Objective: Comparing analog and digital hearing aids reducing disability caused by hearing deficiency among moderate to severe sensorineural hearing-impaired persons.
Method and Material: This descriptive-analytic study was carried out on two groups of subjects participated in this study in some audiology clinics of hearing aid since May 2002 to October 2003. Twenty subjects wore analog hearing aids and twenty one subjects wore digital hearing aids. In this study , no subject had previous middle ear or psychological problems. APHAB questionnaire was completed before using hearing aid and 2 months after to determine benefit of hearing aid use. Results: Total score mean of APHAB inventory before and after use of analoge hearing aids were 52.215+6.420 and 32.300+3.443 respectively. Also total score mean of APHAB inventory before and after use of digital hearing aids were 54.9252+9.028 and 26.321+10.916 respectively. There was no significant difference between total mean score of APHAB inventory before and after using analog and digital hearing aids (P=0.058).While there was significant difference between total mean score of APHAB questionnaire before and after use of analog hearing aids (P<0.001) and also before and after use of digital hearing aids (P<0.001). Moreover age, gender , litracy level , occupation , degree of hearing loss and manner of hearing aid usage did not have significant effect on APHAB results. Configuration of loss had siginficant effect on aversiveness subscale before and after use of analog hearing aids (P=0.008). Previous experience and duration of hearing aid usage had significant effect on aversiveness subscale before and after use of digital hearing aids (P=0.043) and (P=0.024), respectively , while all of these three items did not have significant effect on total mean score of APHAB inventory and also total mean scores of three subscales of ease of communication , reverberation and background noise.
Conclusion: Comparing to analog hearing aid , digital one is significantly benefitial for reverberation and background noise for hearing-impaired persons , but it has no benefit for ease of communication and aversiveness that may be arised from effects of the individual expectation , psychological and personal factors.

Background and Aim: In recent years, attention of the health care managers is attracted to three factors including promotion of services quality, accessibility and procurement of financial resources of relevant organizations. The aim of this study is to consider the executive status of guideline of managed health care for preoperative assessments of ENT patients at Bazarganan Hospital in 2005.
Materials and Methods: The present research is conducted on 140 cases in descriptive form. The research information is collected by using a check list. Indexes and method of descriptive statistics are used for the data analysis and statistical study.
Results: Of one hundred and forty ENT patient records, in 136 (97%) of the cases American Society of Anesthesia criteria had been registered. Vital signs, patient histories and CBC were recorded in 137 (98%), 138 (99.5%) and 139 (98.3%) patients recordes, respectively. Eight (69.7%) over 60 years old cases had been X-rayed. EKG has been performed on all fifteen cases over 40 years old. Thirty nine (28%) recordes contained internist and cardiologist counselling.
Conclusions: Assessment of guidline indicates very good status. Application of managed care guidelines of preoperative assessment in ENT surgeries could play a crucial role in reducing complication of ENT surgeries and the improvement of the implication of the guidelines.

Background and Aim: Self-reported and questionaire method for hearing impairment assessment allow us to study and to detect the invisible related issues, while They can not be done by traditional audiometry procedures. The purpose of this study is to compare measurement of hearing handicap using self-reported and staff version of NHHI and hearing thresholds in nursing home residents.

Materials and Method: The study participants were 43 individuals, 23 males and 20 females, aged 45-95 years. Pure tone average were calculated after conventional Pure tone audiometry . the self- and staff- reported questionnaire were also fulfilled.

Results: Nine (20.9%) individuals have normal hearing, 6 (14%) have slight, 10 (23.3%) mild, 7 (16.3%) moderate, 6 (16.3%) moderate to severe, 4 (9.3%) severe, and 1 (2.3%) profound hearing loss. Mean score of self and of staff reported versions were 32.22 % +29.31 and 32.67% +30.98, respectively. According to Kruskal-wallis test, there were significant correlation between self-reported and hearing level and between staff-reported and hearing level. The Pierson coefficient variation test between self and staff-reported, and self-reported and hearing level, staff-reported and hearing level showed significant correlation.

