#Proud to be #Millennial: My Roundabout Entry into Graduate Studies via Africa – spotlight post by Jonathan Suen

?????The millennial generation occasionally gets flack as being pampered, coddled, and too often awarded “A’s” for churning out mere baseline satisfactory efforts. To be quite frank, I have chided similar social commentaries. My post is not intended as a harsh editorial against my own cohort. To sincerely laud a few of our selected tendencies that I have both personally observed and read about (see Forbes’ “30 Under 30 Social Entrepreneurs”), the millennial adult is seemingly also likely to be more (1) globally aware of current affairs, (2) audaciously committed to ensuring social justices, (3) spurred by high motivations to not settle for low standards, (4) consciously aware of our adverse human impact upon the environment, and (5) exposed to a myriad of rich cross-cultural experiences. All in all, we carry some positive characteristics that are definitely worth taking notice! It is each of our own responsibilities, however, to consider how we want to embody those qualities for ourselves through words and actions. This narrative follows a snapshot of my attempt to meet that challenge for my own sustainable benefit before pursuing graduate studies in audiology.

pcvolunteerI’m not going to romanticize how I ended up joining the Peace Corps following my undergraduate years (spoiler alert: the words “existentialist” and “crisis” are forthcoming). I was already an enthusiastic volunteer for most things community-based. Shaped by a number of influences growing up, I simply enjoyed volunteering what skills and time I had available when they were needed. I was also a typical American-born child of immigrants in New York; this made me susceptible to the millennial traps of young adulthood transitions. So yes, I also experienced an existentialist lapse of that “quarter-life crisis” (± a few years) that so many of us nowadays seem go through at some point in varying degrees, wondering what is going to happen after I graduate? Where am I going to work? WHAT DO I REALLY WANT TO DO WITH MY LIFE?

Overwhelmed by seemingly more options today, the pressures of making firm decisions on most major life questions leaves some dumbfounded and unsettled. While mostly avoiding the risk of a deer-in-headlights shutdown, I ultimately found myself wanting to
pursue an alternative trajectory immediately after college. Having never lived nor studied abroad, considerations for Peace Corps service looked appealing for satisfying my
urge for travel. Serendipitously coming upon a specific deaf education program operating keny-LMAP-mdin Kenya, east Africa, was oddly affirming for integrating my habit in local volunteerism with the skills developed through my studies in working within signing environments. The opportunity to work closely with deaf children under such contexts cemented my tenacity to proceed with the process of applying for a spot following commencement. So again, no embellishment is necessary for my prompt and motivation. A pairing of volunteerism-momentum with a large, healthy dose of millennial-induced frightening anxiety prompted the call to join the Peace Corps in my particular storybook. Looking back, it will likely rank among the best decisions I’ve ever made. My existentialist crisis oriented and galvanized me well.

Be we millennial representatives or not, those who have completed their service are all referred to as “Returned Peace Corps Volunteers,” or “RPCVs” in short. During our service it is often discussed how we would ever individually meet the demands of adequately answering the question: So how was the Peace Corps? We discern how we should honor both the genuineness of the question and our own experiences without cheapening either. Most RPCVs report that sharing a simple synopsis, essentially summarizing an intimate experience to a watered down version, would prove difficult.
The personal stories can widely vary and is as diverse as the amount and types of Peace Corps programs that are operating worldwide (there’s currently 8 different regions globally hosting the federal agency). However, despite the sheer variations of accounts,
sink-or-swimone thing is still likely common across all set-ups: it will challenge you in a manner
where you will find yourself making the judgment call at one point or another– Do I sink or swim? The memory of confronting that question may be one experience that most of us share. We were not going to throw in the towel without first putting up a fight against our own visceral temptations to bow out due to one legitimate reason or another. Our competitions were usually set against our own mental volleys, and we were motivated not to settle easily for a previous staminal threshold after getting this far already at testing our own limits.

My own account took me to east Africa, a place I’ve never been. The African continent itself is HUGE! Its geography is larger than Europe, China, India, and the continental USA combined. Needless to say, its people are just as beautifully diverse and multi-faceted as any of the other world regions able to be superimposed within its boundaries. The africa-1Republic of Kenya is a nation that is just slightly smaller in area than the state of Texas. The social demographic represents an estimated 42 distinct ethnic communities. If you ask the Deaf community of Kenya, some of them would then say there are 43 to be mentioned. My Peace Corps volunteer (PCV) class and I arrived poised and mentally ready to work as Deaf Educators. Following our pre-service training (PST) within the lower Great Rift Valley on the awe-inspiring foothills of Mount Kilimanjaro (the highest peak in Africa, located in neighboring Tanzania), we were to be separately posted to teach at deaf primary or secondary schools across the nation.

During PST we lived individually with Kenyan host families, where we actively and incidentally learned the intricacies of managing home life in Kenya. PST was also when certified Deaf Kenyans trained us on the fundamentals and dynamic grammar of Kenyan thanksgiving 2009Sign Language (KSL). Colloquial Swahili, the lingua franca of Kenya, was the second language that my colleagues and I keenly practiced to pick up. As it turned out with KSL, it varied regionally in the developing republic so much so that we found ourselves at times questioning the distinction between related dialects and wholly separate languages. Upon arrival at my “site”, a full 2-days’ bus journey from the capital city of Nairobi, I quickly realized that one of my first tasks was to decode the local KSL at our village’s primary school unit. It was a boarding school environment within a rural corner of the country where no native adult signers were around to model a
language framework for the deaf children. Most deaf adults migrate to larger urban centers where opportunities and support services are more readily available. The
linguistic outcome for our school was the legacy of an amalgamation of pidgin home signs peace corp volunteersshared communally and freely among the pupils. As the visiting outsider, I often wondered when confronted with this task: Do I sink or swim? Upon reflection nowadays, I wish I could re-watch some of those days of my attempts at unraveling their KSL as a series of sitcom scenes. PCVs would also eventually learn that owning an element of humor, especially comfort in laughing at oneself, would be critical for thriving.

