Wide Dynamic Range Compression Benefits Health And Social Care Essay

Wide Dynamic Range Compression Benefits Health And Social Care Essay Adults with a moderate sensorineural hearing loss have a need for soft sounds to be amplified to help with clarity of speech without going over a level which the person finds too loud. Moderate sensorineural hearing loss is caused by damage to outer hair cells, which can lead to a reduced dynamic range and ultimately, recruitment. The dynamic range is the range between the threshold of hearing and the uncomfortable loudness levels (ULL). Venema (1998) refers to this as the floor (threshold) being raised and the ceiling (ULL) remaining the same. When the ULLs are unchanged, as thresholds worsen, an irregular increase in loudness is perceived typically referred to as recruitment. In order to distinguish between different types of hearing aids and find the most suitable for this type of hearing loss we have to look to see if the hearing aids can encompass the persons dynamic range without going over their uncomfortable loudness levels. It has been suggested that output limiting compress ion (CL) and wide dynamic range compression (WDRC) hearing aids are more beneficial for this type of hearing loss compared to linear hearing aids with peak clipping. Ultimately, for a moderate sensorineural hearing loss it is believed that WDRC is the most beneficial type of amplification at this time. The outer hair cells in the organ of Corti have been referred to as the amplifiers of the cochlea (Brownell, et al., 1985). In the absence of outer hair cell function, a moderate sensorineural hearing loss of around 40-50 dB is present (Ryan and Dallos, 1975). The most prevalent type of hearing loss in adults is presbyacusis or age-related hearing loss (Valente, et. al. 2008). Presbyacusis begins as a bilateral, symmetrical, high frequency sensorineural hearing loss affecting the outer hair cells in the basal end of the cochlea. People with this type of hearing loss tend to complain about background noises such as speech babble in a noisy pub. This can account for, what is commonly referred to as the upward spread of masking, which is caused by lower frequencies masking higher frequencies (Valente et. al., 2008). This results in softer, higher frequency sounds from speech such as consonants being masked by lower frequency speech sounds such as vowels. Presbyacusis causes a subtle dec rease in hearing over time (Valente et. al., 2008) and as a result, patients do not usually attend clinics until their families notice that the television is too loud or the patient themselves realize that they cannot hear as well in noisy situations as they used to. Hearing aids can include different types of compression circuits, which can benefit different types of hearing loss. Lets first look at input and output compression circuits. They differ to each other depending on where the volume control is located in the circuit. Output compression circuits have the volume control before the compression takes place. This type of compression affects the compression kneepoint and the gain but not the maximum power output. It is also the type of circuit used with CL amplification strategy and is associated with high compression ratios and kneepoints. Input compression has the volume control located after the compression circuit; therefore the sound is compressed before the volume control affects the sound. This means that the kneepoint is unaffected while the gain and maximum power output are. This type of compression circuit is what tends to be used with wide dynamic range compression (WDRC) strategy and is associated with low compression ratios and kneepoints (Venema, 1998; Dillon, 2001). The first type of compression is output limiting compression amplification. The input is linear until it reaches a high kneepoint and then it compresses the sound with a high compression ratio (Venema, 1998; Valente, et. al., 2008). This type of compression is very similar to peak clipping (PC), which is found in linear hearing aids, however it is more pleasant for the listener than PC because there is less distortion. People with normal hearing or mild to moderate hearing loss will notice that the quality of speech is more distorted with limiting when compared to people with severe to profound hearing loss who will not notice this effect as much (Dillon, 2000). In a study of 12 adults with mild to moderate sensorineural hearing loss, sound quality and clarity were improved with output limiting