碩士 / 長榮大學 / 職業安全與衛生學系碩士班 / 98 / City cleaning staffs are responsible for street neat and tidy in the city. At work, they not only have to carry trash following the dump truck along the street; but also have to clean the ditches and sweep the streets. This job, with working hours extending from day to evening, is an extremely physically exerted work. This study used public and private city cleaning staffs as research population to investigate their workplace hazard and health problems. A structured questionnaire was administered to the study population. Finally, three hundred and ninety three completed questionnaires were available for the data analysis. Data collected in the questionnaire included personal characteristics, job factors, workplace hazards and health problems. Prevalent rates for workplace hazards and health problems were first analyzed; and afterward Chi-square test was applied to analyze the relationship between personal characteristics, job factors, workplace hazards, and health problems. Study results show that the most prominent self-reported health problems among city cleaning staffs were joint pain and soreness (19.6%), following by heat stroke (18.3%), common cold (17.3%), sweating (14.8%), and skin disease (14.5%). For workplace hazards, the five most reported hazards were: street crowded with people and cars (31.8%), narrow alley (26.2%), trash contamination (22.6%), little rest time (22.6%), and traffic noise (16.5%). For personal protective equipment (PPE), the most used PPE was reflective safety vest (81%), work uniform (64%), dusk mask (46%), clothed glove (46%), rubber glove (28%), and active carbon mask (26%). Analysis also reveals that work type (driving, sweeping, carrying trash, cleaning ditches and replacement) was significantly different with many health problems, such as heat stroke, common cold, sweating, strong dazzling light, eye dazzling, decreased eyesight, burn, noise, hearing loss, joint pain and soreness, nerve injury, neck and shoulder injury, and insomnia. For relationship between workplace hazards and health problems, it was found that eye problems were related to traffic dusk, chemical and biological contamination in trash and dazzling light; respiratory track problems were related to traffic dusk, chemical and biological contamination in trash; tinnitus and hearing loss was related to loud music conveying of the dump truck and traffic noise; body temperature associated symptoms were related to extreme environmental temperatures, biological contamination in trash and ditch cleaning; skin disease and erosion were related to chemical and biological contamination during trash collection; join pain and soreness was related to speeding of the dump truck, vibration, furniture carrying, trash collection and ditch cleaning; back pain and soreness and muscular skeletal problems were related to heavy weight carrying. The work of cleaning staffs, that handle wastes and maintain the environment, is in the terminal end of our living environment. They face complicated environment where trash materials mix with harmful agents and the outdoor temperature vary extremely. Under such circumstances, personal protective equipments are observed relatively in shortage and even under improper usage condition. We suggest that environmental agencies should put more efforts in revising current occupational safety and health policy toward the city cleaning staffs and provide proper and sufficient personal protective equipment for their usage.

