Evaluation of Parental Perspectives and Concerns about Pediatric Cochlear Implantation: A Social Media Analysis

OBJECTIVE

Parents often experience uncertainty during decision-making for their child's cochlear implantation (CI) surgery, and online forums provide insight on parental opinions that might not be expressed in clinic. This study aims to evaluate parental perspectives and concerns about pediatric CI using social media analysis.

STUDY DESIGN

Qualitative study.

SETTING

Three online forums involving parental posts about pediatric CI.

INTERVENTION/METHODS

Forums were queried using keywords (e.g., "cochlear implant") to gather all U.S. parent-initiated posts about pediatric CI from 2006 to 2021. Thematic content analysis was performed to classify posts by overarching domain, themes, and subthemes. Posts were reviewed for thematic synthesis and double coded. Descriptive statistics were calculated for each theme by unique users.

RESULTS

A total of 79 posts by 41 unique users were analyzed. Themes relating to decision for CI included facilitators, inhibitors, resources, and feelings. Parents posted about lack of benefit from hearing aids promoting decision for CI and high cost as an inhibitor. Some expressed concern about making a major decision for a minor. Parents often mentioned their child's healthcare providers and social media as resources.

CONCLUSION

Through social media posts, parental priorities and concerns for decision-making of CI surgery were identified. Findings may guide discussions between physicians and parents and facilitate shared decision-making about CI.

Progressive Dominant Hearing Loss (Autosomal Dominant Deafness-41) and P2RX2 Gene Mutations: A Phenotype-Genotype Study

OBJECTIVES/HYPOTHESIS

P2RX2 encoding P2X purinoreceptor 2 has been identified as the gene responsible for autosomal dominant deafness-41 (DFNA41) as well as mediating vulnerability to noise-induced hearing loss (NIHL). The objective of this study was to investigate the audiological and molecular characteristics of P2RX2-related deafness, with emphasis on its role in NIHL by determining the audiological characteristics of a previously reported six-generation DFNA41 family with a 10-year follow-up. We have also summarized phenotype-genotype correlations of P2RX2-related deafness in human and mouse models.

STUDY DESIGN

We describe clinical longitudinal follow-up in the DFNA41 family with P2RX2 (p.Val60Leu) mutation and perform a systematic literature search in PubMed and poster presentations on meeting/conference websites to identify current insights into P2RX2-mediated NIHL.

METHODS

Clinical and physical examinations of the family members were performed, and audiograms were obtained to assess the hearing thresholds. Clinical follow-up features in this DFNA41 family are presented along with correlation analyses of phenotype-genotype in all reported families with P2RX2-related deafness.

RESULTS

Progressive hearing impairment was confirmed by history and by audiological follow-up testing in all the patients. The onset of hearing loss was between age 25 and 35 years. All affected subjects had bilateral sensorineural hearing loss involving all frequencies with some significant gender differences.

CONCLUSIONS

Our study and the review of the literature suggest that P2RX2 plays a crucial role in predisposition to noise-induced and age-related hearing loss. A better knowledge about the P2RX2-associated genetic variants can help in developing novel therapeutic strategies.

LEVEL OF EVIDENCE

2b Laryngoscope, 130:1657-1663, 2020.

Anterior femoral curvature revisited: race assessment from the femur

The increasing need for accurate race assessment from postcranial skeletal remains has emphasized the lack of simple, replicable methods by which to accomplish the task. Several techniques have been proposed, but without adequate results. Anterior femoral curvature was first suggested and researched by T. Dale Stewart in 1962 (6). The technique used in that study was subjective at best. He provided no substantial discrimination between whites or blacks. Two later studies only reused Stewart's technique and/or data. This study was assumed to address these issues and provide an improved technique. Skeletal collections at the Smithsonian, as well as the forensic collections at the University of Florida and the University of Tennessee, provided the specimens for this study. The historical collection of the First African Baptist Church of Philadelphia, PA, and the modern forensic collection at Louisiana State University provided the test samples. Only black and white individuals were used, and those were selected based on previous soft tissue or positive identification. Thirteen measurements were taken, including six newly developed measures. Age, race, and sex were also documented. Discriminant analysis was used to develop functions for race assessment. After analyzing the data through SPSSx using Discriminant, the variables selected provided an accuracy of 88.15% using the right femur and 86.10% with the left femur. Age was divided into two groups: under 30 and over 30. Most skeletons can be easily aged into these categories.

Emotional and cardiovascular responses to adults' angry behavior and to challenging tasks in children of hypertensive and normotensive parents

Cardiovascular, overt-motor, and verbal-reported responses to interadult emotional expressions, including anger, and to challenging task situations were examined in a sample of 49 10-14-year-old children of hypertensive (EH) and normotensive parents (NT). Sons of EH parents showed greater systolic blood pressure reactivity to interadult anger and to the digit span task than sons of NT parents. A consistent pattern was not found for girls. Marital distress and overt maternal anger expression predicted verbal-reported and overt-motor responses to interadult anger. Family history of EH and sex did not predict these responses. Implications include (a) heightened systolic blood pressure response to stress may be found in sons of EH parents before they are diagnosed to have EH disorders, (b) relations between family history of EH and cardiovascular response may be sex moderated, and (c) vulnerability to stress may be related to specific familial histories and backgrounds.