I’ve joked before that if ever posed the same question again: “So how was the Peace Corps?” and depending on my mood or interpretation of the moment’s authenticity, I wouldn’t be above quoting the Peace Corps slogan “It was the toughest job [I’ll] ever love!” As it turns out, when the amusement from facetious mockery subsides, the
meaning underlying those words remains accurate. Interwoven throughout my time in
the Peace Corps were opportunities to stretch myself beyond my own inadvertently self-
imposed limitations. The degree of self-awareness and subsequent empowerment that it walingaffords me in return to push past those limits is immeasurable. Additionally, the gradual comfort that one develops and internalizes when exposed to cross-cultural dynamics (domestically or abroad) further lends into strengthened fluency in effectively bridging communication gaps across different people. That task coincidentally, if I may boldly claim, would be at the core of what audiology is dignified to do for service.

There’s a classical Peace Corps public service announcement from 1968 conveying the message ironically with New York City’s Lady Liberty. She stands on her pedestal with her right arm outstretched and pointing towards the open sea. The text reads: “MAKE AMERICA A BETTER PLACE. // LEAVE THE COUNTRY.”  With that in mind, I’ll leave you with the following passage:

“We need to travel. If we don’t offer ourselves to the unknown, our senses dull. Our world becomes small and we lose our sense of wonder. Our eyes don’t lift to the horizon; our ears don’t hear the sounds around us. The edge is off our experience, and we pass our days in a routine that is both comfortable and limiting. We wake up one day and find that we have lost our dreams in order to protect our days. Don’t let yourself become one of these people. The fear of the unknown and the lure of comfortable will conspire to keep you from taking the chances the traveler has to take. But if you take them, you will never regret your choice. To be sure, there will be moments of doubt when you stand alone on an empty road in an icy rain, or when you are ill with fever in a rented bed. But as the pains of the moment will come, so too will they fall away. In the end, you will be so much richer, so much stronger, so much clearer, so much happier, and so much a better person that all the risk and the hardship will seem like nothing compared to the knowledge and wisdom you have gained.”

–Kent Nerburn, Letters to My Son (1999)

Jon Suen picJonathan (“Jon”) Suen completed his undergraduate studies at Boston University in Massachusetts, where he studied Speech, Language, and Hearing Sciences and American Sign Language. Following his service with the Peace Corps (2009-2011), Jon is now studying audiology (Au.D.) at Gallaudet University in Washington, DC. He is currently in his third year within the four-year program. Through his studies at Gallaudet so far, he has found his budding interests within audiology spanning a wide array: from roots in global development, to clinical research, to aural rehabilitation, from across pediatric to adult populations. Jon is excited to see where the field takes him next. Follow him @SuenJonathan via Twitter.

 

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Vanish: Hide Your Patient’s Hearing Aids – guest post by Robert M. Traynor

stigmaThe Problem: About 4 years ago, a hearing aid consumer came to me with a problem. Al Musser was using a very nice set of relatively new, high-end receiver-in-the-canal (RIC) hearing instruments but remained concerned that the receiver wire covers were too obvious in his ear. To the audiologist, his RIC fitting was perceived as a very cosmetic solution; to Al, the RIC fitting remained stigmatizing. Stigma has been defined as “the possession of, or belief that one possesses, some attribute or characteristic that conveys a social identity that is devalued in a particular social context” (Crocker, Major, & Steele, 1998). The National Institutes of Health (2014) recently concluded that stigma remains pervasive with hearing aid use. The hearing industry has responded to this issue with smaller, more cosmetically appealing open-fit hearing instruments that have eliminated the need for occluding earmolds.  Despite these advancements, some hearing-aid-wearing patients continue to be self-conscious of their instruments.

VANISH-otpIn response to his experience, Al envisioned a solution whereby the receiver wire covers could blend better with the color of his skin. Over the past several years, he traveled to various dye laboratories and plastics companies to learn more about the composition of plastic tube and receiver wire covers.  From that experience, he formulated a patent-pending dye process that makes thin tubes and receiver wire covers (RWC) less reflective, effectively blending with the color of the hearing instrument user’s own skin. This simple method of dyeing vanish logothin tubes and receiver wire covers is now commercially available as Vanish, a new innovative product recognized at the 2014 AudiologyNOW! Convention as winner of the New Product Showcase by the American Academy of Audiology. So, how does this new product work?

