Additional Disability Research Articles

Children with Auditory Brainstem Implants: Language Proficiency and Reading Comprehension Process.

Auditory performance and language proficiency in young children who utilize auditory brainstem implants (ABI) throughout the first three years of life is difficult to predict. ABI users have challenges as a result of delays in language proficiency and the acquisition of reading comprehension, even if ABI technology offers auditory experiences that enhance spoken language development. The aim of this study was to evaluate about the impact of language proficiency on reading comprehension skills in children with ABI. In this study, 20 children with ABI were evaluated for their reading comprehension abilities and language proficiency using an Informal Reading Inventory, Test of Early Language Development (TELD-3), Categories of Auditory Performance-II (CAP-II), and Speech Intelligibility Rating (SIR). Three distinct aspects of reading comprehension were assessed and analyzed to provide a composite score for reading comprehension abilities. TELD-3, which measures receptive and expressive language proficiency, was presented through spoken language. Studies have shown that there was a relationship between language proficiency and reading comprehension in children with ABI. In the present study, it was determined that the total scores of reading comprehension skills of the children who had poor language proficiency and enrolled in the school for the deaf were also low. The children use short, basic sentences, often repeat words and phrases, and have a restricted vocabulary. In addition, the children had difficulty reading characters and detailed paragraphs and could not remember events in a logical order. Children with ABI may potentially have complicated reading comprehension abilities due to lack of access to all the speech formants needed to develop spoken language. In addition, variables affecting the reading levels of children with ABI include factors such as age at implantation, duration of implant use, presence of additional disability, communication model and access to auditory rehabilitation. The reading comprehension skills of ABI users were evaluated in this study for the first time in the literature and may constitute a starting point for the examination of variables affecting reading comprehension in this area.

Identification of the Needs of Patients ≥ 75 Years Admitted to an Acute Hospital

Abstract Background More than 30% of older people are discharged with new or additional disability following an acute hospital admission.1, 2 Older adults who are frail experience even higher levels of hospital-associated disability.3 For patients who experience hospital-associated disability, fewer than half will recover to their pre-illness level of functioning after 1 year and rates of death and nursing home placement are high.4 The economic consequences of hospital-associated disability are longer hospital length-of stay, increased rates of re-admission after discharge, an increased requirement for home care packages and long-term residential care beds. Methods An observational study was undertaken to determine the profile and needs of adults ≥75 years admitted to an acute hospital. Medical records were reviewed by two advanced nurse practitioners on day 1 of admission. From January 8th -22nd 2024, 352 hospital admission episodes were reviewed. Objectives Results Conclusion In conclusion, the results highlighted a need for 1. An increase in beds available in a Specialist Geriatric ward 2. A greater awareness at ED level of admitting specialty 3. An increase in the number of beds to be made available such as rehabilitation beds to facilitate early discharge from the acute hospital.

Disability Benefit Reform and Benefit Outcomes: A Re-examination of the Introduction of the UK Personal Independence Payment Using Linked Population Data

ObjectivesMany countries face the problem of how to provide support for additional costs faced by disabled people while restricting disability benefit program growth given tight public finances. In 2013, the UK reformed its main additional costs disability benefit with this objective, changing both medical screening and payment rates with the introduction of the Personal Independence Payment (PIP). This study uses newly available linked administrative population data to examine the impact of this major reform on disability benefit receipt. ApproachWe use the newly available 2011CBI dataset, which links Census records to microdata on benefit receipt for the population of England and Wales from 2011-2015. Difference-in-difference and synthetic control methods are used to estimate the reform impact on the probability of flowing onto disability benefits, exploiting the structure of the roll-out of PIP’s introduction across English regions. ResultsIntroducing PIP led to a sharp fall in the probability of disability benefit onflow, with tentative evidence of a partial reversal in the following year. Further analysis is required to quantify the extent to which this reflects well-known administrative delays in processing applications as opposed to a step change in the probability of claims being successful. ConclusionsThis study is the first to present linked administrative population data estimates of the benefit recipiency effects of the introduction of PIP. In doing so it both contributes to the wider international literature on disability benefit reform and provides an early research application of a significant new administrative dataset for England and Wales.

