The Perkeso website meant for compensation.
Friday, August 21, 2009
More OSHA stuff.
The Perkeso website meant for compensation.
Thursday, August 20, 2009
OSHA
Hope you ppl have done your practicals!
See ya tmr (:
Tuesday, August 18, 2009
Hearing Aid
What is a hearing aid?
A hearing aid is a small electronic device that you wear in or behind your ear. It makes some sounds louder so that a person with hearing loss can listen, communicate, and participate more fully in daily activities. A hearing aid can help people hear more in both quiet and noisy situations. However, only about one out of five people who would benefit from a hearing aid actually uses one.
A hearing aid has three basic parts: a microphone, amplifier, and speaker. The hearing aid receives sound through a microphone, which converts the sound waves to electrical signals and sends them to an amplifier. The amplifier increases the power of the signals and then sends them to the ear through a speaker.
How can hearing aids help?
Hearing aids are primarily useful in improving the hearing and speech comprehension of people who have hearing loss that results from damage to the small sensory cells in the inner ear, called hair cells. This type of hearing loss is called sensorineural hearing loss. The damage can occur as a result of disease, aging, or injury from noise or certain medicines.
A hearing aid magnifies sound vibrations entering the ear. Surviving hair cells detect the larger vibrations and convert them into neural signals that are passed along to the brain. The greater the damage to a person’s hair cells, the more severe the hearing loss, and the greater the hearing aid amplification needed to make up the difference. However, there are practical limits to the amount of amplification a hearing aid can provide. In addition, if the inner ear is too damaged, even large vibrations will not be converted into neural signals. In this situation, a hearing aid would be ineffective.
How can I find out if I need a hearing aid?
If you think you might have hearing loss and could benefit from a hearing aid, visit your physician, who may refer you to an otolaryngologist or audiologist. An otolaryngologist is a physician who specializes in ear, nose, and throat disorders and will investigate the cause of the hearing loss. An audiologist is a hearing health professional who identifies and measures hearing loss and will perform a hearing test to assess the type and degree of loss.
Are there different styles of hearing aids?
There are three basic styles of hearing aids. The styles differ by size, their placement on or inside the ear, and the degree to which they amplify sound.
- Behind-the-ear (BTE) hearing aids consist of a hard plastic case worn behind the ear and connected to a plastic earmold that fits inside the outer ear. The electronic parts are held in the case behind the ear. Sound travels from the hearing aid through the earmold and into the ear. BTE aids are used by people of all ages for mild to profound hearing loss.
A new kind of BTE aid is an open-fit hearing aid. Small, open-fit aids fit behind the ear completely, with only a narrow tube inserted into the ear canal, enabling the canal to remain open. For this reason, open-fit hearing aids may be a good choice for people who experience a buildup of earwax, since this type of aid is less likely to be damaged by such substances. In addition, some people may prefer the open-fit hearing aid because their perception of their voice does not sound “plugged up.” - In-the-ear (ITE) hearing aids fit completely inside the outer ear and are used for mild to severe hearing loss. The case holding the electronic components is made of hard plastic. Some ITE aids may have certain added features installed, such as a telecoil. A telecoil is a small magnetic coil that allows users to receive sound through the circuitry of the hearing aid, rather than through its microphone. This makes it easier to hear conversations over the telephone. A telecoil also helps people hear in public facilities that have installed special sound systems, called induction loop systems. Induction loop systems can be found in many churches, schools, airports, and auditoriums. ITE aids usually are not worn by young children because the casings need to be replaced often as the ear grows.
Canal aids fit into the ear canal and are available in two styles. The in-the-canal (ITC) hearing aid is made to fit the size and shape of a person’s ear canal. A completely-in-canal (CIC) hearing aid is nearly hidden in the ear canal. Both types are used for mild to moderately severe hearing loss.
