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Health behavior change (HBC) refers to facilitating changes to habits and/or behavior related to health. In healthcare practice, it is quite common that the interactions between practitioner and patient involve conversations related to HBC. This could be mainly in relation to the practitioner trying to directly persuade the patients to make some changes in their health behavior. However, the patients may not be motivated to do so as they do not see this change as important. For this reason, direct persuasion may result in a breakdown of communication. In such instances, alternative approaches and means of indirect persuasion, such as empowering the patient and their family members, could be helpful. Furthermore, there are several models and/or theories proposed which explain the health behavior and also provide a structured framework for health behavior change. Many such models/approaches have been proven effective in facilitating HBC and health promotion in areas such as cessation of smoking, weight loss and so on. This paper provides an overview of main models/theories related to HBC and some insights into how these models/approaches could be adapted to facilitate behavior change in hearing healthcare, mainly in relation to: i) hearing help-seeking and hearing-aid uptake; and ii) hearing conservation in relation to music-induced hearing loss (MIHL). In addition, elements of current research related to this area and future directions are highlighted.

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In Swedish, as in other languages, the words used to refer to disabilities and people with disabilities are manifold. Recommendations as to which terms to use have been changed several times over the last hundred years. In this exploratory paper we have used textual resources provided by Swe-Clarin to study such changes quantitatively. We demonstrate that old and new recommendations co-exist for long periods of time, and that usage sometimes converges.

In Swedish, as in other languages, the words used to refer to disabilities and people with disabilities are manifold. Recommendations as to which terms to use have been changed several times over the last hundred years. In this exploratory paper we have used textual resources provided by Swe-Clarin to study such changes quantitatively. We demonstrate that old and new recommendations co-exist for long periods of time, and that usage sometimes converges.

In Swedish, as in other languages, the words used to refer to disabilities and people with disabilities are manifold. Recommendations as to which terms to use have been changed several times over the last hundred years. In this exploratory paper we have used textual resources provided by Swe-Clarin to study such changes quantitatively. We demonstrate that old and new recommendations co-exist for long periods of time, and that usage sometimes converges.

In Swedish, as in other languages, the words used to refer to disabilities and people with disabilities are manifold. Recommendations as to which terms to use have been changed several times over the last hundred years. In this exploratory paper we have used textual resources provided by Swe-Clarin to study such changes quantitatively. We demonstrate that old and new recommendations co-exist for long periods of time, and that usage sometimes converges.

In Swedish, as in other languages, the words used to refer to disabilities and people with disabilities are manifold. Recommendations as to which terms to use have been changed several times over the last hundred years. In this exploratory paper we have used textual resources provided by Swe-Clarin to study such changes quantitatively. We demonstrate that old and new recommendations co-exist for long periods of time, and that usage sometimes converges.

In Swedish, as in other languages, the words used to refer to disabilities and people with disabilities are manifold. Recommendations as to which terms to use have been changed several times over the last hundred years. In this exploratory paper we have used textual resources provided by Swe-Clarin to study such changes quantitatively. We demonstrate that old and new recommendations co-exist for long periods of time, and that usage sometimes converges.

This paper is about the role of working memory capacity in speech understanding under challenging listening conditions. The theoretical model that has driven most of the research reported in this paper is called the Ease-of-Language understanding model (Ronnberg, 2003; Ronnberg et al., 2008). The Ease-of-Language understanding model is part of a larger scientific endeavor called cognitive hearing science.

Children with impairments are known to experience more restricted participation than other children. It also appears that low levels of participation are related to a higher prevalence of mental health problems in children with neurodevelopmental disorders (NDD). The purpose of this conceptual paper is to describe and define the constructs mental health problems, mental health, and participation to ensure that future research investigating participation as a means to mental health in children and adolescents with NDD is founded on conceptual clarity. We first discuss the difference between two aspects of mental health problems, namely mental disorder and mental illness. This discussion serves to highlight three areas of conceptual difficulty and their consequences for understanding the mental health of children with NDD that we then consider in the article: (1) how to define mental health problems, (2) how to define and assess mental health problems and mental health, i.e., wellbeing as separate constructs, and (3) how to describe the relationship between participation and wellbeing. We then discuss the implications of our propositions for measurement and the use of participation interventions as a means to enhance mental health (defined as wellbeing). Conclusions: Mental disorders include both diagnoses related to impairments in the developmental period, i.e., NDD and diagnoses related to mental illness. These two types of mental disorders must be separated. Children with NDD, just like other people, may exhibit aspects of both mental health problems and wellbeing simultaneously. Measures of wellbeing defined as a continuum from flourishing to languishing for children with NDD need to be designed and evaluated. Wellbeing can lead to further participation and act to protect from mental health problems., Funding Agencies|Swedish Research Council (VR)Swedish Research Council [2018-05824]