碩士 / 明新科技大學 / 化學工程與材料科技系碩士班 / 103 / Armillariella mellea is one of the fungi food-medicine mushroom with the effects of tranquilizing central nervous and reducing death rate of mice inducing by nicotine. Simultaneously, it can treat dizziness, palsy, insomnia, tinnitus, etc. Many researchers demonstrated that A. mellea polysaccharide has excellent anti-tumor activies. Recently, although many researchers focus on activity components and fermentation products as well as development in health-food, little literature was reported concerning effect of plant oils and Vitamins supplement on production and insulinotropic activity of polysaccharides of A. mellea by submerged culture. Thus, the project was proposed to investigate the effect of plant oils and vitamins on the production of polysaccharide in submerged culture of A. mellea and their antioxidant properties. Amongst the various plant oils and vitamins tested, 0.2% (w/v) Thiamine hydrochloride (Vit.B1 . HCl) and 0.2% (v/v) Cotton oil exhibited the greatest biomass and exopolysaccharoide production. In 5 L stirred tank bioreactor culture, adding 0.2% (v/v) cotton oil to medium can obtain the maximum biomass and exopolysaccharide production with 7.41 gL-1及0.43 mg mL-1, respectively. Adding 0.2% (w/v) Vit.B1 . HCl to medium can obtain the maximum biomass and exopolysaccharide production with 17.9 gL-1及0.41 mgmL-1, respectively. Besides, in 20 L stirred tank bioreactor culture, adding 0.2% (v/v) Cotton oil to medium also can obtain the maximum biomass and exopolysaccharide production with 9.01 gL-1 and 0.46 mgmL-1, respectively. Four fractions (EPS-A, EPS-B, EPS-C, and EPS-D) of exopolysaccharide isolated from 20 L stirred tank bioreactor culture show 1.28×104 Da, 1.36×104 Da, 6.82×103 Da, and 1×104 Da of molecular weights, respectively. Molecular weight of exopolysaccharide from 20L stirred tank bioreactor culture is 2.31×106 Da. The protein/polysaccharide ratios of four fractions (EPS-A, EPS-B, EPS-C, and EPS-D) are 28.21%, 27.04%, 27.39%, and 28.09%, respectively. The protein/polysaccharide ratio of exopolysaccharide from 20L stirred tank bioreactor culture is 28.32%. Antioxidant activity results of four fractions (EPS-A, EPS-B, EPS-C, and EPS-D) point out that EPS-A has a higher reducing powers with 0.008 mgmL-1 of EC50, EPS-B has better scavenging effects on 1,1-diphenol-2-picrylhydrazyl radicals with 0.15 mgmL-1 of EC50, EPS-C shows the low EC50 values of chelating effects of 1.74 mgmL-1. The exopolysaccharide from 20L stirred tank bioreactor culture exhibited a high antioxidant activity and scavenging effects on superoxide anions with EC50 values of 0.6 mgmL-1 and 0.56 mgmL-1, respectively. EC50 values of EPS-D are below 8.64 mgmL-1 indicating good antioxidant activities. Because all EC50 are below 10 mgmL-1 except scavenging effects on superoxide anions of EPS-A and EPS-B with EC50 values of 16.14 mgmL-1 and 11.58 mgmL-1, respectively, polysaccharides from A. mellea submerged culture are of exceptional antioxidant activities.

Hintergrund: Der Morbus Menière beeinträchtigt durch seine charakteristischen Symptome die Lebensqualität der Betroffenen nachhaltig und in vielfältiger Weise. Nach erfolglosen konservativ-medikamentösen Maßnahmen verbleibt als Lebensqualität-verbessernde Therapie neben der transtympanalen Gentamicinapplikation nur die chirurgische Intervention. Patienten und Methoden: Im Zeitraum von 1989 bis 2001 wurden 151 Patienten mit Morbus Menière saccotomiert. 56.3% waren männlich und 43.7% weiblich. Das mittlere Alter lag bei 48.4 Jahre. Bei 76% der Patienten war der Ersteingriff erfolgreich. 