Aural rehabilitation is defined as a comprehensive service which includes hearing aid fitting, hearing aid orientation, auditory training, and informational/educational counseling for people with hearing loss in order to reduce deficits of auditory function, difficulty in communication, and limited social activity, and ultimately to enhance their quality of life. Although it is well known that auditory training among a large scope of the aural rehabilitation is critical to improve residual hearing of hearing-impaired adults and/or older adults, there are some limitations to conduct it in the clinic in terms of time consuming and individual difference. In this review paper, we introduce two of the most popular web-based auditory training programs, namely Listening and Communication Enhancement And customized learning: Exercises for Aural Rehabilitation. The paper analyzes their purpose, contents, effect (or benefit) of auditory training, and clinical application, while arguing their pros and cons. In conclusion, we discuss a necessary of developing auditory training platforms for the hearing-impaired adults and older adults, and then of forging systematic web-based auditory training tools with a low-cost and high efficiency because aging population is rapidly increasing in Korea.
Adult ; Aging ; Correction of Hearing Impairment* ; Counseling ; Education* ; Exercise* ; Hearing ; Hearing Aids ; Hearing Loss ; Humans ; Individuality ; Korea ; Learning* ; Quality of Life

OBJECTIVES: The aim of this study was to analyze the current status and problems of hearing screening tests for newborns in low-income families in the southeastern Korea.METHODS: This study analyzed data from the Ministry of Health and Welfare's project on the early detection of hearing loss in newborns in low-income families in the southeastern Korea (2011-2015).RESULTS: The referral rate was 1.33, 1.69, and 1.27% in Daegu, Gyeongbuk, and Ulsan, respectively. The confirmatory test rate was 36.09, 23.38, and 52.94% in Daegu, Gyeongbuk, and Ulsan, respectively. The incidence of hearing loss (adjusted) was 0.41, 0.62, and 0.41% in Daegu, Gyeongbuk, and Ulsan, respectively. After confirming hearing loss, newborns with hearing handicaps were mostly lost to follow-up, and rehabilitation methods, such as hearing aids or cochlear implants, were not used. The screening tests were performed within 1 month of birth, and the confirmatory tests were generally performed within 3 months of birth. However, more than 3 months passed before the confirmatory tests were performed in infants with risk factors for hearing loss in Gyeongbuk and Ulsan.CONCLUSIONS: Hearing screening tests were conducted in newborns from low-income families in southeastern Korea who received a coupon for free testing, but the newborns that were referred after the screening tests were not promptly linked to the hospitals where confirmatory tests were performed. Furthermore, hearing rehabilitation was not consistently performed after hearing loss was confirmed. To successful early hearing loss detection and intervention, a systematic tracking system of hearing loss children is needed.
Child ; Cochlear Implants ; Correction of Hearing Impairment ; Daegu ; Gyeongsangbuk-do ; Hearing Aids ; Hearing Loss ; Hearing Tests ; Hearing ; Humans ; Incidence ; Infant ; Infant, Newborn ; Korea ; Lost to Follow-Up ; Mass Screening ; Parturition ; Referral and Consultation ; Rehabilitation ; Risk Factors ; Ulsan

OBJECTIVES: The aim of this study was to analyze the current status and problems of hearing screening tests for newborns in low-income families in the southeastern Korea. METHODS: This study analyzed data from the Ministry of Health and Welfare's project on the early detection of hearing loss in newborns in low-income families in the southeastern Korea (2011-2015). RESULTS: The referral rate was 1.33, 1.69, and 1.27% in Daegu, Gyeongbuk, and Ulsan, respectively. The confirmatory test rate was 36.09, 23.38, and 52.94% in Daegu, Gyeongbuk, and Ulsan, respectively. The incidence of hearing loss (adjusted) was 0.41, 0.62, and 0.41% in Daegu, Gyeongbuk, and Ulsan, respectively. After confirming hearing loss, newborns with hearing handicaps were mostly lost to follow-up, and rehabilitation methods, such as hearing aids or cochlear implants, were not used. The screening tests were performed within 1 month of birth, and the confirmatory tests were generally performed within 3 months of birth. However, more than 3 months passed before the confirmatory tests were performed in infants with risk factors for hearing loss in Gyeongbuk and Ulsan. CONCLUSIONS: Hearing screening tests were conducted in newborns from low-income families in southeastern Korea who received a coupon for free testing, but the newborns that were referred after the screening tests were not promptly linked to the hospitals where confirmatory tests were performed. Furthermore, hearing rehabilitation was not consistently performed after hearing loss was confirmed. To successful early hearing loss detection and intervention, a systematic tracking system of hearing loss children is needed.
Child ; Cochlear Implants ; Correction of Hearing Impairment ; Daegu ; Gyeongsangbuk-do ; Hearing Aids ; Hearing Loss ; Hearing Tests ; Hearing* ; Humans ; Incidence ; Infant ; Infant, Newborn* ; Korea* ; Lost to Follow-Up ; Mass Screening* ; Parturition ; Referral and Consultation ; Rehabilitation ; Risk Factors ; Ulsan

