By Rajesh Kumar, M.P.H.

As New Zealand entered Level 4 lockdown at the end of March, researchers around the country faced many questions: How do we progress ongoing research that requires face-to-face contact with human participants when there is no certainty about when we will be able to resume contact with others again?  What if the protocols have been finalised and funding already awarded?  And what if your participants are 65 years plus?

Technological solutions came to the rescue of researchers at the Eisdell Moore Centre (EMC) when faced with this very dilemma during the six-week Covid-19 lockdown in New Zealand.

A multi-disciplinary team of researchers from varied disciplines of psychology, audiology and dementia prevention was awarded funding earlier this year to explore the usefulness of a computer-based perceptual training protocol in preserving or improving cognitive performance.

Lead researcher Professor of Psychology Suzanne Purdy says several studies have already demonstrated a link between hearing loss and cognitive impairment, although causal mechanisms are still unknown. And each year lived with unaddressed impairment could potentially be causing deterioration in cognition due to the consequences of sensory deficits such as social isolation.

The focus of much research in this field so far has been on providing individuals experiencing hearing impairment with hearing aids following early diagnosis of cognitive difficulties. But the uptake of hearing aids is not optimal, due to reasons such as clients’ reluctance to wear them and costs associated with the devices.

Conversely, addressing poor hearing and auditory processing through perceptual training may prevent early cognitive decline and prevent or delay dementia. A positive effect of auditory perceptual training on cognition, the researchers believe, could strengthen evidence for sensory deficits having a negative impact on cognition.

Professor Purdy and her team want to see if online auditory perceptual training aimed at enhancing auditory processing can affect cognition in both young and old, so that cognitive decline associated with hearing impairment could be prevented. Currently, there is sparse evidence demonstrating efficacy of computer-based perceptual training in older adults with sensory impairment.

Researcher Dr Joan Leung says the original research planned to take an iPad preloaded with the SoundStorm app to the elderly and an equal number of younger healthy subjects to deliver the perceptual training on site. Prior to this, participants would be assessed at the University of Auckland clinics using a neuropsychological and hearing test battery. Training would ensue and then be followed up by testing to compare and take note of any changes to cognition scores, if any.

Auditory processing testing for speech-in-noise is to be done using the internet version of the University of Canterbury Digit Triplet Test developed by EMC member, Professor Gregory O’Beirne.  This validated test has been described by the researchers as a robust hearing screening test that individuals can access from home, particularly those in rural areas where audiological services are sparse and for those who have mobility issues which restrict attendance at clinical appointments.

Since face-to-face contact was no longer feasible under the Covid-19 lockdown, the team began looking for alternatives for face to face testing and training research protocols.  Acoustic Pioneer (by Matt Barker) involving online auditory training games developed originally for children with auditory processing disorder, was found to be a good online alternative.  Just before the lockdown, the team applied in urgency to the EMC, and received approval, for a variance in the study protocol so that the study could be conducted remotely using this on young and elderly subjects.

Dr Leung says the first part of the study that’s funded by the EMC Grant-in-aid would likely generate qualitative information regarding the feasibility and acceptability of these online tools and the process of remote-testing. Detailed written instructions, and video-conferencing with participants should address any queries during the assessment and/or training stages of the study.

Evaluation of online neuro-cognitive and auditory processing assessments before and after training will determine whether this approach is reliable for future phases of the research.

“This grant will be used to refine the remote-testing and training battery, first with young and then with older (65 years +) healthy control participants” Dr Leung says, “We will take these findings to our colleagues at the Dementia Prevention Research Clinic to propose a collaborative application for larger grants to trial the method on subjects with cognitive impairment.”

When asked about the elderly participants’ access to technology and internet, Professor Purdy quotes anecdotal evidence suggesting that Covid-19 shutdown had motivated families and older individuals to improve access to technology to allow for online video calls and activities during social isolation.

Contrary to the view that older people struggle with technology, she says there is widespread access to digital technology and the internet amongst older New Zealanders [See: “Golden age no stranger to digital age”] and InternetNZ are endeavouring to grow this through their digital inclusion plan, “which is good news for this research.”

