Personal attenuation ratings versus derated noise reduction ratings for hearing protection devices.

National and international regulatory and consensus standards setting bodies have previously proposed derating hearing protector ratings to provide a better match between ratings determined in a laboratory and the real-world measurements of attenuation for workers. The National Institute for Occupational Safety and Health has proposed a derating scheme that depends upon the type of protector. This paper examines four real-world studies where personal attenuation ratings (PARs) were measured at least twice, before and after an intervention in earplug fitting techniques.

The Effect of Using an Active Earmuff on High Frequency Hearing in United States Marine Corps Weapons Instructors.

Objectives: To investigate the change in hearing and perceived comfort over 1 year related to using an active hearing protection device (HPD) among United States Marine Corps (USMC) personnel routinely exposed to hazardous noise.

Methods: USMC Weapons Instructors (n = 127) were issued an active earmuff that met military standards and was compatible with other protective equipment. These participants completed pre- and post-hearing tests and comfort surveys.

I Feel Like I Am Flying and Full of Life: Contemporary Dance for Parkinson's Patients.

Parkinson's is a neurodegenerative disease characterized by motor and non-motor symptoms which are strongly associated with patients' quality of life, affecting social skills and support. It strikes not only the motor abilities but may harm cognitive and emotional functioning. For the past 15 years, contemporary dance has been employed as an intervention to help people diagnosed with Parkinson's disease cope physically and mentally by way of motor, vestibular, and sensory stimulation as well as social interaction.

The Effect of Age on T-Regulatory Cell Number and Function in Patients With Asthma.

T-regulatory cells (Tregs) play a key role in suppressing effector cells and maintaining self-tolerance. Studies of younger adults and children suggest that insufficient differentiation and functional defects of Tregs may contribute to the development of asthma; however, data from older patients with asthma are limited. To address the effects of aging on the relationship of Treg frequency and function with clinical outcomes, we collected induced sputum (differential cell count and Treg frequency) and peripheral blood (Treg function and frequency) from aged (> 60 years of age) and younger (20-40 years old) patients with asthma.

How hearing conservation training format impacts personal attenuation ratings in U.S. Marine Corps Training Recruits.

Objective: The purpose of this fit-testing study in the field was to systematically compare three Hearing Protection Device (HPD) fit-training methods and determine whether they differ in the acquisition of HPD fitting skill and resulting amount of earplug attenuation.

Design: Subjects were randomly assigned to receive HPD fit-training using one of three training methods: , (eHPD), and . Personal Attenuation Ratings (PARs) were acquired via HPD fit-testing and used to verify attenuations pre- and post-training.

Use of Telehealth Screening to Detect Diabetic Retinopathy and Other Ocular Findings in Primary Care Settings.

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The viability of hearing protection device fit-testing at navy and marine corps accession points.

Introduction: The viability of hearing protection device (HPD) verification (i.e., fit-testing) on a large scale was investigated to address this gap in a military accession environment.

COAGULASE-NEGATIVE STAPHYLOCOCCUS-INDUCED FROSTED BRANCH ANGIITIS AFTER INTRAVITREAL ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR INJECTION.

Purpose: To describe a case of frosted branch angiitis after intravitreal ranibizumab injection.

Methods: Retrospective chart review.

Results: A patient with a history of neovascular age-related macular degeneration underwent intravitreal ranibizumab injection and subsequently developed coagulase-negative Staphylococcus endophthalmitis with findings of frosted branch angiitis.

Optogenetics, visual prosthesis and electrostimulation for retinal dystrophies.

Purpose Of Review: Outer retinal degenerations such as retinitis pigmentosa can cause profound vision loss. Various treatment strategies are being pursued to potentially restore functional vision in these patients.

Recent Findings: Advances in retinal prostheses have restored some vision in patients previously blind from retinitis pigmentosa.

E-Learning in postsecondary education.

Over the past decade postsecondary education has been moving increasingly from the classroom to online. During the fall 2010 term 31 percent of U.S.

Acute retinal artery occlusion in systemic sclerosis: a rare manifestation of systemic sclerosis fibroproliferative vasculopathy.

Objectives: To describe three patients with systemic sclerosis (SSc) who developed acute unilateral blindness in the absence of any common etiologic factor for blindness. In one patient, the affected eye required enucleation and was examined histopathologically.

Methods: Following identification of the first patient with retinal artery occlusion at the Scleroderma Center of Thomas Jefferson University, every patient evaluated at the Center from May 2001 to December 2010 was prospectively assessed for the development of acute unilateral blindness.

Telehealth practice recommendations for diabetic retinopathy, second edition.

