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Background and Aims: Patients with balance disorders are evaluated by a battery of vestibular function tests including videonystagmography (VNG). However, the caloric test component of VNG is risky to be performed in patients with ear infections. In order to perform the test in such patients, closed-loop technique has been performed. This study aimed to compare the efficacies of closed- and open-loop techniques of the caloric test using VNG in patients with vertigo so that it can be applied to patients with ear infections also. Setting and Design: A prospective study was conducted at the neurotology clinic in our tertiary health-care Institution between May 2019 and April 2020. Subjects and Methods: The study involved 83 patients aged between 20 and 60 years with complaints of giddiness patients who were evaluated using videonystagmography with open-loop and closed-loop method and the results were compared. Results: By comparing the outcome of caloric responses in both ears using both these techniques, it is evident that both techniques' outcome is similar in detecting the caloric response of the ear as there was no statistically significant differences among both irrigation techniques. Conclusions: Closed-loop irrigation technique is equally as effective as open-loop technique in the evaluation of vertigo so that it can be used for the evaluation of vestibular system for patients in whom the open-loop technique is contraindicated. [ABSTRACT FROM AUTHOR]

Background: Chronic bothersome tinnitus is a prevalent tinnitus subtype placing a high burden on affected individuals, economies, and healthcare systems. Patient and professional perspectives seem to be partly misaligned on how to improve tinnitus research and treatments in the future. This qualitative interview study was aimed at exploring, comparing, and stipulating the perspectives of different tinnitus stakeholder groups on ways of redirecting research and treatments to reduce patients' suffering while accounting for challenges within these practices. Methods: This study used the participatory action research approach to facilitate the stakeholder involvement. Semi-structured online interviews including five participants (two tinnitus patients, two tinnitus researchers and medical specialists, one general practitioner) were conducted. Inductive grounded theory and the constant comparative method were used for data analysis. Results: Four categories for suggested research adaptations ((I) ethical patient involvement; (II) prioritising cure versus coping research; (III) funding; (IV) ethical publication) and six categories for suggested treatment adaptations ((I) ethical professional support; (II) patient involvement; (III) interdisciplinarity; (IV) professional tinnitus education; (V) clinical treatment guidelines; (VI) psychological treatment) were identified. Participants held partly similar priorities such as increasing pathophysiological and cure research. Differences between participants included, for instance, patients aiming for increasing patient involvement in tinnitus research and treatments compared to professionals arguing that the excessive focus on patients' conditions might reduce the patients' chances of habituating to their symptoms. Conclusions: Four action redirections for improving tinnitus research and treatment practices were defined: (I) facilitating communication between and within stakeholder groups, (II) increasing the reflective use of patient involvement, (III) increasing interdisciplinarity, and (IV) reducing barriers to receiving psychological treatment. [ABSTRACT FROM AUTHOR]

Copyright of Psicoterapia Cognitiva e Comportamentale is the property of Edizioni Centro Studi Erickson SpA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Psychologically informed practice is a structural framework originating in physiotherapy, that aids clinicians to identify, consider, and address the psychological factors related to chronic conditions and their management. Hearing loss is a chronic condition associated with a variety of psychosocial impacts, and psychological factors are known to heavily influence the engagement, adherence, and success of hearing rehabilitation. This framework could provide a structured method to manage these factors by using evidence-based psychological theory and applications. This article presents an argument for psychologically informed practice to be used within hearing healthcare, proposes how this framework could be adapted to meet the unique needs of audiology, and considers the pathways and barriers to implementation., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 The American Auditory Society.)

Acceptance and commitment therapy (ACT) was found to be effective with a diverse range of clinical conditions. The aim of this study is to evaluate the efficacy of ACT-based treatment for individuals with tinnitus. Meta-analysis of the scientific literature of Medline via PubMed, EMBASE, Web of Science and Google Scholar. The meta-analysis included 3 studies. The pooled mean difference in the Tinnitus Handicap Inventory (THI) score was 17.67 points lower [95% CI (− 23.50) to (− 11.84)] for the intervention arm compared to the non-treated control arm. The significant clinical reduction in the THI score indicates that ACT is an effective treatment for tinnitus. [ABSTRACT FROM AUTHOR]

Purpose: This review aims to explore the influences of tinnitus retraining therapy (TRT) on patients with tinnitus., Methods: PubMed, MEDLINE, EMBASE, CINAHL, PEDro, SCOPUS, and Web of Science were screened for randomized controlled trials (RCTs) that explored the effects of TRT on patients with tinnitus from inception to June 30, 2024. The methodological quality of the included RCTs was evaluated using the physiotherapy evidence database (PEDro) scale., Results: Fifteen studies met our eligibility criteria. A total of 2069 patients with tinnitus (mean age 52.93 years; 66% male) were involved in the present review. The quality of the selected studies ranged from 5 to 8 on the PEDro scale, with a median score of 7. TRT did not provide superior effects in treating patients with tinnitus compared to tinnitus masking (TM), tinnitus educational counselling (TED), TRT with open ear hearing aids, Tailor-made notched music training (TMNMT), partial TRT, usual care, and smart TRT., Conclusions: TRT intervention is considered a treatment option for patients with tinnitus. Combining TRT with other interventions, such as cognitive-behavioral therapy, pharmacotherapy, or tDS, may show even greater efficacy. Additional studies are strongly required to recognize the long-term effects of TRT on tinnitus, determine who most likely would benefit from the intervention regarding tinnitus type and severity, and identify the optimal treatment protocol., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