“We will provide any support necessary, such as online training on how to use the online tool, to a spouse or caregiver and help them through the process,” Dr Leung adds.

Meagan Barclay, EMC Research Operations Manager and a selection committee member, says when Covid-19 level 4 restrictions came into effect, the EMC management committee decided to take a flexible and pragmatic approach to all grants that had already been awarded. The flexibility included allowing researchers to request variations in protocols or potentially on aims of projects, if it would facilitate research outputs during lockdown.

“This project was a really good example of how researchers Suzanne Purdy and Joan Leung adapted quickly to the changed research environment and explained to us how their study could be entirely conducted online. The results of this project will be really interesting, not just in terms of their direct findings, but also their learnings of conducting research in this way,” says Dr Barclay.

Researchers say the study has also provided them with an opportunity to collaborate with a private company to perform the neuropsychological assessments online. CNS-VS (Computerized Neurocognitive Assessment – Vital Signs) offers customisable neuropsychological test batteries that have been shown to be sensitive and applicable to populations with mild cognitive impairment.

“From our point of view, it’s a win-win situation. By making their products more accessible online, private companies expand their reach, while researchers have opportunities to explore different ways of conducting research with human participants” says Dr Barclay.  “Online research studies provide opportunities to access larger pools of participants as well as potentially improving the efficiency.”

 

(Rajesh Kumar is a former journalist and a part-time consultant at the EMC. He is currently preparing for his PhD in Public Health).

By Rajesh Kumar, M.P.H.

Maintaining clinical audiology services during Covid-19 lockdown posed significant challenges. But out of those challenges have emerged new opportunities for accelerated development of eHealth solutions that could help future-proof the profession.

Ongoing management of tinnitus is one area that could benefit sooner than others with some of the ‘shovel ready’ eHealth solutions. At the Eisdell Moore Centre (EMC), deputy director Associate Professor Grant Searchfield and his team are involved with the development of Tinnitus Tunes, an online repository of clinically proven information, advice and the latest research on tinnitus for patients, researchers and health professionals.

Tinnitus Tunes capitalises on proven techniques honed over 15 years of diagnosis, treatment and ongoing management of tinnitus patients at the University of Auckland Hearing & Tinnitus Clinic, to ensure the expertise can become accessible from anywhere at any time. In its early stages, the web-based tool is already being utilised by people from 34 countries.

Similarly, Tinnibot is a robotic solution that aims to address the lack of access to clinical psychologists for tinnitus clients struggling to deal with their condition.  It offers a virtual alternative in the form of a chatbot that audiologists, GPs or ENT specialists could refer their clients to. Dr Fabrice Bardy, a Hearing Scientist from Europe, recently received EMC funding to study its efficacy and effectiveness for delivering cognitive behavioural therapy (CBT) to tinnitus clients.

“There are very few psychologists who are trained to provided tinnitus counselling, so it made sense to provide the service digitally to increase the reach and make the service accessible to all,” says Bardy, adding that in cases where a chatbot was not proving to be sufficient, an integrated video call platform would make sure the clients can get in touch with a real, human psychologist.

High needs? 

Clinicians say tinnitus lends itself easily to these technological solutions due to the clients’ “high needs” that place a huge demand on limited resources. The situation becomes dire in rural communities, not to mention a Covid-19 type sudden crisis, wherein providing even basic ongoing face-to-face support may not be feasible.

Once the diagnosis is confirmed and treatment and management options are discussed, hundreds of clients do not necessarily need an ongoing in-clinic interaction with their service providers to answer the questions they may have. That’s where an online service like Tinnitus Tunes can provide a viable alternative.

The typical journey of a tinnitus client

Tania Linford, research audiologist and a professional teaching fellow, had to move all her face-to-face consultations with tinnitus clients, booked months in advance, to video chat during the Covid-19 lockdown.

