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Hearing loss, also known as hearing impairment, is a partial or total inability to hear. A deaf person has little to no hearing. Hearing loss may occur in one or both ears.] In children, hearing problems can affect the ability to learn spoken language and in adults it can create difficulties with social interaction and at work. In some people, particularly older people, hearing loss can result in loneliness. Hearing loss can be temporary or permanent.
Hearing loss may be caused by a number of factors, including: genetics, ageing, exposure to noise, some infections, birth complications, trauma to the ear, and certain medications or toxins. A common condition that results in hearing loss is chronic ear infections. Certain infections during pregnancy, such as syphilis and rubella, may also cause hearing loss in the child. Hearing loss is diagnosed when hearing testing finds that a person is unable to hear 25 decibels in at least one ear. Testing for poor hearing is recommended for all newborns. Hearing loss can be categorized as mild (25 to 40 dB), moderate (41 to 55 dB), moderate-severe (56 to 70 dB), severe (71 to 90 dB), or profound (greater than 90 dB). There are three main types of hearing loss: conductive hearing loss, sensorineural hearing loss, and mixed hearing loss.
About half of hearing loss globally is preventable through public health measures. Such practices include immunization, proper care around pregnancy, avoiding loud noise, and avoiding certain medications. The World Health Organization recommends that young people limit the use of personal audio players to an hour a day in an effort to limit exposure to noise. Early identification and support are particularly important in children. For many hearing aids, sign language, cochlear implants and subtitles are useful. Lip reading is another useful skill some develop. Access to hearing aids, however, is limited in many areas of the world.
As of 2013 hearing loss affects about 1.1 billion people to some degree. It causes disability in 5% (360 to 538 million) and moderate to severe disability in 124 million people. Of those with moderate to severe disability 108 million live in low and middle income countries. Of those with hearing loss, it began during childhood for 65 million. Those who use sign language and are members of Deaf culture see themselves as having a difference rather than an illness. Most members of Deaf culture oppose attempts to cure deafness and some within this community view cochlear implants with concern as they have the potential to eliminate their culture. The term hearing impairment is often viewed negatively as it emphasises what people cannot do.
Hearing loss exists when there is diminished acuity to sounds normally heard. The terms hearing impaired or hard of hearing are usually reserved for people who have relative inability to hear sound in the speech frequencies. The severity of a hearing loss is categorized according to the increase in volume above the usual level necessary before the listener can detect it.
Deafness is defined as a degree of loss such that a person is unable to understand speech even in the presence of amplification. In profound deafness, even the highest intensity sounds produced by an audiometer (an instrument used to measure hearing by producing pure tone sounds through a range of frequencies) may not be detected. In total deafness, no sounds at all, regardless of amplification or method of production, are heard.
Speech perception – Another aspect of hearing involves the perceived clarity of a word rather than the intensity of sound made by the word. In humans, that aspect is usually measured by tests of speech discrimination. These tests measure one's ability to understand speech, not to merely detect sound. There are very rare types of hearing loss which affect speech discrimination alone. One example is auditory neuropathy, a variety of hearing loss in which the outer hair cells of the cochlea are intact and functioning, but sound information is not faithfully transmitted to the auditory nerve and brain properly.
Use of the terms "hearing impaired", "deaf-mute", or "deaf and dumb" to describe deaf and hard of hearing people is discouraged by advocacy organizations as they are offensive to many deaf and hard of hearing people.
Hearing standards
Human hearing extends in frequency from 20–20,000 Hz, and in intensity from 0 dB to 120 dB HL or more. 0 dB does not represent absence of sound, but rather the softest sound an average unimpaired human ear can hear; some people can hear down to −5 or even −10 dB. Sound is generally uncomfortably loud above 90 dB and 115 dB represents the threshold of pain. The ear does not hear all frequencies equally well; hearing sensitivity peaks around 3000 Hz. There are many qualities of human hearing besides frequency range and intensity that cannot easily be measured quantitatively. But for many practical purposes, normal hearing is defined by a frequency versus intensity graph, or audiogram, charting sensitivity thresholds of hearing at defined frequencies. Because of the cumulative impact of age and exposure to noise and other acoustic insults, 'typical' hearing may not be normal.
difficulty using the telephone
loss of directionality of sound
difficulty understanding speech, especially of children and women whose voices are of a higher frequency.
difficulty understanding speech in the presence of background noise (cocktail party effect)
sounds or speech becoming dull, muffled or attenuated
need for increased volume on television, radio, music and other audio sources
Hearing loss is sensory, but may have accompanying symptoms:
a blocked feeling
There may also be accompanying secondary symptoms:
hyperacusis, heightened sensitivity with accompanying auditory pain to certain intensities and frequencies of sound, sometimes defined as "auditory recruitment"
tinnitus, ringing, buzzing, hissing or other sounds in the ear when no external sound is present
vertigo and disequilibrium
tympanophonia, abnormal hearing of one's own voice and respiratory sounds, usually as a result of a patulous (a constantly open) eustachian tube or dehiscent superior semicircular canals
disturbances of facial movement (indicating a possible tumour or stroke) or in persons with Bell's Palsy
Hearing loss has multiple causes, including ageing, genetics, perinatal problems and acquired causes like noise and disease. For some kinds of hearing loss the cause may be classified as of unknown cause.
There is a progressive loss of ability to hear high frequencies with aging known as presbycusis. For men, this can start as early as 25 and women at 30. Although genetically variable it is a normal concomitant of ageing and is distinct from hearing losses caused by noise exposure, toxins or disease agents. Common conditions that can increase the risk of hearing loss in elderly people are high blood pressure, diabetes or the use of certain medications harmful to the ear. While everyone loses hearing with age, the amount and type of hearing loss is variable.
Hearing loss due to noise may be temporary, called a 'temporary threshold shift', a reduced sensitivity to sound over a wide frequency range resulting from exposure to a brief but very loud noise like a gunshot, firecracker, jet engine, jackhammer, etc. or to exposure to loud sound over a few hours such as during a pop concert or nightclub session. Recovery of hearing is usually within 24 hours, but may take up to a week. Both constant exposure to loud sounds (85 dB(A) or above) and one-time exposure to extremely loud sounds (120 dB(A) or above) may cause permanent hearing loss.Noise exposure is the cause of approximately half of all cases of hearing loss, causing some degree of problems in 5% of the population globally. The National Institute for Occupational Safety and Health(NIOSH) recognizes that the majority of hearing loss is not due to age, but due to noise exposure. By correcting for age in assessing hearing, one tends to overestimate the hearing loss due to noise for some and underestimate it for others.
Noise-induced hearing loss (NIHL) typically manifests as elevated hearing thresholds (i.e. less sensitivity or muting) between 3000 and 6000 Hz, centred at 4000 Hz. As noise damage progresses, damage spreads to affect lower and higher frequencies. On an audiogram, the resulting configuration has a distinctive notch, called a 'noise' notch. As ageing and other effects contribute to higher frequency loss (6–8 kHz on an audiogram), this notch may be obscured and entirely disappear.
Various governmental, industry and standards organizations set noise standards.
The U.S. Environmental Protection Agency has identified the level of 70 dB(A) (40% louder to twice as loud as normal conversation; typical level of TV, radio, stereo; city street noise) for 24‑hour exposure as the level necessary to protect the public from hearing loss and other disruptive effects from noise, such as sleep disturbance, stress-related problems, learning detriment, etc. Noise levels are typically in the 65 to 75 dB (A) range for those living near airports of freeways and may result in hearing damage if sufficient time is spent outdoors.[31]
Louder sounds cause damage in a shorter period of time. Estimation of a "safe" duration of exposure is possible using an exchange rate of 3 dB. As 3 dB represents a doubling of the intensity of sound, duration of exposure must be cut in half to maintain the same energy dose. For workplace noise regulation, the "safe" daily exposure amount at 85 dB A, known as an exposure action value, is 8 hours, while the "safe" exposure at 91 dB(A) is only 2 hours. Different standards use exposure action values between 80dBA and 90dBA. Note that for some people, sound may be damaging at even lower levels than 85 dB A. Exposures to other ototoxins (such as pesticides, some medications including chemotherapy agents, solvents, etc.) can lead to greater susceptibility to noise damage, as well as causing its own damage. This is called a synergistic interaction. Since noise damage is cumulative over long periods of time, persons who are exposed to non-workplace noise, like recreational activities or environmental noise, may have compounding damage from all sources.
Some national and international organizations and agencies use an exchange rate of 4 dB or 5 dB. While these exchange rates may indicate a wider zone of comfort or safety, they can significantly underestimate the damage caused by loud noise. For example, at 100 dB (nightclub music level), a 3 dB exchange rate would limit exposure to 15 minutes; the 5 dB exchange rate allows an hour.
Many people are unaware of the presence of environmental sound at damaging levels, or of the level at which sound becomes harmful. Common sources of damaging noise levels include car stereos, children's toys, motor vehicles, crowds, lawn and maintenance equipment, power tools, gun use, musical instruments, and even hair dryers. Noise damage is cumulative; all sources of damage must be considered to assess risk. If one is exposed to loud sound (including music) at high levels or for extended durations (85 dB A or greater), then hearing loss will occur. Sound intensity (sound energy, or propensity to cause damage to the ears) increases dramatically with proximity according to an inverse square law: halving the distance to the sound quadruples the sound intensity.
In the USA, 12.5% of children aged 6–19 years have permanent hearing damage from excessive noise exposure. The World Health Organization estimates that half of those between 12 and 35 are at risk from using personal audio devices that are too loud.