Because they are small, canal aids may be difficult for a person to adjust and remove. In addition, canal aids have less space available for batteries and additional devices, such as a telecoil. They usually are not recommended for young children or for people with severe to profound hearing loss because their reduced size limits their power and volume.Do all hearing aids work the same way?
Hearing aids work differently depending on the electronics used. The two main types of electronics are analog and digital.
Analog aids convert sound waves into electrical signals, which are amplified. Analog/adjustable hearing aids are custom built to meet the needs of each user. The aid is programmed by the manufacturer according to the specifications recommended by your audiologist. Analog/programmable hearing aids have more than one program or setting. An audiologist can program the aid using a computer, and the user can change the program for different listening environments—from a small, quiet room to a crowded restaurant to large, open areas, such as a theater or stadium. Analog/programmable circuitry can be used in all types of hearing aids. Analog aids usually are less expensive than digital aids.
Digital aids convert sound waves into numerical codes, similar to the binary code of a computer, before amplifying them. Because the code also includes information about a sound’s pitch or loudness, the aid can be specially programmed to amplify some frequencies more than others. Digital circuitry gives an audiologist more flexibility in adjusting the aid to a user’s needs and to certain listening environments. These aids also can be programmed to focus on sounds coming from a specific direction. Digital circuitry can be used in all types of hearing aids.
Which hearing aid will work best for me?
The hearing aid that will work best for you depends on the kind and severity of your hearing loss. If you have a hearing loss in both of your ears, two hearing aids are generally recommended because two aids provide a more natural signal to the brain. Hearing in both ears also will help you understand speech and locate where the sound is coming from.
You and your audiologist should select a hearing aid that best suits your needs and lifestyle. Price is also a key consideration because hearing aids range from hundreds to several thousand dollars. Similar to other equipment purchases, style and features affect cost. However, don’t use price alone to determine the best hearing aid for you. Just because one hearing aid is more expensive than another does not necessarily mean that it will better suit your needs.
A hearing aid will not restore your normal hearing. With practice, however, a hearing aid will increase your awareness of sounds and their sources. You will want to wear your hearing aid regularly, so select one that is convenient and easy for you to use. Other features to consider include parts or services covered by the warranty, estimated schedule and costs for maintenance and repair, options and upgrade opportunities, and the hearing aid company’s reputation for quality and customer service.
What questions should I ask before buying a hearing aid?
Before you buy a hearing aid, ask your audiologist these important questions:
- What features would be most useful to me?
- What is the total cost of the hearing aid? Do the benefits of newer technologies outweigh the higher costs?
- Is there a trial period to test the hearing aids? (Most manufacturers allow a 30- to 60-day trial period during which aids can be returned for a refund.) What fees are nonrefundable if the aids are returned after the trial period?
- How long is the warranty? Can it be extended? Does the warranty cover future maintenance and repairs?
- Can the audiologist make adjustments and provide servicing and minor repairs? Will loaner aids be provided when repairs are needed?
- What instruction does the audiologist provide?
How can I adjust to my hearing aid?
Hearing aids take time and patience to use successfully. Wearing your aids regularly will help you adjust to them.
Become familiar with your hearing aid’s features. With your audiologist present, practice putting in and taking out the aid, cleaning it, identifying right and left aids, and replacing the batteries. Ask how to test it in listening environments where you have problems with hearing. Learn to adjust the aid’s volume and to program it for sounds that are too loud or too soft. Work with your audiologist until you are comfortable and satisfied.
You may experience some of the following problems as you adjust to wearing your new aid.
- My hearing aid feels uncomfortable. Some individuals may find a hearing aid to be slightly uncomfortable at first. Ask your audiologist how long you should wear your hearing aid while you are adjusting to it.
- My voice sounds too loud. The “plugged-up” sensation that causes a hearing aid user’s voice to
sound louder inside the head is called the occlusion effect, and it is very common for new hearing
aid users. Check with your audiologist to see if a correction is possible. Most individuals get used to
this effect over time. - I get feedback from my hearing aid. A whistling sound can be caused by a hearing aid that does not fit or work well or is clogged by earwax or fluid. See your audiologist for adjustments.
