Hearing Journal最新文献

{"title":"A New Definition of Noise","authors":"Daniel Fink","doi":"10.1097/01.hj.0000995260.15519.9e","DOIUrl":"https://doi.org/10.1097/01.hj.0000995260.15519.9e","url":null,"abstract":"There’s a new definition of noise: Noise is unwanted and/or harmful sound.1 The new definition replaces the obsolete definition—Noise is unwanted sound. This change was adopted by the International Commission on Biological Effects of Noise at its 14th Congress in June.2Editorial, noiseWhy is a new definition needed? The American National Standards Institute and Acoustical Society of America Standard 2.32 definition is Noise. (a) Undesired sound. By extension, noise is any unwanted disturbance within a useful frequency band, such as undesired electric waves in a transmission channel or device. (b) Erratic, intermittent, or statistically random oscillation.3 (Other organizations and many dictionaries use the definition noise is unwanted sound.) This definition, developed by the Acoustical Society of America almost 100 years ago in the early days of acoustical science, misses two main problems. First, it puts the onus on anyone complaining about noise, implying that we are complainers, weak, neurotic, or perhaps trying to stop the advance of progress. Second, it ignores what is now known about the adverse auditory and non-auditory health effects of noise exposure.4 Noise has been called “the new secondhand smoke.”5 With the old definition of noise, those of us who want a quieter world were in the same place as we were in the 1980s and 1990s, when we wanted smoke-free restaurants, stores, doctors’ waiting rooms, workplaces, planes, and trains. Smoking was seen as a harmless habit, and those who asked that someone refrain from smoking in their presence were viewed as fussy or self-centered, trying to interfere with the smoker’s harmless pleasure. That changed to a certain extent in 1964, when the first Surgeon General’s Report on Smoking and Health was published6, but smoking was still commonplace. Much greater progress was made after 1993, when the Environmental Protection Agency determined that environmental tobacco smoke, commonly called secondhand smoke, was a health hazard causing cancer with no known safe lower level of exposure.7 Our concerns about secondhand smoke suddenly became health concerns. Regulators and legislators started listening to us—despite Big Tobacco’s claims that smokers’ freedom to smoke was being restricted, a sneaky campaign by Big Tobacco raising doubts about the dangers of tobacco smoke and postulating other causes of cancer in smokers8 and those in the hospitality business expressing concerns about decreased revenue if people couldn’t smoke in their establishments. Of course, there were no major causes of lung cancer in smokers other than smoking, and multiple studies show that if smokers didn’t patronize restaurants and bars that didn’t allow smoking, others who didn’t want a side order of secondhand smoke with their meal were glad to return to restaurants.9 The end result, with cigarette taxes increased, cigarette advertising limited, and smoking becoming socially unacceptable, was that millions of smokers quit and the","PeriodicalId":39705,"journal":{"name":"Hearing Journal","volume":"39 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136105399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inspiring Success at Your Practice Part 2: The 7 Levels of Energy To Elevate Employee Engagement","authors":"Amy Badstubner, Kari Morgenstein Dermer","doi":"10.1097/01.hj.0000995256.76987.1b","DOIUrl":"https://doi.org/10.1097/01.hj.0000995256.76987.1b","url":null,"abstract":"This three-part series explores different aspects of professional coaching. Catch up with Part 1: Leading With a Coaching Mindset here: https://bit.ly/3tmfhmh.Figure 1: The above image shows the thoughts, feelings, and actions associated with each of the 7 Levels of Energy. Chart adapted from work done by Bruce D. Schneider. Employee engagement, Energy Leadership Index Assessment, practice management, practice management series.The concept of employee engagement has evolved significantly over time. Its multifaceted nature makes it a topic that can be easy to talk about, but hard to implement. Undoubtedly, in today’s landscape, employee engagement holds unparalleled significance, particularly within the health care sector, where its relevance has surged to unprecedented heights.1,2 However, it is possible that conventional strategies to drive engagement have fallen short in meeting contemporary challenges. In our coaching group, both with clients and for our own team, we use the 7 Levels of Energy Framework.3 This system not only offers a fresh perspective, but also a structured methodology that is easy to grasp and has the power to amplify employee engagement. THE 7 LEVELS OF ENERGY