Risk of Suicide Across Medical Conditions and the Role of Prior Mental Disorder

According to the World Health Organization, more than 700 000 individuals worldwide die by suicide each year. Medical conditions likely increase the risk of suicide. To (1) provide age- and sex-specific pairwise estimates of the risk of suicide across a comprehensive range of medical conditions, (2) investigate whether there is a dose-response-like relationship at play (ie, the higher the disability burden due to medical morbidity, the higher the risk of suicide), and (3) determine if the risk of suicide with medical conditions is particularly pronounced among those who had mental disorder preceding the medical conditions. This cohort study was an observational study of population-based data for all individuals living in Denmark at some point between 2000 and 2020. The data analysis took place from September 2023 to May 2024. Thirty-one specific medical conditions as well as prior mental disorder. The main outcome was suicide. Associations between the 31 specific medical conditions, nested within 9 categories, and suicide were examined via Poisson regression, yielding incidence rate ratios (IRRs). Subsequent analyses included an interaction term to assess whether a previous hospital-treated mental disorder modified the associations. Finally, the association between the disability burden of medical conditions and suicide was examined for those with and without prior mental disorder, respectively. A total of 6 635 857 individuals (3 337 613 females and 3 298 244 males) were included in the analyses of the associations between medical conditions and suicide. Except for endocrine disorders, all categories of medical conditions were associated with a statistically significant increased risk of suicide (which was most pronounced for gastrointestinal conditions [IRR, 1.7; 95% CI,1.5-1.8], cancer [IRR, 1.5; 95% CI, 1.4-1.6], and hematological conditions [IRR, 1.5; 95% CI, 1.3-1.6]). Interaction between mental disorder and individual medical conditions did not seem to play a major role for suicide risk. For those without but not for those with mental disorder, there was a dose-response-like relationship between the disability burden of medical conditions and suicide. Medical conditions are generally associated with increased risk of suicide in a dose-response-like manner. Individuals with hospital-treated mental disorder appear to be at such elevated risk of suicide that additional disability associated with medical conditions has little impact in this regard.

Why I’m not working: People with vision impairments explain

BACKGROUND: Approximately half of people with vision impairments are not employed or looking for work. Many of these people have additional health or disability concerns, but little is known about those concerns or other reasons they are out of the workforce. OBJECTIVE: We investigated employment barriers impacting labor force participation among people with vision impairments, their perceptions of their skills and training needs, and the impact of not working on their economic status. METHODS: Thirty people with vision impairments who were not in the labor force participated in exploratory interviews conducted using a semi-structured protocol. We used a qualitative software program and multiple researchers to code the interviews, identify and analyze themes, and organize participants’ information. RESULTS: Employment barriers included concerns about health and disability, employer attitudes, transportation, training needs, economics, age, and lack of support. Some participants wanted to work now or in the past but were unable to find employment that accommodated their needs and generated a salary that made it economically worthwhile. CONCLUSION: Participants appear to need assistance identifying career paths leading to economic security, training for these careers, locating affordable transportation, and working with employers to gain workplace accommodations. Providing support and encouraging family support may positively influence interest in employment.

Resource Utilization and Costs Associated With Cardiogenic Shock Complicating Myocardial Infarction: A Population-Based Cohort Study

BackgroundCardiogenic shock due to acute myocardial infarction (AMI-CS) is associated with significant short- and long-term morbidity and mortality. Despite this, little is known about associated cost. ObjectivesThe purpose of this study was to evaluate the health care costs and resource use associated with AMI-CS using administrative data from the province of Ontario, Canada. MethodsThis was a retrospective cohort study of adult patients with AMI-CS from April 2009 to March 2019. One-year costs following index admission were reported at an individual level. We used generalized linear models to identify factors associated with increased cost. We stratified patients by revascularization strategy to compare cost in each group and examined total cost at a patient level per individual fiscal year. ResultsWe included 9,789 consecutive patients with AMI-CS across 135 centers in Ontario (mean age 70.5 years; 67.7% male). Mortality in-hospital was 30.2%, and mortality at 2 years was 45.9%. The median inpatient cost per patient was $23,912 (IQR: $12,234-$41,833) with a median total 1-year cost of $37,913 (IQR: $20,113-$66,582). The median 1-year cost was $17,730 (IQR: $9,323-$38,379) for those who died in hospital, and $45,713 (IQR: $29,688-$77,683) for those surviving to discharge, with $12,719 (IQR: $4,262-$35,275) occurring after discharge. Patients who received coronary artery bypass grafting incurred the highest cost among revascularization groups. No significant differences were observed in cost per fiscal year from 2009 to 2019. ConclusionsAMI-CS is associated with significant health care costs, both during the index hospitalization and following discharge. To optimize cost-effectiveness, future therapies should aim to reduce disability in addition to improving mortality.

