What is A Healthy Sound Frequency

Sounds come in different volumes and frequencies; These are the two things we can tell apart when we hear a sound. Most people know that it is possible to lose hearing from sounds in terms of volume and intensity, but most don't know that people can lose their hearing. Hearing in terms of pitch. In particular, people can experience high frequency hearing loss. This is the case when people cannot hear sounds at higher frequencies or higher pitches. This type of hearing loss is sometimes called ski slope hearing loss because an audiogram shows a ski slope formation when analyzing a person's hearing. People with high frequency hearing loss generally cannot hear sounds above 2000 hertz, most sensitively in the 2000-5000 Hz frequency range. In this range, a person may not hear phone ringing, birds chirping, or a running drill. People with high frequency hearing loss may also have difficulty hearing a woman or child speak, and they may not be able to hear some consonants (usually F, H, S). What is a healthy sound frequency range? Read on to find out.

Human Frequency Range:

Humans typically have a frequency range of 20-20,000 Hz. Although at the 20,000 Hz end, they’ll be likely to experience discomfort. However, this is the standard for a healthy young person. We get older, our hearing gets worse. Higher frequencies are lost with age. In general, the highest frequency a middle-aged person can hear is around 1214 kilohertz (or 12,00014,000 Hz). If you are a man, your hearing is likely to deteriorate faster. Although we have a fairly limited range as humans, there are many animals that have exceptional frequency ranges.Dogs can hear between 6745,000 Hz and cats are even more impressive, hearing frequencies up to 5579 kHz. At the other end of the spectrum, whales and elephants are known to use sounds below 20 Hz that humans cannot hear (also known as infrasound) to communicate over long distances. Its sounds can travel hundreds of miles. Would you like to protect and preserve your frequency range? Fortunately, there are steps you can take to ensure your best hearing over the years.

How to preserve your hearing:

Hearing Some hearing damage is inevitable. As we age, the tiny hair cells in our ears begin to break down. When they break down, our inner ear becomes less sensitive to sound vibrations. As a result, the sounds are no longer heard as well as they were before. to.However, a lot of hearing loss can also be prevented. Exposure to loud noises, especially over a long period of time, is harmful to our hearing. To preserve your hearing, avoid hearing loud noises whenever possible, especially over long periods of time. What volume is too high? As a general rule of thumb, if you have to shout over the sound, it's too loud. When loud noises are inevitable, consider investing in good quality earplugs or earmuffs.

It is easy to recognize with a hearing test and can be supported by the use of hearing aids. However, it is important to protect your hearing as it cannot be restored if it goes away.

Attune is a leading independent provider of hearing health services. Attune, a fantastic alliance of medical professionals, understands hearing loss and how to deliver quality care and services to patients.

Why Do a Hearing Test?

 

 

From time to time your doctor may recommend a hearing test. Many people feel that only older people have difficulty keeping up with everyday noises and conversations. However, a hearing test can be fruitful for many. Even those who appear to have no obvious signs of hearing loss Clinical experts recommend adults take a hearing test every 10 years up to the age of 50. From the age of 50, a test should be done every 3 years to make sure everything is okay. Many people often have mild hearing loss, but they may not realize it as it can be a slow and gradual process.

So why get a hearing test?

• It was recently recommended by your GP
• You have never had one done before and you need to make sure they work well.
• Sometimes you notice that you can hear much more clearly on one side of your ear than on the other.
• People often repeat themselves when talking to you
• Your ears ring from time to time
• You seem to have an imbalance which could be due to an imbalance in ear fluids
• Peace of Mind and Confidence in
• Age. As you get older your cells degenerate, and so does your hearing. The exposure to sounds you’ve had your whole life slowly deteriorates your hearing and the cells inside your ear.
• You turn the TV volume up above average.
• You have an obstruction due to wax that has inadvertently affected your hearing.

It's a small process that doesn't require a lot of effort or energy. All you have to do is discuss your hearing problems. The audiologist will do a test to measure a person's level of sensitivity and capacity to hear.

Take this short survey to see if you need a hearing test. At Attune we offer a free 15-minute hearing test so you can determine if your hearing needs extra attention. Our team of trained audiologists will make sure you walk happily. So give us a call today or book an appointment online.

