Socioeconomic Disparities and Other Factors Affecting Time to Dispensing of Pediatric Hearing Aids.

INTRODUCTION: Pediatric hearing loss can significantly impact speech, language, social, and educational development. Providing access to speech and environmental sounds using amplification devices, such as hearing aids, can help improve developmental outcomes. However, timely rehabilitation and intervention may be delayed due to limited access to resources, further prolonging the adverse effects of childhood hearing loss. The aim of this study was to investigate socioeconomic barriers in time to dispensing hearing aids in a diverse pediatric patient population. METHODS: Data from an existing internal database from a tertiary pediatric hospital were analyzed from January 2020 through August 2022 for barriers associated with hearing aid (HA) dispensing delays. Demographic and clinical characteristics were obtained. Multivariate regression and survival analysis statistics were used to identify factors associated with delayed time to dispensing hearing aids. RESULTS: Of the 121 patients who had been appropriately diagnosed and fit, 108 (89.3%) had received hearings aids and 13 (10.7%) had not at the time of the study. Of those who had received HA, time to dispensing was not significantly impacted by sex, race, ethnicity, language, or income level. Insurance was found to be an influencing factor in time to receiving the HA. CONCLUSION: Factors such as insurance and hearing loss laterality contribute to delays in receiving hearing aids. Identifying these specific barriers and disparities in hearing rehabilitation services will prove vital in facilitating an expedited and equitable pathway to receiving hearing aids. LEVEL OF EVIDENCE: 3 Laryngoscope, 2024.

A minimal robophysical model of quadriflagellate self-propulsion.

Locomotion at the microscale is remarkably sophisticated. Microorganisms have evolved diverse strategies to move within highly viscous environments, using deformable, propulsion-generating appendages such as cilia and flagella to drive helical or undulatory motion. In single-celled algae, these appendages can be arranged in different ways around an approximately 10 µm long cell body, and coordinated in distinct temporal patterns. Inspired by the observation that some quadriflagellates (bearing four flagella) have an outwardly similar morphology and flagellar beat pattern, yet swim at different speeds, this study seeks to determine whether variations in swimming performance could arise solely from differences in swimming gait. Robotics approaches are particularly suited to such investigations, where the phase relationships between appendages can be readily manipulated. Here, we developed autonomous, algae-inspired robophysical models that can self-propel in a viscous fluid. These macroscopic robots (length and width = 8.5 cm, height = 2 cm) have four independently actuated 'flagella' (length = 13 cm) that oscillate under low-Reynolds number conditions (Re∼O(10-1)). We tested the swimming performance of these robot models with appendages arranged two distinct configurations, and coordinated in three distinct gaits. The gaits, namely the pronk, the trot, and the gallop, correspond to gaits adopted by distinct microalgal species. When the appendages are inserted perpendicularly around a central 'body', the robot achieved a net performance of 0.15-0.63 body lengths per cycle, with the trot gait being the fastest. Robotic swimming performance was found to be comparable to that of the algal microswimmers across all gaits. By creating a minimal robot that can successfully reproduce cilia-inspired drag-based swimming, our work paves the way for the design of next-generation devices that have the capacity to autonomously navigate aqueous environments.

Patient Safety in Audiology.

There is a need to educate audiologists, physicians, and other clinicians about patient safety in audiology. This article addresses the many aspects of patient safety and the applicability to the practice of audiology in health care. Clinical examples of strategies to build a culture of patient safety are provided.

The Role of the Speech-Language Pathologist in Creating a Model for Interprofessional Practice in an Ambulatory Care Clinic.

There is a need to better coordinate services for children in urban settings who are at risk for communication disorders. This article addresses the barriers to obtaining services and discusses the process for creating a model for interprofessional practice to better serve patients from lower socioeconomic backgrounds.

Culture-Based Considerations in Programming for Stuttering Intervention With African American Clients and Their Families.

This article describes a clinical framework that may be used with African American children who stutter and their families. It includes discussion of the clinical importance of culture-based factors such as myths, oral presentation styles, narrative discourse styles, and cognitive learning styles, as well as rules for interaction and turn-taking. These factors are considered relative to the various clinical stages in the evaluation and treatment of stuttering in African Americans.