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This is an experiment because the researcher controls the length of time in the room discount finasteride hair loss thyroid. We measure the age and income of 50 people to independent variable is length of time order finasteride uk hair loss 6 months after chemo, the conditions see if older people tend to make more money cost of finasteride hair loss in men 3 button. This is not necessarily true (people who weigh more tend to be taller discount 1mg finasteride with mastercard hair loss 7 year old daughter, but being heavier does not make you taller! The problem is that, coincidentally, some additional variable may be present that we are not aware of, and it may actually be doing the causing. For example, we’ve seen that less study time appears to cause participants to produce higher error scores. But perhaps those participants who studied for 1 hour coinciden- tally had headaches and the actual cause of their higher error scores was not lack of study time but headaches. Or, perhaps those who studied for 4 hours happened to be more motivated than those in the other groups, and this produced their lower error scores. Re- searchers try to eliminate these other variables, but we can never be certain that we have done so. Our greatest confidence in our conclusions about the causes of behavior come from experiments because they provide the greatest opportunity to control or eliminate those other, potentially causal variables. Therefore, we discuss the relationship in an experi- ment as if changing the independent variable “causes” the scores on the dependent vari- able to change. The quotation marks are there, however, because we can never definitively prove that this is true; it is always possible that some hidden variable was present that was actually the cause. Correlational studies provide little confidence in the causes of a behavior because this design involves little control of other variables that might be the actual cause. Therefore, we never conclude that changes in one variable cause the other variable to change based on a correlational study. Instead, it is enough that we simply describe The Characteristics of Scores 27 how nature relates the variables. Changes in X might cause changes in Y, but we have no convincing evidence of this. That old saying that “You can prove anything with statistics” is totally incorrect! No statistical procedure can prove that one variable causes another variable to change. Think about it: How could some formula written on a piece of paper “know” what causes particular scores to occur in nature? Thus, instead of proof, any research merely provides evidence that supports a partic- ular conclusion. How well the study controls other variables is part of the evidence, as are the statistical results. This evidence helps us to argue for a certain conclusion, but it is not “proof” because there is always the possibility that we are wrong. Al- though participants are always measured, different variables can produce scores that have different underlying mathematical characteristics. The particular mathematical characteristics of the scores also determine which descriptive or inferential procedure to use. Therefore, always pay attention to two important characteristics of the vari- ables: the type of measurement scale involved and whether the scale is continuous or discrete. The Four Types of Measurement Scales Numbers mean different things in different contexts. The meaning of the number 1 on a license plate is different from the meaning of the number 1 in a race, which is differ- ent still from the meaning of the number 1 in a hockey score. The kind of information that a score conveys depends on the scale of measurement that is used in measuring it. There are four types of measurement scales: nominal, ordinal, interval, and ratio. With a nominal scale, each score does not actually indicate an amount; rather, it is used for identification. The key here is that nominal scores indicate only that one individual is qualitatively different from another, so in research, nominal scores classify or categorize individuals. For example, in a correlational study, we might measure the political affiliation of participants by asking if they are Democrat, Republican, or “Other. Then we might also measure participants’ income, to determine whether as party affiliation “scores” change, income scores also change. Or, if an experiment compares the conditions of male and female, then the independent variable is a nominal, categorical variable, where we might assign a “1” to identify each male, and a “2” to identify each female. Because we assign the num- bers arbitrarily, they do not have the mathematical properties that numbers normally have. For example, here the number 1 does not indicate more than 0 but less than 2 as it usually does. The key here is that ordinal scores indicate only a relative amount—identifying who scored relatively high or low. Also, there is no zero in ranks, and the same amount does not separate every pair of adjacent scores: 1st may be only slightly ahead of 2nd, but 2nd may be miles ahead of 3rd. Here each score indicates an actual quantity, and an equal amount separates any adjacent scores. Therefore, the key here is that you can have less than zero, so an interval scale allows negative numbers. For example, temperature (in Celsius or Fahrenheit) involves an in- terval scale: Because 0° does not mean that zero heat is present, you can have even less heat at 21°. In research, interval scales are common with intelligence or personality tests: A score of zero does not mean zero intelligence or zero personality. Or, in our studying research we might determine the average test score and then assign students a zero if they are average, a 1, 2, and so on, for the amount they are above average, and a 1, 2, and so on, for the amount they are below average. Or, if we create conditions based on whether participants are in a positive, negative, or neutral mood, then this indepen- dent variable reflects an interval scale. Notice that with an interval scale, it is incorrect to make “ratio” statements that com- pare one score to another score. However, if we measure the same physical temperatures using the Fahren- heit scale, we would have about 35° and 39°, respectively. Essentially, if we don’t know the true amount of a variable that is present at 0, then we don’t know the true amount that is present at any other score. Only with our final scale of measurement, a ratio scale, do the scores reflect the true amount of the variable that is present. Here the scores measure an actual amount, there is an equal unit of measurement, and 0 truly means that none of the variable is present. The key here is that you cannot have negative numbers because you cannot have less than nothing.