The Process:  The Vanish process is quick and simple and can be completed in a few easy steps. Prior to dyeing the tube or RWC, determine the patient’s customized vanish-color pickingtube/RWC dyeing color by matching the color of the patient’s skin using the color selection chart. Select the appropriate color by holding the chart at the level of the ear in natural daylight. Each color choice is associated with a specific dying-process time. Care must be exercised to ensure the thin tube/RWC is exposed to the Vanish dye for the precise amount of time to ensure the desired color is achieved. Once the best color choice has been selected, click Hide Hearing Aids with Vanish to view a video demonstrating the process.

colors

Vanish includes everything needed to dye two thin tubes or RWC including the reusable dyeing tray, dye, and scuffing pad and is available in either Light/Medium (Item# VAN-1-LIGHT) or Dark (Item# VAN-1-DARK).  Replenish your supply with Vanish refill kits which come packaged with dye and scuffing pad only.  The 10-binaural-refill kit (dyes 20 tubes/RWC) is available in either Light/Medium (Item# VAN-10-LIGHT) and/or Dark (Item# VAN-10-DARK) and the 20-binaural-refill (dyes 40 tubes/RWC) is also available in either Light/Medium (Item# VAN-20-LIGHT) and/or Dark (Item# VAN-20-DARK). The refills do NOT come with a reusable dyeing tray.

Add value to your clinical practice by customizing your patient’s behind-the-ear hearing aids with Vanish.  The process is fast, easy, and inexpensive. To order Vanish for your clinical practice, contact Oaktree Products, Inc. toll-free at 800.347.1960 and ask for customer service. You can also order online at www.oaktreeproducts.com.

robert Traynor imageRobert M. Traynor, Ed.D., MBA is the CEO and practicing ABA certified audiologist at Audiology Associates of Greeley, Inc., Greeley, Colorado with a clinical emphasis in amplification and operative monitoring. Dr. Traynor holds degrees from the University of Northern Colorado (BA, 1972, MA 1973, Ed.D., 1975), the University of Phoenix (MBA, 2006) as well as Post Doctoral Study at Northwestern University (1984). He taught Audiology at the University of Northern Colorado (1973-1982), University of Arkansas for Medical Sciences (1976-77) and Colorado State University (1982-1993). He was Senior International Audiology Consultant to a major hearing instrument manufacturer for 17 years serving on research and development committees and traveling all over the world providing academic audiological and product orientation for distributors and staff. Dr. Traynor is also a retired Lt. Colonel from the US Army Reserve Medical Service Corps and currently serves as an Adjunct Professor of Audiology at the University of Florida, the University of Colorado, and the University of Northern Colorado. He serves as an audiology consultant to Harmony Products, makers of Vanish. A clinician and practice manager for over 35+ years, Dr. Traynor has lectured on most aspects of the field of Audiology in over 40 countries. Dr. Traynor is the co-author of Strategic Practice Management a text used in most universities to train audiologists in practice management, now in its second edition.

References:

Crocker, J., Major, B., & Steele, C. (1998). Social stigma. In D. T. Gilbert, S. T. Fiske & G. Lindzey (Eds.), The handbook of social psychology, Vol 2 (4th ed.), (pp. 504–553).  New York, NY: McGraw-Hill.

National Institutes of Health (2014).  Department of Health and Human Services, Research Portfolio. http://report.nih.gov/nihfactsheets/viewfactsheet.aspx?csid=95. Accessed February 14, 2014.

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Audiology Unplugged: the New Amico Otoscope Set

outletAnnoyed with having to unscrew your otoscope handle so you can plug it into a wall outlet to recharge? While far more convenient than the standard AC outlet rechargeable handles, the cost of desk-charging otoscopes can get a little pricey. And, be sure to read the fine print to understand what you will actually be getting for the money you spend; some desk chargers are packaged with a NiCad or Lithium Ion handle but exclude the otoscope head. Even upgrading a current wall outlet rechargeable otoscope handle to a desk-charging model can cost more money than the process may be worth.  So, what is an audiologist to do? Check out the new Amico Otoscope Set

AMICO-LEDThe Amico Otoscope Set offers the convenience and quality of a high-end desk charging otoscope at about half the price. The set includes a fiber optic otoscope head with an LED bulb, Lithium Ion handle with no memory effect, and a drop-in desk charger.  No need to unscrew your otoscope handle and plug into a wall outlet for recharge. Another plus for this new otoscope is that both Welch Allyn and Heine specula will fit the Amico’s diagnostic head.  As a newer product, it is ony available in 110V version; a 220V is NOT available. For more information, contact Oaktree Products at 800.347.1960 and ask customer service to tell you more about the Amico-LED.  This new otoscope set is offered at a very special price during the month of May 2014 including free domestic ground shipping on your entire order with the purchase of any Amico Otoscope Set! What are you waiting for? Call to order your new otoscope today!!

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Moment of Remembrance

Memorial-Day-iPad-WallpaperMemorial Day is a federal holiday observed on the last Monday of May that offers the bonus of a three-day weekend to many, serving as the unofficial kick-off to summer. Americans celebrate with barbeques, family get-togethers and the like. Over the years, the true meaning of Memorial Day has perhaps been lost and it makes sense to reflect as to what next Monday is intended to represent.

Originally referred to as Decoration Day, Memorial Day was designated an official federal holiday in 1971. Whereas Veteran’s Day has been set aside to thank and honor those who honorably served in the military, Memorial Day is a day of remembrance in honor of the men and women who have died while serving the U.S. military. In May of 2000, President Bill Clinton released a White House memo, directing all executive departments and agencies to memorial daypromote a “National Moment of Remembrance“. In this very same memo, all Americans were encouraged to pause for one minute at 3:00 pm local time on Memorial Day, to remember and reflect on the sacrifices made by so many serving the U.S. military. Please join me and my co-workers at Oaktree Products in St. Louis, Missouri for a moment of silence on this Memorial Day (Monday, May 26, 2014) at 3:00 pm local time to honor those who died while serving our country.