Hearing Aid Fitting & Assessments

 

Before your hearing aid fitting appointment your audiologist will complete a comprehensive diagnostic assessment of your hearing. This may confirm whether or not you have deafness and whether further medical investigation is needed.

If the results indicate further medical investigation, your audiologist will suggest you come to your MD for further recommendation and management and can require medical clearance before you're fitted with hearing aids. It permits your audiologist to get correct hearing thresholds and therefore prescribe the correct hearing aids to you.

The assessment will embrace a series of tests that all give the audiologist with a pic of your hearing and ear health at that moment in time. As a result of hearing will and will modification over time, it's necessary that you simply get regular hearing tests at a frequency suggested by your audiologist to observe your deafness and guarantee your hearing aids are optimally fitted.

Hearing aids

Hearing aids are devices which amplify sound to assist individuals with hearing loss to listen to better. How do they work?

Hearing aids are created of totally different components together with a microphone, electronic equipment and a speaker.

• Microphone: Picks up sound motion within the air and turns this into electrical signals.
• Amplifier: Raises the extent of the electrical signal.
• Speaker: Transmits the signal back to the ear.

Varieties of hearing aids

There are varied types of hearing aids on the market. Your audiologist can discuss which of them are acceptable given your hearing loss, needs, wants, and lifestyle. loosely the kinds of hearing aids include:

• Behind the ear (BTE): a chunk that sits behind the ear and one that sits inside the ear, with a tube linking the 2 pieces. The piece within the ear could also be non-custom (tip on the end) or custom (ear mould).
• Receiver in the canal (RIC): almost like a BTE but it's a skinny wire (receiver) instead of a tube.
• In the ear or in the canal (ITE/ITC): One piece that inserts completely in the ear/ear canal.
• Completely in the canal (CIC): One piece that inserts additional in the external auditory canal and can not be simply seen.

Every type/style of hearing aid has its edges and limitations and also the right one depends on the individual.

As you'll be able to see, the hearing aid fitting method is a comprehensive process: together with the hearing test, understanding of your needs, discussing the different hearing aid choices and options available, and at last fitting your hearing aids. You will want to work alongside your audiologist to make sure the most effective outcomes are achieved.

It's necessary that you purchase hearing aids from an audiology clinic and have them fitted by an authorized audiologist to ensure these processes are being carried out. Contact your local audiologist for a hearing test. Attune has audiologists and information for all hearing levels.

Can You Wear Hearing Aids While Exercising?

Hearing aids can be used for most sports such as yoga, gymnastics, golf, jogging, or dancing. Hearing aids can improve your training experience in many ways. When doing water sports such as swimming or surfing, it may be best to remove the headphones to prevent the water from damaging the internal components. This only applies if you have hearing aids that are specifically designed for this purpose. In 2012, the Hear-the-World Foundation carried out a study that found that 70 percent of hearing aid users enjoy sports activities more with their hearing aids. 47 percent of users said that exercising is more fun with the headphones you trust. 

Some Reasons If You Want To Exercise With Headphones Include:

• Increased Security, Communication And Connectivity: Headphones Help Keep You Safe When you exercise with headphones, you become much more aware of your surroundings.

• Hearing Aids Help You Stay Connected: In addition, many modern hearing aids come with wireless options that allow you to connect hearing aids and cell phones via Bluetooth so that hearing aid wearers can stream music or incoming calls and messages straight to their ears. So if you enjoy listening to your favorite podcasts or audio books or motivational music while exercising, the headphones will make your workout even more enjoyable. 

How to Secure Your Hearing Aids While Exercising?

Another common problem that can arise when exercising with hearing aids: How do you hold them in your ear and keep them from falling out? During intense exercises such as running, wrestling, and dancing that involve a lot of active movement, the hearing aids can slip out of the ear. To combat this problem, you have several options based on the type of hearing aid you have. For example, if you have behind-the-ear hearing aids (BTE), you can wear a headband that covers the hearing aids to keep them in place or tight-fitting caps so the hearing aids are more securely anchored on your head . Alternatively, you can invest in a headphone clip or lanyard to keep your hearing aids from falling out of your ear.This headphone clip is attached to your headphones and "clips" to your clothing.

If you’re looking to get your hearing tested, look no further than Attune Hearing. Australia’s only independent accredited hearing healthcare provider. Attune’s qualified audiologists conduct comprehensive hearing tests to help you on your hearing journey. Head to their website or contact the team today.