Hearing loss due to noise has been described as primarily a condition of modern society. In preindustrial times, humans had far less exposure to loud sounds. Studies of primitive peoples indicate that much of what has been attributed to age-related hearing loss may be long term cumulative damage from all sources, especially noise. People living in preindustrial societies have considerably less hearing loss than similar populations living in modern society. Among primitive people who have migrated into modern society, hearing loss is proportional to the number of years spent in modern society. Military service in World War II, the Korean War, and the Vietnam War, has likely also caused hearing loss in large numbers of men from those generations, though proving that hearing loss was a direct result of military service is problematic without entry and exit audiograms.
Hearing loss in adolescents may be caused by loud noise from toys, music by headphones, and concerts or events. In 2017, the Centers for Disease Control and Prevention brought their researchers together with experts from the World Health Organization and academia to examine the risk of hearing loss from excessive noise exposure in and outside the workplace in different age groups, as well as actions being taken to reduce the burden of the condition. A summary report was published in 2018.
Hearing loss can be inherited. Around 75–80% of all these cases are inherited by recessive genes, 20–25% are inherited by dominant genes, 1–2% are inherited by X-linked patterns, and fewer than 1% are inherited by mitochondrial inheritance.
When looking at the genetics of deafness, there are 2 different forms, syndromic and nonsyndromic. Syndromic deafness occurs when there are other signs or medical problems aside from deafness in an individual. This accounts for around 30% of deaf individuals who are deaf from a genetic standpoint. Nonsyndromic deafness occurs when there are no other signs or medical problems associated with an individual other than deafness. From a genetic standpoint, this accounts for the other 70% of cases, and represents the majority of hereditary hearing loss. Syndromic cases occur with disorders such as Usher syndrome, Stickler syndrome, Waardenburg syndrome, Alport's syndrome, and neurofibromatosis type 2. These are diseases that have deafness as one of the symptoms or as a common feature associated with it. Many of the genetic mutations giving rise to syndromic deafness have been identified. In nonsyndromic cases, where deafness is the only finding, it is more difficult to identify the genetic mutation although some have been discovered.
Gene mapping has identified the genetic locations for several nonsyndromic dominant (DFNA#) and recessive (DFNB#) forms of deafness. The first gene mapped for non-syndromic deafness, DFNA1, involves a splice site mutation in the formin related homolog diaphanous 1 (DIAPH1). A single base change in a large Costa Rican family was identified as causative in a rare form of low frequency onset progressive hearing loss with autosomal dominant inheritance exhibiting variable age of onset and complete penetrance by age 30. The most common type of congenital hearing loss in developed countries is DFNB1, also known as connexin 26 deafness or GJB2-related deafness.
The most common dominant syndromic forms of hearing loss include Stickler syndrome and Waardenburg syndrome.
The most common recessive syndromic forms of hearing loss are Pendred syndrome and Usher syndrome.
The congenital defect microtia, deformed or unformed outer ear, can be associated with partial or complete conductive deafness, depending upon the severity of the deformity and whether the middle ear is also affected. It can also be associated with abnormalities of the inner ear giving rise to an additional sensorineural component to the hearing loss (mixed deafness).
Dozens of additional genes for nonsyndromic deafness have been identified.
Perinatal problems
Fetal alcohol spectrum disorders are reported to cause hearing loss in up to 64% of infants born to alcoholic mothers, from the ototoxic effect on the developing fetus plus malnutrition during pregnancy from the excess alcohol intake.
Premature birth can be associated with sensorineural hearing loss because of an increased risk of hypoxia, hyperbilirubinaemia, ototoxic medication and infection as well as noise exposure in the neonatal units. The risk of hearing loss is greatest for those weighing less than 1500 g at birth.
Auditory neuropathy a disorder of poor speech perception even though the tympanic membrane, middle ear structures, and cochlear nerve are intact. People with auditory neuropathy may have normal hearing or hearing loss ranging from mild to severe.
Inherited disorders
People with Down syndrome are more likely to have hearing loss. This is usually due to middle ear effusions in childhood but towards the end of the second decade they may develop a high frequency sensorineural hearing loss which can get progressively worse with time.
Charcot–Marie–Tooth disease variant 1E (CMT1E) is noted for demyelinating in addition to deafness.
Autoimmune disease is recognized as a cause for cochlear damage. Although rare, it is possible for autoimmune processes to target the cochlea specifically as a first presentation. Granulomatosis with polyangiitis is one of the autoimmune conditions that may precipitate hearing loss. Cogan's syndrome commonly presents with hearing loss.
Multiple sclerosis can have an effect on hearing as well. Multiple sclerosis, or MS, is an autoimmune disease where the immune system attacks the myelin sheath, a covering that protects the nerves. If the auditory nerve becomes damaged, the affected person will become completely deaf in one or both ears. There is no cure for MS.
Meningitis may damage the auditory nerve or the cochlea.
Cholesteatoma is a (acquired or congenital) benign collection of squamous epithelial cells within the middle ear. Acquired cholesteatomas are commonly caused by repeated middle ear infections
Otosclerosis is a condition that can cause fixation of the stapes (or stirrup) in the middle ear preventing its movement and causing a conductive hearing loss.
Perilymph fistula – a microtear in either the round or oval window (membranes separating the middle and inner ear) of the cochlea causing perilymph to leak into the middle ear. This usually occurs as a consequence of trauma, including barotrauma, and can give rise to vertigo as well as hearing loss.
Ménière's disease (endolymphatic hydrops) occurs when there is an elevated pressure in the endolymph in the cochlea. Its symptoms include fluctuating low frequency hearing loss, aural fullness, tinnitus, and dizziness lasting for hours
Recurring ear infections or concomitant secondary infections (such as bacterial infection subsequent to viral infection) can result in hearing loss
Strokes – Depending on what blood vessels are affected by the stroke, one of the symptoms can be deafness
Superior semicircular canal dehiscence, a gap in the bone cover above the inner ear, can lead to low-frequency conductive hearing loss, autophony and vertigo.
Syndromic hearing loss can be either conductive or sensorineural. It occurs with abnormalities in other parts of the bodies. Examples include Pierre Robin, Treacher-Collins, Retinitis Pigmentosa, Pedreds, and Turners syndrome, among others.
Syphilis is commonly transmitted from pregnant women to their fetuses, and about a third of infected children will eventually become deaf.
Vestibular schwannoma, erroneously known as Acoustic neuromas, and other types of brain tumors can cause hearing loss by infringement of the tumor on the vestibulocochlear nerve
Viral infections of the ear can cause sensorineural hearing loss usually as the consequence of a labyrinthitis. The person may be generally unwell at the time.
Measles may cause auditory nerve damage but usually gives rise to a chronic middle ear problem giving rise to a mixed hearing loss.
Mumps (Epidemic parotitis) may result in profound sensorineural hearing loss (90 dB or more), unilateral (one ear) or bilateral (both ears).
congenital rubella (also called German measles) syndrome, can cause deafness in newborns
several varieties of herpes viruses that cause other diseases can also infect the ear, and can result in hearing loss: congenital infection with cytomegalovirus is responsible for deafness in newborn children and also progressive sensorineural hearing loss in childhood; herpes simplex type 1, oral herpes associated with cold sores; Epstein Barr virus that causes mononucleosis; varicella zosteroticus that causes facial paralysis (Ramsay Hunt syndrome)
People with HIV/AIDS may develop hearing problems due to medications they take for the disease, the HIV virus, or due to an increased rate of other infections.
West Nile virus, which can cause a variety of neurological disorders, can also cause hearing loss by attacking the auditory nerve.
Some medications may reversibly affect hearing. These medications are considered ototoxic. This includes loop diuretics such as furosemide and bumetanide, non-steroidal anti-inflammatory drugs (NSAIDs) both over-the-counter (aspirin, ibuprofen, naproxen) as well as prescription (celecoxib, diclofenac, etc.), paracetamol, quinine, and macrolide antibiotics. The link between NSAIDs and hearing loss tends to be greater in women, especially those who take ibuprofen six or more times a week. Others may cause permanent hearing loss. The most important group is the aminoglycosides (main member gentamicin) and platinum based chemotherapeutics such as cisplatin and carboplatin.
On October 18, 2007, the U.S. Food and Drug Administration (FDA) announced that a warning about possible sudden hearing loss would be added to drug labels of PDE5 inhibitors, which are used for erectile dysfunction.
Audiologic monitoring for ototoxicity allows for the (1) early detection of changes to hearing status presumably attributed to a drug/treatment regime so that changes in the drug regimen may be considered, and (2) audiologic intervention when handicapping hearing impairment has occurred.
Co-administration of anti-oxidants and ototoxic medications may limit the extent of the ototoxic damage
In addition to medications, hearing loss can also result from specific chemicals in the environment: metals, such as lead; solvents, such as toluene (found in crude oil, gasoline and automobile exhaust, for example); and asphyxiants. Combined with noise, these ototoxic chemicals have an additive effect on a person's hearing loss
Hearing loss due to chemicals starts in the high frequency range and is irreversible. It damages the cochlea with lesions and degrades central portions of the auditory system. For some ototoxic chemical exposures, particularly styrene, the risk of hearing loss can be higher than being exposed to noise alone. The effects is greatest when the combined exposure include impulse noise.
toluene, styrene, xylene, n-hexane, ethyl benzene, white spirits/Stoddard, carbon disulfide, jet fuel, perchloroethylene, trichloroethylene, p-xylene
Asphyxiants
carbon monoxide, hydrogen cyanide
lead, mercury, cadmium, arsenic, tin-hydrocarbon compounds (trimethyltin)
Pesticides and herbicides – The evidence is weak regarding association between herbicides and hearing loss; hearing loss in such circumstances may be due to concommitant exposure to insecticides.
paraquat, organophosphates
A 2018 informational bulletin by the US Occupational Safety and Health Administration (OSHA) and the National Institute for Occupational Safety and Health (NIOSH) introduces the issue, provides examples of ototoxic chemicals, lists the industries and occupations at risk and provides prevention information.
Physical trauma
There can be damage either to the ear, whether the external or middle ear, to the cochlea, or to the brain centers that process the aural information conveyed by the ears. Damage to the middle ear may include fracture and discontinuity of the ossicular chain. Damage to the inner ear (cochlea) may be caused by temporal bone fracture. People who sustain head injury are especially vulnerable to hearing loss or tinnitus, either temporary or permanent.
