text:
NEW ORLEANS - As if on a mission to make up for all the Lakers missing parts, Kobe Bryant resorted to what's carried him all these years.
He scored.
Bryant's team-leading 29 points on 10-of-17 shooting in 34 minutes carried the Lakers to a 103-87 victory Wednesday over the Hornets in New Orleans Arena to snap a two-game losing streak and give the team its second road victory.
Bryant's effort helped the Lakers forget for one game about the absences to Steve Nash (fractured left leg), Pau Gasol (tendinitis in both knees) and Steve Blake (surgery to treat a lower abdominal strain). Bryant's four dunks, baseline jumpers and floaters also cemented him further among the NBA's elite.
He rests at 30,016 career points spanning a storied 17-year NBA career that includes five NBA championships, two Finals MVPs, one regular season MVP and four All-Star MVPs. Only Kareem Abdul-Jabbar (38,387), Karl Malone (36,928), Michael Jordan (32,292) and Wilt Chamberlain (31,419) have scored more baskets in NBA history.
"That means he's old," D'Antoni said, drawing laughs. "Not many people can get that achievement. That's something that's earned."
Once Bryant slashed to the basket with a runner in the lane with 1:16 remaining in the second quarter, the Lakers guard became the youngest player to reach the milestone at 34 years and 105 days old.
"Throughout my career, I never thought about this," Bryant said. "I don't know why I'm still working as hard as I am after 17 years. I enjoy what I do.
"That's the thing I'm most proud of, that every year and every day I'm working hard at it."
When the Hornets' public announcer brought up Bryant's record before the second half began, the fans at New Orleans Arena gave Bryant a loud round of applause. Bryant then held up his right hand to express appreciation. Interestingly, the milestone came against the team that drafted him in 1996 (Charlotte Hornets) before trading away his rights to the Lakers for Vlade Divac.
"Sports always seems to have that connectivity," Bryant said. "It always seems to come full circle."
Still, Lakers forward Metta World Peace jokingly wished Bryant saved his record-breaking play for Friday when the Lakers visit the Oklahoma City Thunder.
"It's a bigger game," said World Peace, whose 11 points eclipsed the 12,000 points mark. "He hits that shot and makes history. Twenty years from now, it will show Kobe scoring 30,000 points and (Kevin) Durant is in the background moving in slow motion.
"You want Kobe to break the record with a Hornet in the background?"
The Lakers can't be choosy these days, with their inconsistent defense, free-throw shooting and playing at the speed required in D'Antoni's offense.
It appeared some of the frustration lingered as Bryant and Dwight Howard exchanged heated words on the court and during timeouts in the first quarter because of defensive breakdowns.
Said Bryant: "That's how I lead. That's how I've found to be successful."
Said Howard: "I don't have a problem with saying anything to anybody, and it should be that way. We have to be able to talk to each other.
"he more chemistry we develop that way, the better we'll be as a team."
But against New Orleans, that became a blip.
Howard, who scored 18 points, didn't fall victim to another "Hack a Dwight." Antawn Jamison (15 points), posted his second consecutive double double while starting at power forward during Gasol's injury. Chris Duhon kept the offense balanced by posting 10 assists in his second consecutive start at point guard. Jordan Hill and Jodie Meeks combined for 18 points off the bench.
The Lakers opened the second half with a 12-0 run.
And then there was Bryant. He tapped into what's carried him his whole career to ensure the Lakers a well-needed win and another milestone.
firstname.lastname@example.com Twitter.com/MedinaLakersNBA


text:
Labeda Gripper Millennium Inline Hockey Skate Wheels - 4 Pack
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subset: commoncrawl


text:
J. Cole & Wale sign on for Axe Concert Series
Listen to J. Cole on iHeartRadio | Listen to Wale on iHeartRadio
J. Cole, Wale, Meek Mill and A$AP Ferg are teaming up with Axe body products for a series of upcoming concerts.
According to MTV News, the emcees will take part in the "AXE One Night Only" party series. Kicking off in New Orleans on October 17th, the short tour will include shows in Austin, Philadelphia and Seattle.
Apart from the four hits rappers, the events will also feature special guests that will be kept secret until just before the shows begin. Fans can learn how to get a hold of tickets by visiting AxeONO.com.
Check out the dates for the "AXE One Night Only" concerts:
October 17th - New Orleans, NO
October 19th - Austin, TX
October 25th - Philadelphia, PA
October 30th - Seattle, WA
Photo Credit Getty Images


text:
The New York Times ran a story this past May about Twitter as a classroom backchannel. The NYT Learning Network even had had those educators featured respond to community comments and discuss their stance on cell phones, technology and backchanneling in the classroom.
The idea reminded me that often I spend all of my time before class determining "essential" questions and then trying to guide students through classroom discussions. Regardless of whether or not students have engaged in the text or done the reading, these questions are still "my" questions.
Using Twitter or even Today's Meet, similarly styled around 140 characters, as a means towards having everyone participate is an important first step. However, this is still a world in which we "make" the questions.
So here's the alternative. After you've familiarized students with Twitter and even used it as a means of backchanneling during discussions or Socratic seminars give students a list of question types you want them to formulate. As they read, make them responsible for creating questions via twitter. Read more


text:
Feminism, Pop-Culture | Posted by Sophie Rae on 07/13/2011
Party Whipped: The Trials of a Teenage Feminist Rocker
I think I've always been somewhat of a feminist, even if I didn't know it.
When I started playing in bands when I was 9, I didn't have any idea that my gender would be an issue. Music was what I loved, and to my Trash and Vaudeville size 00 jeans-wearing self, playing super-distorted covers of Clash songs seemed like the most natural thing in the world.
But as we kept playing and as my nievaté began to dwindle (I had reached the age of 12 and my peak of intellectual maturity), I started to notice something weird. In interviews, I was asked to talk not about my music but about my favorite lip gloss flavor …


text:
Hi folks!
I'm facing some issues regarding Parallels 4 on MacOS X 10.5.5 and BT3. I installed a VM, that worked fine in Parallels 3. I have to update it, but I can't boot it any more.
Afterwards there's no reaction by the VM any more.
Did anybody solve these incompatibilities jet? I didn't find a posting. Did you reinstall the whole "shit"? Or better: did anybody reinstall and provides a shiny little download of a VM for me
* wtf? 15 pots before you can post a site???


text:
hearing loss
出典: meddic
- n.
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2014/06/30 01:59:47」(JST)
wiki en[Wiki en表示]
|Hearing loss
|Classification and external resources
The international symbol of deafness or hard of hearing
Hearing loss, hearing impairment, or deafness, is a partial or total inability to hear.[1] In children it may affect the development of language and can cause work related difficulties for adults.[2]
It is caused by many factors, including: genetics, aging, exposure to noise, illness, chemicals and physical trauma. Hearing testing may be used to determine the severity of the hearing loss. While the results are expressed in decibels, hearing loss is usually described as mild, mild-moderate, moderate, moderately severe, severe, or profound. Hearing loss is usually acquired by a person who at some point in life had no hearing impairment.
There are a number of measures that can prevent hearing loss and include avoidance of loud noise, chemical agents, and physical trauma. Testing for poor hearing is recommended for all newborns.[2] But, in some cases such as due to disease, illness, or genetics, it is impossible to reverse or prevent. Hearing aids are partially effective for many.
Globally hearing loss affects about 10% of the population to some degree.[3] It caused moderate to severe disability in 124 million people as of 2004 (108 million of whom are in low and middle income countries).[4] Of these 65 million developed the condition during childhood.[5] It is one of the most common medical conditions presenting to physicians.[6] It is viewed by some in the deaf community as a condition, not an illness. Treatments such as cochlear implants have caused controversy in the deaf community.
- 1 Definition
- 1.1 Hearing loss
- 1.2 Speech perception
- 2 Causes
- 2.1 Age
- 2.2 Noise
- 2.3 Genetic
- 2.4 Illness
- 2.4.1 Neurological disorders
- 2.5 Medications
- 2.6 Chemicals
- 2.7 Physical trauma
- 2.8 Neurobiological factors
- 3 Diagnosis
- 3.1 Classification
- 3.1.1 Conductive hearing loss
- 3.1.2 Sensorineural hearing loss
- 3.1.3 Mixed hearing loss
- 3.1.4 Before language
- 3.1.5 After language
- 3.1.6 Unilateral and bilateral
- 3.1 Classification
- 4 Screening
- 5 Prevention
- 6 Management
- 6.1 Hearing aids
- 6.2 Cochlear implants
- 6.3 Assistive devices
- 6.4 Wireless devices
- 6.5 Classroom
- 7 Epidemiology
- 8 Society and culture
- 8.1 Deaf culture
- 8.2 Views of treatments
- 8.3 Sign language
- 8.4 School
- 8.4.1 Government policies
- 8.4.2 Inclusion vs. pullout
- 8.5 Myths
- 9 Research
- 10 References
- 11 External links
Hearing loss
Hearing loss exists when there is diminished sensitivity to the sounds normally heard.[5] The terms hearing impairment or hard of hearing are usually reserved for people who have relative insensitivity to sound in the speech frequencies. The severity of a hearing loss is categorized according to the increase in volume above the usual level necessary before the listener can detect it.