Predictors and Clinical Characteristics of Relapses in LGI1-Antibody Encephalitis.

Relapses occur in 15%-25% of patients with leucine-rich glioma-inactivated 1 antibody (LGI1-Ab) autoimmune encephalitis and may cause additional disability. In this study, we clinically characterized the relapses and identified factors predicting their occurrence. This is a retrospective chart review of patients with LGI1-Ab encephalitis diagnosed at our center between 2005 and 2022. Relapse was defined as worsening of previous or appearance of new symptoms after at least 3 months of clinical stabilization. Among 210 patients, 30 (14%) experienced a total of 33 relapses. The median time to first relapse was 23.9 months (range: 4.9-110.1, interquartile range [IQR]: 17.8). The CSF was inflammatory in 11/25 (44%) relapses, while LGI1-Abs were found in the serum in 16/24 (67%) and in the CSF in 12/26 (46%); brain MRI was abnormal in 16/26 (62%) relapses. Compared with the initial episode, relapses manifested less frequently with 3 or more symptoms (4/30 patients, 13% vs 28/30, 93%; p < 0.001) and had lower maximal modified Rankin scale (mRS) score (median 3, range: 2-5, IQR: 1 vs 3, range: 2-5, IQR: 0; p = 0.001). The median mRS at last follow-up after relapse (2, range: 0-4, IQR: 2) was significantly higher than after the initial episode (1, range: 0-4, IQR: 1; p = 0.005). Relapsing patients did not differ in their initial clinical and diagnostic features from 85 patients without relapse. Nevertheless, residual cognitive dysfunction after the initial episode (hazard ratio:13.8, 95% confidence interval [1.5; 129.5]; p = 0.022) and no administration of corticosteroids at the initial episode (hazard ratio: 4.8, 95% confidence interval [1.1; 21.1]; p = 0.036) were significantly associated with an increased risk of relapse. Relapses may occur years after the initial encephalitis episode and are usually milder but cause additional disability. Corticosteroid treatment reduces the risk of future relapses, while patients with residual cognitive dysfunction after the initial episode have an increased relapse risk.

Periodontal Health among Individuals with Intellectual Disabilities Living in a Saudi Institutional Rehabilitation Centre.

The aim of this study was to explore periodontal health among intellectually disabled individuals living in an institutional rehabilitation centre in the Al-Baha Region of Saudi Arabia. A cross-sectional study was conducted from November 2023 to January 2024. Clinical oral examinations were carried out using the World Health Organization criteria for bleeding sites and the presence of periodontal pockets. Simplified oral hygiene and community periodontal indices were employed to evaluate participants' oral health. A total of 89 participants, comprising both males and females with intellectual disabilities, were included in this study. Gender, severity of intellectual disability, type of additional physical disability, tooth brushing habits and oral hygiene status were significantly associated with the presence of periodontal disease. Additionally, poor oral hygiene, not brushing teeth and periodontal pockets of 4-5 mm and 6 mm or more were significantly more prevalent among individuals with severe and moderate intellectual disabilities (p = 0.001, p = 0.001, p = 0.001 and p = 0.001, respectively). The prevalence of periodontal disease among the studied population was 54%. The odds of having periodontal disease were significantly higher in the severe intellectual disability group compared to the mild intellectual disability group (OR = 2.328, 95% CI = 1.430-3.631, p = 0.03). It was also found that intellectually disabled participants with additional physical disabilities suffered more from periodontal disease than those without additional physical disabilities (OR = 0.971, 95% CI = 0.235-4.023, p = 0.025). Overall, individuals with intellectual disabilities had a significant demand for periodontal care. This study highlighted the need for more organised preventive programmes for individuals with intellectual disabilities. Dentists should be vigilant about improving periodontal health, focus on preventive programmes and provide comprehensive dental care with an emphasis on periodic recall and monitoring.