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What Does a Chicken Have to Do with Hearing Loss?

TN-69843_One-chick-looking-left-2-smaller_originalWhat would you think if someone told you that a baby chick holds the cure for hearing loss? One of the keys to restoring normal hearing in humans is cochlear hair cell regeneration, something that most animals other than mammals, including chickens, can do.  The Hearing Health Foundation recently launched a new public service announcement (PSA) called “Chirp the News” which features a baby chick with hearing loss who goes on to live a happy, normal-hearing life. After viewing it, my curiosity was piqued. I had an opportunity to ask Shari Eberts, Chairman of the HHF’s Board of Directors, a couple of questions and wanted to share what I learned.

Question: For those that are not familiar with your organization, what is the Hearing Health Foundation and/or what is the Foundation’s mission?

Hearing Health Foundation (HHF) is the largest private funder of hearing research, with a mission to prevent and cure hearing loss and tinnitus through groundbreaking research. Hearing-Health-Foundation-Logo-WebSince 1958 HHF has given away millions of dollars to hearing and balance research, including work that led to cochlear implant technology and now through the Hearing Restoration Project is working on a cure for hearing loss and tinnitus. Hearing Health Foundation also publishes Hearing Health magazine, a free consumer resource on hearing loss and related technology, research, and products.

Question: Shari, it is my understanding that you acquired a hearing loss in your late 20’s.  Can you tell me a little bit about how your hearing loss was identified, the cause of your hearing loss, and how it has impacted your personal and professional lives?  

inner earI first noticed my hearing loss in business school. Students were participating in class, and I would sometimes miss their comments, particularly the funny ones that were made almost as an aside. My father and my grandmother both had a hearing loss, so I figured I should get tested. It turns out that I had a mild hearing loss in both ears. The loss is genetic and is centered in the mid-range or speech frequencies. Luckily, my high pitch hearing is almost perfect. My loss has gotten progressively worse each year since business school, but I am able to manage it with hearing aids and by advocating for myself. At first, I didn’t want to admit that I had a hearing loss, and I hid it from others, but eventually I began to realize how much better my life could be if I used my hearing aids, and I began wearing them all the time. I am glad that I do.

As someone who lives with hearing loss everyday, I am personally thrilled with the prospects for a cure. Life with hearing loss can be frustrating.  Sometimes you miss the joke when everyone else is laughing and sometimes you miss important information because you don’t hear it. Supportive family and friends can make living with hearing loss easier, but a genuine cure would be life changing. After having met and worked with our consortium scientists for these past two years, I am confident that we will have a cure in my lifetime. I am counting the days.

Question: Knowing that you acquired a hearing loss in your late 20’s, it makes sense that you would be passionate about educating people about hearing loss and learning about various research focusing on a cure. With so many different organizations dedicated to hearing loss, what made you specifically gravitate toward Hearing Health Foundation? What makes this organization so unique?

scientistsHHF’s approach to research is unique and I believe it will shorten the timeline to a cure. For years, scientific research has been conducted in relative isolation—one researcher or one institution working alone to tackle a major health issue. HHF developed the HRP Consortium model to do things differently. Our HRP scientists work on research projects together, share their unpublished data and tools, and collaborate on the development and refinement of the HRP’s strategic research plan. The group meets bi-annually in person, monthly by conference call, and communicates frequently by email. This continual dialogue is helping to eliminate repetitive work across the team, saving time and research dollars, and most importantly, accelerating the timetable to a cure.

Our HRP Consortium is the dream team of hair cell regeneration, comprising the best auditory scientists at leading institutions worldwide such as Harvard and Stanford. With more than 200 years of combined experience in hearing research, the HRP Consortium publishes widely (over 400 published papers among them) and have well established labs (receiving over 600 NIH grants combined). We have every confidence we have the right team in place, and the right model to accelerate the timeline to a cure.

Question: The Hearing Health Foundation was established in 1958 and had been seeking donations from the public to help fund “groundbreaking research” for the prevention of and cure for hearing loss. Can you provide a historical synopsis of some of the more significant research achieved by the Foundation since its inception?

hair-cellHHF’s founder, Collette Ramsey Baker, was steadfast in her support of funding for new technologies and treatments for hearing loss. For example, back in the 1960s, HHF began funding research into cochlear implant technology. HHF’s founder, Collette Ramsey Baker, prevailed despite objections and doubts from supporters that she was wasting money. Cochlear implants have proven to be a valuable treatment option for people with profound hearing loss, benefiting 125,000 people in the U.S. and 300,000 people worldwide. HHF has also research that led to the development of many of today’s standard treatments for otosclerosis (abnormal bone growth in the ear) and ear infections.   In the 1990s, HHF was a leader in advocating for Universal Newborn Hearing Screening legislation, which increased testing from 5% of newborns to 94% by 2007. In 2011, HHF launched our most important project yet, the Hearing Restoration Project (HRP),  which aims to discover a biological cure for hearing loss and tinnitus.