Describing the typical journey of a tinnitus client, she says the consultation with a new client complaining of ringing in the ears includes a comprehensive history taking to find out what may have caused tinnitus and what might be contributing to it, in addition to checking the client’s ear health and general wellbeing.

“Explanation about tinnitus is more effective if I am using a PowerPoint to explain the mechanisms, causes and treatments options…the clients usually need more resources to refer to later on and resources such as Tinnitus Tunes can prove to be extremely useful,” she says of the “informational” counselling.

The next steps usually involve a much more individualised approach following audiometry to perform a full diagnostic hearing test to see if the client has hearing loss and the extent of the loss, speech test and tympanometry to look for eardrum or middle ear issues. The clients still need to visit a physical clinic for these.

Those exhibiting certain ‘red flag’ symptoms such as unilateral tinnitus, pulsatile tinnitus, asymmetry in hearing, conductive hearing loss, unexplained hearing loss, fullness/pressure in the ears, pain in the ears, pulsating tinnitus, middle ear abnormality or sinus issues need to be referred to ENT specialists. And those experiencing despair, depression or anxiety type psychological issues also need to be referred to specialist tinnitus psychologists. Tinni Bot aims to address the latter, Tinnitus Tunes offers informational counselling and ongoing support.

A client perspective

Steve Booth, a tinnitus client currently being helped by the Auckland University Hearing and Tinnitus Clinic, says not many health professionals realise how devastating the condition can be for the sufferers. Their usual advice is: the condition is incurable and they need to learn to live with it for life.

“Ringing in the ears intrudes on every aspect of your life… it becomes the centre of your universe. And learning that the condition is incurable can cause despair, leading to anxiety and depression,” says Booth.

Because the client is unable to function properly in their day-to-day life, the GPs usually put them on anti-anxiety or anti-depression pills, he says, leaving clients at their wits’ end because the root cause of the problem remains unaddressed.

“We want proactive, productive advice. And hope. Not devices or pills…Hope is actually the best thing you can give to a client, under the circumstances,” says Booth.

Having used tinnitus tunes, he says the service can be particularly useful in the initial phase when a million questions are whirling around the heads of the tinnitus clients.

“It acknowledges that tinnitus can be devastating, and reassures that there are thousands of others like me who are suffering the same way and gives clinically proven tools such as brain retraining, the use of white noise, identifying triggers for sudden exacerbations and managing stress to effectively manage the condition and live a normal life.”

Associate Professor Searchfield is hopeful several new solutions will soon begin emerging to fill the tinnitus diagnosis and treatment gaps that currently exist, to create an effective, wraparound digital solution for the clients.

“The (digital solutions) can also be a viable alternative for resource-poor communities in the wider Pacific region where physical access to audiologists and counsellors is extremely patchy or non-existent,” he concludes.

(Rajesh Kumar is a former journalist and a part-time consultant at the EMC. He is currently preparing for his PhD in Public Health).

On 12 February 80 researchers, clinicians, NGOs and industry partners from the hearing and balance sector came together for the Eisdell Moore Centre’s annual symposium.

The symposium celebrated the third anniversary of the Centre and brought the five members of the EMC’s International Science Advisory Board to Auckland for the meeting.

The day saw excellent plenary lectures from two members of the Science Advisory Board; Professor Louise Hickson from University of Queensland and Professor Stefan Launer from Sonova International.

Professor Hickson’s presentation ‘Hearing Rehabilitation Research and Clinical Practice: Working Together for Greatest Impact’, showed the value of active collaborations with clinicians and clinical centres to ensure research outcomes are effectively translated into clinical practice.

Stefan Launer’s presentation ‘Hearing health in the context of healthy living’, provided valuable insight into where he sees the hearing device sector moving, as the importance of healthy hearing on wellbeing as we age becomes more apparent.

In addition to the plenaries, 28 talks and six posters from EMC members showcased the breadth and depth of research being undertaken by the Centre; from basic science through to applied and translational research.  Many of these studies and collaborations have received funding from the Eisdell Moore Centre through the generous donation made by the Hearing Research Foundation.