32 Patienten (21.2%) benötigten nach der Saccotomie eine Saccusrevision und bei 4 Patienten erfolgte nach der Saccotomie/Resaccotomie eine transtemporale bzw. translabyrinthäre Neurektomie. Ergebnisse: Bei 69% der erstoperierten Patienten besserten sich Dauer, Schwere und Frequenz der Schwindelanfälle dauerhaft, wobei ein Drittel aller Patienten vollkommen beschwerdefrei wurde. Die mittlere Nachbeobachtungszeit betrug 85.3 Monate. Bei 11 Patienten traten intra-/postoperative Komplikationen nach Saccotomie auf. Bei 4 Patienten (2,7%) kam es zu einer Duraverletzung und bei 3 Patienten (2%) zu einer Eröffnung des Bogenganges mit anschließender Ertaubung. Eine Verletzung des N. facialis trat in keinem Fall auf. Insgesamt ertaubten 7 Patienten (4.6%) nach Saccotomie, wobei in allen Fällen präoperativ eine pancochleäre Schwerhörigkeit von 60–70 dB bestand. Schlussfolgerung: Auch im Vergleich zu publizierten Ergebnissen nach transtympanaler Gentamicintherapie bleiben differenzierte chirurgische Konzepte zentrale Therapiepfeiler in der Behandlung des Morbus Menière, die bei Versagen konservativer Möglichkeiten komplikationsarm eingesetzt werden können. / Background: Among the typical symptoms in Menière’s disease, attacks of vertigo, hearing loss, tinnitus and fullness of the ear, vertigo is the most molesting symptom patients complain about. If conservative treatment failed to reduce the severity and frequency of vertigo attacks, surgical treatment is beside transtympanic gentamicin application the only effort to improve quality of life. Patients and methods: 151 patients, who underwent endolymphatic sac surgery at the ENT-Department of the University of Würzburg, were analysed retrospectively by records and questionnaire. 43.7% were females and 56.3% males. The age was between 18 and 80 years on average 48.4 years. 32 patients (21.2%) underwent endolymphatic sac revision surgery after having an asymptomatic period up to 2 years after first surgery. Results: Duration, severity and frequency of vertigo were controlled permanently in 75% of the patients by endolymphatic sac surgery, 80% of them were completely and permanently free of any symptoms. The mean follow-up period comprised 7 years. 7 patients (4.6%) deafened after surgery; all of them had a preoperative pancochlear hearing loss of 60-70 dB. Other relevant complications didn’t occur. Conclusion: Compared to the results of transtympanic gentamicin application with rates of deafness up to 25 to 40 % endolymphatic sac surgery is a safe and effective treatment of Menière’s disease and should be taken into account, when conservative treatment failed.

Made available in DSpace on 2016-04-27T18:12:15Z (GMT). No. of bitstreams: 1 Dissertacao ISABELA FREIXO CORTES.pdf: 748379 bytes, checksum: c0a989077152897b66ad2094af8a32c0 (MD5) Previous issue date: 2006-07-25 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Objective: The aim of this research was to study auditory and extra-auditory complaints of physical education teachers exposed to electronically amplified music, to describe the audiometric findings and to investigate the influence of the variables, time in the profession, work-journey and the presence of audiometric notch. Method: A number of 32 teachers were evaluated, aged from 21 to 35 years old, with at least one year of working and daily exposition of four hours to electronically amplified music. Besides occupational and clinical anamnesis pure tone thresholds were analyzed according to the presence of audiometric notch. Results: Most of the teachers (87,5%) have had extra-occupational exposure. The most frequent complaints were dizziness (12,5%); irritability and nervousness (28,1%); insomnia (31,3%); headache (37,5%); tinnitus (28,10%); aural fullness (18,8%); and difficulty to hear, sometimes (43,8%). Concerning to the audiometric findings, 90,62% of the teachers did not have hearing losses, against 9,37% who did. Bilateral neurossensorial loss was present in 3,12%; increased audiometric thresholds 3kHz and 4kHz in 6,25%. The frequency of 6 kHz was the most reached by the audiometric notch, and half of the teachers had it in at least one hear. Conclusion: There was no statistic significant difference comparing audiometric incision with teachers complains or with time of profession and wok journey. Making physical education