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Introduction Previous research suggests that African Americans are less likely than Caucasians to perceive tinnitus in sustained silence. Objective To evaluate the association between non-cutaneous melanin as indicated by eye color and the emergence of temporary tinnitus during a brief period of silence. Methods A cross-section of adults grouped according to their eye color were exposed to silence. A total of 62 adults, aged 18 to 35 years (10 males, 52 females) were required to sit in silence for 10 minutes, after which they filled out a questionnaire to report their eye color and any perception of sounds in the ears or head. Results In total, 63% of the participants perceived tinnitus while sitting in silence, and, of these 95% perceived the tinnitus sounds within 5 minutes of sitting in silence. Though African Americans were less likely to perceive tinnitus in silence, this difference was not significant (p = 0.6). After a period of silence, 69% of the subjects with light-colored eyes and 58% of the dark-eyed subjects perceived tinnitus. This difference was not statistically significant (χ2(1) = 0.77; p = 0.38). Conclusion When exposed to reduced auditory stimulation, 3 out of 5 normal-hearing people are likely to experience tinnitus. However, there was no relationship between eye color and the perception of tinnitus in silence. Although melanin has been shown to play a role in the protection of the ear against noise trauma and the effects of age-related hearing loss, its role in the emergence of tinnitus needs further investigation.

Purpose The intended purpose of this research note is to share the findings of a needs assessment online survey of speech and hearing professionals practicing in North Carolina to explore their interest in pursuing a research-focused PhD in Communication Sciences and Disorders (CSD) and to document their perceptions of barriers to pursing a PhD in CSD. In view of the well-documented shortage of doctor of philosophy (PhD) faculty to attract, retain, and mentor doctoral students to advance research and to prepare future speech and hearing professionals, CSD faculty must assess the needs, perceptions, and barriers prospective students encounter when considering pursuing a doctoral research degree in CSD. Method The article describes the results of a survey of 242 speech and hearing professionals to investigate their interest in obtaining an academic research-focused PhD in CSD and to solicit their perceived barriers to pursuing a research doctoral degree in CSD. Results Two thirds of the respondents (63.6%) reported that they had considered pursuing a PhD in CSD. Desire for knowledge, desire to teach, and work advancement were the top reasons given for pursuing a PhD in CSD. Eighty-two percent of respondents had no interest in traditional full-time study. Forty-two percent of respondents indicated that they would be interested in part-time and distance doctoral study. The barriers of time, distance, and money emerged as those most frequently identified barriers by respondents. Conclusion The implications inform higher education faculty on how they can best address the needs of an untapped pool of prospective doctoral students in CSD.

Objective The present study compared wave I amplitude of auditory brainstem responses (ABRs), a potential indicator of cochlear synaptopathy, among musicians and non-musicians with normal audiograms. Design Noise exposure background (NEB) was evaluated using an online questionnaire. Two-channel ABRs were recorded from the left ear using click stimuli. One channel utilized an ipsilateral tiptrode, and another channel utilized an ipsilateral mastoid electrode. ABRs were collected at 90, 75, and 60 dBnHL. A mixed model was used to analyze the effect of group, electrodes, and stimulus levels on ABR wave I amplitude. Study sample 75 collegiate students with normal hearing participated in the study and were grouped into a non-music major group (n = 25), a brass major group (n = 25), and a voice major group (n = 25). Results The NEB was negatively associated with the action potential (AP) and ABR wave I amplitude for click intensity levels at 75 dBnHL. The mean amplitude of the ABR wave I was not significantly different between the three groups. Conclusion The weak negative association of AP and ABR wave I amplitude with NEB cannot be solely attributed to evidence of cochlear synaptopathy in humans as the possibility of hair cell damage cannot be ruled out. Future research should investigate the effects of reduced cochlear output on the supra-threshold speech processing abilities of student musicians.

Purpose The purpose of the study was to identify key nursing diagnoses with related factors and signs/symptoms using NANDA-I for patients with heart failure (HF). Methods A retrospective descriptive design was used to address the research questions. Data were obtained from the records of patients discharged for 1 year with the medical diagnoses of HF from a Midwestern community hospital. A total of 272 inpatient records were analyzed to describe the frequency and percentage of NANDA-I diagnosis with related factors and signs/symptoms. Results The top 10 NANDA-I diagnoses associated with related factors and signs/symptoms were identified. Conclusion Further research related to standardized nursing terminologies such as NANDA-I using large clinical databases from health information systems is needed to support evidence-based nursing diagnosis decision making.

