Defining Essential Services for Deaf and Hard of Hearing Children during the COVID-19 Pandemic

Attitudes toward COVID-19 vaccination among urogynecology patients

Objective

Urogynecology patients skew older and often require intimate exams to treat non-life-threatening conditions, thus making care particularly susceptible to the effects of COVID-19. We aim to understand COVID-19 vaccination attitudes amongst urogynecology patients during the pandemic, which has adversely affected healthcare delivery, to identify measures that can be undertaken to improve care going forward.

Study design

Cross-sectional surveys of urogynecology patients were conducted in three different states (Delaware, New Jersey, and Pennsylvania) between March and August 2021. Demographics, vaccination status, and COVID-19 attitudes were analyzed. Chi-square tests investigated group differences between vaccine-hesitant and unhesitant subjects.

Results

Out of 158 surveys, eighty-three percent of respondents were vaccinated or planning to get vaccinated. Older age and regular flu vaccination predicted COVID-19 vaccination. Ninety-three percent of subjects were comfortable attending in-person visits. However, vaccine-hesitant individuals were less comfortable attending in-person and were significantly less likely to be comforted by clinic interventions, such as masking. Hesitant and unhesitant groups trusted doctors or medical professionals most for their source of COVID-19 information.

Conclusions

Urogynecology patients mirror the general older population's COVID-19 vaccination attitudes, with distinct differences between hesitant and unhesitant groups. Vaccine-hesitant subjects appear less comfortable coming to in-person visits and less comforted by possible interventions, posing a difficult obstacle for clinics to overcome. High levels of patient trust suggest healthcare providers can play a crucial role in encouraging COVID-19 vaccination and combating misinformation.

Neonatal hearing screening using a smartphone-based otoacoustic emission device: A comparative study

OBJECTIVE

Increasing options are becoming available for clinicians and healthcare professionals who use smartphone-based applications (apps) to identify hearing loss. The use of smartphone-based apps for newborn hearing screening (NHS) has been proposed as an alternative screening method in NHS programs. This study aims to compare the screening outcomes of a smartphone-based otoacoustic emission (OAE) screening device to a commercially available OAE screening device.

METHODS

NHS was conducted in the post-natal maternity ward and neonatal intensive care unit (NICU) of two tertiary public healthcare hospitals over a period of 8 months. Within participant DPOAE and TEOAE screening outcomes of a smartphone-based OAE device (hearOAE) were compared to that of the Otodynamics ILO V6.

RESULTS

A total of 176 infants (n = 352 ears; 48.9 % female) underwent NHS (DPOAE n = 176; TEOAE n = 176). The mean age at was 4.5 days (SD 11.3). Signal-to-noise ratio (SNR) were higher with the hearOAE with TEOAE NHS, and equivalent or higher SNR at four out of six frequencies with DPOAEs. Mean and total noise levels were significantly lower for the hearOAE compared to the Otodynamics with DPOAEs noise levels of five out of six frequencies being equivalent to, or lower than the Otodynamics (p < 0.001). Lower noise levels are likely to be advantageous in less-than-ideal test conditions. Inter-device DPOAE comparison indicated no statistically significant difference in the refer rate between the devices (p = 0.238). DPOAE pass rates between devices differed in 6 ears (p > 0.05), and in 20 ears for TEOAEs, with the hearOAE demonstrating a higher TEOAE pass rate (p = 0.009). The hearOAE did, however, demonstrate lower noise levels at three out five frequencies, which may have impacted the pass rate. No statistically significant correlation was found between the independent variables and the screening outcome (pass/refer) for TEOAEs using either device (p = 0.105 to 0.810). A high concordance of NHS outcomes within-participants of 89.7 % and 85.0 % for DPOAE and TEOAE respectively, was measured.

CONCLUSIONS

The mHealth based OAE device demonstrated good agreement in NHS outcomes compared to a commercially available device. This verifies the performance of the novel smartphone based OAE device, and may facilitate increased accessibility of decentralised NHS service in resource constrained populations.

The Challenges Encountered by Conventional Hearing Aid and/or Cochlear Implant Users During the COVID-19 Pandemic

PURPOSE

The purpose of this study was to evaluate the stress, quality of life, and access to hearing health services experienced by adults and children who use hearing aid and/or cochlear implant and their families during the COVID-19 pandemic.

METHOD

Perceived Stress Scale, Personal Wellbeing Index, and World Health Organization Quality of Life questionnaires were applied online to 30 adults with hearing loss and parents of 61 children with hearing loss. Also, a survey was conducted to acquire more about the demographics of people who use cochlear implants and conventional hearing aids, as well as the difficulties they encountered during the COVID-19 period.