Sound waves reach the outer ear and are conducted down the ear canal to the eardrum, causing it to vibrate. The vibrations are transferred by the 3 tiny ear bones of the middle ear to the fluid in the inner ear. The fluid moves hair cells (stereocilia), and their movement generates nerve impulses which are then taken to the brain by the cochlear nerve. The auditory nerve takes the impulses to the brainstem, which sends the impulses to the midbrain. Finally, the signal goes to the auditory cortex of the temporal lobe to be interpreted as sound.
Hearing loss is most commonly caused by long-term exposure to loud noises, from recreation or from work, that damage the hair cells, which do not grow back on their own.
Older people may lose their hearing from long exposure to noise, changes in the inner ear, changes in the middle ear, or from changes along the nerves from the ear to the brain.
An audiologist conducting an audiometric hearing test in a sound-proof testing booth
Identification of a hearing loss is usually conducted by a general practitioner medical doctor, otolaryngologist, certified and licensed audiologist, school or industrial audiometrist, or other audiometric technician. Diagnosis of the cause of a hearing loss is carried out by a specialist physician (audiovestibular physician) or otorhinolaryngologist.
A case history (usually a written form, with questionnaire) can provide valuable information about the context of the hearing loss, and indicate what kind of diagnostic procedures to employ. Case history will include such items as:
major concern
birth and pregnancy information
workplace environment
otoscopy, visual examination of the outer ear, ear canal, eardrum, and middle ear (through the translucent eardrum) using an optical instrument inserted into the ear canal called an otoscope
tympanometry
differential testing – the Weber, Rinne, Bing and Schwabach tests are simple manual tests of auditory function conducted with a low frequency (usually 512 Hz) tuning fork that can provide a quick indication of type of hearing loss: unilateral/bilateral, conductive, or other
In case of infection or inflammation, blood or other body fluids may be submitted for laboratory analysis.
Hearing loss is generally measured by playing generated or recorded sounds, and determining whether the person can hear them. Hearing sensitivity varies according to the frequency of sounds. To take this into account, hearing sensitivity can be measured for a range of frequencies and plotted on an audiogram.
Another method for quantifying hearing loss is a speech-in-noise test. As the name implies, a speech-in-noise test gives an indication of how well one can understand speech in a noisy environment. A person with a hearing loss will often be less able to understand speech, especially in noisy conditions. This is especially true for people who have a sensorineural loss – which is by far the most common type of hearing loss. As such, speech-in-noise tests can provide valuable information about a person's hearing ability, and can be used to detect the presence of a sensorineural hearing loss. A recently developed digit-triple speech-in-noise test may be a more efficient screening test.
Otoacoustic emissions test is an objective hearing test that may be administered to toddlers and children too young to cooperate in a conventional hearing test. The test is also useful in older children and adults and is an important measure in diagnosing auditory neuropathy described above.
Auditory brainstem response testing is an electrophysiological test used to test for hearing deficits caused by pathology within the ear, the cochlear nerve and also within the brainstem. This test can be used to identify delay in the conduction of neural impulses due to tumours or inflammation but can also be an objective test of hearing thresholds. Other electrophysiological tests, such as cortical evoked responses, can look at the hearing pathway up to the level of the auditory cortex.
MRI and CT scans can be useful to identify the pathology of many causes of hearing loss. They are only needed in selected cases.
Hearing loss is categorized by type, severity, and configuration. Furthermore, a hearing loss may exist in only one ear (unilateral) or in both ears (bilateral). Hearing loss can be temporary or permanent, sudden or progressive.
The severity of a hearing loss is ranked according to ranges of nominal thresholds in which a sound must be so it can be detected by an individual. It is measured in decibels of hearing loss, or dB HL. The measurement of hearing loss in an individual is conducted over several frequencies, mostly 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz. The hearing loss of the individual is the average of the hearing loss values over the different frequencies. Hearing loss can be ranked differently according to different organisations; and so, in different countries different systems are in use.
Hearing loss may be ranked as slight, mild, moderate, moderately severe, severe or profound as defined below:
Slight: between 16 and 25 dB HL
Mild:
for adults: between 26 and 40 dB HL
for children: between 20 and 40 dB HL
Moderate: between 41 and 54 dB HL
Moderately severe: between 55 and 70 dB HL
Severe: between 71 and 90 dB HL
Profound: 91 dB HL or greater
Totally deaf: Have no hearing at all. This is called anacusis.
The 'Audiometric Classifications of Hearing Impairment' according to the International Bureau Audiophonology (BIAP) in Belgium is as follows:
Normal or subnormal hearing: average tone loss is equal or below 20 dB HL
Mild hearing loss: average tone loss between 21 and 40 dB HL
Moderate hearing loss
First degree: average tone loss between 41 and 55 dB HL
Second degree: average tone loss between 56 and 70 dB HL
Severe hearing loss
Very severe hearing loss
First degree: average tone loss between 91 and 100 dB HL
Second degree: average tone loss between 101 and 110 dB HL
Third degree: average tone loss between 111 and 119 dB HL
Total hearing loss or Cophosis: average tone loss is equal or more than 120 dB HL
Hearing loss may affect one or both ears. If both ears are affected, then one ear may be more affected than the other. Thus it is possible, for example, to have normal hearing in one ear and none at all in the other, or to have mild hearing loss in one ear and moderate hearing loss in the other.
For certain legal purposes such as insurance claims, hearing loss is described in terms of percentages. Given that hearing loss can vary by frequency and that audiograms are plotted with a logarithmic scale, the idea of a percentage of hearing loss is somewhat arbitrary, but where decibels of loss are converted via a legally recognized formula, it is possible to calculate a standardized "percentage of hearing loss", which is suitable for legal purposes only.
There are three main types of hearing loss, conductive hearing loss, sensorineural hearing loss. Combinations of conductive and sensorineural hearing losses are called a mixed hearing loss. An additional problem which is increasingly recognised is auditory processing disorder which is not a hearing loss as such but a difficulty perceiving sound.
Conductive hearing loss is present when the sound is not reaching the inner ear, the cochlea. This can be due to external ear canal malformation, dysfunction of the eardrum or malfunction of the bones of the middle ear. The eardrum may show defects from small to total resulting in hearing loss of different degree. Scar tissue after ear infections may also make the eardrum dysfunction as well as when it is retracted and adherent to the medial part of the middle ear.
Dysfunction of the three small bones of the middle ear – malleus, incus, and stapes – may cause conductive hearing loss. The mobility of the ossicles may be impaired for different reasons including a boney disorder of the ossicles called otosclerosis and disruption of the ossicular chain due to trauma, infection or ankylosis may also cause hearing loss.
Sensorineural hearing loss is one caused by dysfunction of the inner ear, the cochlea or the nerve that transmits the impulses from the cochlea to the hearing centre in the brain. The most common reason for sensorineural hearing loss is damage to the hair cells in the cochlea. Depending on the definition it could be estimated that more than 50% of the population over the age of 70 has impaired hearing.
Central deafness
Damage to the brain can lead to a central deafness. The peripheral ear and the auditory nerve may function well but the central connections are damaged by tumour, trauma or other disease and the patient is unable to process speech information.
Mixed hearing loss is a combination of conductive and sensorineural hearing loss. Chronic ear infection (a fairly common diagnosis) can cause a defective ear drum or middle-ear ossicle damages, or both. In addition to the conductive loss, a sensory component may be present.
This is not an actual hearing loss but gives rise to significant difficulties in hearing. One kind of auditory processing disorder is King-Kopetzky syndrome, which is characterized by an inability to process out background noise in noisy environments despite normal performance on traditional hearing tests. An auditory processing disorders is sometimes linked to language disorders in persons of all ages.
The shape of an audiogram shows the relative configuration of the hearing loss, such as a Carhart notch for otosclerosis, 'noise' notch for noise-induced damage, high frequency rolloff for presbycusis, or a flat audiogram for conductive hearing loss. In conjunction with speech audiometry, it may indicate central auditory processing disorder, or the presence of a schwannoma or other tumor. There are four general configurations of hearing loss:
1. Flat: thresholds essentially equal across test frequencies.
2. Sloping: lower (better) thresholds in low-frequency regions and higher (poorer) thresholds in high-frequency regions.
3. Rising: higher (poorer) thresholds in low-frequency regions and lower (better) thresholds in higher-frequency regions.
4. Trough-shaped ("cookie-bite" or "U" shaped): greatest hearing loss in the mid-frequency range, with lower (better) thresholds in low- and high-frequency regions.
Unilateral and bilateral
People with unilateral hearing loss or single-sided deafness (SSD) have difficulty in:
hearing conversation on their impaired side
localizing sound
understanding speech in the presence of background noise.
In quiet conditions, speech discrimination is approximately the same for normal hearing and those with unilateral deafness; however, in noisy environments speech discrimination varies individually and ranges from mild to severe.
One reason for the hearing problems these patients often experience is due to the head shadow effect. Newborn children with no hearing on one side but one normal ear could still have problems. Speech development could be delayed and difficulties to concentrate in school are common. More children with unilateral hearing loss have to repeat classes than their peers. Taking part in social activities could be a problem. Early aiding is therefore of utmost importance.
It is estimated that half of cases of hearing loss are preventable. About 60% of hearing loss in children under the age of 15 can be avoided. A number of preventative strategies are effective including: immunization against rubella to prevent congenital rubella syndrome, immunization against H. influenza and S. pneumoniae to reduce cases of meningitis, and avoiding or protecting against excessive noise exposure. The World Health Organization also recommends immunization against measles, mumps, and meningitis, efforts to prevent premature birth, and avoidance of certain medication as prevention.
Noise exposure is the most significant risk factor for noise-induced hearing loss that can be prevented. Different programs exist for specific populations such as school-age children, adolescents and workers. Education regarding noise exposure increases the use of hearing protectors. The use of antioxidants is being studied for the prevention of noise-induced hearing loss, particularly for scenarios in which noise exposure cannot be reduced, such as during military operations.
Workplace noise regulation
