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The Heart of the Matter: What Does America Really Know about Coronary Artery Disease Treatments? University of Michigan scientist Susan Shore examines the location of stimulating and recording electrodes used to track nerve cell activity in the brain’s auditory center. Touch-sensing nerve cells step up their activity in the brain after hearing cells are damaged, a study by U-M Kresge Hearing Research Institute scientists shows.
The research findings were made in animals, but they suggest that available treatments such as acupuncture, if used to target nerves in the head and neck, may provide relief for some people plagued by tinnitus, says Susan E.
People with tinnitus sense ringing or other sounds in their ears or head when there is no outside source.
Increasing numbers of baby boomers are also finding that when they can’t hear as well as they used to, tinnitus seems to move in. Tinnitus varies in individuals from a faint, high-pitched tone to whooshing ocean waves to annoying cricket-like chirping or screeching brakes. Some people, oddly enough, find that if they clench the jaw or press on the face or neck, they can temporarily stop tinnitus, or in some cases bring it on. In normal hearing, the dorsal cochlear nucleus is the first stop in the brain for sound signals arriving from the ear via the auditory nerve.
The somatosensory system is a nerve network in the body that provides information to the brain about touch, vibration, skin temperature and pain. But when people experience hearing loss or some other event, such as having a cavity filled or a tooth implanted, these neurons from the face and head can respond like overly helpful relatives in a family crisis. U-M researcher Susan Shore and U-M graduate student Seth Koehler discuss electrophysiological data being collected during an experiment. Shore’s research team knew from earlier research that some neurons in the cochlear nucleus become hyperactive after hearing damage, and this hyperactivity has been linked to tinnitus in animals. Many people with temporomandibular joint syndrome (TMJ), a condition that causes frequent pain in the jaw, experience tinnitus. In addition to Shore and Koehler, Mark Oldakowski, a U-M research associate at the time of the study, Sana Syed, then a U-M student in the Undergraduate Research Opportunity Program and Larry F. Funding for this research came from the Tinnitus Research Consortium, the Tinnitus Research Initiative and the National Institutes of Health.
In some patients with occupational noise-induced hearing loss, a significant aspect of the handicap concerns the concomitant tinnitus; thus, this disorder must be considered in evaluating a disability percentage in the insurance context. In clinical practice, tinnitus is a fairly common symptom in patients with chronic acoustic trauma and noise-induced hearing loss (NIHL) [1].
The method proposed in this article is based on a rational, ranked progression in decision making: At each of four steps, a fairly large number of elementary (cellular) decisions, easily made and reproducible among different experts, leads to a higher decision level (Fig. 3.2 Besides reporting the tinnitus, does the patient also demonstrate an occupational hearing loss? In case of one or more nonaffirmative responses, the expert must judge whether to come to a final positive or negative decision for each question of level 3. 2.5 Does the hearing loss show the characteristics of NIHL at a functional hearing assessment?
2.7 Is the anamnesis and is the history of complaints suggestive of progressive occupational hearing loss? 2.8 Does the functional assessment of tinnitus (tinnitometry) suggest the etiology of cochlear noise damage?
2.9 Does the medical history demonstrate compatibility of tinnitus with the etiology of cochlear noise damage? 2.10 Is the anamnesis and is the history of complaints suggestive of tinnitus related to progressive occupational hearing loss? 2.11 Are there convincing objective elements for the nature and severity of impairment, disability, or handicap? 2.12 Are there convincing subjective elements for the nature and severity of impairment, disability, or handicap?
To check for agreement among different experts of first-level decisions and for concordance in higherlevel decisions, we selected 10 exemplary files from among the patient material of the Institute of Occupational Disorders.
A variant of Cohen's Kappa [4] was applied, as this statistical test takes into account the possibility of chance agreement among raters (as no more than three choices are possible). Tinnitus is frequently associated with occupational hearing loss and can be an additional item of claim in countries applying a specific insurance system for occupational disorders. This research was presented at the Thirty-First Congress of the Neurootological and Equilibriometric Society, Bad Kissingen, Germany, March 25-27, 2004. You must have JavaScript enabled in your browser to utilize the functionality of this website. Jo is currently senior producer for the three-year UK Unlimited Commissions programme (working with Shape and Artsadmin) for disabled artists and companies.