HOW TO PROTECT YOURSELF FROM EAR INFECTIONS

 INTRODUCTION

Earaches tend to be more common in childhood but can affect all ages. Sometimes an ear infection may start seemingly out of the blue and it’s not always possible to prevent them, but an understanding of what causes ear infections and steps we can take to protect our ears can help reduce your chances of getting an ear infection or suffering complications from one.

The ear is made up of three main parts: the outer ear, the middle ear, and the inner ear. We will be focussing on how to protect the two parts that are most commonly affected by ear infections – the outer ear and the middle ear.

OUTER EAR INFECTIONS

The outer ear is the part that we can see on the outside (the pinna) plus the ear canal. The technical term for an outer ear infection is Otitis Externa. Some people call it swimmer’s ear as outer ear infections are commonly caused by water that has remained in the ear after swimming or bathing. The moisture can become a breeding ground for fungi or bacteria. 
Outer ear infections may also occur if the ear is scratched or irritated and bacteria is introduced by putting your fingers or foreign objects into the ear.
Common symptoms of an outer ear infection include itchiness, pain, tenderness, redness and swelling. Sometimes there may be a smelly discharge.

HOW CAN WE PROTECT OUR EARS FROM OUTER EAR INFECTIONS?

You can protect your or your child’s outer ears with these tips:

• Don’t forget to wash your ears to protect against bacteria or fungi being introduced into the ear canal.

• Make sure to dry your ears after swimming or showering to protect the ear from a moist breeding ground for infection. If you have very narrow ear canals that don’t dry easily then you may wish to further protect your ears from moisture by wearing earplugs while swimming.

• Avoid putting foreign objects into the ear to protect your ear from any scratches or irritation and protect against introducing pathogens into the ear canal.

MIDDLE EAR INFECTIONS

The middle ear is the air-filled space between the eardrum and the oval window of the inner ear. It contains three tiny bones called ossicles, which vibrate along with the eardrum to transmit sound to the inner ear. The middle ear is connected to the nasal cavity and back of the throat with the Eustachian tube, which helps protect the middle ear by keeping the air pressure in the middle ear the same as the air outside the body.

Middle ear infections often occur due to a cold or other upper respiratory tract issue spreading to the ear and causing a build-up of fluid in the middle ear space, which may be unable to drain through the Eustachian tube if it is blocked by congestion and swelling in the nasal passages and throat. The technical term for a middle ear infection is Otitis Media. Some people refer to it as glue ear. 

Otitis Media with Effusion (OME) refers to a middle ear fluid build-up without symptoms of infection such as pain, discharge, or fever. This may be due to fluid and mucous continuing to build up after an initial infection has subsided. The ears may feel blocked and hearing may be reduced or muffled due to the fluid blocking the eardrum from moving properly. 

Acute Otitis Media (AOM) refers to an abrupt middle ear fluid build-up as a result of a bacterial or viral infection. Symptoms may include eardrum redness, swelling, earaches, fever and reduced hearing. The eardrum may also perforate and lead to discharge from the ear.

Children are more prone to middle ear issues because their Eustachian tubes are shorter and flatter compared to an adult’s, which tends to slope down more and be more effective for drainage.

HOW CAN WE PROTECT OUR EARS FROM MIDDLE EAR INFECTIONS?

Some people are more prone to middle ear infections than others due to their anatomy or other predisposing factors, and prevention may involve seeing an Ear Nose and Throat specialist for individualised care. The following are some general tips that can help protect your or your child’s ears from middle ear infections:

• Middle ear infections are often caused by bacteria such as Streptococcus pneumoniae or viruses such as influenza, so make sure you are up to date on vaccinations to protect yourself as much as possible, including the pneumococcal vaccine and the annual flu shot.

• Wash your hands with soap and water regularly to protect against bacteria and viruses.

• Try to avoid coming into contact with people who are sick with colds or other upper respiratory tract infections.

• Avoid smoking or exposure to second-hand smoke to protect yourself against upper respiratory tract issues caused by cigarette smoke.

• Stay on top of managing any allergies to protect yourself against congestion and other respiratory issues. Avoid triggers where possible and keep any allergy medications up to date.