A growing number of health-related sciences, including audiology, have increasingly recognized the importance of affective phenomena. However, in audiology, affective phenomena are mostly studied as a consequence of hearing status. This review first addresses anatomical and functional bidirectional connections between auditory and affective systems that support a reciprocal affect-hearing relationship. We then postulate, by focusing on four practical examples (hearing public campaigns, hearing intervention uptake, thorough hearing evaluation, and tinnitus), that some important challenges in audiology are likely affect-related and that potential solutions could be developed by inspiration from affective science advances. We continue by introducing useful resources from affective science that could help audiology professionals learn about the wide range of affective constructs and integrate them into hearing research and clinical practice in structured and applicable ways. Six important considerations for good quality affective audiology research are summarized. We conclude that it is worthwhile and feasible to explore the explanatory power of emotions, feelings, motivations, attitudes, moods, and other affective processes in depth when trying to understand and predict how people with hearing difficulties perceive, react, and adapt to their environment. [ABSTRACT FROM AUTHOR]

In this comprehensive review, we discuss recent updates on tinnitus evaluation and treatment. Tinnitus evaluation commences with comprehensive medical history taking and audiological evaluation, which can provide valuable insight into the nature and extent of auditory disturbances. Additionally, tinnitus evaluation includes investigation of psychosomatic comorbidities to determine the intricate interplay between psychological factors and tinnitus perception. Various therapeutic approaches are available to minimize the burden of tinnitus. Cognitive behavioral therapy reshapes negative thought patterns and behaviors that are closely associated with tinnitus-induced distress. Acceptance and commitment therapy fosters mindfulness and value-aligned actions to address emotional effects. Tinnitus retraining therapy combines counseling and sound therapy for habituation. Tailor-made notched music therapy offers customized auditory experiences for symptom relief. Hearing aids and cochlear implants compensate for hearing loss and associated stress. Both neuromodulation and neurofeedback may be potentially useful. The role of pharmacotherapy and dietary supplements remains uncertain. Physiotherapy and head-neck manipulation relieve tinnitus associated with orofacial factors. Virtual reality, smartphone applications, and photobiomodulation may serve as novel therapeutic avenues. Although promising interventions are available, further research is warranted to confirm their effectiveness and long-term effects. [ABSTRACT FROM AUTHOR]

This study was done to study the effect of Tinnitus Retraining Therapy (TRT) in Bilateral Normal Hearing Individual with subjective tinnitus and to evaluate the success of simplified TRT with relation to duration of tinnitus, the patient's age and state of mind. As on date there is no definite cure available for tinnitus, so current TRT focuses on reducing the impact of tinnitus on the patient's quality of life. This study included total fifty (50) participants with bilateral normal hearing sensitivity, who had reported to the department of ENT with a complaint of tinnitus in one or both ears. All the participants are active serving military personnel and their dependents of Indian Armed Forces. All the participants had undergone basic audiological test batteries to assess the hearing acuity followed by TRT and its components (TRT counselling and sound therapy) in randomized manner. Audiological test batteries include pure tone audiometry to make sure that the participants have normal hearing acuity in both the ears and then tinnitus matching i.e. pitch and loudness match and measurement of Uncomfortable Level (UCL) followed by sound therapy and counselling. There was significant improvement reported in impact of tinnitus after completion of six (06) months of TRT schedule. Amongst the participants, 40% reported with complete relief from tinnitus, 30% reported with remarkable benefit but they can still perceive the tinnitus, 20% reported with no benefit with TRT and rest of the 10% were not able to tell whether they have got any benefit or not. Normal hearing individual with tinnitus can be benefitted with TRT accompanied with counselling and the improvement in impact of tinnitus severity that ensued over six months of TRT appear to be vigorous with significant clinical outcomes. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to assess the effectiveness of an Internet delivered Mindfulness Based Tinnitus Stress Reduction (i-MBTSR) program during the COVID-19 pandemic. Tinnitus, often a chronic condition, is experienced by 15% of the population. For those with severe, bothersome tinnitus, quality of life is reduced and the treatment options are limited. We evaluated an approach intended to decrease tinnitus-related distress. Method: This study examined the data collected for an online i-MBTSR course using a retrospective design. The intervention included an 8-week self-paced i-MBTSR course, including didactic information about mindfulness and tinnitus, as well as meditation practices. Outcome measures included the Tinnitus Functional Index (TFI) and Perceived Stress Scale (PSS), which were measured at four time periods. These time points included pretreatment, midtreatment at 3 weeks, immediately posttreatment, and at 6-month follow-up. Results: Forty-three participants completed the intervention. The mean preintervention tinnitus severity rating was 59.96 ("severe tinnitus") as measured by the TFI. Mean TFI scores dropped to 44.16 (p < .001) at midtreatment and to 34.23 (p = .001) at posttreatment. Repeated-measures analysis of variance and multivariate analysis of variance tests were conducted to determine changes in the two scales at the four time periods. There were significant differences in perceived stress and tinnitus self-function found in all measures and submeasures between the pre-, mid-, and posttreatment time points with the exception of the TFI Auditory subtest. These gains remained significant for those who completed the 6-month follow-up. Conclusions: The i-MBTSR course appears to be a viable and effective treatment modality. A shorter 3-week course may be effective. Case-control studies to more systematically investigate the effectiveness of i-MBTSR for tinnitus are required. [ABSTRACT FROM AUTHOR]