compression when compared to peak clipping (Hawkins and Naidoo, 1993). It is generally accepted that linear hearing aids with peak clipping no longer have a place in audiology clinics and hear ing aid companies have stopped manufacturing them. Wide dynamic range compression (WDRC) is a compression strategy that aims to amplify soft sounds by a lot, medium sounds by a moderate amount and loud sounds by a small amount (Souza and Turner, 1998). WDRC tends to give more gain to soft sounds and has fairly short attack and release times (Marriage, et al., 2005). WDRC is a nonlinear compression strategy, which tries to mimic the non-linearity of the cochlea and attempts to account for loudness recruitment with sensorineural hearing loss (Moore, et al., 1992). The threshold kneepoint is usually low at around 50 dB in order to amplify quiet sounds, compressions ratios are usually lower than 4:1 and attack and release times are short so that consonant sounds are not masked by vowel sounds (Valente, et. al., 2008). WDRC is a relatively new compression strategy that is used commonly in modern digital technology hearing aids. There are mixed views as to whether WDRC is of more benefit than linear amplification. It has been noted in some literature that measurable benefits of WDRC include improved hearing for soft speech sounds (Souza and Turner, 1998), speech in quiet, speech in noise, more comfortable listening situations for loud speech (Moore, et. al., 1992; Davies-Venn, 2009) and improved acclimatisation (Yund et. al., 2006). In contrast it has also been reviewed that WDRC may improve audibility but not necessarily intelligibility when compared to linear amplification (Marriage, et. al., 2005; Souza and Turner, 1998). WDRC may be of more benefit for people with mild to moderate sensorineural hearing loss compared to people with severe to profound sensorineural hearing loss. This may be due to the suggestion that as hearing gets worse i.e. in severe to profound sensorineural hearing loss that temporal cues are relied on more heavily to understand speech. Since fast WDRC can change temporal cues it may be that this population of hearing aid wearers benefits more from compression limiting (Jenstad and Souza, 2005; Davies-Venn et. al. 2009). In 1992, Brian Moore, et. al. tested twenty subjects with moderate sensorineural hearing loss, measuring speech discrimination ability in quiet and speech reception thresholds (SRTs) in noise. The subjects were fitted with two types of hearing aids: Linear amplifiers and two-band WDRC compressors. They were tested with their new hearing aids and also in an unaided condition and with their own original hearing aids. With the compression hearing aids the subjects had good speech discrimination scores at all intensity levels in the quiet and the other three conditions showed decreasing speech intelligibility as the intensity level got quieter. The WDRC aids proved to help subjects achieve lower SRTs in noise compared to the other conditions. Patients with reduced dynamic ranges also benefited from the compression hearing aids more than the linear aids in that they found the loud sounds more comfortable. When surveyed the subjects also preferred the sound of the WDRC hearing aids (Moore, et al., 1992). Another benefit of WDRC over liner amplification is improved acclimatisation. Acclimatisation is the time it takes for the brain to get accustomed to sound from a particular type of amplification and to have increased speech recognition. Yund et. al. (2006) did an acclimatisation study with 39 subjects with mild to moderate sloping sensorineural hearing loss, who had never worn hearing aids. They showed that subjects who wore the WDRC hearing aids experienced acclimatisation, whereas the patients who wore linear hearing aids did not show any increased speech discrimination scores. They believed this was because the WDRC hearing aid was able to process the normal hearing dynamic range into the dynamic range of subjects with mild to moderate sensorineural hearing loss. After a period of wearing linear amplification, subjects were then fitted with WDRC hearing aids. These subjects still struggled with acclimatisation after a period with their WDRC hearing aids and needed extra help in t he form of auditory training to get rid of the effects of the linear amplification on the brain. Overall, it was concluded that hearing aids with more sophisticated technology may be the best aids for acclimatisation (Yund, et. al., 2006). One study compared the