Noise is widely recognized as an occupational hazard. In the United States, the National Institute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA) work together to provide standards and enforcement on workplace noise levels. The hierarchy of hazard controls demonstrates the different levels of controls to reduce or eliminate exposure to noise and prevent hearing loss, including engineering controls and personal protective equipment (PPE). Other programs and initiative have been created to prevent hearing loss in the workplace. For example, the Safe-in-Sound Award was created to recognize organizations that can demonstrate results of successful noise control and other interventions. Additionally, the Buy Quiet program was created to encourage employers to purchase quieter machinery and tools. By purchasing less noisy power tools like those found on the NIOSH Power Tools Database and limiting exposure to ototoxic chemicals, great strides can be made in preventing hearing loss.
Companies can also provide personal hearing protector devices tailored to both the worker and type of employment. Some hearing protectors universally block out all noise, and some allow for certain noises to be heard. Workers are more likely to wear hearing protector devices when they are properly fitted.
Often interventions to prevent noise-induced hearing loss have many components. A 2017 Cochrane review found that stricter legislation might reduce noise levels. Providing workers with information on their noise exposure levels was not shown to decrease exposure to noise. Ear protection, if used correctly, can reduce noise to safer levels, but often, providing them is not sufficient to prevent hearing loss. Engineering noise out and other solutions such as proper maintenance of equipment can lead to noise reduction, but further field studies on resulting noise exposures following such interventions are needed. Other possible solutions include improved enforcement of existing legislation and better implementation of well-designed prevention programmes, which have not yet been proven conclusively to be effective. The conclusion of the Cochrane Review was that further research could modify what is now regarding the effectiveness of the evaluated interventions.
The United States Preventive Services Task Force recommends screening for all newborns.
The American Academy of Pediatrics advises that children should have their hearing tested several times throughout their schooling:
When they enter school
At ages 6, 8, and 10
At least once during middle school
At least once during high school
While the American College of Physicians indicated that there is not enough evidence to determine the utility of screening in adults over 50 years old who do not have any symptoms, the American Language, Speech Pathology and Hearing Association recommends that adults should be screened at least every decade through age 50 and at 3-year intervals thereafter, to minimize the detrimental effects of the untreated condition on quality of life. For the same reason, the US Office of Disease Prevention and Health Promotion included as one of Healthy People 2020 objectives: to increase the proportion of persons who have had a hearing examination.
Treatment depends on the specific cause if known as well as the extent, type and configuration of the hearing loss. Most hearing loss, that resulting from age and noise, is progressive and irreversible, and there are currently no approved or recommended treatments; management is by hearing aid. A few specific kinds of hearing loss are amenable to surgical treatment. In other cases, treatment is addressed to underlying pathologies, but any hearing loss incurred may be permanent.
There are a number of devices that can improve hearing in those who are deaf or hard of hearing or allow people with these conditions to manage better in their lives.
Hearing aids are devices that work to improve the hearing and speech comprehension of those with hearing loss. They work by magnifying the sound vibrations in the ear so that one can understand what is being said around them. Hearing aids have been shown to have a large beneficial effect in helping adults with mild to moderate hearing loss take part in everyday situations, and a smaller beneficial effect in improving physical, social, emotional and mental well-being in these people. Some people feel as if they cannot live without one because they say it is the only thing that keeps them engaged with the public. Conversely, there are many people who choose not to wear their hearing aids for a multitude of reasons. Up to 40% of adults with hearing aids for hearing loss fail to use them, or do not use them to their full effect. There are a number of reasons for this, stemming from factors such as: the aid amplifying background noises instead of the sounds they intended to hear; issues with comfort, care, or maintenance of the device; aesthetic factors; financial factors; and personal preference for quietness.
There is little evidence that interventions to encourage the regular use of hearing aids, (e.g. improving the information given to people about how to use hearing aids), increase daily hours of hearing aid use, and there is currently no agreed set of outcome measures for assessing this type of intervention.
Many deaf and hard of hearing individuals use assistive devices in their daily lives:
Individuals can communicate by telephone using telephone typewriters (TTY). Other common names are textphone, minicom and telecommunications device for the deaf (TDD). These devices look like typewriters or word processors and transmit typed text over regular telephone lines. This allows communication through visual messaging. TTYs can transmit messages to individuals who don't have TTY by using the National Relay service which is an operator that acts as a messenger to each caller. For mobile phones, software apps are available to provide TDD/textphone functionality on some carriers/models to provide 2-way communications.
There are several new telecommunications relay service technologies including IP Relay and captioned telephone technologies. A deaf or hard of hearing person can communicate over the phone with a hearing person via a human translator. Phone captioning is a service in which a hearing person's speech is captioned by a third party, enabling a deaf or hard of hearing person to conduct a conversation with a hearing person over the phone. Wireless, Internet and mobile phone/SMS text messaging are beginning to take over the role of the TDD.
Real-time text technologies, involving streaming text that is continuously transmitted as it is typed or otherwise composed. This allows conversational use of text. Software programs are now available that automatically generate a closed-captioning of conversations. Examples include discussions in conference rooms, teleconference calls, classroom lectures, and/or religious services.
Instant messaging software.
Videophones and similar video technologies can be used for distance communication using sign language. Video conferencing technologies permit signed conversations as well as permitting a sign language–English interpreter to voice and sign conversations between a deaf or hard of hearing person and that person's hearing party, negating the use of a TTY device or computer keyboard.
Video relay service and video remote interpreting (VRI) services also use a third-party telecommunication service to allow a deaf or hard-of-hearing person to communicate quickly and conveniently with a hearing person, through a sign language interpreter.
Hearing dogs are a specific type of assistance dog specifically selected and trained to assist the deaf and hard of hearing by alerting their handler to important sounds, such as doorbells, smoke alarms, ringing telephones, or alarm clocks.
The advent of the Internet's World Wide Web and closed captioning has given the deaf and hard of hearing unprecedented access to information. Electronic mail and online chat have reduced the need for deaf and hard-of-hearing people to use a third-party Telecommunications Relay Service to communicate with the hearing and other deaf people.
A person with hearing loss cannot always hear the phone or distinguish their own ringtone from another. A signaling transmitter can be attached to a phone that will cause a light or a vibration device to activate. Transmitters can also be used to activate visual cues to represent fire alarms.
Individuals with hearing loss require phones with amplifiers that have a higher power of amplification when compared to a regular phone. The Hearing Aid Telephone Interconnect System is a hands free amplification system which allows people to amplify sound when using telephones, cell phones, computer and pay phones by way of the attachment of a portable unit.
Wireless hearing aids
A wireless device has two main components: a transmitter and a receiver. The transmitter broadcasts the captured sound, and the receiver detects the broadcast audio and enables the incoming audio stream to be connected to accommodations such as hearing aids or captioning systems.
Three types of wireless systems are commonly used: FM, audio induction loop, and InfraRed. Each system has advantages and benefits for particular uses. FM systems can be battery operated or plugged into an electrical outlet. FM system produce an analog audio signal, meaning they have extremely high fidelity. Many FM systems are very small in size, allowing them to be used in mobile situations. The audio induction loop permits the listener with hearing loss to be free of wearing a receiver provided that the listener has a hearing aid or cochlear implant processor with an accessory called a "telecoil". If the listener does not have a telecoil, then he or she must carry a receiver with an earpiece. As with FM systems, the infrared (IR) system also requires a receiver to be worn or carried by the listener. An advantage of IR wireless systems is that people in adjoining rooms cannot listen in on conversations, making it useful for situations where privacy and confidentiality are required. Another way to achieve confidentiality is to use a hardwired amplifier, which contains or is connected to a microphone and transmits no signal beyond the earpiece plugged directly into it.
Illustration of a cochlear implant
There is no treatment, surgical or otherwise, for sensorineural hearing loss due to the most common causes (age, noise, and genetic defects). For a few specific conditions, surgical intervention can provide a remedy:
surgical correction of superior canal dehiscence
myringotomy, surgical insertion of drainage ventilation tubes in the tympanic membrane. Such placement is usually temporary until the underlying pathology (infection or other inflammation) can be resolved.
radiotherapy or surgical excision of vestibular schwannoma or acoustic neuroma, though, in most cases, it is unlikely that hearing will be preserved
Stapedectomy and stapedotomy for otosclerosis – replacement or reshaping of the stapes bone of the middle ear can restore hearing in cases of conductive hearing loss
Surgical and implantable hearing aids are an alternative to conventional external hearing aids. If the ear is dry and not infected, an air conduction aid could be tried; if the ear is draining, a direct bone conduction hearing aid is often the best solution. If the conductive part of the hearing loss is more than 30–35 dB, an air conduction device could have problems overcoming this gap. A bone-anchored hearing aid could, in this situation, be a good option. The active bone conduction hearing implant Bonebridge (a product of MED-EL corporation) is also an option. This implant is invisible under the intact skin and therefore minimises the risk of skin irritations.
Cochlear implants improve outcomes in people with hearing loss in either one or both ears. They work by artificial stimulation of the cochlear nerve by providing an electric impulse substitution for the firing of hair cells. They are expensive, and require programming along with extensive training for effectiveness.