EXTRA TIPS TO PROTECT BABIES:

• Breastfeeding exclusively until a baby is 6 months old and continuing breastfeeding until 12 months can protect babies from all kinds of infections, including middle ear infections.

• Be mindful with bottles and pacifiers as their use while laying down can increase the chance of getting middle ear infections. The use of pacifiers beyond 12 months of age also increases the risk of middle ear infections.

• Daycare centres can, unfortunately, expose babies and children to a lot of germs. Make sure vaccinations are up to date and protect them where possible by cleaning their hands with soap and water and trying to keep dirty objects from going into their mouths. 

WHEN TO SEE YOUR DOCTOR

If the only symptom has been an earache then it could be given a day or two before seeking medical advice, as some ear infections resolve on their own after a few days. It is important though to book in to see the doctor for their help to protect your ears if the earache persists if running a fever, if there is a discharge of blood or pus from the ear, or if your hearing is affected.

Appropriate treatment of outer and middle ear infections will protect your ears from complications. If there appears to be a recurrent or chronic issue, then referral to an Ear Nose and Throat (ENT) specialist might be worthwhile to investigate why the issue is not resolving and which extra measures may be necessary to protect your ears and hearing. If ear infections are not treated appropriately then there may be a risk of permanent injury to the ear or hearing, as well as the risk of the infection spreading to other parts of the head.

Often a hearing assessment by an audiologist may also be recommended as part of your doctor’s investigation process. These assessments will look at the function of each part of the ear to determine how well it is functioning and to rule out certain issues, which helps your doctor to determine the best management options to protect your ears.

SUMMARY

Hopefully, some of these general tips will help to protect your or your child’s ears from a painful ear infection. Your doctor would recommend additional measures based on the specific issue, so seeking medical advice is the best way to protect your ears if an earache persists or if you have any other symptoms. 

If you would like to get an idea of whether past ear infections have done any permanent harm to your ears, it would be worth booking in to see a qualified audiologist at Attune Hearing for a comprehensive hearing assessment to check the function of the ear. This would also give you a hearing baseline for future comparisons, which is helpful to your doctor and audiologist if any future ear infections or changes occur. Contact Attune Hearing on 1300 736 702 or book an appointment online today. 

Does my child have hearing loss?

 

Development of hearing 

Our sense of hearing starts developing as early as the second month of pregnancy. By 18 weeks of pregnancy, babies are thought to hear their very first sounds. Babies in the womb at around week 25 or 26 have been shown to respond to voices and noise.  In their fluid filled environment though the sounds are likely to be muffled and therefore responses to sound are difficult to measure.

Once the baby is born, it is difficult to tell sometimes if they are hearing however hearing tests are done to determine any difficulties. In the first couple of months babies’ responses are very subtle and difficult to observe. They may startle to loud sounds, wake to some sounds, stir in their sleep or show other body responses such as eye widening or body tensing. The sounds they respond to are usually sudden loud or sharp sounds such as a door banging, someone sneezing or a toddler squealing. Babies of this age are unable to turn to their names and rarely respond to softer sounds.

By 4-6 months of age babies begin to develop the ability to turn towards the direction of sound but only if it is on the same level of the ear. They can be soothed from crying by the sound of a voice and their eyes can often shift towards the source of a sound. Over 6-month-old babies can turn well to the direction of sound and will listen when you speak to them. They will begin to understand some simple words and will begin to babble. More complex sounds such as musical toys and TV jingles will be more interesting to them.

By 10-12 months old your child should be responding to sounds from any direction. They should be able to turn to their name and recognise familiar sounds around them. They should be babbling and starting to form words such as mum, dad and no.

What signs should I look for if I suspect my child has a hearing loss?

If you suspect your child has a hearing loss the best thing you can do is contact an Audiologist to perform a hearing test. It is advised that you do not try assessing the child’s hearing yourself as this may lead to unnecessary anxiety. You can observe your child’s responsiveness to sound which may be useful information for the Audiologist.