benefits of linear and nonlinear hearing aids with speech tests and Glasgow Hearing Aid Benefit Profile (GHABP) questionnaires. The majority of subjects preferred the WDRC nonlinear hearing aids compared to the linear hearing aids. They showed better scores on speech tests, had better speech recognition, and preferred the overall listening experience with the WDRC hearing aids. WDRC hearing aids can be programmed with fast or slow attack and release times or a combination as this can be adjusted for different channels. In this study the researchers found that there was more of a preference for slow attack and release times for the most comfort and satisfaction compared to fast WDRC (Gatehouse, et. al., 2006). In comparison, Shi and Doherty (2008) found better speech recognition scores for both slow and fast, attack and release times compared to linear hearing aids, however found no difference between scores for slow and fast times in WDRC. When attack and relea se times are shorter the soft speech sounds are amplified more than the louder ones. If the release time is long then the soft and loud speech sounds are amplified at the same level, which may result in the softer phonemes being masked by the louder ones (Valente, et. al., 2008). Where to set attack and release times may be different for each patient depending on their preference; however in these studies it has been shown that having attack and release times using WDRC improves speech recognition scores compared to linear hearing aids. WDRC multi-channel hearing aids have a distinct advantage over single channel hearing aids because they have the ability to use BILL and TILL (features of WDRC) at the same time (Sandlin, 2000). BILL is the bass increase at low levels and TILL is the treble increase at low levels (Dillon, 2001, pp 169). BILL will tend to go into compression a lot more with low frequency sounds and not as much with high frequency sounds. The strategy of BILL is to allow the hearing aid wearer to hear better in background noise. TILL will go into compression more often with high frequency sounds and not as much with low frequency sounds. The strategy of TILL is to increase audibility of high frequency sounds. Both BILL and TILL used in conjunction can create a good fitting strategy for a flat moderate high frequency sensorineural hearing loss (Venema, 1998). Dillon (2000) described two problems that can arise with WDRC hearing aids. The first problem is that while WDRC hearing aids amplify very soft speech well, they also amplify very soft background noises such as the clock ticking or the sound of clothes moving (Dillon, 2000). Fortunately with newer digital technology, hearing aids are able to separate speech from background noise more intuitively than with analogue technology. A way to deal with these very low level background noises is to use expansion. Expansion is the opposite of compression and aims to make the weakest sounds in the quietest environments unnoticeable as it is below the listeners aided threshold (Valente, et. al., 2008). The second disadvantage is the problem of feedback being introduced when the hearing aid wearer is in a quiet environment and the gain is increased (Dillon, 2000; Valente, et. al., 2008). In the past few years digital feedback suppression/cancellation has become more sophisticated and this does not seem to be a problem with WDRC in hearing aid wearers as long as a suitable earmould is fitted. Wide dynamic range compression has been shown to have advantages over linear amplification using compression limiting and peak clipping circuits. In some researchers opinions it has still not been unequivocally proven that WDRC is the best fitting strategy for all types of hearing loss. As levels gets worse than moderate sensorineural hearing loss, the loss of outer and inner hair cell function causes temporal cues to worsen. It is unclear whether fast WDRC may be causing distortion in speech signals due to this. What is clear is that for mild to moderate sensorineural hearing loss, most commonly observed with presbyacusis, WDRC seems to improve speech recognition in quiet, in noise, overall comfort and it is easier to acclimatise to wearing hearing aids. There is not a great amount of recent literature on the subject of the benefits of WDRC in the moderate sensorineural hearing loss category. It would be interesting to see new research conducted to determine whether there are more b enefits in multichannel WDRC with newer, more intuitive, digital technology hearing aids.