Cochlear implantation outcomes in children with multiple disabilities: a topic that’s worth revisiting

ObjectivesTo determine the benefits of cochlear implantation in hearing loss children with multiple disabilities (MD) in terms of auditory outcomes, speech performance, and their quality of life. MethodsThis was a cross sectional study from January 2019 to December 2020 in which thirty-one children with hearing loss and multiple disabilities were evaluated. Their improvement in auditory and speech performances were assessed using Categories of Auditory Performance version II (CAP-II) and the Speech Intelligibility Rating (SIR) scales. The assessment was done at 6-month intervals, with the baseline evaluation done at least six months after activation of the implant. Parents were asked to fill the Parents Evaluation of Aural/Oral Performance of Children (PEACH) diary and Perceived Benefit Questionnaire (PBQ) to evaluate the child’s quality of life. ResultsAll 31 children have Global Developmental Delay (GDD), with 11 having an additional disability. Both mean CAP-II and SIR scores showed significant improvement with increased hearing age (p < 0.05) after 6-month intervals. In addition, 20 out of 31 children (64.5%) have achieved verbal communication after implantation. The mean PEACH score in quiet was significantly better than in noise (p = 0.007) and improved with the increased of hearing age. The majority of parents (96%‒100%) perceived a cochlear implant as beneficial to their child in terms of auditory response, awareness, interaction, communication, and speech development. ConclusionsCochlear implantation had shown benefits in children with multiple disabilities. Outcome measures should not only focus on auditory and speech performances but the improvement in quality of life. Hence, individualized each case with realistic expectation from families must be emphasized in this group of children. Level of evidenceLevel 3.

The interplay of body composition, pain intensity, and psychological status in Egyptian patients with knee osteoarthritis

BackgroundThere is a clear relationship between poor mental health, obesity, and osteoarthritis (OA). Individuals who experience symptoms of anxiety and depression are more likely to report higher levels of pain and disability in OA. In addition, higher body mass index (BMI) levels can contribute to additional pain and disability in individuals with OA. We aimed to explore the interplay of Body composition, pain intensity, and psychological status in Egyptian patients with knee OA.ResultsThis cross-sectional study included 60 patients with Knee OA diagnosed clinically according to the American College of Rheumatology (ACR) criteria. Body composition measurement was performed with an InBody analyzer. Pain was assessed by the pain visual analog scale (VAS), disability was measured with Western Ontario and McMaster Universities Osteoarthritis (WOMAC) scores, and depressed mood and/or anxiety was measured by the Hospital Anxiety and Depression Scale (HADS). Body mass index (BMI), total body fat (TBF) %, fat mass (FM), and fat mass index (FMI) were positively correlated with pain and disability in patients with knee OA. TBF% was positively correlated with depression and anxiety.ConclusionsThis study has shed light on the association between mental disorders, body composition measurements, knee pain, and disability. Interventions to treat osteoarthritis in elderly patients should focus on treating mood changes such as anxiety and depression, psychological support, and controlling body mass with proper diet and exercise programs.

The economic burden of Ebola virus disease: a review and recommendations for analysis

Background Ebola virus disease (EVD) continues to be a major public health threat globally, particularly in the low-and-middle-income countries (LMICs) of Africa. The social and economic burdens of EVD are substantial and have triggered extensive research into prevention and control. We aim to highlight the impact and economic implications, identify research gaps, and offer recommendations for future economic studies pertaining to EVD. Method We conducted a comprehensive librarian-led search in PubMed/Medline, Embase, Google Scholar, EconLit and Scopus for economic evaluations of EVD. After study selection and data extraction, findings on the impact and economics of EVD were synthesized using a narrative approach, while identifying gaps, and recommending critical areas for future EVD economic studies. Results The economic evaluations focused on the burden of illness, vaccine cost-effectiveness, willingness-to-pay for a vaccine, EVD funding, and preparedness costs. The estimated economic impact of the 2014 EVD outbreak in Guinea, Liberia, and Sierra Leone across studies ranged from $30 billion to $50 billion. Facility construction and modification emerged as significant cost drivers for preparedness. The EVD vaccine demonstrated cost-effectiveness in a dynamic transmission model; resulting in an incremental cost-effectiveness ratio of about $96 per additional disability adjusted life year averted. Individuals exhibited greater willingness to be vaccinated if it incurred no personal cost, with a minority willing to pay about $1 for the vaccine. Conclusions The severe impact of EVD puts pressure on governments and the international community for better resource utilization and re-allocation. Several technical and methodological issues related to economic evaluation of EVD remain to be addressed, especially for LMICs. We recommend conducting cost-of-sequelae and cost-of-distribution analyses in addition to adapting existing economic analytical methods to EVD. Characteristics of the affected regions should be considered to provide evidence-based economic plans and economic-evaluation of mitigations that enhance resource allocation for prevention and treatment.

