"A lonely time for deaf and hard of hearing kids": A qualitative study of the impact of pandemic precautions on classroom communication for adolescents with hearing loss.

BACKGROUND: Pandemic public health measures, such as masks and social distancing, present unique challenges for people who are hard-of-hearing. This study sought to understand how adolescents with varying levels of hearing loss would describe their experiences communicating in a classroom environment during a pandemic and its associated public health measures. METHODS: Qualitative study utilizing one-on-one semi-structured interviews conducted from July 2021 to April 2022. Interviews were transcribed and analyzed using a reflexive thematic analysis to conceptualize the main themes from the data. Adolescents ages 12-17 who attended school in person during the COVID-19 pandemic with either normal hearing or; bilateral cochlear implants or; bone-anchored hearing aids or; unilateral moderate to severe (40-70 dB) conductive hearing loss secondary to mastoidectomy, were interviewed. Participants were recruited from BC Children's Hospital Otolaryngology clinic via a convenience sample. RESULTS: Fourteen adolescents were interviewed with a median age of 15, 9 with hearing loss and 5 with normal hearing. Pandemic associated challenges such as masks muffling speech, protocol fatigue, and missing pre-pandemic life were present in both the hearing loss and normal hearing groups. Classroom communication for adolescents with hearing loss was disproportionately affected by pandemic measures, leading to challenges making friends, feeling behind their peers in learning, and listening fatigue. Resilience was noted among adolescents with hearing loss in their ability to adapt to pandemic measures and changing classroom dynamics. For adolescents with unilateral hearing loss, the pandemic provided an improved listening environment via a reduction in background noise. CONCLUSION: Pre-existing classroom communication challenges for adolescents with hearing loss were amplified under pandemic public health measures and shared, in part, by those with normal hearing. These findings can be used to further inform classroom design to the optimize learning environment for deaf and hard of hearing students.

Safety and efficacy of three-dimensional versus two-dimensional endoscopy in otolaryngology surgery and training: A systematic review.

OBJECTIVE: Three-dimensional (3D) endoscopy has been developed to provide depth perception to allow for improved visualisation during otolaryngology surgery. We conducted a systematic review to determine the surgical safety and efficacy of 3D endoscopy in comparison to two-dimensional (2D) endoscopy in performing otolaryngology procedures, and the role of 3D endoscopy as a training tool for novice otolaryngology surgeons. METHODS: Primary studies were identified through MEDLINE, Embase and Web of Science databases, which were searched for articles published through June 2022 that compared the outcomes of 2D and 3D endoscopy in otolaryngology surgical procedures or otolaryngology-relevant simulations. Candidate articles were independently reviewed by two authors. RESULTS: A total of 18 full-text articles met inclusion criteria for this study. In clinical trials (n = 8 studies, 362 subjects), there were no significant differences in performance time, intraoperative or postoperative complications with 3D endoscopes when compared to 2D. In simulation studies (n = 10 studies, 336 participants), 3D endoscopes demonstrated a decreased error rate (n = 5 studies) and shorter performance time (n = 3 studies). Studies also reported improved depth perception (n = 14 studies) and visualisation preference (n = 5 studies) with 3D over 2D systems. The 3D systems were found to have a shorter learning curve and better manoeuvrability among novice surgeons. CONCLUSION: 3D endoscopy showed equivalent safety and efficacy compared to 2D endoscopy in otolaryngology surgery. The improved depth perception and performance for novices using 3D endoscopes suggests the technology may be superior to 2D endoscopes as a training tool for otolaryngology surgeons.

Facts do not speak for themselves: Community norms, dialog, and evidentiary practices in discussions of COVID-19 on Reddit.

The present study sought to explore the distinct discourse norms and evidentiary practices in discussions of COVID-19 in four subcommunities on Reddit. Qualitative analysis found that communities differed in the degree to which they reinforce and augment Reddit's platform-wide norms for dialog and evidence use. One of the three communities (r/AskTrumpSupporters) differed from the rest by establishing discourse norms for turn-taking between politically opposed users and structuring dialog around authentic questions aimed at understanding alternative points of view. Quantitative analyses revealed that this community significantly differed from the other communities in the proportion of dialogic exchanges and in the use of evidentiary practices (sourcing, source evaluation, and interpretation of evidence). Excerpts of dialog from this community are used to illustrate findings. We conclude with implications for educators interested in preparing youth to critically engage with scientific information they encounter in public discourse.

Tracheal inflammatory myofibroblastic tumor presenting as an obstructive pediatric foreign body.

We describe an unusual presentation of a suspected pediatric foreign body (FB) aspiration which was found to be an occlusive inflammatory myofibroblastic tumor (IMT) of the distal trachea. These are rarely reported entities, with the potential for significant airway bleeds. Multidisciplinary discussion and involvement allowed for a safe patient outcome.

Constraints and Affordances of Online Engagement With Scientific Information-A Literature Review.