Background Administration of vasopressors in patients with septic shock can be a difficult skill for nurses to learn. Simulation-based learning (SBL) may be a useful tool for improving nurses' self-efficacy and skill performance in this context. Methods The purpose was to determine if an SBL experience increases nurses' self-efficacy and performance across three time points, using a quasi-experimental pre–post test design. Results We identified statistical trends in 16 RNs for improvement in self-efficacy (general and situational) and performance over time. Conclusions SBL training demonstrated an effect on self-efficacy and performance. Additional research is needed to confirm these findings.

The purpose of this study was to quantify how the use of two different cutoff criteria affects the test failure rate and potential diagnosis of central auditory processing disorder ([C]APD) in a sample of children subjected to central auditory processing ([C]AP) assessment. Test failure rates for the central test battery (CTB) using two different cutoff criteria (1 and 2 SDs below the mean) were measured retrospectively for 98 children who completed (C)AP assessment. The rates of potential (C)APD diagnosis ranged from 86.8% [when a 1 standard deviation (SD) cutoff was used] to 66.2% (when a 2 SD cutoff was used). The current use of two different cutoffs for the CTB has a large impact on the diagnostic rate for (C)APD. These findings have clinical implications for the diagnosis of (C)APD due to the widespread use of the CTB in the United States for the assessment of (C)APD in children. Thus, it is important to create awareness among audiologists that use of the 2 SDs cutoff criterion is recommended for reducing false positives (error).

Objective: This preliminary study examined if baseline measures of stress-related biomarkers as measured by salivary secretions of specific autonomic (measured by salivary α-amylase), endocrine (measured by salivary cortisol), and immune (measured by salivary neopterin) responses are greater in male subjects with tinnitus in response to an induced-stress task. Method: Twenty male subjects with no significant hearing loss, 10 with tinnitus and 10 without tinnitus were enrolled in this study. Salivary secretions were collected before and after the induced stress task at four different time intervals. Results: Salivary α-amylase levels were lower in the tinnitus group in comparison to subjects without tinnitus, suggesting impaired sympathetic activity in the subjects with tinnitus although these levels remained stable throughout the stress experiment. While no significant effects could be obtained for salivary cortisol or neopterin, salivary neopterin levels were trending toward significance over all measurements. Behavioral measures of stress were found to correlate negatively with measures of salivary α-amylase and salivary neopterin. Conclusion: The results of this study suggest impaired stress-related salivary α-amylase mechanisms in male subjects with tinnitus, as evidenced by the different stress reactions induced in the endocrine system (as measured by salivary cortisol) and the immune system (as measured by salivary neopterin).

In this article, the authors describe a biopsychosocial approach to group audiologic/aural rehabilitation (AR) for late deafened adults with cochlear implants. A detailed account of Cochlear Implant Connections is provided, including the individual components of this innovative program. A qualitative review of written narratives and videotaped AR sessions illustrates the ongoing needs, expectations, challenges, and experiences of this underserved patient population. These challenges underscore the need for ongoing AR, including instruction, counseling, and support, to promote late deafened adults’ psychosocial adjustment and to maximize their peripheral and central auditory adaptation to cochlear implant use.

The aim was to demonstrate the need for a quality of life assessment in biopsychosocial aural rehabilitation (AR) practices with late deafened adults (LDAs) with cochlear implants (CIs). We present a case report of a medical records review of two LDAs enrolled in a biopsychosocial group AR program. A speech perception test Contrasts for Auditory and Speech Training (CAST) and a quality of life (QoL) assessment the Nijmegen Cochlear Implant Questionnaire (NCIQ) were given prior to AR therapy. CAST scores indicated both patients had excellent basic speech perception. However, NCIQ results revealed patients’ difficulties in basic and advanced listening settings. NCIQ highlighted patients’ self-perceived poor self-esteem and ongoing challenges to their QoL. Speech perception testing results alone are not enough to document the daily challenges of QoL needs of LDAs with CIs. The inclusion of a QoL measure such as the NCIQ is vital in evaluating outcomes of cochlear implantation in LDAs.

