Degree of satisfaction among hearing aid users

Introduction: Hearing loss (HL) is defined as the complete or partial loss of hearing ability. Aims: To characterize (1) the degree of satisfaction among adult and elderly hearing aid (HA) users who were treated by a public hearing health service and (2) the relationship between satisfaction and the variables of gender, age, degree of HL, and type of HA. Method: The clinical and experimental study included the administration of the Satisfaction with Amplification in Daily Life (SADL) questionnaire to 110 patients who had used HAs for more than 3 months and were 18 years of age or older. Results: Test patients were sex-balanced (48% were women) and had a mean age of 67 years. A relatively high incidence of sensorineural moderate HL was detected in the study patients (66%) and device B was the most commonly used HA type (48%). No significant differences were evident between HA satisfaction and sex. The importance placed on services/costs and personal image varied between age groups. Correlation was evident at all levels between user satisfaction and amplification. Decreased satisfaction was observed in individuals with severe and/or profound HL. The type of HA used yielded statistically significant differences in the positive effects referring. Conclusion: No correlations were evident between the different factors proposed. HA users exhibited high levels of satisfaction in all SADL areas

The relationship between the speech perception and the degree of satisfaction among adult users of cochlear implants

Introduction: In recent years, the benefits associated with the use of cochlear implants (CIs), especially with regard to speech perception, have proven to surpass those produced by the use of hearing aids, making CIs a highly efficient resource for patients with severe/profound hearing loss. However, few studies so far have assessed the satisfaction of adult users of CIs. Objective: To analyze the relationship between the level of speech perception and degree of satisfaction of adult users of CI. Method: This was a prospective cross-sectional study conducted in the Audiological Research Center (CPA) of the Hospital of Craniofacial Anomalies, University of São Paulo (HRAC/USP), in Bauru, São Paulo, Brazil. A total of 12 users of CIs with pre-lingual or post-lingual hearing loss participated in this study. The following tools were used in the assessment: a questionnaire, "Satisfaction with Amplification in Daily Life" (SADL), culturally adapted to Brazilian Portuguese, as well as its relationship with the speech perception results; a speech perception test under quiet conditions; and the Hearing in Noise Test (HINT)Brazil under free field conditions. Results: The participants in the study were on the whole satisfied with their devices, and the degree of satisfaction correlated positively with the ability to perceive monosyllabic words under quiet conditions. The satisfaction did not correlate with the level of speech perception in noisy environments. Conclusion: Assessments of satisfaction may help professionals to predict what other factors, in addition to speech perception, may contribute to the satisfaction of CI users in order to reorganize the intervention process to improve the users' quality of life.

The importance of vertical and horizontal dimensions of the sediment matrix in structuring nematodes across spatial scales

Intensive surveys have been conducted to unravel spatial patterns of benthic infauna communities. Although it has been recognized that benthic organisms are spatially structured along the horizontal and vertical dimensions of the sediment, little is known on how these two dimensions interact with each other. In this study we investigated the interdependence between the vertical and horizontal dimensions in structuring marine nematodes assemblages. We tested whether the similarity in nematode species composition along the horizontal dimension was dependent on the vertical layer of the sediment. To test this hypothesis, three-cm interval sediment samples (15 cm depth) were taken independently from two bedforms in three estuaries. Results indicated that assemblages living in the top layers are more abundant, species rich and less variable, in terms of species presence/absence and relative abundances, than assemblages living in the deeper layers. Results showed that redox potential explained the greatest amount (12%) of variability in species composition, more than depth or particle size. The fauna inhabiting the more oxygenated layers were more homogeneous across the horizontal scales than those from the reduced layers. In contrast to previous studies, which suggested that reduced layers are characterized by a specific set of tolerant species, the present study showed that species assemblages in the deeper layers are more causal (characterized mainly by vagrant species). The proposed mechanism is that at the superficial oxygenated layers, species have higher chances of being resuspended and displaced over longer distances by passive transport, while at the deeper anoxic layers they are restricted to active dispersal from the above and nearby sediments. Such restriction in the dispersal potential together with the unfavorable environmental conditions leads to randomness in the presence of species resulting in the high variability between assemblages along the horizontal dimension.

Grau de satisfação de usuários de um hospital privado

OBJETIVOS: Conhecer o grau de satisfação dos usuários de um hospital privado e os fatores intervenientes nessa satisfação, baseado no modelo de Parasuraman, Zeithaml e Berry. MÉTODOS: Estudo exploratório descritivo de abordagem quantitativa realizado em um hospital privado com amostra constituída de 288 usuários. A coleta dos dados ocorreu de abril a julho de 2009, por meio de um questionário e a análise estatística descritiva e inferencial. RESULTADOS: Identificaram os níveis de satisfação dos usuários, bem como as dimensões com maior escore: garantia e confiabilidade e com menor escore: responsividade e empatia. As equipes de enfermagem e médica obtiveram as maiores pontuações. CONCLUSÕES: Observou-se a necessidade de intervenção nas áreas de nutrição e atendimento inicial. Assim, este estudo propiciou um diagnóstico multissetorial, subsidiando os gestores da instituição na revisão de processos assistenciais e gerenciais.