OBJECTIVE: Because of communication difficulties, the hearing-impaired face many disadvantages throughout their lives. One of those is limited access to health care services, particularly medication service. Though they suffer from problems related to taking medication properly, there have been few studies on their actual condition of medication use in Korea. This study is to investigate any obstacles to properly taking medications and, therefore, to suggest preliminary evidence for policy measures to improve safe medication use among the hearing-impaired. METHODS: Study participants consisted of hearing-impaired individuals living in Seoul. We also interviewed two sign language interpreters in order to illuminate health care state of the hearing-impaired. In-depth interview for each study participant was recorded and was translated into a written script for analysis. RESULTS: Study participants were comprised of four women (66.6%) and two men (33.3%). There were one participants in 20's, two participants in 30's, one 40's, and two 50's. Sign language interpreters were all women. One was in her 30's and the other was in her 40's. Communication difficulties have been found to be key barrier to use medication safely. A negative image of pharmacists also hinders safe medication usage, lowering access to local pharmacy and leading discretional self-medication. This article provides pharmacists with solutions to promote adherence in this population. CONCLUSION: The hearing-impaired had limited access to medication-related information as well as using services in a hospital and local pharmacy due to their disability. Institutional improvement for safe medication usage among the hearing-impaired is necessary.
Delivery of Health Care ; Female ; Health Services Accessibility ; Hearing ; Humans ; Korea ; Male ; Pharmacists ; Pharmacy ; Seoul ; Sign Language

Alzheimer's disease (AD) is a neurodegenerative disorder in which neuronal loss causes cognitive decline and other neuropsychiatric problems. It can be diagnosed based on history, examination, and appropriate objective assessments, using standard criteria such as the Diagnostic and Statistical Manual of Mental Disorders or the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA). Brain imaging and biomarkers are making progress in the differential diagnoses among the different disorders. The cholinesterase inhibitors, donepezil, rivastigmine and galantamine and N-methyl-D-aspartate receptors antagonist memantine are approved by the US Food and Drug Administration for AD. Recently some acetylcholinesterase inhibitors gained approval for the treatment of severe AD and became available in a higher dose formulation or a patch formulation. Optimal care in AD is multifactorial and it should include early diagnosis and multidisciplinary care with pharmacological and nonpharmacological interventions including exercise interventions, cognitive interventions and maintenance of social networks.
Alzheimer Disease* ; Biomarkers ; Cholinesterase Inhibitors ; Communication Disorders ; Diagnosis* ; Diagnosis, Differential ; Diagnostic and Statistical Manual of Mental Disorders ; Early Diagnosis ; Galantamine ; Memantine ; Neurodegenerative Diseases ; Neuroimaging ; Neurons ; Receptors, N-Methyl-D-Aspartate ; Rivastigmine ; Stroke ; United States Food and Drug Administration

Implantable devices for aural rehabilitation are widely developed worldwide. In the manuscript, we review the implantable middle ear hearing devices currently in use, such as the Vibrant Soundbridge system (Med-El Corporation), the MAXUM system (Ototronix LLC), the fourth-generation of Carina prosthesis (Otologics LLC), and the Esteem device. Implantable hearing aids will unquestionably be the major drivers of advancement in otologic practice in early future, improving the quality of life of an increasingly aged population, which will consequently require increased levels of hearing support.
Correction of Hearing Impairment ; Ear, Middle* ; Hearing ; Hearing Aids ; Ossicular Prosthesis* ; Prostheses and Implants ; Quality of Life

BACKGROUND AND OBJECTIVES: Although popular as a method for aural rehabilitation with hearing impairment, hearing aids are susceptible to inflow of foreign materials such as water, sweat, and dust, causing corrosion of the circuit board and eventual device failure. Performance of hearing aids is evaluated by assessing the applicability of hydrophobic nano-coating technique using waterproof hearing aids electronic devices. SUBJECTS AND METHOD: Performance was evaluated using a Fonix 7000 for the maximum output sound pressure level (Max OSPL 90), high frequency average full on gain (HFA FOG), total harmonic distortion and input noise level for 13 hearing aids. Nine of the 13 hearing aids were tested after nano-coating was applied to 2.5 µm of thickness. Fro the immersion test, hearing aids were subjected to 1 m of depth of water and performance was immediately measured; they were also measured after a day and also after a month. RESULTS: In the coated group, Max OSPL 90, HFA FOG were significantly reduced but the corrosion of the circuit board was not observed. The four hearing aids without nano-coating failed to work immediately after the immersion test. However, there were no changes in performance after a month of immersion in any of the aids. For the non-coated group, corrosion of the circuit board was observed after 1 month. CONCLUSION: Nano-coating is a competitive technology and an advangtage to have to ensure waterproof effect and corrosion prevention. Thus it should be recognized as essential technology to enhance performance of hearing aids.
Correction of Hearing Impairment ; Corrosion ; Dust ; Equipment Failure ; Hearing Aids* ; Hearing Loss ; Hearing Tests ; Hearing* ; Immersion ; Noise ; Pilot Projects* ; Rehabilitation ; Sweat ; Water ; Weather