teachers aware the risks of electronic amplified music can offer to the hearing system and health in general, is fundamental / Os objetivos desta pesquisa foram estudar as queixas auditivas e extra-auditivas em professores de uma academia de ginástica expostos à música eletronicamente amplificada, descrever os achados audiométricos e investigar a influência das variáveis, tempo de profissão, carga horária de trabalho e presença de entalhe audiométrico. Método: Foram avaliados 32 professores, com idade entre 21 à 35 anos, tendo no mínimo um ano de atuação e exposição diária mínima de quatro horas à música eletronicamente amplificada. Além da anamnese clínica e ocupacional, foram analisados os limiares tonais por via aérea dos professores quanto à presença de entalhe audiométrico.Resultados: Verificamos uma elevada porcentagem de professores (87,50%) com exposições extra-ocupacionais. As queixas mais freqüentes foram: tontura (12,5%); irritabilidade e nervosismo (28,1%); insônia (31,3%); dor de cabeça (37,5%); zumbido (28,10%); plenitude auricular (18,80%) e dificuldade de escutar, às vezes (43,8%). Em relação aos achados audiométricos, 90,62% dos professores não apresentaram perdas auditivas, contra 9,37% que apresentaram alteração, 3,12% por perda neurossensorial bilateral e 6,25% queda nas freqüências de 3kHz ou 4kHz. A freqüência mais acometida pelo entalhe audiométrico foi a de 6kHz, sendo que 50,00% o apresentaram em, pelo menos, uma orelha. Conclusão: Não houve diferença estatisticamente significante comparando o tempo de profissão e as horas trabalhadas com os resultados do entalhe audiométrico e nem comparando o entalhe com as queixas dos professores. Orientar os professores de academias de ginástica a respeito dos riscos que a música eletronicamente amplificada pode oferecer ao sistema auditivo e à saúde é primordial

Made available in DSpace on 2016-04-27T18:12:39Z (GMT). No. of bitstreams: 1 Millena Nobrega Campos de Sousa.pdf: 1030142 bytes, checksum: fc11f9c7d90aa6efa2c5cd789b259a0e (MD5) Previous issue date: 2009-02-19 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / Introduction: The electronically amplified music represents an occupational exposure to noise for employees of nightclubs. Such exposure can cause health effects of these workers. Aim: Verifying the effects of noise on hearing and health of employees of nightclubs in the city of Sao Paulo, exposed to electronically amplified music. Method: The sample comprised 50 employees of two nightclubs in the city of Sao Paulo. The procedures were performed: anamnesis, tympanometry and Distortion-Product Otoacoustic Emissions (DPOAE). Results: The most complaints were: tinnitus (18.0%) and intolerance to loud sounds (16.0%), headache (24.0%) and insomnia (22.0%), respectively. Most employees 31(81.6%) reported audiometry within the normal pattern of bilateral normality. The DPOAE test showed absence of responses in the left ear in 21 (42.0%) employees and 17 (34.0%) in the right ear. The absence was bilateral in 22% of the sample (n = 11). The most affected were f2 3174 Hz, 4004 Hz and 6348 Hz. There was a correlation between the results of DPOAE of the right ear with only the variables complained of dizziness and smoking habits. Conclusion: The DPOAE test may be useful for early identification of changes that come in a PAIR employees exposed to electronically amplified music / Introdução: A música eletronicamente amplificada representa a exposição ocupacional a ruído para funcionários de casas noturnas. Tal exposição pode ocasionar efeitos na saúde destes trabalhadores. Objetivos: Verificar a ocorrência dos efeitos do ruído sobre a audição e a saúde em funcionários de casas noturnas da cidade de São Paulo, expostos à música eletronicamente amplificada. Método: A amostra foi composta por 50 funcionários de duas casas noturnas da cidade de São Paulo. Os procedimentos realizados foram: questionário, timpanometria e teste de emissões otoacústicas - produto