A Plan for Fun!

Oaktree logocircleToday is OAKtoberfest, an annual employee-appreciation event that takes place every October at Oaktree Products, Inc. Every employee of Oaktree Products works really hard and remains dedicated to providing the highest level of service to customers day in and day out. As a small token of appreciation to all the awesome employees, Oaktree Products will close a little early today (4 pm central time) for our OAKtoberfest celebration so we can spend time together as a group to grill some brats, listen to live music provided by the local band Delicious Fishes, check out the various pumpkins that employees carved, and have some fun before we get ready to watch Game 1 of the World Series between the Boston Red Sox and our very own St. Louis Cardinals. As mentioned in a previous blog post of mine, “All work and no play makes Jack a dull boy”.  With that in mind, be sure to plan for your own fun at work and take the time to express appreciation to your employees, coworkers, and colleagues.  Happy OAKtober and Go Cards!!!!!

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Product Designed to Alert Patients of Emergency Signals

bad-weather2As a public service, the National Oceanic and Atmospheric Administration (NOAA) provides an “all-hazards” radio network, broadcasting weather and emergency information for all types of hazards including natural (earthquakes, avalanches), environmental (chemical releases, oil spills), and public safety (AMBER alerts, 911). NOAA weather radios (NWR) activate to announce immediate information about life threatening events, giving extra time to prepare and evacuate if necessary. The broadcast is preceded by the Emergency Response Signal, a dedicated signal that serves as an indicator that an important message is about to follow.

ca-360If you have a patient with hearing loss who needs to hear emergency signals broadcast by their NOAA (Weather Alert) radio, the Serene Central Alert CA-360 (item# CA-360) is the perfect solution. The relatively new Serene CA-360 functions as a bedside alarm clock, providing audio, visual (built-in strobe), and vibrotactile (bed shaker) alerts in direct response to the doorbell, landline telephone, and NOAA (Weather Alert) Radio. The CA-360 is equipped with a NOAA plug on the back panel which will accommodate NWR radios equipped with a 3.5mm alert output jack  (Midland Model WR-120, Radio Shack Model 12-382, First Alert Model WX-150, Sangean CL-100 to name a few).

ca-axFurthermore, the Serene CA-360 offers a handful of additional accessories (sold separately) that expands its functionality to also alert individuals of other need-to-hear sounds including the residential smoke detector.  Specifically, the Audio Alarm accessory (item# CA-AX) detects the unique T3 audio signal residential smoke detectors are required to generate. It then wirelessly sends a signal to the CA-360, triggering the necessary auditory, visual and vibrotactile alerts at bedside. Not a bad product to let your patients know about and to have nearby! For more information on the CA-360 and other Serene products, contact customer service at Oaktree Products at 800.347.1960.

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Audiology ToTT: Retention Clip Solution for RIC/RITEs

ask question“Does anyone know of a hearing aid retainer that will work with a receiver-in-the-canal (RIC) and/or receiver-in-the-ear (RITE) for my adult patient?”  That is a question I hear asked more and more these days. A hearing aid retainer is an accessory that attaches to a hearing instrument to prevent loss of the device during activity. There are a variety of retainers available for pediatric and adult patient populations; they all have been specifically designed to work with either ITEs or more traditional BTEs. Critter, Dino and Sea Clips, Huggie Aids, and Ear Gear remain popular with pediatric patients whereas the OtoClip, OtoClip Colors, OtoClip for Eyeglasses, and Loop’em tend to attract adult hearing instrument wearers.  In the absence of a hearing aid retainer specifically designed for RIC/RITEs, is there a solution currently out there?

The answer, of course, is yes! I am happy to report that the solution offered in this post was recently verified by audiologist Suzanne Yoder via the American Academy of Audiology’s (AAA) Audiology Community platform in her response to a colleague asking this  question. otoclip for iteThe ITE versions of either the OtoClip or OtoClip Colors can be used with RIC/RITEs. Simply attach the OtoClip onto the RIC/RITE wire via the clasp located at the end of the loop.  Once the RIC/RITE is positioned in the ear, have the patient move the OtoClip cord up and over the ear, allowing the cord to simply rest between the mastoid and the back of the pinna. By the way, there is no need to invest in the ITE Fastener Kit; that kit is only necessary when intending to use the OtoClip with an ITE. Contact Oaktree Products toll-free at 800.347.1960 and ask for customer service for more information and to place your order.

