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 theory Substance theory Substance theory, or substance–attribute theory, is an ontological theory about objecthood, positing that a "substance" is distinct from its properties. A "thing-in-itself" is a property-bearer that must be distinguished from the properties it bears. "Substance" is a key concept in ontology and metaphysics, which may be classified into monist, dualist, or pluralist varieties according to how many substances or individuals are said to populate, furnish, or exist in the world. According to monistic views, there is only one substance. Stoicism and Spinoza, for example, hold monistic views, that pneuma or God, respectively, is the one substance in the