Deafness is defined as a degree of impairment such that a person is unable to understand speech even in the presence of amplification.[5] In profound deafness, even the loudest sounds produced by an audiometer (an instrument used to measure hearing by producing pure tone sounds through a range of frequencies) may not be detected. In total deafness, no sounds at all, regardless of amplification or method of production, are heard.
Speech perception
Another aspect of hearing involves the perceived clarity of a sound rather than its amplitude. In humans, that aspect is usually measured by tests of speech perception. These tests measure one's ability to understand speech, not to merely detect sound. There are very rare types of hearing impairments which affect speech understanding alone.[7]
The following are some of the major causes of hearing loss.
There is a progressive loss of ability to hear high frequencies with increasing age known as presbycusis. This begins in early adulthood, but does not usually interfere with ability to understand conversation until much later. Although genetically variable it is a normal concomitant of aging and is distinct from hearing losses caused by noise exposure, toxins or disease agents.[8]
Noise is the cause of approximately half of all cases of hearing loss, causing some degree of problems in 5% of the population globally.[3]
Populations living near airports or freeways are exposed to levels of noise typically in the 65 to 75 dB(A) range. If lifestyles include significant outdoor or open window conditions, these exposures over time can degrade hearing. The U.S. EPA and various states have set noise standards to protect people from these health risks. The EPA has identified the level of 70 dB(A) for 24 hour exposure as the level necessary to protect the public from hearing loss and other disruptive effects from noise, such as sleep disturbance, stress-related problems, learning detriment, etc. (EPA, 1974).
Noise-induced hearing loss (NIHL) is typically centered at 3000, 4000, or 6000 Hz. As noise damage progresses, damage spreads to affect lower and higher frequencies. On an audiogram, the resulting configuration has a distinctive notch, sometimes referred to as a "noise notch." As aging and other effects contribute to higher frequency loss (6–8 kHz on an audiogram), this notch may be obscured and entirely disappear.
Louder sounds cause damage in a shorter period of time. Estimation of a "safe" duration of exposure is possible using an exchange rate of 3 dB. As 3 dB represents a doubling of intensity of sound, duration of exposure must be cut in half to maintain the same energy dose. For example, the "safe" daily exposure amount at 85 dB A, known as an exposure action value, is 8 hours, while the "safe" exposure at 91 dB(A) is only 2 hours (National Institute for Occupational Safety and Health, 1998). Note that for some people, sound may be damaging at even lower levels than 85 dB A. Exposures to other ototoxins (such as pesticides, some medications including chemotherapy agents, solvents, etc.) can lead to greater susceptibility to noise damage, as well as causing their own damage. This is called a synergistic interaction.
Some American health and safety agencies (such as OSHA, the Occupational Safety and Health Administration, and MSHA, the Mine Safety and Health Administration), use an exchange rate of 5 dB.[9] While this exchange rate is simpler to use, it drastically underestimates the damage caused by very loud noise. For example, at 115 dB, a 3 dB exchange rate would limit exposure to about half a minute; the 5 dB exchange rate allows 15 minutes.
Many people are unaware of the presence of environmental sound at damaging levels, or of the level at which sound becomes harmful. Common sources of damaging noise levels include car stereos, children's toys, transportation, crowds, lawn and maintenance equipment, power tools, gun use, and even hair dryers. Noise damage is cumulative; all sources of damage must be considered to assess risk. If one is exposed to loud sound (including music) at high levels or for extended durations (85 dB A or greater), then hearing impairment will occur. Sound levels increase with proximity; as the source is brought closer to the ear, the sound level increases. Mainly, deafness or hard of hearing happens in the older.
In the USA, 12.5% of children aged 6–19 years have permanent hearing damage from excessive noise exposure.[10]
Hearing loss can be inherited. Around 75–80% of all cases are inherited by recessive genes, 20–25% are inherited by dominant genes, 1–2% are inherited by X-linked patterns, and fewer than 1% are inherited by mitochondrial inheritance.[11]
When looking at the genetics of deafness, there are 2 different forms, syndromic and nonsyndromic. Syndromic deafness occurs when there are other medical problems aside from deafness in an individual. This accounts for around 30% of deaf individuals who are deaf from a genetic standpoint.[11] Nonsyndromic deafness occurs when there are no other problems associated with an individual other than deafness. From a genetic standpoint, this accounts for the other 70% of cases, which attributes to the vast majority of hereditary hearing loss.[11] Syndromic cases occur with diseases such as Usher syndrome, Stickler, Waardenburg syndrome, Alport's Syndrome, and Neurofibromatosis type 2. These are diseases that have deafness as one of the symptoms or a common feature associated with it. The genetics that correspond with these various diseases are very complicated and are difficult to explain scientifically because the cause is unknown. In nonsyndromic cases where deafness is the only 'symptom' seen in the individual it is easier to pinpoint the physical genes.
Recent gene mapping has identified dozens of nonsyndromic dominant (DFNA#) and recessive (DFNB#) forms of deafness.
- The first gene mapped for non-syndromic deafness, DFNA1, involves a splice site mutation in the formin related homolog diaphanous 1 (DIAPH1). A single base change in a large Costa Rican family was identified as causative in a rare form of low frequency onset progressive hearing loss with autosomal dominant inheritance exhibiting variable age of onset and complete penetrance by age 30.[12]
- The most common type of congenital hearing impairment in developed countries is DFNB1, also known as Connexin 26 deafness or GJB2-related deafness.
- The most common dominant syndromic forms of hearing impairment include Stickler syndrome and Waardenburg syndrome.
- The most common recessive syndromic forms of hearing impairment are Pendred syndrome, Large vestibular aqueduct syndrome and Usher syndrome.
- The congenital defect microtia can cause full or partial deafness depending upon the severity of the deformity and whether or not certain parts of the inner or middle ear are affected.
- Mutations in PTPRQ Are a Cause of Autosomal-Recessive Nonsyndromic Hearing Impairment.[13]
- Measles may cause auditory nerve damage
- Meningitis may damage the auditory nerve or the cochlea
- Autoimmune disease has only recently been recognized as a potential cause for cochlear damage. Although probably rare, it is possible for autoimmune processes to target the cochlea specifically, without symptoms affecting other organs. Wegener's granulomatosis is one of the autoimmune conditions that may precipitate hearing loss.
- Mumps (Epidemic parotitis) may result in profound sensorineural hearing loss (90 dB or more), unilateral (one ear) or bilateral (both ears).
- Presbycusis is a progressive hearing impairment accompanying age, typically affecting sensitivity to higher frequencies (above about 2 kHz).
- Adenoids that do not disappear by adolescence may continue to grow and may obstruct the Eustachian tube, causing conductive hearing impairment and nasal infections that can spread to the middle ear.
- People with HIV/AIDS frequently experience auditory system anomalies.
- Chlamydia may cause hearing loss in newborns to whom the disease has been passed at birth.
- Fetal alcohol syndrome is reported to cause hearing loss in up to 64% of infants born to alcoholic mothers, from the ototoxic effect on the developing fetus plus malnutrition during pregnancy from the excess alcohol intake.
- Premature birth causes sensorineural hearing loss approximately 5% of the time.
- Syphilis is commonly transmitted from pregnant women to their fetuses, and about a third of infected children will eventually become deaf.
- Otosclerosis is a hardening of the stapes (or stirrup) in the middle ear and causes conductive hearing loss.
- Medulloblastoma and other types of brain tumors can cause hearing loss, whether by the placement of the tumor around the Vestibulocochlear nerve, surgical resection, or platinum-based chemotherapy drugs such as cisplatin.
- Superior canal dehiscence, a gap in the bone cover above the inner ear, can lead to low-frequency conductive hearing loss, autophony and vertigo
Neurological disorders
Neurological disorders such as multiple sclerosis and strokes can have an effect on hearing as well. Multiple sclerosis, or MS, is an autoimmune disease where the immune system attacks the myelin sheath, a covering that protects the nerves. Once the myelin sheaths are destroyed they cannot be repaired. Without the myelin to protect the nerves, nerves become damaged, creating disorientation for the patient. This is a painful process and may end in the debilitation of the affected person until they are paralyzed and have one or more senses gone. One of those may be hearing. If the auditory nerve becomes damaged then the affected person will become completely deaf in one or both ears. There is no cure for MS.[14] Depending on what nerves are damaged from a stroke, one of the side effects can be deafness.[15] Charcot–Marie–Tooth disease variant 1E (CMT1E) is noted for demyelinating in addition to deafness.[16]
Some medications cause irreversible damage to the ear, and are limited in their use for this reason. The most important group is the aminoglycosides (main member gentamicin) and platinum based chemotherapeutics such as cisplatin.
