scholarly journals Pediatric Auditory Brainstem Implantation: Impact on Audiological Rehabilitation and Tonal Language Development

2018 ◽  
Vol 23 (2) ◽  
pp. 126-134 ◽  
Author(s):  
John Ka Keung Sung ◽  
Betty Pui Ki Luk ◽  
Terence Ka Cheong Wong ◽  
Jiun Fong Thong ◽  
Hoi Tung Wong ◽  
...  
Keyword(s):  
Hong Kong ◽  
Language Development ◽  
Cochlear Implant ◽  
Pediatric Patients ◽  
Auditory Brainstem ◽  
Speech Development ◽  
Vowel Identification ◽  
Tonal Language ◽  
Prelingual Deafness ◽  
The Impact

Objective: This is a retrospective review of the impact of an Auditory Brainstem Implant (ABI) on the audiological rehabilitation and tonal language development of pediatric patients with prelingual profound deafness in Hong Kong. Results: From January 2009 to February 2015, 11 pediatric patients with profound prelingual deafness received an ABI in Hong Kong (age range 1.67–3.75 years). Etiologies included Cochlear Nerve Deficiency in 7, Severe Cochlear Malformations in 2, and Retrocochlear Deafness in 2. All of them were rehabilitated in Cantonese, a dialect of Chinese. Standard pediatric cochlear implant outcome measurements were used in this study that comprised of the 7-Sound Detection, Syllable Identification, Vowel Identification, Consonant Identification, Tone Imitation, Tone Production and Speech Perception Category. Audiological rehabilitation and speech development outcomes were reviewed. Age-matched outcomes of pediatric cochlear implant users were used for comparisons. Conclusion: Encouraging results of speech development were found, especially with continued use of the ABI. There was considerable variation in outcomes. Children with coexisting developmental and nonauditory cognitive disabilities did not perform as well. Auditory brainstem implantation is a safe and beneficial treatment for profound prelingual deafness in Cantonese-speaking pediatric patients.

scholarly journals Vancomycin Prescribing Practices and Therapeutic Drug Monitoring for Critically Ill Neonatal and Pediatric Patients: A Survey of Physicians and Pharmacists in Hong Kong

2020 ◽  
Vol 8 ◽  
Author(s):  
Twinny Cheuk Hin Chow ◽  
Janice Yuen Shun Li ◽  
Jasper Chak Ling Wong ◽  
Freddie Man Hong Poon ◽  
Hugh Simon Lam ◽  
...  
Keyword(s):  
Hong Kong ◽  
Critically Ill ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Therapeutic Monitoring ◽  
Therapeutic Drug ◽  
Prescribing Practices ◽  
Cross Sectional ◽  
The Impact ◽  
Trough Levels

Background: Deviations from the optimal vancomycin dosing may occur in the neonatal and pediatric population due to inconsistencies in the recommended dosing algorithms. This study aims to collect the expert opinions of clinicians who practice in the neonatal or pediatric intensive care units (NICU/PICUs) of 12 major medical centers in Hong Kong.Methods: This was a multicenter, cross-sectional study. Eligible physicians and pharmacists completed a structured questionnaire to identify the challenges they encountered when selecting the initial intermittent vancomycin dosing. They also answered questions concerning therapeutic monitoring services (TDM) for vancomycin, including the targeted trough levels for empirical vancomycin regimens administered for complicated and uncomplicated infections.Results: A total of 23 physicians and 43 pharmacists completed the survey. The top clinical parameters reported as most important for determining the initial vancomycin dosing were renal function (90.9%), post-menstrual/postnatal age (81.8%), body weight (66.7%), and suspected/documented pathogen (53.0%). Respondents reported challenges such as difficulties in determining the optimal initial dose for a targeted level (53.0%), inconsistencies between dosing references (43.9%) and a lack of clear hospital guidelines (27.3%). Half of the pharmacists (48.8%) reported that they had helped to interpret the TDM results and recommend vancomycin dose adjustments in >75% of cases. For methicillin-resistant Staphylococcus aureus infection, physicians, and pharmacists reported target trough levels of ~10–15 and 15–20 mg/L, respectively. For suspected moderate/uncomplicated Gram-positive infections physicians tended to prefer a lower trough range of 5–10 mg/L, while pharmacists preferred a range of 10–15 mg/L.Conclusions: Our results demonstrate that clinicians used varying vancomycin dosing guidelines in their practices. The multidisciplinary TDM service in Hong Kong can be improved further by establishing a standardized dosing guideline and implementing a well-structured, evidence-based service protocol. Future work includes conducting drug utilization studies to evaluate real-world antimicrobial usage patterns and the impact on tangible clinical outcomes, and developing pharmacokinetic-guided dose calculator for antimicrobials in critically ill neonates and pediatric patients.