Patient-reported outcomes based on discontinuation or continuous treatment with natalizumab: New York State Multiple Sclerosis Consortium (NYSMSC) study

BackgroundPatient-reported outcomes (PRO) are increasingly utilized as part of the routine clinical assessment in people with multiple sclerosis (pwMS). The long-term effect of disease modifying therapies (DMTs) and their discontinuation on PRO measures remains largely unknown. MethodsTwo pwMS groups treated with natalizumab were selected from the New York State MS Consortium (NYSMSC) database. The first group utilized long-term follow-up data of pwMS that either still continue natalizumab treatment or discontinued. Minimal requirement of three visits (before natalizumab initiation, during treatment and after discontinuation/latest follow-up) was implemented. The second group consisted of pwMS that completed PRO questionnaire on the day of the infusion and 7 days later PROs were assessed using the LIFEware System™ that assesses limitations in multiple physical and psychosocial domains. Additional physical disability was assessed using Expanded Disability Status Scale (EDSS) and Timed 25-ft walk test (T25FWT). PRO reports were Rasch-transformed, ranging from 0 to 100, with higher scores indicating a better outcome. Linear mixed-effect models and paired analyses were utilized. ResultsWithin the prospective cohort, 242 pwMS were followed on average of 6.5 years. Greater number of PRO domains worsened in the 141 pwMS that discontinued natalizumab when compared to 101 pwMS that remained on the drug (10 vs. 2 PRO domains). PwMS that discontinued natalizumab had significant decline in PROs regarding lower extremities, bladder and bower control and psychosocial aspects (feeling lonesome). Contrarily, pwMS that continued natalizumab had significant improvement in bladder and bowel PRO measures. Seven days after the natalizumab infusion, the 67 pwMS from the prospective cohort reported improvement in PRO measures of fatigue (62.8 vs. 66.4, p = 0.019), bladder limitations (80.3 vs. 85.0, p = 0.012), and feelings of lonesomeness (81.2 vs. 88.0, p = 0.009). ConclusionContinuous natalizumab treatment provides long-term stability or improvement in PRO measures. Natalizumab also provides short term improvements recorded after the infusion.

Disability education and implications for genetic counselor training.

The genetic counseling (GC) community has faced criticism about the duality of promoting patient autonomy while also advocating for individuals with disabilities. This study assessed the attitudes of the disability community and GCs to identify content that should be included in GC disability education and evaluate the landscape of GC disability education. Members of the disability community and GCs completed an electronic survey distributed through electronic listservs and partnering organizations. A total of 672 responses were analyzed from both the disability community (n = 596) and the GC community (n = 76). Members of the disability community noted differences in GC comfort level discussing different aspects of disability with GCs being perceived as being very knowledgeable about medical aspects 71% of the time versus 49% of the time when discussing social/lifestyle aspects of disability. This discordance was reflected in GCs reported comfort level in discussing medical aspects (89%) and social aspects of disability (65%) during a session. Most GC respondents (71%) felt they received adequate knowledge during their disability education and variation was reported in the execution of disability education by training programs. Disability education content recommendations from the disability community and GCs included emphasizing four key aspects of disability: medical, social/lifestyle, lived experience, and the disability rights movement. Respondents of both cohorts stressed the inclusion of and exposure to persons with disabilities in disability education to understand the lived experience of persons with disabilities. The disability community identified additional disability education content to be included such as empathy training, family hardships, and mental health. The results of this study have practice implications and provide a foundation for training expectations to ensure future GCs possess the necessary skills to improve the quality of services provided to families and persons with disabilities.