Ocular telemedicine and telehealth have the potential to decrease vision loss from DR. Planning, execution, and follow-up are key factors for success. Telemedicine is complex, requiring the services of expert teams working collaboratively to provide care matching the quality of conventional clinical settings.

B-type natriuretic peptide testing and the accuracy of heart failure diagnosis in the emergency department.

Background: It is often difficult to diagnose heart failure (HF) accurately in patients presenting with dyspnea to the emergency department (ED). This study assessed whether B-type natriuretic peptide (BNP) testing in these patients improved the accuracy of HF diagnosis.

Methods And Results: Patients presenting to the Alfred and the Northern Hospital EDs with a chief complaint of dyspnea were enrolled prospectively from August 2005 to April 2007.

Ocular telemedicine between Nepal and the USA: prevalence of vitreoretinal disease in rural Nepal.

This study is aimed at reporting experiences with telemedicine between Nepal and the USA and at reporting the prevalence of age-related macular degeneration (AMD) and diabetic retinopathy (DR) in rural Nepal. AMD and DR are becoming more significant factors for non-reversible vision loss in rural Nepal due to increasing life expectancy and urbanisation. The prevalence of DM is low compared with the developed world, but the percentage of diabetics with DR is high, presumably due to limited access to healthcare.

Individual differences within and across feedback suppression hearing aids.

Background: New and improved methods of feedback suppression are routinely introduced in hearing aids; however, comparisons of additional gain before feedback (AGBF) values across instruments are complicated by potential variability across subjects and measurement methods.

Purpose: To examine the variability in AGBF values across individual listeners and an acoustic manikin.

Research Design: A descriptive study of the reliability and variability of the AGBF measured within six commercially available feedback suppression (FS) algorithms using probe microphone techniques.

B-type natriuretic peptide testing, clinical outcomes, and health services use in emergency department patients with dyspnea: a randomized trial.

Background: B-type natriuretic peptide (BNP) is used to diagnose heart failure, but the effects of using the test on all dyspneic patients is uncertain.

Objective: To assess whether BNP testing alters clinical outcomes and health services use of acutely dyspneic patients.

Design: Randomized, single-blind study.

Preferred and minimum acceptable listening levels for musicians while using floor and in-ear monitors.

Purpose: This study examined the impact that changing on-stage music and crowd noise levels during musical performance had on preferred listening levels (PLLs) and minimum acceptable listening levels (MALLs) across both floor and in-ear monitors.

Method: Participants for this study were 23- to 48-year-old musicians, with and without hearing loss, who had 10 years of musical training or comparable professional experience. For this study, PLLs and MALLs were established for the musician's own voice, whereas the levels of other onstage musical signals were systematically varied.

Feasibility and short-term efficacy of percutaneous mitral annular reduction for the therapy of functional mitral regurgitation in patients with heart failure.

Background: While functional mitral regurgitation (MR) commonly accompanies heart failure and contributes to heart failure progression, mitral repair in the setting of HF is not routinely practiced because of the attendant significant morbidity and mortality. This limitation has fostered the development of percutaneous devices to reduce MR, and our group has recently reported the short- and long-term effectiveness of a percutaneous mitral annuloplasty device placed in the coronary sinus (Percutaneous Mitral Annuloplasty Device (PMAD), Cardiac Dimensions(R), Inc., Kirkland, WA) in reducing MR in experimental animal models of heart failure with associated MR.

A complicated percutaneous coil embolisation of a large coronary artery fistula.

A coronary artery fistula is a rare cause of cardiac symptoms or signs in an adult. We report here the successful percutaneous treatment of a large fistula in an adult who had suffered an acute myocardial infarction peri-operatively due to a steal phenomenon. Due to the fistula size, a specially constructed occlusion device was utilised for effective treatment.

Telehealth practice recommendations for diabetic retinopathy.

Telehealth holds the promise of increased adherence to evidenced-based medicine and improved consistency of care. Goals for an ocular telehealth program include preserving vision, reducing vision loss, and providing better access to medicine. Establishing recommendations for an ocular telehealth program may improve clinical outcomes and promote informed and reasonable patient expectations.

Surgical ablation of retinal angiomatous proliferation.

Age-related macular degeneration (AMD) remains the leading cause of visual loss in adults older than 65 years. Retinal angiomatous proliferation (RAP) is a newly recognized manifestation of exudative AMD that has a poor natural history and demonstrated resistance to treatment with conventional laser photocoagulation. A novel surgical technique has been developed in this pilot series that shows promise in the treatment of this subtype of neovascular lesions.