Cochlear implants as well as bone conduction implants can help with single sided deafness. Middle ear implants or bone conduction implants can help with conductive hearing loss.
People with cochlear implants are at a higher risk for bacterial meningitis. Thus, meningitis vaccination is recommended. People who have hearing loss, especially those who develop a hearing problem in childhood or old age, may need support and technical adaptations as part of the rehabilitation process. Recent research shows variations in efficacy but some studies show that if implanted at a very young age, some profoundly impaired children can acquire effective hearing and speech, particularly if supported by appropriate rehabilitation.
For a classroom setting, children with hearing loss often benefit from direct instruction and communication. Optimally children with hearing loss will be mainstreamed in a typical classroom and receive supportive services. One such is to sit as close to the teacher as possible improves the student's ability to hear the teacher's voice and to more easily read the teacher's lips. When lecturing, teachers can help the student by facing them and by limiting unnecessary noise in the classroom. In particular, the teacher can avoid talking when their back is turned to the classroom, such as while writing on a whiteboard.
Some other approaches for classroom accommodations include pairing deaf or hard of hearing students with hearing students. This allows the deaf or hard of hearing student to ask the hearing student questions about concepts that they have not understood. The use of CART (Communication Access Real Time) systems, where an individual types a captioning of what the teacher is saying, is also beneficial. The student views this captioning on their computer. Automated captioning systems are also becoming a popular option. In an automated system, software, instead of a person, is used to generate the captioning. Unlike CART systems, automated systems generally do not require an Internet connection and thus they can be used anywhere and anytime. Another advantage of automated systems over CART is that they are much lower in cost. However, automated systems are generally designed to only transcribe what the teacher is saying and to not transcribe what other students say. An automated system works best for situations where just the teacher is speaking, whereas a CART system will be preferred for situations where there is a lot of classroom discussion.
For those students who are completely deaf, one of the most common interventions is having the child communicate with others through an interpreter using sign language.
Disability-adjusted life year for hearing loss (adult onset) per 100,000 inhabitants in 2004.
Globally, hearing loss affects about 10% of the population to some degree. It caused moderate to severe disability in 124.2 million people as of 2004 (107.9 million of whom are in low and middle income countries). Of these 65 million acquired the condition during childhood. At birth ~3 per 1000 in developed countries and more than 6 per 1000 in developing countries have hearing problems.
Hearing loss increases with age. In those between 20 and 35 rates of hearing loss are 3% while in those 44 to 55 it is 11% and in those 65 to 85 it is 43%.
A 2017 report by the World Health Organization estimated the costs of unaddressed hearing loss and the cost-effectiveness of interventions, for the health-care sector, for the education sector and as broad societal costs. Globally, the annual cost of unaddressed hearing loss was estimated to be in the range of $750–790 billion.
https://en.wikipedia.org/wiki/Hearing_losshttps://en.wikipedia.org/wiki/Hearing_loss
labyrinthine fistula
Ménière's disease
Ear tube surgery in Iran
Azithromycin Tablet Macrolide Antibiotics
Super wet liposuction blood loss
PCOS medication for weight loss
Mastoiditis
connective tissue disease
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What you are thinking and feeling at any given moment is painting for you the portrait of your life that will be complete and gifted to you in so many days ahead. This is how it works in this universe. It works no other way. This is how it was designed and this is how it functions at this present time and will continue to function like this until such a day when your Creator decides that he wishes to change these parameters, these rules of operation. If you understand this, then we say to you start today, start painting a brighter, more promising and more positive outlook for yourselves. This doom and gloom scenery that many of you are painting with each brush stroke today may not be the portrait many of you have in mind to hang on your wall of your new reality.
We have been reading your posts and comments and communicating in other ways with some of those that we have connections to and we have a fairly good idea what many of you wish for yourselves, and it is safe to say it is not more of the same. Do you think that you must therefore change what you are feeling inside, what you are thinking inside, what you are creating for yourselves inside? These go hand-in-hand; your thoughts today and your future tomorrow. There is no dividing these two, they are eternally linked. If it is tomorrow you wish to change, then it is today you need to change. This you must understand, this you must remember, this you must focus on each and every day, or each and every day you will be creating the same days to line up like railroad tracks long and far into the distance that you will travel. It is time for many of you to begin laying new tracks that will take you to new destinations of your choosing. That is all we have to say about that. We wish you to always remember these words, as so many of you deserve and wish for yourselves better, and it is better that is available to you now.
Moving on to pressing matters in your world, we are observing tides turning in the great collective consciousness of your people. We see no longer a race who wishes for war or for violence of any kind. We see a people who now long for and call for peace and love, global brotherhood and cooperation. This is such a wonderful site to behold from our vantage point, and we say to all of you that you will have what it is you wish for yourselves and your families, this will not be denied. The world that you now long for, a world where there is peace that silences the war and the fighting will be yours and prosperity will be the new call of the day.
There will be prosperity where there was bloodshed. This is what happens when the guns of war are silenced. Like a vacuum something must fill the void that has been vacated, and when war and violence is done away with and no longer consumes the creative energies of a collective only good follows in its place, for this is the natural course. You will not be experiencing more of the same in different persona, a different mask and cloak. You will be experiencing something so different, so unbelievable, so liberating, so beautiful, invigorating, joyous, uplifting, satisfying and rewarding. You will be experiencing a world where money is not a commodity that is fought over. You will be experiencing a world where money is not rare and is not the ultimate target of so much energy, focus and fighting. You will be experiencing a world where money and wealth is shared freely and equally among all of you, where no one will be left for want or need for anything.
This is the world that you are creating today, and we say to you do not allow yourselves for one day longer to be pessimistic, to live in doubt, live in fear, insecurity and uncertainty about your tomorrow, for we tell you we see the tomorrow you are creating today and it is wonderful, it is magnificent, and each and every one of you will prosper so greatly in so many different ways. We say to you do not give up now, do not let your guard down, do not allow yourselves to stumble upon the old ways, habits and the tendencies and the attitudes that created for you the world that you are now leaving behind. You now all see the negative, unproductive, unrewarding, un-free, unloving, unfeeling and unsafe world that can be created through negative thought, action, intent and dream.
No one in this entire universe can tell you better, the people of Earth, what kind of sorrow, misery, hardship, sadness, fear, loneliness and destitution that can be created when you allow yourselves to begin to create such a world through your negative vibrations and your powers of creative manifestation. You all have learned this lesson and you have learned it the hard way, the hardest way anyone in this universe must learn a lesson. You learned it by living through it, in not just one lifetime, but many successive incarnations before you are permitted to return home to where it is you originally come from, and this place is not, in almost every case, the place that you visit after each incarnation, for where it is you truly come from, where it is that is your home is, is not the place that you have been visiting for a short while after you leave one physical vessel to be born into a new vessel.
Do you understand what we are saying here, that it is not through the death experience that you can 'escape', if you will, this reality and into a new? It was not designed in such a way that someone could simply take their own life or wander through it and 'graduate', if you will, into a new reality. It was not designed such as this for several reasons. We say to you one of these reasons was to make sure each and every one of you who signed up for this mission, this journey, this experience got exactly what it is from all of this that you wanted in the first place, what this entire reality was created for in the first place, which was for each and every one of you to learn all the lessons necessary to allow you to grow wings and take flight into the higher stretches of this universe. That was the purpose of the creation of this entire reality.
This reality you call Earth in the 3rd dimension is not an abomination, was not a mistake, was not a miscarriage of creation. It was a beautiful, wonderful and perfect creation and it has served each and every one of you perfectly well for what it is you wished to experience for yourselves, and now it comes the time for many of you to receive just what it is you wanted from all this. This is the day that now stands just before you so soon it is only a blink of an eye, the beat of your heart relative to the long eons that you have been away from your home and have been on this journey. Do you understand how very close you all are and that losing patience now when you are just another breath away would be unwise and imprudent, as to remain as positive as you can to help usher in your new day is so vitally important?
We want each of you to remember this; that your vibrations must be kept as high as possible to allow you to connect, to plug-in, to blend into the higher vibrations of this universe. This is one of the reasons why we, the members of the Galactic Federation of Light, paint for you our pictures of how wonderful, beautiful, exciting, rewarding and promising your new world and your new lives will be, for we want you, because you need to, keep your spirits high, keep your vibrations high, for there is nothing more important that you can do today than to keep your vibrations as high as possible. This is so important for you to remember and we will stress this point again to you often throughout the days ahead, as we wish you to keep this thought in the forefront of your consciousness; your vibrational frequencies are the key that will unlock the door that will present itself to you in the not too distant future.
This is all we have for you today, and we say to you preserve and safeguard the keys that you possess inside you, for they are priceless and they are what will unlock every dream, every hope and every desire that you have ever had.
We are key masters as well. We are the Galactic Federation of Light.