A growing number of health-related sciences, including audiology, have increasingly recognized the importance of affective phenomena. However, in audiology, affective phenomena are mostly studied as a consequence of hearing status. This review first addresses anatomical and functional bidirectional connections between auditory and affective systems that support a reciprocal affect-hearing relationship. We then postulate, by focusing on four practical examples (hearing public campaigns, hearing intervention uptake, thorough hearing evaluation, and tinnitus), that some important challenges in audiology are likely affect-related and that potential solutions could be developed by inspiration from affective science advances. We continue by introducing useful resources from affective science that could help audiology professionals learn about the wide range of affective constructs and integrate them into hearing research and clinical practice in structured and applicable ways. Six important considerations for good quality affective audiology research are summarized. We conclude that it is worthwhile and feasible to explore the explanatory power of emotions, feelings, motivations, attitudes, moods, and other affective processes in depth when trying to understand and predict how people with hearing difficulties perceive, react, and adapt to their environment. [ABSTRACT FROM AUTHOR]

Pulsatile tinnitus is a debilitating symptom affecting millions of Americans and can be a harbinger of hemorrhagic or ischemic stroke. Careful diagnostic evaluation of pulsatile tinnitus is critical in providing optimal care and guiding the appropriate treatment strategy. When a vascular cause of pulsatile tinnitus has been established, attention must be focused on the patient's risk of hemorrhagic stroke, ischemic stroke, or blindness, as well as the risks of the available treatment options, in order to guide decision- making. Herein we review our approach to management of the vascular causes of pulsatile tinnitus and provide a literature review while highlighting gaps in our current knowledge and evidence basis. [ABSTRACT FROM AUTHOR]

Subjective chronic tinnitus consists of a more or less continuous perception of sound in the absence of a corresponding acoustic source, which can lead to various psychological problems like depression, anxiety, attentional deficits and sleep disturbances. The prevalence is 10%–15% of the general population. Various therapy and management options have been proposed, but outcomes vary, and no generally accepted cure exists. In this review, the coherence of the most frequently used aetiological models shall be evaluated, and the efficacy of several treatment options will be discussed. With respect to tinnitus treatments, we focus on controlled studies and meta‐analyses. Although there are some therapies that outweigh placebo effects such as cognitive behavioural therapy, neurofeedback or neuromodulation techniques, they mainly target secondary symptoms and not the tinnitus tone itself. Furthermore, positive treatment effects only seem to last for a limited period of time. We conclude that long‐lasting combination therapies such as neurofeedback of auditory cortex inhibitory EEG signatures, cognitive therapy and sound‐tactile stimulation may provide more efficient outcomes if they target the intensity of the tinnitus tone itself and not only secondary psychological symptoms. [ABSTRACT FROM AUTHOR]

Lupinus albus L. (lupin) has a high tolerance for phosphorus deficient conditions as its roots can solubilize the unavailable phosphorus in the rhizosphere soil. The roots may also be able to solubilize other elements, but this requires further investigation. In this study, therefore, we conducted two experiments to comprehensively investigate the effects of lupin roots on the mineral dynamics of the rhizosphere soil. First, a mixed cropping experiment was conducted, in which lupin shared a rhizosphere with soybean (Glycine max (L.) Merr.) in a long-term experimental field with four fertilizer treatments: complete fertilization (+NPK), without nitrogen (−N), without phosphorus (−P), and without potassium (−K). The results of shoot dry weight of plants cultivated alone indicated that lupin is highly tolerant to all N, P, and K deficiencies, while soybean can adapt to N deficiency with the help of rhizobia but is less tolerant to P and K deficiencies than lupin. When mixed-cropped with lupin, the concentrations of many elements in the soybean leaf increased, particularly with the −N and −P treatments. Furthermore, soybean growth was significantly improved when cropped with lupin in the −N and −P treatments. Second, a comparison of the elemental profiles of hydroponically and field-soil-grown plants was conducted. Under hydroponic conditions, the rhizosphere effect is negligible when the culture medium is well circulated. The lupin/soybean ratios for leaf mineral concentrations were considerably larger in the field cultivated plants when compared with the hydroponic cultivations for elements such as sodium, potassium, cesium, phosphorus, iron, copper, and molybdenum, as there were lower concentrations of these elements in the soybean leaves in the field. These results indicate that lupin roots can solubilize a variety of insoluble elements in the soil, which may be the reason why lupin can adapt to various nutrient deficient soils. In the lupin rhizosphere, the solubilization of cesium, which is generally strongly fixed by soil minerals and not easily leached, was particularly pronounced. This implies that the surface structure of clay minerals might be altered in the lupin rhizosphere, resulting in the fixed forms of various elements becoming available. [ABSTRACT FROM AUTHOR]