Syndromes

  • The flu shot contains killed (inactive) viruses. So you cannot get the flu from this type of vaccine. Some people do get a low-grade fever for a day or two after the shot. The flu shot is approved for people age 6 months and older.
  • Swelling of the hands and face/eyes (edema)
  • School health
  • Tea and coffee
  • The incisions on your belly are closed with stitches.
  • Have pictures taken of people you see a lot and label them with their names. Place these by the door or by the phone.
  • Tricuspid regurgitation
  • What do you eat in a typical day?
  • Excessive bleeding

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Sulfur in petrola- tum (10 percent) is one of few effective scabicidal sarcoma buy 1mg finasteride with amex hair loss 7 year old, soft-tissue A sarcoma that begins in treatments that may be used safely without fear of the muscle purchase 1 mg finasteride free shipping hair loss cure xanax, fat buy finasteride cheap hair loss 8 months after pregnancy, fibrous tissue best finasteride 1 mg hair loss medicine, blood vessels, or toxicity in very small children and in pregnant other supporting tissue of the body. A comas most often occur in adolescents or young magnifying glass reveals short, wavy lines of red adults, are typically slow-growing, and may escape skin, which are the burrows made by the mites. They occur mainly Treatment involves use of several scabicide medica- in the arms and legs, near large joints, especially the tions. Although the tumor is called synovial sar- coma, it has never been shown to arise from syn- scabies, keratotic A severe form of scabies that ovial cells (the cells that line a joint), and the cell of is caused by delaying treatment of the initial infesta- origin is not known. Keratotic scabies is characterized by mite-filled coma can be suspected via X-ray or imaging, made lesions covered with scabs. These lesions often via biopsy, and confirmed via cytogenetic studies become infected with bacteria such as staphylococ- that show a translocation (an exchange of material) cus. The tumor tends to recur locally and to involve local lymph scan 1 Data or an image obtained from the exam- nodes. Distant spread (metastasis) occurs in half of ination of organs or regions of the body by gather- cases, sometimes many years after the initial diag- ing information with a sensing device. The group A streptococcal bacteria pro- duce a toxin that causes a scarlet rash that initially Schmorl’s node An upward and downward pro- appears on the neck and chest, then spreads over trusion (pushing into) of a spinal disk’s soft tissue the body, and lasts around 3 days. Scarlet fever is usually with minor degeneration of the aging spine, are not a serious illness when treated promptly with detectable via X-ray as spine abnormalities. However, untreated Schmorl’s nodes are most common in the middle streptococcal infection can cause kidney inflamma- and lower spine. Schwann cell An insulating cell found in the peripheral nervous system that surrounds nerve Scheuermann’s disease A skeletal disease that fibers (axons). Schwann cells form the myelin usually begins in adolescence in which the verte- sheath that facilitates the conduction of impulses brae grow unevenly, resulting in wedge-shaped ver- along the nerve. Also known as juvenile kyphosis and curvature of schwannoma A tumor that arises in the Schwann the spine. Although sciatica can result (flat affect), agitation, catatonia, confusion, psy- from a herniated disc pressing directly on the nerve, chosis, unusual behavior, and social withdrawal. Treatment options Treatment involves use of neuroleptic medication include avoiding movements that further irritate the and supportive interpersonal therapy. The progno- condition, use of medication, physical therapy, and sis is fairly good, with two-thirds of those diagnosed sometimes surgery. This condition is very scintigraphy A diagnostic test in which a two- rare in young children, but it occurs with more fre- dimensional picture of a body radiation source is quency in the teenage years. For known as childhood schizophrenia, but it is a com- example, scintigraphy of the biliary system (cho- pletely different disorder. See also autism; child- lescintigraphy) is done to diagnose obstruction of hood disintegrative disorder; developmental the bile ducts by a gallstone, a tumor, or another disorder; schizophrenia. The chemical • E Esophagus (esophageal involvement is removed from the blood by the liver and secreted by the scleroderma) into the bile that the liver makes. The