- I hear background noise. A hearing aid does not completely separate the sounds you want to hear from the ones you do not want to hear. Sometimes, however, the hearing aid may need to be adjusted. Talk with your audiologist.
- I hear a buzzing sound when I use my cell phone. Some people who wear hearing aids or have implanted hearing devices experience problems with the radio frequency interference caused by digital cell phones. Both hearing aids and cell phones are improving, however, so these problems are occurring less often. When you are being fitted for a new hearing aid, take your cell phone with you to see if it will work well with the aid.
How can I care for my hearing aid?
Proper maintenance and care will extend the life of your hearing aid. Make it a habit to:
- Keep hearing aids away from heat and moisture.
- Clean hearing aids as instructed. Earwax and ear drainage can damage a hearing aid.
- Avoid using hairspray or other hair care products while wearing hearing aids.
- Turn off hearing aids when they are not in use.
- Replace dead batteries immediately.
- Keep replacement batteries and small aids away from children and pets.
Are new types of aids available?
Although they work differently than the hearing aids described above, implantable hearing aids are designed to help increase the transmission of sound vibrations entering the inner ear. A middle ear implant (MEI) is a small device attached to one of the bones of the middle ear. Rather than amplifying the sound traveling to the eardrum, an MEI moves these bones directly. Both techniques have the net result of strengthening sound vibrations entering the inner ear so that they can be detected by individuals with sensorineural hearing loss.
A bone-anchored hearing aid (BAHA) is a small device that attaches to the bone behind the ear. The device transmits sound vibrations directly to the inner ear through the skull, bypassing the middle ear. BAHAs are generally used by individuals with middle ear problems or deafness in one ear. Because surgery is required to implant either of these devices, many hearing specialists feel that the benefits may not outweigh the risks.
Can I obtain financial assistance for a hearing aid?
Hearing aids are generally not covered by health insurance companies, although some do. For eligible children and young adults ages 21 and under, Medicaid will pay for the diagnosis and treatment of hearing loss, including hearing aids, under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) service. Also, children may be covered by their state’s early intervention program or State Children’s Health Insurance Program (SCHIP).
Medicare does not cover hearing aids for adults; however, diagnostic evaluations are covered if they are ordered by a physician for the purpose of assisting the physician in developing a treatment plan. Since Medicare has declared the BAHA a prosthetic device and not a hearing aid, Medicare will cover the BAHA if other coverage policies are met.
Some nonprofit organizations provide financial assistance for hearing aids, while others may help provide used or refurbished aids. Contact the National Institute on Deafness and Other Communication Disorders’ (NIDCD’s) Information Clearinghouse with questions about organizations that offer financial assistance for hearing aids.
A new kind of BTE aid is an open-fit hearing aid. Small, open-fit aids fit behind the ear completely, with only a narrow tube inserted into the ear canal, enabling the canal to remain open. For this reason, open-fit hearing aids may be a good choice for people who experience a buildup of earwax, since this type of aid is less likely to be damaged by such substances. In addition, some people may prefer the open-fit hearing aid because their perception of their voice does not sound “plugged up.”
sound louder inside the head is called the occlusion effect, and it is very common for new hearing
aid users. Check with your audiologist to see if a correction is possible. Most individuals get used to
this effect over time.
Proper maintenance and care will extend the life of your hearing aid. Make it a habit to:
Sunday, August 16, 2009
Noise-Induced Hearing Loss
The sound pathwayEvery day, we experience sound in our environment, such as the sounds from television and radio, household appliances, and traffic. Normally, we hear these sounds at safe levels that do not affect our hearing. However, when we are exposed to harmful noise—sounds that are too loud or loud sounds that last a long time—sensitive structures in our inner ear can be damaged, causing noise-induced hearing loss (NIHL). These sensitive structures, called hair cells, are small sensory cells that convert sound energy into electrical signals that travel to the brain. Once damaged, our hair cells cannot grow back
What sounds cause NIHL?
