Objective Measurement of Listening Device Use and Its Relation to Hearing Acuity.

OBJECTIVES: To examine whether adolescents exceed recommended noise exposure limits when using personal listening devices (PLDs) and to investigate the relationship between objectively measured PLD use and hearing thresholds. STUDY DESIGN: Cross-sectional study. SETTING: This study was embedded within an ongoing prospective birth cohort study in Rotterdam, the Netherlands. Data were collected from May 2017 to September 2019. METHODS: A smartphone application was developed to measure daily noise exposure from PLDs. Listening habits were monitored among 314 adolescents with a mean age of 13 years 7 months (SD, 5 months), of whom 51.6% were male. Hearing acuity was measured by pure tone audiometry, and tympanometry was performed in both ears. RESULTS: Within the study group, 2.2% adolescents exceeded the recommended daily noise dose (85 dBA as an 8-hour time-weighted average) among all days when the application was active and 9.9% when among only the listening days. No significant correlation was found between the daily noise dose from PLDs and pure tone thresholds. CONCLUSIONS: The majority of adolescents exhibited listening habits that could be considered safe. As noise-induced hearing loss develops slowly over time, it could be that the effects of PLD use on hearing are not evident yet in this young population with a relatively short duration of PLD use.

Personal Music Players and Hearing Loss: The HUNT Cohort Study.

It is unclear whether the current average use of personal music players (PMPs) including mobile phones has affected hearing in the general population. The association between the use of PMPs and hearing loss was assessed in a large population cross-sectional and follow-up study with the following distribution: cross-sectional (2018): n = 26,606, 56% women, mean age 54 years and 20-year follow-up (baseline 1998): n = 12,115, 57% women, mean age at baseline 43 years. Hearing threshold was determined as pure-tone average over the frequencies 3, 4, and 6 kHz. We used linear regression to assess relationships between hearing threshold and PMP use (yes), duration (1-2/2-6/>6 h per week), or sound volume (low/medium/high), with nonuse as reference. The PMP use increased from 8% in 1998 to 30% in 2018. Compared with nonusers, neither use nor duration was related to hearing threshold. As to sound volume, listening at low levels was associated with better thresholds (-2.5 dB [-4.1 to -0.8]), while listening at high levels was associated with worse thresholds (1.4 dB [0.1 to 2.8]). We adjusted for age, sex, baseline hearing threshold, education, noise exposure, ear infections, head injury, and daily smoking. The association with sound volume was nearly twice as strong when adjusting for hearing threshold at baseline. Accordingly, the possibility of reverse causality was reduced although not eliminated by the follow-up design. This large population study showed no association between normal PMP use and 20-year progression in hearing; however users listening to high levels increased their hearing threshold.

Sonotherapy in the reduction of anxiety and postoperative pain in patients with regional anesthesia as a sole technique: randomized, controlled clinical trial.

OBJECTIVE: To determine if sonotherapy reduces the anxiety level and postoperative pain in adults undergoing outpatient orthopedic surgery under regional anesthesia. METHOD: A randomized, double-blind, placebo-controlled study in 80 adult patients undergoing orthopedic surgery, 40 received intervention with sonotherapy and 40 did not receive it. Pain, anxiety in the preoperative period, immediate postoperative, high, 24 and 48 hours later were measured. Hemodynamic parameters were measured in four moments. RESULTS: No significant differences were found between the two groups in the pain scales neither anxiety. A significant reduction of the systolic blood pressure was observed after the application of sonotherapy and in recovery. There was no difference in other hemodynamic variables such as heart rate, respiratory rate, arterial oxygen saturation or diastolic blood pressure between groups, however, the observed changes in some of them occurred faster in the intervention group. CONCLUSIONS: In adult patients undergoing outpatient orthopaedic surgery under regional anaesthesia, sound therapy is a novel strategy that significantly reduces systolic blood pressure, considered as an indicator of decreased anxiety. However, in our study, no difference could be demonstrated in terms of pain control or the need for additional sedation or analgesia.