Overall it was an excellent symposium that showcased the significant progress the Centre has made over the last three years.  Feedback was very positive, with attendees highlighting how these events provide great opportunities for meeting colleagues working in the field of hearing and balance, learning about the most recent research being undertaken in New Zealand and for valuable discussion and collaboration opportunities.

The international Science Advisory Board was very impressed with the research being done in New Zealand and the opportunity that the EMC provides to facilitate collaborative, multidisciplinary research.

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Elizabeth Holt knows Pacific people are facing problems accessing hearing health care, and the Eisdell Moore Centre’s Pacific Research Co-ordinator is looking for answers.

She knows Pacific children in New Zealand are over-represented in otitis media (glue ear) statistics, she knows there are similar problems in many Pacific countries, but she also knows from her PhD research that one Pacific country in particular is the exception to the rule.

“We know the general things that cause barriers for health care access [in New Zealand] for Pacific people,” she says.

“But in terms of [barriers] specifically to do with hearing health and hearing health care services, that’s a little bit more … anecdotal.”

Elizabeth’s work for the Eisdell Moore Centre (EMC) is to improve research on the hearing health of Pacific people in New Zealand and in the Pacific; to identify the issues and barriers they face; and to look at potential solutions.

At the same time, she is working on her PhD, studying the ear and hearing health of Niuean children, and while that research lets her draw parallels with her wider work for the EMC, it is also showing that good access to health services can produce vastly different outcomes.

Elizabeth, who has a Bachelor of Health Science in physiotherapy, a Post-Graduate Diploma in Public Health, and a Master of Public Health, says a key barrier to solving the hearing health issues facing Pacific people has been a lack of solid data.

She discovered that problem when she was on a 2013 internship with the World Health Organisation (WHO) in Geneva as part of her diploma in public health, and it is one of the reasons she’s now working on hearing health.

Elizabeth was tasked by the WHO with finding information on hearing loss and related issues among Pacific people – and she found virtually nothing.

“That made me think, well if the WHO can’t get the information… something needs to be done,” she says. “I realised there was a real need in this area.”

Working in public health in New Zealand, Australia and England for more than a decade, Elizabeth knew health systems were often not responding adequately to peoples’ needs, and tthat made her want to study public health systems in greater depth.

“I was very much aware of how public health can improve the health of populations, [but] I felt like I was always the ambulance at the bottom of the cliff,” she says.

Elizabeth, whose mother is Tongan and who has extensive experience of Pacific life, knew before she took up her five-month internship at the WHO, that there was significant ear disease in Pacific children in New Zealand, but discovering such a lack of meaningful data was an eye-opener.

Building on her diploma, she began her Masters degree in 2014, focusing on otitis media in Pacific children and exploring the potential of a programme to identify its causes, and strategies to reduce it and manage it and its consequences. It’s work that’s part of her programme with the EMC.

She says that with otitis media, Pacific – and Māori – children needing early intervention the most, are often the least likely to get it.

“If you’re looking at it from a public health perspective they’re more likely to be exposed to the risk factors for otitis media, such as poor housing, overcrowding – poverty essentially,” she says.

“[But] barriers to accessing timely health care … is a big problem. [The children] get identified and treated much later than actually they need to be.”

Talking to Pacific health professionals, she says some of the barriers can include stereotyping, while one of the answers, she believes, can be cultural.

“We do know that by providing a Pacific primary health care service, such as we have in West and South Auckland, the patients can speak their own Pacific language, things are done in a culturally appropriate manner – for example they can bring their family – and information can be given in their own language,” she says.

“That reduces the anxiety around accessing a service you feel is not for you.”

Elizabeth’s three-year work programme with the EMC, which started in late 2018, includes understanding the barriers to accessing health care and facilitating research around Pacific hearing health.

She is also conducting a survey of Pacific hearing health services, is working with the EMC to organise a public health hearing course for Pacific clinicians in October, and is following that with a regional meeting with the WHO and The Pacific Community Organisation, which is working to expand ear, nose, and throat (ENT) and audiology services in the Pacific.