NIHL can be caused by a one-time exposure to an intense “impulse” sound, such as an explosion, or by continuous exposure to loud sounds over an extended period of time, such as noise generated in a woodworking shop.
Sound is measured in units called decibels. On the decibel scale, an increase of 10 means that a sound is 10 times more intense, or powerful. To your ears, it sounds twice as loud. The humming of a refrigerator is 45 decibels, normal conversation is approximately 60 decibels, and the noise from heavy city traffic can reach 85 decibels. Sources of noise that can cause NIHL include motorcycles, firecrackers, and small firearms, all emitting sounds from 120 to 150 decibels. Long or repeated exposure to sounds at or above 85 decibels can cause hearing loss. The louder the sound, the shorter the time period before NIHL can occur. Sounds of less than 75 decibels, even after long exposure, are unlikely to cause hearing loss.
Although being aware of decibel levels is an important factor in protecting one’s hearing, distance from the source of the sound and duration of exposure to the sound are equally important. A good rule of thumb is to avoid noises that are “too loud” and “too close” or that last “too long.”
What are the effects of NIHL?
Exposure to harmful sounds causes damage to the hair cells as well as the auditory, or hearing, nerve (see figure). Impulse sound can result in immediate hearing loss that may be permanent. This kind of hearing loss may be accompanied by tinnitus—a ringing, buzzing, or roaring in the ears or head—which may subside over time. Hearing loss and tinnitus may be experienced in one or both ears, and tinnitus may continue constantly or occasionally throughout a lifetime.
Continuous exposure to loud noise also can damage the structure of hair cells, resulting in hearing loss and tinnitus, although the process occurs more gradually than for impulse noise.
Exposure to impulse and continuous noise may cause only a temporary hearing loss. If a person regains hearing, the temporary hearing loss is called a temporary threshold shift. The temporary threshold shift largely disappears 16 to 48 hours after exposure to loud noise. You can prevent NIHL from both impulse and continuous noise by regularly using hearing protectors such as earplugs or earmuffs.
Scientists believe that, depending on the type of noise, the pure force of vibrations from the noise can cause hearing loss. Recent studies also show that exposure to harmful noise levels triggers the formation of molecules inside the ear that damage hair cells and result in NIHL. These destructive molecules play an important role in hearing loss in children and adults who listen to loud noise for too long
What are the symptoms of NIHL?
When a person is exposed to loud noise over a long period of time, symptoms of NIHL will increase gradually. Over time, the sounds a person hears may become distorted or muffled, and it may be difficult for the person to understand speech. Someone with NIHL may not even be aware of the loss, but it can be detected with a hearing test.
Who is affected by NIHL?
People of all ages, including children, teens, young adults, and older people, can develop NIHL. Approximately 15 percent of Americans between the ages of 20 and 69—or 26 million Americans—have high frequency hearing loss that may have been caused by exposure to loud sounds or noise at work or in leisure activities. Recreational activities that can put someone at risk for NIHL include target shooting and hunting, snowmobile riding, woodworking and other hobbies, playing in a band, and attending rock concerts. Harmful noises at home may come from lawnmowers, leaf blowers, and shop tools.
Can NIHL be prevented?
NIHL is 100 percent preventable. All individuals should understand the hazards of noise and how to practice good hearing health in everyday life. To protect your hearing:
•Know which noises can cause damage (those at or above 85 decibels).
•Wear earplugs or other hearing protective devices when involved in a loud activity (special earplugs and earmuffs are available at hardware and sporting goods stores).
•Be alert to hazardous noise in the environment.
•Protect the ears of children who are too young to protect their own.
