ABSTRACT
PIP: The implications of future demographic trends for labor market and social policies in the Federal Republic of Germany are discussed. The focus is on how trends such as demographic aging and declining fertility will affect the labor market, employment, and old-age security.^ieng
Subject(s)
Age Distribution , Demography , Economics , Employment , Fertility , Forecasting , Government Programs , Old Age Assistance , Population Dynamics , Public Policy , Social Change , Social Security , Socioeconomic Factors , Age Factors , Developed Countries , Europe , Financial Management , Financing, Government , Germany, West , Health Workforce , Organization and Administration , Population , Population Characteristics , Research , Social Class , Statistics as TopicABSTRACT
The ipsilateral registered stapedius reflex is often reduced for intensity levels greater than 105 dB (SPL). Because of a reduced impedance, that is not influenced by the reflex arc, an "inverse" reflex curve can be registered. This phenomenon described by Lehnhardt et al. (1) as a "acoustic'mechanical effect" occurs without latency and interferes at levels higher than 105 dB (SPL) with the reflectory impedance change. This effect often dominates and causes a pronounced inverse ipsilateral reaction characterized by an impedance reduction. Frequently middle ears with a steep gradient of the tympanogram show an acoustic-mechanical effect. The missing reflectory component of the impedance change in deafness, in otosclerosis and in facial nerve disorders mostly causes an inverse impedance change. Investigations in temporal bone, in middle-ear models and from the middle ear of the guinea pig led to the assumption, that inverse impedance changes be related to coupling phenomenons of the tympanic-membrane and the ossicles. Excluding artifacts of the measuring device and investigating different states of the middle ear, it can be concluded, that these phenomenons are characteristic for intensity levels greater than 105 dB (SPL).
Subject(s)
Ear, Middle/innervation , Muscles/innervation , Reflex, Acoustic , Stapedius/innervation , Acoustic Impedance Tests , Animals , Deafness/physiopathology , Facial Nerve Diseases/physiopathology , Guinea Pigs , Humans , Otosclerosis/physiopathology , Stapedius/physiopathologyABSTRACT
A psychological test to size the quantitative social hearing handicap was developed by High and Fairbanks as a normative anemnesis. The splitting of the social hearing handicap index (SHHI) in the components of deafness and selection ability shows the importance of the selection ability for social hearing. Comparing the pure tone audiogramm with the SHHI of 54 patients demonstrates the low correlation of the audiogramm with the SHHI and especially its selection component. Only when the hearing loss is severe the selection component will correspond to the threshold.