RESUMEN
The aim was to investigate leisure noise exposure and sociodemographic determinants of risky leisure noise exposure over five years in 2148 students visiting grade 9 of any school type in a German city from 2009-2011. Within the OHRKAN cohort study, leisure noise exposure was calculated from literature-retrieved sound pressure levels (SPLs) and self-reported duration of 18 leisure activities at baseline and two follow-ups. Risky exposure was defined as exceeding 85 dB(A) averaged over a 40-h-week. Determinants of risky total leisure noise (TLN) exposure and risky exposure to portable listening devices (PLDs) were investigated using generalised estimating equations (GEEs). Up to 73% of students exceeded noise levels of 85 dB(A) at some timepoint. The noise exposure and importance of different leisure activities changed with increasing age. Risky exposure to TLN and PLDs was associated with lower education, single parent households and being male. Risky PLD exposure was additionally associated with a migrant background. Current prevention measures for leisure noise exposure must be extended to at-risk groups. Besides enhancing campaigns in lower education schools, acoustical insulation in sports halls, noise warnings on tools or in videogames could address especially men. Migrants need education about healthy PLD use in their native language if necessary.
Asunto(s)
Conducta del Adolescente , Pérdida Auditiva Provocada por Ruido/etiología , Actividades Recreativas , Reproductor MP3 , Música , Ruido/efectos adversos , Adolescente , Factores de Edad , Escolaridad , Alemania , Audición , Pérdida Auditiva Provocada por Ruido/fisiopatología , Pérdida Auditiva Provocada por Ruido/prevención & control , Pérdida Auditiva Provocada por Ruido/psicología , Humanos , Estudios Longitudinales , Ruido/prevención & control , Medición de Riesgo , Factores de Riesgo , Factores Sexuales , Familia Monoparental , Factores de TiempoRESUMEN
INTRODUCTION: Caregiver intervention studies typically assess whether participants attain general goals (eg, improved mental/physical health) but not their own individual goals. We used goal attainment scaling to evaluate whether participants of a telephone intervention based on cognitive behavioral therapy (CBT) attained their personal goals. We also evaluated treatment compliance and implementation. METHODS: A sample of 139 family caregivers of people with dementia received 12 telephone sessions over 6 months. Participants personal goals were specified during the first and second sessions. Participants and therapists assessed goal attainment at the end of the intervention. RESULTS: Nearly all participants reported meaningful improvements with regard to their personal goals. Specifically, 20.9% exceeded, 56.4% completely attained, and 21.8% partially attained at least one of their personal goals. There was high agreement between self- and therapist ratings. Treatment compliance and implementation were highly satisfactory. CONCLUSIONS: The CBT telephone intervention successfully helped participants attain their personal goals.
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Cuidadores/psicología , Terapia Cognitivo-Conductual/métodos , Demencia/enfermería , Objetivos , Anciano , Depresión/terapia , Femenino , Humanos , Masculino , Calidad de Vida/psicología , TeléfonoRESUMEN
OBJECTIVE: Analysis of changes in leisure noise exposure among adolescents during 2.5 years of follow-up. METHODS: The analysis is based on the Ohrkan cohort study. A total of 2 149 9th graders in the City of Regensburg (mostly aged 15-16 years) were recruited between 2009-2011. At 2.5-year follow-up, the participants were asked again about leisure noise exposure. Both at baseline (O-I) and in the follow-up (O-II), self-reported frequency of participation in noisy activities was combined with literature-based values of usual sound levels to calculate the total weekly noise exposure. This exposure was compared to the lower exposure action value (lEAV) of 80 dB(A) given by the occupational health and safety regulations. Logistic regression was used to determine the factors associated with leisure noise exposure above the lEAV. RESULTS: Exposure data from both time points were available for 1 704 adolescents (54% female). The percentage of participants who were exposed to leisure noise exceeding the lEAV increased from 75 to 92% due to more persons visiting discotheques in O-II. In both surveys, the activity reported by the highest percentage of participants and with the longest exposure duration was listening to pop music via portable listening devices (PLD) although the proportion of users decreased slightly. Not being a pupil affected PLD use at volume levels >80 dB (A) whereas older age was associated with noise exposure in discotheques. CONCLUSIONS: O-II shows that adolescents are engaged in leisure activities under harmful noise levels and that noise exposure sources are changing with age. These issues should be considered in the developing of prevention programs.
Asunto(s)
Pérdida Auditiva Provocada por Ruido , Actividades Recreativas , Adolescente , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Alemania , Humanos , MasculinoRESUMEN
BACKGROUND: Studies investigating leisure noise effect on extended high frequency hearing are insufficient and they have inconsistent results. The aim of this study was to investigate if extended high-frequency hearing threshold shift is related to audiometric notch, and if total leisure noise exposure is associated with extended high-frequency hearing threshold shift. MATERIALS AND METHODS: A questionnaire of the Ohrkan cohort study was used to collect information on demographics and leisure time activities. Conventional and extended high-frequency audiometry was performed. We did logistic regression between extended high-frequency hearing threshold shift and audiometric notch as well as between total leisure noise exposure and extended high-frequency hearing threshold shift. Potential confounders (sex, school type, and firecrackers) were included. RESULTS: Data from 278 participants (aged 18-23 years, 53.2% female) were analyzed. Associations between hearing threshold shift at 10, 11.2, 12.5, and 14 kHz with audiometric notch were observed with a higher prevalence of threshold shift at the four frequencies, compared to the notch. However, we found no associations between total leisure noise exposure and hearing threshold shift at any extended high frequency. CONCLUSION: This exploratory analysis suggests that while extended high-frequency hearing threshold shifts are not related to total leisure noise exposure, they are strongly associated with audiometric notch. This leads us to further explore the hypothesis that extended high-frequency threshold shift might be indicative of the appearance of audiometric notch at a later time point, which can be investigated in the future follow-ups of the Ohrkan cohort.
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Audiometría de Tonos Puros/estadística & datos numéricos , Umbral Auditivo/fisiología , Exposición a Riesgos Ambientales/efectos adversos , Actividades Recreativas/psicología , Ruido , Adolescente , Audiometría de Tonos Puros/métodos , Femenino , Alemania , Audición/fisiología , Humanos , Masculino , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Nutrition professionals are essential members of the multidisciplinary clinical team treating individuals with eating disorders. They possess knowledge and expertise that includes nutrition, physiology, and skills for promoting behavior change relative to the psycho-socio-cultural aspects of eating. This review provides an overview of the current state of the art in the practice of nutrition therapy for eating disorders, providing guidance in nutrition assessment, interventions, monitoring and interpretation of information and data, awareness of emerging roles for nutrition, and important considerations regarding professional boundaries practiced in the field of eating disorders. Training and experience in nutrition therapy specific to eating disorders promote a positive outcome in patients. Nutrition professionals are involved in all levels of care, including individual and group treatment in inpatient hospitalization or residential programs, partial hospitalization, and outpatient programs. It is beyond the scope of this article to address specific nutrition considerations relevant to individuals. Additional research is needed to delineate the most effective strategies for nutrition therapy in the treatment of eating disorders.