Some medications may reversibly affect hearing. This includes some diuretics, aspirin and NSAIDs, and macrolide antibiotics. According to a study by researchers at Brigham and Woman's Hospital in Boston, the link between nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and hearing loss tends to be greater in women, especially those who take ibuprofen six or more times a week.[17] Others may cause permanent hearing loss.[18] On October 18, 2007, the U.S. Food and Drug Administration (FDA) announced that a warning about possible sudden hearing loss would be added to drug labels of PDE5 inhibitors, which are used for erectile dysfunction.[19]
In addition to medications, hearing loss can also result from specific drugs; metals, such as lead; solvents, such as toluene (found in crude oil, gasoline[20] and automobile exhaust,[20] for example); and asphyxiants.[21] Combined with noise, these ototoxic chemicals have an additive effect on a person's hearing loss.[21]
Hearing loss due to chemicals starts in the high frequency range and is irreversible. It damages the cochlea with lesions and degrades central portions of the auditory system.[21] For some ototoxic chemical exposures, particularly styrene,[22] the risk of hearing loss can be higher than being exposed to noise alone. Controlling noise and using hearing protectors are insufficient for preventing hearing loss from these chemicals. However, taking antioxidants helps prevent ototoxic hearing loss, at least to a degree.[22] The following list provides an accurate catalogue of ototoxic chemicals:[21][22]
- Drugs
- antimalarial, antibiotics, anti-inflammatory (non-steroidal), antineoplastic, diuretics
- Solvents
- toluene, styrene, xylene, n-hexane, ethyl benzene, white spirits/Stoddard, carbon disulfide, fuels, perchloroethylene, trichloroethylene, p-xylene
- Asphyxiants
- carbon monoxide, hydrogen cyanide
- Metals
- lead, mercury, organotin compounds (trimethyltin)
- Pesticides/Herbicides
- paraquat, organophosphates
Physical trauma
There can be damage either to the ear itself or to the brain centers that process the aural information conveyed by the ears.
People who sustain head injury are especially vulnerable to hearing loss or tinnitus, either temporary or permanent. I. King Jordan lost his hearing after suffering a skull fracture as a result of a motorcycle accident at age 21.[23]
Lesions to the auditory association cortex produced by physical trauma can result in deafness and other problems in auditory perception. The place where the lesion occurs on the auditory cortex plays an important role in what type of hearing deficit will occur in a person. A study conducted by Clarke et al. (2000) tested three subjects for the ability to identify a produced environmental sound, the source of the sound, and whether or not the source is moving. All three subjects had trauma to different parts of the auditory cortex, and each patient demonstrated a different set of auditory deficits, suggesting that different parts of the auditory cortex controlled different parts of the hearing process.[24] This means, lesion one part of auditory cortex and it could result in one or two deficits. It would take larger lesions at the right parts to produce deafness.
Neurobiological factors
From a neurobiological perspective, there are simply two reasons that could cause a person to be deaf: either there is something wrong with the mechanical portion of the process, meaning the ear, or there is something wrong with the neural portion of the process, meaning the brain.
The process of understanding how sound travels to the brain is imperative in understanding how and why these two reasons would cause a person to go deaf. The process is as follows: sound waves are transmitted to the outer ear, sound waves are conducted down to ear canal, bringing the sound waves to the eardrum where they vibrate, these vibrations are now passed through the 3 tiny ear bones in the middle, which cause the fluid to move in the inner ear, the fluid moves the hair cells, the movement of the hair cells cause the vibrations to be converted into nerve impulses, the nerve impulses are taken to the brain by the auditory nerve,[25] the auditory nerve takes the impulses to the medulla oblongata, the brainstem send the impulses to the midbrain, which finally goes to the auditory cortex of the temporal lobe to be interpreted as sound.[26]
This process is complex and involves several steps that depend on the previous step in order for the vibrations or nerve impulses to be passed on. This is why if anything goes wrong at either the mechanical or neural portion of the process, it could result in sound not being processed by the brain, hence, leading to deafness.
The severity of a hearing impairment is ranked according to the additional intensity above a nominal threshold that a sound must be before being detected by an individual; it is (measured in decibels of hearing loss, or dB HL). Hearing impairment may be ranked as mild, moderate, moderately severe, severe or profound as defined below:
- Mild:
- for adults: between 26 and 40 dB HL
- for children: between 20 and 40 dB HL[5]
- Moderate: between 41 and 54 dB HL[5]
- Moderately severe: between 55 and 70 dB HL[5]
- Severe: between 71 and 90 dB HL[5]
- Profound: 91 dB HL or greater[5]
- Totally Deaf: Have no hearing at all.
Hearing sensitivity varies according to the frequency of sounds. To take this into account, hearing sensitivity can be measured for a range of frequencies and plotted on an audiogram.
For certain legal purposes such as insurance claims, hearing impairments are described in terms of percentages. Given that hearing impairments can vary by frequency and that audiograms are plotted with a logarithmic scale, the idea of a percentage of hearing loss is somewhat arbitrary, but where decibels of loss are converted via a recognized legal formula, it is possible to calculate a standardized "percentage of hearing loss" which is suitable for legal purposes only.
Another method for quantifying hearing impairments is a speech-in-noise test. As the name implies, a speech-in-noise test gives an indication of how well one can understand speech in a noisy environment. A person with a hearing loss will often be less able to understand speech, especially in noisy conditions. This is especially true for people who have a sensorineural loss – which is by far the most common type of hearing loss. As such, speech-in-noise tests can provide valuable information about a person's hearing ability, and can be used to detect the presence of a sensorineural hearing loss. A triple-digit speech-in-noise test was developed by RNID as part of an EU funded project Hearcom. The RNID version is available over the phone, on the web[27] and as an app on the iPhone.
Hearing impairments are categorized by their type, their severity, and the age of onset (before or after language is acquired). Furthermore, a hearing impairment may exist in only one ear (unilateral) or in both ears (bilateral). There are three main types of hearing impairments, conductive hearing impairment and sensorineural hearing impairment and a combination of the two called mixed hearing loss.[5]
Conductive hearing loss
A conductive hearing impairment is present when the sound is not reaching the inner ear, the cochlea. This can be due to external ear canal malformation, dysfunction of the eardrum or malfunction of the bones of the middle ear. The ear drum may show defects from small to total resulting in hearing loss of different degree. Scar tissue after ear infections may also make the ear drum dysfunction as well as when it is retracted and adherent to the medial part of the middle ear.
Dysfunction of the three small bones of the middle ear – malleus, incus, and stapes – may cause conductive hearing loss. The mobility of the ossicles may be impaired for different reasons and disruption of the ossicular chain due to trauma, infection or anchylosis may also cause hearing loss.
Sensorineural hearing loss
A sensorineural hearing loss is one caused by dysfunction of the inner ear, the cochlea, the nerve that transmits the impulses from the cochlea to the hearing centre in the brain or damage in the brain. The most common reason for sensorineural hearing impairment is damage to the hair cells in the cochlea. Depending on the definition it could be estimated that more than 50% of the population over the age of 70 has impaired hearing.
Mixed hearing loss
Mixed hearing loss is a combination of the two types discussed above. Chronic ear infection (a fairly common diagnosis) can cause a defective ear drum or middle-ear ossicle damages, or both. Surgery is often attempted but not always successful. On top of the conductive loss, a sensory component is often added. If the ear is dry and not infected, an air conduction aid could be tried; if the ear is draining, a direct bone condition hearing aid is often the best solution. If the conductive part of the hearing loss is more than 30–35 dB, an air conduction device could have problems overcoming this gap. A direct bone conduction aid like the Baha or the Ponto could, in this situation, be a good option.
Before language
Prelingual deafness is hearing impairment that is sustained before the acquisition of language, which can occur due to a congenital condition or through hearing loss in early infancy. Prelingual deafness impairs an individual's ability to acquire a spoken language. Children born into signing families rarely have delays in language development, but most prelingual hearing impairment is acquired via either disease or trauma rather than genetically inherited, so families with deaf children nearly always lack previous experience with sign language. Cochlear implants allow prelingually deaf children to acquire an oral language with remarkable success if implantation is performed within the first 2–4 years.[28]
After language
Post-lingual deafness is hearing impairment that is sustained after the acquisition of language, which can occur due to disease, trauma, or as a side-effect of a medicine. Typically, hearing loss is gradual and often detected by family and friends of affected individuals long before the patients themselves will acknowledge the disability.[citation needed] Common treatments include hearing aids, cochlear implants and learning lip reading. Post-lingual deafness is far more common than pre-lingual deafness. Those who lose their hearing later in life, such as in late adolescence or adulthood, face their own challenges, living with the adaptations that allow them to live independently.
Unilateral and bilateral
People with unilateral hearing loss or single-sided deafness (SSD) have difficulty in:
- hearing conversation on their impaired side
- localizing sound
- understanding speech in the presence of background noise.
In quiet conditions, speech discrimination is approximately the same for normal hearing and those with unilateral deafness; however, in noisy environments speech discrimination varies individually and ranges from mild to severe.
A similar effect can result from King-Kopetzky syndrome (also known as Auditory disability with normal hearing and obscure auditory dysfunction), which is characterized by an inability to process out background noise in noisy environments despite normal performance on traditional hearing tests. See also: "cocktail party effect", House Ear Institute's Hearing In Noise Test.
One reason for the hearing problems these patients often experience is due to the head shadow effect. Newborn children with no hearing on one side but one normal ear could still have problems.[29] Speech development could be delayed and difficulties to concentrate in school are common. More children with unilateral hearing loss have to repeat classes than their peers. Taking part in social activities could be a problem. Early aiding is therefore of utmost importance.
The United States Preventive Services Task Force recommends screening for all newborns.[2]
The American Academy of Pediatrics advises that children should have their hearing tested several times throughout their schooling:[10]
- When they enter school
- At ages 6, 8, and 10,
- At least once during middle school
- At least once during high school
There is not enough evidence to determine the utility of screening in adults over 50 years old who do not have any symptoms.[30]
It is estimated that half of cases of hearing loss are preventable.[5] A number of preventative strategies are effective including: immunization against rubella to reduce congenital infections, immunization against H. influenza and S. pneumoniae to reduce cases of otitis media, and avoiding or protecting against excessive noise exposure.[5] Education on the perils of hazardous noise exposure increases the use of hearing protectors.[31]
There are a number of devices that can improve hearing in those who are hearing impaired or deaf or allow people with these conditions to manage better in their lives.