chemical then • S Sclerodactyly (localized thickening goes everywhere that the bile goes: into the bile and tightness of the skin of the fingers or ducts, the gallbladder, and the intestine. By placing toes) over the abdomen a camera that senses radioactiv- • T Telangiectasias (dilated capillaries ity, a picture of the liver, bile ducts, and gallbladder that form tiny red areas, frequently on the can be obtained that corresponds to the location of the radioactivity. There is technique sometimes used as a supplemental test in some evidence that genes play at least a partial role the detection of breast cancer. The immune system plays a can sometimes work better than standard mam- central role in the disease process. It is not unusual mography in situations where there is considerable to find other autoimmune diseases in families of uncertainty, as in women who have especially dense scleroderma patients. The disease occurs more fre- sclera The tough white outer coat that covers the quently in females than in males. The sclera is continuous in sclerosing cholangitis See primary sclerosing the front of the eye with the cornea and in the back cholangitis. Scleritis can occur with diseases such as rheumatoid arthri- sclerosis, multiple See multiple sclerosis. Treatment may include use of anti-inflammatory and cortisone sclerotherapy The injection of a chemical irri- medications taken by mouth, intravenously, or tant into a vein to sclerose (“harden”) it. The vein turns into scar tissue sclerodactyly Localized thickening and tightness that fades from view. Sclerotherapy may be done to commonly associated with atrophy of the underlying treat varicose veins, spider veins, hemorrhoids, and soft tissues. Of every 1,000 children, 3 to 5 develop sometimes also in other organs of the body. Diffuse scleroderma affects many internal cause) scoliosis is the most common type and and external areas of the body, including the skin of appears after the age of 10, commonly in teens. Limited Girls are more likely than boys to have this type of scleroderma affects only certain body sections. Severe scoliosis may require treatment that deposits of calcium in the skin) includes bracing, casting, surgical correction, and/or physical therapy. Also known as winter blues, winter depression, and hibernation scoliosis, congenital Lateral (sideways) curv- reaction. For example, func- tional scoliosis can be caused by pain on one side of seborrheic keratosis See keratosis, seborrheic. The causes of structural scolio- Seckel syndrome A rare inherited form of sis include cerebral palsy, polio, muscular dystro- dwarfism and growth delay. Other symptoms and phy, Marfan syndrome, infections of the spine, and features associated with Seckel syndrome include tumors of the spine. Structural scoliosis is different an abnormally small head (microcephaly); varying from functional scoliosis, in which the spine degrees of mental retardation; and/or unusual char- appears to have a lateral curve (scoliosis) but is acteristic facial features including “beak-like” pro- structurally normal. The syndrome is inherited in an autosomal recessive manner and can be due to score, Apgar See Apgar score. Also known as bird-headed dwarfism, microcephalic primordial scrape An abrasion or cut that is caused by some- dwarfism, nanocephalic dwarfism, and Seckel-type thing rubbing roughly against the skin. It can cause the scurvy A disorder that is caused by lack of vita- same illnesses, including lung cancer, that actually min C. Treatment involves including foods secretin A hormone that is made by glands in the that are high in vitamin C in the diet and taking vita- small intestine whose primary function is the stimu- min C supplements if necessary. Also known as petit mal obtained via surgery is usually sectioned (sliced), seizure. The patient does not actually become unconscious, section, longitudinal See longitudinal section. The patient may have section, lower segment caesarean See cae- physical, sensory, and thought disturbances. If sedatives are misused or accidentally seizure, febrile A convulsion that occurs in asso- combined, as in the case of combining prescription ciation with a fever. Febrile seizures are common in sedatives with alcohol, they can dangerously infants and young children and are usually of no last- depress important signals that are needed to main- ing importance. The sed rate measures the rate at which red nerve function that is caused by abnormal electrical blood cells in a test tube separate from blood serum activity in a localized area of the brain.

