Effectiveness of educational programs in hearing health: a systematic review and meta-analysis

OBJECTIVE

To evaluate the effectiveness of hearing health education programs aimed at preventing noise-induced hearing loss (NIHL), of recreational and occupational origin, by means of a systematic review and meta-analysis.

DESIGN

The search strategy was carried out in on five electronic databases, as well as referrals from experts. The risk of bias was judged, and the random effects meta-analysis was performed. The certainty of the evidence was assessed.

STUDY SAMPLE

Effectiveness studies that used educational intervention in hearing health and prevention of NIHL were included.

RESULTS

42 studies were included. The Dangerous Decibels program was the only one that could be quantitatively analysed and showed improvement in the post-intervention period of up to one week [SMD = 0.60; CI95% = 0.38-0.82; I2 = 92.5%) and after eight weeks [SMD = 0.45; CI95% = 0.26-0.63; I2 = 81.6%) compared to the baseline. The certainty of evidence was judged as very low.

CONCLUSIONS

The Dangerous Decibels program is effective after eight weeks of intervention. The other programs cannot be quantified. They still present uncertainty about their effectiveness. The level of certainty is still low for this assessment.

Translation, adaptation, and cross-cultural validation into Brazilian portuguese of the hearing protection assessment questionnaire (HPA)

PURPOSE

The aim of the present study is to translate, adapt, and cross-culturally validate the Brazilian Portuguese version of the questionnaire Hearing Protection Assessment Questionnaire (HPA).

METHODS

The original instrument, developed in English, seeks to assess barriers and supports related to the use of hearing protection devices (HPD), as well as workers' knowledge, habits and attitudes towards occupational noise. The translation, adaptation, and cross-cultural validation of the questionnaire consisted of five steps: Translation of the questionnaire from English to Portuguese; 2) Reverse translation from Portuguese to English; 3) Analysis of the instrument by three experts in the field; 4) Pre-test of the questionnaire with ten workers; 5) Application of the instrument to 509 workers in a meatpacking industry after the pre-employment medical exam.

RESULTS

The results indicate the construction and content validity of the Brazilian Portuguese version for use with a working population and its internal consistency.

CONCLUSION

This study resulted in the translation, cultural adaptation, and validation of the Hearing Protection Assessment Questionnaire (HPA), in order to be used to assess the use of individual hearing protection in the occupational field, called Hearing Protection Assessment Questionnaire (HPA).

Evaluation of the Dangerous Decibels Brazil Program in Workers Exposed to Noise

Introduction

Noise-induced hearing loss can be avoided by taking preventive measures.

Objective

To assess the effectiveness of the Brazilian version of the Dangerous Decibels® program for noise-exposed workers, using the ecological model as an educational intervention plan.

Method

Non-randomized interventional study with a quantitative, experimental trial design, conducted at a meatpacking company. The participants were divided into two groups—the first one (n = 132, divided into 6 subgroups) received the Dangerous Decibels® Brazil educational intervention (DDBEI) adapted to workers while the second group (n = 138, divided into 5 subgroups) received a conventional educational intervention (CEI). The interventions lasted 50 min. The Hearing Protection Assessment Questionnaire (HPA-5) was administered before and after the interventions. The five dimensions (attitude, behavior, knowledge, supports, and barriers) were compared using the Student’s t-test for paired data (<0.05).

Results

After both the DDBEI and CEI training, workers improved significantly in barriers, supports, knowledge, attitudes, and behavior around noise. By chance, the CEI group scored lower in all measures than the DDBEI group before training, and though both groups improved, the difference was maintained after training.

Conclusion

The Brazilian version of the Dangerous Decibels® program for noise-exposed workers was effective, influencing positively the factors at different levels of the ecological model. Though the DDBEI was no more effective than the CEI, the CEI participants began at much lower levels, so the effectiveness of the DDBEI may have been underestimated.

The use of the Dangerous Decibels® program for refrigeration company workers and their children: an intergenerational pilot study

ABSTRACT Objective: to report the use of the Dangerous Decibels® program for workers of a refrigeration company and their children as an intervention strategy for hearing health. Methods: an intervention study conducted in the city of Chapecó, SC, Brazil. Eight workers from a refrigeration company and their children participated in the study. The strategies adopted were those proposed by the Dangerous Decibels® program. Results: the Dangerous Decibels® program strategies contributed to the reflection on noise and favored interaction among participants. Workers and their children mutually committed to protecting and preserving hearing by passing on the knowledge gained to other family members, friends, and co-workers. The three basic principles of the Dangerous Decibels® program adopted by the participants were: Move away from noise, turn down the volume and protect the ears. Conclusion: the Dangerous Decibels® program developed in an intergenerational context was well received and accepted by workers and their children. As an educational intervention strategy for hearing health, it proved to be viable, convenient and with adequate content to be used simultaneously in populations of different age groups.