Children with impairments are known to experience more restricted participation than other children. It also appears that low levels of participation are related to a higher prevalence of mental health problems in children with neurodevelopmental disorders (NDD). The purpose of this conceptual paper is to describe and define the constructs mental health problems, mental health, and participation to ensure that future research investigating participation as a means to mental health in children and adolescents with NDD is founded on conceptual clarity. We first discuss the difference between two aspects of mental health problems, namely mental disorder and mental illness. This discussion serves to highlight three areas of conceptual difficulty and their consequences for understanding the mental health of children with NDD that we then consider in the article: (1) how to define mental health problems, (2) how to define and assess mental health problems and mental health, i.e., wellbeing as separate constructs, and (3) how to describe the relationship between participation and wellbeing. We then discuss the implications of our propositions for measurement and the use of participation interventions as a means to enhance mental health (defined as wellbeing). Conclusions: Mental disorders include both diagnoses related to impairments in the developmental period, i.e., NDD and diagnoses related to mental illness. These two types of mental disorders must be separated. Children with NDD, just like other people, may exhibit aspects of both mental health problems and wellbeing simultaneously. Measures of wellbeing defined as a continuum from flourishing to languishing for children with NDD need to be designed and evaluated. Wellbeing can lead to further participation and act to protect from mental health problems., Funding Agencies|Swedish Research Council (VR)Swedish Research Council [2018-05824]

Children with impairments are known to experience more restricted participation than other children. It also appears that low levels of participation are related to a higher prevalence of mental health problems in children with neurodevelopmental disorders (NDD). The purpose of this conceptual paper is to describe and define the constructs mental health problems, mental health, and participation to ensure that future research investigating participation as a means to mental health in children and adolescents with NDD is founded on conceptual clarity. We first discuss the difference between two aspects of mental health problems, namely mental disorder and mental illness. This discussion serves to highlight three areas of conceptual difficulty and their consequences for understanding the mental health of children with NDD that we then consider in the article: (1) how to define mental health problems, (2) how to define and assess mental health problems and mental health, i.e., wellbeing as separate constructs, and (3) how to describe the relationship between participation and wellbeing. We then discuss the implications of our propositions for measurement and the use of participation interventions as a means to enhance mental health (defined as wellbeing). Conclusions: Mental disorders include both diagnoses related to impairments in the developmental period, i.e., NDD and diagnoses related to mental illness. These two types of mental disorders must be separated. Children with NDD, just like other people, may exhibit aspects of both mental health problems and wellbeing simultaneously. Measures of wellbeing defined as a continuum from flourishing to languishing for children with NDD need to be designed and evaluated. Wellbeing can lead to further participation and act to protect from mental health problems., Funding Agencies|Swedish Research Council (VR)Swedish Research Council [2018-05824]

Children with impairments are known to experience more restricted participation than other children. It also appears that low levels of participation are related to a higher prevalence of mental health problems in children with neurodevelopmental disorders (NDD). The purpose of this conceptual paper is to describe and define the constructs mental health problems, mental health, and participation to ensure that future research investigating participation as a means to mental health in children and adolescents with NDD is founded on conceptual clarity. We first discuss the difference between two aspects of mental health problems, namely mental disorder and mental illness. This discussion serves to highlight three areas of conceptual difficulty and their consequences for understanding the mental health of children with NDD that we then consider in the article: (1) how to define mental health problems, (2) how to define and assess mental health problems and mental health, i.e., wellbeing as separate constructs, and (3) how to describe the relationship between participation and wellbeing. We then discuss the implications of our propositions for measurement and the use of participation interventions as a means to enhance mental health (defined as wellbeing). Conclusions: Mental disorders include both diagnoses related to impairments in the developmental period, i.e., NDD and diagnoses related to mental illness. These two types of mental disorders must be separated. Children with NDD, just like other people, may exhibit aspects of both mental health problems and wellbeing simultaneously. Measures of wellbeing defined as a continuum from flourishing to languishing for children with NDD need to be designed and evaluated. Wellbeing can lead to further participation and act to protect from mental health problems., Funding Agencies|Swedish Research Council (VR)Swedish Research Council [2018-05824]