OBJETIVO: Evaluar la eficacia de la sonoterapia en la diminución de la ansiedad y el dolor posoperatorio en adultos llevados a cirugía ambulatoria de ortopedia bajo anestesia regional. MÉTODO: estudio aleatorizado, doble ciego, controlado con placebo, en 80 pacientes adultos sometidos a cirugía ortopédica; 40 recibieron intervención con sonoterapia y 40 no la recibieron. Se midieron el dolor y la ansiedad en el preoperatorio, en el posoperatorio inmediato, al alta, y 24 y 48 horas después. Se midieron parámetros hemodinámicos en cuatro momentos. RESULTADOS: No se encontraron diferencias significativas entre ambos grupos en las escalas de dolor ni ansiedad. Se observó una reducción significativa de la presión arterial sistólica luego de la aplicación de la intervención y en recuperación. No se observaron diferencias en otras variables hemodinámicas entre los grupos, pero la reducción de algunas ocurre de forma más rápida en el grupo de intervención. CONCLUSIONES: En pacientes adultos llevados a cirugía ambulatoria de ortopedia bajo anestesia regional, la sonoterapia es una estrategia novedosa que reduce la presión arterial sistólica, y esto puede considerarse como un indicador de disminución de la ansiedad. En nuestro estudio no se pudo demostrar diferencia en términos de control del dolor ni de requerimiento de sedación o analgesia adicional.

Hábitos auditivos recreacionales y umbral tonal en la frecuencia audiométrica 6. 000 Hz en jóvenes universitarios / Recreational hearing habits and pure tone threshold at 6. 000 Hz frequency in university students

RESUMEN Introducción: La Organización Mundial de la Salud (OMS) (2013) define entre las causas de pérdida auditiva, la exposición a ruido. Una fuente de este ruido son los reproductores personales de música, cuyo uso representa una conducta de riesgo emergente. Es así como, existen estudios que registran daño auditivo inducido por ruido en los usuarios de reproductores personales en comparación con los no usuarios. Objetivo: Investigar la relación entre hábitos auditivos recreacionales y el rendimiento audiométrico en la frecuencia 6.000 Hz en jóvenes universitarios. Material y método: Se evaluaron 50 sujetos entre 18 y 26 años sin antecedentes otológicos. Se aplicó el Cuestionario CHAR y se realizó una audiometría tonal por vía aérea de 125 Hz a 8.000 Hz. Resultados: El análisis audiométrico, determinó la existencia de escotoma en el umbral auditivo de la frecuencia 6.000 Hz en 52% de los sujetos evaluados. Además se encontraron diferencias estadísticamente significativas entre los grupos con umbral bajo y sobre 20 dB en dicha frecuencia, relacionado con los años de exposición y volumen de uso del dispositivo. Conclusión: La exposición a ruido recreacional puede producir daño auditivo a temprana edad, generando la necesidad de planes para prevenir el daño prematuro de la audición en jóvenes.

ABSTRACT Introduction: Noise exposure is one of most common causes of hearing loss according to the World Health Organization (WHO). The use of personal music players is one of the sources of this harmful noise, which has been demonstrated to constitute a risky habit. Previous studies have found hearing loss produced by noise in users of music players compared to subjects who do not used them. Aim: The present study aimed to investigate the relationship between recreational hearing habits and hearing performance at 6000 Hz frequency in university students. Material and method: Fifty subjects (age range of 18-26 years), without history of otologic disorders were assessed. The CHAR questionnaire and an air conduction pure tone audiometry (125 Hz-8000 Hz) were administered to each participant. Results: Findings from pure tone audiometry demonstrated the presence of hearing scotoma at 6000 Hz frequency in fifty-two percent of subjects. Moreover, statistically significant differences were found when comparing subjects with normal threshold and subjects with threshold greater than 20 dB at 6000 Hz. This was related to years and intensity of noise exposure. Conclusion: Recreational noise exposure may cause hearing loss in early stages of lifespan. Prevention strategies to avoid early hearing loss in young subjects are required.

Comparison of acoustic therapies for tinnitus suppression: a preliminary trial.