Hawaiian Islands

Hawaii and Tourism â€Å"Hawaii is like no other place on earth† (Goshawks). Hawaii attracts many tourists per year because of Its history, geography, and entertainment This state is known for its many islands, volcanoes, and climate as well. When I think about Hawaii all imagine is standing on the beach overlooking the ocean getting hit with the nice warm breeze hearing laughter and seeing smiles. Since â€Å"Hawaii Is one of the most isolated places on Earth† It makes vacationing there completely stress and worry free, because you are far away from home and nothing n your mind but having a great vacation (Inner p. ). The state was founded by the Polynesians and it was also named by them. The word Hawaii in the Polynesian language meaner â€Å"Homeland† (Wisped). Having a name with such a powerful meaning says a lot about the state. I think It shows that anyone could look to Hawaii as their own homeland. Hawaii's communication with Europe started when it was fou nded by two British Explorers (Wisped). James Cook and captain clerk were suppose to be searching for the Northwest Passage, and discovered the Hawaiian Islands on January 18, 1778 They then spent the majority of he year searching for the Northwest Passage.When Cook had no luck, he abandoned his search and turned their ship south towards the islands. Cook and Clerk arrived in Hawaii between November of 1778 and January 1779 where they landed at Keelhaul Bay. Awaiting their arrival were thousands of excited natives. When Cook decided to leave the newly found island he found that the natives had stolen one of his ships. Cook proceeded to leave, however a few days later returned with marines to take the king hostage. The king had no objections to abandoning his Island and ongoing with Cook and the marines, however the fellow natives tried convincing the king not to go.The attitudes of everyone quickly changed when word that a chief had been killed, not far up the Island. â€Å"The nat ives attacked and the marines fired back with guns and bayonets. The battle only lasted a few minutes but when it was over, Cook lay dead on the beach† (south-pole). Since the Europeans had now discovered the Islands It progressively grew until It became the fiftieth state to Join the U. S. â€Å"Hawaii's tourism industry officially began in 1927. That year. The first luxury passenger ship, the S. S. Mallow, began voyages between San Francisco and the Islands† (En p. 34).With the new ship making voyages It brought great new revenue to the islands. However, the world changed forever when the Japanese bombed the U. S. Navy that was stationed In Pearl Harbor, Hawaii on December 7th 1941. This attack made Americans weary tot the Japanese and soon the Japanese were singled out; to show how loyal they were to America they signed up to fight in World War II (Inner p. 3536). Things finally started looking up for Hawaii; on August 21, 1959 It was announced that Hawaii was now a part tot the united States tot America. The tourism coming into Hawaii was finally picking back up too (Inner p. 36).The amount of tourism Hawaii sees Is constantly rising. As of September 2012 Hawaii has had 583,363 total visitors. Exactly one year ago in September tot 2011 Hawaii only and 553,187 total visitors, that's a 5. 5% change over one year (Hawaii Tourism Authority). Many tourists go to Hawaii Just because of the history of the islands, however many go for the geography as well. â€Å"There are six major islands to visit in Hawaii: Kuaka, AAU, Monomial, Lana', Mama, and Hawaii Island† (Goshawks). No matter which of the six ajar islands you are on; the weather is the roughly the same with very little changes throughout the year.The fact that â€Å"tourists are attracted by Hawaii's pleasant, sunny climate† makes Hawaii such a desirable place to vacation (Inner p. 13). Hawaii only has two seasons all year long summer, which ranges from May to October, and winte r, which ranges from November to April. The temperatures in the summer range from a low of OFF to a high of OFF; in the winter the temperatures range from a low of OFF to a high of OFF (Goshawks). Many people think of the islands as Just an island, but they are not. The Hawaiian Islands are really tops of volcanic mountains. The Hawaiian islands were created when boiling lava surged upward through almost 2,000 miles of cracks in the floor of the Pacific Ocean† (Inner p. 8). When the hot lava met the mildly cold water it became hard. As the years progressed this happened more and more eventually causing it to appear above the water as an active volcanic island. It took many years for the Hawaiian Islands to actually get carved out into what it is today (Inner p. 8-9). Kuaka is one of the prettiest islands to visit from Hawaii. It is one of the top five largest islands to see and