Biofortification is a long-term strategy of delivering more iron (Fe) and zinc (Zn) to those most in need. Plant breeding programs within the CGIAR and NARS have made major advances in Fe- and Zn-dense variety development and there have been successful releases of new biofortified varieties. Recent research effort has led to a substantial improvement in our knowledge of Fe and Zn homeostasis and gene regulation, resulting in the identification of candidate genes for marker assisted selection. International cooperation between the agricultural and nutrition community has been strengthened, with numerous implementation and partnership strategies developed and employed over the years. The evidence on the effectiveness of Fe and Zn biofortified crops is slowly building up and the results are encouraging. Biofortification continues to be scaled out and further work is required to reach the general aim of eradicating the hidden hunger of Fe and Zn deficiency in the world's population and ensuring nutritional security. [ABSTRACT FROM AUTHOR]

Objective: To investigate the initial reduction of tinnitus effects by combining common therapies applicable in general otology clinics and establishing optimal treatment strategies., Study Design: Retrospective cohort study., Setting: A tertiary university hospital., Patients: Patients with nonpulsatile subjective tinnitus who visited the hospital between January and December 2022., Interventions: Combination therapies consisting of at least one of the directive counseling based on the neurophysiological model, hearing aids, medication, and/or neuromodulation were performed., Main Outcome Measures: Tinnitus Handicap Inventory (THI) questionnaire at both their initial visit and 1-month follow-up., Results: A total of 151 patients were enrolled. THI improvement of 20 points or more was observed in 31.8% of participants. One-way analysis of variance revealed that counseling had a significant reduction in THI, whereas neuromodulation, medication, and hearing aids did not. THI improvement was significantly associated with received counseling, severity of initial THI, and mean loudness discomfort level. Hearing aids and neuromodulation were not significant prognostic factors for improvement., Conclusion: Counseling alone is the best treatment for most patients with tinnitus. There will be other patients with tinnitus that, in addition to counseling, would benefit from hearing aids, medications, and/or certain forms of neuromodulation., (Copyright © 2023, Otology & Neurotology, Inc.)

Background: The Netherlands is currently considered a low endemic country for carbapenem-resistant Enterobacterales (CRE) and carbapenemase-producing Enterobacterales (CPE), experiencing only sporadic hospital outbreaks. This study aims to describe susceptibility to carbapenems and the epidemiology of carbapenemase production in Enterobacterales in the Netherlands in 2017–2019. Methods: Three complementary nationwide surveillance systems are in place to monitor carbapenem susceptibility in the Netherlands. Routine antimicrobial susceptibility test results from medical microbiology laboratories were used to study phenotypic susceptibility of Escherichia coli and Klebsiella pneumoniae. Pathogen surveillance (of all Enterobacterales species) and mandatory notifications were used to describe the characteristics of CPE positive isolates and affected persons. Results: The prevalence of isolates with gradient strip test-confirmed elevated meropenem (> 0.25 mg/L) or imipenem (> 1 mg/L) minimum inhibitory concentration (MIC) in the Netherlands was very low in 2017–2019, with percentages of 0.06% in E. coli and 0.49% in K. pneumoniae, and carbapenem resistances of 0.02% and 0.18%, respectively. A total of 895 unique species/carbapenemase-encoding allele combinations of CPE from 764 persons were submitted between 2017 and 2019, with the annual number of submissions increasing slightly each year. Epidemiological data was available for 660 persons. Screening because of presumed colonisation risk was the reason for sampling in 70.0% (462/660) of persons. Hospitalization abroad was the most common risk factor, being identified in 45.9% of persons. Conclusions: Carbapenem resistance of E. coli and K. pneumoniae remains low in the Netherlands. The annual number of CPE isolates slightly increased during the period 2017–2019. Recent hospitalization abroad is the main risk factor for acquisition of CPE. [ABSTRACT FROM AUTHOR]

Background: Suppressing intrusive thoughts can result in a post-suppression rebound effect where the same thoughts become hyperaccessible. The current study aimed to investigate if similar so-called rebound effects could be observed when people attempted to mentally suppress awareness of nonsensical auditory stimuli. Based on previous research on thought suppression and mental control in other domains, we hypothesized that attempting to suppress awareness of a task-irrelevant sound while under cognitive load would impact evaluations of the sound on affective dimensions and loudness, and result in increased general vigilance, as evidenced by faster responding on subsequent tasks. Methods: We performed two experiments where participants in a suppression condition were initially instructed to mentally suppress awareness of a sound while performing a mentally challenging task. Participants in a control condition performed the same task without receiving any instructions regarding the sound. In Experiment 1, the sound was affectively neutral, while in Experiment 2 participants were presented with an inherently aversive (tinnitus-like) sound. After this initial phase, participants performed tasks measuring vigilance and attention, and were also asked to give subjective ratings of the sounds on a number of affective dimensions and loudness. Results: In Experiment 1, participants in the suppression condition showed faster response times on both a visual search task and an auditory spatial cueing task, as compared to participants in the control condition. Contrary to our predictions, participants in the suppression condition did not rate the distractor sound as louder than participants in the control condition, and there were no differences on affective dimensions. In Experiment 2, results revealed that participants in the suppression condition made more errors on a visual search task, specifically on trials where the previously suppressed sound was presented. In contrast to results from Experiment 1, participants in the suppression condition also rated the targeted sound as louder. Conclusions: The findings provide preliminary support for a post-suppression rebound effect in the auditory domain and further suggest that this effect may be moderated by the emotional properties of the auditory stimulus. [ABSTRACT FROM AUTHOR]

