Mobile Technology-Based Real-Time Teleotolaryngology Care Facilitated by a Nonotolaryngologist Physician in an Adult Population.

OBJECTIVES: Telehealth can improve access to specialist care. Very few reports of the use of smartphones for teleotolaryngology exist. The objective of this study is to evaluate the use of mobile teleotolaryngology facilitated by a nonotolaryngologist physician. METHODS: A prospective study in adult patients attending a general otolaryngology outpatient clinic. The telehealth encounter with a remote otolaryngologist was facilitated by a final-year medical student simulating a general physician prior to the scheduled visit. The patient and the remote otolaryngologist rated their satisfaction with the encounter. The remote otolaryngologist formulated a diagnosis and rated the level of certainty of this diagnosis. Diagnoses from the telehealth encounter and the face-to-face encounter were compared. RESULTS: Forty-eight patients with an average age of 42.5 years participated in this study. In 79.2% of the consultations, there was concordance between the diagnoses. The average patient and remote otolaryngologist satisfaction with the encounter was 9.5 ± 0.9 and 8.7 ± 1.3, respectively. Twenty-four of the 48 visits (50%) were defined as unnecessary. In the otology group, concordance rates and rates of preventable visits were highest. CONCLUSIONS: Synchronous telehealth consultations, facilitated by a general physician, can be an alternative to visiting a general otolaryngology clinic, especially for otologic patients.

Parents reported higher satisfaction rates when children recognised hospital staff from photographs placed in prominent locations.

AIM: Improved communication with staff during a child's hospitalisation is an important determinant of family satisfaction. We examined whether displaying staff photographs in prominent locations would help children and their parents or guardians to recognise staff and whether this enhanced identification would improve parental satisfaction with their child's hospitalisation. METHODS: No photographs were displayed during the first part of the study. During the second part of the study, staff photographs were placed in prominent locations throughout the paediatric ward. Parents filled in a satisfaction questionnaire on discharge, and the children and their parents were asked how many staff members they could name. RESULTS: The children named a significantly larger number of staff members in phase two than phase one, while the parents' score was unchanged. Overall parental satisfaction was significantly higher in phase two. The parent's age, the duration of the child's hospitalisation and taking part in phase two of the study were significant predictors of parental satisfaction. CONCLUSION: When children were more able to recognise and name hospital staff, this indirectly improved parental satisfaction, even if the number that parents could identify remained unchanged. Displaying staff photographs is a simple way of increasing parental satisfaction during a child's hospitalisation.

Acupuncture for posttonsillectomy pain in children: a randomized, controlled study.

BACKGROUND: Surgeons have searched for the technique or medication that will produce a 'painless tonsillectomy'; however, this seems to be an impossible goal. Previous studies have shown that perioperative acupuncture may be a useful adjunct for acute postoperative pain and that acupuncture, in addition to nonsteroidal anti-inflammatory drugs, is effective in adults for the treatment of postoperative swallowing pain after tonsillectomy. Acupuncture has been shown to be safe in children. A retrospective review of acupuncture for posttonsillectomy pain in juvenile patients showed a significantly reduced pain score immediately after treatment. AIM: To examine whether acupuncture, in addition to conventional analgesic treatment, will be effective in the treatment of posttonsillectomy pain in children. METHODS: We conducted a randomized, controlled, single-blinded study comparing conventional postoperative analgesic treatment with the same regime plus acupuncture to assess whether postoperative treatment of children aged 3-12 years undergoing tonsillectomy with acupuncture will reduce pain and to examine possible unwanted effects of this treatment. RESULTS: Sixty children were recruited and randomly divided into a study group and a control group. The results indicate that in the study group, there was less pain, less analgesic drug consumption, and higher patient/parent satisfaction with analgesic treatment scores. No adverse effects were recorded. CONCLUSIONS: Acupuncture, in addition to conventional analgesic treatment, is an effective treatment for posttonsillectomy pain. Acupuncture is safe and well received by children and their parents.

Universal newborn hearing screening in Zefat, Israel: the first two years.

OBJECTIVE: Unidentified hearing loss at birth can adversely affect speech and language development as well as academic achievement and social-emotional development. Historically, moderate-to-severe hearing loss in young children was not detected until well beyond the newborn period. Around 0.5 to 5 in every 1000 neonates and infants have congenital or early childhood onset sensorineural hearing impairment. When identification and intervention occur at no later than 6 months of age, the infants perform much higher on school-related measures. Therefore, early detection is vitally important. Toward the end of 2009, the Israeli ministry of health issued a directive establishing a universal newborn hearing screening program in all hospitals in the country from 01.01.10. The objectives of this study are to evaluate a newly established universal newborn hearing screening program, to assess performance and to compare measurements of performance to performance benchmarks representing a consensus of expert opinion. The benchmarks are the minimal requirements that should be attained by high-quality early hearing detection programs. METHODS: As specified by the ministry of health, a two-stage screening protocol was implemented using otoacoustic emissions and automated auditory brainstem response. Screening results of all neonates born from the initiation of the program on 15th March 2010 until the end of 2011 were reviewed. RESULTS: The total number of live births during the study period was 5496. Of these, 5334 (97%) started screening for hearing loss but only 5212 completed the screening process, giving a screening coverage of 94.8%. Of the 5212 neonates completing the screening process, 270 (5.18%) were referred for full diagnostic testing. CONCLUSIONS: The newly established universal newborn hearing screening program at the Ziv Medical Center in Zefat closely approaches, but does not yet meet the minimal requirements that should be attained by high-quality early hearing detection programs. Every effort should be made to complete the screening tests before discharge from hospital. Screening staff should actively encourage parents to participate in all stages of early detection.