it will take your breath away.This island is used to film movies that have major Jungles and beautif ul beaches. Also this island is full of beautiful coconut trees (Inner p. 55). AAU is the closest island to Kuaka and is the home of Pearl Harbor. This island is known for its pineapples and coffee fields (Inner p. 56-57). This island is also home to the â€Å"Triple Crown of Surfing competition† which is held on the â€Å"beaches of Williwaw, Waianae Bay, Sunsets, Chukka, and other world-famous North Shore beaches† (Inner p. 57). This island is mostly sited to see the historical attributes that is offered here.Monomial is the second closest island to Kuaka and is shaped like a shoe. This island is the fifth largest island in Hawaii (Inner p. 59). This island is the best island out of them all to have a lazy vacation. It is a â€Å"great place to go snorkeling or swimming or to enjoy a sightseeing tour, complete with the African wildlife† (Inner p. 60). The people that reside on this island are never in a hurry to do anything and are some of the nicest people yo u would ever meet (Inner p. 60). Lanai is the most self contained island of them all. It is the best island to go for peace and quiet.The island only has two hotels and hardly anywhere to shop. This island only attracts tourists that want beautiful clear water and to see the beauty of the island. This island is best suited for big city tourists (Inner . 60). The island Mama is â€Å"actually two inactive volcanoes connected by an isthmus, or strip of land† (Inner p. 62). This island is perfect for tourists visit so they can see volcanoes. Also, this island has the best tour to see a whale shooting water out of its blowhole, which is absolutely an unforgettable sight (Inner p. 64). The last major island to visit is Hawaii itself.This is the island that gave the state its name. This island is the largest of them all in fact â€Å"Hawaii is twice as big as the other islands added together† (Inner p. 64). This island is home to several volcanoes, including the most active one in the entire world, Killable. Watching this volcano erupt is absolutely breathtaking, but it is extremely dangerous. It has completely engulfed over two hundred homes and covered several beaches. The only g detect the volcanic eruptions have to this island is the fact that it is growing. â€Å"Its lava flows have added almost 600 acres of new land to the island's coast since 1983† (Inner p. 5). This island in my opinion would be the best island to visit due to the fact it is the most breath taking island because of its scenery. I have never been to Hawaii but from the pictures I have seen I'm sure it is absolutely gorgeous. The last reason I feel Hawaii is such a great tourist spot is the entertainment and the enthusiasm of the state. Hawaii is home to the Luau and the Hula dance. Americans have parties with a Luau theme all the time. Luaus are â€Å"traditional native Hawaiian feasts† that are â€Å"held in nor of graduations, weddings, or a baby's first birthda y' (Inner p. 7). The luau is now used as a theme for all kinds of parties whether it is a birthday or Just a get together. Americans have also adapted the â€Å"flower garlands, called leis† (Inner p. 4). The leis are the number one symbol that is best known in Hawaii (McCain p. 88). Whether you are in Hawaii or any state, when you see leis it automatically brings Hawaii to your mind. I see them garlands hanging on rear view mirrors in vehicles all the time. I also see this at the luau theme based parties. When tourists visit Hawaii here is always a Luau going on because it is such a popular event.Another popular event for tourists to learn and experience while at the Luau is the Hula. The Hula dance was used during religious gatherings. â€Å"Both men and women learned to dance, but only men performed in the temples† (McCain p. 89). The dance is mostly made up of hip and hand movements, which make up the words of the song that is being played while the dance is perfor med. Many people still practice and study the Hawaiian culture and are always creating different ways to act out the symbols of the state (McCain p. 89-90). I know when I see someone on TV doing the Hula dance it brings the great state of Hawaii to mind.In conclusion, the history, geography, and entertainment of Hawaii are what attract tourists to this state. The fact that the climate is always the same and that there is so much history to learn from the islands. While also gaining new ways to entertain is what makes this state amazing. From doing this research on the state has Just made me want to visit the islands even more then I did before. It has made me believe that Hawaii is the best vacation spot, no matter what time of the year. Works Cited Hawaii's Official Tourism Site. Hawaii's Official Tourism Site, 2012.