This study aimed to develop and validate a Japanese version of the Tinnitus Acceptance Questionnaire (TAQ), an instrument that measures the process of intentional acceptance of adverse experiences associated with tinnitus. A total of 125 patients with chronic tinnitus from multiple institutions participated in this study. Participants completed the Japanese versions of the TAQ, Tinnitus Handicap Inventory, Valuing Questionnaire, Acceptance and Action Questionnaire-II, and Hospital Anxiety and Depression Scale. A second TAQ was administered 1–2 weeks later. Because the model fitted poorly in confirmatory factor analysis, exploratory factor analysis was conducted, which yielded a two-factor structure that was divided into forward and reversed item groups. Hypotheses regarding criterion and construct validity were clearly supported. A high Cronbach's α coefficient value was obtained for the TAQ total score (0.88). The interclass correlation coefficient for test–retest reliability was within the acceptable range (0.95). The results of the exploratory factor analysis were considered to be due to artifacts caused by the characteristics of the Japanese language. The present study confirmed the validity and reliability of the Japanese version of the TAQ in measuring tinnitus-specific receptivity. [ABSTRACT FROM AUTHOR]

Purpose: This clinical focus article is a companion to the work of Erdman et al. (2019), in which we described the rationale, development, and implementation of the standardof- care protocol used in the Tinnitus Retraining Therapy Trial (TRTT), a multicenter, placebo-controlled, randomized, definitive efficacy trial of tinnitus retraining therapy (TRT). We now describe the historical background, development, and standardized implementation and delivery of the TRT counseling protocol (tinnitus counseling [TC]) used in the TRTT. TC is conjectured to be the key component in the TRT protocol for initiating the habituation process that reduces the response to the tinnitus signal and, ultimately, reduces its impact. In the TRTT, participants assigned to receive TC achieved > 30% reduction in the impact of tinnitus. Method and Results: The design and implementation of standardized treatments in multisite randomized controlled trials presents many challenges for investigators. Here, subsequent to presenting the background, rationale, and the TRT protocol model, we describe the development, refinement, and training/certification for standardized delivery of TC in the TRTT. The primary challenges encountered while distilling and streamlining TC for standardized delivery across multiple clinicians and their replacements at six participating military treatment centers in the TRTT are considered, and the resulting counseling protocol is detailed. Conclusions: The standardized and streamlined TC used in the TRTT was successful for treating debilitating tinnitus among persons with functionally adequate unaided hearing sensitivity. The structured TC protocol described here appears to be the main determinant of the significant and sizable TRT treatment effects measured in the TRTT, thus bolstering the merits of this standardized counseling approach as one model for the clinical implementation of TRT for the treatment of primary tinnitus. [ABSTRACT FROM AUTHOR]

Determining the relative distribution of each chemical form of the elements and their relationship with the physical, chemical, and clay mineralogical properties of soils can help researchers to achieve the sustainable agricultural management. The present study was conducted to evaluate the chemical forms of four micronutrients (Zn, Cu, Fe and Mn) in some surface and subsurface soils of Kohgiluyeh and Boyer Ahmad province and their relationship with the physical, chemical and mineralogical properties of the soils. The results showed that the exchangeable and sorbed chemical forms of the studied elements were very low and negligible, but the residual, carbonate, and organic forms had the highest to lowest values of the chemical forms of these elements, respectively. Examination of the correlation of the chemical forms of these elements with soil properties showed the effective correlation of organic carbon values with the Zn chemical forms; also, there was a correlation between clay, silt, cation exchange capacity and calcium carbonate and the chemical forms of Cu, Fe and Mn. The correlation between the quantities of clay minerals and the chemical forms of these elements showed that the amounts of different forms of the studied elements were directly related to 2:1 clay silicate minerals (especially vermiculite). Evaluation of Fe and Mn chemical forms also showed that the amounts of these elements were higher in the soils with developed profiles (Alfisol and Mollisol), the wetter climate and zeric moisture regime rather than in soils with non-developed profiles (Entisols and Inceptisols) and a drier climate and a ustic moisture regime. In general, the results showed that variations of soil forming factors such as climate (as well as the total amount of each micronutrients), could be effective on the chemical forms of micronutrients (especially on Mn and Fe); these can be effective in the management of weakly to highly-developed soils orders. [ABSTRACT FROM AUTHOR]

