Association between the home-to-healthcare center distance and hearing aid abandonment among older adults.

Background: Access to audiology services for older adults residing in sparsely populated regions is often limited compared to those in central urban areas. The geographic accessibility to follow-up care, particularly the influence of distance, may contribute to an increased risk of hearing aid abandonment. Objective: To assess the association between the home-to-healthcare-calibration-center distance and hearing aid abandonment among older adults fitted in the Chilean public health system. Methods: 455 patients who received hearing aids from two public hospitals in two regions were considered. Univariate and multivariate Poisson regression models with robust variance estimation were used to analyze the association between the geographical distance and hearing aid abandonment, accounting for confounding effects. Results: Approximately 18% of the sample abandoned the hearing aid, and around 50% reported using the hearing aid every day. A twofold increase in distance between home and the hearing center yielded a 35% (RR = 1.35; 95% CI: 1.04-1.74; p = 0.022) increased risk of hearing aid abandonment. Also, those in the second quintile had a 2.17 times the risk of abandoning the hearing aid compared to the first quintile (up to 2.3 km). Under the assumption that patients reside within the first quintile of distance, a potential reduction of 45% in the incidence of hearing aid abandonment would be observed. The observed risk remained consistent across different statistical models to assess sensitivity. Conclusion: A higher distance between the residence and the healthcare center increases hearing aid abandonment risk. The association may be explained by barriers in purchasing supplies required to maintain the device (batteries, cleaning elements, potential repairs, or maintenance).

Normalization of Rowland Universal Dementia Assessment Scale (RUDAS) in Chilean older people.

Rowland Universal Dementia Assessment Scale (RUDAS) is a cognitive screening that evaluates older people with low educational levels. In Chile, there are no normative data to assess this population. Objective: To obtain normative data on RUDAS in older Chilean people with up to 12 years of schooling, and to determine whether age and schooling years influence a person's performance on RUDAS and on the items that constitute it. Methods: A group of cognitively healthy people 60 years old or over, with up to 12 schooling years was evaluated (n=135). Multiple regression models were applied to obtain normative data on RUDAS, according to age and schooling years, and to measure the effects of schooling on different items. Results: Regression analysis showed that none of the items had schooling as a significant predictor, except for the visuoconstruction item. The variables age and schooling explained 12.6% (R^2=0.126) of the RUDAS total score variance. The item visuoconstruction was the most associated with the educational level (OR=1,147). Conclusion: This study showed that RUDAS is a recommended instrument for evaluating older people with low educational levels. However, more studies are needed to prove the validity of the RUDAS on Chilean older people.

RUDAS é uma triagem cognitiva que avalia idosos com baixa escolaridade. No Chile não existem dados normativos para avaliar essa população. Objetivo: Obter dados normativos sobre RUDAS em idosos chilenos com até 12 anos de escolaridade. Além disso, determinar se a idade e a escolaridade influenciam o desempenho de uma pessoa no RUDAS e nos itens que o constituem. Métodos: Foi avaliado um grupo de pessoas cognitivamente saudáveis, com 60 anos ou mais e até 12 anos de escolaridade (n=135). Modelos de regressão múltipla foram utilizados para obter dados normativos do RUDAS, segundo idade e anos de escolaridade, e para mensurar os efeitos da escolaridade em diferentes itens. Resultados: A análise de regressão mostrou que nenhum dos itens teve a escolaridade como preditor significativo, exceto o item visuoconstrução. As variáveis idade e escolaridade explicam 12,6% (R

Intervenciones parentales para el desarrollo lingüístico- comunicativo en preescolares con Trastornos del Neurodesarrollo: una revisión sistemática / Parental interventions for linguistic-communicative development in preschoolers with Neurodevelopmental Disorders: a systematic review

Resumen En el actual escenario sociosanitario enfrentado a raíz de la pandemia por SARS-CoV-2, múltiples actividades se han visto mermadas, e incluso, suspendidas por los largos periodos de aislamiento social y las medidas de cuidado para evitar contagios. En este sentido, muchas personas han dejado de recibir con la misma regularidad, o bajo las mismas circunstancias, sus tratamientos, incluyendo a niños con Trastornos del Neurodesarrollo (TND). Es así como surgen las intervenciones Parentales. Estas son programas donde los padres o cuidadores primarios son entrenados para llevar a cabo acciones terapéuticas con el niño y cuyo objetivo puede estar orientado a promover múltiples habilidades. El objetivo de la presente revisión sistemática fue determinar el efecto de estas intervenciones para promover el lenguaje y la comunicación en niños con diagnóstico de TND de entre 2 y 5 años. Se realizó una búsqueda sistemática en las bases de datos ERIC, MEDLINE y PubMed, considerando publicaciones de entre enero del 2010 y marzo de 2022. De las 9885 referencias iniciales, y posterior a las etapas de tamizaje y elegibilidad, 5 fuentes primarias cumplieron con los criterios de selección. Los resultados indican que las intervenciones parentales para habilidades de comunicación serían efectivas e incluso se mantendrían los efectos en medidas de seguimiento. En cuanto a las habilidades de lenguaje, los resultados a través de los estudios son contradictorios. Por otra parte, ninguno de los estudios reporta efectos adversos para los niños. En cuanto a efectos beneficios o adversos para padres o cuidadores primarios, ninguno de los estudios incluidos reporta medidas asociadas.