She has also written a number of articles defining the UK's Creative Case and articulating the perspective that diversity is at the heart of great art.


In 2013, Jo undertook a personal challenge to do one thing differently every day for the whole year, to push the barriers within her own practice.
Jo has won both Cosmopolitan's woman of achievement award and her village's cup for making jam.
Two projectors can be toured in excess baggage. Digital media and player can be brought in hand luggage. Take Me to Bed is an installation, an invitation, to come close to non-traditional dance bodies and their dances. The United Kingdom's international organisation for cultural relations and educational opportunities.
Remember a while backĀ I told you about the Middleton case at the Federal Circuit Court of Appeals?
Well, it looks like the Court appliedĀ the exact OPPOSITE logic – this time, to the benefit of the VA. The record is not clear if that psychotic episode was due to an independent psychosis or if the Veteran’s experimentation with LSD caused it. In any event, the VA sided with the Veteran, and service-connected him at discharge with 50% impairment rating in October 1975.
Ken has made some serious sacrifice in his life and profession to ensure that Veterans get the best representation available – and he is at it to this day. The Court said that where the Impairment Rating regulation requires use of insulin injections to get compensation for service connected diabetes greater than 10%, the regulation is clear and cannot be avoided. So, even if the Veteran gets an injection of a drug that creates insulin, the exact wording of the regulation is so clear that he is not entitled to compensation higher than 10%. Listen, I can deal with Courts, Judges and Attorneys that make decisions I don’t agree with. I can deal with Courts, Judges and Attorneys that make what I think are the wrong decision. I can even deal with Courts getting new Judges who decide to shift the Court’s analysis in a different philosophical direction. But the appearance of this possibility does as much as anything to tear the fabric of justice: the appearance of outcome based reasoning is one of the big reasons that Veterans have so little trust in the benefits system that is supposed to be helping them.
1) At least one of the parties never knows what to expect when you go before a court – at least until that party figures out which outcome the court prefers.
Again, to be clear, I’m not accusing any specific judge of any misconduct in particular. What I am saying is that the inconsistent logic in court decisions does not help to eliminate the perception that the Veterans benefits appeal system is a matter of something other than facts, fairness and justice. Hands down the best thing you have ever written and arguably the very best piece of veteran law analysis on a layman’s level ever done by anyone. One thing I’ve always strived to do on this blog is to write in a fashion that takes boring legalese and turns it into information that Veterans can use in their own claims. Great things on the horizon – please let me know what information I can put out that would be MOST helpful to the MOST Veterans. Nerves that sense touch in your face and neck may be behind the racket in your brain, University of Michigan researchers say.
Her work sheds light on the link between hearing loss and the widespread problem of tinnitus.
The condition commonly occurs with hearing loss, but also after head or neck trauma such as whiplash or dental work. To understand tinnitus and its strange link to touch sensations, Shore and her research team have conducted a series of studies in guinea pigs, measuring nerve activity in a part of the brain called the dorsal cochlear nucleus that processes auditory and other signals. The somatosensory system is coming in, but may overcompensate and help cause tinnitis,” she says. The part of the system that provides sensations from the face and head, called the trigeminal system, brings signals to the cochlear nucleus that help us hear and speak.
Hughes, a professor at the Southern Illinois University School of Medicine, are co-authors of the paper.
In a medicolegal context, tinnitus is mostly a subsidiary item of claim, additional to that for NIHL.
The essentially subjective nature of tinnitus renders very difficult - at least in some patients - the choice of equitable medicolegal decisions about the presence and severity of tinnitus.
The four progressive levels of decision making (1-4), consisting of 65, 12, 4, and 1 decision, respectively.
Adequate decision making, even at an elementary level, requires exhaustive and encyclopedic knowledge of otoneurology.