Hearing aids
Hearing aids, which amplify the incoming sound, will improve hearing ability, but nothing can restore normal hearing.[why?][citation needed]
Cochlear implants
Cochlear implants improve outcomes in people with hearing loss in either one or both ears.[32] They work by artificial stimulation of the cochlear nerve by providing an electric impulse substitution for the firing of hair cells. They are expensive, and require programming along with extensive training for effectiveness. Cochlear implant are at higher risk for bacterial meningitis. Thus, meningitis vaccination is recommended.[33] People who have hearing impairments, especially those who develop a hearing problem in childhood or old age, may need support and technical adaptations as part of the rehabilitation process. Recent research shows variations in efficacy but some studies[34] show that if implanted at a very young age, some profoundly impaired children can acquire effective hearing and speech, particularly if supported by appropriate rehabilitation.
Assistive devices
Many hearing impaired individuals use assistive devices in their daily lives:
- Individuals can communicate by telephone using telecommunications device for the deaf (TDD). These devices look like typewriters or word processors and transmit typed text over regular telephone lines. Other names in common use are textphone and minicom.
- There are several new telecommunications relay service technologies including IP Relay and captioned telephone technologies. A hearing-impaired person can communicate over the phone with a hearing person via a human translator. Wireless, Internet and mobile phone/SMS text messaging are beginning to take over the role of the TDD.
- Real-time text technologies, involving streaming text that is continuously transmitted as it is typed or otherwise composed. This allows conversational use of text. Software programs are now available that automatically generate a closed-captioning of conversations. Examples include discussions in conference rooms, classroom lectures, and/or religious services. One such example of an available product is Auditory Sciences'Interact-AS product suite.[35]
- Instant messaging software. In addition, AOL Instant Messenger provides a real-time text feature called Real-Time IM.[36][37]
- Videophones and similar video technologies can be used for distance communication using sign language. Video conferencing technologies permit signed conversations as well as permitting a sign language–English interpreter to voice and sign conversations between a hearing impaired person and that person's hearing party, negating the use of a TTY device or computer keyboard.
- Video relay service and video remote interpreting (VRI) services also use a third-party telecommunication service to allow a deaf or hard-of-hearing person to communicate quickly and conveniently with a hearing person, through a sign language interpreter.
- Phone captioning is a service in which a hearing person's speech is captioned by a third party, enabling a hearing impaired person to conduct a conversation with a hearing person over the phone.[38]
- For mobile phones, software apps are available to provide TDD/textphone functionality on some carriers/models to provide 2-way communications.
- Hearing dogs are a specific type of assistance dog specifically selected and trained to assist the deaf and hearing impaired by alerting their handler to important sounds, such as doorbells, smoke alarms, ringing telephones, or alarm clocks.
- Other assistive devices include those that use flashing lights to signal events such as a ringing telephone, a doorbell, or a fire alarm.
- The advent of the Internet's World Wide Web and closed captioning has given the hearing impaired unprecedented access to information. Electronic mail and online chat have reduced the need for deaf and hard-of-hearing people to use a third-party Telecommunications Relay Service to communicate with the hearing and other hearing impaired people.
Wireless devices
A wireless device has two main components: a transmitter and a receiver. The transmitter broadcasts the captured sound, and the receiver detects the broadcast audio and enables the incoming audio stream to be connected to accommodations such as hearing aids or captioning systems.
Three types of wireless systems are commonly used: FM, audio induction loop, and InfraRed. Each system has advantages and benefits for particular uses. FM systems can be battery operated or plugged into an electrical outlet. FM system produce an analog audio signal, meaning they have extremely high fidelity. Many FM systems are very small in size, allowing them to be used in mobile situations. The audio induction loop permits the listener with hearing loss to be free of wearing a receiver provided that the listener has a hearing aid or cochlear implant processor with an accessory called a "telecoil". If the listener does not have a telecoil, then he or she must carry a receiver with an earpiece. As with FM systems, the infrared (IR) system also requires a receiver to be worn or carried by the listener. An advantage of IR wireless systems is that people in adjoining rooms cannot listen in on conversations, making it useful for situations where privacy and confidentiality are required. Another way to achieve confidentiality is to use a hardwired amplifier, which contains or is connected to a microphone and transmits no signal beyond the earpiece plugged directly it.
For a classroom setting, children with hearing impairments often benefit from interventions. One simple example is providing favorable seating for the child. Having the student sit as close to the teacher as possible improves the student's ability to hear the teacher's voice and to more easily read the teacher's lips. When lecturing, teachers should try to look at the student as much as possible and limit unnecessary noise in the classroom. In particular, the teacher should avoid talking when their back is turned to the classroom, such as while writing on a whiteboard.
Some other approaches for classroom accommodations include pairing hearing impaired students with hearing students. This allows the hearing impaired student to ask the hearing student questions about concepts that they have not understood. The use of CART (Communication Access Real Time) systems, where an individual types a captioning of what the teacher is saying, is also beneficial.[39] The student views this captioning on their computer. Automated captioning systems are also becoming a popular option.[40] In an automated system software, instead of a person, is used to generate the captioning. Unlike CART systems, automated systems generally do not require an Internet connection and thus they can be used anywhere and anytime. Another advantage of automated systems over CART is that they are much lower in cost. However, automated systems are generally designed to only transcribe what the teacher is saying and to not transcribe what other students say. An automated system works best for situations where just the teacher is speaking, whereas a CART system will be preferred for situations where there is a lot of classroom discussion.
For those students who are completely deaf, one of the most common interventions is having the child communicate with others through an interpreter using sign language.[41]
Globally hearing loss affects about 10% of the population to some degree.[3] It caused moderate to severe disability in 124.2 million people as of 2004 (107.9 million of whom are in low and middle income countries).[4] Of these 65 million acquired the condition during childhood.[5] At birth ~3 per 1000 in developed countries and more than 6 per 1000 in developing countries have hearing problems.[5]
Hearing loss increases with age. In those between 20 and 35 rates of hearing loss are 3% while in those 44 to 55 it is 11% and in those 65 to 85 it is 43%.[2]
Society and culture
Deaf culture
Jack Gannon, a professor at Gallaudet University, said this about deaf culture. "Deaf culture is a set of learned behaviors and perceptions that shape the values and norms of deaf people based on their shared or common experiences." Some doctors believe that being deaf makes a person more social. Dr. Bill Vicar, from ASL University, shared his experiences as a deaf person, "[deaf people] tend to congregate around the kitchen table rather than the living room sofa… our good-byes take nearly forever, and our hellos often consist of serious hugs. When two of us meet for the first time we tend to exchange detailed biographies."[42] Deaf culture is not about contemplating what deaf people cannot do and how to fix their problems, an approach known as the "pathological view of the deaf."[43] Instead deaf people celebrate what they can do. There is a strong sense of unity between deaf people as they share their experiences of suffering through a similar struggle. This celebration creates a unity between even deaf strangers. Dr. Bill Vicars expresses the power of this bond when stating, "if given the chance to become hearing most [deaf people] would choose to remain deaf."[44]
Views of treatments
There has been considerable controversy within the culturally deaf community over cochlear implants. For the most part, there is little objection to those who lost their hearing later in life, or culturally deaf adults choosing to be fitted with a cochlear implant.
Many in the deaf community strongly object to a deaf child being fitted with a cochlear implant (often on the advice of an audiologist); new parents may not have sufficient information on raising deaf children and placed in an oral-only program that emphasizes the ability to speak and listen over other forms of communication such as sign language or total communication. Other concerns include loss of deaf culture and limitations on hearing restoration.
Most parents and doctors tell children not to play sports or get involved in activities that can cause injuries to the head, for example soccer, hockey, or basketball. A child with a hearing loss may prefer to stay away from noisy places, such as rock concerts, football games, airports, etc., as this can cause noise overflow, a type of headache that occurs in many children and adults when they are near loud noises.
Sign language
Sign languages convey meaning by manual communication and body language instead of acoustically conveyed sound patterns. This can involve simultaneously combining hand shapes, orientation and movement of the hands, arms or body, and facial expressions to fluidly express a speaker's thoughts.
There is no single "sign language". Wherever communities of deaf people exist, sign languages develop. While they use space for grammar in a way that oral languages do not, sign languages exhibit the same linguistic properties and use the same language faculty as do oral languages. Hundreds of sign languages are in use around the world and are at the cores of local deaf cultures. Some sign languages have obtained some form of legal recognition, while others have no status at all. Deaf sign languages are not based on the spoken languages of their region, and often have very different syntax, partly but not entirely owing to their ability to use spatial relationships to express aspects of meaning. (See Sign languages' relationships with spoken languages.)