OBJECTIVE: This study obtained preliminary data using two types of sound therapy to suppress tinnitus and/or reduce its functional effects: (1) Notched noise (1000-12,000 Hz notched within a 1-octave range centred around the tinnitus pitch match [PM] frequency); and (2) Matched noise (1-octave wide band of noise centred around the PM frequency). A third (Placebo) group listened to low frequency noise (250-700 Hz). DESIGN: Participants with bothersome tinnitus were randomised into one of the three groups and instructed to listen to the acoustic stimulus for 6 hours a day for 2 weeks. Stimuli were delivered using an iPod Nano, and tinnitus counselling was not performed. Outcome measures were recorded at the 0, 2 and 4 week study visits. STUDY SAMPLE: Thirty participants with constant and bothersome tinnitus were recruited and randomised. RESULTS: All groups showed, on average, overall improvement, both immediately post-treatment and 2 weeks following treatment. Outcomes varied between groups on the different measures and at the two outcome points. CONCLUSION: This study showed improvement for all of the groups, lending support to the premise that any type of sound stimulation is beneficial for relieving effects of tinnitus. These results may serve as a preliminary evidence for a larger study.

Utilização de estéreos pessoais por alunos do ensino médio: mensuração da intensidade utilizada e hábitos de uso / Use of digital audio players by high school students: measurement of use intensity and usage habits

RESUMO Objetivo Esta pesquisa teve como objetivo mensurar em um ambiente ruidoso o nível de pressão sonora dos estéreos pessoais de jovens do ensino médio, levantar suas queixas auditivas e extra-auditivas e seus hábitos de uso. Considerando-se ainda a preocupação com a saúde auditiva e as fontes utilizadas pelos jovens para obtenção de informações sobre o assunto. Método Trata-se de um estudo observacional, descritivo, quantitativo, de delineamento transversal, do qual participaram jovens do ensino médio. Inicialmente foi realizado o exame de emissões otoacústicas evocadas por estímulos transientes, seguido da resolução de um questionário e a mensuração do nível de pressão sonora dos reprodutores de música utilizados em situação ruidosa simulada. Resultados A partir da mensuração dos estéreos pessoais, foram encontradas as intensidades mínima, de 69 dB(A), e máxima, de 93 dB(A). Os resultados mostraram hábitos nocivos à saúde auditiva sendo realizados pelos jovens, tais como tempo de uso (horas, dias e anos) e intensidade utilizada nos estéreos pessoais, assim como sintomas que podem indicar suscetibilidade a perdas auditivas. Observou-se que os jovens, em sua maioria, afirmam preocupar-se com sua audição, no entanto não há mudança de atitude diante dessas situações. Conclusão O hábito do uso do estéreo pessoal é iniciado muito cedo dentro da população escolar e, em muitos casos, esse costume é praticado com o equipamento em intensidades elevadas, o que pode acarretar diversos prejuízos a esses alunos.

ABSTRACT Purpose The main goal of this study was to measure the sound pressure level of digital audio players of high school students and investigate their auditory and non-auditory complaints, and their hearing habits. Another goal was to consider the concern with hearing health and the knowledge sources used by young people to gather information about the subject. Methods This is an observational, descriptive, quantitative, and cross-sectional study, which had the participation of high school students. The first step was an examination of transient-evoked optoacoustic emissions, followed by the application of a questionnaire and the measurement of the volume of audio players. Results The results showed harmful habits of young people regarding hearing health, such as an excessive time of use (hours, days and years) and high volume levels of digital audio players (DAPs), as well as symptoms that may point to hearing loss. It was found that most young people seem to be concerned about their hearing; however, there is no change of attitude to such situations. Conclusion The students develop the habit of using DAPs at very early ages and, in many cases, this habit is practiced with the equipment operating at high intensities, which can cause several hearing losses in these students.