Question: What research is the Foundation currently working on that is anticipated to have a significant and/or practical impact on hearing loss prevention and/or cure within the next 10 years?

hair cells-colorHHF officially launched its Hearing Restoration Project (HRP) in 2011 and is currently funding 5 projects from its consortium scientists, but the initial discovery that led to the HRP came many years before. Many types of hearing loss result from damage to the delicate hair cells of the inner ear. Humans can’t regrow these cells—but in a game-changing breakthrough in 1987, HHF-funded scientists discovered that birds can. While studying how drugs that are known to cause hearing damage affect the tiny sensory cells in the ear, these scientists needed to permanently damage a chicken’s hair cells. For 10 days, research assistants administered a common antibiotic, known to cause hearing loss, to laboratory chickens. On day 11 many of the hair cells were lost and a few days later, even more were lost. Surprisingly, when the scientists looked three weeks later, almost all the hair cells had returned.  They didn’t believe these results so they did the experiment again and again. Sure enough, chickens can naturally regenerate their inner ear hair cells, restoring their hearing after damage.

The amazing thing is that regeneration happens naturally and very robustly in almost all animals – mammals are the exception. This makes HHF and the researchers confident that we will find a way to stimulate this regeneration in mammals, including humans.

The HRP consortium of scientists has developed a strategic research plan to develop a cure for hearing loss and tinnitus in 10 years. This three-phase plan starts with discovery research and culminates in clinical trials. The plan, developed specifically by the HRP scientists and updated to incorporate new findings and approaches, is a living document meant to guide but not limit the work. Relevance to this strategic plan is one of the criteria for a project to receive HRP funding.

Zebrafish1-smallThe HRP is currently in Phase I of its strategic research plan (years 1-5). This first phase focuses on searching for the genes or series of genes that trigger natural regeneration of hair cells in animals such as birds and zebrafish. This phase will also examine which genes in mammals prevent the natural regeneration of hair cells. Finally, Phase I will determine the types of cells in mammals’ ears that could serve as available targets for regeneration therapies. Phase II (years 3-8) starts with the residual cells that remain in a mammal’s inner ear after hearing loss and uses the genes identified in Phase I to trigger hair cell regeneration. In Phase III (years 8-10), the HRP Consortium will partner with a pharmaceutical or other company to develop drugs that mimic the identified genes, resulting in a regenerative therapy.

Question: How can audiologists and other hearing health care providers get involved with the Hearing Health Foundation?

hh_fall_2012_coverHHF is always eager to partner with hearing health care providers! In fact, we have developed a brochure specifically for use by hearing health care providers that includes important information for their patients about how hearing works, the types of hearing loss, and common treatment solutions. It also lets patients know about the resources HHF can offer, like its free quarterly magazine. Hearing Health Magazine is the award-winning leading consumer publication on hearing loss filled with the latest on research breakthroughs, strategies to manage hearing loss, personal stories, hearing technologies and products and features on seniors, pediatrics, parents, musicians, veterans and more!   Please feel free to contact us at info@hhf.org if you are a hearing health care professional and would like copies of our patient brochure or magazine.

Question: How can the general public support the mission and goals of the Hearing Health Foundation?

There are lots of ways for people to learn more about HHF and help support our research for a cure for hearing loss and tinnitus.

  1. Visit our website to learn more
  2. Stay up to date on all the latest news by liking us on Facebook and following us on Twitter
  3. Sign up for our informative monthly e-newsletter
  4. Subscribe to Hearing Health Magazine, our award-winning leading consumer publication on hearing loss. Get the latest on research breakthroughs, strategies to manage hearing loss, personal stories, hearing technologies and products, and features on seniors, pediatrics, veterans, musicians and more.
  5. Inspire others by sharing your personal story and draw comfort from the stories of others
  6. Create a fundraising event or giving page
  7. Make a tribute gift to honor a loved one with hearing loss or a favorite audiologist
  8. Support our work with a tax-deductible donation

Shari-Eberts_smShari Eberts is Chairman of the Board of Directors at the Hearing Health Foundation, an organization whose mission is to prevent and cure hearing loss and tinnitus via collaborative, groundbreaking research. She received her BS from Duke University in 1990 and MBA from the Harvard Business School in 1995. Previously employed by Goldman Sachs and McKinsey & Company, Shari spent 13 years at J.P. Morgan in the capacity of a senior equity analyst (broadlines retail) and, most recently as Associate Director of U.S. Equity Research.  This mom of two and former Wall-Streeter joined HHR in 2010 and has committed herself to supporting the search for a cure for hearing loss and tinnitus.

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Hearing Aids Made for iPhone – guest post by Jennifer Groth

MFILike many technical fields, audiology is rife with acronyms. Many are identical to those used in other fields, to the consternation of anyone trying to learn them. Take “REM” or “CIC”, for example. Recently, a new acronym has begun to make inroads in audiology, or at least in the area of hearing aids: “MFi”. An abbreviation for “Made for iPhone/iPod/iPad”, MFi is a licensing program from Apple for developers of hardware and software peripherals that work with their iOS devices (iOS is the proprietary operating system for Apple devices). It means that an electronic accessory has been designed to connect specifically to iPhone and has been certified by the developer to meet Apple silver-apple-logoperformance standards. Manufacturers who join this program are allowed to display related logos on their products. When speaking of hearing aids, these “peripherals” may be accessory devices that communicate with iOS devices, or they may be the hearing aids themselves. Does it matter that hearing aids or hearing aid accessories can connect to smart devices? After all, the majority of hearing aid users and candidates are older individuals. It is common to assume that people in this group are non-users of electronic “gadgets”. As an illustration of this in popular culture, the host of an evening talk show recently riffed on the news that hearing aids could now connect to the iPhone, joking “Now, if hearing aid users only knew what an iPhone was.” However, recent data on usage of smartphones and tablets points to two important trends among older individuals. One is simply that ownership of these devices is growing rapidly year-over-year. The other is that a significant percentage of older individuals already own smartphones or tablets. One in five clients over the age of 70 is likely to be a smart phone user and an even greater proportion will have tablets. These numbers suggest that many hearing aid candidates will find it relevant that their hearing aids can communicate with smart devices regardless of their age.