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All This Noise About Noise! – guest post by Laurie Wells

loud-music“Kids these days!  What about their hearing? Surely they must all be going deaf!!”  How many conversations like this do we audiologists have each day with our patients, clients, neighbors and friends? The demise of the next generation’s hearing due to extensive use of personal listening devices, recreational, occupational and just plain old average every day noise is a hot topic rapidly reaching a boiling point. We even have a new world record for the loudest stadium noise as recorded by the Guinness Book of World Records – 136.6 dB – set by the Seahawks fans on September 15, 2013. As those who strive to protect, work hard to restore, yet still feel the thrill of powerful sound, what can we do to counter this love-hate relationship with aggressive acoustics?

Noise as a Public Health Concern

noiseWe have made positive cultural changes in our attitudes and behaviors towards health issues: smoking, drunk driving, use of seatbelts, child safety seats, bicycle helmets, and sun protection. What about noise? Noise has traditionally been earmarked (pun intended) as an occupational hazard. In fact, nearly every consumer article about noise references the Occupational Safety and Health Administration’s (OSHA) noise exposure limit as a guideline for limiting hearing risk. The OSHA permissible exposure level is 90 dBA averaged over an 8-hour work day. Exposures that exceed this limit require hearing protection to reduce the exposure. Equivalent exposures are figured by applying a 5-dB exchange for either halving or doubling the exposure time: 90 dBA for 8 hours is equivalent to 85 dBA for 16 hours, 95 dBA for 4 hours, 100 dBA for 2 hours, etc. This maximum noise allowance was made law in 1971. Since then, many other things have changed, such as our basic understanding of how the ear is harmed by loud sound.  Noise isn’t confined to eight-hour work days. Many work twelve-hour shifts, more than one job, or pull double shifts working overtime as often as possible. Workers don’t get to Eternal_clockstart their “ear clock” over after they leave the job site – the noise hazard continues to accumulate as they engage in noisy activities away from work. Noise-exposed workers who understand how and when to protect their hearing on the job don’t always generalize this knowledge or habit to their recreational activities or families. Since hearing loss prevention programs are employment based, people with noisy hobbies but not noisy jobs likely don’t receive training, hearing protection, or annual audiograms. Are the federal occupational noise limits appropriate for today’s noisy world with longer working hours, different noise sources, and the multiplicity of off-the-job noises? Are they suitable guidelines for parents struggling to cope with their children’s listening habits and desires? Is noise-induced hearing loss (NIHL) on the rise?

earplugsIt may be too early to tell about the trend of NIHL for the current generation. However, the issue of hazardous sound levels has gained national attention as a health problem beyond the workplace. The national public health campaign, Healthy People 2020, specifies one of its primary objectives is to increase the use of hearing protection devices (earplugs or earmuffs) among adolescents and adults. The National Institute for Occupational Safety and Health (NIOSH) has prioritized health and safety training for young workers (less than 24 years of age), who made up 13% of the work force in 2010 and are at a higher risk of work-noisehazardrelated illnesses and injuries than older workers. Also, NIOSH recognizes the importance of integrating occupational safety and health promotion beyond the workplace with its Total Worker Health™ initiative. Multiple public awareness campaigns have been launched to raise awareness about risks to hearing from noise in children. A unique organization, called Dangerous Decibels, has developed a highly successful hearing health promotion program aimed at reducing NIHL and tinnitus. Distinguishable from other efforts, Dangerous Decibels integrates health communication theory as the foundation to change individual knowledge, attitudes, and behaviors. Dangerous Decibels has developed educational materials, delivery models, and conducts research to help shape its programming.  Besides all that, it’s fun! Kids and adults love it.