FRAMEWORK By leveraging the various energy levels described by Schneider, we can delve deeper into the motivations, attitudes, and behaviors that shape employee engagement. This approach not only enriches our understanding of employees and how employees show up, but also equips organizations with a toolkit capable of driving sustainable change. Let’s clarify what we mean by “energy” for this article. Don’t worry—we are not revisiting your psychoacoustics class or asking you to make any calculations. Here, energy refers to the lens or filters you have that shape your perceptions, attitudes, and actions.4 There are 7 Levels of Energy we have the potential to experience day to day (Figure 1). We often experience several levels of energy in one day or even within an hour. It is important to note that no energy level is good or bad; they all have advantages and disadvantages. All the levels serve a purpose. The objective, however, is to raise our awareness so we can recognize how we are showing up and actively choose if that level is serving our needs at the time. It is through this self-awareness and intentional choice that we can harness our personal power for a more fulfilling and purpose-driven life, both personally and professionally.5 EMPLOYEE ENGAGEMENT EXAMPLES Below are examples of what employee engagement might look like for each level of energy. Level 1: “No one understands me. I get overlooked for every opportunity.” “I have been here for 10 years and have never been given a raise. It’s not fair!” Level 2: “I am livid that Sally gets to leave early. Why can’t I?” “My boss makes me so angry because she doesn’t know how hard I work.” Level 3: “Things are fine at my job; it could always be worse somewhere else.” “My boss seems disappointed with me, but it’s all go","PeriodicalId":39705,"journal":{"name":"Hearing Journal","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136105229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prioritizing Hearing Aid Service Delivery Models for Low-Income Communities","authors":"Caitlin Frisby, Karina de Sousa, David R. Moore, De Wet Swanepoel","doi":"10.1097/01.hj.0000995248.41694.44","DOIUrl":"https://doi.org/10.1097/01.hj.0000995248.41694.44","url":null,"abstract":"Millions of individuals worldwide are affected by hearing loss, with a global estimate of 2.5 billion projected by 2050.1 Hearing loss has a profound effect on individuals’ overall quality of life, including communication, social interactions, education, and employment.1–4 However, hearing aid uptake is generally low. In Africa, less than 10% of individuals needing hearing aids acquire them, with some estimates as low as 3%.1,5 The global burden of hearing loss is exacerbated by the limited number of hearing health care services and the lack of trained professionals.1,6 The global shortage of hearing health care professionals, particularly in low- and middle-income settings, is a major challenge to existing service delivery models, which require specialist health care providers. Generally, low- and lower-middle-income regions have one or fewer ENT specialists or audiologists per million population.7 In Africa, 56% and 78% of countries have less than one ENT specialist or audiologist per million population, respectively.7Figure 1: From left: An example of a CHW conducting a hearing assessment; a community member receiving hearing aids; and hearing aids placed in community members’ ears. Hearing aid, service delivery models, low-income communities, telehealth, teleaudiology.Table 1: Important Considerations for Community-Based Hearing Aid Provision Service-Delivery Models.Considering the shortage of services and providers, the World Health Organization (WHO) has identified several key priorities to improve access to hearing health care services. These include community-based care facilitated by minimally trained community health care workers (CHWs) using innovative technologies.1 Task-shifting from professionals to CHWs has been proposed to address the shortage and decentralize access to care.1 This approach could enable CHWs to facilitate screening and assessment of hearing loss, referral of cases requiring medical intervention, fitting low-cost pre-set hearing aids for eligible individuals, and ensuring tailored follow-up care designed for low- and middle-income settings. The WHO has set up a technical working group developing guidelines for hearing aid provision service-delivery models in low-income settings. INNOVATIVE COMMUNITY-BASED HEARING AID PROVISION A recent review8 demonstrated that CHWs can be utilized across a range of hearing health care services and that these services are feasible for community-based hearing care. Services included infant hearing screening in rural areas9 and childhood and adult hearing screening in various decentralized settings.10,11 Studies conducted