•Make family, friends, and colleagues aware of the hazards of noise.
•If you suspect hearing loss, have a medical examination by an otolaryngologist (a physician who specializes in diseases of the ears, nose, throat, head, and neck) and a hearing test by an audiologist (a health professional trained to measure and help individuals deal with hearing loss).
How we hear
Hair cells in the inner earHearing depends on a series of events that change sound waves in the air into electrical signals. Our auditory nerve then carries these signals to the brain through a complex series of steps.
•Sound waves enter the outer ear and travel through a narrow passageway called the ear canal, which leads to the eardrum.
•The eardrum vibrates from the incoming sound waves and sends these vibrations to three tiny bones in the middle ear. These bones are called the malleus, incus, and stapes.
•The bones in the middle ear amplify, or increase, the sound vibrations and send them to the inner ear—also called the cochlea—which is shaped like a snail and is filled with fluid. An elastic membrane runs from the beginning to the end of the cochlea, splitting it into an upper and lower part. This membrane is called the “basilar” membrane because it serves as the base, or ground floor, on which key hearing structures sit.
•The sound vibrations cause the fluid inside the cochlea to ripple, and a traveling wave forms along the basilar membrane. Hair cells—sensory cells sitting on top of the membrane—“ride the wave.”
•As the hair cells move up and down, their bristly structures bump up against an overlying membrane and tilt to one side. This tilting action causes pore-like channels, which are on the surface of the bristles, to open up. When that happens, certain chemicals rush in, creating an electrical signal.
•The auditory nerve carries this electrical signal to the brain, which translates it into a “sound” that we recognize and understand.
•Hair cells near the base of the cochlea detect higher-pitched sounds, such as a cell phone ringing. Those nearer the apex, or centermost point, detect lower-pitched sounds, such as a large dog barking.
What research about NIHL is being conducted?
The National Institute on Deafness and Other Communication Disorders (NIDCD) researches the causes, diagnosis, treatment, and prevention of hearing loss. Most hearing loss is caused by damaged hair cells, which do not grow back in humans and other mammals. NIDCD-supported researchers have helped to identify some of the many genes important for ear development and hearing; they have also been studying the possibility of using gene therapy to regrow hair cells in mammals.
NIDCD researchers also are investigating a potential way to prevent NIHL after noise exposure. Noise exposure triggers the formation of destructive molecules, called free radicals, which cause hair cell death. Researchers initially had thought that antioxidants—chemicals that protect against cell damage from free radicals—might prevent NIHL only if the antioxidants were given before noise exposure. In a recent study, however, the antioxidants in salicylate (aspirin) and Trolox (vitamin E) were given to guinea pigs as long as three days after noise exposure and still significantly reduced hearing loss. These results suggest that there is a window of opportunity in which it is possible to rescue hearing from noise trauma. NIDCD-funded researchers are now testing the ability of nutrients, such as vitamins and minerals, to prevent NIHL in military personnel and college students.
Type, Degree and Configuration of Hearing Loss
Hearing loss can be categorized by where or what part of the auditory system is damaged. There are three basic types of hearing loss: conductive hearing loss, sensorineural hearing loss and mixed hearing loss.
Conductive Hearing Loss
Conductive hearing loss occurs when sound is not conducted efficiently through the outer ear canal to the eardrum and the tiny bones, or ossicles, of the middle ear. Conductive hearing loss usually involves a reduction in sound level, or the ability to hear faint sounds. This type of hearing loss can often be medically or surgically corrected.
Examples of conditions that may cause a conductive hearing loss include:
■Conditions associated with middle ear pathology such as fluid in the middle ear from colds, allergies (serous otitis media), poor eustachian tube function, ear infection (otitis media), perforated eardrum, benign tumors
■Impacted earwax (cerumen)
■Infection in the ear canal (external otitis)
■Presence of a foreign body
■Absence or malformation of the outer ear, ear canal, or middle ear
Sensorineural Hearing Loss
Sensorineural hearing loss occurs when there is damage to the inner ear (cochlea) or to the nerve pathways from the inner ear (retrocochlear) to the brain. Sensorineural hearing loss cannot be medically or surgically corrected. It is a permanent loss.