Purpose: Progressive Tinnitus Management (PTM) is an evidence-based interdisciplinary stepped-care approach to improving quality of life for patients with tinnitus. PTM was endorsed by Department of Veterans Affairs (VA) Audiology leadership in 2009. Factors affecting implementation of PTM are unknown. We conducted a study to: 1) estimate levels of PTM program implementation in VA Audiology and Mental Health clinics across the country; and 2) identify barriers and facilitators to PTM implementation based on the experiences of VA audiologists and mental health providers. Method: We conducted an anonymous, web-based survey targeting Audiology and Mental Health leaders at 144 major VA facilities. Quantitative analyses summarized respondents' facility characteristics and levels of program implementation (full PTM, partial PTM, or no PTM). Qualitative analyses identified themes in factors influencing the implementation of PTM across VA sites. Results: Surveys from 87 audiologists and 66 mental health clinicians revealed that few facilities offered full PTM; the majority offered partial or no PTM. Inductive analysis of the open-ended survey responses identified seven factors influencing implementation of PTM: 1) available resources, 2) service collaboration, 3) prioritization, 4) Veterans' preferences and needs, 5) clinician training, 6) awareness of (evidence-based) options, and 7) perceptions of scope of practice. Conclusion: Results suggest wide variation in services provided, a need for greater engagement of mental health providers in tinnitus care, and an interest among both audiologists and mental health providers in receiving tinnitus-related training. Future research should address barriers to PTM implementation, including methods to: 1) improve understanding among mental health providers of their potential role in tinnitus management; 2) enhance coordination of tinnitus-related care between health care disciplines; and 3) collect empirical data on Veterans' need for and interest in PTM, including delivery by telehealth modalities. [ABSTRACT FROM AUTHOR]

Iron (Fe) and manganese (Mn) are two essential micronutrients for plant growth, which their deficiency has usually been observed in calcareous soils. Herein the chemical fractionation status of Fe and Mn in surface and subsurface soils of 16 pedons under different climatic conditions, as well as their relationship with some chemical and mineralogical properties, was investigated. As results, the residual, carbonate, and organic chemical forms contained the highest to the lowest levels of chemical forms of Fe and Mn, respectively. Quantitative investigation of chemical forms of Fe and Mn in soils with higher degree of development (Alfisols and Mollisols) and wetter climate (xeric moisture regime) showed a higher content of these elements compared to the soils with a lower degree of development (Entisols and Inceptisols) and drier climate (ustic moisture regime). The correlation between different chemical forms of Fe and Mn with some chemical and physical properties revealed that the organic carbon, cation exchange capacity, pH, calcium carbonate equivalent, and percentage of the soil particle size had the highest effects on the chemical forms of Fe and Mn. Besides, the investigation of the correlation between different chemical forms of Fe and Mn with clay minerals indicated a significant positive and negative correlation with 2:1 silicate minerals (smectite and vermiculite) and palygorskite, respectively. In general, the results demonstrated that the variation of soil formation factors such as climate can significantly affect the chemical forms of Fe and Mn micronutrients and the management of soil orders with a low-to-high level of development. [ABSTRACT FROM AUTHOR]

This study was aimed at validating the Individual Recovery Outcomes Counter (I.ROC) for deaf, hard-of-hearing, and tinnitus patients in a mental health care setting. There is a need for an accessible instrument to monitor treatment effects in this population. The I.ROC measures recovery, seeing recovery as a process of experiencing a meaningful life, despite the limitations caused by illness or disability. A total of 84 adults referred to 2 specialist mental health centers for deaf, hard-of-hearing, and tinnitus adults in the Netherlands completed the Dutch version of I.ROC and 3 other instruments. A total of 25 patients refused or did not complete the instruments: 50% of patients using sign language and 18% of patients using spoken language. Participants completed the measures at intake and then every 3 months. In this sample I.ROC demonstrated good internal consistency and convergent validity. Sensitivity to change was good, especially over a period of 6 or 9 months. This study provides preliminary evidence that the I.ROC is a valid instrument measuring recovery for hard-of-hearing and tinnitus patients using spoken language. For deaf patients using sign language, specifically those with limited language skills in spoken and written Dutch, more research is needed. [ABSTRACT FROM AUTHOR]

Introduction: Most of the individuals suffering from tinnitus report of negative effects on their lives to the extent that clinical intervention is necessary. Although traditional tinnitus management has proven to be effective in treating tinnitus, there are a few drawbacks. The major drawback is the lack of professionals for the treatment of tinnitus, especially in remote areas. Considering the growing usage of the internet as a platform for availing treatment, there is a requirement for the development of applications in the health care sector. Recent search related to tinnitus treatment revealed that more than 200 applications are available online in the most popular platforms like Android and iOS. However, most of the applications for the treatment of tinnitus lack validation, and thus, there is a need for research on this ground. Method: Five studies evaluating the efficacy of Internet/app delivered tinnitus treatments were identified. The treatment forms included were Tinnitus E-program, Mobile serious game, Tinnitus web-based sound therapy, and Tailor-made notch music therapy delivered through a smart phone. Results: Each study used a variety of standardized and validated questionnaires to measure the outcome of the treatment. The outcome measures were diverse, but both Internet/app-based and traditional methods like Tinnitus Retraining Therapy, Cognitive Behavioral Therapy, and Acceptance and Commitment Therapy had similar improvements in terms of tinnitus distress and quality of life. Conclusion: It can be construed that the development of tinnitus treatment applications and web-based platforms will have a significant impact on the normal life of individuals with tinnitus. [ABSTRACT FROM AUTHOR]

