.Peer ReviewedPostprint (author's final draft

Empowering and assisting natural human mobility: The simbiosis walker

This paper presents the complete development of the Simbiosis Smart Walker. The device is equipped with a set of sensor subsystems to acquire user-machine interaction forces and the temporal evolution of user's feet during gait. The authors present an adaptive filtering technique used for the identification and separation of different components found on the human-machine interaction forces. This technique allowed isolating the components related with the navigational commands and developing a Fuzzy logic controller to guide the device. The Smart Walker was clinically validated at the Spinal Cord Injury Hospital of Toledo - Spain, presenting great acceptability by spinal chord injury patients and clinical staf

Oral health and quality of life of the geriatric patient: contexts of autonomy

Background: The state of oral health plays an important role in the concept of frailty among the elderly, as they tend to suffer from poor oral health conditions. Objective: The aim of our systematic review is to study the impact of oral health on the quality of life of the geriatric patient in different contexts of autonomy. Material and Methods: A systematic literature review was carried out of which the selection of articles, with publication date between 2008 and 2020 was conducted through computer platforms. The studies were analyzed and evaluated respecting the previously established inclusion criteria. The review corpus consisted of 16 articles, which presented methodological quality. Results: Oral health has an impact on the quality of life of the elderly, both in the context of institutionalization and at a community level. Oral health has an effect on the quality of life of the elderly, namely in the dimensions of physical pain, physical disability, psychological discomfort, functional limitation, psychological and social disability. The higher the level of dependency the lower the oral health which has the greatest impact on quality of life. The presence of periodontitis, dental caries, edentulism, oral lesions and unsuitable dental prostheses result in a worse perception of quality of life. Conclusion: The evidence found in this study reveals that the state of oral health among the elderly influences their quality of life, regardless of the context of autonomy, indicating the need for oral health policies aimed at this specific population.info:eu-repo/semantics/publishedVersio

Oral health and self-rated health in community-dwelling older adults in Colombia

Background The relationship between oral health and specific health conditions, such as cardiovascular disease or cognitive impairment, has been extensively studied. However, the effect of oral health status on self-rated health has not been assessed. This could be relevant in older people considering that poor self-rated health status and oral diseases are highly prevalent in this population. The aim of this study was to determine the association between different parameters of oral health and self-rated health status (SRHS) in Colombian community-dwelling older adults. Methods This is a secondary analysis of the SABE-Colombia study performed in 2015. The dependent variable was defined as the SRHS status assessed by the question "Compared with other people, your age: Do you consider your health status to be better, equal, or worse?” We considered four independent variables: total edentulism considering the high prevalence in older people, the GOHAI score to assess self-rated oral health, and the use of fixed and removable dental prostheses as potential modifiers of oral health. An adjusted ordinal logistic regression was performed by each independent variable. Results After the exclusion of missing data, 17,945 persons were included in the final analysis. A total of 10.6% reported worse SRHS, 37.6% reported equal SRHS, and 51.6% reported better SRHS. The worse SRHS group was older and had a higher proportion of dependence, cognitive impairment, and depressive symptoms. The frequency of total edentulism and the lower mean score of GOHAI were significant in the worse SHRS group. An ordinal logistic regression for each independent variable was performed, finding that edentulism increases the probability of worse SHRS, while the GOHAI and use of removable or fixed dental prostheses increase the probability of better SRHS. Conclusion We found an association between total edentulism, GOHAI Index, the use of dental prostheses (both removable and fixed), and self-rated health status, showing the relevance of oral health status to self-rated health status independent of comorbidities and geriatric syndromes. This result supports the inclusion of oral health evaluation in comprehensive geriatric assessment. Peer Review reportsQ1Fondo Se ha estudiado ampliamente la relación entre la salud bucal y afecciones de salud específicas, como las enfermedades cardiovasculares o el deterioro cognitivo. Sin embargo, no se ha evaluado el efecto del estado de salud bucal sobre la salud autovalorada. Esto podría ser relevante en las personas mayores, considerando que el mal estado de salud autovalorado y las enfermedades bucales son altamente prevalentes en esta población. El objetivo de este estudio fue determinar la asociación entre diferentes parámetros de salud bucal y el estado de salud autoevaluado (ESSR) en adultos mayores colombianos que viven en comunidades. Métodos Este es un análisis secundario del estudio SABE-Colombia realizado en 2015. La variable dependiente se definió como el estado de SRHS evaluado mediante la pregunta "En comparación con otras personas, tu edad: ¿Consideras que tu estado de salud es mejor, igual o ¿peor?" Se consideraron cuatro variables independientes: edentulismo total considerando la alta prevalencia en personas mayores, el puntaje GOHAI para evaluar la salud bucal autovalorada y el uso de prótesis dentales fijas y removibles como potenciales modificadores de la salud bucal.Se realizó una regresión logística ordinal ajustada. por cada variable independiente. Resultados Después de excluir los datos faltantes, se incluyeron en el análisis final 17.945 personas. Un total de 10,6% reportó peor SRHS, 37,6% reportó igual SRHS y 51,6% reportó mejor SRHS. El grupo con peor SRHS era de mayor edad y tenía una mayor proporción de dependencia, deterioro cognitivo y síntomas depresivos. La frecuencia de edentulismo total y la puntuación media más baja de GOHAI fueron significativas en el grupo con peor SHRS. Se realizó una regresión logística ordinal para cada variable independiente, encontrando que el edentulismo aumenta la probabilidad de peor SHRS, mientras que el GOHAI y el uso de prótesis dentales fijas o removibles aumentan la probabilidad de mejor SRHS. Conclusión Encontramos una asociación entre el edentulismo total, el índice GOHAI, el uso de prótesis dentales (tanto removibles como fijas) y el estado de salud autoevaluado, lo que muestra la relevancia del estado de salud bucal para el estado de salud autoevaluado independientemente de comorbilidades y síndromes geriátricos. Este resultado respalda la inclusión de la evaluación de la salud bucal en la evaluación geriátrica integral. Informes de revisión por pareshttps://orcid.org/0000-0002-8584-3191https://scholar.google.com/citations?user=ns-9aAgAAAAJ&hl=es&oi=aohttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0001337521Revista Nacional - IndexadaS

