Objective To evaluate the effectiveness of two screening methods (imitanciometry screening and questionnaire) to identify children at risk for conductive hearing loss, comparing this data with complete audiologic evaluation. Methods Of 507 children aged between three and six, 111 completed all procedures. The observational methods used were: imitanciometry screening, a questionnaire to identify risk factors for hearing loss and complete audiologic evaluation. Results obtained in the first two instruments were compared with results from complete audiologic evaluation (gold standard). From these comparisons, sensitivity and specificity, accuracy, positive and negative predictive values, and odds ratio were determined for the two screening methods and for the combination of both methods. Results The two methods applied in series (questionnaire and after imitanciometry screening) showed a greater odds ratio and better correlation between sensitivity and proportion of falsepositives (ROC curve). Conclusion Combining the two tests in series improved screening accuracy. This combination was the best tool for identifying children at risk for conductive hearing loss.
OBJETIVO: Investigar e comparar o desempenho em letramento escolar de indivíduos de 1ª e 2ª séries do Ensino Fundamental de uma escola pública antes e após Programas de Práticas Reflexivas de Linguagem (PPRL). MÉTODOS: Participaram desta pesquisa 97 escolares de 1ª série e 149 de 2ª série entre os anos de 2006 e 2008. Os indivíduos realizaram triagens do letramento escolar antes e após PPRL. Estes tiveram a duração média de quatro meses; foram realizados em situação coletiva e em parceria com os professores das classes selecionadas. Foram elaborados segundo os temas norteadores: promoção de práticas de letramento; conscientização sobre o uso da voz e dos níveis de ruído nas escolas; promoção de narrativas orais e escritas, envolvendo a metalinguagem e principalmente a consciência fonológica e promoção de práticas de leitura e compreensão de leitura. Ao término de cada programa, foram realizadas triagens finais, com a finalidade de analisar e comparar o desempenho dos escolares antes e após a realização dos programas. Os dados foram analisados qualitativa e quantitativamente. RESULTADOS: Houve diferenças significativas no desempenho entre as séries tanto nas triagens iniciais, quanto nas finais nas provas de ditado, leitura de palavras e frases e cloze de frases. CONCLUSÃO: A 2ª série apresentou resultados melhores do que a 1ª série. Os resultados foram mais significativos nas provas que demandaram conhecimento mais aprofundado da relação fonema-grafema e vice-versa, sugerindo que o letramento escolar é necessário quando o letramento social não se faz presente.
Summary
Introduction: Few population-based studies have quantified hearing levels in Brazil; additional studies on this subject are needed.
Purpose: The purpose of this study was to characterize hearing complaints and the audiological profile of the population served by the Clinical Audiology Service of an Academic Health Center in the western region of São Paulo, Brazil, between 2003 and 2008. An additional aim was to check whether there is a positive association between the signs/symptoms and type of hearing loss.
Methods: This was a retrospective study of the records of 2,145 patients. The health history, tonal and vocal audiometry, and imitanciometry findings were analyzed.
Results: The mean age of the patients was 20.6 years. The majority of the subjects had normal hearing thresholds, and the prevalence of hearing loss was approximately 35%. As the patient's age increased, the frequency of conductive hearing loss decreased and that of sensorineural hearing loss increased. There was a tendency toward hearing loss worsening with age.
Conclusion: Hearing complaints can predict the type of hearing loss; therefore, they should always be valued because they can be used as a form of screening and thus help to determine the diagnostic hypothesis. This could help to reduce the gap between the patient's perception of the complaints and the audiological assessment and thus improve the prognosis.
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