in Bangladesh and India showcased the effectiveness of community-based hearing aid service provision models facilitated by CHWs.12,13 The Bangladesh study involved CHWs fitting pocket model hearing aids for children, comparing the community-based model to a traditional center-based approach. Both approaches yielded similar outcomes on most items of the International","PeriodicalId":39705,"journal":{"name":"Hearing Journal","volume":"41 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136105223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Diagnostic Indicators of a Contracted Tensor Tympani Muscle","authors":"Ryan C. Mulligan, Antony R. Joseph","doi":"10.1097/01.hj.0000995244.44386.bd","DOIUrl":"https://doi.org/10.1097/01.hj.0000995244.44386.bd","url":null,"abstract":"The tensor tympani muscle (TTM) is a long-striated muscle that originates in a bony canal superior to the cartilaginous section of the Eustachian tube. The tendon of the muscle emerges laterally from the opening of the canal, courses through the middle ear cavity, and attaches at the neck of the manubrium. Contraction of the TTM draws the manubrium of the malleus medially, resulting in an inward displacement of the tympanic membrane (TM) and increased middle ear pressure. TTM contraction has been shown to occur simultaneously with the contraction of the tensor veli palatini muscle (TVPM).1,2 The TVPM assists with swallowing and is considered the primary dilator of the Eustachian tube (ET).3 Both the TTM and TVPM are innervated by the mandibular division of the trigeminal nerve and share continuous muscle fibers.4,5Figure 1: (A) Jerger Type A tympanograms obtained with the TTM at rest, which yielded a normal tracing, bilaterally. (B) A tympanogram obtained during extended TTM contraction, which resulted in a tracing with a reduced peak compliance for both ears. (C, left Column) A tympanogram performed following the Toynbee maneuver resulted in negative peak pressure. (C, right Column) Following TM contraction, a second tympanogram was obtained which revealed a return to relative ambient peak pressure.Figure 2: (A) Repetitive TM contractions were recorded over a 15-second window. Each deflection contained four distinct stages: (1) a reduction in compliance (downward tracing) with TTM contraction, (2) an increase in compliance (upward tracing) with the relaxation of the TTM, (3) a further increase or spike in compliance (upward tracing) above baseline, and (4) a near return to baseline compliance (leveling of the tracing). The brief upward spike in compliance above baseline (arrow) is consistent with the breakage of the ET seal. (B) TTM contraction resulted in upward deflections with negative pressure applied to the EAC. The superimposed dotted line highlights the change in baseline compliance between TTM contractions. This appears to reflect a flow of air bolus through the ET with repeated TTM contraction. (C) Extended TTM contraction over a 15-second window.Figure 3: Right ear pure-tone air- and bone-conduction thresholds were obtained with the TTM in a relaxed state (gray) and contracted (red). TTM contraction resulted in mild low-frequency hearing loss.The TTM has been implicated in numerous conditions including middle ear myoclonus, palatal tremor, and Meniere’s disease; albeit its presumed role in these pathologies is speculative.6–8 A previous report theorized that TTM injury may lead to continuous, tonic TTM contraction with secondary otologic symptoms that include tinnitus, aural fullness, vertigo, and otalgia.9 The principal clinical tool that is used for the assessment of TTM contraction is immittance audiometry. TTM contraction has been shown to produce distinct tympanometric findings such as low static compliance and tracings that chang","PeriodicalId":39705,"journal":{"name":"Hearing Journal","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136105053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The AI Revolution: Rethinking Assessment in Audiology Training Programs","authors":"Prasha Sooful, Andrea Simpson, Mich Thornton, and Bojana Šarkic´","doi":"10.1097/01.hj.0000995264.80206.87","DOIUrl":"https://doi.org/10.1097/01.hj.0000995264.80206.87","url":null,"abstract":"The release of ChatGPT in 2022, a large language model (LLP) trained by Open AI, garnered considerable attention from various sectors, including the technological domain, academic community, and the public.1 In health care settings, the potential for chatbots to enhance patient engagement, facilitate remote care, and improve access to hearing health care services has been increasingly recognized.2 In the realm of higher education, ChatGPT is the subject of extensive research and testing across a range of fields, including law, medicine, and business.3–7 The algorithm has demonstrated impressive adaptability and versatility, positioning