Many urgent problems that societies currently face-from climate change to a global pandemic-require citizens to engage with scientific information as members of democratic societies as well as to solve problems in their personal lives. Most often, to solve their epistemic aims (aims directed at achieving knowledge and understanding) regarding such socio-scientific issues, individuals search for information online, where there exists a multitude of possibly relevant and highly interconnected sources of different perspectives, sometimes providing conflicting information. The paper provides a review of the literature aimed at identifying (a) constraints and affordances that scientific knowledge and the online information environment entail and (b) individuals' cognitive and motivational processes that have been found to hinder, or conversely, support practices of engagement (such as critical information evaluation or two-sided dialogue). Doing this, a conceptual framework for understanding and fostering what we call online engagement with scientific information is introduced, which is conceived as consisting of individual engagement (engaging on one's own in the search, selection, evaluation, and integration of information) and dialogic engagement (engaging in discourse with others to interpret, articulate and critically examine scientific information). In turn, this paper identifies individual and contextual conditions for individuals' goal-directed and effortful online engagement with scientific information.

Strategies for restarting Pediatric Otolaryngology outpatient clinics after a pandemic-related shutdown such as from COVID-19.

The novel coronavirus 19 SARS-CoV2 caused a change in the practice of Otolaryngology around the globe. The high viral load in the nasal cavity, nasopharynx and airway subjects Otolaryngologists to a high risk of catching the virus during aerosol generating procedures. After the first outbreak wave has subsided, many teams are now discussing how our 'new normal' practice will look. We share our guidelines on restarting elective clinical work in order to create a safe environment for patients and staff in a Pediatric Otolaryngology outpatient clinic.

Early Placement of Ventilation Tubes in Infants with Cleft Lip and Palate: A Systematic Review.

Objective Studies have shown that the majority of cleft lip and palate (CLP) children have middle ear fluid present at the time of lip repair (3-4 months). Despite hearing loss, the majority of children do not undergo ventilation tube treatment if required until the time of palate repair (9-12 months). We aimed to examine the effectiveness and potential complications of early ventilation tube placement prior to palatoplasty in infants with cleft lip and palate. Data Sources Medline (1946-2015), Embase (1980-2015), and EBM Reviews (Cochrane Central Register of Controlled). Review Methods Data sources were searched for publications that described the results of early ventilation tube placement in children with CLP prior to cleft palate repair. Two independent reviewers appraised the selected studies. Results Of 226 studies identified, 6 studies met the inclusion criteria. Early ventilation tube insertion in CLP gave similar speech and audiology outcomes to non-CLP children undergoing ventilation tube insertion and better outcomes than those children with CLP having later ventilation tube insertion at or after the time of palate closure. The main reported side effect was otorrhea, being higher for children with CLP having early ventilation tube insertion (67% vs 33%), with a reduction in otorrhea with increasing age. Larger studies with longer-term outcome reporting are required to fully address the study objectives. Conclusion Published data are limited but appear to support early insertion of ventilation tubes in children with CLP to restore middle ear function and maximize audiologic and speech outcomes.

Arguing collaboratively: Argumentative discourse types and their potential for knowledge building.

BACKGROUND: There is growing interest in using argumentative discourse in educational settings. However, in a previous study, we found that discourse goals (persuasion vs. consensus) while arguing can affect student outcomes in both content learning and reasoning. AIMS: In this study, we look at argumentative discourse data from a previous study to ask how differences in discourse might account for the differences we observed in learning and reasoning outcomes. SAMPLE: One hundred and five dialogues (57 disputative, 48 consensus) between 7th grade science students attending a public high school near Tarragona, Spain. METHODS: Participants were randomly assigned to conditions and paired with peers who disagreed with them on three topics related to renewable energy sources. After instruction on each topic, they were asked to either 'argue to convince' (persuasion condition) or 'argue to reach consensus' (consensus condition) on that topic. Conversations were audio-recorded and transcribed for analysis. RESULTS: Students in the persuasion condition engaged in shorter conversational exchanges around argumentative claims and were more likely to use moves that foreclosed discussion, whereas students in the consensus condition were more likely to use moves that elicited, elaborated on, and integrated their partners' ideas. CONCLUSIONS: When arguing to reach - rather than defend - a conclusion, students are more likely to coconstruct knowledge by exchanging and integrating arguments. These findings are consistent with predictions about the potential of argumentation for knowledge building and suggest that teachers must attend to discourse goals when using argumentation to support learning and reasoning.

Hearing preservation cochlear implantation in adolescents.

OBJECTIVE: This study describes our experience of cochlear implantation (CI) with hearing preservation in adolescents. Our aim was to determine if hearing preservation is successful in this population, if the preserved hearing is maintained, and what the potential benefit of preserving hearing in this population is. PATIENTS: Fourteen profoundly deaf adolescents with preservation of low-frequency hearing (125, 250, and 500 Hz). INTERVENTION: Twelve adolescents had a single-sided CI, and two had bilateral CI. All were having their first implantation, and all patients had hearing preservation surgery (soft surgery). MAIN OUTCOME MEASURES: Hearing preservation was measured with preoperative and postoperative pure-tone audiograms. Speech audiometry was performed before implantation and at subsequent follow-up appointments. RESULTS: Hearing preservation (measurable hearing thresholds) was achieved in 13 of 14 patients. Average follow-up was 2 years 10 months (range, 4 mo-4 yr 9 mo). Three of 13 patients with initial successful hearing preservation had deterioration of their hearing at subsequent follow-up. The addition of naturally preserved hearing to the cochlear implant improved speech audiometry scores compared with using the implants in isolation. CONCLUSION: This study demonstrates that residual hearing can be consistently preserved and maintained in adolescents during the short-/medium-term using a soft surgical technique to insert standard-length electrodes. The potential benefit of preserving residual low-frequency hearing seems to be improvement in speech discrimination in challenging hearing conditions, although larger studies are required.