is the port of nxPascal Library to CodeTyphon Studio.
nxPascal is a free game engine that tries to remain lightweight and portable.
2D and 3D OpenGL graphics.
Demos on most features, for both Lazarus and Delphi.
2D, 3D and much of gaming supporting math.
Pathfinding with own rough but fast algorithm.
Network class supporting TCP and UDP.
Optional sound wrappers for OpenAL and BASS.
Class for handling and rendering a user interface with buttons, listboxes etc.
Basically nxPascal is modular, consistencies are separated in different units.
You might choose to just want to use part of the features presented here, if you wish to use another graphics engine or something else. nxGL supports custom window creation, so you can do all that different way, but still being able to use even graphics features of this engine.


text:
// __author__    = João Magalhães <joamag@hive.pt>
// __version__   = 1.0.0
// __revision__  = $LastChangedRevision$
// __date__      = $LastChangedDate$
// __copyright__ = Copyright (c) 2008-2022 Hive Solutions Lda.
// __license__   = Apache License, Version 2.0

#import "HMLoginViewController.h"

@implementation HMLoginViewController

- (id)initWithNibName:(NSString *)nibNameOrNil bundle:(NSBundle *)nibBundleOrNil {
    self = [super initWithNibName:nibNameOrNil bundle:nibBundleOrNil];
    if(self) {
    }
    return self;
}

- (void)viewDidLoad {
    [super viewDidLoad];
}

- (void)viewWillAppear:(BOOL)animated {
    [super viewWillAppear:animated];

    // retrieves the current view, casting it as a login view
    // this is an unsafe operation
    HMLoginView *loginView = (HMLoginView *) self.view;

    // forces the username field to become the first
    // responder (focus on the text field element)
    [loginView.usernameField becomeFirstResponder];

    // sets the current view controller as the delagate for both text
    // fields and then sets the return key as the done key and the text
    // field finished as the handler of such behavior
    [loginView.usernameField setDelegate:self];
    [loginView.passwordField setDelegate:self];
    [loginView.usernameField setReturnKeyType:UIReturnKeyDone];
    [loginView.passwordField setReturnKeyType:UIReturnKeyDone];
    [loginView.usernameField addTarget:self
                                action:@selector(textFieldFinished:)
                      forControlEvents:UIControlEventEditingDidEndOnExit];
    [loginView.passwordField addTarget:self
                                action:@selector(textFieldFinished:)
                      forControlEvents:UIControlEventEditingDidEndOnExit];

    // registers the signin button fot the "tap" event so that the
    // text field finished action is triggered
    [loginView.signinButton addTarget:self
                    action:@selector(textFieldFinished:)
          forControlEvents:UIControlEventTouchUpInside];
}

- (void)didReceiveMemoryWarning {
    [super didReceiveMemoryWarning];
}

- (BOOL)shouldAutorotate {
    if([[UIDevice currentDevice] userInterfaceIdiom] != UIUserInterfaceIdiomPhone) { return YES; }
    return NO;
}

#pragma GCC diagnostic push
#pragma GCC diagnostic ignored "-Wdeprecated-implementations"
- (BOOL)shouldAutorotateToInterfaceOrientation:(UIInterfaceOrientation)interfaceOrientation {
    if([[UIDevice currentDevice] userInterfaceIdiom] != UIUserInterfaceIdiomPhone) { return YES; }
    return NO;
}
#pragma GCC diagnostic pop

- (IBAction)textFieldFinished:(id)sender {
    // retrieves the current view, casting it as a login view
    // this is an unsafe operation
    HMLoginView *loginView = (HMLoginView *) self.view;

    // retrieves both the username and the password text field and uses
    // them to retrieve these values to be used in the authentication
    NSString *username = loginView.usernameField.text;
    NSString *password = loginView.passwordField.text;

    // creates the base path template containing both the username and
    // the password values than formats the value using these values
    NSString *basePath = @"%@?username=%@&password=%@";
    NSString *path = [NSString stringWithFormat:basePath, self.loginPath, username, password];

    // creates a new proxy request to be used in the authentication procedure
    // note that this is an asynchronous call and may take some time
    _proxyRequest = [[HMProxyRequest alloc] initWithPath:self path:path];
    _proxyRequest.delegate = self;
    _proxyRequest.useSession = NO;
    [_proxyRequest load];

    // sends the resign as first responder to the "broadcast" application
    // this should hide the currently present keyboard
    [[UIApplication sharedApplication] sendAction:@selector(resignFirstResponder)
                                               to:nil
                                             from:nil
                                         forEvent:nil];
}

- (void)handleException:(NSDictionary *)exception {
    // retrieves the message contained in the exception structure
    // to be able to display it in a window
    NSString *message = [exception objectForKey:@"message"];
    message = [HMString capitalizedString:message];
    message = [HMResources localizedString:message withDefault:message];

    // creates the alert window that will be used to display the error
    // associated with the current authentication failure and then shows
    // it in a modal fashion, then returns immediately to the caller method
    UIAlertView *alert = [[UIAlertView alloc] initWithTitle:[HMResources localizedString:@"LoginError" withDefault:@"Login Error"]
                                                    message:message
                                                   delegate:nil
                                          cancelButtonTitle:[HMResources localizedString:@"Confirm" withDefault:@"Confirm"]
                                          otherButtonTitles:nil];
    [alert show];
}

- (void)didReceive {
}

- (void)didReceiveData:(id)data {
    // checks if the current data contains an exception value and
    // in such case handles it and returns immediately
    NSDictionary *exception = [data valueForKey:@"exception"];
    if(exception) { [self handleException:exception]; return; }

    // retrieves the username, the object id and the session id
    // values from the authentication structure to be used in the
    // current persistent storage
    NSString *username = [data valueForKey:@"username"];
    NSString *objectId = [data valueForKey:@"object_id"];
    NSString *sessionId = [data valueForKey:@"session_id"];

    // retrieves the preferences object and uses it to set the "new"
    // session identifier value in it
    NSUserDefaults *preferences = [NSUserDefaults standardUserDefaults];
    [preferences setValue:username forKey:@"username"];
    [preferences setValue:objectId forKey:@"objectId"];
    [preferences setValue:sessionId forKey:@"sessionId"];
    [preferences synchronize];

    // closes the current modal window triggering the pop of the
    // previous panel (will show it again)
    [self dismissViewControllerAnimated:YES completion:nil];
}