MFi Hearing Aid Accessories:

The first MFi devices to become available were hearing aid accessories that act as a go-between to transfer data and audio content from the iPhone to the hearing aids and back BluetoothLogoagain. Every hearing aid manufacturer with wireless hearing aid systems has included an accessory that can act as a Bluetooth headset and that can connect to any cell phone with Bluetooth wireless technology, and it is not necessary to join the Apple MFi program to do this. Manufacturers need only ensure that their accessory product incorporates a radio operating in the 2.4 GHz band, that it adheres to the Bluetooth standard and that it supports the Bluetooth headset profile. In this way, the wireless accessory can be used to accept the phone signal via 2.4 GHz-based Bluetooth, translate the signal to whatever wireless technology is used by the hearing aids, and relay the signal on to the hearing aids. Likewise, most of these accessories also contain a microphone that picks up the user’s voice and transmits it via Bluetooth back to the phone just as a consumer Bluetooth headset would do. Audio is not the only signal that can be transmitted via Bluetooth. Data can also be transmitted in both directions, giving the user information about their hearing aids as well as additional ways of interacting with them beyond whatever on-board controls the hearing aids may have. For this to work, the hearing aid manufacturer writes ReSound Phone Clip+an app that can be downloaded to the user’s Bluetooth enabled smart device. The most common function of such an app is to provide remote control of the hearing aids. In order to distribute their app for iOS devices, the manufacturer must join the MFi program and meet Apple certification requirements. The ReSound Phone Clip+ (shown right) is an example of an MFi wireless hearing aid accessory. It relays data from the ReSound Control app via the Bluetooth link to the iPhone to provide remote control functionality for wireless ReSound hearing instruments.

MFi Hearing Aids:

Until now, it has not been feasible to implement Bluetooth directly in hearing aids mainly due to power constraints, thus necessitating a wireless accessory for any communication with cell phones or smart devices. However, Bluetooth version 4.0 includes a low energy feature which meets the power constraints of hearing aids. Branded by the Bluetooth SIG (Special Interest Group) as “Bluetooth Smart”, this technology is a “power-friendly” version of the open Bluetooth wireless standard and has become popular particularly for monitoring devices like heart rate monitors and fitness trackers. The availability of the low energy Bluetooth feature has made MFi hearing aids possible. An MFi hearing aid connects wirelessly to iOS devices without any additional hardware. According to Apple, “these hearing aids deliver a power-efficient, high-quality digital audio experience” and also allow users to manage their hearing aids from their iPhone devices. A current list of ReSound LiNX LINX LNX LX LN HandMFi hearing aids can be found on the Apple Accessibility website. One such hearing aid is the ReSound LiNX. A major part of the challenge of developing MFi hearing aids is mastery of robust radio frequency transmission at 2.4 GHz. Because its digital wireless hearing aid system was already based on radio frequency transmission at 2.4 GHz rather than the more common near-field magnetic induction (NFMI), ReSound was in a favorable position to develop an MFi hearing aid – the ReSound LiNX – relatively quickly. So what can MFi hearing aids do? One of the most attractive features of MFi is audio streaming in high quality stereo. Any type of audio played from an iOS device can be streamed to MFi hearing aids, including music, podcasts, games, FaceTime calls, Netflix or YouTube videos just to name a few. While all of these uses certainly can add to the enjoyment and utility of using an Apple device, perhaps the most significant benefit is the streaming of phone calls to the hearing aids. Phone use is made difficult by the absence of visual cues, inappropriate or inadequate coupling to the phone and the presence of background noise. Not surprisingly, many hearing aid users feel they are unsuccessful on the phone. Receiving the phone signal directly from the phone to the hearing aids with no intermediate accessory provides an obvious benefit in terms of convenience to the user. In addition, it has been established that a bilateral wireless signal optimizes benefit for hearing on the phone 1. A recent study of the benefit of different phone options including MFi reinforced this finding, but also suggests that MFi may provide additional benefit compared to streaming the phone signal via a wireless accessory with conventional Bluetooth 2. In this study, listeners were administered an adaptive speech-in-noise test with the speech presented unilaterally in four different telephone conditions:

