Spoken Language Skills in Children With Bilateral Hearing Aids or Bilateral Cochlear Implants at the Age of Three Years

Objectives: Early hearing aid (HA) fitting and cochlear implants (CIs) aim to reduce the effects of hearing loss (HL) on spoken language development. The goals of this study were (1) to examine spoken language skills of children with bilateral HAs and children with bilateral CIs; (2) to compare their language skills to the age-norms of peers with normal hearing (NH); and (3) to investigate factors associated with spoken language outcomes. Design: Spoken language results of 56 Finnish children with HL were obtained from a nationwide prospective multicenter study. Children with HL comprised two groups: children with mild-to-severe HL who used bilateral HAs (BiHA group, n = 28) and children with profound HL who used bilateral CIs (BiCI group, n = 28). Children's spoken language comprehension, expressive and receptive vocabulary, and phonological skills were compared with normative values of children with NH at the age of three years. Odds ratio (OR) was calculated to compare proportions of children below age-norms in BiHA and BiCI groups. Factors associated with spoken language outcomes were modeled with analysis of covariance. Results: At the age of 3 years, 50%-96% of children with HL performed 1 SD or more below the mean of the normative sample of age-peers with NH in spoken language skills, depending on the language domain. Receptive vocabulary and phonological skills were the most vulnerable language domains. In receptive vocabulary, 82% of the children in the BiHA group and 50% of the children in the BiCI group scored 1 SD or more below the normative mean. The BiHA group was 4.4 times more likely to have poorer receptive vocabulary than the BiCI group. In phonological skills, 96% of children in the BiHA group and 60% of the children in the BiCI group scored 1 SD or more below the normative mean. The BiHA group was 18.0 times more likely to have poorer phonological skills than the BiCI group. The analysis of covariance models showed that unaided pure-tone average, PTA(0.5-4 kHz), had a significant effect on spoken language comprehension in the BiHA group. For the BiCI group, age at HL diagnosis and age at CI activation had a significant effect on expressive vocabulary. High maternal level of education had a significant effect on language comprehension and expressive vocabulary and female gender on phonological skills. Conclusions: At the age of 3 years, especially receptive vocabulary and phonological skills caused difficulties for children with HL showing also considerable individual variation. Children with bilateral HAs seemed to be more likely to have poorer receptive vocabulary and phonological skills than children with bilateral CIs. A variety of factors was associated with outcomes in both groups. Close monitoring of spoken language skills of children with HL is important for ensuring similar opportunities for all children with HL and timely intervention, when needed.Peer reviewe

Spoken Language Skills in Children With Bilateral Hearing Aids or Bilateral Cochlear Implants at the Age of Three Years

Objectives: Early hearing aid (HA) fitting and cochlear implants (CIs) aim to reduce the effects of hearing loss (HL) on spoken language development. The goals of this study were (1) to examine spoken language skills of children with bilateral HAs and children with bilateral CIs; (2) to compare their language skills to the age-norms of peers with normal hearing (NH); and (3) to investigate factors associated with spoken language outcomes. Design:Spoken language results of 56 Finnish children with HL were obtained from a nationwide prospective multicenter study. Children with HL comprised two groups: children with mild-to-severe HL who used bilateral HAs (BiHA group, n = 28) and children with profound HL who used bilateral CIs (BiCI group, n = 28). Children's spoken language comprehension, expressive and receptive vocabulary, and phonological skills were compared with normative values of children with NH at the age of three years. Odds ratio (OR) was calculated to compare proportions of children below age-norms in BiHA and BiCI groups. Factors associated with spoken language outcomes were modeled with analysis of covariance. Results: At the age of 3 years, 50%-96% of children with HL performed 1 SD or more below the mean of the normative sample of age-peers with NH in spoken language skills, depending on the language domain. Receptive vocabulary and phonological skills were the most vulnerable language domains. In receptive vocabulary, 82% of the children in the BiHA group and 50% of the children in the BiCI group scored 1 SD or more below the normative mean. The BiHA group was 4.4 times more likely to have poorer receptive vocabulary than the BiCI group. In phonological skills, 96% of children in the BiHA group and 60% of the children in the BiCI group scored 1 SD or more below the normative mean. The BiHA group was 18.0 times more likely to have poorer phonological skills than the BiCI group. The analysis of covariance models showed that unaided pure-tone average, PTA(0.5-4 kHz), had a significant effect on spoken language comprehension in the BiHA group. For the BiCI group, age at HL diagnosis and age at CI activation had a significant effect on expressive vocabulary. High maternal level of education had a significant effect on language comprehension and expressive vocabulary and female gender on phonological skills. Conclusions: At the age of 3 years, especially receptive vocabulary and phonological skills caused difficulties for children with HL showing also considerable individual variation. Children with bilateral HAs seemed to be more likely to have poorer receptive vocabulary and phonological skills than children with bilateral CIs. A variety of factors was associated with outcomes in both groups. Close monitoring of spoken language skills of children with HL is important for ensuring similar opportunities for all children with HL and timely intervention, when needed.</p