- (void)didReceiveError:(NSError *)error {
}

@end

redpajama_set_name: RedPajamaGithub


text:
John McCaffrey may refer to:
 John McCaffrey (fundraiser) (born 1968), North Irish fundraising professional
 John McCaffrey (hurler) (born 1987), Irish hurler
 Bert McCaffrey (John Albert McCaffrey, 1893–1955), Canadian ice hockey player
 Pete McCaffrey (John Paul McCaffrey, 1938–2012), American basketball player

redpajama_set_name: RedPajamaWikipedia


The Slack integration allows you to post a message to a channel of your choosing.
As with other integrations you must first visit the Integration Labs page on https://app.brightreps.com and click "Set Up" on the Slack integration before the step type is enabled as part of the Step Types in the Flow Builder.
To enable the integration you must sign in to your Slack account (unless you are already signed in) and allow access to the BrightReps app.
Click the "Click To Connect To Slack" button. That should open up a new window asking you to sign in to your Slack account (unless you are already signed in).
Once you've signed, in the next step will ask for your permission to allow access to the BrightReps app to access your account.
If everything went fine with that step the window will close and you will be redirected back to the Slack Integration page which should now say "Connected" under Status.


text:
using System;
using System.Linq;
using Microsoft.AspNetCore.Mvc.Filters;
using Microsoft.Extensions.DependencyInjection;
using Smidge.Models;

namespace Smidge.Controllers
{
    /// <summary>
    /// Adds the compression headers
    /// </summary>
    public sealed class AddCompressionHeaderAttribute : Attribute, IFilterFactory, IOrderedFilter
    {
        /// <summary>Creates an instance of the executable filter.</summary>
        /// <param name="serviceProvider">The request <see cref="T:System.IServiceProvider" />.</param>
        /// <returns>An instance of the executable filter.</returns>
        public IFilterMetadata CreateInstance(IServiceProvider serviceProvider)
        {
            return new AddCompressionFilter(
                serviceProvider.GetRequiredService<IRequestHelper>(),
                serviceProvider.GetRequiredService<IBundleManager>());
        }

        public bool IsReusable => true;

        public int Order { get; set; }

        private class AddCompressionFilter : IActionFilter
        {
            private readonly IRequestHelper _requestHelper;
            private readonly IBundleManager _bundleManager;

            public AddCompressionFilter(IRequestHelper requestHelper, IBundleManager bundleManager)
            {
                _requestHelper = requestHelper ?? throw new ArgumentNullException(nameof(requestHelper));
                _bundleManager = bundleManager ?? throw new ArgumentNullException(nameof(bundleManager));
            }

            public void OnActionExecuting(ActionExecutingContext context)
            {
                if (context.ActionArguments.Count == 0)
                    return;

                //put the model in the context, we'll resolve that after it's executed
                if (context.ActionArguments.First().Value is RequestModel file)
                    context.HttpContext.Items[nameof(AddCompressionHeaderAttribute)] = file;
            }

            /// <summary>
            /// Adds the compression headers
            /// </summary>
            /// <param name="context"></param>
            public void OnActionExecuted(ActionExecutedContext context)
            {
                if (context.Exception != null) return;

                //get the model from the items
                if (context.HttpContext.Items.TryGetValue(nameof(AddCompressionHeaderAttribute), out var requestModel) && requestModel is RequestModel file)
                {
                    var enableCompression = true;

                    //check if it's a bundle (not composite file)
                    if (file is BundleRequestModel bundleRequest && _bundleManager.TryGetValue(bundleRequest.FileKey, out var bundle))
                    {
                        var bundleOptions = bundle.GetBundleOptions(_bundleManager, bundleRequest.Debug);
                        enableCompression = bundleOptions.CompressResult;
                    }

                    if (enableCompression)
                        context.HttpContext.Response.AddCompressionResponseHeader(_requestHelper.GetClientCompression(context.HttpContext.Request.Headers));
                }
            }
        }
    }
}


text:
American Numismatic Association
Shows & Conventions
ANA Worlds Fair of Money
World's Fair of Money 2020 Suspended Due to COVID-19
World's Fair of Money Alternate Options to be Condisdered by ANA Board of Governors
The American Numismatic Assciation (ANA) announced today the suspension of the 2020 World's Fair of Money®. The show, originally scheduled for August 4-8 in Pittsburgh, Pennsylvania, is the largest annual coin and paper-currency event in the United States.
The ANA Board of Governors has been deliberating the impact of COVID-19 restrictions on the show and whether aggressive mitigation requirements to ensure the safety of attendees made continuing with the Pittsburgh event feasible. Current State of Pennsylvania guidelines restrict indoor gatherings to a maximum of 250 people at any one time. The World's Fair of Money typically attracts upward of 10,000 people during its five-day smorgasbord of educational offerings, live auctions, affiliated club meetings, and a bourse floor with nearly a thousand dealers and government mints from around the world.
The Board resolved in a vote on June 16 to postpone the show and to consider alternate sites and/or dates for the 2020 World's Fair of Money.
According to Jennifer Ackerman, ANA conventions director, because of Pennsylvania's restrictions on indoor gatherings, "[N]one of the usual World's Fair of Money offerings would be possible at the Pittsburgh show. No exhibits, no educational programming, no Kids Zone, no club meetings, no banquet, and a significantly reduced bourse. Our team has been in nearly daily conversations with the convention center, but it's become evident that they are unable to fulfill their contractual obligations."
Pittsburgh World's Fair of Money Committee Chair Tom Uram noted the Pennsylvania Association of Numismatists (PAN) had "anticipated a convention that would showcase the ANA and the city of Pittsburgh. But based on our analysis and review of all relevant information – the diminished show experience for attendees, health and safety issues, security, financial impact and the significant unknown outside variables – the host committee recommended that the ANA Board not hold the Pittsburgh World's Fair of Money," he says.
Since 1891, the American Numismatic Association's convention has only been cancelled twice; in 1918 during the flu pandemic and again in 1945 because of World War II.
"The decision to postpone the World's Fair of Money was very emotional and extremely difficult," says ANA President Steve Ellsworth. "The convention staff and the Pittsburgh organizing committee worked hard to make the show a reality. PAN went beyond all expectations to deliver what would have been a fantastic event, and I'm deeply disappointed that the collecting community won't be able to experience the results of their efforts. I know we will return to Pittsburgh in the not-so-distant future. In the meantime, we will pursue opportunities to host the event in another city in the weeks ahead."
Options briefly discussed include The Broadmoor in Colorado Springs, Colorado, and the Mountain America Expo Center and Salt Palace Convention Center, both of which are located in Salt Lake City, Utah.
"During these trying and socially-isolated times, we were looking forward to reconnecting with our fellow numismatists," says ANA Executive Director Kim Kiick. "We're disappointed we won't be seeing everyone in Pittsburgh but are working hard to create other opportunities to connect."
"The ANA and PAN recognize that dealers, clubs and many individuals may have already made plans and reservations in Pittsburgh for August," says Ackerman.
Hotel room reservations within the reserved block in the Omni William Penn, Embassy Suites by Hilton, Courtyard or Westin Convention Center that were made through VisitPittsburgh Housing Services automatically will be cancelled within 48 hours; do not contact the hotel directly. For those that made lodging accommodations directly with a hotel, cancellation will need to be made directly with those entities. Lodging questions should be directed to housing@visitpittsburgh.com.
Dealers will be contacted directly by the ANA convention team.
"To mitigate the influx of calls and emails, dealers will be contacted by phone within the next week to discuss the option of a future credit towards an ANA show or a refund," Ackerman says. "The ANA convention staff will be reaching out to every dealer who reserved a table at Pittsburgh. Your patience is much appreciated."
The American Numismatic Association (ANA) is a congressionally chartered, nonprofit educational organization dedicated to encouraging the study and collection of coins and related items. The ANA helps its 28,000 members and the public discover and explore the world of money through its vast array of educational and outreach programs, as well as its museum, library, publications and conventions. For more information, call (719) 632-2646 or visit money.org.
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redpajama_set_name: RedPajamaCommonCrawl


i liked the stringz-n-thingz article also.
Stefan, that's impressive work on redesigning the Chord EGG, incorporating the Chord EGG into a unique alarm clock, crafting a great looking enclosure, and writing and illustrating an article about your creation for the benefit of all of us. Thanks.


text:
Q: jQuery.appear runs script while visible to user I want to use this script to run a command every second when an element is visible until it disappears.
https://github.com/morr/jquery.appear
However, I'm missing a manual and the example doesn't help me either.
From the page:
$('someselector').appear(); // It supports optinal hash with "force_process" and "interval" keys. Check source code for details.

I think this would be the right code fragment for this?
My goal is to replace the source of an element as soon as its ID becomes visible.
$.get( 'https://localhost/LightRoom1.php', function( data ) { $('#LightRoom1').prop( 'src', data ); } );

This should be done every second when #LightRoom1 becomes visible and stop when it is not visible.
There are multiple elements beginning with #Light*. So the id has to be passed into the path and the id selector as well.

Any help or advice is appreciated, Thank you in advance.

A: Something like this?
var $myDiv = $('#LightRoom');

// Bind handler for the 'appear' event
$myDiv.on('appear', function() {
    // element appeared, execute your code
});

// Bind handler for the 'disappear' event
$myDiv.on('disappear', function() {
    // element disappeared, execute your code
});

Hope this helps.