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This article reviews the evidence related to the efficacy of Cognitive Behavioral Therapy (CBT) for alleviating the distress caused by tinnitus, hyperacusis and misophonia. Where available, the review was focused on meta-analyses of randomized controlled trials (RCTs) using either passive control groups (typically waiting list or education only) or active control groups (receiving some other form of treatment). Where data from RCTs were not available, case studies and retrospective studies were reviewed. Analyses were conducted separately for studies of patients with tinnitus, hyperacusis and misophonia. RCTs show that CBT is effective in alleviating the distress caused by tinnitus in comparison to passive control groups and sometimes active control groups. CBT for tinnitus can be effective both in individual and in group settings, whether delivered by psychiatrists, clinical psychologists, or specially trained audiologists. CBT for tinnitus can also be effective when delivered via the internet, when combined with help from audiologists. Usually, CBT does not reduce the loudness of tinnitus but it can improve quality of life. Case studies and some limited RCTs suggest that CBT can also be effective in alleviating the distress caused by hyperacusis and misophonia. However, RCTs with active control groups are currently lacking. There is strong evidence supporting the effectiveness of CBT in alleviating the distress caused by tinnitus. However, it is not yet clear whether CBT is more effective than some other forms of treatment. RCTs with active control groups are needed to establish more clearly the extent to which CBT is effective in alleviating the distress caused by hyperacusis and misophonia. [ABSTRACT FROM AUTHOR]

Tinnitus is often in comorbidity with anxiety and depression, and several authors have proposed a reduced efficiency of the top-down executive control in its perception. This single-group study describes a novel application of the metacognitive therapy (MCT), which works on a top-down engagement of proactive attentional control mechanisms on a group of patients with tinnitus, to see its impact on the perception of tinnitus and its anxiety and depression correlates. Eight metacognitive therapy group-sessions were proposed to a group of nine patients, as part of a regional project conducted at the University General Hospital "Paolo Giaccone" of Palermo. The last was a follow-up session, proposed three months after the seventh. The Tinnitus Handicap Inventory (THI) and the Hospital Anxiety and Depression Scale (HADS) were administered during the first, the seventh and the follow-up group session. The distress perceived by tinnitus (THI), lowered at a tolerable level at re-test, by maintaining this result up to 3 months after the conclusion of the experience (F(2) = 13.1, p = 0.001; effect size = 0.731). Distress scores (HADS) (F(2) = 8.3, p = 0.016; effect size = 0.462) and anxiety sub-scores (F(2) = 12.06, p = 0.001; effect size = 0.670) improved at the end of the experience, and the benefits stayed stable over the course of the follow-up, while depression scores did not change (p = 0.549). The use of MCT appears to offer promise in reducing the perception of the tinnitus and the anxiety of participants and reduces the significance of annoying thinking. Further studies are necessary to test its efficacy and replicability in a controlled trial. [ABSTRACT FROM AUTHOR]

Tinnitus retraining therapy involves masking of tinnitus at sound perception level in combination with structured counselling sessions. To assess efficacy of Tinnitus retraining therapy (TRT) in Patients of Tinnitus with Sensori Neural Hearing loss. Prospective study was carried out on patients who presented with Tinnitus in ENT OPD from December 2015 to December 2016. Severity of tinnitus was documented using Tinnitus handicap inventory scale. Response to tinnitus is evaluated at the end of 3 months. In our study 57 patients in age group 21-78 years were selected and Tinnitus retraining therapy was administered. Most of patients had moderate (75.43%) perception of tinnitus before initiation of therapy. After completion of therapy tinnitus completely disappeared in 34 (59.65%) patients. Improvement in Tinnitus perception was observed in total of 49 (85.96%) patients. There was no improvement in Tinnitus perception in 8 (14.03%) patients. TRT aims in reducing the tinnitus perception by inducing habituation of tinnitus-induced reactions allowing patients to achieve control over their tinnitus, live a normal life, and participate in everyday activities. [ABSTRACT FROM AUTHOR]

In the recent years, there has been an increasing interest in the potential of internet- and smartphone-based technologies for the support of tinnitus patients. A broad spectrum of relevant approaches, some in the form of studies, others in the form of market products, have been mentioned in literature. They include auditory treatments, internet-based Cognitive Behavioral Therapy (iCBT), serious games, and questionnaires for tinnitus monitoring. The goal of this study is to highlight the role of existing internet-based and smart technologies for the advancement of tinnitus clinical practice: we consider contributions that refer to treatments and diagnostics, and we include contributions refering to self-help measures. We elaborate on the potential and challenges of such solutions and identify constraints associated to their deployment, such as the demand for familiarity with internet-based services and the need to re-design interactive services so that they fit on the small surface of a smartwatch. [ABSTRACT FROM AUTHOR]

Purpose: Acoustic trauma is more prevalent in military settings, especially among individuals with combat-related military occupational specialties. Gunfire, improvised explosive devices, and mortar explosions are a few examples that may cause hearing degradation and tinnitus. It is possible that the same events that are associated with auditory problems can cause traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD).Method: This paper reviews the distinct and overlapping symptoms of tinnitus, TBI, and PTSD, and how these disorders interact to synergistically promote negative outcomes.Results: Tinnitus may serve as a significant contributor to symptoms of TBI and PTSD. Therefore, tinnitus subtypes could be identified as physiologically or psychologically based, or both.Conclusions: Additional research is warranted to determine the common and unique symptoms and associated neurological pathways of tinnitus, TBI, and PTSD. Brief treatment recommendations are provided, including a multidisciplinary approach for the physical and psychological distress associated with tinnitus. [ABSTRACT FROM AUTHOR]

