Market profile of speech and language therapist in the area of Audiology Clinic

PURPOSE: to investigate the market profile of speech therapist professional working in the area of clinical audiology in Fortaleza, identifying the postgraduate level, professional salary range, the level of satisfaction, working hours and employment contract of this professional. METHOD: a cross-sectional study was conducted from February to April 2010. A questionnaire about the professional s performance in the area of Clinical Audiology was applied in 30 speech and hearing therapists, 29 (96.7%) females and one (3.3%) male, with average age of 31.4 years, ranging between 24 and 44 year old, in the city of Fortaleza, Ceará. The questionnaire consisted of the following items: academic history, salary range, acting area, acting department, working hours per week, employment contract and professional level of satisfaction. Data were organized and statistically analyzed by the test of equality of two proportions. RESULTS: thirteen (43.3%) of the clinical speech and hearing therapists earn between 4 to 6 minimum wages. Twenty-four (80%) interviewees working in the area of Clinical Audiology are self-employed four (13.3%) have formal contract and two (6.7%) are corporate entities. Sixteen (53.3%) of the speech and hearing therapists are satisfied with their job. CONCLUSION: the professional working in the area of Clinical Audiology in the city of Fortaleza presents, predominantly, specialization course, salary range from 4 to 6 minimum wages and 10 to 20 working hours per week. Most speech and hearing therapists are self-employed and are satisfied with their career.OBJETIVO: investigar o perfil mercadológico do fonoaudiólogo atuante na área de audiologia clínica da cidade de Fortaleza, buscando identificar a formação em nível de pós-graduação, quantificar a faixa salarial, analisar o nível de satisfação do profissional e avaliar a jornada de trabalho e o vínculo empregatício desse profissional. MÉTODO: estudo transversal, realizado no período de fevereiro a abril de 2010, tendo-se aplicado um questionário acerca da atuação fonoaudiológica na área de Audiologia Clínica em 30 fonoaudiólogos, 29 (96,7%) do gênero feminino e um (3,3%) do gênero masculino, com idade média de 31,4 anos, variando entre 24 e 44 anos de idade, na cidade de Fortaleza, Ceará. O questionário abrangeu os seguintes itens: dados de formação acadêmica, remuneração, área de atuação, setor de atuação, jornada de trabalho em horas semanais, vínculo empregatício e nível de satisfação com a área de atuação. Os dados foram organizados e analisados estatisticamente por meio do teste de igualdade de duas proporções. RESULTADOS: treze (43,3%) dos fonoaudiólogos que atuam com Audiologia Clínica recebem entre quatro a seis salários mínimos. Vinte e quatro (80%) fonoaudiólogos atuantes na área da Audiologia Clínica são autônomos, quatro (13,3%) tem Carteira de Trabalho assinada e dois (6,7%) são pessoas jurídicas. Dezesseis (53,3%) dos fonoaudiólogos estão satisfeitos com a sua profissão. CONCLUSÃO: o fonoaudiólogo atuante na área de Audiologia Clínica na cidade de Fortaleza apresenta, predominantemente, curso de especialização, renda salarial entre quatro e seis salários mínimos, com jornada de trabalho de 10 a 20 horas semanais. A maioria são profissionais autônomos e sentem-se satisfeitos com sua atuação profissional.Universidade de FortalezaUniversidade Federal do CearáUniversidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Potencial evocado auditivo cortical com estímulo simples (tone burst) e complexo (fala) em crianças com implante coclear