Note: If tinnitus is accepted, the expert must define the percentage of impairment or invalidity. A positive decision about all four of these essential aspects is requested for acknowledging the tinnitus as a part of the occupational disease and for providing compensation.


Similarly, documents proving that the patient has sought relief of tinnitus before making any claim for compensation are highly relevant in this context (repeated medical consultation, acupuncture, purchase of tinnitus maskers, etc.).
All files were examined by four different medical specialists (otorhinolaryngologists) interested in legal and forensic medicine. Fund for Occupational Diseases, Brussels, Belgium and Institute of Phoniatrics, Utrecht University Medical Center, the Netherlands. The installation requires a 14 m blank wall for projection or 2 x 7 m as ideally the bodies in the beds should be displayed life sized.
Stallworth took issue with the decision to sever his VA disability compensation completely.
They used a 16-electrode array to measure signals from the trigeminal nerve and multisensory neurons in the dorsal cochlear nucleus.
Department of Veterans Affairs.Tinnitus is largely a mystery, a phantom sound heard in the absence of actual sound.
To reach a maximum of medicolegal objectivity, a system was developed within the Belgian Institute of Occupational Disorders (Brussels) in the form of a four-level decision structure, after exhaustive but noninvasive assessment of patients. This difficulty implies that assessment must involve a large set of parameters combining subjective and objective items [3]. The four levels are worked through in progression from level 1 to level 4 and consist of 65,12,4, and 1 decision, respectively.
Each specialist was required to make his or her decision according to the pathway proposed in this protocol.
The test reveals a Kappa value of 0.74, demonstrating a high interrater consistency at the first level.
A decision - making system based on an exhaustive assessment and a four - level decision structure proves to be helpful. When they compared results in the two groups, they found clear differences in trigeminal nerve activity. An aggregate of multiple-choice responses (affirmative, neutral, negative) to elementary questions leads to a decision of the next level, which in turn determines - together with the other decisions at the same level - the conclusion at a still higher level. Further, as in some cases tinnitus may cause devastating (and objectionable) effects on one's lifestyle and ability to work, it may attract levels of compensation higher than those for hearing loss [2]. The ultimate decision is to accept or reject the tinnitus as a true component of the occupational disorder (noise-induced cochlear damage).
An aggregate of multiplechoice decisions (affirmative, neutral, negative) on elementary questions leads to a decision at the next level, which in turn determines - together with the other decisions at the same level - the conclusion at a still higher level. It is a symptom, not a disease, and though exposure to loud noise may cause it, some cases have no apparent trigger. A positive outcome on all four level-3 questions is required for recognition of noise-induced hearing loss-related tinnitus as an occupational disorder and for financial compensation (final decision, level 4).
Directly related to this decision is a determination of the percentage of disability or impairment that may be attributed to this tinnitus component. When, within an exhaustive assessment, those topics for which a patient's assertion can be objectively controlled systematically demonstrate reliability, a reasonable assumption is that those for which such an objective control is impossible are also credible. A variant of Cohen's Kappa for multiple raters demonstrated high interrater consistency at the first level (10 cases, 4 raters).
We assessed 10 exemplary files on which this system was applied by four experts rating independently. The main goals are to reach an optimal consistency among experts in these decisions and to offer optimal transparency in case of litigation.
The findings could lead to a testable model that helps to identify what region or regions of the brain might be responsible for causing the two conditions. A variant of Cohen's Kappa for multiple raters demonstrated high interrater consistency at the first level.
In this way, the final medicolegal decision relies on standardized criteria and becomes perfectly transparent in cases of litigation. Having conceptualized a broader, more comprehensive neural network, the researchers hope to eventually test the model by deactivating specific segments of the neural network. In this way, the final medicolegal decision relies on standardized criteria and becomes perfectly transparent.
There is emotion and arousal, but the final puzzling piece to the network is activity in the cerebellum, normally activated during motor planning events like reaching for a cup or catching a ball.



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