Queixas e hábitos auditivos de usuários de equipamento portátil de som / Complaints and hearing habits of portable stereo set users / Quejas y los hábitos de los usuarios de la audición de sonido portátiles

A exposição a ruídos em atividades de lazer, especialmente com o uso de fones de ouvido, pode afetar a saúde, o trabalho e as relações sociais de usuários desses dispositivos, sobretudo no que diz respeito à intensidade e ao tempo de exposição ao som. Objetivo: Caracterizar as queixas e hábitos auditivos de um grupo de usuários de equipamento portátil de som. Método: Foi aplicado um questionário semiestruturado sobre hábitos auditivos em um grupo de alunos e profissionais de uma universidade privada durante um evento social na própria instituição. Oitenta sujeitos responderam perguntas sobre hábitos e queixas auditivas e tiveram o nível de pressão sonora do equipamento de som (MP3, celular, IPod) estimado por meio de um medidor de nível de pressão sonora. Resultados: As principais queixas referidas após o uso do equipamento foram zumbido, dificuldade para entender e necessidade de aumentar o volume da televisão ou rádio após ouvir música. As queixas auditivas foram mais frequentes entre aqueles usuários que ouviam música em mais elevada intensidade. Conclusão: A maioria dos entrevistados relatou queixas auditivas após o uso do equipamento portátil de som (EPS), sendo mais frequentes entre aqueles que ouviam música em mais elevada intensidade.

Exposure to noise in leisure activities, especially with the use of headphones, can affect the health, labor and social relations of users of these devices, especially with regard to the intensity and the sound exposure time. Objective: To characterize the complaints and hearing habits of a group of adults in their use of portable stereo set. Methods: A semi-structured questionnaire about hearing habits was applied to a group of students during a social event at the University. Eighty subjects answered questions about habits and hearing complaints and had the sound pressure level of sound equipment (MP3, mobile phone, iPod) estimated by means of a sound pressure level meter. Results: The main complaints reported after the use of the equipment were buzzing, trouble understanding and need to increase the volume of television or radio after listening to music. Hearing problems were more frequent among those users who listened to music at a higher intensity. Conclusion: The majority of respondents reported hearing problems after portable stereo set use, which were more frequent among those who listened to music at a higher intensity.

La exposición al ruido en actividades de ocio, especialmente con el uso de auriculares, puede afectar a la salud, el trabajo y las relaciones sociales de los usuarios de estos dispositivos, especialmente en relación con la intensidad y el tiempo de exposición al ruido. Objetivo: Caracterizar las quejas y hábitos de escucha de un grupo de adultos debido al uso portátil equipo de sonido. Se aplicó un cuestionario semi-estructurado sobre hábitos de escucha en un grupo de estudiantes durante un evento social en la Universidad. Método: Ochenta sujetos respondieron preguntas sobre los hábitos y recibir las quejas y tenía el nivel de presión sonora de equipos de sonido (MP3, teléfonos móviles, iPod) estimado utilizando un medidor de nivel de presión sonora. Resultados: Las principales quejas reportadas después de la utilización de los equipos zumbaban, problemas para comprender y necesitan aumentar la intensidad de la televisión o la radio después de escuchar música. las afecciones auditivas fueron más frecuentes entre aquellos usuarios que escucharon música a una mayor intensidad. Conclusión: La mayoría de los encuestados declaró haber oído las quejas después de EPS de uso, que fueron más frecuentes entre los que escuchaban música a una mayor intensidad.

A feasibility pilot study on the use of complementary therapies delivered via mobile technologies on Icelandic surgical patients' reports of anxiety, pain, and self-efficacy in healing.