de distorção (EOAPD). Resultados: As queixas mais encontradas foram: zumbido (18,0%) e intolerância a sons fortes (16,0%), dor de cabeça (24,0%) e insônia (22,0%), respectivamente. A maioria dos funcionários 31 (81,6%) relatou audiometria dentro dos padrões de normalidade. O teste de EOAPD apresentou ausência de respostas na orelha esquerda em 21 (42,0%) funcionários e em 17 (34,0%) na orelha direita. A ausência bilateral ocorreu em 22% da amostra (n=11). As f2 mais acometidas foram 3174 Hz, 4004 Hz e 6348 Hz. Houve correlação entre os resultados da EOAPD da orelha direita apenas com as variáveis queixa de tontura e hábito de fumar. Conclusão: O teste de EOAPD pode ser útil na identificação precoce das alterações que procedem a PAIR em funcionários expostos à música eletronicamente

碩士 / 明新科技大學 / 化學工程研究所 / 98 / Armillariella mellea is one of the fungi food-medicine mushrooms to tranquilize the central nervous system and to reduce the mice death rate induced by nicotine. It can also treat dizziness, palsy, insomnia, tinnitus, etc., simultaneously. Many researchers have demonstrated that A. mellea polysaccharides are excellent in anti-tumor and antioxidant activities. Emphasis of this study has been laid upon the culture condition optimization in 20-L stirred-tank cultures and the isolation of exopolysaccharides (EPS) from A. mellea for the investigation of antioxidant activities and structure characteristics. The crude EPS from submerged cultures of A. mellea was purified by using Sepharose CL-4B column chromatography with two EPS peaks (EPS-A and EPS-B) eluted. Antioxidant activity results point out that EPS-B has high reducing powers, scavenging effects on 1,1-diphenol-2-picrylhydrazyl radicals and antioxidant activities. Corresponding EC50 values are 14.44 mgmL-1, 2.28 mgmL-1 and 3.41 mgmL-1. The high EC50 values of chelating effects and scavenging effects on superoxide anions of EPS-A are 2.06 mgmL-1 and 0.12 mgmL-1, respectively. Because all EC50 are below 10 mgmL-1 except reducing powers, EPS-A and EPS-B in A. mellea are of exceptional antioxidant activities. In addition, the protein/polysaccharide ratios of EPS-A and EPS-B are 21.74% and 9.12%, respectively. Molecular weight analyses of EPS-A and EPS-B by using Molecular Sieve chromatography tell that EPS-A is 1.39×105 Da in mocecular weight and EPS-B is 1.19×104 Da. Composition analyses of neutral monosaccharides in EPS-A and EPS-B reveal that glucose is the major monosaccharide of EPS-A w galactose and glucose are the major monosaccharides of EPS-B. Structures were elucidated by NMR in 1H-NMR and 13C-NMR spectral for comparison with known compounds that have β-D-glucan chains. IR spectrum shows an absorption bond of sugar functional group from polysaccharides. The higher the polysaccharide concentration, the more the murine tumor necrosis factor-alpha (mTNF-α). The maximum mTNF-α concentration values of EPS-A and EPS-B are 740.36±22.81 pgmL-1 and 680.10±12.60 pgmL-1, respectively. Comprehensive results confirm that the bigger the molecular weights of purified polysaccharides, the better the murine tumor necrosis factor-alpha (mTNF-α) values. Higher ratios of protein/polysaccharide of purified polysaccharides correspond proportionally to better murine tumor necrosis factor-alpha (mTNF-α) values. With the structure of purified polysaccharides, murine tumor necrosis factor-alpha (mTNF-α) values are related to the structure of purified polysaccharids containingβ-D-glucan. The higher molecular weight and protein/polysaccharide ratio of purified polysaccharides bear out antioxidant activities of better chelating effects and scavenging effects on superoxide anions. Since the molecular weight is related to protein/polysaccharide ratios of purified polysaccharides, the lower molecular weight and protein/polysaccharide ratios of purified polysaccharides are beneficial to reducing powers, scavenging effects on 1,1-diphenol-2-picrylhydrazyl radicals and antioxidant activities.