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The most important protein produced in the stomach for inhibition of acid secretion is somatostatin purchase finasteride online from canada hair loss medication side effects. Further inhibition of gastric acid secretion is medi- ated by intestinal peptides secreted from the duodenum in response to acid pH order finasteride 5mg with amex hair loss low iron. These peptides include gastric inhibitory peptide and vasoactive intestinal peptide buy generic finasteride 1mg online hair loss legs men. Finally best order finasteride hair loss 40s, hy- perglycemia and hypertonic fluids in the duodenum also inhibit gastric acid secretion through mechanisms that are unknown. These diseases present typically with watery diarrhea in 50-to 60-year- old patients. Collagenous colitis is markedly more common in women, whereas lympho- cytic colitis has an equal sex distribution. Collagenous colitis features increased subepithelial collagen deposition and inflammation with increased intraepithelial lymphocytes. In lymphocytic colitis, there is no collagen deposition and there are greater numbers of intraepithelial lymphocytes than is the case in collagenous colitis. Treatment for collagenous colitis ranges from sulfasalazine or mesalamine to glucocorticoids, depending on severity. As more sensitive immunoassays have been developed, this window period has become less prevalent. The figure below demonstrates the time course of serum markers and clinical symptoms in acute hepatitis B. Endo- scopic ultrasonography is useful in locating the gastrin-secreting tumor once the positive secretin test is obtained. Genetic testing for mutations in the gene that encodes the menin protein can detect the fraction of patients with gastrinomas that are a manifestation of Multiple Endocrine Neoplasia type I (Wermer’s syndrome). Gastrinoma is the second most common tumor in this syndrome behind parathyroid adenoma, but its peak inci- dence is generally in the third decade. Alarm features warrant further investigation to rule out other gastrointestinal disorders such as diverticular disease or in- flammatory bowel disease. Although these patients are hypersensitive to colonic stimuli, this does not carry over to the peripheral nervous system. Elevated venous pressure leads to congestion of the hepatic sinusoids and of the central vein and centrilobular hepatocytes. Centrilobular fibrosis de- velops, and fibrosis extends outward from the central vein, not the portal triads. Budd- Chiari syndrome, or occlusion of the hepatic veins or inferior vena cava, may be confused with congestive hepatopathy. However, the signs and symptoms of congestive heart fail- ure are absent in patients with Budd-Chiari syndrome, and these patients can be easily distinguished clinically from those with heart failure. Venoocclusive disease may result from hepatic irradiation and high-dose chemotherapy in preparation for hematopoietic stem cell transplantation. Al- though echocardiography is a useful tool for assessing left and right ventricular function, findings may be unimpressive in patients with constrictive pericarditis. Cardiac magnetic resonance imaging may also be helpful in determining which patients should proceed to cardiac surgery. Somatic nerves supplying the parietal peritoneum transmit the pain stimulus, allowing localization. The pain of peritoneal in- flammation is invariably accentuated by pressure or changes in tension of the peritoneum. Asking a patient to cough will increase the intraabdominal pressure and lead to rebound tenderness without palpating the abdomen. Costovertebral angle ten- derness, a sign suggestive of pyelonephritis, and heme-positive stools are neither sensitive nor specific for peritonitis. The presence or quality of bowel sounds are not reliable physi- cal examination findings to distinguish an acute abdomen from a more benign diagnosis. The contractions are due to dysfunction of the inhibitory nerves, with pain correlating with contractions of long du- ration and large amplitude. Clinically, patients present with sharp substernal chest pain that may mimic cardiac disease with radiation to the arms, chest, and jaw. Symptoms last for a few seconds to minutes and may be related to swallowing or emotional stress. The presence of cardiac disease needs to be evaluated before consideration of a noncardiac cause of chest pain. The diagnostic proce- dure of choice is barium swallow, which shows loss of normal peristaltic contractions be- low the level of the aortic arch. Instead, there are numerous uncoordinated simultaneous contractions that produce multiple ripples in the esophageal wall with sacculation and pseudodiverticula. Treatment is aimed primarily at preventing these contractions with medications that cause smooth muscle relaxation, such as nitrates and calcium channel blockers. Scleroderma causes atrophy of the smooth muscle within the lower two-thirds of the esophagus and is represented on bar- ium swallow as dilation of the distal esophagus with loss of peristaltic contractions. Gas- troesophageal reflux disease is a common disorder that affects 15% of persons at least once per week and is marked by loss of lower esophageal sphincter tone with reflux of barium back into the distal esophagus. A strategy of vaccinating only high-risk individuals in the United States has been shown to be ineffective, and uni- versal vaccination against hepatitis B is now recommended. Routine evaluation of hepatitis serologies is not cost-effective and is not recommended. The vac- cine is given in three divided intramuscular doses at 0, 1, and 6 months. Painless jaundice always requires an extensive workup, as many of the underlying pathologies are ominous and early detection and intervention often offers the only hope for a good outcome. The cholestatic picture without significant eleva- tion of the transaminases on the liver function tests makes acute hepatitis unlikely. This is seen when there is a duodenal source of bleeding or when the nasogastric tube does not enter the stomach. Exacerbations occur during times of stress, fatigue, alcohol use, or decreased caloric intake. Crigler-Najjar syndrome type 1 is a congenital disease characterized by more dramatic elevations in bilirubin that occur first in the neonatal pe- riod. Medications and toxins may produce jaundice in the setting of cholestasis or hepatocellular injury. Obstructive cholelithiasis is characterized by right upper quad- rant pain that is often exacerbated by fatty meals. The absence of symptoms or elevation in other liver function tests also makes this diagnosis unlikely. When a Zenker’s diverticulum fills with food, it may produce dysphagia by compressing the esophagus.