Previous research on the causes of exercise addiction has focused primarily on the relationships among personality traits, social influences, and disordered eating ( Bamber, Cockerill, & Carroll, 2000 ; Beals, 2004 ). Few studies, however, have examined the psychophysiological nature of exercise addiction. In a related area of research in which brain activity has been related to affect and mood, results show that frontal asymmetry, as measured by electroencephalogram (EEG), is associated with negative emotions. More specifically, greater activity at right frontal electrode sites is found among individuals suffering from negative affect and depression. Because a defining feature of exercise addiction is the use of exercise to control negative mood states, it is expected that those with exercise addiction exhibit different frontal activity. This study explores the hypothesized relationship between exercise addiction and the level of baseline frontal activity asymmetry, as measured by EEG. Regularly active women (n = 28, M age = 32.43, SD = 10.89) were recruited to participate in the study. Exercise addiction status was determined by the Exercise Addiction Inventory (EAI) ( Terry, Szabo, & Griffiths, 2004 ). After completing the EAI, each participant took part in an EEG session consisting of eight 1-min resting trials, four with eyes open, and four with eyes closed, presented in counterbalanced order. Electrodes were applied to the left and right frontal sites (F3 and F4). A regression analysis, predicting exercise addiction from frontal asymmetry, was significant, F(1, 27) = 6.4, p < .05, and indicated that greater relative left frontal activity with higher exercise addiction scores. There may be a link between frontal asymmetry, as an indicator of negative emotions, and exercise addiction in women.

This study examined the level of preparedness of North Carolina speech-language pathologists (SLPs) who serve school-aged children with cochlear implants (CIs). A survey distributed to 190 school-based SLPs in North Carolina revealed that 79% of the participants felt they had little to no confidence in managing CI technology or in providing services to children with CIs. Survey results disclosed that 47% of SLPs had either no formal instruction or only one college lecture on CIs. Findings indicated that a lack of instruction in other hearing-related topics exists at both the undergraduate and graduate levels. These results underscore the urgent need for revising preservice curricula for SLPs and audiologists to include more practical training in the habilitation/rehabilitation of children with CIs. Findings also emphasize the need for current practitioners to engage in continuing education to update their knowledge of emerging innovations in CI technology and habilitation.

The purpose of the study was to identify key nursing diagnoses with related factors and signs/symptoms using NANDA-I for patients with heart failure (HF).A retrospective descriptive design was used to address the research questions. Data were obtained from the records of patients discharged for 1 year with the medical diagnoses of HF from a Midwestern community hospital. A total of 272 inpatient records were analyzed to describe the frequency and percentage of NANDA-I diagnosis with related factors and signs/symptoms.The top 10 NANDA-I diagnoses associated with related factors and signs/symptoms were identified.Further research related to standardized nursing terminologies such as NANDA-I using large clinical databases from health information systems is needed to support evidence-based nursing diagnosis decision making.

OBJECTIVE: The effect of sustained silence was studied on the emergence of tinnitus perception in 120 normal hearing young adult Caucasians and African Americans. STUDY DESIGN AND SETTING: After sitting in a sound booth for a period of 20 minutes, participants were asked to complete a questionnaire documenting whether they perceived sounds in the silent setting and descriptions of the sounds they heard. RESULTS: Tinnitus-like sounds were perceived in 64% of listeners overall. No significant differences in tinnitus perception were observed between males and females. However, there was a significant difference in tinnitus perception between Caucasian and African American subjects, with tinnitus sounds emerging in sustained silence less frequently in African American listeners. Tinnitus emerged quickly in a majority of subjects (less than 4 minutes) and African American subjects who perceived tinnitus heard a greater number of individual tinnitus-like sounds than did Caucasian subjects. Ring (57%), buzz (21 %), pulse (22%), heartbeat (21 %), and hum (14%) were the most common sounds heard, with ring being the most common overall tinnitus per-ception. CONCLUSIONS AND SIGNIFICANCE: Few investigators have documented at the emergence of tinnitus in normal hearing subjects. Results of the current study found significant differences in tinnitus perception between Caucasian and African American subjects, but found no significant differences when comparing males and female subjects. EBM rating: C. (Otolaryngol Head Neck Surg 2005;132:20-4.)

The effects of stimulus rate and gender on the auditory middle latency response (AMLR) waveforms were examined in 20 young adult male and female subjects. Four different repetition rates were presented to subjects (1.1/sec, 4.1/sec, 7.7/sec, and 11.3/sec). Stimulus repetition rate had a significant effect on Pa latency, Pa amplitude, and Pb amplitude. Pa and Pb amplitudes decreased with increasing the stimulus rate, and Pa latency significantly increased with increasing the stimulus rate. No significant differences were seen on Pb latency or site of recording. Gender had a significant effect on Pa latency and Pa amplitude. Pa latencies were longer in male subjects, and Pa amplitudes were larger in female subjects. Gender did not have a significant effect on the Pb waveform.