Innovations in Noise-Induced Hearing Loss and Tinnitus in Kids: October 15-16th

innovationShaping attitudes and behaviors about healthy hearing in youth promises to enhance awareness about the value of hearing and promote protective habits as these kids grow up and engage in noisier activities, either at work or at play. Dangerous Decibels has been actively educating audiologists, teachers, nurses, physicians, speech language pathologists, industrial hygienists, health care workers, parents and others who make a commitment to conduct educational events for kids about hearing. This year, Dangerous Decibels was awarded a grant from the 3M Foundation to further its cause by disseminating its effective training programs. On October 15-16th, 2013 in St. Paul, MN, will be a two‑day conference, Innovations in Noise-Induced Hearing Loss and Tinnitus Prevention in Kids. The most current information regarding NIHL and tinnitus in children, and state-of-the-art interventions and dissemination methodologies for effective prevention will be provided. Day one offers talks by experts in the field, concluded by a live, interactive session with colleagues in New Zealand engaged in a national partnership focused on hearing loss prevention in youth. Day two highlights a dozen different interventions and harmony-smallerprograms specifically targeting youth. Poster sessions and resource tables will be present throughout the meeting. A special event on the evening of October 16th will address the social phenomenon of sound exposure risks from personal music players and ways to conduct engaging, effective outreach and education. The event, How loud is your music? U-build-it Jolene will feature several “Jolene” mannequins and their handlers who will share how to use these colorful and sometimes provocative devices in reaching out to music listeners of all ages.  Due to the collaborative support from 3M Foundation, National Hearing Conservation Association, and Prevention Research Centers, participation in these events is free of charge, however registration is required. Space is still available! Click on REGISTER for more information or directly access the information online via www.dangerousdecibels.org/innovations/

All this noise about noise…

opportunityAbout that 136.6 dB at the football stadium, whether one believes the decibel numbers or not, the media hype about noise presents an incredible opportunity for us.  Because of this record-breaking event, volunteers from Seattle’s Hearing, Speech, and Deafness Center organized and distributed 30,000 pair of earplugs (donated by 3M) to fans in advance of the game.  All this noise about noise…keep your ear to the ground. You’ll hear the rumblings of this exciting cultural change!

laurie_wellsLaurie Wells joined 3M in August, 2012 as Senior Acoustics Regulatory Affairs Specialist for 3M Personal Safety Division.  Her primary experience lies in professional review of the audiometric monitoring program and management of hearing loss prevention programs.  Laurie holds the Doctor of Audiology degree from Salus University School of Audiology and is Board Certified in Audiology.  In addition, she is a certified Professional Supervisor of the Audiometric Monitoring Program© and a certified Course Director for the Council for Accreditation in Occupational Hearing Conservation (CAOHC).  Currently, she represents the American Academy of Audiology (AAA) on the CAOHC Council where she holds the elected position of Vice-Chair of Education.  Laurie is past-president of the National Hearing Conservation Association, and served on its board from 1999 – 2007. Recently she was awarded the Michael B. Threadgill Award (2012) and the Outstanding Lecturer Award (2011) at the NHCA annual convention.

References and Resources

3M Hearing Conservation: http://www.e-a-r.com/hearingconservation/

Dangerous Decibels: http://www.dangerousdecibels.org/

Healthy People 2020: http://www.healthypeople.gov/2020/

National Hearing Conservation Association: http://hearingconservation.org/

National Institute for Occupational Health and Safety: http://www.cdc.gov/niosh/topics/youth/

National Institute for Occupational Health and Safety: http://www.cdc.gov/niosh/twh/totalhealth.html

Occupational Health & Safety Administration Hearing Conservation Regulation: https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9735

Seattle Times: http://seattletimes.com/html/seahawks/2021833455_seahawksscene16xml.html?goback=%2Egmp_4340015%2Egde_4340015_member_275033288#%21

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Vote on the next Oaktree Products Catalog Cover!

It is that time of year again! Based on the tremendous success of last year’s poll, we are once again calling upon all awesome people of the universe to decide the next cover of the 2014 Oaktree Products catalog!  Choose the ONE catalog cover you like the most from the three choices below and then click the VOTE button at the bottom of the ballot; for a better view of the covers, click the actual cover photo to enlarge the image.  Cast your vote and spread the word to all other hearing industry peeps to do the same! Polls will remain open through  October 31, 2013 11:59 pm CST.  The cover with the most votes wins so don’t delay and cast your vote today!

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Changes to Hamilton CapTel Program for Audiologists

cahngesPer the recent ruling by the FCC (Order FC 13-118), audiologists need to be aware of changes that may impact how patients with hearing loss can obtain a Hamilton CapTel telephone. Since May of 2013, patients with hearing loss were able to obtain this caption telephone at no charge through Hamilton CapTel’s Holistic Hearing Healthcare Program (see previous blog post).  The process required an audiologist or other hearing health care professional to complete and submit a certification form to Hamilton CapTel, verifying that the applicant (patient) had a hearing loss and could benefit from Captioned Telephone Service (CTS). Upon receipt of a completed certification form, Hamilton CapTel delivered a new phone directly to the patient at no charge. This process has changed per a new order issued earlier this month by the FCC.

captelEffective Saturday, September 21, 2013, patients with hearing loss experiencing difficulty hearing over the phone will continue to have access to Hamilton CapTel phones; however, the phone will no longer be available at no cost to the patient. The patient will be required to pay for the phone. It is important to emphasize that captioning services provided by the Hamilton CapTel phone will continue to be available at no cost per the Americans with Disabilities Act. Look for more details regarding updates to the Hamilton Captel Hearing Healthcare Program via direct mail scheduled in the near future.