At the same time, her PhD on middle-ear health and hearing among children in Niue, where hearing health is so well catered for, is showing what good practice can achieve.

Eisdell Moore Centre Director Professor Peter Thorne says the centre is looking to work such as Elizabeth’s to help drive strategies around Pacific hearing health and to encourage more research.

“The work is critical to the centre,” he said. “We’re committed to seeing more research with Pacific communities as part of our strategic mission.”

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Clockwise from left: Public Health Course for Hearing Impairment participants; Dr Silina Motofaga from the Pacific Community at the Pacific Regional meeting; Public Health Course participants hard at work at the Tāmaki Innovation Campus; Participants of the Pacific Regional Meeting outside the Fale Pasifika, University of Auckland; Dr Shelly Chadha telling us about her career pathway to the World Health Organisation; Prof. Peter Thorne thanking Prof. Andrew Smith for delivering the Course

 

Tuesday the 22 October saw participants from around the Pacific Region gather at the Tāmaki Innovation Campus at the University of Auckland to kick off our Public Health Course on Hearing Impairment. 

12 doctors and nurses working in ENT clinics in Fiji, Samoa, Tonga, Niue, Cook Islands, Kiribati, Vanuatu and Solomon Islands joined participants from audiology clinics, NGOs and professional organisations from around New Zealand for an intensive 4 days of learning about public health approaches to hearing loss. 

Delivered by Prof. Andrew Smith from the London School of Hygiene and Tropical Medicine, the course covered Public Health Planning from strategies for prevention through population-based survey methods and health economics to monitoring and evaluation of public health programs.  Participants also worked together for the 4 days developing their own Public Health Projects that utilised all of their learnings and final presentations of these projects were excellent. 

Feedback on the course was overwhelmingly positive, with all participants indicating they would recommend to others, although our Pacific colleagues did find Auckland a little chilly in October!

 

For a taste of what the course delivered, head to our webinar page, where our November webinar features Prof. Smith discussing “Challenges and Opportunities for Global Public Hearing Health”.

 

The Pacific Regional Meeting on Ear and Hearing Care followed the course and was also hosted by the EMC, in conjunction with the World Health Organisation.  

Dr Shelly Chadha, the Medical Officer for the WHO programme for prevention of deafness and hearing loss, joined us for the meeting alongside the NZ Ministry of Health and a number of other professional organisations and NGO’s from around the Pacific. 

There was a fantastic sense of community throughout the meeting and a shared vision and passion for the cause, with much of the discussion focusing on improvement of service delivery in the Pacific region as well as the development of advocacy and prevention programmes. 

The key outcome of the meeting was that the Pacific ENT and Audiology Group (PENTAG) should be established as an organisation to lead this work going forwards. 

Three PENTAG members are also members of the EMC – Dr Sione Pifeleti from Samoa, Dr Chunghyeon Oh from Fiji and Dr Sepiuta Lopati from Tonga – look out for profiles of our Pacific Colleagues in 2020!

 

We would like to gratefully acknowledge the following for the generous support of the Public Health Course and the Pacific Regional  meeting:

 

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The EMC is thrilled to have Prof. Lin as our Visiting Professor this year. 

We will be hosting seminars in Christchurch, Dunedin and Auckland from 29 October to 1 November in conjunction with The Pindrop Foundation and Brain Research New Zealand.

 

Dr Lin is the Director of the Cochlear Center for Hearing and Public Health and a Professor of Otolaryngology, Medicine, Mental Health, and Epidemiology at the Johns Hopkins University School of Medicine and Bloomberg School of Public Health. His epidemiologic research established the impact of hearing loss on the risk of cognitive decline, dementia, and brain aging in older adults and served as the basis of the 2017 Lancet Commission on dementia conclusion that hearing loss was the single largest potentially modifiable risk factor for dementia. He now currently leads the ACHIEVE study which is a $20M NIH-funded randomized trial investigating if treating hearing loss can reduce the risk of cognitive decline in older adults. As the founder and inaugural director of the Cochlear Center for Hearing and Public Health, Dr. Lin leads a first-in-kind research center that is dedicated to training a generation of clinicians and researchers to understand and address the impact of hearing loss on older adults and public health. You can read more about the Center and his work here

 

For more information on the seminars in the various centres, follow the links below.