BACKGROUND: Complementary therapies (CT), such as relaxation technique, massage, guided imagery, and accupuncture have shown to benefit patients undergoing surgery. The aim of this study was to determine the feasibility of using audio relaxation technique (ART), music intervention (MI), nature video application with music (NVAM), and nature video application without music (NVA) delivered via mobile technologies in a clinical setting. Secondary, the effects of ART, MI, NVAM and NVA on patients' state anxiety, pain perception, and perceived self-efficacy in healing were determined. METHODS: A randomized clinical trial (RCT) involving 105 same day surgery (SDS) patients, who were assigned to an ART (n = 25), MI (n = 25), NVAM (n = 15), NVA (n = 16), or a control group (n = 24) were assessed for state anxiety, self-reported pain, and self-efficacy four days prior to surgery, immediately prior and following a surgical intervention, and day five post-operative. RESULTS: ANOVA found no statistically significant differences in anxiety scores; pain, or perceived self-efficacy between the five groups. Matched pairs t-Test revealed all participants had an increase in anxiety from pre-op to day 10 follow-up; a significant change in pain levels from pre-op to day 10 follow-up; and all participants had a significant increase in general self-efficacy from pre-op to day 10 follow-up. Mean pain level scores from day 1 to pre-op showed a significant decrease in pain for the ART group and NVAM group. Matched pairs t-Test for self-efficacy scores indicated the MI group and the NVA group had significant increases in self-efficacy. A significant decrease in anxiety from pre-op to day 10 for participants reporting a prior history of anxiety and for those reporting prior history of taking anti-anxiety medications. CONCLUSIONS: Despite the non-significant findings between the five groups, at any measurement point, there were valuable trends toward significance and confirmed feasibility in a clinical setting. Among the groups there were statistically significant findings for all interventions on anxiety, pain, and self-efficacy. The feasability of the implementation of novel interventions of NVAM and NVAM adds to clinical practice and the CT literature. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02236455 (September 4, 2014).

Evaluation of early hearing damage in personal listening device users using extended high-frequency audiometry and otoacoustic emissions.

Although sound exposure from personal listening devices (PLDs) could potentially lead to noise-induced hearing loss (NIHL), the actual hearing risk associated with the use of these devices is still unclear. In this study, early hearing effects related to PLD usage were evaluated in 35 young adult PLD users (listening for >1 h/day, at >50% of the maximum volume setting of their devices) and their age- and sex-matched controls using a combination of conventional and extended high-frequency audiometry as well as transient-evoked otoacoustic emission (TEOAE) and distortion product of otoacoustic emission (DPOAE) measurements. The mean listening duration of the PLD users was 2.7 ± 1.0 h/day while their estimated average listening volume was 81.3 ± 9.0 dBA (free-field corrected). Typical signs of NIHL were not detected in the audiogram of PLD users and their audiometric thresholds at most of the conventional test frequencies (0.25-8 kHz) were comparable with those obtained from controls. However, compared with the controls, mean hearing thresholds of PLD users at many of the extended high-frequencies (9-16 kHz) were significantly higher. In addition, TEOAE and DPOAE amplitudes in users were reduced compared with controls. The deterioration of extended high-frequency thresholds and the decrease in DPOAE amplitudes were more evident in the users' right ears. These results indicate the presence of an early stage of hearing damage in the PLD user group. Preventive steps should be taken as the initial hearing damage in these users could eventually progress into permanent NIHL after many years of PLD use.

[QR-Code based patient tracking: a cost-effective option to improve patient safety]. / QR-Code Patienten-Tracking: eine kostengünstige Möglichkeit zur Verbesserung der Patientensicherheit.

BACKGROUND: Hospitals are implementing a risk management system to avoid patient or surgery mix-ups. The trend is to use preoperative checklists. This work deals specifically with a type of patient identification, which is realized by storing patient data on a patient-fixed medium. MATERIAL AND METHODS: In 127 ENT surgeries data relevant for patient identification were encrypted in a 2D-QR-Code. The code, as a separate document coming with the patient chart or as a patient wristband, has been decrypted in the OR and the patient data were presented visible for all persons. The decoding time, the compliance of the patient data, as well as the duration of the patient identification was compared with the traditional patient identification by inspection of the patient chart. RESULTS: A total of 125 QR codes were read. The time for the decrypting of QR-Code was 5.6 s, the time for the screen view for patient identification was 7.9 s, and for a comparison group of 75 operations traditional patient identification was 27.3 s. Overall, there were 6 relevant information errors in the two parts of the experiment. This represents a ratio of 0.6% for 8 relevant classes per each encrypted QR code. CONCLUSION: This work allows a cost effective way to technically support patient identification based on electronic patient data. It was shown that the use in the clinical routine is possible. The disadvantage is a potential misinformation from incorrect or missing information in the HIS, or due to changes of the data after the code was created. The QR-code-based patient tracking is seen as a useful complement to the already widely used identification wristband.