Growing up with Additional Disabled Child: The Life Story of a Mom

The aim of this study, which was carried out according to the life story/narrative research design, which is one of the qualitative research methods, is to examine the life story of a mother living with a child with an additional disability. In this context, a 5-year-old child with deficiencies such as hearing loss, autism and ADHD and his mother were included in the study. The research data consists of semi-structured interviews, observations, and document analysis. The collected data were analyzed with the inductive analysis method. As a result of the analysis, four main themes and ten sub-themes were reached. It was found that the mother had problems in the diagnosis process of the child, in the use of hearing aids, placement in appropriate educational environments, familial support and social support services. Based on these problems, it is necessary to make updates in planning legal regulations and related legislation.&#x0D;

Comprehensive Review of Types, Characteristics, Assessment and Management of Tinnitus

Tinnitus is explained as an apparition of auditory thought. It is a sound perception without acoustic, corresponding, or mechanically associatedwith the cochlea. Tinnitus showcases one of the most distressing and common otologic problems, and it causes various psychological and somatic disordersthat intervene with the life quality. Although tinnitus has become almost a global symptom, the occurrence of tinnitus surges with age. Tinnitus alsocharacterizes a common sign among offspring with hearing loss. Tinnitus is an individual occurrence that is difficult to appraise objectively, with it beingquantified, measured, and defined only based on patients' answers. Although tinnitus can have various reasons, it usually results from otologic illnesses,with the most mutual cause believed to be hearing impairment induced by noise. The various healing methods for tinnitus have formed mixed outcomes;thus, it is generally supposed that tinnitus has varied physiological bases. Sometimes, no treatment represents the better alternative, mandating cliniciansto placate patients without unnecessary prescriptions. Although treatment does not necessarily relieve tinnitus, accurate diagnosis and treatment areimportant for reducing the annoyance related to tinnitus and averting additional disability. Furthermore, there also exist placebo effects that have beenpartially accredited to responses to attention. Nevertheless, therapy signifies an essential part of conduct, irrespective of the organizational methodaccepted for a patient. An informed explanation of tinnitus, collected with encouragement, recovers the condition of most patients over time. For thosewith insistent tinnitus, cognitive and interactive therapy, amplified by pharmacologic intervention, might characterize the most promising managementregimen. Most prominently, a strong clinician-patient association underpins successful organization and high patient consummation levels.

Investigation of factors influencing low physical activity levels in community-dwelling older adults with chronic pain: a cross-sectional study

Low levels of physical activity in individuals with chronic pain can lead to additional functional impairment and disability. This study aims to investigate the predictors of low physical activity levels in individuals with chronic pain, and to determine the accuracy of the artificial neural network used to analyze these predictors. Community-dwelling older adults with chronic pain (n = 103) were surveyed for their physical activity levels and classified into low, moderate, or high physical activity level groups. Chronic pain-related measurements, physical function assessment, and clinical history, which all influence physical activity, were also taken at the same time. Logistic regression analysis and analysis of multilayer perceptron, an artificial neural network algorithm, were performed. Both analyses revealed that history of falls was a predictor of low levels of physical activity in community-dwelling older adults. Multilayer perceptron analysis was shown to have excellent accuracy. Our results emphasize the importance of fall prevention in improving the physical activity levels of community-dwelling older adults with chronic pain. Future cross-sectional studies should compare multiple analysis methods to show results with improved accuracy.

Pediatric Hearing Aid Management: Experiences and Perspectives of Spanish-Speaking Parents.

The purpose of the study was twofold: (a) to explore hearing aid management experiences of Spanish-speaking parents who have young children using hearing aids and (b) to explore parents' access to the Internet and perceptions about remote audiology services. The study used a mixed methods design. Data were collected through a phone interview. Eleven mothers of children aged 14-60 months participated. Most of the children (9/11) had a bilateral hearing loss, and two had an additional disability. Three themes emerged for hearing aid management experiences: audiology services, routines, and emotional challenges/supports. Parents had variable levels of confidence in their skills ranging from no confidence to complete confidence, with the greatest variability for three items: (a) using the listening tube to make sure that the sound quality of the hearing aid is good, (b) removing moisture from the earmold tubing, and (c) troubleshooting problems when your child's hearing aids are not working. All participants reported having consistent Internet access and had positive perceptions about the possibility of remote audiology services. This study provided insights into hearing aid management experiences and perceptions of Spanish-speaking parents. Parents described variability for audiology services, routines for hearing aid use and care, and access to other parents of children with hearing loss. Spanish-speaking parents present additional elements in the hearing care process that need to be incorporated in planning. Remote services may be an opportunity to enhance access to support that could improve effectiveness of hearing aid management.