Introdução: O registro do componente P1 do potencial evocado auditivo cortical vem sendo amplamente utilizado a fim de analisar o comportamento das vias auditivas diante da estimulação pelo implante coclear, sendo assim, considerado um biomarcador do desenvolvimento do sistema auditivo central. Objetivo: O estudo tem como objetivo verificar a influência da reabilitação auditiva nos parâmetros de latência e amplitude do componente P1 do potencial evocado auditivo cortical eliciado por estímulo simples (tone burst) e estímulo complexo (fala) em crianças com implante coclear. Método: Participaram deste estudo seis indivíduos de ambos os sexos com faixa etária de cinco a 10 anos, apresentando perda auditiva sensorioneural de graus severo a profundo e usuários de implante coclear há, no mínimo, 12 meses. Os participantes deveriam estar em acompanhamento fonoaudiológico com abordagem terapêutica aurioral. Todos os indivíduos foram submetidos à pesquisa do potencial evocado auditivo cortical em um primeiro momento e após três meses de reabilitação auditiva. Para eliciar as respostas foram utilizados estímulos simples (tone burst) e estímulos complexos (fala) apresentados em campo livre a 70 dB NA. Os resultados foram analisados estatisticamente e comparadas as duas avaliações realizadas. Resultados: Não houve diferença significante entre o tipo de estímulo eliciador do potencial evocado auditivo cortical tanto para latência como para amplitude do componente P1. Verificou-se diferença estatisticamente significante entre a latência do componente P1 nos dois momentos de avaliação, tanto para tone burst como para estímulo de fala, com redução da latência na avaliação após três meses de reabilitação auditiva. Não houve diferença estatisticamente significante em relação à amplitude de P1 sob os dois tipos de estímulo e nem sob as duas avaliações. Conclusão: A partir da análise dos resultados, concluiu-se que a reabilitação auditiva influenciou na latência, a qual mostrou-se mais precoce na segunda avaliação, e não na amplitude dos potenciais evocados auditivos corticais eliciados tanto por estímulo simples tone burst como por estímulo complexo de fala.Dados abertos - Sucupira - Teses e dissertações (2013 a 2016

The influence of electrical stimulation levels on hearing thresholds, speech recognition and cortical auditory evoked potential in cochlear implant users