Abbé Charles-Michel de l'Épée was the first person to open a deaf school, in Paris. Épée taught French Sign Language (LSF) to children, and started the spread of many deaf schools across Europe. The American Thomas Gallaudet, who had traveled to England to learn methods of teaching deaf children in order to start a deaf school in the US, witnessed a demonstration of deaf teaching skills from Épée's successor Abbé Sicard and two of the school's deaf faculty members, Laurent Clerc and Jean Massieu. Gallaudet studied under these French masters and perfected his own teaching skills; then, accompanied by Clerc, he returned to the United States, where in 1817 they founded the first successful American deaf school, in Hartford, Connecticut. American Sign Language, or ASL, started to evolve from primarily LSF, and other outside influences.[45]
|The examples and perspective in this section deal primarily with the United States and do not represent a worldwide view of the subject. Please improve this article and discuss the issue on the talk page. (December 2012)
Government policies
Those who are hearing disabled do have access to a free and appropriate public education. If a child does qualify as being hearing impaired and receives an individualized education plan, the IEP team must consider, "the child's language and communication needs. The IEP must include opportunities for direct communication with peers and professionals. It must also include the student's academic level, and finally must include the students full range of needs"[46] The government also distinguishes between deafness from hearing loss. The U.S. Department of Education states that deafness is hearing loss that is so severe that a person cannot process any type of oral information even if they have some sort of hearing-enhancing device. The U.S. Department of Education states that a hearing impairment is when a person's education is affected by how much that person is able to hear. This definition is not included under the term deafness. In order for a person to qualify for special services, they have to hear more than 20 decibels and their educational performance must be affected by their hearing loss. This is what the government has to say about governmental policies and individualized services.
Inclusion vs. pullout
There are mixed opinions on the subject between those who live in deaf communities, and those who have deaf family members who do not live in deaf communities. Deaf communities are those communities where only sign languages are typically used.
Many parents who have a child with a hearing impairment prefer their child to be in the least restrictive environment of their school. This may be because most children with hearing loss are born to hearing parents. This can also be because of the recent push for inclusion in the public schools.
It is commonly misunderstood that least restrictive environment means mainstreaming or inclusion. Sometimes the resources available at the public schools do not match up to the resources at a residential school for the deaf. Many hearing parents choose to have their deaf child educated in the general education classroom as much as possible because they are told that mainstreaming is the least restrictive environment, which is not always the case. However, there are parents that live in Deaf communities who feel that the general education classroom is not the least restrictive environment for their child. These parents feel that placing their child in a residential school where all children are deaf may be more appropriate for their child because the staff tend to be more aware of the needs and struggles of deaf children. Another reason that these parents feel a residential school may be more appropriate is because in a general education classroom, the student will not be able to communicate with their classmates due to the language barrier.
In a residential school where all the children use the same language (whether it be a school using ASL, Total Communication or Oralism), students will be able to interact normally with other students, without having to worry about being criticized. An argument supporting inclusion, on the other hand, exposes the student to people who aren't just like them, preparing them for adult life. Through interacting, children with hearing disabilities can expose themselves to other cultures which in the future may be beneficial for them when it comes to finding jobs and living on their own in a society where their disability may put them in the minority. These are some reasons why a person may or may not want to put their child in an inclusion classroom.[46]
|This article is in a list format that may be better presented using prose. You can help by converting this article to prose, if appropriate. Editing help is available. (April 2013)
|This article is written like a personal reflection or opinion essay that states the Wikipedia editor's particular feelings about a topic, rather than the opinions of experts. Please help improve it by rewriting it in an encyclopedic style. (April 2013)
There are many myths regarding people with hearing losses including, but not limited to:
- Everyone who is deaf or hard of hearing uses sign language.
- There are a variety of different sign systems used by hearing-impaired individuals.[47]
- Individuals who experience hearing loss later in life usually do not know sign language.[48]
- People who are educated in the method of oralism or mainstream do not always know sign language.
- People who cannot hear are not allowed to drive.
- Deaf people may use special devices to alert them to sirens or other noises, or panoramic mirrors to enable improved visibility.[49]
- Many countries allow deaf people to drive, although at least 26 countries do not allow deaf citizens to hold a driver's license.[49]
- All forms of hearing loss can be solved by hearing aids or cochlear implants.
- While many hearing-impaired individuals do use hearing aids, others may not benefit from the use of a hearing aid.[47] One reason can be that they do not have any external ear canals in which to place the molds; another, that the hearing aids are not powerful enough.
- For some hearing-impaired individuals who experience distortion of incoming sounds, a cochlear implant may actually worsen the distortion.[47] A bone conduction hearing solution (BAHA) however, will never affect the hearing in a negative way, since it reroutes the sound through the skull.
- All deaf/hard of hearing people are experts in Deaf Culture.
- Deaf people may have a variety of different beliefs, experiences, and methods of communication.[48]
- This may be influenced by the age at which hearing was lost and the individual's personal background.[48]
- All deaf people want to be hearing.
- While some individuals with hearing loss want to become hearing, this is not the case for everyone. Some take pride in their deafness or view themselves as a minority rather than a disability group.[50]
- People who can't hear can't use a phone.
- Teletypewriters, Video phones and cell phone text messages are used by deaf people to communicate. A hearing person may use an ordinary telephone and a Telecommunications Relay Service to communicate with a deaf person.
- Some people with moderate hearing loss may have enough hearing to use amplified telephones, even if they are culturally Deaf and depend primarily on sign language to communicate.
- Everyone who cannot hear can lip read.
- Only about 30% of spoken English is visible on the lips.[47][48]
- Lip reading requires not only good lighting, but also a good understanding of the oral language in question and may also depend on contextual knowledge about what is being said.[48]
- Most deaf people have deaf parents.
- Less than 5% of deaf children in the United States have a deaf parent.[51]
A 2005 study achieved successful regrowth of cochlea cells in guinea pigs.[52] However, the regrowth of cochlear hair cells does not imply the restoration of hearing sensitivity, as the sensory cells may or may not make connections with neurons that carry the signals from hair cells to the brain. A 2008 study has shown that gene therapy targeting Atoh1 can cause hair cell growth and attract neuronal processes in embryonic mice. Some hope that a similar treatment will one day ameliorate hearing loss in humans.[53]
Recent research, reported in 2012 achieved growth of cochlear nerve cells resulting in hearing improvements in gerbils,[54] using stem cells. Also reported in 2013 was regrowth of hair cells in deaf adult mice using a drug intervention resulting in hearing improvement.[55] The Hearing Health Foundation in the US has embarked on an ambitious project called the Hearing Restoration Project.[56] Also Action on Hearing loss in the UK is also aiming to restore hearing.[57]
Besides research studies seeking to improve hearing, such as the ones listed above, research studies on the deaf have also been carried out in order to understand more about audition. Pijil and Shwarz (2005) conducted their study on the deaf who lost their hearing later in life and, hence, used cochlear implants to hear. They discovered further evidence for rate coding of pitch, a system that codes for information for frequencies by the rate that neurons fire in the auditory system, especially for lower frequencies as they are coded by the frequencies that neurons fire from the basilar membrane in a synchronous manner. Their results showed that the subjects could identify different pitches that were proportional to the frequency stimulated by a single electrode. The lower frequencies were detected when the basilar membrane was stimulated, providing even further evidence for rate coding.[24]
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- ^ a b c Rehm, Heidi. "The Genetics of Deafness; A Guide for Patients and Families". Harvard Medical School Center For Hereditary Deafness. Harvard Medical School.
- ^ Lynch, Eric D.; Lee, Ming K.; Morrow, Jan E.; Welcsh, Piri L.; León, Pedro E.; King, Mary-Claire (1997-11-14). "Nonsyndromic deafness DFNA1 associated with mutation of a human homolog of the Drosophila gene diaphanous". Science 278 (5341): 1315–18. doi:10.1126/science.278.5341.1315. PMID 9360932.
- ^ Schraders, M.; Oostrik, J.; Huygen, P.L.; Strom, T.M.; van Wijk, E.; Kunst, H.P.; Hoefsloot, L.H.; Cremers, C.W.; Admiraal, R.J.; Kremer, H. (March 2010). "Mutations in PTPRQ Are a Cause of Autosomal-Recessive Nonsyndromic Hearing Impairment DFNB84 and Associated with Vestibular Dysfunction". The American Journal of Human Genetics 86 (4): 604–10. doi:10.1016/j.ajhg.2010.02.015. PMC 2850434. PMID 20346435.
- ^ "Multiple Sclerosis". Mayo Clinic. 2010-12-11. Retrieved 2011-12-02.
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- ^ Curhan, Sharon G.; Shargorodsky, Josef; Eavey, Roland; Curhan, Gary C. (2012-02-29). "Analgesic Use and the Risk of Hearing Loss in Women". Oxford Journals: American Journal of EPIDEMIOLOGY.
- ^ Cone, Barbara; Dorn, Patricia; Konrad-Martin, Dawn; Lister, Jennifer; Ortiz, Candice; Schairer, Kim. "Ototoxic Medications (Medication Effects)". American Speech-Language-Hearing Association.
- ^ "FDA Announces Revisions to Labels for Cialis, Levitra and Viagra". Food and Drug Administration. 2007-10-18. Retrieved 2011-10-30.
- ^ a b "Tox Town – Toluene – Toxic chemicals and environmental health risks where you live and work – Text Version". toxtown.nlm.nih.gov. Retrieved 2010-06-09.
- ^ a b c d Morata, Thais C. "Addressing the Risk for Hearing Loss from Industrial Chemicals". CDC. Retrieved 2008-06-05.
- ^ a b c Johnson, Ann-Christin (2008-09-09). "Occupational exposure to chemicals and hearing impairment – the need for a noise notation" (PDF). Karolinska Institutet: 1–48. Archived from the original on 2012-09-06. Retrieved 2009-06-19.
- ^ "The World of the Deaf," The Washington Post, February 26, 1978, p. G1.