• Are they responding to a variety of sounds at home? Observe your child at different times during the day. Look for signs that they can hear a favourite TV jingle from another room or the crackle of you opening a biscuit packet from a distance. Ensure the child is not too distracted or tired or that the house is not too noisy.
• Is their speech developing appropriately? This is often the first obvious sign of late onset hearing loss or temporary hearing loss. Discuss with your maternal and child health nurse, GP or speech pathologist to determine if there is a speech delay.
• Do they have recurrent ear infections, throat infections or colds? This is the most common reason for hearing loss in children under the age of 7. Fluid or mucous builds up in the normally air-filled space in the middle ear and results in a temporary hearing loss similar to listening under water. This is often temporary and can be fixed surgically if it is a persistent issue. Your child would need to see an Ear, Nose and Throat doctor for management.
• Is there a history of hearing loss in the family from a young age? There are certain hearing losses that are hereditary. These hearing losses often are diagnosed in childhood and can progress to worsening hearing as an adult. Genetic tests are currently available for some of the genes which are known to cause hearing loss.
• Did my baby have a newborn hearing test? In all states in Australia, newborn hearing screening tests are offered to babies before discharge from hospital. If your baby was born at home or overseas, they may have missed the screen. You can contact your closest Audiology department or ask your GP for details of where you can arrange a hearing test.
• Could there be other reasons my child is not responding to sound? Sometimes children with developmental delays or physical delays may not show clear responses to sound. Children with Autism Spectrum Disorder often show little interest in environmental sounds. Extremely premature babies may be delayed with their responsiveness and babies or children with physical disabilities may not be able to turn their heads in response to sound.

Types of hearing loss in children

Conductive hearing loss

This is the most common hearing loss in children and is a result of a build-up of fluid or mucous in the middle ear space. This occurs when there is a blockage in the eustachian tube which connects the nose and the ear. This eustachian tube usually acts to equalise the air pressure in the middle ear cavity. The eustachian tube can become blocked with a cold or as a result of enlarged tonsils and/or adenoids which sit at the base of the nose. If the eustachian tube stays blocked for long enough the mucous can build up in the middle ear cavity and can remain there until the eustachian tube is able to clear the blockage.In many cases the child presents with hearing loss as a result of this fluid in the ear. It can be in one or both ears and can fluctuate depending on how blocked the ears are. The degree of hearing loss can range from a very mild dulling of sound to a more serious deficit resulting in speech sounds being reduced to a whisper. The hearing loss is generally temporary with the hearing nerve remaining intact. The fluid can resolve on its own or may need medical treatment, some even require minor surgery with grommets to aerate the middle ears. If the conductive hearing loss is due to structural abnormality of the middle ear, in some cases it may not be surgically corrected. Special hearing aids are suitable for these children to access hearing to develop speech and language.

Conductive hearing loss is most common in younger children but can happen at any age. Tell-tale signs of conductive hearing loss could include:

• Pulling/tugging/banging ears
• Recurrent ear infections
• Sensitivity to sudden loud sounds (eg vacuum, hand dryer)
• Constant colds/snotty nose/snoring
• Slower than expected speech development
• Balance issues
• Learning delays in school aged children

Sensorineural hearing loss

Less common than conductive hearing loss but current statistics suggest 1 in 1000 children in Australia have a sensorineural hearing loss. These hearing losses are defined as losses due to an impairment in the nerve of hearing or cochlea. Hearing loss can be in one ear or both ears and can vary in degree from very mild to no hearing at all. The cause of sensorineural hearing loss is not always known. The most common causes are genetics, ototoxic medications administered as newborns, illnesses such as meningitis, maternal CMV, jaundice, chromosomal abnormalities and extreme prematurity. Children can be born with the sensorineural hearing loss or it can be acquired later in childhood.

Mixed hearing loss

A mixed hearing loss is where a child has a combination of a conductive hearing loss and a sensorineural hearing loss. Often the conductive hearing loss is temporary and can resolve or be medically treated. In some cases, particularly if the child has a syndrome involving structural abnormalities such the child has hearing loss at the nerve but also some conductive loss due to a malformation of the middle ear.

 Auditory Neuropathy Spectrum Disorder

ANSD is a very rare condition where the cochlea shows response to sound but the signal to the brain becomes disrupted and this results in a hearing impairment. This nerve disruption or dyssynchrony is more common in very premature babies, those with high jaundice at birth and in some genetic conditions.

How can I check if my child has a hearing loss?

Audiologists are university trained specialists in hearing assessment. You are best to see a Paediatric Audiologist especially if your child is under 7 years of age. Different age groups require different modes of assessment and sometimes several techniques are used to obtain an accurate result. All Audiologists should perform middle ear function tests and some form of hearing assessment to gain a good understanding of your child’s hearing and middle ear status. They may refer your child for further medical advice depending on the result.