itself as a promising tool for teaching and learning, including generating assessments.8Figure 1: Prompts to generate ChatGPT ideas on ways to use it in higher education and specifically Audiology.Table 1: Sample CREATE Prompt for a Specific Audiology Assessment.Table 2: Sample Audiology Assessment Question Co-designed with ChatGPT.Table 3: Example of Assessment Rubric Generated by ChatGPT.Despite the growing recognition of ChatGPT’s potential in higher education, reactions to its use have been mixed due to the increased potential of plagiarism. Institutions have responded to this risk by increasing precautionary measures (i.e., reverting to traditional pen and paper exams and face-to-face oral assessments), prohibition (i.e., banning AI tools with the support of AI detection software), while others have accepted it (i.e., incorporating AI tools into assessment development and design).8–12 Promoting authenticity and academic integrity in assessment continues to present a priority for educational institutions.13–15 Besides providing the foundation for high academic standards and best practice, authentic assessments and academic integrity enrich students with skills that advance their employability, particularly in fields dominated by technological advances, including audiology.16 As a health care profession, most audiology training programs naturally include practical and authentic assessment, such as clinical exams, objective structured clinical exams, simulations, clinical placements, and clinical vivas. These face-to-face assessments reduce the risk of plagiarism, however, they can be time-consuming for staff. In addition, theoretical aspects of the program are usually assessed via written means. It is these written tasks where AI provides both risk and opportunity. CONSIDERATIONS FOR EDUCATORS When creating effective assessment questions using ChatGPT, there are a few key considerations that educators should keep in mind. First, it is important to ensure that the prompts align with the course objectives and the level of complexity appropriate for the intended level of study.15 ChatGPT prompts are a way to enable conversations between users and the AI which can be tailored to specific subjects and can make responses more accurate and efficient. One way to generate a powerful prompt is to use the CREATE model (Cha","PeriodicalId":39705,"journal":{"name":"Hearing Journal","volume":"41 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136105224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New American Academy of Pediatrics Practice Recommendations Address the Hazards of Noise","authors":"Sophie J. Balk","doi":"10.1097/01.hj.0000995236.30278.bb","DOIUrl":"https://doi.org/10.1097/01.hj.0000995236.30278.bb","url":null,"abstract":"Noise exposures experienced by infants, children, and adolescents can be hazardous. Teens—and even young children—use headphones, ear buds, and other personal listening devices. Young people attend concerts, dances, and celebratory events where music is often painfully loud. Noise experienced at young ages can cause hearing loss; other noise effects can adversely affect learning, quality of life, and life trajectories.www.shutterstock.com. American Academy of Pediatrics, AAP, noise, technical report, policy statement, pediatrics, hearing loss, prevention.Noise exposure is poorly understood as a public health hazard. Despite scientific evidence to the contrary, noise is treated differently than many other environmental hazards. If fact, noisy environments—such as restaurants where holding nearby conversations can be difficult without shouting—are often accepted as a given. Two reports from the American Academy of Pediatrics (AAP) highlight children’s susceptibilities to the effects of noise. The Technical Report (https://bit.ly/3tLk80x) provides a scientific basis for a Policy Statement; the Policy Statement (https://bit.ly/46JL27u) gives key information and recommendations to pediatricians, government, and medical and other organizations. AAP reports inform clinical practice and advocacy efforts for 67,000 AAP members and other pediatric clinicians. This article includes concepts and recommendations from these publications. UPDATED DEFINITION Noise has often been defined as “unpleasant or unwanted sound.” A new definition—noise is “unwanted and/or harmful sound”—was adopted by the International Commission on Biological Effects of Noise (ICBEN) in June 2023.1 This definition is more accurate, since harmful noise levels are frequently sought during leisure activities. NOISE CATEGORIES Occupational noise is experienced in the workplace. Environmental noise usually arises from fossil fuel-powered sources. Outdoor sources include road traffic, railways, airplanes and airports, industrial sites, wind farms, leaf blowers, and lawn mowers. Environmental