- ^ a b Carlson, N. R. (2010). Physiology of behavior. (11 ed.). Upper Saddle River, New Jersey: Pearson Education, Inc.
- ^ U.S.C. (2012). How We Hear. Sc.edu. Retrieved from http://www.sc.edu/ehs/modules/Noise/hearing.htm
- ^ Hayes, K. (2009). Hear. About.com. Retrieved from http://ent.about.com/od/entanatomybasics/ht/How We Hear.htm
- ^ "Take the check! – Action On Hearing Loss: RNID". RNID. Retrieved 2013-01-22.
- ^ Kral A, O'Donoghue GM. Profound Deafness in Childhood. New England J Medicine 2010: 363; 1438-50.
- ^ Lieu JE. Speech-language and educational consequences of unilateral hearing loss in children. Arch Otolaryngol Head Neck Surg. 2004: 130(5);524-30.
- ^ Moyer, Virginia A. (2012-11-06). "Screening for Hearing Loss in Older Adults: U.S. Preventive Services Task Force Recommendation Statement". Annals of Internal Medicine 157 (9). The American College of Physicians. pp. 655–661. Retrieved 2012-11-06.
- ^ El Dib, R.P.; Mathew, J.L.; Martins, R.H. (2012-04-18). "Interventions to promote the wearing of hearing protection". In El Dib, Regina P. Cochrane database of systematic reviews (Online) 4: CD005234. doi:10.1002/14651858.CD005234.pub5. PMID 22513929.
- ^ "Cochlear Implantation in Adults A Systematic Review and Meta-analysis". JAMA Otolaryngol Head Neck Surgery. 2013. doi:10.1001/jamaoto.2013.1744.
- ^ "FDA Public Health Notification: Risk of Bacterial Meningitis in Children with Cochlear Implants". FDA. 2002-07-24. Retrieved 2008-11-09.
- ^ "Elliot & Oliver's Story – Research". cochlearimplant.net. 2006. Archived from the original on 2008-03-02.
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- ^ Deaf Heritage: A Narrative History of Deaf America by Jack Gannon (National Association of the Deaf, 1981)
- ^ "American Deaf Culture". Sign Media, Incorporated. Sign Media, Inc. Retrieved 14 May 2013.
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- ^ Frishberg, Nancy (September 1975). "Arbitrariness and Iconicity: Historical Change in American Sign Language". Language 51 (3): 696. doi:10.2307/412894.
- ^ a b Smith, D. D., & Tyler, N. C. (2010). Introduction to Special Education. Columbus: Merrill.
- ^ a b c d "Myths About Deaf and Hard of Hearing". Tutor Workshop. Retrieved 2010-12-10.
- ^ a b c d e "What Do You Know About Deaf Culture?" (PDF). Minnesota Coalition for Battered Women. 2003-03-26.
- ^ a b "Sound and Fury – Deaf Culture – Living with Deafness". PBS. Retrieved 2010-12-10.
- ^ "Myths about Deaf People (and the truth)". ifmyhandscouldspeak. 2010-04-24.
- ^ Mitchell, Ross E.; Karchmer, Michael A. (2004). "Chasing the mythical ten percent: Parental hearing status of deaf and hard of hearing students in the United States". Sign Language Studies 4 (2): 138–163. doi:10.1353/sls.2004.0005.
- ^ Coghlan, Andy (2005-02-14). "Gene therapy is first deafness 'cure'". NewScientist.com News Service.
- ^ Gubbels, SP; Woessner, DW; Mitchell, JC; Ricci, AJ; Brigande, JV (2008). "Functional auditory hair cells produced in the mammalian cochlea by in utero gene transfer". Nature 455 (7212): 537–41. doi:10.1038/nature07265. PMC 2925035. PMID 18754012.
- ^ Gewin, Virginia (2012-09-12). "Human embryonic stem cells restore gerbil hearing". Nature. doi:10.1038/nature.2012.11402. Retrieved 2013-01-22.
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- ^ "Biomedical research – Action On Hearing Loss". RNID. Retrieved 2013-01-22.
External links
|Wikimedia Commons has media related to Hearing impairment.
- Hearing loss at DMOZ
UpToDate Contents
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- 2. 成人における難聴の評価 evaluation of hearing loss in adults
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|「deaf」「難聴」「聴覚消失」「hypoacusis」「hearing impairment」
|「inherited hearing loss」
- 難聴の、聾の、聾の
- 関
- deafness、hearing impairment、hearing loss
WordNet [license wordnet]「lacking or deprived of the sense of hearing wholly or in part」
WordNet [license wordnet]「people who have severe hearing impairments; "many of the deaf use sign language"」
PrepTutorEJDIC [license prepejdic]「『耳が遠い』,耳が不自由な / 《the deaf;名詞的に》耳が不自合な人々 / 《補語にのみ用いて》(…を)『聞こうとしない』(…に)むとんじゃくである《+『to』+『名』》」
WordNet [license wordnet]「(usually followed by `to'」
- 英
- hearing loss
- 関
- 聴覚
- 内耳性難聴 = 迷路性難聴
- 後迷路性難聴 retrolabyrinthine hearing loss = 中央性難聴
- ISBN 978-4931400559 p.184より引用
- 伝音性難聴
- 急性:悪性外耳道炎、中耳炎
- 慢性:上咽頭腫瘍
- 感音性難聴
「hearing impairment」
- 関
- deaf、deafness、hearing loss、hypoacusis
「inherited hearing loss」
- n.
- 損失、減少
- 関
- decline、decrease、diminish、diminution、down-regulate、down-regulation、downregulate、downregulation、fall、reduce、reduction
WordNet [license wordnet]「the amount by which the cost of a business exceeds its revenue; "the company operated at a loss last year"; "the company operated in the red last year"」
- 同
- red ink, red
WordNet [license wordnet]「gradual decline in amount or activity; "weight loss"; "a serious loss of business"」
WordNet [license wordnet]「something that is lost; "the car was a total loss"; "loss of livestock left the rancher bankrupt"」
WordNet [license wordnet]「the disadvantage that results from losing something; "his loss of credibility led to his resignation"; "losing him is no great deprivation"」
WordNet [license wordnet]「the act of losing someone or something; "everyone expected him to win so his loss was a shock"」
WordNet [license wordnet]「the experience of losing a loved one; "he sympathized on the loss of their grandfather"」
PrepTutorEJDIC [license prepejdic]「〈U〉(…を)『失うこと』,紛失《+『of』+『名』》 / 〈C〉(…の)『損害』,損失;損失額《+『of』+『名』》 / 〈U〉〈C〉(…に)『負けること』,(…の)敗北;失敗《+『of』+『名』》 / 〈U〉(状態・程度の)『減少』,低下 / 《複数形で》(戦場における)(人の)損害,此傷者数」
- n。
WordNet [license wordnet]「able to perceive sound」
WordNet [license wordnet]「an opportunity to state your case and be heard; "they condemned him without a hearing"; "he saw that he had lost his audience"」
WordNet [license wordnet]「(law) a proceeding (usually by a court) where evidence is taken for the purpose of determining an issue of fact and reaching a decision based on that evidence」
WordNet [license wordnet]「the ability to hear; the auditory faculty; "his hearing was impaired"」
- 同
- audition, auditory sense, sense of hearing, auditory modality
WordNet [license wordnet]「a session (of a committee or grand jury) in which witnesses are called and testimony is taken; "the investigative committee will hold hearings in Chicago"」
PrepTutorEJDIC [license prepejdic]「〈U〉『聴力』,聴覚〈U〉〈C〉(…を)『聞くこと』,(…の)聞き取り《+『of』+『名』》・〈C〉聞いてもらう機会,聞いてやること・聴取・聴聞会〈C〉(法廷などでの)尋問,審問,;(刑罰の減免を求める)釈明,意見陳述 / 〈U〉聞こえる距離(範囲)」
PrepTutorEJDIC [license prepejdic]「負ける,損をする,勝ち目がない」
PrepTutorEJDIC [license prepejdic]「見よ,そら」


text:
|Geelong Bollard
Then up early this morning, ready to face the day which was chilly (well chilly to a Queenslander) but was fine and sunny. We were greeted at the venue by one of the famous Geelong Bollards by Jan Mitchell.
He was quite an elegant gentleman with his striped jacket and boater hat. He also had, like any genealogist, the camera available and ready to photograph that headstone, house or document!
All the exhibitors worked hard at getting their displays and databases ready for when the exhibition opened at 8.30. Quite a number of people came down from Melbourne via train and took advantage of a cup of coffee at the cafe before the official opening time. The Registration staff were very busy getting everyone their name-tags, showbags and program and this busynes continued throughout the day.
Lots of people looking through the exhibition hall until the talks began..There was a bit of confusion with the signs which was a shame but was soon rectified.
I attended Rosemary Kopittke's talk on Find My Past. I have heard Rosemary talk on FindMyPast before but with all the recent changes and improvements to their site, it was well worth listening again. Also today FindMyPast announced the release of one million merchant seaman records!!!
Rememebr to check back regularly to this site (and their sister sites FindMyPast.au and the new FindMyPast.ie) as there are so many new record releases that it is easy to miss the announcement. FindMyPast does announce new releases on Twitter (@FindMyPast , @FindMyPastIE and @FindMyPastAU are the tags you should follow if you are on Twitter) and Facebook and also on their blog.