Screening of snoring with an MP3 recorder.

PURPOSE: Snoring patients seeking medical assistance represent a wide range of clinical and sleep study findings from nonsleepy nonapneic snoring to severe obstructive sleep apnea syndrome. The prevalence of snoring is high and it significantly impacts quality of life. Its objective diagnosis usually requires a sleep study. We developed a system to analyze snoring sounds with a Moving Picture Experts Group Layer-3 Audio (MP3) recorder device and present its value in the screening of snoring. METHODS: We recorded snoring sounds during in-lab polysomnography (PSG) in 200 consecutive patients referred for a suspicion of obstructive sleep apnea. Snoring was recorded during the PSG with two microphones: one attached to the throat and the other to the ceiling; an MP3 device was attached to the patient's collar. Snoring was confirmed when the MP3 acoustic signal exceeded twice the median value of the acoustic signal for the entire recording. Results of the MP3 snoring recording were compared to the snoring recordings from the PSG. RESULTS: MP3 recording proved technically successful for 87% of the patients. The Pearson correlation between PSG snoring and MP3 snoring was highly significant at 0.77 (p < 0.001). The MP3 recording device underestimated the snoring time by a mean ± SD of 32 ± 55 min. CONCLUSIONS: The recording of snoring with an MP3 device provides reliable information about the patient's snoring.

Can Uhear me now? Validation of an iPod-based hearing loss screening test.

OBJECTIVE: To evaluate the uHear iPod-based application as a test for hearing loss. METHODS: We recruited 100 adult participants through a single otology practice. Patients with otorrhea and cognitive impairment were excluded. All patients completed the uHear test in the clinic and in the sound booth and underwent a standard audiogram by the same audiologist. We compared the results of the uHear test to the standard audiogram. RESULTS: The uHear was able to correctly diagnose the presence of hearing loss (pure-tone average [PTA] > 40 dB) with a sensitivity of 98% (95% CI = 89-100), a specificity of 82% (95% CI = 75-88), and a positive likelihood ratio of 9 (95% CI = 6.0-16). Compared to the audiogram, the uHear overestimated the PTA among all ears by 14 dB in the clinic and by 8 dB in the sound booth (p < .0001). Compared to the audiogram, the uHear overestimated the PTA among ears with hearing loss by 6 dB in the clinic and by 4 dB in the sound booth. CONCLUSIONS: The uHear application is a reasonable screening test to rule out moderate hearing loss (PTA > 40 dB) and and is valid at quantifying the degree of hearing loss in patients known to have abnormal hearing.

Post-coma persons emerged from a minimally conscious state and showing multiple disabilities learn to manage a radio-listening activity.

This study assessed microswitch-based technology to enable three post-coma adults, who had emerged from a minimally conscious state but presented motor and communication disabilities, to operate a radio device. The material involved a modified radio device, a microprocessor-based electronic control unit, a personal microswitch, and an amplified MP3 player. The study was carried out according to a non-concurrent multiple baseline design across participants. During the intervention, all three participants learned to operate the radio device, changing stations and tuning on some of them longer amounts of time than on others (i.e., suggesting preferences among the topics covered by those stations). They also ended a number of sessions before the maximum length of time allowed for them had elapsed. The practical (rehabilitation) implications of the findings were discussed.

[Hearing the impact of MP3 on a survey of middle school students].

OBJECTIVE: To understand the usage of MP3 and effects on hearing of middle school students in Xi'an, and discuss controlling strategies. METHOD: Stratified random cluster sampling method was used in the 1567 middle school students in Xi'an through questionnaire survey, ear examination and hearing examination, data were analysed by the SPSS13.0 statistical software. RESULT: 1) The rate of holding MP3 in the middle school students was 85.2%. Average daily use time was (1.41 +/- 1.11) h. 2) The noise group of pure tone hearing threshold was significantly higher compared with the control group (P<0.01), and increased the detection rate of hearing loss with the increasing use of MP3. 3) The detection rate of symptoms increased with the increasing use of MP3. CONCLUSION: The usage of MP3 can harm hearing in middle school students, which can result in neurasthenic syndrome.