scholarly journals Impact of Cochlear Implant on Auditory and Speech Perception, and Language Development in Prelingual Deaf Children

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
MD Abu Bashar
Keyword(s):  
Speech Perception ◽  
Language Development ◽  
Speech Production ◽  
Cochlear Implants ◽  
Normal Development ◽  
Speech Development ◽  
Deaf Children ◽  
Current Review ◽  
Profound Deafness ◽  
The Impact

Profound deafness during childhood affects the normal development of auditory and speech perception, speech production, and language skills. Cochlear implants (CIs) have revolutionized the scenario of rehabilitation of profoundly deaf individuals. A prelingual deaf is one who is congenitally deaf or whose hearing loss occurred before speech development. The current review was undertaken to assess the impact of cochlear implants (CIs) in prelingual deaf children on their hearing and speech perception, speech production and language development.

scholarly journals The Impact of Cumulative Cochlear Implant Wear Time on Spoken Language Outcomes at Age 3 Years

2021 ◽  
pp. 1-7
Author(s):  
Erika B. Gagnon ◽  
Hannah Eskridge ◽  
Kevin D. Brown ◽  
Lisa R. Park
Keyword(s):  
Language Development ◽  
Cochlear Implant ◽  
Retrospective Chart Review ◽  
Spoken Language ◽  
Speech Processor ◽  
Wear Time ◽  
Age Appropriate ◽  
Speech And Language Development ◽  
Spoken Language Skills ◽  
The Impact

Purpose The purpose of this study was to analyze the impact of cumulative hearing hour percentage (HHP) on pediatric cochlear implant users' speech and language development at age 3 years and to determine an evidence-based wear time recommendation that yields typical spoken language standard scores. Method A retrospective chart review of 40 pediatric cochlear implant recipients was completed. Children met the following criteria: prelingually deafened, implanted at age 2 years or younger, utilized a speech processor with datalogging capabilities, a minimum of 1 year of cochlear implant use, and language testing completed at approximately age 3 years. Exclusion criteria included significant inner ear malformation (i.e., common cavity) or developmental delay that would preclude spoken language development. Results Multiple regression analysis revealed that age and implantation and HHP were predictive of spoken language skills at age 3 years. Further analysis yielded wear time recommendations associated with age-appropriate spoken language based on the age at implantation. Conclusions When the goal is age-appropriate spoken language, wear time recommendations should reflect a child's current age, age at implantation, and the comparative daily sound access of age-matched normal-hearing peers. The HHP measurement can help provide that information. The minimum wear time recommendation should be set to 80% HHP with the ultimate goal of 100% HHP to give pediatric cochlear implant recipients enough access to sound and language to achieve their spoken language goals.

scholarly journals Impact of Cochlear Implant on Auditory and Speech Perception and Language Development in Prelingual Deaf Children.

2020 ◽  
pp. 1-7
Keyword(s):  
Speech Perception ◽  
Language Development ◽  
Speech Production ◽  
Cochlear Implants ◽  
Normal Development ◽  
Speech Development ◽  
Deaf Children ◽  
Current Review ◽  
Profound Deafness ◽  
The Impact

Abstract Profound deafness during childhood affects the normal development of auditory and speech perception, speech production and language skills. Cochlear implants (CIs) have revolutionized the scenario of rehabilitation of profoundly deaf individuals. A prelingual deaf is one who is congenitally deaf or whose hearing loss occurred before speech development. The current review was undertaken to assess the impact of cochlear implants (CIs) in prelingual deaf children on their hearing and speech perception, speech production and language development.