noise has disproportionate effects on underserved communities. Indoor sources include equipment, infant sleep machines, video games, toys, televisions, and classrooms. Recreational noise (“leisure noise”) sources include personal listening devices; restaurants; music at events; sports venues; and recreational firearm use. Listening to music and attending social and celebratory events are very important to many, yet noise from these sources can be hazardous. OCCUPATIONAL STANDARDS Noise-induced hearing loss in adults resulting from workplace and military exposure has been known for centuries. Standards for workplace safety in the United States are set by the National Institute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA). These standards are designed to protect workers from noise-induced hearing loss over 40-year careers. The Recommended Exposure L","PeriodicalId":39705,"journal":{"name":"Hearing Journal","volume":"112 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136105396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptom: Asymmetric Mixed Hearing Loss","authors":"Daim Tabba, Karen Tawk, Mehdi Abouzari, Hamid R. Djalilian","doi":"10.1097/01.hj.0000995252.00927.cc","DOIUrl":"https://doi.org/10.1097/01.hj.0000995252.00927.cc","url":null,"abstract":"A 69-year-old female presents as a consult regarding right-sided hearing loss and tinnitus. She has had the symptoms since the 1970s and was recommended surgery at that time, although it was not pursued. She is currently presenting because her symptoms have become worse over the past five years. The patient additionally endorses migraine headaches with vertigo. The patient denies any family history of hearing loss or ear surgery. Tympanic membranes are normal on microscopy. Weber test shows lateralization to the right ear and Rinne test shows bone conduction greater than air conduction on the right side. The patient had an audiogram completed (see Figure 1).Figure 1: The patient’s audiogram at presentation. Asymmetric mixed hearing loss, round window obliteration, Clinical Consultation.Figure 2: Axial (horizontal) CT of temporal bones showing the obliterated round window in the axial direction on the right. Asymmetric mixed hearing loss, round window obliteration, Clinical Consultation.Figure 3: Axial (horizontal) CT of temporal bones showing air (black) in a round window niche on the left. Asymmetric mixed hearing loss, round window obliteration, Clinical Consultation.Figure 4: Coronal (parallel to the face) CT of temporal bones showing the obliterated round window in the coronal direction. Asymmetric mixed hearing loss, round window obliteration, Clinical Consultation.Figure 5: Sagittal (vertical parallel to the ear) CT of temporal bones demonstrating the obliterated round window in the sagittal direction. Asymmetric mixed hearing loss, round window obliteration, Clinical Consultation.DIAGNOSIS: ROUND WINDOW OBLITERATION By Daim Tabba, BA, BS; Karen Tawk, MD; Mehdi Abouzari, MD, PhD; and Hamid R. Djalilian, MD Upon examination of the patient’s audiograms, it is evident that the patient primarily has an asymmetric (right-sided) mixed hearing loss. Typically, when a patient presents with a normal physical exam and conductive hearing loss, the most likely diagnosis is otosclerosis. Otosclerosis refers to abnormal bone remodeling in the inner ear such that the normally dense endochondral layer of the bony otic capsule is replaced by one or more foci of vascular bone leading to bony overgrowth. As this overgrowth develops, the stapes can no longer properly function and becomes fixated. As such, conduction gradually worsens.1 Cochlear involvement, as would be the case with round window involvement by the otosclerotic bone, can lead to sensorineural hearing loss and if the round window becomes obliterated, it can lead to conductive hearing loss. leading to a mixed hearing loss overall.2 Other potential pathologies linked to mixed hearing loss include the third-window effect, or an enlarged vestibular aqueduct (EVA). The third-window effect in EVA occurs from the loss of vibrations of the inner ear fluids through an enlarged vestibular aqueduct, which is effectively a third window into the inner ear. This diagnosis seems unlikely because it is rare tha","PeriodicalId":39705,"journal":{"name":"Hearing Journal","volume":"113 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136105057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurology, Cognition, Cognitive Screenings and Audiology, Part 2","authors":"Douglas L. Beck","doi":"10.1097/01.hj.0000995232.86614.1a","DOIUrl":"https://doi.org/10.1097/01.hj.0000995232.86614.1a","url":null,"abstract":"Welcome back to The Hearing Journal’s newest column, Perspectives With Dr. Beck. Dr. Beck’s interview with James E. Galvin, MD, MPH, continues with an even deeper look into the nuanced