Introdução: A programação do implante coclear (IC) baseia-se tanto na medida dos níveis mínimos de corrente elétrica necessários para estimular o nervo auditivo como na medida dos níveis máximos para gerar sensação forte, sem desconforto. Na busca de norteadores na adequação desta programação, os potenciais evocados auditivos corticais (PEAC) estão se destacando como uma ferramenta de grande importância na avaliação de usuários de IC, fornecendo informações sobre o comportamento do sistema auditivo central. Objetivo: avaliar a influência da manipulação errônea dos níveis de estimulação elétrica na programação do processador de fala sobre os limiares auditivos, o reconhecimento de fala e o potencial evocado auditivo cortical em adultos usuários de IC. Método: Trata-se de um estudo prospectivo de corte transversal, com casuística composta por indivíduos adultos de ambos os sexos, com idade mínima de 18 anos, surdez de instalação pós-lingual, usuários de IC unilateral, com experiência mínima de 12 meses de uso do dispositivo. Os indivíduos selecionados deveriam apresentar média dos limiares auditivos em campo livre com o implante coclear igual ou melhor do que 34 dBNA e reconhecimento de monossílabos diferente de 0%. Foram excluídos indivíduos que não conseguiram colaborar com os procedimentos ou que apresentaram ausência das ondas do PEAC. Os participantes realizaram a programação habitual, nomeado MO (mapa original otimizado). Em seguida foram feitos três mapas experimentalmente errados: mapa original otimizado com menos 10 unidades de corrente elétrica no nível máximo (C), nomeado MC- (mapa menos C); mapa original otimizado com menos 10 unidades de corrente no nível mínimo (T), nomeado MT- (mapa menos T) e mapa original otimizado com mais 10 unidades de corrente no nível mínimo (T), nomeado MT+ (mapa mais MT). Em todos os programas, os participantes foram submetidos à pesquisa dos limiares auditivos em campo livre de 250Hz a 6000Hz, aos testes de reconhecimento de frases e monossílabos gravados apresentados a 65dB NPS no silêncio e no ruído, e ao registro dos PEAC. Todos os testes foram realizados em cabine acusticamente tratada, em ordem randomizada de apresentação dos mapas. Os dados foram foram comparados pelo teste de Wilcoxon. Resultados: Trinta indivíduos foram selecionados e assinaram o termo de consentimento livre e esclarecido. O mapa MC- proporcionou piora de todos os limiares em campo livre, dos testes de reconhecimento de fala no silêncio e no ruído e atraso na latência da onda P1 com diferença estatisticamente significante em relação aos resultados com o mapa MO. O mapa MT- piorou os limiares auditivos e reduziu com significância estatística a latência da onda P2; o mapa MT+ melhorou os limiares em campo livre, exceto 6000Hz, alterando o reconhecimento de fala sem significância estatística. Conclusão: Os resultados sugerem que níveis máximos abaixo dos limiares comportamentais proporcionam piora no desempenho do implante coclear, tanto nos limiares auditivos como nos testes de reconhecimento de fala no silêncio e no ruído e aumento da latência do componente P1 do PEAC. Por outro lado, a manipulação dos níveis mínimos mostrou alteração na audibilidade sem impacto significante no reconhecimento de falaIntroduction: Cochlear implants (CI) programming is based on both the measurement of the minimum levels required to stimulate the auditory nerve and the maximum levels to generate loud, yet comfortable loudness. In the search for guidance in the adequacy of this programming, the cortical auditory evoked potentials (CAEP) have been gaining space as an important tool in the evaluation of CI users, providing information on the central auditory system. Objective: To evaluate the influence of mishandling of electrical stimulation levels on speech processor programming on hearing thresholds, speech recognition and cortical auditory evoked potential in adult CI users. Method: This is a prospective cross-sectional study, with a sample of adults of both sexes, aged at least 18 years, post-lingual deafness, unilateral CI users with minimum experience of 12 months of device use. Selected subjects should have average free field hearing thresholds with cochlear implant equal to or better than 34 dBHL and monosyllable recognition different from 0%. Individuals who could not collaborate with the procedures or who had no CAEP waves were excluded. Participants were routinely programmed, and the map was named MO (optimized original map). Then three experimentally wrong maps were made: optimized original map with 10 current units below the maximum level (C), named MC- (map minus C); optimized original map with minus 10 current units at minimum level (T), named MT- (map minus T) and optimized original map with 10 current units below minimum level (T), named MT + (map plus MT). In all programs, participants underwent free-field auditory thresholds research from 250Hz to 6000Hz, recorded sentences and monosyllabic recognition tests presented at 65dB SPL in quiet and in noise, and PEAC evaluation. All tests were performed in an acoustically treated booth, in a randomized order of map presentation. Data were compared by Wilcoxon test. Results: Thirty individuals were selected and signed an informed consent form. The MC- map provided worsening of all free field thresholds, quiet and noise speech recognition, and P1 wave latency delay with significant difference from the results with the MO map. The MT- map worsened the hearing thresholds and statistically significantly reduced the P2 wave latency; MT + map improved free field thresholds except 6000Hz, worsening speech recognition, without statistical significance. Conclusion: The results suggest that maximum levels below the behavioral thresholds lead to worse cochlear implant performance in both hearing thresholds and speech recognition tests in silence and noise and increased CAEP component P1 latency. On the other hand, the manipulation of minimum levels showed alteration in audibility without significant impact on speech recognitio

