Objective Ménière’s disease (MD) is a clinical condition defined by spontaneous vertigo attacks (each lasting 20 minutes to 12 hours) with documented low- to midfrequency sensorineural hearing loss in the affected ear before, during, or after one of the episodes of vertigo. It also presents with fluctuating aural symptoms (hearing loss, tinnitus, or ear fullness) in the affected ear. The underlying etiology of MD is not completely clear, yet it has been associated with inner ear fluid (endolymph) volume increases, culminating in episodic ear symptoms (vertigo, fluctuating hearing loss, tinnitus, and aural fullness). Physical examination findings are often unremarkable, and audiometric testing may or may not show low- to midfrequency sensorineural hearing loss. Conventional imaging, if performed, is also typically normal. The goals of MD treatment are to prevent or reduce vertigo severity and frequency; relieve or prevent hearing loss, tinnitus, and aural fullness; and improve quality of life. Treatment approaches to MD are many and typically include modifications of lifestyle factors (eg, diet) and medical, surgical, or a combination of therapies. Purpose The primary purpose of this clinical practice guideline is to improve the quality of the diagnostic workup and treatment outcomes of MD. To achieve this purpose, the goals of this guideline are to use the best available published scientific and/or clinical evidence to enhance diagnostic accuracy and appropriate therapeutic interventions (medical and surgical) while reducing unindicated diagnostic testing and/or imaging.

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Objective Ménière’s disease (MD) is a clinical condition defined by spontaneous vertigo attacks (each lasting 20 minutes to 12 hours) with documented low- to midfrequency sensorineural hearing loss in the affected ear before, during, or after one of the episodes of vertigo. It also presents with fluctuating aural symptoms (hearing loss, tinnitus, or ear fullness) in the affected ear. The underlying etiology of MD is not completely clear, yet it has been associated with inner ear fluid volume increases, culminating in episodic ear symptoms (vertigo, fluctuating hearing loss, tinnitus, and aural fullness). Physical examination findings are often unremarkable, and audiometric testing may or may not show low- to midfrequency sensorineural hearing loss. Imaging, if performed, is also typically normal. The goals of MD treatment are to prevent or reduce vertigo severity and frequency; relieve or prevent hearing loss, tinnitus, and aural fullness; and improve quality of life. Treatment approaches to MD are many, and approaches typically include modifications of lifestyle factors (eg, diet) and medical, surgical, or a combination of therapies. Purpose The primary purpose of this clinical practice guideline is to improve the quality of the diagnostic workup and treatment outcomes of MD. To achieve this purpose, the goals of this guideline are to use the best available published scientific and/or clinical evidence to enhance diagnostic accuracy and appropriate therapeutic interventions (medical and surgical) while reducing unindicated diagnostic testing and/or imaging.

A multitude of relationships have been identified through correlational data between meaning in life, resilience, and posttraumatic growth following natural hazards, such that a cohesive and replicable model is needed across diverse samples. Further, additional research is needed on the link between resilience and disaster preparedness. The objective of the article is to develop a cohesive and replicable model of positive factors (i.e., meaning in life, resilience, posttraumatic growth, and disaster preparedness) in the context of tornadoes and to replicate this model across two samples. The first sample consisted of students at a university in a tornado-prone region, and the second was a sample of faculty and staff at the same university. Structural equation modeling was used to analyze the data. Across both studies, meaning in life positively predicted resilience and posttraumatic growth. Resilience positively predicted disaster preparedness, and the model supported the theory that resilience and posttraumatic growth are distinct constructs (Comparative Fit Index ϭ .947 for study 1 and .974 for study 2; Standardized Root Mean Square Residual ϭ .050 for study 1 and .045 for study 2; Root Mean Square Error of Approximation ϭ .070 for study 1 and .074 for study 2, with 90% confidence interval [.053, .088] for study 1 and [.047, .103] for study 2). Meaning in life is positively related to both resilience and posttraumatic growth in tornado survivors. Psychological resilience is related to disaster preparedness behaviors, so considering resilience within the context of natural hazards is essential.

The research Ethics committee of the Faculty of Pedagogy and Psychology (ELTE) granted a central permission (permission nr: 2019/47). Many other labs obtained IRB approval too, which approvals can be found here: https://osf.io/j6kte/ . Participants had to give informed consent before starting the experiment. Only participants recruited through Mturk or Prolific received monetary compensation.Note that full information on the approval of the study protocol must also be provided in the manuscript.