Using an App to monitor postoperative pain at home in pediatric patients

2021 ◽  
pp. 136749352091931
Author(s):  
Emanuela Tiozzo ◽  
Valentina Biagioli ◽  
Matilde Brancaccio ◽  
Riccardo Ricci ◽  
Anna Marchetti ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Intensity ◽  
Health Professionals ◽  
Pediatric Patients ◽  
Pain Scale ◽  
Factors Associated ◽  
Prospective Comparative Study ◽  
Paper And Pencil ◽  
The Impact ◽  
At Home

A prospective comparative study was conducted in 487 pediatric patients (69% male, mean age = 6.4 ± 4.0) to evaluate (a) the incidence, intensity, and characteristics of pain in pediatric patients at home during the first 24 hours and 5 days after surgery and (b) the factors associated with higher pain intensity, including the impact of an application (App) compared to the paper-and-pencil approach. Postoperative pain was assessed by patients or their parents at home using the ‘Bambino Gesù’ Children’s Hospital (Ospedale Pediatrico Bambino Gesù, OPBG) tool for participants aged 4–17 years or the Faces, Legs, Arms, Cry, and Consolability scale for participants less than four years old. Participants were assigned to two groups: those who used the paper-and-pencil version of the pain scale and those who used the App. Overall, 209 of the 472 (44%) participants reported pain during the first 24 hours, and 92 of the 420 (22%) reported pain between one and five days after surgery. Higher pain intensity scores were associated with being in the App group, directly assessing own pain, and using the OPBG tool. The App was effective in facilitating pain assessment. Health professionals could empower pediatric patients and their parents in assessing pain at home through a dedicated App.

Impact of Cochlear Implantation on Neurocognitive Subdomains in Adult Cochlear Implant Recipients

2021 ◽  
pp. 1-10
Author(s):  
Christiane Völter ◽  
Lisa Götze ◽  
Imme Haubitz ◽  
Janine Müther ◽  
Stefan Dazert ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Verbal Fluency ◽  
Homogeneous Population ◽  
Delayed Recall ◽  
Hearing Status ◽  
Age Related ◽  
Significant Difference ◽  
The Impact

<b><i>Introduction:</i></b> Age-related hearing loss affects about one-third of the population worldwide. Studies suggest that hearing loss may be linked to cognitive decline and auditory rehabilitation may improve cognitive functions. So far, the data are limited, and the underlying mechanisms are not fully understood. The study aimed to analyze the impact of cochlear implantation on cognition in a large homogeneous population of hearing-impaired adults using a comprehensive non-auditory cognitive assessment with regard to normal-hearing (NH) subjects. <b><i>Material and Methods:</i></b> Seventy-one cochlear implant (CI) candidates with a postlingual, bilateral severe or profound hearing loss aged 66.3 years (standard deviation [SD] 9.2) and 105 NH subjects aged 65.96 years (SD 9.4) were enrolled. The computer-based neurocognitive tool applied included 11 subtests covering attention (M3), short- and long-term memory (recall and delayed recall), working memory (0- and 2-back, Operation Span [OSPAN] task), processing speed (Trail Making Test [TMT] A), mental flexibility (TMT B), inhibition (cFlanker and iFlanker), and verbal fluency. CI patients underwent a neurocognitive testing preoperatively as well as 12 months postoperatively. Impact of hearing status, age, gender, and education on cognitive subdomains was studied. Additionally, after controlling for education and age, cognitive performance of CI subjects (<i>n</i> = 41) was compared to that of NH (<i>n</i> = 34). <b><i>Results:</i></b> CI users achieved significantly better neurocognitive scores 12 months after cochlear implantation than before in most subtests (M3, [delayed] recall, 2-back, OSPAN, iFlanker, and verbal fluency; all <i>p</i> &#x3c; 0.05) except for the TMT A and B. A significant correlation could be found between the postoperative improvement in speech perception and in the attentional task M3 (<i>p</i> = 0.01). Hearing status (<i>p</i> = 0.0006) had the strongest effect on attention, whereas education had a high impact on recall (<i>p</i> = 0.002), OSPAN (<i>p</i> = 0.0004), and TMT A (<i>p</i> = 0.005) and B (<i>p</i> = 0.003). Inhibition was mainly age-dependent with better results in younger subjects (<i>p</i> = 0.016). Verbal fluency was predicted by gender as females outperformed men (<i>p</i> = 0.009). Even after controlling for age and education NH subjects showed a significantly better performance than CI candidates in the recall (<i>p</i> = 0.03) and delayed recall (<i>p</i> = 0.01) tasks. Postoperatively, there was no significant difference between the 2 groups anymore. <b><i>Conclusion:</i></b> Impact of cochlear implantation on neurocognitive functions differs according to the cognitive subdomains. Postoperatively, CI recipients performed as good as age- and education-matched NH subjects.