Oral Findings and Health Status among Turkish Geriatric Patients with or without Dementia (Oral Lesions and Dementia Patients)

SummaryBackgroundIn this study, we aimed to investigate the frequency of oral mucosal lesions and systemic disease in patients with or without dementia.MethodsThe patient group comprised patients from the Istanbul Metropolitan Municipality Darulaceze Retirement Home and the control group consisted of patients who attended university clinics. The examination took place in a quiet room within the nursing home in the company of a member of the care staff well-known to the patient, and the control group was collected from participants who wanted to be included in the study. The study group consisted of 250 patients with dementia (110 male, 140 female) with a mean age of 74.1 ± 10.9 years and 200 control patients (90 male, 110 female) with mean age of 70.5 ± 10.2 years. We examined patients using a mouth mirror. Medical information was collected from patients and nurses.ResultsIn this study, 164 patients with dementia (64.8%) and 109 control patients (54.5 %) had one or more oral mucosal lesions (p = 0.016). Eighty-eight patients with dementia (35.2%) and sixty control patients (30%) were edentulous (p > 0.05), and 28 in the patient group (31.8 %) and 43 in the control group (71.6 %) were able to use prostheses (p < 0.05).ConclusionOral mucosal lesions are more common in patients with dementia and dental care should be performed regularly for this group. In addition, because removable prostheses can be lost by patients with dementia, implant-supported fixed prostheses should be preferred for this group

Motivations and barriers to prosthesis users participation in physical activity, exercise and sport : a review of the literature

The UK will host the Paralympics in 2012 and the Commonwealth Games in 2014 showcasing the talents of elite athletes and aiming to inspire the population to become involved. However, low levels of physical activity (PA) are prevalent: only 40% of men and 28% of women meet the minimum UK recommendations. The limb absent population is no exception. To determine if people with limb amputations are participating in physical activity and sport; whether post-amputation activity levels match pre-amputation levels; and if there are motivations and barriers to participation. Study design: Literature review Five reviewers systematically search of peer reviewed and gray literature in seven bibliographic databases and the Cochrane Library. Results: Following rigorous elimination, 12 articles were finally included in the review and critically appraised. Four themes were identified: components, rehabilitation outcomes, body image and motivations and barriers to participation. People with limb absence are not participating in PA conducive to health benefits, and only a minority participate in exercise and sports. Participation following amputation does not mirror that of pre-amputation levels, and more barriers than motivations exist to adopting and maintaining a physically active lifestyle. This literature review aims to inform those involved in rehabilitation and ongoing care of those with limb absence about what motivates or precludes their participation in physical activity, exercise and sport. Such knowledge could be applied to improving health and well being in this population

Associação entre saúde bucal, qualidade de vida, níveis salivares de cortisol e alfa-amilase em idosos institucionalizados