What happens if my child has a hearing loss?

If a child has been diagnosed with a hearing loss it will depend on the degree and type of hearing loss as to how the hearing loss is managed. If the hearing loss is medically treatable the Audiologist will refer you to an Ear, Nose and Throat specialist to determine if grommet surgery or similar is warranted. If the hearing loss is more permanent, then the impact on the child’s development will be determined. If it is thought that the hearing loss is likely to delay a child’s speech development or learning, then hearing aid fitting may be recommended. In cases where children have severe or profound hearing losses or ANSD, cochlear implantation may be an option.

In all cases the development of speech and language is of the utmost importance to the Audiologist. Their job is to accurately diagnose and manage hearing losses in children. Speak to your GP, maternal and child health nurse or paediatrician if you are unsure of Audiological services in your area. Attune Hearing is Australia’s only accredited hearing healthcare provider, offering hearing services to those who need help on their hearing journey.

Should I consider purchasing a hearing aid online?

Hearing aids seem to be getting smaller in size, but more expensive in price.  Most hearing aids need replacing after 5-6 years, so it’s a cost which is likely to be ongoing throughout your life.  Consumers are becoming savvier with price shopping and hearing aids certainly appear cheaper online than in Audiology clinics, so many people often wonder whether purchasing online is worth the savings.  In this article, we will look at some pros and cons to purchasing online vs in-clinic, and other points to consider to help you make up your own mind.

If you are sure of exactly what you want, purchasing hearing aids online is easy –Select the device and accessories you like, buy on-line.  Some retailers ask you to upload your audiogram and then send the pre-programmed devices directly to you with instructions and videos on how to use them.  Tuning is often done remotely so you never have to set foot in a clinic!  Other retailers book you in for a face-to-face appointment with an Audiologist to fit the hearing aids.  You may then have a follow-up appointment, either face to face, over the phone or via video call with the Audiologist.

While purchasing online is straightforward, hearing loss, however, is not.  

Rehabilitating hearing loss is even more complex, and achieving better hearing is not just a matter of wearing a hearing aid.  Two people with the same hearing levels on paper can have a completely different perception of speech and different hearing abilities in background noise, which means they will both achieve very different outcomes with the same hearing aid.  Just ask any experienced Audiologist!  This is truly where having a good rapport with your Audiologist, and having a good aftercare package is worth it in the long run.  The cost you pay isn’t just for a product, it’s for the service also, which is often more important.  Your Audiologist should provide you with personalised rehabilitation advice, realistic expectations from the start based on your individual hearing (fact: hearing aids won’t ever replace normal hearing), and communication advice and training.

There is another point to consider also – the hearing aid is truly only as good as the fitting.  While hearing aid software is designed to calculate a default amount of volume to give you based on your Haudiogram, nothing beats having your Audiologist measure the hearing aid in your ear using speech.  An in-clinic visit with an Audiologist is essential for this step (called real ear measures or REM) to take place.  Even when this is performed you may still not be satisfied with the sound quality, and will therefore rely on your Audiologist’s expertise to question you and apply your feedback to adjust the hearing aids accordingly.  This process can take a few appointments where changes are made then you need to try the hearing aids in the real world (as opposed to your Audiologist’s sound-proof office!) to assess.

If you do purchase hearing aids online and aren’t happy with them, sometimes it’s difficult to get a second opinion from a different Audiologist.  Many clinics will not service hearing aids purchased privately elsewhere or will charge you a high fee to take you on as a client.  In addition, if you purchase hearing aids from overseas, there is a good chance they won’t be able to be programmed in Australia.

In summary, while you can certainly purchase hearing aids cheaply online, it is important to consider the big picture.  

Thoroughly check the inclusions of the hearing aid package, and enquire about the cost of any future appointments or maintenance.  Make sure there is an option to see an Audiologist face-to-face if you need to.  The cost you pay shouldn’t just be about the hearing aids, make sure you allow for peace of mind.  Having a good rapport with your local Audiologist is priceless! If you’re looking at getting a hearing test, head to an Attune clinic today and talk to a professional audiologist who can guide you in the right direction when buying a hearing aid. Contact Attune on 1300 010 064 or head to the website to book an appointment!