relationship between audiology and cognition. Dr. Galvin is the Alexandria and Bernard Schoninger Endowed Chair in Memory Disorders and Professor of Neurology and Psychiatry & Behavioral Sciences at the University of Miami Miller School of Medicine. He is Founding Director of the Comprehensive Center for Brain Health, Director and Principal Investigator of the Lewy Body Dementia Research Center of Excellence, and Chief of the Division of Cognitive Neurology leading brain health and neurodegenerative disease research and clinical programs. If you missed Part 1 of this interview from the October issue of The Hearing Journal, catch up here: https://bit.ly/46Aps4L.www.shutterstock.com. Perspectives With Dr. Beck, neurology, cognition, cognitive screening, James Galvin.James E. Galvin, MD, MPH. Perspectives With Dr. Beck, neurology, cognition, cognitive screening, James Galvin.Dr. Beck: Good morning, Jim. Thanks for joining me again to discuss pharmaceutical developments and realistic expectations for people with Alzheimer’s Disease and Related Disorders (ADRD). Dr. Galvin: I’m happy to help, Doug. Dr. Beck: To review some of our previous discussion, we had discussed the Lancet’s 2020 article1, which indicated some 60% of dementia risk is due to age and DNA, and perhaps 40% is due to potentially modifiable risk factors, the largest of which was untreated hearing loss (8.2% PAF [population attributable factor]). Dr. Galvin: Yes, and we discussed that some of the potentially modifiable risk factors interact with other listed and unlisted risk factors, too, and so it is not a simple fraction or percentage risk for any individual. Epidemiology provides us with very -important trends and averages for a group, which does not necessarily tell us about the specific risks related to the individual we’re assessing or treating. We really need to consider many different factors beyond those listed in the Lancet article, and all these things must be considered and weighted accordingly. Dr. Beck: Agreed. Further, Nianago and colleagues (2022) reported the most significant potentially modifiable risk factor for dementia was mid-life obesity.2 And so, all of this is evolving rapidly, and it seems we’re left with nature versus nurture, or genetics and/or environmental factors as the primary risk factors. So, all that’s old is new again! Dr. Galvin: Yes, and so it’s important to choose your parents carefully! But seriously, these potentially modifiable risk factors interact with each other, and they interact with your genetic makeup and all your lifestyle choices, factors, and habits. The result of these interactions varies from individual to individual. And so, all these factors are actually dynamically interrelated and focusing on just one factor may miss the forest for the trees. And ","PeriodicalId":39705,"journal":{"name":"Hearing Journal","volume":"20 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136105056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Other Side of Disability Access","authors":"John Drinkwater","doi":"10.1097/01.hj.0000991292.86677.5f","DOIUrl":"https://doi.org/10.1097/01.hj.0000991292.86677.5f","url":null,"abstract":"When it comes to accommodation requests under the Americans with Disabilities Act, employee requests have record keeping, oversight, accountability and due process. Customers don’t even have the protection of record keeping, and without that the rest is meaningless. This article proposes similar protections for customers. GOALS AND POLICIES The vast majority of companies are committed to continuously improving diversity and inclusion, and to provide an environment that is safe, welcoming, inclusive, and respectful for all. Under Title III of the ADA, places of public accommodation (private businesses that are open to the public) must give people with disabilities an equal opportunity to participate in and to benefit from their services.1 Businesses are expected to consult with the person with a disability. The Department of Justice notes: “Businesses have formal and informal policies, practices, and procedures. However, sometimes they can make it difficult or impossible for a customer with a disability to access goods and services. That is why the ADA requires businesses to make ‘reasonable modifications’ to their usual ways of doing things when serving people with disabilities. Most modifications involve only minor adjustments in policies.”2 At many businesses, this is handled informally, with a discussion and an acceptable accommodation. Many requests don’t cost anything, such as adjusting the volume of background music for the hearing disabled.3 However, what happens if a request applies to multiple disabled people, or multiple locations in the same city and can’t be addressed by an individual employee, or an employee denies a legitimate accommodation