Fatores de risco para perda auditiva em idosos - doi: 10.5020/18061230.2012.p176

Objective: To identify risk factors related to sensorineural hearing loss in elderly. Methods: The sample consisted of 60 selected elderly, divided into two groups: the Case Group, composed by 30 individuals, 21 females and 9 males, aged at least 60 years, presenting sensorineural hearing loss, and the Control Group, composed by 30 individuals matched on gender and age, with normal hearing. The patients were submitted to audiological anamnesis and tonal audiometry. The hearing impairment was defined according to average threshold greater than 35dBNA, in the frequencies of 1,000; 2,000 and 4,000 Hz, in the best ear. Results: Statistically significant odds ratios were: a) to audiological history: noise exposure and family history of deafness; b) to situations involving hearing difficulty: television, church, telephone, silent environment, spatial location of sound, difficulty with voices and noisy environment; c) to otologic history: tinnitus, otorrhea and nausea; and d) to medical history: visual problems, smoke, alcohol, thyroid problems and kidney disease. Conclusion: The findings of this study highlighted, for sensorineural hearing loss, risk factors related to audiologic, otologic and medical history, and to situations involving hearing difficultyIdentificar os fatores de risco relacionados à perda auditiva sensorioneural em idosos. Métodos: Casuística constituída por 60 pacientes idosos separados em dois grupos: o Grupo de Caso, composto por 30 idosos, 21 do sexo feminino e 9 do sexo masculino, com idade mínima de 60 anos de idade, apresentando perda auditiva sensorioneural; e o Grupo Controle, composto por 30 idosos, pareados por gênero e idade, apresentando audição normal. Os pacientes foram submetidos à anamnese audiológica e audiometria tonal. O comprometimento auditivo foi definido de acordo com média de limiar maior que 35dBNA, nas frequências de 1000, 2000 e 4000 Hz, na melhor orelha. Resultados: As razões de chances estatisticamente significantes foram: a) para história audiológica: exposição a ruído e história familiar de surdez; b) para situações de dificuldade auditiva: televisão, igreja, telefone, ambiente silencioso, localizar sons, dificuldade com vozes e ambiente ruidoso; c) para história otológica: zumbido, otorréia e nauseas; e d) para história médica: problemas visuais, fumo, álcool, problemas na tireóide e doenças renais. Conclusão: Os achados do estudo evidenciaram, para a perda auditiva sensorioneural no idoso, fatores de risco relacionados à história audiológica, otológica e médica, e às situações de dificuldade auditiva

Risk factors for hearing loss in elderly

Objective: To identify risk factors related to sensorineural hearing loss in elderly. Methods: The sample consisted of 60 selected elderly, divided into two groups: the Case Group, composed by 30 individuals, 21 females and 9 males, aged at least 60 years, presenting sensorineural hearing loss, and the Control Group, composed by 30 individuals matched on gender and age, with normal hearing. The patients were submitted to audiological anamnesis and tonal audiometry. The hearing impairment was defined according to average threshold greater than 35dBNA, in the frequencies of 1,000; 2,000 and 4,000 Hz, in the best ear. Results: Statistically significant odds ratios were: a) to audiological history: noise exposure and family history of deafness; b) to situations involving hearing difficulty: television, church, telephone, silent environment, spatial location of sound, difficulty with voices and noisy environment; c) to otologic history: tinnitus, otorrhea and nausea; and d) to medical history: visual problems, smoke, alcohol, thyroid problems and kidney disease. Conclusion: The findings of this study highlighted, for sensorineural hearing loss, risk factors related to audiologic, otologic and medical history, and to situations involving hearing difficulty

Perfil mercadológico do profissional fonoaudiólogo atuante na área de triagem auditiva escolar Market profile of speech therapist professional working in the area of school hearing screening