BACKGROUND AND PURPOSE: The apolipoprotein E (Apo E) epsilon4 allele is known to be a risk factor for Alzheimer's disease (AD). However, there are debates about the relationship between Apo E epsilon4 frequency and subcortical vascular dementia (SVaD). We compared the frequency of the Apo E epsilon4 allele in AD and SVaD in Koreans. METHODS: The study was comprised of 400 subjects who visited the Dementia Clinic at Daegu Catholic University from July 2007 to December 2011. Neuropsychological tests, a brain MRI, and blood laboratory tests were performed on all subjects. Two hundred and ninety subjects were AD, 32 subjects were SVaD and 78 subjects were normal. The diagnosis for SVaD was based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and Erkinjuntti criteria, and the diagnosis for AD was based on the DSM-IV and National Institute of Neurological and Communicative Disorders and Stroke and Alzheimer's disease and Related Disorders Association criteria. Apo E polymorphism was genotyped in all subjects. RESULTS: The Apo E epsilon4 allele frequency was 17.4% in AD, 10.9% in SVaD and 8.3% in the normal group (p=0.03). The odds ratio (OR) after age adjustment for AD conferred to the Apo E epsilon4 was 2.04 (p=0.04). But, the OR for SVaD conferred to the Apo E epsilon4 allele was 1.34 (p=0.62), indicating that the Apo E epsilon4 allele does not significantly confer the risk of SVaD. CONCLUSIONS: Apo E epsilon4 is a reliable predictor of AD but has modest efficacy for predicting SVaD in Koreans.
Alleles ; Alzheimer Disease* ; Apolipoproteins E ; Apolipoproteins* ; Brain ; Communication Disorders ; Daegu ; Dementia ; Dementia, Vascular* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Gene Frequency ; Magnetic Resonance Imaging ; Neuropsychological Tests ; Odds Ratio ; Risk Factors ; Stroke

OBJECTIVE: Comorbid depression is common in patients with Alzheimer's disease (AD). An increase in white matter lesions (WMLs) has been associated with depression in both elderly individuals with normal cognition and patients with Alzheimer's disease. We investigated whether the severity and location of WMLs influence the association between WMLs and comorbid depression in AD. METHODS: We enrolled 93 AD patients from Seoul National University Bundang Hospital. We administered both the Mini International Neuropsychiatric Inventory (MINI) and the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K) clinical and neuropsychological battery. Subjects also underwent brain magnetic resonance imaging (MRI). We diagnosed AD according to the criteria of the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association. We diagnosed depressive disorders according to the DSM-IV diagnostic criteria, and evaluated the severity of depressive symptoms using the Korean version of the Geriatric Depression Scale (GDS-K). We quantified the WML volumes from the brain MRI using a fully automated segmentation algorithm. RESULTS: The log of the WML volume in the frontal lobe was significantly associated with depressive disorders (odds ratio=1.905, 95% CI=1.027-3.533, p=0.041), but not with the severity of depressive symptoms as measured by the GDS-K. CONCLUSION: The WML volume in the frontal lobe conferred a risk of comorbid depressive disorders in AD, which implies that comorbid depression in AD may be attributed to vascular causes.
Aged ; Alzheimer Disease* ; Brain ; Cognition ; Communication Disorders ; Depression* ; Depressive Disorder ; Diagnostic and Statistical Manual of Mental Disorders ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging ; Seoul ; Stroke

Social concerns about sensorineural hearing loss have been increasing with the advent of an aging society. As most hearing loss is incurable and permanent, audiologic rehabilitation is the only option for restoring hearing. Sensorineural hearing loss includes both sensory loss of the cochlea and functional loss of the 8th cranial nerve. Because sensorineural hearing loss patients often have difficulty in understanding and locating specific sounds amidst the other ambient noise, functional amplification with hearing aids in sensorineural hearing loss is challenging work. By applying digital signal processing techniques to hearing aids, hearing rehabilitation has undergone remarkable development in recent years. Herein, the basic concepts underlying digital signal processing are reviewed briefly, followed by a short historical background of hearing aid development. The principles of hearing aid selection, counselling, frequent problems encountered in hearing aid fitting and validation are also discussed.
Aging ; Cochlea ; Correction of Hearing Impairment ; Cranial Nerves ; Hearing ; Hearing Aids* ; Hearing Loss ; Hearing Loss, Sensorineural* ; Humans ; Noise ; Rehabilitation* ; Signal Processing, Computer-Assisted