A: I think you have to use the event listeners:
 $('someselector').on('appear', function(event, $all_appeared_elements) {
  // this element is now inside browser viewport
});
$('someselector').on('disappear', function(event, $all_disappeared_elements) {
  // this element is now outside browser viewport
});

and jquery wildcard selector such as "[id^=LightRoom]" to select any ID starting with "LightRoom".
Then you have to set an interval with javascript function setInterval() to repeat your code every n seconds and clear it when the element disappear using clearInterval()
Check if this code can help you:
var intervals = [];
$("[id^=LightRoom]").on('appear', function(event, $all_appeared_elements) {
// create an interval to repeat action every 1 second
// and store it inside interval array using id as key
var appeared = $(this).attr("id");
intervals[appeared] = setInterval(function(){
                            $.get( 'https://localhost/" + appeared + ".php', function( data ) {
                                $(appeared).prop( 'src', data );
                            } );
                        }, 1000);
});

$("[id^=LightRoom]").on('disappear', function(event, $all_disappeared_elements) {
// delete intervals for non-visible elements
    var disappeared = $(this).attr("id");
    clearInterval(intervals[disappeared]);
});

redpajama_set_name: RedPajamaStackExchange


text:
India's economic downturn leaves middle classes fearing the worst
Price rises, the falling rupee and a huge balance of payments deficit have prompted predictions of a full-blown economic crisis
Maseeh Rahman in Delhi
Sun 25 Aug 2013 09.05 EDT First published on Sun 25 Aug 2013 09.05 EDT
Freelance workers such as the sarangi player Ghulam Ali have been particularly hard-hit by India's economic downturn. Photograph: Maseeh Rahman for the Guardian
In a small house in the Indian capital, a musician was doing the maths. During the good months, when his deft accompaniments to classical or popular vocalists are in demand, sarangi player Ghulam Ali can make as much as R50,000 (£500). The problem for Ali is that he's not sure there will be many good months in the near future.
"Those like us without a regular monthly income are the worst hit," he said, referring to the sudden downturn in the Indian economy that has analysts whispering about a possible full-blown crisis. "For a musician, it means fewer concerts even as everything has become more expensive – food, transport, electricity, cooking gas, even foreign travel. We artists like to eat and dress well, so for my family it means fewer outings, less money for the children's education, fewer acquisitions. No question now, for instance, of buying a computer for my kids."
Ali and his wife, Rozitaskeen, have two daughters and a son, aged 12, 10 and six, and they share a small house with Ali's three younger brothers, their families and his parents. The family is fairly typically middle class, but as a freelance musician Ali also belongs to the overwhelming majority of Indians (estimated at three-quarters of the working-age population) who do not have steady, full-time employment.
These people are the most vulnerable as India flirts with its biggest financial wobble for perhaps 20 years. Not since economic liberalisation unleashed private enterprise in the 1990s has there been such concern.
After the 2008 world economic crisis India recorded 9% GDP growth for at least two years but in recent weeks the rupee has tumbled, losing a sixth of its value against the dollar this month alone. Share prices have fallen, commodity prices are rising, investment is stalling, growth is slowing, and the government is staring at a huge balance of payments deficit. A sense of impending doom is building. Compounding the fears are signs that other emerging economies in Asia are also vulnerable, drawing inevitable questions as to whether this could turn into a repeat of the 1997 Asian financial crisis.
"It is a crisis," said economist Jayati Ghosh. "This is the big one. But it has been building up for a while due to many reasons: the growing current account deficit, the industrial slowdown, the lack of infrastructure development, the negative investment in the economy."
She sees the crisis as evidence that "the model of development which focuses only on GDP growth" has run its course. What is needed now is "wage and employment-led growth".
Other experts trace the problem to the failure of Manmohan Singh's government to push through structural reforms that could boost growth. The ruling Congress party's emphasis on huge government subsidy schemes, such as jobs for the rural poor, has added to an already high fiscal deficit.
"Just trying to accelerate growth from the present low level [annual GDP growth is now down to 5%] will help the economy," said economist Surjit Bhalla.
India imports much more than it exports, and so the current account deficit is at an unsustainable 4.8% of GDP. Until it is brought down, there can be very little hope of reviving investor confidence in the economy.
Gold has played an important role in skewing the trade deficit. A century ago, the economist John Maynard Keynes wrote that India's irrational love for gold was "ruinous to her economic development", and the obsession still runs deep. India's annual production of gold is barely 10 tonnes, so last year it imported 860 tonnes, which were made into jewellery or stored as coins and bars in family safes.
The government is now trying to stem the hunger for gold by increasing import duties. This has revived gold smuggling, a menace which in the 1960s led to the creation of the Mumbai underworld.
Jewellers are pushing for a more imaginative solution. It is estimated that households and Hindu temples are hoarding around 25,000 tonnes of gold bars and coins. Jewellers are lobbying government to implement a scheme that could unearth 10% of the treasure.
"It will meet the demand for jewellery for the next three years," said Vikas Chudasama, the secretary general of the All India Gems and Jewellery Association.
Economists and corporate bigwigs hope Singh's government comes up with other such solutions for resolving the economic crisis. The finance minister, Palaniappan Chidambaram, has tried to revive confidence by promising action, but major reforms have yet to be announced.
On the upside, this year's monsoon will lead to bumper agricultural production, and the cheaper rupee also comes with a thick silver lining. There will a surge in exports, especially in sectors such as information technology and pharmaceuticals, where India is a strong performer.
There is growing anxiety about the future, but India's middle class may not have lost faith yet in the possibility of economic regeneration. "I cannot see things improving soon," Ali said. "But I feel good days will come again."


"Alleluia" has been named an Honor Award winner in the 10th Annual Great American Song Contest. Over 1500 songwriters from forty countries around the world entered the 2008 event. In addition to top winners in each category, the judges selected approximately 100 Finalists.
It's been reported from good sources that Debbie Rice made a giant hit today at our Brazosport Wednesday Review Club.
Debbie made a songwriter's presentation on how she writes songs and music. And then she moved right into her fascinating keyboard performance. We're expecting many great things from Debbie Rice.
Debbie has been blessed with a talent. The Lord gives her the inspiration. Its really neat to see what she's able to do and what will come next.
She's got some stuff out there where you can download her music if you would like to listen.
Debbies music draws you into a place that many people need to be drawn to. It is as if God is sending a message through her music to all of those that haven't listened before to HIS words, that haven't felt the wonderful feeling HE can give you if you if you just believe. Her music reaches deep down into your heart and soul, then raises you up to a high that is the best high a person could ever have !!!


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We acted for the management shareholders of Kaon Holdings Pty Ltd in the sale of the company to Siemens Limited. Kaon was acquired by Siemens for its world leading fuse saver technology.


text:
Discussion "Diplomacy in the 21st century" in LAMPA on 20 August
We invite you to join us in LAMPA Conversation festival on Friday 20 August at 17:00 for the discussion "Diplomacy in the 21st century" both online and in Cēsis city.
This discussion will examine the changes experienced by the field of diplomacy in recent decades, both in terms of how diplomacy is practiced and the issues diplomats confront, using the last 30 years of bilateral diplomacy between Latvia and the United States of America as a frame.
Diplomacy played a central role in the dramatic events of 1991, when Latvia reclaimed its independence from the failing Soviet Union and began the long task of rebuilding the political, economic, military, and diplomatic institutions needed to protect this independence and ensure the country's sovereignty and integration with like-minded allies. Thirty years later, diplomacy remains front and centre as the United States, Latvia, and their allies work to strengthen the alliance in the face of new challenges.
Academics, diplomats, and politicians will reflect on their personal experiences and/or observations of the diplomatic field during this time. Among the questions they will consider:
• What has changed for practicing American and Latvian diplomats since 1991, and what has stayed the same?
• What lessons have we learned (or failed to learn) about diplomacy since 1991?
• How is digitalization, social media, and disinformation influencing the practice of diplomacy?
• What can we expect in the field of diplomacy as we look ahead to 21st century challenges?
• How has the pandemic affected the diplomatic field?
The discussion will be moderated by Toms Rostoks, Visiting Lecturer at RGSL, Associated Professor at the University of Latvia, participants include Richard Damstra, Public Affairs Officer at the U.S. Embassy in Latvia, Imants Lieģis, Former Latvian Ambassador and Minister of Defence, Senior Researcher at LIIA, Sarma Gintere, Third Secretary, Embassy of the Republic of Latvia to the United States of America, RGSL Alumni, Ilze Rūse, Professor at RGSL, Latvian Ambassador to the Kingdom of Sweden. The language of the discussion: English, with a translation to Latvian.
The discussion is organized by Riga Graduate School of Law and USA Embassy in Riga in collaboration with Fonds atvērtai sabiedrībai DOTS.
The discussion will take place in Pils laukums in Cēsis on stage 10 Skatuve UZZIBSNĪ and online here https://festivalslampa.lv/lv/programma/pasakumi/1713 or on our Facebook page.