Conclusion: The NHHI self assessment associated with other equipments significantly improved the identification and assessment of adults and elderly hearing handicap in nursing home residents. According to the study condition, it may be concluded that the self and staff version of NHHI questionnaire are significantly identical and can be used instead.

Background and Aim: Hearing assessment in infants and children younger than two years is an important issue, because the golden time of the language learning and speaking is under the age of two. Steady state auditory evoked potentials (SSAEPs) is one of the best ways of the objective hearing assessment for infants and young children. The need for long time of stimulation and recording restricted the clinical uses of this method. Therefore, the reduction of the recording time is a common problem. SSAEP signals are contaminated with background EEG signals of the brain and nervous system. To discriminate these signals the approach is using averaging method.
Materials and Methods: In this work two adaptive methods were programmed and tried on (SSAEP) signals. The first method was the work of the Ziarani et al. and the second was the enhanced Kalman filter. To assess suggested methods and to compare them with traditional averaging one, two sets of clinical signals prepared with Rotmen research group in university of Toronto were applied.
Results: The speed of the extraction of the SSAEP signals with the Ziarani method is 1.6 times faster than the averaging method. The extraction time of the enhanced adaptive Kalman filter is 13.1 times faster than currently used averaging methods.
Conclusion: The Kalman filter method seems to be more reliable than the other two methods. In addition, this new application of the Kalman filter in hearing assessment could be more beneficial and faster than other methods as an objective method.

Background and Aim: Internal Evaluation means assessment of abilities and potentials. To promote the quality of education, research, health and finally rehabilitation is one of the most important roles and responsibilities of the universities. Promotion of quality of the theoretical and practical education for the Audiology students provides this major with its final goal that is to serve society. The purpose of this study was to evaluate the strength, weaknesses, opportunities and threats (SWOTs) of the Audiology department and to identify the ways of diminishing weaknesses and threats.
Materials and Methods: This descriptive cross-sectional study was conducted on undergraduates, postgraduates, graduates, academic staff, and the director of Audiology department in 9 areas, including management flowchart, educational programs, instructional methods and curriculum models, students, educational areas and equipments, graduate, academic staff, research, and treatment. Data were collected by questionnaires. Results were analyzed descriptively and were expressed in raw and percentage.
Results: The scores of areas in two measures were as follows: management flowchart 4.36 (87.31%), educational programs 4.17 (83.58%), instructional methods and curriculum models 4.01 (80.26%), students 3.43 (68.60%), educational areas and equipment 3.60 (72.11%), from the view of undergraduates, post graduates, faculties, graduates 3.60 (72.03%), academic staff 4.03 (80.6%), research 3.52 (70.4%), and treatment 4.54 (90.80%). The highest score was, therefore, of the treatment area and the lowest belonged to the educational area and equipments. The score of the Audiology department, as the main factor was 3.89 out of 5 which was 77.88%.
Conclusion: Audiology group total score indicates the desirable status that can be promoted to the most desirable if SWOTs are considered.

Background and Aim: In recent years, several tools for assessment of quality of patient life have been designed especially for dysphonics. Nowadays, we have useful assessments in health system that are refered for numerous clinical decisions. In this way, this investigation compares clinician and patient perception in dysphonic and normal voiced for first time.

Methods: This study was carried out on 30 dysphonic and 30 subjects with normal voice. Their age, sex and job were same. In two groups, Consensus Auditory - Perceptual Evaluation of Voice (CAPE-V) was used for evaluation of clinician perception and Voice Handicap Index - 30 (VHI-30) for assessment of patient perception. After collecting data, they were analyzed by Mann- witney and Wilcoxon tests.

Results: The research revealed that mean of total and each section score of VHI-30 have significant difference between dysphonic and control group (p<0.01). Comparison of total and every parameter score of CAPE-V and speed also indicated significant difference between two groups (p<0.01). Study of reliability shows weak reliability (r=0.34) between clinician and patient perception of voice in dysphonics.

