Audiology and hearing health professionals in developed and developing countries (2002), Lyn et al. (1998), and Swart et al. (1995), impacted cerumen is one of the most common ear diseases and causes of hearing loss, with prevalence rate between 7.4% and 63%. Additionally, otoscopy does not require a great deal of expertise beyond basic training and is useful to refer a child when the tympanic membrane cannot be visualized due to occlusion of the external auditory meatus by cerumen. Pure-tone audiometry screening, in which there is typically no attempt to find threshold, has been found to accurately assess hearing status in children six years and older, when trained health workers
Substance dependence the "Diagnostic and Statistical Manual of Mental Disorders" ("DSM-IV"), substance dependence is redefined as a drug addiction, and can be diagnosed without the occurrence of a withdrawal syndrome. It is now described accordingly: "When an individual persists in use of alcohol or other drugs despite problems related to use of the substance, substance dependence may be diagnosed. Compulsive and repetitive use may result in tolerance to the effect of the drug and withdrawal symptoms when use is reduced or stopped. This, along with Substance Abuse are considered Substance Use Disorders." Withdrawal is the body's reaction to abstaining from a substance