 

[/et_pb_text][et_pb_button _builder_version=”3.21.4″ button_text=”CHRISTCHURCH 5pm, 29 October 2019 – Hearing, Aging, and Public Health – From Epidemiologic Insights to Policy” z_index_tablet=”500″ button_url=”https://www.emcentre.ac.nz/files/2019/10/Frank-Lin-seminar_Christchurch.pdf” /][et_pb_button _builder_version=”3.21.4″ button_text=”DUNEDIN 12pm, 30 October 2019 – Hearing, Cognition and Brain Aging” z_index_tablet=”500″ button_url=”https://www.emcentre.ac.nz/files/2019/10/Professor-Frank-Lin-talk-30th-October_Dunedin.pdf” /][et_pb_button _builder_version=”3.21.4″ button_text=”AUCKLAND 12 pm, 1 November 2019 – Hearing, Cognition and Brain Aging” z_index_tablet=”500″ button_url=”https://www.emcentre.ac.nz/files/2019/10/Advert_Seminar_Frank-Lin_b.pdf” /][/et_pb_column][/et_pb_row][/et_pb_section]

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Left to right: Melissa Baily, Dr Bill Keith, Professor Suzanne Purdy and Flora McKay (not pictured) wrote the New Zealand Guidelines for Auditory Processing Disorder.

 

Guidelines for identifying and treating auditory processing disorder are set to become a key resource for clinicians here and overseas, and are a major milestone in dealing with a condition that affects tens of thousands of New Zealand children.

The New Zealand Guidelines on Auditory Processing Disorder, launched on August 29 by the New Zealand Audiological Society and the Eisdell Moore Centre at the University of Auckland, have been more than three years in the making.

Co-author Dr Bill Keith says the comprehensive and detailed guidelines will be distributed to clinicians and professional groups in New Zealand and overseas, and will also be a resource for those with the condition and their families.

Auditory processing disorder (APD) affects our ability to understand and process what we are hearing, and was described in a recent research grant application as “the most neglected and under-funded area of hearing and deafness services in New Zealand”.

A 2014 report on APD, commissioned by the Ministries of Health and Education, estimated 6.2 per cent of children – 60,000 based on 2019 Department of Statistics population figures – are affected, as well as adults (it’s a common consequence of head injury) and the elderly.

Dr Keith says its prevalence among children means “there’s one in every classroom”.

APD has also been linked to dyslexia and other reading and language disabilities, and treatment of APD could potentially benefit people with those conditions as well.

Dr Keith, one of the four authors of the guidelines and a leader in researching and treating the condition, says the state of APD services in New Zealand is “appalling”.

Because it affects a child’s ability to learn, funding for treatment comes from the Ministry of Education, and it’s the only hearing condition whose treatment falls outside the aegis of the Ministry of Health.

“Education doesn’t have the expertise for this,” Dr Keith says. “It’s a health issue – a whole of life issue – not an education issue.”

The impact of APD on children can be profound with researchers preparing the ministry-funded report describing how parents saw their children’s confidence and self-esteem being undermined.

One parent described how her daughter “sat in the toilets at school all day crying”, while another said her son “sits with his hands over his ears in class”. For many parents, the only option was to take their children out of school and teach them at home.

But Dr Keith says that because of the brain’s plasticity, auditory processing disorder is “very treatable”, and that’s where the guidelines hold the key.

The guidelines recommend three main approaches – auditory training, amplification with remote microphone hearing aid systems, and language therapy.

“Through neuroplasticity, auditory training and amplification can engender permanent improvements in auditory skills,” the guidelines say.