Orientador: Maria Beatriz Duarte GaviãoTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: O número de idosos está aumentando mundialmente, fato que sugere a necessidade de melhor entendimento de fatores individuais e ambientais relacionados ao envelhecimento. O objetivo deste estudo foi analisar a qualidade de vida geral, a avaliação subjetiva das condições bucais, os níveis de depressão e estresse percebido, presença de disfunções orofaciais e níveis salivares de cortisol e alfa-amilase em idosos institucionalizados. A amostra foi composta por 76 indivíduos de ambos os gêneros, com idade mínima de 60 anos, submetidos a exame clínico intraoral para a verificação da presença de próteses. Foram aplicados os questionários "Medical Outcomes Study 36-Item Short-Form Health Survey" (SF-36) para a avaliação da qualidade de vida geral; "Oral Health Assessment Index" (GOHAI) para a avaliação subjetiva das condições bucais; "Perceived Stress Scale" (PSS), para avaliação da percepção de situações estressantes; "Geriatric Depression Scale" (GDS-15) para a avaliação da presença de depressão e "Nordic Orofacial Test ¿ Screening" (NOT-S) para a avaliação da presença de disfunções orofaciais. As amostras de saliva foram coletadas durante dois dias, ao acordar e 30 minutos após, obtendo a Resposta do Cortisol ao Acordar - ACR e a Resposta da Alfa-amilase ao Acordar - AAAR. Os dados foram submetidos à análise estatística por meio do coeficiente de correlação de Spearman, regressão linear múltipla (?=0.05), teste Chi-square ou Exato de Fisher e teste Kruskal-Wallis. Os resultados mostraram correlação positiva entre o valor total de GOHAI e SF-36, correlação negativa entre o domínio função física de GOHAI e PSS e escores de GDS-15. A regressão linear múltipla mostrou uma interrelação entre os escores de PSS e domínio físico do GOHAI porém não houve associação com ACR e AAAR. Correlação positiva foi observada entre o domínio Função Psicossocial de GOHAI e NOT-S para os indíviduos com próteses em ambas arcadas dentárias e entre GOHAI total e NOT-S para os indivíduos com pelo menos uma prótese. Pode-se concluir que os indivíduos avaliaram a condição bucal como desfavorável e da mesma forma consideraram a saúde geral como inapropriada. Da mesma forma, os indivíduos portadores de próteses ou não podem apresentar dificuldades relacionadas com aspectos físicos e psicológicos, que podem causar dor e desconforto ocasionando impactos na qualidade de vidaAbstract: The number of elderly is increasing worldwide, which suggests the need for better understanding of individual and environmental factors related to aging. The aim of this study was to assess overall quality of life and subjective assessment of oral conditions, levels of depression and perceived stress, presence of orofacial dysfunctions and levels of salivary cortisol and alpha-amylase in institutionalized elderly. The sample comprised 76 subjects of both genders, with minimum age 60 years, submitted to intraoral clinical examination to verify the presence of prostheses. Questionnaire "Medical Outcomes Study 36-Item Short-Form Health Survey" (SF-36) was applied to assess overall quality of life; "Oral Health Assessment Index" (GOHAI) for the subjective assessment of oral conditions; "Perceived Stress Scale" (PSS), to evaluate the perception of stressful situations; "Geriatric Depression Scale" (GDS-15) for evaluating the presence of depression and "Nordic Orofacial Test - Screening" (NOT-S) to assess the presence of orofacial dysfunctions. Multiple linear regression showed an interrelationship between PSS scores and physical domain of GOHAI but there was no association with ACR and AAAR. Positive correlation was observed between Psychosocial Function GOHAI domain and NOT-S for individuals with prostheses in both dental arches and between total NOT-S and GOHAI for individuals with at least one prostheses. Similarly, individuals with prostheses or not may present difficulties related to physical and psychological aspects, which may cause pain and discomfort impacting on quality of lifeDoutoradoAnatomiaDoutora em Biologia Buco-Denta

Biochemical and microbiological analysis of the saliva of institutionalized elderly : with edentulism, use of dentures and presence of biofilm

To analyze biochemical and microbiological parameters of the saliva of institutionalized elders and to investigate the relation of these parameters with edentulism, use of dentures and presence of biofilm. A cross-sectional study carried was out in seven long-term institutions. Samples (n=161) of unstimulated saliva were collected for analysis of salivary flow, quantification of total proteins and identification of microorganisms. Oral examination was carried out to verify the number of missing teeth, the use of dentures and the presence of visible biofilm on the surface of teeth and dentures. Associations were performed using chi-square or Fisher?s exact test (?0.05). Associations were observed between the presence of dentures biofilm and the colonization of Streptococcus sp. (p=0.038) and Candida sp. (p=0.03). The absence of teeth and use of dentures do not influence the amount of total proteins and the microorganisms count in saliva. Denture biofilms are associated with the presence of Streptococcus sp. and Candida sp. in saliva of institutionalized elders