Most clinicians agree that critically ill patients are at significant risk of developing stress-related ulcers and may have already developed mucosal lesions even if they are asymptomatic. Many options, including new pharmacologic advances, are available for the treatment and prophylaxis of stress-related ulcers; therefore, all critically ill patients should receive prophylaxis, even if they do not require treatment. Nutrition may play a significant role in the future in preventing stress-related ulcers. By improving stores of critical elements such as antioxidants, vitamins, and minerals before surgery, patients may lower the risk of developing stress ulcers. Critical care clinicians are critical in preventing and treating stress-related ulcers and should be vigilant in their patient care.

This study aimed to investigate differences between ears in performance on a monaural word recognition in noise test among individuals across a broad range of ages assessed for (C)APD. Word recognition scores in quiet and in speech noise were collected retrospectively from the medical files of 107 individuals between the ages of 7 and 30 years who were diagnosed with (C)APD. No ear advantage was found on the word recognition in noise task in groups less than ten years. Performance in both ears was equally poor. Right ear performance improved across age groups, with scores of individuals above age 10 years falling within the normal range. In contrast, left ear performance remained essentially stable and in the impaired range across all age groups. Findings indicate poor left hemispheric dominance for speech perception in noise in children below the age of 10 years with (C)APD. However, a right ear advantage on this monaural speech in noise task was observed for individuals 10 years and older.

Auditory middle latency response (AMLR) brain maps were obtained in 11 young adults with normal hearing. AMLR waveforms were elicited with monaural clicks presented at three stimulus intensity levels (50, 70, and 90 dB nHL). Recordings were made for right and left ear stimulus presentations. All recordings were obtained in an eyes open/awake status for each subject. Peak-to-peak amplitudes and absolute latencies of the AMLR Pa and Pb waveforms were measured at the Cz electrode site. Pa and Pb waveforms were present 100 percent of the time in response to the 90 dB nHL presentation. The prevalence of Pa and Pb to the 70 dB nHL presentation varied from 86 to 95 percent. The prevalence of Pa and Pb to the 50 dB nHL stimulus never reached 100 percent, ranging in prevalence from 77 to 68 percent. No significant ear effect was seen for amplitude or latency measures of Pa or Pb. AMLR brain maps of the voltage field distributions of Pa and Pb waveforms showed different topographic features. Scalp topography of the Pa waveform was altered by a reduction in stimulus intensity level. At 90 dB nHL, the Pa brain map showed a large positivity midline over the frontal and central scalp areas. At lower stimulus intensity levels, frontal positivity was reduced, and scalp negativity over occipital regions was increased. Pb scalp topography was also altered by a reduction in stimulus intensity level. Varying the stimulus intensity significantly altered Pa and Pb distributions of amplitude and latency measures. Pa and Pb distributions were skewed regardless of stimulus intensity. Abbreviations: AMLR = auditory middle latency response, EEG = electroencephalography

Telehealth is the practice of providing health care services to people who are distant from the provider by the use of telecommunications and information technology. These services include client care, consultations, education, and research. Concerns include financial cost, reimbursement, liability, licensure, and confidentiality. Research to document treatment cost-effectiveness and efficacy is ongoing.

The area-under-the-curve (AUC) measure of the auditory middle latency response (AMLR) waveform was derived and analyzed from recordings in 50 subjects with normal hearing. The AUC metric is believed to represent the total amount of neural energy contributing to the evoked response. This proposed method of measure, therefore, may provide an alternative method of quantifying the response. The subjects were divided into five age groups ( n = 10 for each group): infants, children, preteens, teens, and adults. Ipsilateral and contralateral recordings of the AMLR were obtained at two stimulus levels (70 and 40 dB nHL) and at two stimulus rates (11.3 and 3.3/s). AUC measures were obtained for each recording at 70 and 40 dB nHL and at 3.3 and 11.3 clicks/s. These area measurements were compared among the five age groups for significant differences due to age. According to the results, no significant differences in the AUC of the AMLR waveform existed as a function of age.

Many nurses indicate that they lack the formal education needed to use resources such as the Internet and computer technology related to healthcare. The results of a survey at a baccalaureate school of nursing revealed that although nearly 100% of those surveyed used computers, very few effectively used available Internet resources. In response, the authors implemented strategies to make available Internet resources "user-friendly" for communication and information gathering.

Written nursing care plans are designed to focus students on individualizing nursing care, which promotes critical thinking and decision making. In actual practice, emphasis has shifted from care plans toward standards of care. The authors discuss a concise, simplified care plan format that includes both standards of care and collaborative problems. This plan of care is compatible with healthcare regulations and requires less time to produce and evaluate.