The New Zealand Guidelines on Auditory Processing Disorder are the result of work by areference group on APD established by the Ministries of Health and Education following the Sapere report on APD released in February 2014.

Dr Keith said the ministries decided no further work on APD treatment policy would be done until a set of guidelines was prepared, and four authors set to work – Dr Keith who established the SoundSkills APD Clinic a decade ago to build a base of knowledge and research; Professor Suzanne Purdy, an international expert on APD and now head of the School of Psychology at the University of Auckland; Melissa Baily, an audiologist at the Ministry of Health; and Flora Kay, the public hospital representative of the NZ Audiological Society.

The draft guidelines were completed in 2017, then went out for review in the sector and by four international peer reviewers in Britain, the United States, Canada and Australia.

Now the guidelines have been launched, Dr Keith says the next step is to go back to the ministries to address the key element in dealing with APD – funding for treatment and support for children with the condition, as well as adults, and the elderly

“The guidelines are essential in themselves, but they are also a step towards the goal of reconvening the reference group, developing policy, and getting funding for treatment.”

A copy of the guidelines is available for download here

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Māori have the highest rate of self-reported disabling hearing loss in New Zealand and Alehandrea (Aleh) Manuel is leading research into how sufferers are accessing services to do something about it.

The work is part of both an Eisdell Moore Centre (EMC) programme and a PhD for the centre’s Māori Hearing Research Co-ordinator – looking at Māori experiences with hearing loss and hearing health services, and at how clinicians provide services and work alongside them.

A key element of Aleh’s approach is rooted in kaupapa Māori research by Māori, for Māori, with Māori – research that recognises one size does not fit all.

“There’s the Māori world, there’s the Western world, there’s the Hard-of-hearing world, there’s the Hearing world, there’s the Deaf world,” she says.

”The current hearing health care system has been built to favour the dominant Western Hearing world”.

Aleh, who is an audiologist and has a Bachelor of Health Science and a Post-Graduate Diploma in Public Health, says she’s aware of the issues facing Māori accessing general health services, including racial, cultural, financial and geographical, and she wants to understand if the same issues apply to hearing health care as well.

She says the cultural barriers can include issues such as lack of culturally appropriate environments, and limited cultural safety training, while health literacy (understanding terminology and documents), and education about the problems can also be factors.

Her work dovetails with her PhD titled Taringa Whakarongo (Listen with your ears) that is studying older Māori and whānau experiences and perspectives of the same issues.

For Aleh, the issue is personal.

“Members of my whānau have occupational noise exposure hearing loss” she says.

“My uncle has one-sided deafness from birth and my partner’s mother has an acoustic neuroma – a tumour in the auditory pathway – that has been removed, but that side has lost hearing.”

Another driver for her research came in 2013 summer internship with Dr Grant Searchfield at the University of Auckland looking into barriers to hearing health care services for Māori and Pacific peoples that turned up a disturbing result – there was little information to be found.

That, coupled with her personal experience, developed a “need” to do something about Māori hearing health, and in 2013 she moved to Queensland to add a Master of Audiology to her suite of qualifications.

She turned down the opportunity to attend medical school to do it.

“There was something in me that wanted to go to hearing health care,” she says. “My whānau were like, ‘why, why?’ and I’m like ‘because I have found a passion in this area’.”

After completing her audiology degree in Brisbane at the end of 2014, Aleh, who is Māori-Filipino and of Tuwhakairiora, Ngāti Porou descent, worked in Townsville for three years on new-technology wideband research for diagnosing middle-ear issues. It was her work there that confirmed her heart was in hearing health care for indigenous people.

Aleh returned to New Zealand in 2018 to start her PhD, and this year began her work for the EMC. She also works part-time as an audiologist at Auckland’s Greenlane Hospital.

Her brief from the Eisdell Moore Centre is to build networks and connections with communities to facilitate safe research for Māori in hearing health care, and to learn ways where clinicians and researchers can work with Māori communities in a culturally appropriate manner.

“One word for my role is facilitator.”

