Phytoestrogens are found in foods such as soy (isoflavones) and flaxseed (lignans), and certain botanical supplements. Their role in estrogen receptor positive (ER+) breast cancer recurrence and treatment is controversial, and it is unknown how this affects intake among patients. The Ontario Cancer Registry was used to identify 417 population-based breast cancer cases (mean time from diagnosis was 57 days). A questionnaire was mailed to determine intake of phytoestrogen foods and supplements in the last 2 mo, changes since diagnosis and differences by ER tumor status or hormonal treatment. Of 278 (67%) respondents, 56% consumed soy foods, 39% consumed isoflavone-rich foods (tofu, soybeans, soy milk, soy nuts), and 70% ate lignan-rich foods, including flaxseed (33%). Only soy milk, flaxseed, and flaxseed bread were commonly consumed more than once/wk. Few patients (4%) took isoflavone (soy, red clover, kudzu, licorice, isoflavones) or lignan/flaxseed supplements. Since diagnosis, 17% started or stopped soy foods (most stopped); this was more prevalent among those receiving hormonal treatment (20%; 95% confidence interval (CI): 14, 26) than not (6%; 95% CI: 1, 12). No other differences by ER status or hormonal treatment were observed. Research is needed to confirm this and to explore influencing factors.
This document was informed by literature reviews conducted in accordance with the Joanna Briggs Institute’s guide to evidence synthesis (Aromataris & Munn, 2017; https://joannabriggs.org) and includes evidence related to client candidacy, delivery models, modalities of delivery, and outcomes of virtual hearing aid fitting and management. This document provides clinical practice guidance for virtual hearing aid fitting and management processes and technological requirements in the delivery of such services (herein referred to as virtual hearing aid care). Virtual hearing aid care can include services delivered directly to a client by a provider or using facilitator-supported services and specialized equipment, depending on client factors, type of care, and the timepoint in the care process (e.g., initial versus follow-up appointments). This document will address virtual care including the following types of hearing aid care: o Programming o Verification o Validation o Management (counselling and education) Currently, virtual hearing aid care is better suited to follow-up appointments
Purpose A growing body of evidence indicates that treatment of hearing loss by provision of hearing aids leads to improvements in auditory and visual working memory. The purpose of this study was to assess whether similar working memory benefits are observed following provision of cochlear implants (CIs). Method Fifteen adults with postlingually acquired severe bilateral sensorineural hearing loss completed the prospective longitudinal study. Participants were candidates for bilateral cochlear implantation with some aidable hearing in each ear. Implantation surgeries were carried out sequentially, approximately 1 year apart. Working memory was measured with the visual Reading Span Test (Daneman & Carpenter, 1980) at 5 time points: pre-operatively following a 6-month bilateral hearing aid trial, after 6 and 12 months of bimodal (CI plus contralateral hearing aid) listening experience following the 1st CI surgery and activation, and again after 6 and 12 months of bilateral CI listening experience following the 2nd CI surgery and activation. Results Compared to the preoperative baseline, CI listening experience yielded significant improvements in participants' ability to recall test words in the correct serial order after 12 months in the bimodal condition. Individual performance outcomes were variable, but almost all participants showed increases in task performance over the course of the study. Conclusions These results suggest that, similar to appropriate interventions with hearing aids, treatment of hearing loss with CIs can yield working memory benefits. A likely mechanism is the freeing of cognitive resources previously devoted to effortful listening.
Rationale There is a growing demand for comprehensive, evidence‐based, and accessible clinical practice guidelines (CPGs) to address virtual service delivery. This demand was particularly evident within the field of hearing healthcare during the COVID‐19 pandemic, when providers were faced with an immediate need to offer services at a distance. Considering the recent advancement in information and communication technologies, the slow uptake of virtual care, and the lack of knowledge tools to support clinical integration in hearing healthcare, a Knowledge‐to‐Action Framework was used to address the virtual care delivery research‐to‐practice gap. Aims and Objectives This paper outlines the development of a CPG specific to provider‐directed virtual hearing aid care. Clinical integration of the guideline took place during the COVID‐19 pandemic and in alignment with an umbrella project aimed at implementing and evaluating virtual hearing aid care incorporating many different stakeholders. Method Evidence from two systematic literature reviews guided the CPG development. Collaborative actions around knowledge creation resulted in the development of a draft CPG (v1.9) and the mobilisation of the guideline into participating clinical sites. Results and Conclusion Literature review findings are discussed along with the co‐creation process that included 13 team members, from various research and clinical backgrounds, who participated in the writing, revising, and finalising of the draft version of the guideline.
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