  1. Using the hearing aid microphone (“Acoustic Phone”)
  2. Using the hearing aid telecoil (“Telecoil Phone”)
  3. Streaming the phone signal via Bluetooth through a wireless hearing aid accessory (“Phone Clip+”)
  4. Streaming the phone signal directly from the iPhone (“LiNX MFi”)

figure groth blogAs shown in the figure to the left, performance in all wireless conditions exceeded the “Acoustic Phone” condition. average SRT scores in dB for the four test conditions including 95% confidence intervals are shown.  All conditions are unilateral, with the phone signal in only one ear. The authors also noted that the greater variability for the “Acoustic Phone” and “Telecoil Phone” conditions than the two digital wireless conditions, which they attributed to individual difficulties in placing and maintaining the telephone correctly for signal reception. As a result they predict more reliable benefit with the digital wireless solutions. What is also striking about these results is that the MFi condition was significantly better than either the “Telecoil Phone” or “Phone Clip+” conditions. This was in contrast to the expectation that the two digital wireless phone solutions would yield equivalent results. The authors speculate that this may be related to a decline in signal quality caused by the extra link needed when using a Bluetooth-based hearing aid accessory (phone-to-accessory-to-hearing aids). As mentioned, MFi also gives users the resound smart apopportunity to manage their hearing aids from the iOS devices. In the case of the ReSound LiNX, the ReSound Smart™ app enables this functionality. First of all, the ReSound Smart app serves as a remote control for the hearing instruments. Users can change programs, adjust volume and choose the input to the hearing aids. One adjustment type allowed by the ReSound Smart app that typically is not available to hearing aid users is an adjustment of treble and bass. This can be particularly useful for specific listening situations, such as music listening. Additionally, this app offers the capability to associate specific hearing instrument settings including the listening program, volume and treble/bass adjustments with a geographical location. This functionality is called “geo-tagging”. Finally, a “find my hearing aid” feature can help locate a misplaced device, and tutorials provide usage and troubleshooting advice that is easily accessible.

Why Only MFi?

iphone3g-questionmarkWhile Apple products are certainly popular, they are of course not the only ones in their category in the marketplace for consumer electronics. In fact, Apple products do not even have a dominant market share for smart devices in some countries. Thus an obvious question is why MFi hearing aids are only, well, made for iPhone and not other smart device operating systems. The answer to this is two-fold. For one thing, the hearing aid industry is tiny compared to consumer electronics and hearing aid manufacturers have comparatively limited development resources. Apple, with its focus on accessibility, was the first manufacturer of smart devices to devise a power efficient audio streaming protocol that would be feasible for direct communication with hearing aids. Therefore, it was an obvious decision to begin with Apple products as hearing aid manufacturers must start somewhere. Another consideration is that the iOS is very well-controlled, unlike other smart device operating systems such as Android. This removes some variables that could affect the performance of the audio streaming and allows hearing aid manufacturers to gain some experience with this functionality. The Apple proprietary audio streaming protocol is available for any hearing aid manufacturer who samsung_androidwishes to implement it for their products to be compatible with iOS devices. The next development in direct connectivity to smart devices will be apps such as the ReSound Smart app for the Android operating system. Because the ReSound LiNX is a Bluetooth Smart device, it is possible to write apps for other operating systems that can be downloaded to Bluetooth Smart ready devices like Android smart phones and tablets. Like the ReSound Smart app for iOS, this will allow users remote control functionality as well as other features that involve data exchange between the hearing aids and smart device. The ReSound Smart app for Android is planned for late 2014. Since there is as yet no standard audio streaming protocol that is appropriate for direct connectivity to hearing aids, it will be longer before this functionality is available for other operating systems or other manufacturers’ smart devices.

A Complete Solution:

SOLUTION-2With all the excitement about MFi, it can be easy to either forget about what other features MFi hearing aids offer, or to shelve them as products that are only appropriate for those clients who already own or who are planning to acquire an Apple device. However, MFi is really a secondary feature, one that at some time in the future may be considered a given in the same way that hearing aids today are expected to have noise reduction algorithms or telecoils. The purpose of an MFi hearing aid is first and foremost to provide amplification of speech and other sounds for persons with hearing loss. The ReSound LiNX is actually a tiny but full-featured receiver-in-the-ear instrument with the same advanced Surround Sound by ReSound technologies available in the ReSound Verso, with the addition of new signal processing algorithms for frequency compression (Sound Shaper) and automatic gain adaptation (Acceptance Manager). It offers a revamped receiver program for fitting hearing losses up to the severe-to-profound range. Furthermore, the ReSound LiNX continues to support the proprietary ReSound 2.4 GHz wireless system. This means that device-to-device wireless program change is available as are the advanced wireless steering algorithms that support binaural hearing. In addition, the ReSound LiNX is fully compatible with ReSound Unite wireless accessories, which provides users with a complete range of connectivity options for any audio sources, not just iOS devices.

Summary:

Resound LINX“Made for iPhone” means that an electronic accessory has met Apple standards to specifically work with iOS devices. MFi hearing aid accessories are go-between devices that use standard Bluetooth wireless technology to provide connectivity between an iOS device and the user’s hearing aids. MFi hearing aids take this a step further, in that they use the low energy feature of Bluetooth to provide direct connectivity between hearing aids and Apple devices. Wearers of MFi hearing aids can stream high quality audio in stereo from iOS devices directly to their hearing aids. Phone usage via wireless streaming bilaterally has been shown to be advantageous, and some evidence has emerged to suggest enhanced benefit with MFi. Connectivity to iOS devices also extends to data, allowing users to control and interact with their hearing aids in new ways. The ReSound LiNX is a fully featured MFi hearing aid that is appropriate for most hearing losses, offers wireless device-to-device communication, and is also compatible with existing ReSound Unite wireless accessories.

J Groth (2)Jennifer Groth serves as Director, Audiology Communications in Global Audiology for GN ReSound Group. Jennifer’s history with GN Resound includes roles as senior research audiologist as well as product manager. Her primary interests are hearing aid technology and open fit hearing aids. Previous to joining GN ReSound, she worked as a clinical audiologist in Denmark. She holds a Master of Arts degree in Speech Pathology & Audiology from the University of Iowa.

