Objective Post-tonsillectomy haemorrhage remains a significant complication despite modifications of technique and instrumentation. Intracapsular tonsillectomy spares the capsule as a protective barrier for underlying blood vessels and musculature. Its efficacy in children with sleep-disordered breathing has been established, along with lowered rates of haemorrhage and pain, but research pertaining to adults and for recurrent infections has been limited. Method This retrospective study, encompassing 730 patients, compared post-operative haemorrhage rates between extracapsular (n = 379) and intracapsular tonsillectomy (n = 351) across all ages and indications using CoblationTM technology. Results A significant difference in post-operative haemorrhage rate was observed between extracapsular and intracapsular tonsillectomy techniques (2.1 vs 0.3 per cent; p = 0.025). In addition, an age of 18 years or older was also found to be an independent risk factor for post-operative haemorrhage (p = 0.01). Conclusion CoblationTM intracapsular tonsillectomy was shown to be safe and effective across all ages and indications, with a low risk of bleeding and revision surgery.
The aim of this study was to describe health-related quality of life (HRQoL) outcomes of school-going pediatric cochlear implant (CI) recipients in a South African cohort from the perspectives of parents and to relate parental ratings of HRQoL to a range of demographic variables. Parents of school-going CI recipients completed the Children with Cochlear Implants:Parental Perspectives (CCIPP) CI specific HRQoL questionnaire. The effect of different demographic variables on HRQoL outcomes was also determined. The study sample included 54 parents of school-going (mean age = 12.2 years; 3.6 SD; range = 6.6-18.3 years) CI recipients with at least six months CI experience.Children's communication and general functioning with a CI received the most positive parental ratings. A number of statistically significant associations between HRQoL outcomes and demographic variables have been confirmed. A mainstream educational setting was associated with better HRQoL outcomes in terms of communication and education, while pre-lingual onset of deafness was associated with better HRQoL outcomes in terms of general functioning and well-being. Shorter duration of deafness and unilateral implantation were associated with higher parental ratings for self-reliance and well-being respectively. Longer duration of CI use was linked to better ratings for general functioning, while shorter duration of CI use was linked to improved ratings for effects of implantation. viii Parents assigned positive ratings to their child's HRQoL. This exploration of children's HRQoL related to their CIs contributes to evidence-based pediatric CI services that support optimal psychosocial outcomes.
Background: Hearing loss prevalence is exceptionally high across developing world regions, including Africa, which has the greatest burden of hearing loss compared to other continents. Despite the availability of cost-efficient preventative and intervention measures for hearing loss, these hearing healthcare resources and services remain inaccessible in many developing countries. The purpose of this study was to describe audiologists’ perceptions regarding hearing healthcare resources and services within South Africa’s (SA) public healthcare system.Methods: A national telephonic survey study was conducted with audiologists in public healthcare system hospitals across SA, and the final sample comprised 100 audiologists.Results: Most audiologists perceived that their hospitals did not have adequate hearing healthcare resources to render efficient audiology services to patients. Furthermore, binaural amplification devices (invasive and non-invasive) for adults with bilateral hearing loss who adhered to the criteria for these devices were perceived to be unavailable in most hospitals. Audiologists also perceived that universal newborn hearing screening services, adult aural rehabilitation services, and follow-up care of all hearing devices post-warranty expiration were limited.Conclusion: A greater understanding of the status of hearing healthcare in SA’s public healthcare system hospitals is critical in gaining support for hearing loss from SA’s legislative sector and advocating for the integration of disability and quality of life concerns related to hearing loss on the national healthcare agenda.
Telehealth promises increased access to hearing healthcare services, primarily in areas where hearing healthcare resources are limited, such as within the South African public healthcare system. Telehealth for hearing healthcare is especially important during the COVID-19 pandemic, where physical distancing has been essential. This study aimed to describe audiologists’ perceptions regarding telehealth services for hearing loss within South Africa’s public healthcare system. This study was divided into two phases. During Phase 1, 97 audiologists completed an electronic survey regarding their perceptions of telehealth for hearing loss within South African public sector hospitals. Synchronous virtual focus-group discussions were conducted during Phase 2. Results indicated that audiologists recognized telehealth services’ potential to improve hearing healthcare efficiency within the public sector, and most (84.1%) were willing to use it. However, telehealth’s actual uptake was low despite almost doubling during the COVID-19 pandemic. Prominent perceived barriers to telehealth were primarily related to hospital resources, including the unavailability of equipment for the remote hearing/specialized assessments, internet-related barriers, and limited IT infrastructure. An increased understanding of telehealth in South Africa’s public healthcare system will assist in identifying and in improving potential barriers to telehealth, including hospital resources and infrastructure.
Using qualitative data via providers' perspectives, the goal of this study was to identify strengths and weaknesses in the current approaches being used to prevent onward transmission of HIV among men who have sex with men (MSM) in Berlin, Germany. In 2013, 18 participants from 10 organizations who provide direct outreach or services to MSM were interviewed (30-75 minutes). With regard to strategies and services that individuals believed contributed to the organization's success, we identified five themes: (1) Having staff and volunteers to "match" the target population, (2) Embracing homosexuality and gay identity, (3) Being invested in the cause, (4) Coordination of services to avoid overlap and duplication, and (5) Seeing eye-to-eye with the target population. Finally, with regard to areas in which organizations felt they could use improvement (i.e., continuing challenges), we identified three themes: (1) Insufficient funding and resources, (2) Insufficient services, and (3) HIV stigma, homophobia, and shifting attitudes about HIV. This study informs HIV prevention approaches in Berlin, Germany as well as other urban centers where MSM are disproportionally affected by the HIV epidemic.
Background: Hearing loss poses a significant burden globally. Its prevalence is exceptionally high in countries across the African region, where healthcare resources and services remain inaccessible. This study aimed to describe audiologists’ perceptions regarding hearing healthcare resources and services within South Africa’s public healthcare system. Methods: A national self-developed telephonic survey was conducted with audiologists in public healthcare system hospitals across South Africa, with the final sample comprising 100 audiologists. Results: Most (82%) audiologists indicated that their hospitals did not have adequate hearing healthcare resources to render efficient audiology services to patients. Binaural amplification devices (invasive and non-invasive) for adults with bilateral hearing loss who adhered to the criteria for these devices were perceived to be unavailable in most hospitals. Audiologists also perceived that universal newborn hearing screening services, adult aural rehabilitation services, and follow-up care for all hearing devices post-warranty expiration were limited. Conclusion: Efforts should be made to upsurge hearing healthcare resources, including increasing the financial budgets allocated to audiology resources so that increased diagnostic and screening audiology equipment and hearing devices can be procured where required, and additional audiologists can be employed within the South African public sector hospitals where needed.
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