scholarly journals Share Contract Revisited: A New Transaction Cost Approach

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Jian Ding ◽  
Yixiao Zhou
Keyword(s):  
Hong Kong ◽  
Transaction Cost ◽  
Empirical Studies ◽  
Theoretical Explanation ◽  
Empirical Testing ◽  
Cost Approach ◽  
Satisfactory Answer ◽  
The Impact

Abstract The purpose of this paper is to explore how sharecropping contracts are chosen over fixed-rent contracts. There are two concerning issues. First, theoretical explanation has been criticized for not providing a satisfactory answer to the question as to why share contracts are chosen. Second, among the existing empirical studies, there are great controversies about the impact of variance of output. Inspired by the latest insights from (Cheung, S. N. S. 2014. Economic Explanation. Hong Kong: Arcadia Press.), this paper not only provides an explanation for the choice of share contract that is suitable for empirical testing, but also solves the puzzle over variance of output.

scholarly journals 1346. Implementation of a Multidisciplinary 48 Hour Antibiotic Timeout in a Pediatric Population

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S684-S684
Author(s):  
Victoria Konold ◽  
Palak Bhagat ◽  
Jennifer Pisano ◽  
Natasha N Pettit ◽  
Anish Choksi ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Pediatric Population ◽  
Intervention Group ◽  
Post Intervention ◽  
Days Of Therapy ◽  
New Antibiotics ◽  
Core Elements ◽  
Quasi Experimental ◽  
Empirical Antibiotics ◽  
The Impact

Abstract Background To meet the core elements required for antimicrobial stewardship programs, our institution implemented a pharmacy-led antibiotic timeout (ATO) process in 2017 and a multidisciplinary ATO process in 2019. An antibiotic timeout is a discussion and review of the need for ongoing empirical antibiotics 2-4 days after initiation. This study sought to evaluate both the multidisciplinary ATO and the pharmacy-led ATO in a pediatric population, compare the impact of each intervention on antibiotic days of therapy (DOT) to a pre-intervention group without an ATO, and to then compare the impact of the pharmacy-led ATO versus multidisciplinary ATO on antibiotic days of therapy (DOT). Methods This was a retrospective, pre-post, quasi-experimental study of pediatric patients comparing antibiotic DOT prior to ATO implementation (pre-ATO), during the pharmacy-led ATO (pharm-ATO), and during the multidisciplinary ATO (multi-ATO). The pre-ATO group was a patient sample from February-September 2016, prior to the initiation of a formal ATO. The pharmacy-led ATO was implemented from February-September 2018. This was followed by a multidisciplinary ATO led by pediatric residents and nurses from February-September 2019. Both the pharm-ATO and the multi-ATO were implemented as an active non-interruptive alert added to the electronic health record patient list. This alert triggered when new antibiotics had been administered to the patient for 48 hours, at which time, the responsible clinician would discuss the antibiotic and document their decision via the alert workspace. Pediatric patients receiving IV or PO antibiotics administered for at least 48 hours were included. The primary outcome was DOT. Secondary outcomes included length of stay (LOS) and mortality. Results 1284 unique antibiotic orders (n= 572 patients) were reviewed in the pre-ATO group, 868 (n= 323 patients) in the pharm-ATO and 949 (n= 305 patients) in the multi-ATO groups. Average DOT was not significantly different pre vs post intervention for either methodology (Table 1). Mortality was similar between groups, but LOS was longer for both intervention groups (Table 1). Impact of an ATO on DOT, Mortality and LOS Conclusion An ATO had no impact on average antibiotic DOT in a pediatric population, regardless of the ATO methodology. Disclosures All Authors: No reported disclosures

scholarly journals The impact of SARS and COVID-19 on major trauma in Hong Kong

2021 ◽  
Author(s):  
Joseph Harold Walline ◽  
Kevin Kei Ching Hung ◽  
Janice Hiu Hung Yeung ◽  
Priscilla P. Song ◽  
Nai-Kwong Cheung ◽  
...  
Keyword(s):  
Hong Kong ◽  
Major Trauma ◽  
The Impact
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