Sensorineural hearing loss not only involves a reduction in sound level, or ability to hear faint sounds, but also affects speech understanding, or ability to hear clearly.
Sensorineural hearing loss can be caused by diseases, birth injury, drugs that are toxic to the auditory system, and genetic syndromes. Sensorineural hearing loss may also occur as a result of noise exposure, viruses, head trauma, aging, and tumors.
Mixed Hearing Loss
Sometimes a conductive hearing loss occurs in combination with a sensorineural hearing loss. In other words, there may be damage in the outer or middle ear and in the inner ear (cochlea) or auditory nerve. When this occurs, the hearing loss is referred to as a mixed hearing loss.
Unilateral Hearing Loss
Unilateral hearing loss (UHL) means that hearing is normal in one ear but there is hearing loss in the other ear. The hearing loss can range from mild to very severe. Approximately one out of 1000 children is born with UHL. Unilateral hearing loss can occur in both adults and children. Nearly 3% of school-aged children have UHL.Children with UHL are at higher risk for having academic, speech/language and social/emotional difficulties than their normal hearing peers. Some children with UHL experience these difficulties but others do not.
Many times we do not know the cause of hearing loss. Below are some possible causes of UHL:
■Hearing loss that runs in the family (genetic or hereditary)
■An outer, middle or inner ear abnormality
■Specific syndromes
■Specific illnesses or infections
■Skull (temporal bone) fractures
■Excessive or extreme noise exposure
■Traumatic brain injury
For more information, see Unilateral Hearing Loss in Children: Guidance for Parents and Caregivers.
Degree of Hearing Loss
Degree of hearing loss refers to the severity of the loss. The numbers are representative of the patient's thresholds, or the softest intensity at which sound is perceived. The following is one of the more commonly used classification systems:
Degree of hearing loss Hearing loss range (dB HL)
Normal -10 to 15
Slight 16 to 25
Mild 26 to 40
Moderate 41 to 55
Moderately severe 56 to 70
Severe 71 to 90
Profound 91+
Source: Clark, J. G. (1981). Uses and abuses of hearing loss classification. Asha, 23, 493–500.
Configuration of Hearing Loss
The configuration or shape of the hearing loss refers to the extent of hearing loss at each frequency and the overall picture of hearing that is created. For example, a hearing loss that only affects the high frequencies would be described as a high-frequency loss. Its configuration would show good hearing in the low frequencies and poor hearing in the high frequencies. On the other hand, if only the low frequencies are affected, the configuration would show poorer hearing for low tones and better hearing for high tones. Some hearing loss configurations are flat, indicating the same amount of hearing loss for low and high tones.
Other descriptors associated with hearing loss are:
■Bilateral versus unilateral. Bilateral hearing loss means both ears are affected. Unilateral hearing loss means only one ear is affected.
■Symmetrical versus asymmetrical. Symmetrical hearing loss means that the degree and configuration of hearing loss are the same in each ear. An asymmetrical hearing loss is one in which the degree and/or configuration of the loss is different for each ear.
■Progressive versus sudden hearing loss. Progressive hearing loss is a hearing loss that becomes increasingly worse over time. A sudden hearing loss is one that has an acute or rapid onset and therefore occurs quickly, requiring immediate medical attention to determine its cause and treatment.
■Fluctuating versus stable hearing loss. Some hearing losses change—sometimes getting better, sometimes getting worse. Fluctuating hearing loss is typically a symptom of conductive hearing loss caused by ear infection and middle ear fluid, but also presents in other conditions such as Meniere's disease.
Link : http://www.asha.org/public/hearing/disorders/types.htm