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A variety of work- cell function can thus be mediated via a variety of different place chemicals are known as potentially ototoxic if exposure mechanisms discount 1mg finasteride mastercard hair loss treatment using onion, including impaired mitochondrial protein synthe- exceeds a certain level (159) cheap finasteride on line hair loss curejoy ayurveda, and there is accumulating evi- sis buy finasteride 5 mg online hair loss zones, accumulation generic finasteride 1mg with mastercard hair loss in men jobs, and defective turnover of abnormal transla- dence that many of these toxins may be able to potentiate the tion products, bioenergy insufficiency, oxidative stress, calcium ototoxicity of noise through oxidative stress mechanisms (1). Overall, the future namely the cochlear hair cells, the cells of the stria vascularis, development of efficient treatment strategies will clearly require or the spiral ganglion neurons. Based on animal studies, treatment with antioxidant gen transfer by a chemiosmotic type of mechanism. Intl Rev Cytol mice also develop a progressive impairment of hearing with 1992; 141:233–357. Sequence and organi- levels does indeed result in progressive degeneration of the zation of the human mitochondrial genome. Nature 1981; auditory system and leads to age-related hearing loss in the 290:357–465. How rapidly does the human by cyberscreening of the expressed sequence tags database. A novel mitochondrial point mitochondrial genome indicates significant differences between mutation in a maternal pedigree with sensorineural deafness. Hum patients with Alzheimer disease and controls in a French-Canadian Mutat 1994; 3:243–247. Hearing impairment and inherited variants are associated with successful aging and neurological dysfunction associated with a mutation in the mito- longevity in humans. Clustering of Caucasian Leber lactic acidosis, and stroke-like episodes: prevalence of the muta- hereditary optic neuropathy patients containing the 11778 or tion in an adult population. Maternally ground plays a role in the expression of Leber hereditary optic inherited non-syndromal hearing impairment in a Spanish family neuropathy by increasing the penetrance of the primary mutations with the 7510T C mutation in the mitochondrial 11778 and 14484. Am J Hum Genet 2003; side-induced and nonsyndromic deafness is associated with the 72:1005–1012. Mater- lymphoblastoid cell-line homoplasmic for the np 7445 deafness- nally inherited diabetes and deafness is a distinct subtype of diabetes associated mitochondrial mutation. Hum Mol Genet 1997; and associates with a single point mutation in the mitochondrial 6:443–449. Quantitative allele-spe- for the inherited susceptibility to aminoglycoside ototoxicity. Nucl Acids Res 2000; A1555G and A7445G mutations among children with prelingual 28:4350–4355. Aging: a theory based on free radical and radiation control region for replication. Mitochondrial between cardiovascular disease and cochlear function in older enzyme-deficient hippocampal neurons and choroidal cells in adults. Hearing threshold in patients mutations cause aging phenotypes without affecting reactive oxy- with diabetes mellitus. Correlations between pres- in secondary processes and spread to primary processes of strial byacusis and extrinsic noxious factors. Acta Otolaryngol Suppl 2004; bone analysis of patients with presbycusis reveals high frequency 552:16–24. Thus parents of a deaf hearing difficulties, now widely regarded as being responsible child with a clearly dominant family history may insist that the for at least 50% of permanent hearing loss both in young chil- child was deafened as a result of a pertussis infection. In certain isolated communi- year-old patients have reported that their parents’ hearing loss ties, a particular genetic cause of prelingual hearing impairment was due to “old age” even though it began at the age of 60 and may achieve a high prevalence and result in a different set of their own hearing loss dated back to such an age or younger. The present author is particularly indebted to Probably the best known example of a high prevalence of the contributions in this respect of Sylviane Chéry-Croze, congenital deafness affecting societal attitudes was the case of Lionel Collet, Berth Danermark, Lesley Jones, Sophia Martha’s Vineyard, an island off the coast of Massachusetts, Kramer, Kerstin Möller, Wanda Neary, and Hung Thai Van. The population, in that case, had a discussions, was Anna Middleton, author of the next chapter in high prevalence of a nonsyndromal recessive condition, which the present book. The aim of the working group was to provide appeared to have originated in Southeast England. The high an interface between the molecular and clinical geneticists and prevalence of the condition resulted in “deafness” being those people facing the real world problems caused by genetic regarded as a normal state and the hearing population using disorders