Plasticity of stomatal distribution pattern and stem tracheid dimensions in Podocarpus lambertii: an ecological study

Leaf and wood plasticity are key elements in the survival of widely distributed plant species. Little is known, however, about variation in stomatal distribution in the leaf epidermis and its correlation with the dimensions of conducting cells in wood. This study aimed at testing the hypothesis that Podocarpus lambertii, a conifer tree, possesses a well-defined pattern of stomatal distribution, and that this pattern can vary together with the dimensions of stem tracheids as a possible strategy to survive in climatically different sites. Leaves and wood were sampled from trees growing in a cold, wet site in south-eastern Brazil and in a warm, dry site in north-eastern Brazil. Stomata were thoroughly mapped in leaves from each study site to determine a spatial sampling strategy. Stomatal density, stomatal index and guard cell length were then sampled in three regions of the leaf: near the midrib, near the leaf margin and in between the two. This sampling strategy was used to test for a pattern and its possible variation between study sites. Wood and stomata data were analysed together via principal component analysis. The following distribution pattern was found in the south-eastern leaves: the stomatal index was up to 25 higher in the central leaf region, between the midrib and the leaf margin, than in the adjacent regions. The inverse pattern was found in the north-eastern leaves, in which the stomatal index was 10 higher near the midrib and the leaf margin. This change in pattern was accompanied by smaller tracheid lumen diameter and length. Podocarpus lambertii individuals in sites with higher temperature and lower water availability jointly regulate stomatal distribution in leaves and tracheid dimensions in wood. The observed stomatal distribution pattern and variation appear to be closely related to the placement of conducting tissue in the mesophyll.

Three-Dimensional Finite Element Analysis of Stress Distribution on Different Bony Ridges With Different Lengths of Morse Taper Implants and Prosthesis Dimensions

This finite element analysis (FEA) compared stress distribution on different bony ridges rehabilitated with different lengths of morse taper implants, varying dimensions of metal-ceramic crowns to maintain the occlusal alignment. Three-dimensional FE models were designed representing a posterior left side segment of the mandible: group control, 3 implants of 11 mm length; group 1, implants of 13 mm, 11 mm and 5 mm length; group 2, 1 implant of 11 mm and 2 implants of 5 mm length; and group 3, 3 implants of 5 mm length. The abutments heights were 3.5 mm for 13- and 11-mm implants (regular), and 0.8 mm for 5-mm implants (short). Evaluation was performed on Ansys software, oblique loads of 365N for molars and 200N for premolars. There was 50% higher stress on cortical bone for the short implants than regular implants. There was 80% higher stress on trabecular bone for the short implants than regular implants. There was higher stress concentration on the bone region of the short implants neck. However, these implants were capable of dissipating the stress to the bones, given the applied loads, but achieving near the threshold between elastic and plastic deformation to the trabecular bone. Distal implants and/or with biggest occlusal table generated greatest stress regions on the surrounding bone. It was concluded that patients requiring short implants associated with increased proportions implant prostheses need careful evaluation and occlusal adjustment, as a possible overload in these short implants, and even in regular ones, can generate stress beyond the physiological threshold of the surrounding bone, compromising the whole system.

As dimensões humana, instrumental e estratégica da Comunicação Organizacional: recorte de um estudo aplicado no segmento corporativo

Na perspectiva de que a Comunicação que ocorre no dia a dia nas organizações assume, entre outras, três principais dimensões (humana, instrumental e estratégica), o principal objetivo desta pesquisa empírica foi verificar, junto a uma amostra representativa de empresas atuantes no território brasileiro, como essas dimensões estão presentes nas práticas cotidianas de Comunicação. Aplicou-se questionário junto a 36 empresas a partir de uma a mostra de 258. Os dados obtidos mostram que a Comunicação vem sendo praticada nessas três dimensões. As organizações evoluíram gradativamente dos modelos mecânicos da transmissão unilateral de informações para a implantação de processos comunicativos mais interativos. No entanto, ainda falta uma Comunicação que permita a abertura de canais dialógicos de fato e que possibilite maior valorização das pessoas.

Utilization of fringe projection technique for evaluation of wound dimensions and of healing progress.

Background: The methods used for evaluating wound dimensions, especially the chronic ones, are invasive and inaccurate. The fringe projection technique with phase shift is a non-invasive, accurate and low-cost optical method. Objective: The aim is to validate the technique through the determination of dimensions of objects of known topography and with different geometries and colors to simulate the wounds and tones of skin color. Taking into account the influence of skin wound optical factors, the technique will be used to evaluate actual patients’ wound dimensions and to study its limitations in this application. Methods: Four sinusoidal fringe patterns, displaced ¼ of period each, were projected onto the objects surface. The object dimensions were obtained from the unwrapped phase map through the observation of the fringe deformations caused by the object topography and using phase shift analysis. An object with simple geometry was used for dimensional calibration and the topographic dimensions of the others were determined from it. After observing the compatibility with the data and validating the method, it was used for measuring the dimensions of real patients’ wounds. Results and Conclusions: The discrepancies between actual topography and dimensions determined with Fringe Projection Technique and for the known object were lower than 0.50 cm. The method was successful in obtaining the topography of real patient’s wounds. Objects and wounds with sharp topographies or causing shadow or reflection are difficult to be evaluated with this technique.