Aleh says the Treaty of Waitangi is a key element in the health equation because it covers self-determination – a principle that applies to the right of Māori to determine issues like care for their hearing health and how they access it.

“Everyone has the right to have access to quality health care,” she says. “What the document is saying is tangata whenua have the right to self-determine that from their own way, and we have a responsibility to honour Māori ways of knowing and thinking.”

One of the keys to achieving that is quality research that will identify attitudes and barriers, and potential strategies and solutions – work that for Aleh is a passion.

 

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The Eisdell Moore Centre at the University of Auckland is pleased to be holding this short course that introduces public health approaches to hearing impairment and provides tools for advocacy and health promotion.

 

When: Tues 22 – Fri 25 October 2019

Where:  Tāmaki Campus, The University of Auckland, 261 Morrin Road, St Johns, Auckland, New Zealand

Cost: NZ$240 for New Zealand and Australian Participants, which includes catering for the 4 days and all course materials.

 

Background:  466 million people in the world have disabling hearing loss.  Hearing loss and ear disease is estimated to have a high prevalence among Māori and Pasifika communities in New Zealand and in communities in Pacific Island Countries (PICs) where there is a lack of supported national programmes and strategies to prevent and manage hearing loss.  A public health approach is advocated to tackle the growing problem of hearing loss and ear disease. 

Aim: To enable participants to understand the magnitude and causes of hearing impairment and the challenges of providing ear and hearing healthcare to underrepresented communities and in Low to Middle Income Countries. The course will familiarise participants with public health approaches to ear and hearing health and show how to develop programmes for hearing loss prevention and management.

 Target Audience:

[/et_pb_text][et_pb_button _builder_version=”3.21.4″ button_text=”Download a Full Course Description here” z_index_tablet=”500″ button_url=”https://www.emcentre.ac.nz/files/2019/08/Advert-Public-Health-Planning-for-Hearing-Impairment-1.pdf” /][et_pb_button _builder_version=”3.21.4″ button_text=”Download the Draft Programme here” z_index_tablet=”500″ button_url=”https://www.emcentre.ac.nz/files/2019/09/EMCAuckland-PHPHI-2019-Draft-programmeGENERAL-2.pdf” /][et_pb_text _builder_version=”3.21.4″ z_index_tablet=”500″]

 

REGISTRATION

New Zealand and Australian Residents can register here

Pacific Island Country Residents can register here

 

ENQUIRIES

For specific enquiries or to have an informal chat about the course, please contact:

Elizabeth Holt

EMC Pacific Research Coordinator

e.holt@auckland.ac.nz 

OR

Meagan Barclay

EMC Research Operations Manager

m.barclay@auckland.ac.nz

 

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Members of the Eisdell Moore Centre, with support from the Ministries of Education and Health and the New Zealand Audiological Society have been working hard over the last couple of years to develop New Zealand Guidelines for Auditory Processing Disorders (APD).  These guidelines provide evidence-based, practical guidance for clinicians and education personnel providing APD services, as well as providing information for the wider community involved with people with APD. 

The Eisdell Moore Centre is very pleased to be hosting the launch of these guidelines in conjunction with the New Zealand Audiological Society who will be publishing the guidelines.

When: 29 August 2019, 5 – 7pm

Where: Function Room 220, Building 730, Tāmaki Innovation Campus, University of Auckland, 261 Morrin Road, St Johns, Auckland.

Program:

5pm: Drinks and nibbles

5:30pm: Karakia mo te whakawatea taonga and welcome from the EMC Director, Prof. Peter Thorne. 

5:40pm: Comments on the need for these guidelines by representatives from the Ministries of Education and Health and Hear4Families, the APD Consumer Support Group in New Zealand.

6:10pm: Presentations from Dr Bill Keith and Professor Suzanne Purdy on the diagnosis and treatment of APD and what the guidelines mean for clinicians, educators and communities.

6:30pm: Closing remarks and acknowledgements by NZAS President Libby Gibbins, followed by further networking.

 

To attend this event, please RSVP here

 

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