affecting the auditory system. Hearing disorders (6), and one of the most interesting examples is found in the affecting working age and older adults are studied using both northern part of the island of Bali. Here there is a village called epidemiological approaches and clinic-based studies, and this Bengkala where some 2% to 3% of the population has congen- provides the main focus for the chapter. These are followed by a qualitative analysis of 146 Current management people’s perception of the impact of their family history on are likely to be better adjusted (15,16), to have a more positive themselves. That, in turn, leads to investigations of such an coping framework (17) and less likely to have psychiatric prob- impact on activity limitations and participation restrictions, lems (18). It has been strongly argued that many such differ- motivation for seeking rehabilitative help, and on rehabilita- ences may be attributable to early and effective mother–child tive outcomes. This is followed by a consideration of the influ- communication, leading to the development of a more stable ence of a family history on the impact of tinnitus and finally by individual (19). Recently a large-scale study on children death may occur and which generally presents with a hearing loss. Overall, in nonsyndromal hearing impairment, it would The results for 338 children whose parents had some hearing seem that a family history with role models available is what difficulties were compared with those of 2519 children whose has had the greatest effect on people affected themselves, rather parents had no such difficulties. The total impact of that ethnicity, average unaided hearing level, age of onset of hearing from a psychosocial standpoint is also relatively modest com- impairment, additional hearing disabilities, parental occupation, pared with other factors such as the severity of the impairment and cochlear implantation, they examined any effect of family and the age of its onset. This indicates that, while the auditory receptive communi- cation of those children with hearing-impaired parents was poorer, their sign language skills were better. It also supports the Family history influences earlier findings of better academic achievement in those children in children These studies date back to the 1940s, but two important inves- Table 10. These, together with a num- parents differed from those with hearing parents ber of related investigations, have been discussed in some detail elsewhere (13), but may be summarised as indicating that it is Communicative skills — the fact of having deaf parents, which is important, rather than a Auditory receptive capabilities Poorer having a specific genetic disorder. No significant difference between the four a Key stage attainments Higher groups in terms of the youngsters’ speech intelligibility was Participation and engagement Better found, but those with deaf parents performed significantly bet- a in education ter than the other three groups in terms of their reading age and in a speech comprehension ratio of lipreading. Interestingly, in a Need for help with social Less need 20-year follow-up of these young people, it was found that those activities, e. Psychosocial aspects of genetic hearing impairment 147 with hearing-impaired parents. Finally, in reported quality of life, It may be noted, however, that this group of children do not have those children with hearing-impaired parents felt less positive the negative feelings about life indicated in the broader study. The results for the other three subject groups are less clear, Unfortunately that study considered neither the severity of although three findings were significant at the (P 0. Those children with one or more Those with one or both parents with “some hearing siblings with hearing difficulties were reported by their teachers difficulties”; as achieving better key stage results in their education. The Those with one or more siblings totally deaf, but hearing factors responsible for such results are not immediately clear parents; and certainly more research is needed in this field. Those with one or more siblings with some hearing diffi- culties, but hearing parents; Those with neither parents nor siblings with hearing problems. Effects of a family history The first four groups were each compared with group 5 after of hearing problems in adults controlling for the demographic and other variables considered in the earlier analysis. The Blue differed from those with hearing parents Mountain survey combined audiometry and questionnaires and was administered to 2956 participants aged 49 years and older. These indicated that, after controlling for age a Engagement in education Better and sex, those with a parental family history of hearing loss had sig- Quality of life nificantly worse hearing than those without (Fig. This shows that while the survey, the question “Do you have difficulty with your hearing?

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