This research had the objective of proposing an otoneurological anamneses focused on children, and describing the profile of body balance in children from five to 13 years old, with the help of the "FOAM-LASER" Dynamic Posturography. This research included 253 children aged from five to 13 years, who attend public schools in Santa Maria RS; all of these individuals presented the Term of Free and Informed Consent signed by their parents or caretakers. After the permission of the school principals, an objective questionnaire was sent to school students and their parents. The questions were elaborated considering the literature on balance to investigate complaints related to the balance in school students. From the 253 subjects who answered to the questionnaires, 96 were submitted to the "FOAM-LASER" Dynamic Posturography, instrument which helps in the diagnosis of the change in postural balance; all data underwent statistical analysis. Considering the results related to these questionnaires, it was observed association between dizziness complaint and tendency to fall, sideways deviation when walking, difficulty playing, being very quiet, irritable, distracted, having trouble sleeping, fear of height, headache, having tinnitus, but listening well and presenting difficulty in learning, difficulty in reading, difficulty in writing, difficulty in understanding. These features can assist the diagnosis of childhood vestibular showing that this instrument can be adopted for such purpose. In relation to the results of "FOAM-LASER" Dynamic Posturography, it was verified that postural balance improved while children grew up and their systems matured. Furthermore, it is noted that the TOS III and VI are the ones that present greater variation during child development. / Este estudo teve como objetivo propor uma anamnese otoneurológica voltada para crianças, e traçar o perfil do equilíbrio corporal em crianças de cinco a 13 anos, com auxílio da Posturografia Dinâmica FOAM-LASER . Participaram deste estudo 253 crianças com idades entre cinco a 13 anos de idade, que frequentam escolas municipais da cidade de Santa Maria RS, todas as crianças apresentaram Termo de Consentimento Livre e Esclarecido TCLE assinado por seus pais ou responsáveis. Após autorização dos diretores das escolas foram enviados aos escolares e a seus pais um questionário objetivo, sendo que as questões foram elaboradas com base na literatura sobre o equilíbrio para investigar queixas relacionadas ao equilíbrio em escolares. Dos 253 sujeitos, que responderam aos questionários, 96 foram submetidos à Posturografia Dinâmica FOAM-LASER , instrumento este que auxilia no diagnóstico da alteração do equilíbrio postural; todos os dados passaram por tratamento estatístico. Quanto aos resultados referentes aos questionários observou-se que houve associação entre a queixa de tontura e tendência a cair, desvio para os lados ao caminhar, dificuldade para brincar, ser muito quieto, irritado, desatento, ter sono agitado, medo de altura, dor de cabeça, ter zumbido, porém ouvir bem e apresentar dificuldade de aprendizagem, dificuldade de leitura, dificuldade de escrita, dificuldade de compreensão. Estas características podem auxiliar no diagnóstico da vestibulopatia na infância mostrando que este instrumento pode ser usado para este fim. Em relação aos resultados da Posturografia Dinâmica FOAM-LASER observou-se que o equilíbrio postural aprimorou-se a medida que a criança foi crescendo e os seus sistemas foram maturando. Ainda, nota-se que os TOS III e VI são aqueles que apresentam maior variação ao longo do desenvolvimento infantil.

Magister Public Health - MPH / Namibia is currently coping with a dual burden of human immunodeficiency (HIV) and HIV-associated tuberculosis (TB). In 2010, HIV prevalence was 18.8%, the TB case notification rate was 634 per 100,000 population, while TB/HIV co-infection was 58% in 2009. There were 372 reported cases of drug-resistant TB (DR-TB) in 2009. This study assessed the prevalence, profile and outcome of adverse events (AEs) associated with the treatment of DR-TB, and risk factors for the adverse events. The researcher used a cross-sectional design. Data was collected from the treatment records of all patients treated for DR-TB (N = 59) at the study facility between January 2008 and February 2010. Descriptive statistics were used to describe the frequency of the adverse events and logistic regression to analyse the association between possible risk factors and (specific) adverse events, with stratification (sub-group analysis) and multivariate analysis to adjust for measured confounders. Results of logistic regression analysis are reported as odds ratio (OR), 95% confidence interval (CI) and p-value, where p<0.05 was considered to be statistically significant. A total of 141 adverse