OBJETIVO: identificar o perfil mercadológico do profissional fonoaudiólogo atuante na área de triagem auditiva escolar na cidade de Fortaleza, determinando o nível de pós-graduação, faixa salarial do profissional, tempo de atuação, nível de satisfação, jornada de trabalho e vinculo empregatício. MÉTODO: um instrumento de coletas de dados foi aplicado em 6 fonoaudiólogos atuantes na área de triagem auditiva escolar (TAE). Os dados foram submetidos à análise estatística com cruzamento de variáveis. RESULTADOS: observou - se que dos profissionais entrevistados, 6 (100%) possuíam especialização e nenhum apresentou mestrado ou doutorado. Destes, 5 (83,3%) recebíam de 4 a 6 salários mínimos com carga horária de 30 a 40 horas semanais, com nível de satisfação ótimo. CONCLUSÃO: tal estudo mostrou média salarial de 4 a 6 salários mínimos e jornada de trabalho de 30 a 40 horas, com 4 profissionais contratados e 2 terceirizados. Todos os fonoaudiólogos apresentaram especialização e o nível de satisfação profissional ótimo foi o mais prevalente.<br>PURPOSE: to identify the market profile of speech therapist professional working in the area of school hearing screening in the city of Fortaleza, determining the postgraduate level, the professional wage range, acting time, level of satisfaction, working hours and employment contract. METHOD: an instrument of data collection was applied in six speech therapists working in the area of school hearing screening (SHS). Collected data were statistically analyzed with variable crossing. RESULTS: it was observed that 06 interviewed professionals (100%) had specialization courses, presenting no masters or doctorate degrees. Five (83.3%) received 4 to 6 minimum wages with 30 to 40 hours per week, with great professional satisfaction. CONCLUSION: this study showed an average wage of 4 to 6 minimum wages and 30 to 40 working hours per week, with 4 contracted professionals and 2 outsourced. All speech therapists had specialization course and the great satisfaction level was the most prevalent

GWAS and meta-analysis identifies 49 genetic variants underlying critical COVID-19