 NOTE: the above article is scheduled to be published on-line in 2014  at Canadian Audiologist, the official publication of the Canadian Academy of Audiology and has been posted with permission

References:

  1. Picou EM, Ricketts TA. Comparison of wireless and acoustic hearing aid-based telephone listening strategies. Ear & Hearing. 2011; 32(2): 209-220.
  2. Nesgaard Pedersen J, Kirkwood B. Speech Intelligibility Benefits of Assisted Telephone Listening Methods. In press. 2014.

© 2014 The GN ReSound Group, all rights reserved. Apple, iPhone, iPad and iPod touch are trademarks of Apple Inc, registered in the U.S. and other countries. Bluetooth is a trademark of Bluetooth SIG, Inc.

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Get Your Audiology Practice Under Control

search_600If you are an audiologist, hearing aid instrument specialist, or AuD student involved in the provision of patient care services, do me a favor and access the current written infection control plan at your work or clinical externship site. Can’t find it?  It should be stored in a common area accessible to the clinical staff. For those clinics located within a larger healthcare institution, a written infection control plan will most likely be filed with the specific regulatory department responsible for overseeing infection control although that filed plan will most likely not address audiology-specific procedures. Still can’t find it? Consider getting your practice under control.

amsed-2The Occupational Safety and Health Administration requires facilities that provide patient care services to have a written infection control plan.  While the written infection control plan is based on the Centers for Disease Control and Prevention (CDC) Standard Precautions, OSHA specifically identifies six required elements of a written infection control plan. While there are several resources available to assist audiologists on how to create a written infection control plan, the quickest way to understanding and starting the process  is to access two free-to-view webinars addressing infection control in the Audiology practice via AudiologyOnline. The first live webinar Infection Control: Why Audiologists Need to Care (Course #23808) will air Friday, May 2 at 12 pm EST and outline a clear rationale as to why infection control must be integrated into an audiology of hearing aid practice. og-ao-defaultThis presentation will also focus on the initial preparation for creating a written infection control plan.  Tune in for the follow-up webinar Infection Control: What to Do and How to Do It (Course #23809) on Friday, May 9 at 12 pm EST. This presentation will focus on specific required components of a written infection control plan, product considerations (without endorsements), and offer free resources to help you get your practice under infection control! As with all AudiologyOnline audio courses, the live webinars are free-to-view and can be accessed as recorded courses 24-hours after the live presentation date. For more information, contact AudiologyOnline.

 

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Business Phone Solutions for Hearing Aid Wearers: Part 3

business-solutions-buttonThis is the third post in a three-part series addressing ideal business phone solutions for hearing aid wearers experiencing difficulty using the phone at work. Part 1 and Part 2 both addressed options for hearing instrument wearers employed in traditional work settings experiencing difficulty using a PBX phone system in the office. Many people conduct business from their home office utilizing a standard landline phone (i.e. non-PBX) and/or via their Bluetooth-enabled cell phone. In either instance, hearing instrument wearers need viable phone solutions for their business communication needs. Here is what you should recommend:

FOR HEARING INSTRUMENT WEARERS with STREAMERS NEEDING HELP WITH LANDLINE HOME PHONE ONLY:

In this situation, the hearing instrument wearer uses the streamer for making and receiving cell phone calls but experiences difficulty using the landline phone within their home business.  The most straightforward solution involves replacing the landline home phone with any available BT enabled landline phones that become available in the market place.  At one time, ClearSounds offered the A6BT Cordless Phone (Item CS-A6BT) that could be paired to a hearing aid streamer, Bluetooth headset, or Bluetooth neckloop.  Unfortunately, that specific phone has been discontinued although there may be similar phones available in the future. one of the following:

FOR HEARING INSTRUMENT WEARERS with T-COILS and NO STREAMER NEEDING HELP WITH CELL PHONE: 

CS-QT41. Amplified Bluetooth Neckloop: for the wearer of T-coil equipped hearing instruments, an amplified Bluetooth neckloop such as the Quattro 4.0 or the original Quattro represent viable options, particularly for active cell phone users who use the cell phone in many different environments (i.e. home office, car, etc.).

2. Non-Bluetooth Amplified Neckloop: another potential amplified neckloop option in addition to the ones mentioned above includes the ClearSounds CLA7v2 Amplified Power Neckloop. This particular neckloop is not Bluetooth but comes equipped with various connection cables, including one for iPhone connection.

3. Bluetooth Neckloop: traditional Bluetooth neckloops that do not offer additional amplification may also be considered including the Artone-3 Loopset.

964. HearAll Cell Phone Amplifier (SA40): this product is a handset that pairs with a Bluetooth cell phone, providing up to 40 dB of amplification.  Once paired, the SA40 may be used like a traditional amplified handset, set to T-mode for use with hearing instrument T-coils, or in speakerphone mode for hands-free use.

The above recommendations represent viable solutions for users of T-coil equipped hearing instruments, both with or without streamers, experiencing difficulty conversing over the phone via a landline home business phone and/or cell phone who do not want to remove their hearing instruments.  There are other options available beyond the recommendations listed in this blog post (i.e. EtyBlu2); however, this post focused on those options that enabled the hearing aid wearer to keep the instruments in the ears. For additional information, refer to the previously posted Part 1 and Part 2 addressing business phone solutions for hearing aid wearers using PBX systems.

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