events were experienced by 90% (53/59) of patients in the sample. HIV-associated TB occurred in 31 (53%) of the sample. The prevalence of gastrointestinal tract (GIT) adverse events was 64%, tinnitus 45%, joint pain 28% and decreased hearing 25%. Abdominal pain, rash, nausea, decreased hearing and joint pain were found to be more common in people living with HIV than in HIV-negative patients. Moderate-to-severe adverse events were mostly experienced after four weeks of DR-TB treatment (OR 6.4; 95% CI 1.6 – 25.6, p= 0.01). Drug-resistant TB patients who were coinfected with HIV were more prone to experiencing three or more adverse events (OR 3.9; 95% CI 1.2 – 13.6, p= 0.03). Patients treated with zidovudine-based ART were at an increased risk of experiencing nausea (OR 7.5; 95% CI 1.1 -51.5, p=0.04). Females were associated with an increased risk of skin rash (OR 15.7; 95% CI 1.7 – 143.7, p=0.01). The use of cycloserine-based DR-TB regimens was associated with joint pain (OR 6.5; 95% CI 1.6 – 25.8, p=0.01), while the risk of ototoxicity was associated with the use of amikacin-containing regimens (OR 12.0; 95% CI 1.3 – 111.3, p=0.03). Adverse events were found to be more common among patients treated for DR-TB (90% prevalence), particularly during the intensive phase of TB therapy. Most of these adverse events were mild and tolerable. Some adverse events were more common among DR-TB patients who were co-infected with HIV than in HIV-negative patients. The characteristics and risk factors of the serious adverse events need further research. The use of cycloserine-based DR-TB regimens was associated with joint pain. Findings of the risk factor analysis are inconclusive because of the small sample size, which severely limited the power of the study. Clinicians should invest more time in the prevention and management of adverse events, and should pay greater attention to the needs of HIV co-infected DR-TB patients who are using second-line anti-TB medications, especially those who are concomitantly undergoing treatment using antiretroviral medicines.

The acoustical environment (noise and reverberation) in eating establishments (EEs) is one of the most commonly overlooked design factors; and yet one of the most important. It can cause problems with verbal communication, especially for the hearing-impaired and second-language people. In extreme cases, too much noise can affect the health and safety of EE employees. Thus, to investigate acoustical environments in EEs, this research study was initiated. The objective was to evaluate the acoustical conditions to which customers and workers are exposed. It was to investigate how to optimize acoustical environments in EEs by way of room-acoustical design, acoustical treatment and noise control. Three EEs of three different types (restaurants, bistros and cafeterias) on and off the UBC campus were studied. To include hard-of-hearing people, two seniors’ homes were also included. To evaluate the acoustical environment of each establishment, Reverberation Time and of noise levels in the unoccupied and occupied EEs were measured. RTs were longer than optimal in unoccupied and occupied EEs due to low absorption. Noise levels varied from 42.5 to 61.5 dBA in unoccupied situations, and from 55.3 to 74.5 dBA when occupied. The noise exposure of employees was also measured. Employees’ daily noise exposure, on average, varied from 59.7 to 83.7 dBA, in compliance with the BC Worksafe regulations. Customer and employee questionnaires asking about the effect of the acoustical environment and factors that affect it, were developed, administered and analyzed. According to the responses, people visiting EEs tend to fall into two groups - one which visits for eating/drinking, talking and relaxing, the other for working/studying, business, celebration and relaxing - with different expectations of eating out. On average, they prefer to dine in a quiet environment with an appropriately low level of music. Sources of noise, such as people talking, moving, kitchen activities and equipment caused employees to suffer from fatigue, headache and tinnitus. Further analysis of measured occupied noise levels showed that customers used Casual to Raised voice levels for conversation, increasing their voice levels with increasing noise level (the Lombard Effect) at a rate of 0.7 dB/dB. Signal-to-noise level difference varied from -12 to 10 dBA. Predicted voice levels with an existing "Lombard prediction" model which developed in parallel with this work was use to predict speech intelligibility and speech privacy at a typical seating position in an EE. Predictions were made of Speech Transmission Index and its components, Early Decay Time and A-weighted Speech to Noise level difference in one of the studied EEs using the CATT-Acoustic software. Different acoustical treatments (e.g. adding absorption, barriers, lowering the density and decreasing the receiver to talker distance) were evaluated. It was found that the most effective treatment was inserting absorptive barriers with the addition of absorptive ceilings, which led to good Speech Intelligibility and normal voice level. Reducing the distance between talkers and receivers is another solution, but this may not always be feasible. Table size, receive-talker relationship and the number of the people in groups limit this solution. / Applied Science, Faculty of / Mechanical Engineering, Department of / Graduate