Conclusion: Dysphonic patients percept their voice problem different and severe rather than clinicians that shows physical, psychological and social affects of dysphonia. This research confirms that patient - based assessment of voice is necessary to be part of common assessments of dysphonia.

Background and Aim: Vocal abuse and misuse are the most frequent causes of voice disorders. Consequently some therapy is needed to stop or modify such behaviors. This research was performed to study the effectiveness of vocal hygiene program on perceptual signs of voice in people with dysphonia.
Methods: A Vocal hygiene program was performed to 8 adults with dysphonia for 6 weeks. At first, Consensus Auditory- Perceptual Evaluation of Voice was used to assess perceptual signs. Then the program was delivered, Individuals were followed in second and forth weeks visits. In the last session, perceptual assessment was performed and individuals&apos opinions were collected. Perceptual findings were compared before and after the therapy.
Results: After the program, mean score of perceptual assessment decreased. Mean score of every perceptual sign revealed significant difference before and after the therapy (p≤0.0001). «Loudness» had maximum score and coordination between speech and respiration indicated minimum score. All participants confirmed efficiency of the therapy.
Conclusion: The vocal hygiene program improves all perceptual signs of voice although not equally. This deduction is confirmed by both clinician-based and patient-based assessments. As a result, vocal hygiene program is necessary for a comprehensive voice therapy but is not solely effective to resolve all voice problems.

Background and Aim: An imbalance between phonatory subsystems may lead to disturbing phonatory muscular balance and consequently voice disorders. Based on theoretical issues, criterion-based laryngeal manual therapy, as a novel treatment method which is supported by classical laryngeal manual therapy, can improve voice quality using manual maneuvers combined with phonatory tasks. The present study aimed to report the treating effects of this method on hyperfunctional voice disorders.

Methods: Twenty adult participants with hyperfunctional voice disorders by the least three months history of voice disorder were selected. The participant’s voices were assessed multidimensionally using acoustic, audio-pecreptual and stroboscopic assessments before and after treatment.

Results: There were a decrease in jitter (p=0.003) and shimmer (p<0.001) and also, increase in harmonic-to-noise ratio (HNR) (p<0.001) of vowel /a/ after treatment. Besides, there was an increase in harmony to noise ratio (p=0.009) and decrease in jitter (p=0.020) of vowel /i/, too. There were not significant changes in shimmer amount of vowel /i/ (p=0.170) after treatment. There were highly significant changes in all aspects of audio-perceptual (p<0.001) and videostroboscopic (p<0.001) parameters.

Background and Aim: Developing appropriate curriculum for the education of deaf children depends on identifying the needs of this group. We aimed to examine educational rehabilitating needs of hearing-impaired children from the point of view of their parents.

Methods: In this descriptive survey study, data gathering tool was a researcher-made questionnaire completed by 64 parents of deaf children.

Results: Parents expressed that fitness of training with the students in school, willingness to participate in the program, and the use of a uditory-verbal therapy as a good way were the main notification preferences to families of hearing-impaired children, exceptional centers, and advertisements. They emphesied that lack of appropriate facilities, children's pertinacity, and their lack of cooperation prevented the implementation of training programs and curriculum in educational centers and home. Good verbal communication and speech was as the parents' first priority expectation of their child at the end of course. There was a significant difference between parents' opinions about the educational needs and rehabilitation (p<0.05). No significant difference was seen between the parents' suggestions about educational problems of hearing-impaired children (p>0.05). Also, there was no significantly association between the gender of child or the educational level of parents with the parents' view.

Conclusion: It seems that parents should be supported by training workshops and consulting. Also, most of the children in this study were trained auditory-verbally and the results do not mean that other educational and rehabilitation methods have not the discussed characteristics.