Nucleation of oriented diamond particles on cobalt substrates has been achieved by a multistep, hot‐filament chemical vapor deposition process, which involves seeding, annealing, nucleation, and then growth. The substrates were seeded with either diamond powders, graphite powders, or gaseous carbon species. Scanning electron microscopy showed that 〈111〉 oriented diamond particles were obtained on 〈0001〉 oriented single crystal cobalt substrates. Micro‐Raman indicated that the quality of the diamond grown on the cobalt substrate was high, with a full width at half maximum of 4.3 cm−1. A very weak graphitic peak was observed on regions of the substrate not covered by the diamond particles, indicating that graphite codeposition was significantly suppressed. Scanning Auger depth profile analysis was done to characterize the diamond nucleation. Based on the experimental observations, a nucleation model is proposed.

A monomeric hexachlorocuprate (II) ion has been found in the compound (3- chloroanilinium)8(CuCl6)Cl4, CuC48H56Cl18N8. The compound crystallizes in the triclinic space group Pl with unit cell dimensions a = 8.5488 (16) Angstroms, b = 13.964 (6) Angstroms, c = 14.273 (7) Angstroms alpha = 90.46 (4), beta = 107.82 (3)Angstroms, and gamma = 102.11 (3)Angstroms, with Z - 1. The coordination about the discrete (CuCl6)4- ion is that of a tetragonally compressed octahedron with bond distances Cu-Cl (1) = 2.2773 (11) Angstroms, Cu- Cl(2) - 2.6061(18) Angstroms, and Cu-Cl(3) - 2.6086(20) Angstroms. The two short bond distances are on the order frequently seen for copper-chloride bonds, but the remaining four bond distances are remarkably long for in-plane 4 + 2 coordination. Keywords: Hexachlorocuprate (II) 3-Chloroanilinium tetragonally compressed octahedron. (js)

The very thought of chest pain often brings terror to patients and health care providers. Chest pain typically invokes a "worst case" scenario of massive myocardial infarction (MI) resulting from cardiovascular disease (CD) and requiring immediate medical attention. However, chest pain is a common complaint suffered by most people at some time in their lives. People complaining of chest pain may be young, middle-aged, or elderly, and they may or may not be under a health care provider's care. Chest pain may be a symptom of a variety of disorders other than CD. Therefore it is helpful to differentiate quickly between the types of chest pain to determine whether immediate assistance is necessary.

This paper reports on the use of an emerging process technique for curing of polymer encapsulants as used in the electronic packaging industry. Previous work performed in the area of materials processing has demonstrated the usefulness of sweeping operating frequencies in order to achieve high levels of electric field uniformity and process control. The use of controlled variable frequency microwave energy has been evaluated as a process technique compatible with electronic packaging requirements. The heating of a series of integrated circuits (ICs) and their subsequent characterization was performed. IC integrity was investigated using X‐Ray, Acoustic Microscopy, Decapsulation and Bond Pull. Processing of liquid encapsulants, underfills and glob‐tops, used in Flip Chip and Chip On Board (COB) applications, was performed. Differential Scanning Calorimetry was used to study cure extent. Further studies show that variable frequency microwave processing leads to fast curing of encapsulants. A reduction in cycle times from 15 to 20 times over conventional curing has been observed. Also, results have showed a reduction in the stresses induced by mismatches in coefficient of thermal expansion.

Product quality control is a crucial part of manufacturing and usually involves materials characterization and diagnosis. Though various microwave assisted nondestructive evaluation (MA-NDE) systems have been fabricated for materials inspection, none of the systems can be applied to materials within a mold or reactor. A broadband variable frequency microwave based, resonant mode MA-NDE was studied as an alternative for characterization of materials within a cavity. The main advantage of the resonant mode MA-NDE are non-intrusive and volumetric diagnosis of the material inside a mold. The principles and possible applications of the resonant mode MA-NDE are discussed. Resonant mode MA-NDE was fully demonstrated by using Vani-Wave to trace material status during microwave curing of Diglycidyl Ether of Bisphenol A (DGEBA)/Diaminodiphenylsulphone (DDS) epoxy samples.

Within the past decade, sensory evoked responses (SERs) have been increasingly applied in acute brain injury. In this paper, we present the rationale for this clinical application and discuss principles and practices that are important for successful measurement and interpretation of sensory evoked responses (SERs) in the intensive care unit. Fundamentals of pathophysiology and management of acute brain injury are reviewed. Varied uses of SERs in brain-injured children and adults are illustrated with case reports. Our experience suggests that SER measurement in acute brain injury is clinically challenging yet rewarding. We conclude that, with sufficient preparation, the audiologist can assume an important position on the intensive care unit team in acute management of brain injury.