RESULTS

Although child user families experienced more problems than adults during the COVID-19 period, the stress levels of child user families were higher than that of adult user families (p = .05). Even though there was no statistically significant difference, the families of pediatric users had lower quality of life than adult users.

CONCLUSIONS

The stress/anxiety problems that arise as a result of this are coming to the forefront of both patients and their relatives. The findings indicate that creative strategies should be developed to give individuals with hearing loss efficient access to hearing health services.

Psychosocial Impact of the COVID-19 Pandemic on Children With Cochlear Implants and Their Parents/Family Members

Purpose:

The purpose of this study was to describe hearing health care and education experiences of children with cochlear implants (CIs) during the COVID-19 pandemic and the potential psychosocial effects of the pandemic on these children and their parents/family members.

Method:

The study used a cross-sectional survey design. The study sample comprised two groups, namely, parents/family members of children with CIs (study group, n = 70, M age = 44.6 ± 12.4 years) and parents/family members of children with normal hearing (control group, n = 58, M age = 43.8 ± 11.5 years). Parents/family members completed the Perceived Stress Scale (PSS), the Coronavirus Anxiety Scale (CAS), and the Family Perspective Profile form, as well as the Demographic Information form.

Results:

The PSS scores of the study group were higher than those of the control group ( p = .001). However, there was no statistically significant difference between groups in the CAS scores ( p = .896). According to the Family Perspective Profile form, almost half of the parents/family members of children with CIs reported that their children experienced difficulties in education and hearing health care services during the pandemic and showed some changes in their attitudes and behaviors.

Conclusions:

During the pandemic, the stress levels of parents/family members of children with CIs were higher than parents/family members of children with normal hearing. In addition to the challenges posed by the pandemic, the difficulties that parents/family members of children with CIs experience in meeting their children's additional needs related to accessing education and hearing health care services may have contributed to increased stress levels.

Otitis Media Practice During the COVID-19 Pandemic

The global coronavirus disease-2019 (COVID-19) pandemic has changed the prevalence and management of many pediatric infectious diseases, including acute otitis media (AOM). Coronaviruses are a group of RNA viruses that cause respiratory tract infections in humans. Before the COVID-19 pandemic, coronavirus serotypes OC43, 229E, HKU1, and NL63 were infrequently detected in middle ear fluid (MEF) specimens and nasopharyngeal aspirates in children with AOM during the 1990s and 2000s and were associated with a mild course of the disease. At times when CoV was detected in OM cases, the overall viral load was relatively low. The new severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the causative pathogen responsible for the eruption of the COVID-19 global pandemic. Following the pandemic declaration in many countries and by the World Health Organization in March 2020, preventive proactive measures were imposed to limit COVID-19. These included social distancing; lockdowns; closure of workplaces; kindergartens and schools; increased hygiene; use of antiseptics and alcohol-based gels; frequent temperature measurements and wearing masks. These measures were not the only ones taken, as hospitals and clinics tried to minimize treating non-urgent medical referrals such as OM, and elective surgical procedures were canceled, such as ventilating tube insertion (VTI). These changes and regulations altered the way OM is practiced during the COVID-19 pandemic. Advents in technology allowed a vast use of telemedicine technologies for OM, however, the accuracy of AOM diagnosis in those encounters was in doubt, and antibiotic prescription rates were still reported to be high. There was an overall decrease in AOM episodes and admissions rates and with high spontaneous resolution rates of MEF in children, and a reduction in VTI surgeries. Despite an initial fear regarding viral shedding during myringotomy, the procedure was shown to be safe. Special draping techniques for otologic surgery were suggested. Other aspects of OM practice included the presentation of adult patients with AOM who tested positive for SARS-2-CoV and its detection in MEF samples in living patients and in the mucosa of the middle ear and mastoid in post-mortem specimens.

The impact of misinformation on the COVID-19 pandemic

Since the inception of the current pandemic, COVID-19 related misinformation has played a role in defaulting control of the situation. It has become evident that the internet, social media, and other communication outlets with readily available data have contributed to the dissemination and availability of misleading information. It has perpetuated beliefs that led to vaccine avoidance, mask refusal, and utilization of medications with insignificant scientific data, ultimately contributing to increased morbidity. Undoubtedly, misinformation has become a challenge and a burden to individual health, public health, and governments globally. Our review article aims at providing an overview and summary regarding the role of media, other information outlets, and their impact on the pandemic. The goal of this article is to increase awareness of the negative impact of misinformation on the pandemic. In addition, we discuss a few recommendations that could aid in decreasing this burden, as preventing the conception and dissemination of misinformation is essential.