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Heine Mini 3000 Otoscopes – All Models NOT the Same

hien mini ledThree different Heine Mini 3000 Pocket Otoscopes are currently available; while they differ in price, it is important to appreciate what it is you are paying for in order to make the most informed decision about your next pocket otoscope investment.   The three pocket otoscope models listed in order of least expensive to most expensive are as follows: 1) Heine Mini 3000 Non-Fiber Optic, 2) Heine Mini 3000 Fiber Optic, and 3) Heine Mini 3000 LED Fiber Optic. All three provide 3X magnification, packaged with at least five disposable specula, run on 2 (AA) batteries, look exactly the same, and come in any color you want (as long as it is black with the small change of scoring the availability of blue but you catch my drift).  So, if all three are equipped with the essentials, why not just purchase the least expensive one, right? Well, it depends what you want in your pocket otoscope and depends on how much you are willing to spend.

savings2The Heine Mini 3000 Non-Fiber Optic otoscope (Item D-01.70.210BK) is the least expensive because it utilizes the older form of direct illumination technology more commonly referred to as non-fiber optic technology.  Non-fiber optic otoscopes directly shine light through the speculum.  This design requires the bulb to be located above the floor of the eye piece compartment, in the middle of the visual field. In other words, the bulb ends up partially blocking the view of the ear canal and tympanic membrane although not to the point where it interferes with performing otoscopy.

fiberopticIn contrast, both the Heine Mini 3000 Fiber Optic (Item D-01.70.110 BK) and the Heine Mini 3000 LED Fiber Optic (Item D-008.70.110) utilize fiber optic technology where the bulb’s illumination is delivered to the speculum via a fiber optic bundle.  The advantage of fiber optic technology is that is provides a completely unobstructed view of the ear canal and tympanic membrane through its lens. For this reason, fiber optic otoscope model pricing will be, on average, about $100 more than comparable non-fiber optic models.

LEDWhile the Heine Mini 3000 Fiber Optic (Item D-01.70.110 BK) and the Heine Mini 3000 LED Fiber Optic (Item D-008.70.110) both utilize fiber optic technology, LED Fiber Optic model will cost approximately $10 more than the standard Heine Mini 3000 Fiber Optic model. As the name suggests, the more expensive Heine Mini 3000 LED Fiber Optic otoscope utilizes a high-performance LED rather than the standard Xenon/Halogen bulb found in the non-fiber optic and the standard fiber optic models.  LED illumination provides the brightest and most homogenous illumination, thereby optimizing visualization of the ear canal and tympanic membrane.  The other advantage of the Heine Mini 3000 LED Fiber Otpic Otoscope is that the LED is guaranteed for the life of the otoscope.

decisionSo, what should you buy? If money is an issue, the Heine Mini 3000 Non-Fiber Optic otoscope is very high quality pocket otoscope.  If spending an extra hundred bucks doesn’t make you sweat, kick in the additional $10 (on top of the $100) and invest in the Heine Mini 3000 LED Fiber Optic otoscope (particularly if you are over 40 years of age and need every advantage to see better).  Since the LED model is guaranteed for life, by the time you spend $30 to replace the Xenon/Halogen bulb in the Heine Mini 3000 Fiber Optic model, you have paid more than what you would have paid for the LED version.

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PSAP or a Hearing Aid? – guest post by Wayne Staab

apples-and-oranges1Personal Sound Amplification Products (PSAPs) are electronic devices that allow an individual to listen better in noisy environments, or for those situations when the signal is not strong enough for a listener, regardless of the reason.  These products are not the same as hearing aids; the Food and Drug Administration (FDA) has issued a guidance document under the Food, Drug, and Cosmetic Act that outlines and identifies applicable legal requirements for hearing aids and for PSAP’s. As defined by these FDA Guidelines, “PSAPs are intended to amplify environmental sound for non-hearing-impaired consumers.  ER135-QSA-BZThey are not intended to compensate for hearing impairment.  Examples of situations in which PSAPs typically are used include hunting (listening for prey), bird watching, listening to lectures with a distant speaker, and listening to soft sounds that would be difficult for normal hearing individuals to hear (e.g., distant conversations, performances).  Because PSAPs are not intended to diagnose, treat, cure or mitigate disease and do not alter the structure or function of the body, they are not devices as defined in the Food, Drug and Cosmetic Act Guidelines.”  (FDA, 2009)