To investigate the effect of oxalic and citric acids on the uptake and relationship of phosphorus and zinc in corn (Zea mays L.), some greenhouse experiments were performed by individual and combined application of monopotassium phosphate [KH232PO4] and zinc sulfate [65ZnSO4.7H2O] fertilizers in microcosm. For this purpose after planting corn seeds, solutions of phosphorus (32P) and zinc (65Zn) (14 and 2 M) and organic acids treatments (1 and 10 mM) were injected in microcosms at suitable times. Then, plants were harvested, digested, extracted, and activity of 32P and 65Zn was measured in samples. Results revealed that the highest uptake of 32P in shoots was 18.8% and observed at 10 mM concentration of oxalic acid. But no effect on 65Zn uptake was seen and the highest uptake was observed in control (1.27%). The highest uptake of 32P and 65Zn in plant shoots and roots was observed at 10 mM concentration of oxalic and citric acids, respectively. [ABSTRACT FROM AUTHOR]

Psychological distress is common among people with hearing problems, but treatments that specifically target this aspect have been almost non-existent. In this pilot randomized controlled trial, an eight-week long Internet-based treatment, informed by Acceptance and Commitment Therapy, was administered to explore the feasibility and efficacy of such a treatment. Included participants were randomized to either treatment (n = 31) or wait-list control (n = 30) condition. All participants were measured prior to randomization and immediately after treatment ended using standardized self-report instruments measuring hearing-related emotional and social adjustment (Hearing Handicap Inventory for the Elderly – S, HHIE-S), quality of life (Quality of Life Inventory, QOLI), and symptoms of depression and anxiety (Patient health Questionnaire, PHQ-9 and Generalized Anxiety Disorder scale, GAD-7). Linear mixed effects regression analysis using the full intention-to-treat sample demonstrated that the treatment had superior outcomes on the main outcome measure as compared with the control group, Cohen’sd = 0.93, 95% CI [0.24, 1.63]. The benefits of treatment over control were also evident in scores of depression, Cohen’sd = 0.61, 95% CI [0.04, 1.19], and quality of life, Cohen’sd = 0.88, 95% CI [0.14, 1.61]. The results provide preliminary support for Internet-delivered acceptance and commitment therapy as a potentially effective treatment of psychological symptoms associated with hearing problems. [ABSTRACT FROM AUTHOR]

Objectives: Tinnitus is a prevalent condition, but little has been published regarding the natural history of the condition. One technique for evaluating the long-term progression of the disease is to examine what happens to participants in the no-intervention control arm of a clinical trial. The aim of this study was to examine no-intervention or waiting-list data reported in trials, in which participants on the active arm received any form of tinnitus intervention.Data Sources: CINAHL, PsychINFO, EMBASE, ASSIA, PubMed, Web of Science, Science Direct, EBSCO Host, and Cochrane.Methods: Inclusion criteria followed the PICOS principles: Participants, adults with tinnitus; Intervention, none; Control, any intervention for alleviating tinnitus; Outcomes, a measure assessing tinnitus symptoms using a multi-item patient-reported tinnitus questionnaire. Secondary outcome measures included multi-item patient-reported questionnaires of mood and health-related quality of life and measures that quantified change in tinnitus loudness; Study design, randomized controlled trials or observational studies utilizing a no-intervention or waiting-list control group. Data were extracted and standardized mean difference was calculated for each study to enable meta-analysis.Results: The evidence strongly favored a statistically significant decrease in the impact of tinnitus over time, though there was significant heterogeneity and clinical significance cannot be interpreted. Outcome data regarding secondary measures did not demonstrate any clinically significant change.Conclusions: Participants allocated to the no-intervention or waiting-list control arm of clinical trials for a tinnitus intervention show a small but significant improvement in self-reported measures of tinnitus with time; the clinical significance of this finding is unknown. There is, however, considerable variation across individuals. These findings support previous work and can cautiously be used when counseling patients. Laryngoscope, 128:217-227, 2018. [ABSTRACT FROM AUTHOR]

Previous studies have supported acceptance and commitment therapy (ACT) for reducing impairment related to various chronic conditions. ACT may possibly be beneficial for bipolar disorder (BD) with co-existing anxiety, which is associated with a poorer treatment outcome. Efforts are needed to identify suitable psychological interventions for BD and co-existing anxiety. In this open clinical trial, we included 26 patients with BD type 1 or 2 at an outpatient psychiatric unit specializing in affective disorders. The intervention consisted of a 12-session manualized group treatment that included psychoeducation, mindfulness, engaging in values-based behaviour, cognitive defusion, acceptance and relapse prevention modules. Participants completed four self-report questionnaires covering anxiety symptoms (Beck Anxiety Inventory - BAI), depressive symptoms (Beck Depression Inventory - BDI-II), quality of life (Quality of Life Inventory - QOLI) and psychological flexibility (Acceptance and Action Questionnaire - AAQ-2) before, during and after the treatment. At post-treatment, the participants reported significant improvements in all outcome measures, with large effects (Cohen’sdbetween 0.73 and 1.98). The mean reduction in anxiety symptoms was 45%. At post-treatment, 96% of the patients were classified as responders on at least one of the outcome measures. A limitation is that the trial is uncontrolled. The results suggest that ACT has the potential to be an effective treatment for BD patients with co-existing anxiety. Further randomized studies are warranted. [ABSTRACT FROM AUTHOR]