request? The ADA uses the same criteria to evaluate both employee accommodation requests under Title I (regulated by the EEOC) and customer requests under Title III (regulated by the DOJ).4 For employees, there are checks and balances that include oversight by the EEOC with record keeping and reporting requirements. But there are none of those record keeping protections for customers. There are many valid circumstances for treating employees and customers differently under the ADA. However, with regard to procedures for handling accommodation requests, employees versus customers is a distinction without a difference—except for the people the act intends to cover! Without records, well-meaning companies don’t know how many requests they have received, on what subject, on what criteria were they approved or denied, and there is no way for them to evaluate whether they are meeting diversity and inclusion commitments. The DOJ is charged with enforcing the ADA for customer accommodation requests, but without records what can they do? It seems that’s a system that allows for unchecked and undocumented discrimination. REALITY Access for the disabled is grounded in the ADA and company policies, but the reality for many disabled is far different. One would think that if one industry focused on accessibili","PeriodicalId":39705,"journal":{"name":"Hearing Journal","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135428064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurology, Cognition, Cognitive Screenings and Audiology, Part 1","authors":"Douglas L. Beck","doi":"10.1097/01.hj.0000991284.64034.ee","DOIUrl":"https://doi.org/10.1097/01.hj.0000991284.64034.ee","url":null,"abstract":"Welcome to the first installment of our new column, Perspectives With Dr. Beck. With career experience spanning the roles of Audiology program director and adjunct professor, private practice co-founder, Editor-in-Chief, society web content editor, and industry manufacturer consultant, Dr. Douglas L. Beck brings his unique wealth of insight to The Hearing Journal through interviews with leading industry experts and in-depth articles exploring audiology’s most significant challenges and opportunities.www.shutterstock.com. Perspectives With Dr. Beck, neurology, cognition, cognitive screening, James Galvin.James E. Galvin, MD, MPH. Perspectives With Dr. Beck, neurology, cognition, cognitive screening, James Galvin.Results from Johns Hopkins University’s Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study linking the use of hearing aids to a more slowed cognitive decline were recently published in The Lancet, leaving audiologists grappling with how involved they should be in their patients’ cognitive screenings. Dr. Beck speaks with James E. Galvin, MD, MPH, in a two-part interview covering the nuanced topic of audiology’s relationship with cognition. Dr. Galvin is the Alexandria and Bernard Schoninger Endowed Chair in Memory Disorders and Professor of Neurology and Psychiatry & Behavioral Sciences at the University of Miami Miller School of Medicine. He is Founding Director of the Comprehensive Center for Brain Health, Director and Principal Investigator of the Lewy Body Dementia Research Center of Excellence, and Chief of the Division of Cognitive Neurology leading brain health and neurodegenerative disease research and clinical programs. Dr. Beck: Good morning, Jim. Thanks for meeting with me today. Dr. Galvin: Hi, Doug. Thanks for inviting me. Dr. Beck: Entirely my pleasure! By way of disclosure, I want to report that you and I met in 2022, before I retired as VP of Clinical Sciences at Cognivue, Inc. At that time you were an advisor on the Cognivue clinical advisory board, and I was always very interested in your thoughts on contemporary issues. Before we get into the clinical issues, where did you go to medical school? Dr. Galvin: I went to medical school at what is now Rutgers University, but when I attended it was called The University of Medicine and Dentistry of New Jersey – New Jersey Medical School in Newark, NJ. Dr. Beck: And because you’re a professor of both neurology and psychiatry at the University of Miami Miller School of Medicine, it seems I should ask…did you do a fellowship in both disciplines, neurology and psychiatry? How does that work? Dr. Galvin: The way it works is the Board is the American Board of Psychiatry and Neurology is the one board for both disciplines. It can be confusing, but generally, the practitioner becomes Board Certified in one discipline, and for me that’s neurology, although members can do a residency in neurology or psychiatry or they can be “double-boarded” and do both neuro-psychiatry, but","PeriodicalId":39705,"journal":{"name":"Hearing Journal","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135428204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}