The FDA defines the PSAP by “use,” from hearing aids in that:

TermsofuseA hearing aid is a wearable sound-amplifying device that is intended to compensate for impaired hearing.  A PSAP is a wearable electronic product that is not intended to compensate for impaired hearing, but rather is intended for non-hearing impaired consumers to amplify sounds in the environment for a number of reasons, such as for recreational activities.  While some of the technology and function of hearing aids and PSAPs may be similar, the intended use (emphasis added) of each article determines whether it is a device or an electronic product.  The intended use may be established by labeling materials.  Promotional materials that make claims or suggest the use of a PSAP for hearing impaired consumers, such as in the description of the types and severity of hearing loss, establish an intended use that causes the product to be a device and therefore subject to the regulatory requirements for a hearing aid device, as described in this guidance.”

The FDA Guidelines further this differentiation by stating that while hearing aids and PSAPs both affect our ability to hear sound, the products have different intended uses, and are therefore subject to different regulatory controls.

The Lines Separating PSAPs and Hearing Aids are Becoming More Blurred

blurred-visionWhile initial (and many today) PSAPs were very basic sound amplifiers, the market is now seeing improvements in sound quality, cosmetics, functions, sound adaptive features and/or amplification, and noise cancellation.  Essentially, many of the features of hearing aids are being incorporated into PSAPs to improve their performance and cosmetic appeal.  So, from a functional point of view, the devices are becoming more similar.  The primary differentiation relates to the conditions and definitions under which they can be sold.  Essentially, the PSAP has to disassociate itself from the hearing aid attributed functions of compensating for reduction in measured hearing sensitivity.

Consumer Confusion

Today there are hundreds of PSAPs in the market place and even a greater number of hearing aids.  How does the consumer determine which is being sold?  There are a number of things to look for:

  1. What is the product called?  If described (called) a hearing aid, it is a hearing aid.  If advertised as a PSAP, it is a PSAP
  2. Who is selling the product?  If by an audiologist or hearing aid dispenser (hearing professional), it is most likely a hearing aid.  If over-the-counter, Internet, or mail order, it is most likely a PSAP.
  3. Was a hearing test conducted?  If so, the product being purchased is most likely a hearing aid.  If not, or if asked to check listening experiences from a list, it is most likely a PSAP.
  4. Price.  If the product has a cost from approximately $15 to $650 per unit, it is most likely a PSAP.  If the cost ranges from approximately $1000 to $3000 per unit, it is most likely a hearing aid.
  5. Is the product defined to compensate for hearing loss?  If so, it is a hearing aid.  If the term hearing loss (or similar terminology related to loss of hearing) is avoided, the intent is to present the product as a PSAP.

Adding to the confusion is that the hearing aid and PSAP often look the same.  Some PSAPs actually were hearing aids in their “previous” life, having lost their sales appeal, or reinvented to fit the sales requirement of a PSAP.  In truth, any hearing aid could become a PSAP, but not all PSAPs would qualify to become quality hearing aids to be sold by the professional hearing community. Additional information about PSAPs can be found on the Hearing Health and Technology Matters Internet Blog Site hearinghealthmatters.org.  Just type “PSAP” in the search box to access multiple posts about PSAPs.

Staab1Dr. Staab is an internationally recognized expert in the hearing health care discipline.  He is President of Dr. Wayne J. Staab and Associates, a marketing, research, educational, publishing, manufacturing, and consulting organization, and also a founding partner/editor of Hearing Health and Technology Matters, an International blog site for hearing. Educated with a Master’s degree in Audiology and Doctoral degree in Hearing Science, he has held both academic and corporate positioned in the hearing industry. Dr. Staab specializes in hearing and hearing aid related issues, authoring numerous books, articles, and book chapters.

References

Guidance for industry and FDA staff.  Regulatory Requirements for Hearing Aid Devices and Personal Sound Amplification Products, Document issued on: February 25, 2009, U.S. Department of Health and Human Services Food and Drug Administration Center for Devices and Radiological Health, Ear, Nose, and Throat Devices Branch, Division of Ophthalmic, Neurological and Ear, Nose, and Throat Devices Office of Device Evaluation

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