Augmentative and alternative communication (AAC) in pediatric cochlear implant recipients with complex needs: A scoping review.

Augmentative and alternative communication (AAC) encompasses all forms of unaided and aided modes of communication, but typically excludes codified language such as spoken words or American Sign Language (ASL). In pediatric patients with a documented additional disability (population of interest), deficits in communication may pose a barrier to language development. While forms of AAC are frequently mentioned in the literature, recent innovations have permitted the use of high-tech AAC in the rehabilitation process. Our objective was to review the implementation of AAC in pediatric cochlear implant recipients with a documented additional disability. A scoping review of existing literature examining the use of AAC in pediatric CI recipients was conducted in the PubMed/MEDLINE and Embase databases. Studies with pediatric cochlear implant recipients with a concomitant diagnosis requiring additional therapeutic intervention outside the scope of standard post-CI follow-up care and rehabilitation from 1985 to 2021 met inclusion criteria (population of interest). Studies limited to spoken or formal sign language (e.g., American Sign Language, ASL) as communication modalities were excluded. Four hundred twenty studies were screened of which 29 were included. 13 were prospective, 10 were retrospective, 1 was cross-sectional, and 5 were case reports. Of these 29 studies, 378 patients met the inclusion criteria (age <18, CI user, additional disability, utilized AAC). Fewer studies (n=7) utilized AAC as the primary intervention for investigation. Autism spectrum disorder, learning disorder, and cognitive delay were frequently mentioned as additional disabilities in conjunction with AAC. Unaided forms of AAC included gesture/behavior, informal sign, and signed exact English, while aided AAC included a Picture Exchange Communication System (PECS), Voice Output Communication Aids (VOCA), and touchscreen programs such as TouchChat® HD. Various audiometric and language development outcome measures were mentioned, most commonly the Peabody Picture Vocabulary Test (PPVT) (n=4) and the Preschool Language Scale, Fourth Edition (PLS-4) (n=4). There is a gap in the literature regarding the use of aided and high-tech AAC in pediatric CI users with a documented additional disability. Given the use of multiple different outcome measures, additional exploration of the intervention of AAC is warranted.

Individuals with multiple disabilities in Türkiye: Descriptive content analysis

This study aims to descriptively analyze the studies on multiple disabilities in Türkiye between 2008 and 2022. The data of the research were searched in Anadolu University Library, Google Scholar, and Higher Education Institution Thesis databases with the keywords multiple disability, multiple disabilities, and additional disability. In this context, 15 postgraduate thesis studies and 17 articles were included in the research. The studies included in the study were analyzed under themes such as the year they were published, the university where the study took place, the keywords of the study, the method of the study, the design, the data collection technique/tool, and data analysis method, the journal in which the study was published and its index. As a result of the descriptive analysis, more adjustments were made to the qualitative research method, design, data collection technique, and paper clips. The studies used several studies in which individuals with multiple disabilities were participants in addition to those with visual impairments. The studies were carried out within the body of Gazi University. The studies have been published in journals that are extensively scanned in the ESCI index. At the end of the research, forward-looking suggestions are presented.

The optimization of zakat funds distribution in Aceh in improving the welfare of the disable

Objectives – The purpose of this study was to determine the optimal level and implementation of the zakat fund distribution program for the Disabled within the perspective of improving the well-being of mustahik.&#x0D; Method – The descriptive qualitative research design is used in this study. In this study, there were five informants, two of whom were key figures. The primary and secondary data sources used in this study were observation, interviews, and documentation.&#x0D; Findings – The study's findings indicate that the distribution of zakat funds for disability has not been carried out optimally, and the funds are channeled through two program criteria, namely moderate disability and severe disability, and have not had a significant impact on improving the welfare of mustahik. Mustahik wishes for more programs, such as those that provide business capital to people with disabilities.&#x0D; Limitation– study only focused on Zakat Fund Compensation Program for the Disabled provided by Baitul Mal Aceh Tamiang regency.&#x0D; Practical Implication– This study demonstrates the need for additional disability compensation programs in Baitul Mal, Aceh Tamiang Regency, such as providing business capital to disabled people so that they can feel prosperous.&#x0D;