Biokaasutuotannon edistämiskeinot - Tilanne Euroopassa

Puuenergia ry toimii yhteistyössä FINBIOn ja Turvetellisuusliiton kanssa, päätoimittaja: Tage Fredriksson, www.puuenergia.fivo

Biokaasutuotannon edistämiskeinot - Tilanne Suomessa

Puuenergia ry toimii yhteistyössä FINBIOn ja Turveteollisuusliiton kanssa, Päätoimittaja: Tage Fredriksson, www.puuenergia.fivo

Terveyden edistäminen Oulun yliopistollisessa sairaalassa

Tutkimuksen tarkoituksena oli kuvata Oulun yliopistollisen sairaalan neljän tulosalueen terveydenhuollon ammattihenkilöiden arvioita toiminnastaan potilaiden terveyden edistämiseksi. Lisäksi tarkoituksena oli selvittää heidän mielipiteitään ja kokemuksiaan terveyden edistämisestä, siinä käytetyistä menetelmistä ja terveyden edistämiseen liittyvistä kehittämistarpeista. Tutkimus tehtiin Pirkanmaan sairaanhoitopiirissä tehdyn vastaavan kyselytutkimuksen pohjalta. Tutkimuksen tavoitteena oli tuottaa uutta tietoa potilaiden terveyden edistämisen nykytilasta, jota Oysin perusterveydenhuollon yksikön terveyden edistämisen työryhmä voi käyttää terveyden edistämisen suunnittelutyön tukena. Kysymykset liittyivät alkoholin riskikäyttöön, tupakointiin, ylipainoon, masennukseen ja perheiden tukemiseen. Tutkimuksen tietoperustassa käsitellään potilaan terveyden edistämiseen liittyvää historiaa, taustaa, käsitteitä sekä lakia. Lisäksi tietoperustassa tarkastellaan terveyden edistämistä yhteiskunnallisesta näkökulmasta. Tutkimus on kvantitatiivinen survey-tutkimus, jossa aineistonhankintamenetelmänä käytettiin webropol-sovellusta. Tutkimuksen vastausprosentti oli 23 % (N=4276), joten tutkimustulokset ovat suuntaa antavia. Tutkimustulosten perusteella voidaan todeta, että terveydenedistäminen on jokaisen sairaalassa työskentelevän tehtävä ja sitä tehdäkseen henkilökunnalle olisi tarjottava enemmän resursseja ja täydennyskoulutusta. Tutkimuksen kehittämisideana oli tuoda esille nykyisten käytäntöjen vahvuudet ja kehittämisalueet, joita edelleen kehittämällä voidaan tuottaa laadukkaampia ja tehokkaampia terveyden edistämisen käytäntöjä erikoissairaanhoidossa. Jatkotutkimuksena voitaisiin tutkia erikoissairaanhoidossa olevien potilaiden ja heidän omaistensa kokemuksia, mielipiteitä ja toiveita terveyden edistämiseksi esimerkiksi palvelumuotoilun avulla.The purpose of this study was to describe the evaluations of health care professionals from four different departments at the Oulu University hospital on their actions in promoting the health of patients. In addition, the aim was to investigate their opinions and experiences in health promoting, the methods used for it and the needs for future development. The study was carried out in the same manner as a report done at the Pirkanmaa health care district. The purpose of the study was to obtain information on the present status of health promotion at the Oulu University hospital. The report is also intended to support the work of the health promotion work group at the unit of basic health care. The questions of the study were related to alcohol consumption, smoking, obesity, depression and family support. The knowledge basis part of the work consists the history, background, concepts and law of health promotion. The knowledge basis contains also evaluation of health promotion from the societal perspective. The study is a quantitative survey where webropol application was used for material acquisition. The response rate of the survey was 23 % (N=4276), meaning that the results are directional. The results show that the personnel working at hospitals need to promote health and in order to succeed; the personnel require more resources and supplemental education. The development idea of the study was to highlight the strengths and weaknesses of the present health promotion practices. Improvements in these areas can then provide higher quality and more efficient methods for promoting health in special health care. The present study could be followed by a survey of the experiences, opinions and expectations on health promotion of patients and their relatives undergoing special health care.Muita tekijöitä on lisäksi: Teija Mykkänen ja Marjukka Salonen-Jänkäl