Definitions of Nhs Application Essay Samples

Definitions of Nhs Application Essay Samples The Key to Successful Nhs Application Essay Samples It is an overall letter of application where you could incorporate all of your experience, explain why you're a fantastic leader, community, team member. To begin with, you ought to know the principal advantages of being a true member of the NHS society. Speaking about Sociology as it's about the happenings in our society, it's simple to comprehend. The candidate must demonstrate he or she's not simply an outstanding student, but in addition a useful and useful member of society. Your National Honor Society essay is a powerful tool which will allow you to grow to be a member of an extremely prestigious organization in the usa. Being inducted in the National Honor Society would not just be a privilege, but nevertheless, it would be an honor. The primary purpose of your National Honor Society essay is to reveal you from the ideal side and help you demonstrate that you're eligible to be a member of this authoritative organization. As an example, information concerning NHS scholarships, chapters, activities, awards, and the way to begin a chapter can readily be accessed through their site. All is possible if you would like to buy a paper since there are many essayA writing services where you find writers with perfect abilities and qualities who can assist. After considering and listing traits and actions, you have a notion of what you wish to discuss in your essay. You might need to understand various award-winning articles and choose a distinctive topic tha t resonates with your abilities and knowledge. An outline is an indispensable feature of the essay as it ensures your ideas are presented systematically and keep up a coherent flow of the paper from top to bottom. 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Possessing a great character makes it possible to in turning into a terrific leader without forgetting to be a scholar. They will supply you with those samples because it's important to them to clearly show their respect for a customer and their professional dedication to the area. In this instance, the applicant should address all the demands of their membership. There are many reasons why you must prefer our services. Nhs Application Essay Samples - Overview There's, obviously, a limit on the range of pages even our finest writers can produce with a pressing deadline, but generally, we figure out how to satisfy all the clients seeking urgent assistance. Don't forget to be open-minded when making decisions regarding what things to put back on paper. Be attentive as it is merely a sample and you can't copy it to your work. A good example of a pa per is the thing you may see in our article. Details of Nhs Application Essay Samples National Honor Society essay samples and tips will direct you in writing a great paper and boosting your opportunity to impress the committee. A specialist writer who's seasoned in writing NHS essays can aid with an outline, give advice, point you in the correct direction, or even compose the full essay below your guidelines. The actual individuals highly praise our essay help site. Writing a national honor society essay all on your own, you can come to an issue of locating a draft to have a look at. Essay writing isn't always straightforward. Another benefit orifl writing essays is it can turn you into a proficient writer. A well-written essay doesn't guarantee that you'll be accepted into an organization, much is dependent on whether you fulfill the selection criteria. Writing a scholarship essay may not be a very simple endeavor for many students. On the contrary, it would motivate me to do better in my classes as a way to continue to keep my GPA in the most suitable place so that I would have the ability to keep on participating in NHS without forgetting the value of being a true scholar. There's been an increasing popularity of alternative therapies to challenge medical pre-eminence and is projected that a fifth of the people has used some sort of alternative medication. Students are requested to have the essential information at the beginning of the full procedure, the student should demonstrate skills in different areas that might include the ability to lead, service , and honorable and admirable character and talents that may be used to enhance the condition of the society. Today, it's estimated that more than one million students take part in NHS activities. The Nhs Application Essay Samples Game I make every attempt to assist my fellow students to do their finest. 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Benefits Of Owning Your Own Business - 862 Words

You would think that once you have finished school and started your career you would be done with trying to improve your way of working, but what happen when you no longer wish to work where you are working but are unable to find a new place to work? You would start to think about how you should open your own business so that you could be your own boss. People who are unhappy in their place of work are not the only ones who want to start their own business. There are many people in our country alone who want to start their own business, I consider it to be one of the â€Å"American Dreams†. Owning a business might look like it could be easy, but many people do not really know all that comes with owning a business. I feel that people often jump into things such as starting their own business without knowing what they are getting themselves into. I am sure there are many pros and many cons of owning your own business. While I am also sure that there are also many pros and many cons that come with working for someone in their place of business. I would like to take it upon myself to research to find out what it is really like to own your own business and what it takes to run a successful one. I feel that many people could benefit from this simply because I am sure there are many people who want to start a business. I also think that people who do start their own business don’t always know what they are doing and quickly find out that they have taken on more than they can handle.Show MoreRelatedBenefits Of Owning Your Own Business852 Words   |  4 PagesSure That Your Business is Properly Insured Owning your own business can be a very rewarding experience, providing a way to engage your passion, while also offering a way to make a comfortable living. However, owning a business leaves you in a position in which you will have a lot that you will be responsible for protecting. 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