Delays in Infant Hearing Detection and Intervention During the COVID-19 Pandemic: Commentary

Early detection and intervention for congenital hearing loss are critical for speech and language development. Newborns should receive hearing screening, diagnosis, and intervention by 1, 3, and 6 months, respectively. The COVID-19 pandemic has caused delays in each step of this process. Increased out-of-hospital births and shortages of essential health care services likely reduced the proportion of newborns completing screening. Additional factors have contributed to delayed diagnosis. We estimate that up to 50% of infants born with hearing loss in Maryland in 2021 may be delayed in diagnosis. Hearing loss interventions have been affected due to delayed initiation, reduced availability, and lack of in-person services. Delayed diagnosis and treatment of congenital hearing loss are likely to have significant effects on individual patients and public health, the full magnitude of which will not be known for years. Opportunities exist for providers to mitigate the negative effects of COVID-19 on pediatric hearing health care.

Distance Education for d/Deaf and Hard of Hearing Students during the COVID-19 Pandemic in Saudi Arabia: Challenges and Support

BACKGROUND

On March 11, 2020, the World Health Organization declared COVID-19 to be a global pandemic. This prompted many countries, including Saudi Arabia, to suspend students' attendance at schools and to start distance education. This sudden shift in the educational system has affected students' learning, particularly for d/Deaf and hard-of-hearing (d/Dhh) students, who have unique language and communication needs.

AIM

This study explores the challenges and support methods for d/Dhh students during their distance education in Saudi Arabia.

METHODS

A qualitative research study using semistructured interviews was conducted with 37 parents of d/Dhh students to answer the research questions.

RESULTS

Three themes emerged from the parents' responses: (1) the challenges faced by d/Dhh students in distance education; (2) the specific needs of d/Dhh students in distance education; and (3) the supports provided to d/Dhh students in distance education.

CONCLUSIONS

Distance education is a strategic choice, and parents must be informed about how to use the Madrasati e-learning platform effectively by providing solutions and supports. Additionally, d/Dhh students require various forms of ongoing support from both their families and schools to ensure that they succeed and benefit from their experiences.

Living with deafblindness during COVID-19: An international webinar to facilitate global knowledge translation

Arguably, individuals living with deafblindness are among the hardest hit by the effects of the corona virus disease of 2019 (COVID- 19), given the importance of the sense of touch for their ability to interact with the world. To address this challenge, it is imperative to facilitate the implementation of evidence- and experience-based recommendations, and to improve knowledge translation on a global scale. Deafblind International organized a webinar to provide a platform where participants could exchange experiences and solutions to overcome the challenges created by the arrival of COVID-19, in order to facilitate information exchange among stakeholders in deafblindness during this pandemic. We present an overview of its content here and place the summarized themes in context with existing research literature. Abstract submission was open for 4 weeks in May 2020, resulting in 30 submissions from 13 countries across 5 continents. Of the 26 presenter teams, 9 (35%) had a co-presenter that was living with deafblindness themselves. The number of individual participants across all sessions ranged from 55 to 140 ( M = 98), with a total of 3709 session registrations overall, and the organizers estimate a total attendance of around 400 participants. Based on extensive field notes taken during the webinar, and repeated viewing of the recordings, qualitative description allowed the team to synthesize eight principal themes across the event: access to information, communication, service accessibility, adaptations to service delivery, online safety and security, physical distancing, mental health and research. The first Deafblind International webinar was able to fill an important gap by bringing together a variety of stakeholders in deafblindness across the globe. The event created a sense of group membership and peer support, brought the participants, researchers, the professionals as well as their service agencies closer together and generated a sense of hope and collaboration.

[Validity of SARS-CoV-2 swabs taken preoperatively in children]

BACKGROUND

 Due to the limited compliance, the technically correct collection of a pooled nasopharyngeal swab is significantly more difficult in children. Especially during operations in the area of the upper respiratory tract, there is a significantly increased risk of infection with COVID-19 for everyone present in the operating room. The aim of the study is to analyze the validity of SARS-CoV-2 swabs taken preoperatively under suboptimal conditions.

MATERIAL AND METHODS

 Retrospective comparison of the PCR results of SARS-CoV-2 swaps taken preoperatively and intraoperatively from 62 children in the period from April to November 2020. Median age was 4.49 years. The PCR diagnosis was carried out one or two days preoperatively (in the case of emergency interventions on the same day) and again intraoperatively using a pooled nasopharyngeal swab.

RESULTS

 All 62 preoperatively taken swabs were negative. Deviating from the preoperative test result, one intraoperatively obtained swab was positive.

CONCLUSIONS

 Due to limited compliance, a correct preoperative swab technique (preanalytics) cannot always be assumed for children. Sufficient protective measures for everyone present in the operating room are therefore imperative. Intraoperative test should be considered if the the preoperative test was performed under difficult conditions.