Spoken language skills in children with bilateral hearing aids or bilateral cochlear implants at the age of three years

Abstract Objectives: Early hearing aid (HA) fitting and cochlear implants (CIs) aim to reduce the effects of hearing loss (HL) on spoken language development. The goals of this study were (1) to examine spoken language skills of children with bilateral HAs and children with bilateral CIs; (2) to compare their language skills to the age-norms of peers with normal hearing (NH); and (3) to investigate factors associated with spoken language outcomes. Design: Spoken language results of 56 Finnish children with HL were obtained from a nationwide prospective multicenter study. Children with HL comprised two groups: children with mild-to-severe HL who used bilateral HAs (BiHA group, n = 28) and children with profound HL who used bilateral CIs (BiCI group, n = 28). Children’s spoken language comprehension, expressive and receptive vocabulary, and phonological skills were compared with normative values of children with NH at the age of three years. Odds ratio (OR) was calculated to compare proportions of children below age-norms in BiHA and BiCI groups. Factors associated with spoken language outcomes were modeled with analysis of covariance. Results: At the age of 3 years, 50%–96% of children with HL performed 1 SD or more below the mean of the normative sample of age-peers with NH in spoken language skills, depending on the language domain. Receptive vocabulary and phonological skills were the most vulnerable language domains. In receptive vocabulary, 82% of the children in the BiHA group and 50% of the children in the BiCI group scored 1 SD or more below the normative mean. The BiHA group was 4.4 times more likely to have poorer receptive vocabulary than the BiCI group. In phonological skills, 96% of children in the BiHA group and 60% of the children in the BiCI group scored 1 SD or more below the normative mean. The BiHA group was 18.0 times more likely to have poorer phonological skills than the BiCI group. The analysis of covariance models showed that unaided pure-tone average, PTA0.5–4 kHz, had a significant effect on spoken language comprehension in the BiHA group. For the BiCI group, age at HL diagnosis and age at CI activation had a significant effect on expressive vocabulary. High maternal level of education had a significant effect on language comprehension and expressive vocabulary and female gender on phonological skills. Conclusions: At the age of 3 years, especially receptive vocabulary and phonological skills caused difficulties for children with HL showing also considerable individual variation. Children with bilateral HAs seemed to be more likely to have poorer receptive vocabulary and phonological skills than children with bilateral CIs. A variety of factors was associated with outcomes in both groups. Close monitoring of spoken language skills of children with HL is important for ensuring similar opportunities for all children with HL and timely intervention, when needed

Longitudinal Metabolome-Wide Signals Prior to the Appearance of a First Islet Autoantibody in Children Participating in the TEDDY Study

Children at increased genetic risk for type 1 diabetes (T1D) after environmental exposures may develop pancreatic islet autoantibodies (IA) at a very young age. Metabolic profile changes over time may imply responses to exposures and signal development of the first IA. Our present research in The Environmental Determinants of Diabetes in the Young (TEDDY) study aimed to identify metabolome-wide signals preceding the first IA against GAD (GADA-first) or against insulin (IAA-first). We profiled metabolomes by mass spectrometry from children's plasma at 3-month intervals after birth until appearance of the first IA. A trajectory analysis discovered each first IA preceded by reduced amino acid proline and branched-chain amino acids (BCAAs), respectively. With independent time point analysis following birth, we discovered dehydroascorbic acid (DHAA) contributing to the risk of each first IA, and γ-aminobutyric acid (GABAs) associated with the first autoantibody against insulin (IAA-first). Methionine and alanine, compounds produced in BCAA metabolism and fatty acids, also preceded IA at different time points. Unsaturated triglycerides and phosphatidylethanolamines decreased in abundance before appearance of either autoantibody. Our findings suggest that IAA-first and GADA-first are heralded by different patterns of DHAA, GABA, multiple amino acids, and fatty acids, which may be important to primary prevention of T1D