Short-term auditory effects of listening to an MP3 player.

OBJECTIVES: To determine the output levels of a commercially available MPEG layer-3 (MP3) player and to evaluate changes in hearing after 1 hour of listening to the MP3 player. DESIGN: First, A-weighted sound pressure levels (measured in decibels [dBA]) for 1 hour of pop-rock music on an MP3 player were measured on a head and torso simulator. Second, after participants listened to 1 hour of pop-rock music using an MP3 player, changes in hearing were evaluated with pure-tone audiometry, transient-evoked otoacoustic emissions, and distortion product otoacoustic emissions. PARTICIPANTS: Twenty-one participants were exposed to pop-rock music in 6 different sessions using 2 types of headphones at multiple preset gain settings of the MP3 player. MAIN OUTCOME MEASURES: Output levels of an MP3 player and temporary threshold and emission shifts after 1 hour of listening. RESULTS: The output levels at the full gain setting were 97.36 dBA and 102.56 dBA for the supra-aural headphones and stock earbuds, respectively. In the noise exposure group, significant changes in hearing thresholds and transient-evoked otoacoustic emission amplitudes were found between preexposure and postexposure measurements. However, this pattern was not seen for distortion product otoacoustic emission amplitudes. Significant differences in the incidence of significant threshold or emission shifts were observed between almost every session of the noise exposure group compared with the control group. CONCLUSIONS: Temporary changes in hearing sensitivity measured by audiometry and otoacoustic emissions indicate the potential harmful effects of listening to an MP3 player. Further research is needed to evaluate the long-term risk of cumulative noise exposure on the auditory system of adolescents and adults.

Feasibility of a patient-controlled cognitive-behavioral intervention for pain, fatigue, and sleep disturbance in cancer.

PURPOSE/OBJECTIVES: To evaluate the feasibility of a patient-controlled cognitive-behavioral intervention for pain, fatigue, and sleep disturbance during treatment for advanced cancer and to assess initial efficacy of the intervention. DESIGN: One group pre- and post-test design. SETTING: Outpatient oncology clinics at a comprehensive cancer center in the midwestern United States. SAMPLE: 30 adults with advanced (recurrent or metastatic) colorectal, lung, prostate, or gynecologic cancer receiving chemotherapy or radiotherapy. METHODS: Participants completed baseline measures (e.g., demographics, symptom inventory) and received education and training to use an MP3 player loaded with 12 cognitive-behavioral strategies (e.g., relaxation exercises, guided imagery, nature sound recordings). Participants used the strategies as needed for symptom management for two weeks, keeping a log of symptom ratings with each use. Following the two-week intervention, participants completed a second symptom inventory and an evaluation of the intervention. MAIN RESEARCH VARIABLES: Feasibility, patient-controlled cognitive-behavioral intervention, pain, fatigue, and sleep disturbance. FINDINGS: Thirty of 43 eligible patients (73%) agreed to participate; of them, 27 (90%) completed the study. Most reported that they enjoyed the intervention, had learned useful skills, and perceived improvement in their symptoms. Symptom scores at two weeks did not differ significantly from baseline; however, significant reductions in pain, fatigue, and sleep disturbance severity were found in ratings made immediately before and after use of a cognitive-behavioral strategy. CONCLUSIONS: The patient-controlled cognitive-behavioral intervention appears to be feasible for additional study and could reduce day-to-day severity of co-occurring pain, fatigue, and sleep disturbance. IMPLICATIONS FOR NURSING: A randomized, controlled trial is needed to test efficacy of the intervention for co-occurring pain, fatigue, and sleep disturbance. Meanwhile, based on previous efficacy studies, cognitive-behavioral strategies can be recommended for certain individual symptoms.

Radiation passport: an iPhone and iPod touch application to track radiation dose and estimate associated cancer risks.

The rapid increase in the use of radiology and related exams and procedures has led to a concomitant increase in associated radiation risk. An application for the iPhone and iPod Touch called 'Radiation Passport' is described, which provides radiation dose estimates and associated cancer risks (non fatal and fatal) and serves as a method by which to track an individual's cumulative exposure.