The Immediate and Long-Term Impact of Military Aircraft Noise on Hearing: A Cross-Sectional Comparison of Fighter Pilots and Ground Staff.

We examined the immediate and long-term impacts of military aircraft noise exposure on noise-induced hearing loss (NIHL) in fighter pilots and ground staff. We recruited 40 pilots, 40 ground staff, and 136 age-matched controls; all participants underwent hearing tests, including conventional pure-tone audiometry (PTA) (0.25-8.0 kHz), extended high-frequency (EHF) audiometry (9.0-18.0 kHz), and distortion-product otoacoustic emission (DPOAE) as a recent reference. A subsequent hearing test immediately after flight-mission noise exposure was requested. The results revealed higher recent hearing thresholds in pilots and ground staff than in controls. Threshold shifts at many octave band frequencies were also significantly elevated in ground staff. The grouped frequency threshold was significantly elevated in the 4-8 kHz high-frequency range. After a single flight-mission noise exposure, both ground staff and pilots showed decreased signal-to-noise ratios for DPOAE (1-8 kHz), whereas only ground staff showed significantly elevated left-ear hearing thresholds at 3, 11.2, and 12.5 kHz by conventional and EHF PTA. Fighter pilots and ground staff serve in hazardous noise-exposed environments that cause hearing damage and subsequent NIHL, but ground staff may be more vulnerable. A comprehensive hearing conservation program should be implemented to protect high-risk service members, and especially ground staff, from high-intensity noise exposure.

Choline and betaine food sources and intakes in Taiwanese.

Choline and betaine are involved in several similar health-relevant metabolic pathways, but the foods sources are different. We have assessed their intakes (individual, sums and ratios) from a dominantly Chinese food cultural point of view. A representative free-living Taiwanese population aged 13-64 years was drawn from the Nutrition and Health Survey in Taiwan (NAHSIT) 1993-1996. Food intake was derived from interviews as 24-hour recalls. The USDA database, with adaptations for Taiwan, provided choline and betaine food compositions. Major food contributors of these nutrients were identified and compared with data from the US Framingham offspring study. Mean and variance reduced median nutrient intakes were calculated. Top ten major food contributors of choline in Taiwan were eggs, pork, chicken, fish, soybean and its products, dark leafy vegetables, dairy, fruit, wheat products and light leafy vegetables in sequence. For betaine, the top ten were dark leafy vegetables, wheat products, fish, pork, bread, chicken, cake/cookies, grain-based alcoholic beverages, rice and its products and sauces. The main contributors of choline in Taiwan and the USA were, respectively, eggs and red meat; and for betaine, greens were similarly best contributor. The rankings of the main food contributors of choline and betaine differed substantially between Taiwan and the USA. The total daily intakes (mean±SE, mg) in Taiwan for choline were 372±19 (median=348) in men and 265±9 (median 261) for women; for betaine, values were 101±3 (median 93) in men and 78±8 (median 76) for women. These allow for health outcome considerations.

Central obesity predicts non-Hodgkin's lymphoma mortality and overall obesity predicts leukemia mortality in adult Taiwanese.

OBJECTIVE: Obesity may increase the risk of neoplasia, including that of the lymphohematopoietic system. In a large Taiwanese cohort, we have evaluated whether body fat and its distribution is associated with non-Hodgkin's lymphoma (NHL) and leukemia mortalities. METHODS: During 1997-2007 in Taiwan, 383,956 subjects aged 19-98 years without any cancer history were obtained through a health screening center and followed up for a median of 7.2 years. Unit records were linked to the national death registry; ICD-9 codes were used to identify 143 NHL and 73 leukemia deaths. Objectively, height, weight, and waist circumference data were measured to calculate body mass index (BMI) and central obesity status. Based on World Health Organization criteria modified for Asia and Taiwan, BMI was classified to <18.5, 18.5-23.9, 24-26.9, and ≥ 27 kg/m(2). Waist circumference ≥ 90 cm in men and ≥ 80 cm in women was defined as central obesity. Cox proportional hazard regression models were adjusted for possible confounders including gender, age, education, smoking status, alcohol consumption, physical activity, and clinic location. RESULTS: BMI was not associated with NHL deaths, although the trend was significant, but central obesity with adjustment was (hazard ratio [HR] = 1.87, 95% confidence interval [CI] = 1.27-2.75) compared with non-centrally obese subjects. BMI, but not central obesity, was associated with leukemia mortality (HR = 1.93, 95% CI = 1.00-3.75). CONCLUSIONS: An increased risk for NHL with increased abdominal fatness and more so with lower BMI is apparent in Taiwanese; this may indicate that metabolically localized and proinflammatory fat is important. For leukemia, where most is myeloid leukemia, increased general fatness is evidently a risk with Taiwanese ethnicity.

The evaluation of cognitive-behavioral group therapy on patient depression and self-esteem.

We evaluated the impact of cognitive-behavioral group therapy on the depression and self-esteem of clinically depressed patients. This longitudinal study involved 26 experimental group patients who received 12 weeks of cognitive-behavioral group therapy and 25 comparison subjects. Two weeks before the study, immediately upon therapy completion, and 1 month later, all the participants underwent pretest, posttest, and follow-up, respectively. The experimental group patients experienced greater cognitive improvements (i.e., depression relief, self-esteem increase) as compared with the comparison group subjects. One month after therapy completion, the depressive symptoms and self-esteem of the experimental group patients remained slightly but significantly better than those of the comparison group subjects.