Data availability: Downloadable summary data are available through the GenOMICC data site (https://genomicc.org/data). Summary statistics are available, but without the 23andMe summary statistics, except for the 10,000 most significant hits, for which full summary statistics are available. The full GWAS summary statistics for the 23andMe discovery dataset will be made available through 23andMe to qualified researchers under an agreement with 23andMe that protects the privacy of the 23andMe participants. For further information and to apply for access to the data, see the 23andMe website (https://research.23andMe.com/dataset-access/). All individual-level genotype and whole-genome sequencing data (for both academic and commercial uses) can be accessed through the UKRI/HDR UK Outbreak Data Analysis Platform (https://odap.ac.uk). A restricted dataset for a subset of GenOMICC participants is also available through the Genomics England data service. Monocyte RNA-seq data are available under the title ‘Monocyte gene expression data’ within the Oxford University Research Archives (https://doi.org/10.5287/ora-ko7q2nq66). Sequencing data will be made freely available to organizations and researchers to conduct research in accordance with the UK Policy Framework for Health and Social Care Research through a data access agreement. Sequencing data have been deposited at the European Genome–Phenome Archive (EGA), which is hosted by the EBI and the CRG, under accession number EGAS00001007111.Extended data figures and tables are available online at https://www.nature.com/articles/s41586-023-06034-3#Sec21 .Supplementary information is available online at https://www.nature.com/articles/s41586-023-06034-3#Sec22 .Code availability: Code to calculate the imputation of P values on the basis of SNPs in linkage disequilibrium is available at GitHub (https://github.com/baillielab/GenOMICC_GWAS).Acknowledgements: We thank the members of the Banco Nacional de ADN and the GRA@CE cohort group; and the research participants and employees of 23andMe for making this work possible. A full list of contributors who have provided data that were collated in the HGI project, including previous iterations, is available online (https://www.covid19hg.org/acknowledgements).Change history: 11 July 2023: A Correction to this paper has been published at: https://doi.org/10.1038/s41586-023-06383-z. -- In the version of this article initially published, the name of Ana Margarita Baldión-Elorza, of the SCOURGE Consortium, appeared incorrectly (as Ana María Baldion) and has now been amended in the HTML and PDF versions of the article.Copyright © The Author(s) 2023, Critical illness in COVID-19 is an extreme and clinically homogeneous disease phenotype that we have previously shown1 to be highly efficient for discovery of genetic associations2. Despite the advanced stage of illness at presentation, we have shown that host genetics in patients who are critically ill with COVID-19 can identify immunomodulatory therapies with strong beneficial effects in this group3. Here we analyse 24,202 cases of COVID-19 with critical illness comprising a combination of microarray genotype and whole-genome sequencing data from cases of critical illness in the international GenOMICC (11,440 cases) study, combined with other studies recruiting hospitalized patients with a strong focus on severe and critical disease: ISARIC4C (676 cases) and the SCOURGE consortium (5,934 cases). To put these results in the context of existing work, we conduct a meta-analysis of the new GenOMICC genome-wide association study (GWAS) results with previously published data. We find 49 genome-wide significant associations, of which 16 have not been reported previously. To investigate the therapeutic implications of these findings, we infer the structural consequences of protein-coding variants, and combine our GWAS results with gene expression data using a monocyte transcriptome-wide association study (TWAS) model, as well as gene and protein expression using Mendelian randomization. We identify potentially druggable targets in multiple systems, including inflammatory signalling (JAK1), monocyte–macrophage activation and endothelial permeability (PDE4A), immunometabolism (SLC2A5 and AK5), and host factors required for viral entry and replication (TMPRSS2 and RAB2A).GenOMICC was funded by Sepsis Research (the Fiona Elizabeth Agnew Trust), the Intensive Care Society, a Wellcome Trust Senior Research Fellowship (to J.K.B., 223164/Z/21/Z), the Department of Health and Social Care (DHSC), Illumina, LifeArc, the Medical Research Council, UKRI, a BBSRC Institute Program Support Grant to the Roslin Institute (BBS/E/D/20002172, BBS/E/D/10002070 and BBS/E/D/30002275) and UKRI grants MC_PC_20004, MC_PC_19025, MC_PC_1905 and MRNO2995X/1. A.D.B. acknowledges funding from the Wellcome PhD training fellowship for clinicians (204979/Z/16/Z), the Edinburgh Clinical Academic Track (ECAT) programme. This research is supported in part by the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation (grant MC_PC_20029). Laboratory work was funded by a Wellcome Intermediate Clinical Fellowship to B.F. (201488/Z/16/Z). We acknowledge the staff at NHS Digital, Public Health England and the Intensive Care National Audit and Research Centre who provided clinical data on the participants; and the National Institute for Healthcare Research Clinical Research Network (NIHR CRN) and the Chief Scientist’s Office (Scotland), who facilitate recruitment into research studies in NHS hospitals, and to the global ISARIC and InFACT consortia. GenOMICC genotype controls were obtained using UK Biobank Resource under project 788 funded by Roslin Institute Strategic Programme Grants from the BBSRC (BBS/E/D/10002070 and BBS/E/D/30002275) and Health Data Research UK (HDR-9004 and HDR-9003). UK Biobank data were used in the GSMR analyses presented here under project 66982. The UK Biobank was established by the Wellcome Trust medical charity, Medical Research Council, Department of Health, Scottish Government and the Northwest Regional Development Agency. It has also had funding from the Welsh Assembly Government, British Heart Foundation and Diabetes UK. The work of L.K. was supported by an RCUK Innovation Fellowship from the National Productivity Investment Fund (MR/R026408/1). J.Y. is supported by the Westlake Education Foundation. SCOURGE is funded by the Instituto de Salud Carlos III (COV20_00622 to A.C., PI20/00876 to C.F.), European Union (ERDF) ‘A way of making Europe’, Fundación Amancio Ortega, Banco de Santander (to A.C.), Cabildo Insular de Tenerife (CGIEU0000219140 ‘Apuestas científicas del ITER para colaborar en la lucha contra la COVID-19’ to C.F.) and Fundación Canaria Instituto de Investigación Sanitaria de Canarias (PIFIISC20/57 to C.F.). We also acknowledge the contribution of the Centro National de Genotipado (CEGEN) and Centro de Supercomputación de Galicia (CESGA) for funding this project by providing supercomputing infrastructures. A.D.L. is a recipient of fellowships from the National Council for Scientific and Technological Development (CNPq)-Brazil (309173/2019-1 and 201527/2020-0)