Polyphenol pattern and antioxidant activity of different tomato lines and cultivars

BACKGROUND/AIMS

Besides antioxidant vitamins and minerals, fruits and vegetables contain flavonoids and related phenolics. The biological activities of these polyphenols have become well known in recent years evidencing their beneficial effects on human health. In this context, the characterization of the flavonoids present in tomatoes is of great interest. Thus the polyphenol pattern (including flavonols, flavanones and cinnamate derivatives), lycopene and beta-carotene concentrations and the total antioxidant activity (TAA) of the phenolic fraction from different tomato lines and cultivars have been determined.

METHODS

The characterization was obtained by means of spectrophotometry and HPLC analyses.

RESULTS

Mean values for single flavonoids were 0.68 +/- 0.16 for naringenin, 0.74 +/- 0.12 for rutin and 0.32 +/- 0.06 for a rutin-pentoside. Mean total polyphenol content was 13.15 +/- 1.15 mg/100 g and mean TAA value was 1.3 +/- 0.10 mmol/g. The obtained TAA values resulted in good accordance with the total polyphenol content (R(2) = 0.7928). The main phenolic acids were chlorogenic (mean +/- SE 0.20 +/- 0.03) and caffeic acid (mean +/- SE 0.03 +/- 0.01). Mean levels of lycopene and beta-carotene were 5.38 +/- 0.90 and 1.18 +/- 0.40 mg/100 g, respectively.

CONCLUSIONS

Almost all the lines characterised by low carotenoid content produce high levels of polyphenols, and consequently have the most powerful antioxidant potential.

LC-APCI-MS/MS analysis of urinary 8-hydroxy-2'-deoxyguanosine

8-Hydroxy-2'-deoxyguanosine (8OHdG) is regarded as an important biomarker of oxidative DNA damage and it may be estimated by using different techniques in various biological matrices, most notably DNA and urine. In the case of DNA, artifactual oxidation may take place during the isolation of DNA, its hydrolysis and possible derivatization (as for GC-MS), invalidating the measurement of 8OHdG. Therefore, the direct analysis of 8OHdG excreted into urine was preferred. Interferences from the urine matrix were excluded by applying LC-APCI-MS/MS in the multiple reaction monitoring (MRM) mode. The abundant fragment ion at m/z 168 arising from 8OHdG was monitored in the urine sample of volunteers supplemented with tomato concentrate for different times. The procedure allowed the detection of levels of 8OHdG as low as 1 ng/ml in urine sample.

[Comparison between killed subunit influenza vaccines and whole virion preparations: study of reactions and protective efficacy in children and adults]

Three hundred eight subjects (of whom 103 children aged 6-12 years) were vaccinated with trivalent--A/USSR/90/77 (H1N1), A/Texas/1/77 (H3N2), B/Hong Kong/8/73 strains--influenza virus vaccines, two of them sub-unit and the third whole-virus preparation. Children and adolescent received two doses with an interval of 4 weeks, adults one dose only. The results of the determination by single radial diffusion test of the hemagglutinin amount for each of the three vaccinal strains and the data of the mouse immunogenicity test show that the antigenic content of A/USSR/90/77 strain in the sub-unit preparations was lower than expected from the concentration in I.U. reported by the vaccine manufacturers. Therefore it is pointed out the necessity to control the antigenic content of inactivated influenza virus vaccines with methods more adequate than those currently adopted. Sub-unit vaccines were much less reactogenic than the whole-virus preparation particularly in the youngest group of vaccinees. The immunogenicity (assessed by serum h.i.a. titers) of sub-unit vaccines, even after a single dose, turned out to be good and equal to that of the whole-virus preparation in primed subjects. In unprimed individuals, as it is shown by the data relative to the A/USSR/90/77 strain in sero-negative children, a two dose regimen is required. In these vaccines the whole-virus vaccine was more immunogenic than the sub-unit preparations, probably because of the lower content in the H1N1 strain of the latter. The increase from 1 ml (1 dose) to 1.6 ml the amount of vaccine, as experimented in adults with one sub-unit preparation, was not followed by an increase in reactogenicity. The larger dose did not influence the antibody response of primed subjects. On the contrary in unprimed vaccinees, as the youngest under 24 years without preexisting antibodies to the H1N1 strain in the present trial, the higher antigenic content produced a marked positive effect.