Background and Aim: Teachers are a large group of professional voice users that several risk factors and voice demands causes various voice complaints among them. As the voice is multidimensional, the aim of this study was acoustic and perceptual measurement of teachers’ voice and comparing the findings between two groups with many and few voice complaints.

Methods: Sixty female teachers of high school in Sari, north of Iran, were chosen by available sampling to participate in this cross-sectional study. According to a voice complaints questionnaire, 21 subjects located in few voice complaints and 31 in many voice complaints group. After a working day, subjects completed a voice self-assessment questionnaire. Also, teachers’voice were recorded during three tasks including sustained vowels /a/ and /i/, text reading and conversational speech. Acoustic parameters were analyzed by Praat software and 2 speech-language pathalogists performed auditory-perceptual assessment by GRBAS ( Grade, Roughness, Breathiness, Asthenia, Strain ) scale.

Results: Comparing of the voice self-assessment between the two groups demonstrated statistically significant difference (p<0.05) however results of the acoustic and auditory-perceptual measurement did not show significant diffrence.

Conclusion: Despite prevalent voice problems in teachers, there are various conditions in terms of complaints and assessments methods. In this study, only a remarkable deviation documented in the client-based assessments in many voice compliants group in comparison with few voice compliants, which would be probably related to different individual’s perception of voice problem between two groups. These results support paying attention to self-assessments in clinical process of voice problems.

Background and Aim: Auditory-perceptual assessment of voice a main approach in the diagnosis and therapy improvement of voice disorders. Despite, there are few Iranian studies about auditory-perceptual assessment of voice. The aim of present study was development and determination of validity and rater reliability of Persian version of the Consensus Auditory Perceptual Evaluation of Voice (CAPE -V).

Methods: The qualitative content validity was detected by collecting 10 questionnaires from 9 experienced speech and language pathologists and a linguist. For reliability purposes, the voice samples of 40 dysphonic (neurogenic, functional with and without laryngeal lesions) adults (20-45 years of age) and 10 normal healthy speakers were recorded. The samples included sustain of vowels and reading the 6 sentences of Persian version of the consensus auditory perceptual evaluation of voice called the ATSHA.

Results: The qualitative content validity was proved for developed Persian version of the consensus auditory perceptual evaluation of voice. Cronbach’s alpha was high (0.95). Intra-rater reliability coefficients ranged from 0.86 for overall severity to 0.42 for pitch inter-rater reliability ranged from 0.85 for overall severity to 0.32 for pitch (p<0.05).

Conclusion: The ATSHA can be used as a valid and reliable Persian scale for auditory perceptual assessment of voice in adults.

Background and Aim: Speech and language pathologists (SLP) often refer to phonological data as part of their assessment protocols in evaluating the communication skills of children. The aim of this study was to develop the Persian version of the phonological test in evaluating and diagnosing communication skills in Persian speaking children and to evaluate its validity and reliability.

Methods: The Persian phonological test (PPT) was conducted on 387 monolingual Persian speaking boys and girls (3-6 years of age) who were selected from 12 nurseries in the northwest region of Tehran. Content validity ratio (CVR) and content validity index (CVI) were assessed by speechtherapists and linguists. Correlation between speech and language pathologists experts' opinions and Persian phonological test results in children with and without phonological disorders was evaluated to investigate the Persian phonological test validity. In addition, the Persian phonological test test-retest reliability was investigated.

Results: Both content validity ratio and content validity index were found to be acceptable (CVR≥94.71 and CVI=97.35). The PPT validity was confirmed by finding a good correlation between s peech and language pathologists experts' opinions and Persian phonological test results ( r _Kappa =0.73 and r _Spearman =0.76). The percent of agreement between transcription and analyzing error patterns in test-retest (ranging from 86.27%-100%) and score-rescore (ranging from 94.28%-100%) showed that Persian phonological test had a very high reliability.

Conclusion: The results of this study show that the Persian phonological test seems to be a suitable tool in evaluating phonological skills of Persian speaking children in clinical settings and research projects.