Then I managed to attend Shauna Hicks' talk on Asylums. I have been trying to get to this one for a bit and each time have been prevented because we have been speaking at the same time or last time the volcano prevented Shauna's from giving the talk in Cairns. As expected it was an excellent talk. Shauna gave a lot of information about the reasons people were admitted to asylums and the wide range of records that are available.Certainly there are restrictions on access to more modern records but considering the sensitive information these can contain, some restrictions are quite reasonable.
|Some of the goodies available
I dropped in and out of a number of other talks in between being on the Research Zone desk along with Kerry Farmer, Carole Riley and Rosemary Kopittke. Dr Diane Snowden's Tasmanian talk and Paul Parton's talks on Family Search looked very good and I heard some very positive feedback about these.
I also had some time to make a few purchases among the goodies available but did restrict myself today as there are quite a number of exhibitors I haven't managed to see as yet.
|David Evans at the Guild stand
One of the major pleasures of attending these Expos (besides the talks and exhibitors) is meeting up with people whom I have met on Twitter, Facebook or via a blog. Today I met Brona who is the human behind the Twitter tag @AncestryComAu. Brona is the one who keeps us aware of new record releases.
If you are at an event and follow me on any of the social media sites please make yourself known as it is always nice to put a face to a name.
There was so much going on today that I would be here all night but I can't leave without telling you about the last presentation of the day. This was a special presentation Hit the Road Digger which was about the building of the Great Ocean Road using no machinery and taking 14 years. This project was masterminded by Geelong Mayor Howard Hitchcock who had also done so much in the building of Geelong. The presentation was given in story and song and was the perfect finish to a busy but lovely day.
And what is even better is I get to attend again tomorrow with lots more interesting talks and I still have a number of exhibitors I wish to see.


text: The best-selling video game from Pandemic Studios is the next new Dynamite Entertainment comic book event! Get ready to join up with the Mercenaries! Mercenaries the game has revolutionized the world of third-person action-shooters by shooters by putting players in the middle of real world combat with the kind of freedom only a mercenary has. And now Dynamite's Mercenaries places you in the middle of the action! Featuring two connecting pieces of cover art by red-hot artist Michael Turner, a stellar script from Mercenaries writer Brian (New Avengers: Illuninati, Ms. Marvel, Red Sonja) Reed and art from Dynamite up-n-comer Edgar Salazar, Mercenaries #1 puts you into the middle of the Mercenaries next adventure!


text:
Conley, Suns limit Generals to one hit
Marlins prospect strikes out eight over five innings of 1-0 win
By Sam Dykstra / Special to MLB.com | April 6, 2013 7:51 PM ET
Nothing good comes from losing the deciding game of a championship series. A defeat like that can stain an otherwise successful season. Sometimes, however, it can have more far-reaching positive effects.
Such appears to be the case with Marlins prospects Adam Conley and J.T. Realmuto.
The battery was part of the Class A Advanced Jupiter squad that fell to Lakeland in five games in last year's Florida State League finals. But Conley and Realmuto developed a relationship that could lead to success at higher levels, specifically Double-A Jacksonville, where both have started the 2013 season.
"We developed a camaraderie in Jupiter, for sure," said Realmuto, Miami's No. 12 prospect. "And that's definitely carried over here this season, I think. We both know what pitches work best in what situations. He's never really shaking me off when it comes to that. We're almost always on the same page and it makes both of our jobs much easier."
It was evident Saturday night.
Conley struck out eight and did not walk a batter over five innings as the Suns held the Jackson Generals to one hit in a 1-0 victory.
James Leverton (three innings) and Scott McGough (one inning) were perfect in relief to preserve the one-hitter. Zack Cox drove in Kyle Jensen with a sacrifice fly in the ninth to give the Suns the walk-off win.
Conley, the Marlins' No. 8 prospect, allowed the Generals' only hit when Brad Miller reached on a broken-bat single to right field with two outs in the first inning. He retired the final 13 batters he faced and threw 40 of 55 pitches for strikes. Miller's hit was the only batted ball to reach the outfield during the 22-year-old left-hander's time on the mound.
"Usually, the biggest staple in a good outing for me is if I'm mixing my pitches well and working the fastball to both sides of the plate," Conley said. "I think I did a good job of that. ... J.T. called a great game, and between him and my defense behind me, I knew I had all I needed to pitch well."
The Washington State prospect went 11-5 with a 3.47 ERA, 135 strikeouts and 43 walks over 127 innings between Jupiter and Class A Greensboro a season ago. Although he enjoyed success, he struck out eight (his total Saturday night) only twice and did not allow a free pass in three of 26 starts.
And yet, there was still the one hit, sticking out among the zeros on the scoreboard at Bragan Field. Conley, though, said he won't lose any sleep over one single.
"I usually have a pretty good awareness for this kind of stuff," he said. "But tonight, it was just getting my first Double-A start, the first start of 2013 out of the way. Now I'm going to try to focus on the process of pitching and repeating that kind of success and everything should work itself out."
Leverton struck out two in relief of his fellow southpaw, while the right-handed McGough got two groundouts and a popout in a perfect ninth. Although they finished off the one-hitter, their catcher would rather highlight the night's other result.
"I don't think there's nearly as much as pressure as maybe a no-hitter," Realmuto said. "I think everyone's more worried about not giving up a run because it was a 0-0 ballgame at that point."
The 1-0 decision gave Jacksonville a collective streak of 13 scoreless innings. And Realmuto thinks the Suns could be set to tack on a few more frames, thanks to the efforts of Conley, Leverton, McGough and Cox.
"Oh, it's awesome, winning 1-0 like that, like we did," Realmuto said. "It means we didn't have to go extras. And the best part about that is saving some of our arms for the future."
Sam Dykstra is a contributor to MLB.com. This story was not subject to the approval of the National Association of Professional Baseball Leagues or its clubs.View More


text:
Nancy is the Administrative Assistant for Adult Student
Admissions. She meets and greets students and aids the Director and
Assistant Director with application processing, appointment
scheduling, and information sessions. Her primary responsibilities
involve maintaining the daily procedures of the office.
Nancy worked for 24 years at Pine Island Elementary School in
the Warwick Valley Central School District where she was the
Assistant to the Director of Staff Development Services and the
Principal. She attended Kent State University and Orange County
Community College, where she majored in Office and Information
Nancy has three grown daughters who have ties to Mount Saint
Mary College. Rebecca, the oldest, has a doctorate from Fordham
University and has been an Adjunct Professor of Psychology.
Jessica graduated in 1998 with a Bachelor of Arts in English with a
Childhood Education concentration, and Emily, who was a lifeguard
for several summers at the Fundamentals Camp hosted by the Mount,
holds a Bachelor of Arts degree from Saint Bonaventure
Nancy lives near the College with her husband, Bob.
Email: firstname.lastname@example.com
Phone: 845-569-3223
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text:
Jonathan Gerard, DMin
Rabbi, DMin
208 Sunset Dr, Chapel Hill, North Carolina 27516
There are many factors that contribute to problems in career decisions, not the least of which is an economy in transition from manufacturing to service and information and health technologies. With a client needing help here, I might focus on dealing with separation from parents expectations, clarify the client's own strengths, and then help to strategize an effective search.
Carla MooreMcNeil, MSW, LCSW
Licensed Clinical Social Worker, Master Hypnotist
502 East Cornwallis Dr, Suite N, Greensboro, North Carolina 27405
Are you at the beginning of your career or are you looking for a new option? A new possibility can be scary especially if you have been performing at a specific job for a while. Some people know very early what their purpose is in life and they find a way to be paid at what they love to do but others may need more time and guidance. If you fall into the second category, I can help you explore and narrow down what and how you would like to invest your time and energy.
Juan Santos, M.S., CRC, LPC
Licensed Counselor
3300 Battleground Avenue Suite 303, Greensboro, North Carolina 27410
Hi - and thanks for stopping by my page. I'm sure that you are "shopping around" for that right counselor for you. Great! I'm sure that you are facing obstacles and challenges which are making life "difficult" - the alternative - is investing in yourself. Make the first step and start your journey today. I am here to guide you and provide the tools that will you get you from A to B. In simple terms, we will work on the problems - obstacles - struggles in your life so that they no longer impact you as they do now.
Tina Lepage, Psy.D.
Group Psychology & Psychiatry Practice Serving the Triangle for Over 15 Years
LEPAGE ASSOCIATES PSYCHOLOGICAL & PSYCHIATRIC SERVICES, 5842 Fayetteville Road, Suite 106, Durham, North Carolina 27713
An area of expertise of the founder of Lepage Associates is career counseling, and she has developed and managed successful professional growth programs for universities, corporations, and the U.S. military. With her extensive experience, she has coached the other psychologists at Lepage Associates in career counseling. This expertise can be very helpful as people consider career options, reconsider career paths and choices, or struggle with practical issues such as selling oneself after years out of the workforce, selling oneself into a new profession, job searching, resume writing, and successful interviewing.
Lindsay Patterson, MSW, LCSW
Licensed Clinical Social Worker
I completed an internship at North Carolina State University Counseling Center where I provided academic and career counseling. If you struggle with academic underachievement or need assistance deciding on a career path, I can help you. I also provide services in areas such as job/career change later in life, job/career loss, and job dissatisfaction.