Abstract In the current socio-sanitary scenario that we are facing as a result of the SARS-CoV-2 Pandemic, there have been many activities that have been reduced and even suspended due to long periods of social isolation and care measures to avoid contagion. In this sense, many people have stopped receiving their treatments with the same regularity or under the same circumstances, including children with Neurodevelopmental Disorders. This is how parental interventions correspond to programs where parents or primary caregivers are trained to carry out therapeutic actions with the child and whose objective may be aimed at promoting multiple skills. The objective of this systematic review was to determine the effect of these interventions to promote language and communication in children diagnosed with Neurodevelopmental Disorders between 2 and 5 years of age. A systematic search was carried out in the ERIC, MEDLINE and PubMed databases including publications between January 2010 and March 2022. Of the 9885 initial references, and after the screening and eligibility stages, 5 primary sources met the selection criteria. The results indicate that parental interventions for communication skills would be effective, and the effects would even be maintained in follow-up measures. Regarding language skills, the results across studies are contradictory. On the other hand, none of the studies reported adverse effects for children. Regarding beneficial or adverse effects for parents or primary caregivers, none of the included studies reported associated measures.

Normalization of Rowland Universal Dementia Assessment Scale (RUDAS) in Chilean older people / Normalização da Escala Universal de Avaliação de Demência de Rowland (RUDAS) em idosos chilenos

ABSTRACT Rowland Universal Dementia Assessment Scale (RUDAS) is a cognitive screening that evaluates older people with low educational levels. In Chile, there are no normative data to assess this population. Objective: To obtain normative data on RUDAS in older Chilean people with up to 12 years of schooling, and to determine whether age and schooling years influence a person's performance on RUDAS and on the items that constitute it. Methods: A group of cognitively healthy people 60 years old or over, with up to 12 schooling years was evaluated (n=135). Multiple regression models were applied to obtain normative data on RUDAS, according to age and schooling years, and to measure the effects of schooling on different items. Results: Regression analysis showed that none of the items had schooling as a significant predictor, except for the visuoconstruction item. The variables age and schooling explained 12.6% (R^2=0.126) of the RUDAS total score variance. The item visuoconstruction was the most associated with the educational level (OR=1,147). Conclusion: This study showed that RUDAS is a recommended instrument for evaluating older people with low educational levels. However, more studies are needed to prove the validity of the RUDAS on Chilean older people.

RESUMO RUDAS é uma triagem cognitiva que avalia idosos com baixa escolaridade. No Chile não existem dados normativos para avaliar essa população. Objetivo: Obter dados normativos sobre RUDAS em idosos chilenos com até 12 anos de escolaridade. Além disso, determinar se a idade e a escolaridade influenciam o desempenho de uma pessoa no RUDAS e nos itens que o constituem. Métodos: Foi avaliado um grupo de pessoas cognitivamente saudáveis, com 60 anos ou mais e até 12 anos de escolaridade (n=135). Modelos de regressão múltipla foram utilizados para obter dados normativos do RUDAS, segundo idade e anos de escolaridade, e para mensurar os efeitos da escolaridade em diferentes itens. Resultados: A análise de regressão mostrou que nenhum dos itens teve a escolaridade como preditor significativo, exceto o item visuoconstrução. As variáveis idade e escolaridade explicam 12,6% (R^2=0,126) da variância do escore total do RUDAS. O item visuoconstrução é o mais associado ao nível de escolaridade (OR=1,147). Conclusão: Este estudo mostrou que o RUDAS é um instrumento recomendado para a avaliação de idosos com baixa escolaridade. No entanto, são necessários mais estudos para comprovar a validade do RUDAS em idosos chilenos.

Adaptation of the "active communication education" programme into Spanish for older adults with hearing loss.

Objective: To adapt the Active Communication Education (ACE) programme into Spanish. In addition, this study aimed at determining the effects of the adapted ACE programme on the social/emotional impacts of hearing loss and hearing functioning in a group of older adults with hearing loss who do not wear hearing aids.Design: This was an exploratory cohort study. Study group participants received the newly adapted ACE programme and control group participants received a cognitive stimulation programme. The Shortened Hearing Handicap Inventory for the Elderly in Spanish (HHIE-S) and the Spanish version of the Amsterdam Inventory for Auditory Disability and Handicap (S-AIADH) were carried out before and after each programme.Study sample: Sixty-six older adults with hearing loss and who did not wear hearing aids were randomly assigned to either an ACE group (n = 30) or a cognitive stimulation group (n = 36).Results: Participants who received the ACE programme showed a significantly larger improvement for the S-AIADH than did the cognitive stimulation group participants.Conclusions: The ACE programme has been adapted into Spanish for use with Chilean older adults with hearing loss. The results show that older adults report better functioning in listening situations after attending the sessions of the adapted ACE programme.