SARS-CoV-2 pandemic in the Brazilian community of rare diseases: A patient reported survey

The COVID-19 pandemic has led to a reorganization of health systems to prioritize the fight against the virus. The adoption of social distancing interfered with the flow of existing policies, and may thus negatively affect the most vulnerable groups, such as the rare disease community. Aimming at characterizing the perception of the impact of COVID-19 on the health care of the Brazilian rare disease community, an online questionnaire addressed to patients with rare diseases and their caregivers was disseminated in the Brazilian territory between June 1st to July 5th, 2020. The questions dealt with the sanitary measures adopted; access to medical services; and mental suffering during the pandemic. The survey was answered by 1,466 participants (<18 yo = 53.3%) representing 192 rare diseases. Regarding physical distancing, 1,372 (93.6%) participants did not leave their residence, or did so only when essential; 1,321 (90.1%) always wore masks when leaving home. 1,042 (71.1%) and 995 (67.9%) participants, respectively, referred medical genetics appointments and rehabilitation therapies were postponed/canceled. Telemedicine was experienced by 1,026 (70%), and 68.3% agreed this is a good strategy for health care. Patients with Inborn Errors of Metabolism (IEM, n = 624, 42.5%) appear to have more access to information and ability to overcome difficulties, and feel less threatened, lonely and depressed than the non-IEM group (p < .05). There was an increment of the rare disease patients' vulnerability in the pandemic scenario. The cooperation of patients/caregivers along with adaptation of the health system is crucial and may be so even post-pandemic.

Children and Adolescents with Disabilities and Exposure to Disasters, Terrorism, and the COVID-19 Pandemic: a Scoping Review

PURPOSE OF REVIEW

This paper reviews the empirical literature on exposures to disaster or terrorism and their impacts on the health and well-being of children with disabilities and their families since the last published update in 2017. We also review the literature on studies examining the mental health and functioning of children with disabilities during the COVID-19 pandemic.

RECENT FINDINGS

Few studies have examined the effects of disaster or terrorism on children with disabilities. Research shows that children with disabilities and their families have higher levels of disaster exposure, lower levels of disaster preparedness, and less recovery support due to longstanding discriminatory practices. Similarly, many reports of the COVID-19 pandemic have documented its negative and disproportionate impacts on children with disabilities and their families. In the setting of climate change, environmental disasters are expected to increase in frequency and severity. Future studies identifying mitigating factors to disasters, including COVID-19; increasing preparedness on an individual, community, and global level; and evaluating post-disaster trauma-informed treatment practices are imperative to support the health and well-being of children with disabilities and their families.

The Interaction of Natural and Vaccine-Induced Immunity with Social Distancing Predicts the Evolution of the COVID-19 Pandemic

The existence and nature of immunity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are currently unknown; however, neutralizing antibodies are thought to play the major role and data from studying other coronaviruses suggest that partial clinical immunity lasting up to 1 year will occur postinfection. We show how immunity, depending on its durability, may work with current social practices to limit the spread of the virus. We further show that a vaccine that is 50% effective and taken by 50% of the population will prevent further loss of life, providing that social distancing is still practiced and that immunity does not wane quickly.IMPORTANCE The ability of our society to function effectively moving forward will depend on how the spread of the SARS-CoV-2 virus is contained. Immunity to the virus will be critical to this equation.

Impact of Corona Virus Disease 2019 on Oral- and Maxillofacial Surgery: Preliminary Results After the Curfew

INTRODUCTION

The COVID-19 pandemic affects basic health care in maxillofacial surgery (MFS) due to the shift in resources and the change in patient disorders treated during the pandemic. This paper aims to elucidate the medical and financial consequences driven by the measures for COVID-19 treatment in a tertiary care centre.

MATERIAL AND METHODS

To evaluate the impact of pandemic measures on daily routines of MFS, the surgical schedule during the first 2 weeks after the onset of the curfew (March 2020), and to compare it with the schedule of the same period of time 1 year earlier. Furthermore, postponed surgeries as well as cancelled follow-ups are listed. The loss of earning was calculated as well as the number and kind of postponed procedures.

RESULTS

The number of surgeries decreased by 45% (n = 163 in 2019 vs n = 89 in 2020), and the duration of the surgeries decreased from 94.2 minutes to 62.1 minutes. No elective surgeries, such as implantology, aesthetic surgery, or orthognathic surgery, took place. Furthermore, also trauma cases decreased from 9 to 3 cases. Considering all variables, the financial loss can be calculated as approximately 100,256.50 Euros per week.

CONCLUSION

The impact of COVID-19 on MFS is certainly of medical and economic importance and is related to the duration of the pandemic.