Aims and Objectives. This study aimed to describe auditory characteristics and balance function in patients with diabetes between 18-55 years of age as well as determine the association between patients' auditory and balance function with diabetes characteristics (type, duration and control). Background. Diabetes is one of the most prevalent non-communicable diseases worldwide with approximately 422 million people diagnosed globally. This number is projected to rise to 642 million by 2040 if no appropriate interventions are implemented to reverse the rise in the number of people with diabetes. South Africa has the second highest diabetes prevalence in Africa (after Nigeria) with 2.6 million cases. A rise in diabetes prevalence should be a concern for audiologists with increasing literature linking diabetes with the risk of acquiring hearing and balance disorders. However, there is currently a lack of research done in South Africa to investigate auditory and balance disorders in patients with diabetes. Therefore, the current study sought to investigate auditory characteristics and balance function in South African patients diagnosed with diabetes. It is anticipated that the study findings will yield evidence that will highlight the role of an audiologist in the clinical management of patients with diabetes. Research Design. The study utilised an observational cross-sectional matched groups design with a cohort (patients with diabetes) and control (volunteers without diabetes) group of participants. Participants were recruited from a Primary Health Care clinic in Polokwane, Limpopo using purposive and convenience sampling for the cohort and control group respectively. Methodology. Several methods were used to collect data pertinent to this study. These included case history interview and a medical folder review to obtain information related to participants' diabetes status. Furthermore, all participants underwent the following assessments: otoscopy, pure tone audiometry, diagnostic distortion product otoacoustic emissions (DPOAE), vision screening, peripheral neuropathy screening, Dynamic Gait Index test (DGI) and the Modified Clinical Test of Sensory Integration (MCTSIB). Data were analyzed using both descriptive and inferential statistical tests. Results. A total of 192 participants took part in this study; 110 in the cohort and 82 in the control group. There were similar distributions of gender in both groups with the following age distributions (in years) for each group; cohort; median =46, range =20-55, control; median =43, range =21-55. Pure tone audiometry assessments showed a significantly higher prevalence of hearing loss in the cohort (55%) when compared to the control (20%) group (p < .001). Participant age, gender and diabetes duration were associated with the likelihood of having hearing loss (age: odds ratio=2.90, 95% CI: 1.19-7.08, p=0.019; gender (male): odds ratio=.266, 95% CI: .104-.677, p=0.005; diabetes duration: odds ratio=1.12, 95% CI: 1.02-1.22, p=0.013). DPOAE assessments showed significantly higher percentages of abnormalities with signal to noise ratio (p < 0.01) and DPOAE level (p < 0.01) in the cohort compared to the control group. A significantly higher proportion (38%) of participants in the cohort group reported tinnitus when compared to 15% in the control (p < .001). Balance screening assessments with the DGI and the MCTSIB, showed significantly poorer performance in the cohort group than the control (DGI:, p < .001; MCTSIB: p < .001). Conclusion. Overall findings of this study showed that participants who were diagnosed with diabetes had a higher proportion of auditory and balance abnormalities when compared to those in the control group. Older age, male gender and longer duration since diabetes diagnosis were associated with a higher likelihood of having hearing loss. The findings of this study therefore suggest that auditory and balance dysfunction should be considered as comorbidities associated with diabetes. This study also highlighted the role of an audiologist in the managment of patients with diabetes with respect to early identification and management of auditory and balance dysfunctions amongst these patients.