Maria Russell, LPC
Licensed Professional Counselor
Salisbury, North Carolina 28146
What do you want to do with your life? Where do you feel God calling you? Are you in the right profession? Is it time for a change? Why does this seem so hard at times? These are all questions that we must answer at some point in our lives. I want to help guide you through this decision making process; to help give you goals and a purpose when it comes to your career.
Charisse Coleman, MS, LPCA, NCC
Licensed Professional Counselor Assoc.
1200 Broad St, Suite 103, Durham, North Carolina 27705
I work well with clients of any age who are considering a new direction for their work lives, or who have already embarked on a new vocational path. I especially love helping clients discover what work fits their values and holds meaning for them. I am effective at faciliating decision-making and assisting clients in identifying, clarifying, and pursuing their goals. In working with me, clients often are able to hear and speak up in their own voice when it's in danger of being crowded out by others' opinions and wishes. I will also offer support and encouragement to empower and embolden clients to answer a calling if they should hear one.
Tammy Holcomb, LPCS, CEDS, NBCCH
Licensed Professional Counselor
5001 S Miami Blvd. Ste 325, Durham, North Carolina 27703
One of the areas I enjoy helping people address is identity, and much of our identity can come from our chosen career. I like to help people explore their strengths and find ways to match these strengths with a career path. I enjoy helping people identify different aspects of their personality that they can build on. I utilize hypnotherapy and experiential exercises to help people develop their vision for the future.
Rachel Ford, Rachel Ford, Ed.S., LPA
Licensed Psychological Associate
7404 B Chapel Hill Road, Raleigh, North Carolina 27607
Career counseling is a specialty of mine. In particular, I enjoy helping college students and adults with career assessment and planning. I offer the online assessment. Strong Interest Inventory. which is very helpful in narrowing down career choices, skills, and interests. I also offer counseling to help clients think through career choices and the influences that have led them to the current time in their vocational journey while charting a path for the future.
Beth Holloway, MA, LPC
Beth Mumford Holloway
5909 Falls of Neuse Road, Suite 208, Raleigh, North Carolina 27609
Years ago people tended to find one profession and stick with it their entire life. That is no longer the case. Many of my client's are seeking to again self-awareness of their strengths and areas of need to find a better fit for their occupation. Others want to explore the possibility of having their dream job or starting their own business. Career counseling can provide that opportunity for client's to clarify their career goals, balancing responsibility with pleasure in their occupation. Counseling is about gaining insights into past failures, overcoming the fear preventing us from taking the next step.
Mike Garrett, Ph.D, LPC
Licensed Professional Counselor
809-1000 Spring Forest Road, Raleigh, North Carolina 27609
Dr. Mike Garrett and Christian Counseling Associates of Raleigh are trained to help you through the life transitions of career evaluation and career re-direction. Career Assessments and Life Coaching make this an uplifting and extremely beneficial process of rethinking and refocusing for the future. Don't get stuck in under-employment or wrong-employment as well as un-employment. Let us help.
Susan Miller, PhD, LPCS, NCC
Licensed Professional Counselor
Miller Counseling Services, PC 156 Mine Lake Ct. Suite 200, Raleigh, North Carolina 27615
Trying to figure out what to do next in your career path? As a trained Life coach and psychotherapist Dr. Miller provides Career Counseling, Entrepreneur Coaching and Life Coaching to help you determine your strengths and weaknesses and process any bumps along the way. She is committed to help you get on your way to a better life path that suits your particular passions and purpose.
Blake Clemmons, MA, LPCA
Licensed Professional Counselor Associate
2124 Crown Centre Dr. Suite 400, Charlotte, NC 28, Charlotte, North Carolina 28227
Is anxiety, stress, depression or addiction keeping you from the career of your dreams? Do you lack motivation to do the work necessary to find a fulfilling and satisfying job? I can help you work through these challenges in your journey to finding a better job. Sometimes fear of interviews, procrastination, anger issues, interpersonal problems with coworkers, and fear of taking appropriate risks can be barriers to personal and career growth. Can you imagine what it would be like to overcome these barriers and live in excitement and freedom in your career instead of fear and drudgery? if you are willing to do the personal work it takes to work through these challenges, I believe I can help.


text: Don - Unregistered January 20, 2012 6:46 PM The new car is growing on me. I thought it was hideous initially, but they look pretty good in full livery. Hopefully, the safety features will keep the cars on the ground on high speed ovals. Can't wait for the season to start! 1 agree 0 disagree


text:
|Synopsis Home
|Isaiah Chapter 30
Chapter 1
Chapters 2 to 4
Chapter 5
Chapter 6
Chapters 7 to 9
Chapters 9:8 to 12
Chapters 13 and 14
Chapters 15 to 18
Chapters 19 to 23
Chapter 24
Chapters 25 and 26
Chapter 27
Chapter 28
Chapter 29
Chapter 30
Chapter 31
Chapter 32
Chapters 33 and 34
Chapter 35
Chapters 36 to 39
Chapter 40
Chapters 41 to 43
Chapters 44 and 45
Chapters 46 to 48
Chapter 49
Chapter 50
Chapters 51 and 52
Chapter 53
Chapter 54
Chapters 55 to 57
Chapters 58 and 59
Chapter 60
Chapters 61 and 62
Chapter 63
Chapters 64 and 65
Chapter 66
Unbelief and trust in man and their result; God's perfect grace
The effect of this unbelief is manifested in chapter 30. The people put their trust in man, according to the wisdom of man. They look to Egypt for help, but in vain. This contempt of Jehovah, accompanied by an absolute refusal to hearken to His word, which called on the people to trust quietly in Him, added yet more to their iniquity. God allows the evil, therefore, to go on to the full; but it is in order to give then free course to His grace. Verse 18 is a marvellous testimony to the ways of Jehovah. He allowed the chastisement to be fully accomplished, that nothing might be left for Him but perfect grace. Grace and glory will abound, when Jehovah shall bind up the breach of His people and heal their wound. At the end of the chapter we have the intervention of Jehovah against this last instrument of His chastisements -- the rod of chapter 10. The Assyrian is destroyed, and in the place where the rod should fall on him, there shall be only songs of triumph. But Tophet, the fire of Jehovah, was prepared for another also -- "for the king." He who shall have assumed that title in Israel shall be consumed also by the indignation of Jehovah.Synopsis by John Darby


text:
Unlike incandescent bulbs that produce glaring, yellow light, this desk lamp's fluorescent bulb generates clear light that reduces eyestrain and enables clearer vision. Simulating the color fidelity of natural sunlight, the bulb has a correlated color temperature of 6,400� Kelvin that illuminates books, crafts, or computer screens with a distortion-free glow. The energy-efficient 27-watt fluorescent bulb is equivalent to a 108-watt incandescent bulb and lasts up to 10,000 hours--ten times longer than a typical bulb. The desk lamp has an adjustable neck and an on/off switch. Select finish: Chrome/Black (chrome lampshade, neck, and base with black wooden pole) or Antique Brass/Cherry (brass lampshade, neck, and base with birch, cherry-finished pole). The bulb illuminates after a one second delay. Desk Lamp. 22" H x 8"-diameter base. (7 lbs.)
Lifetime Guarantee
The Eyestrain Reducing Desk Lamp comes with The Hammacher Schlemmer Lifetime Guarantee. If this product ever disappoints you, for any reason, you may return your Hammacher Schlemmer purchase for exchange, credit, or refund.
Should you have any questions, we are available seven days a week (8:00 am – midnight EST). Please call 1-800-321-1484 to speak with a specialist or email us at email@example.com to receive a response within three business hours or less.
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(based on 9 reviews)
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(1 of 1 customers found this review helpful)
Excellent Design
By Moe
from Bethesda, MD
It is attractively designed, sturdy and adjustable neck. Unfortunateely I will have to return mine due to the harshness of the light. Other than that I would highly recommend this lamp.
Bottom Line Yes, I would recommend this to a friend
Was this review helpful? Yes / No
- flag this review
I would defintely buy this product again
By PB
from Victoria, Texas
I work at my computer 8-12 hours a day and this light has eased my eye strain. I love it - in fact, I'm buying another one for another desk I work at!
It's a lamp
By NiagaraJoe
from Milton.FL
Bulb hangs below edge of lamp sheild because the electric socket is not mounted properly in the lamp. It was not worth the hassle of returning for a new one - the next one might have the same problem.
Bottom Line No, I would not recommend this to a friend
I would purchase again if a two-or-three way bulb exists.
By Scooter
from Alexandria Virginia
I like the flexibility of the lamp; but am disappointed that the bulb has only one level of brightness.
I have more than one
By No nickname
from Bethlehem, PA
Great delivery time. Used as a desk lamp.Love the style.
Loved my new lamp
By Paula
from Texas
This lamp gives out alot of light.Good for reading and doing craft products.
Efficient, broad 'daylight' at my desk
By Re
from Southern Maine
this is second time I have bought the product to now add another desk lamp to my home because of quality, function, ease of placement and use.
This is just what it says a great desk l
By MARTY
from Copperas Cove, Texas
Fast delivery
Was sent the wrong item first time
By Old Girl
from Jamsestown, nc
Received the floor lamp when we had ordered the desk lamp and had to exchange it for the the right one. Had no problems with the exchange. He loves the lamp, it gives him the exact light he needs
COPYRIGHT © 2017 HAMMACHER SCHLEMMER & COMPANY, INC. ALL RIGHTS RESERVED. W107147 E. 57th ST • NEW YORK, NY • 10022 • 1-800-_321-1484