Children with impairments are known to experience more restricted participation than other children. It also appears that low levels of participation are related to a higher prevalence of mental health problems in children with neurodevelopmental disorders (NDD). The purpose of this conceptual paper is to describe and define the constructs mental health problems, mental health, and participation to ensure that future research investigating participation as a means to mental health in children and adolescents with NDD is founded on conceptual clarity. We first discuss the difference between two aspects of mental health problems, namely mental disorder and mental illness. This discussion serves to highlight three areas of conceptual difficulty and their consequences for understanding the mental health of children with NDD that we then consider in the article: (1) how to define mental health problems, (2) how to define and assess mental health problems and mental health, i.e., wellbeing as separate constructs, and (3) how to describe the relationship between participation and wellbeing. We then discuss the implications of our propositions for measurement and the use of participation interventions as a means to enhance mental health (defined as wellbeing). Conclusions: Mental disorders include both diagnoses related to impairments in the developmental period, i.e., NDD and diagnoses related to mental illness. These two types of mental disorders must be separated. Children with NDD, just like other people, may exhibit aspects of both mental health problems and wellbeing simultaneously. Measures of wellbeing defined as a continuum from flourishing to languishing for children with NDD need to be designed and evaluated. Wellbeing can lead to further participation and act to protect from mental health problems., Funding Agencies|Swedish Research Council (VR)Swedish Research Council [2018-05824]

This thesis employed an integrated approach and investigated intra- and inter-individual differences relevant for normally hearing (NH) and hearing-impaired (HI) adults in native (Swedish) and non-native (English) languages in adverse listening conditions. The integrated approach encompassed the role of cognition as a focal point of interest as well as perceptualauditory and linguistic factors. Paper I examined the extent to which proficiency in a non-native language influenced native and non-native speech perception performance for NH listeners in noise maskers compared to native and non-native speech maskers. Working memory capacity in native and non-native languages and non-verbal intelligence were also assessed. The design of paper II was identical to that of paper I, however the participants in paper II had a hearingimpairment. The purpose of paper III was to assess how NH and HI listeners subjectively evaluated the perceived disturbance from the speech- and noise maskers in the native and nonnative languages. Paper IV examined how well native and non-native stories that were presented unmasked and masked with native and non-native speech were recalled by NH listeners. Paper IV further investigated the role of working memory capacity in the episodic long-term memory of story contents as well as proficiency in native and non-native languages. The results showed that generally, the speech maskers affected performance and perceived disturbance more than the noise maskers did. Regarding the non-native target language, interference from speech maskers in the dominant native language is taxing for speech perception performance, perceived disturbance and memory processes. However, large inter- individual variability between the listeners was observed. Part of this variability relates to non-native language proficiency. Perceptual and cognitive effort may hinder efficient long-term memory encoding, even when stimuli are appropriately identified at a perceptual level. A, Avhandlingens övergripande syfte var att genom ett integrerat tillvägagångssätt undersöka mellan- och inom-individuella skillnader relevanta för normalhörande och hörselskadade vuxna i svenska och engelska språket under ogynnsamma lyssningsförhållanden. Med kognitiva faktorer i fokus, omfattade det integrerade tillvägagångssättet också perceptuella-auditiva och lingvistiska faktorer. Studie I undersökte i vilken utsträckning färdigheter i engelska inverkade på taluppfattning av ett modersmål och ett andra språk som var maskerat med brus jämfört med störande tal på svenska och engelska. Normalhörande vuxna deltog. Arbetsminneskapacitet på svenska och engelska liksom icke-verbal intelligens bedömdes också i studien. Designen i studie II var identisk med designen i studie I, förutom att personer med hörselnedsättning ingick som deltagare. Syftet med studie III var att bedöma hur normalhörande personer och personer med hörselnedsättning subjektivt utvärderade den upplevda störningen från tal- och brus på ett modersmål och ett andra språk. Studie IV undersökte hur väl normalhörande deltagare kom ihåg berättelser på svenska och engelska som presenterades omaskerade eller med störande tal på svenska eller engelska. Studie IV undersökte vidare arbetsminneskapacitet och episodiskt långtidsminne av berättelsernas innehåll liksom också färdighet i svenska och engelska språket. Resultaten visade att generellt var maskeringseffekten större vid störande tal jämfört med andra bruskällor både vad avser taluppfattning såväl som upplevd störning. Vad det gäller det engelska språket som talsignal, är störning från det svenska modersmålet påfrestande för taluppfattning, upplevd störning såväl som för minnesprocesser. Dock har stor inter- och intra-individuell variation mellan deltagarna observerats. En del av denna variation avser engelska språkfärdigheter. Perceptuell och kognitiv påfrestning kan minska möjligheten till att säkra långsiktiga minnesprocesser även om ett stimuli var ko

This thesis employed an integrated approach and investigated intra- and inter-individual differences relevant for normally hearing (NH) and hearing-impaired (HI) adults in native (Swedish) and non-native (English) languages in adverse listening conditions. The integrated approach encompassed the role of cognition as a focal point of interest as well as perceptualauditory and linguistic factors. Paper I examined the extent to which proficiency in a non-native language influenced native and non-native speech perception performance for NH listeners in noise maskers compared to native and non-native speech maskers. Working memory capacity in native and non-native languages and non-verbal intelligence were also assessed. The design of paper II was identical to that of paper I, however the participants in paper II had a hearingimpairment. The purpose of paper III was to assess how NH and HI listeners subjectively evaluated the perceived disturbance from the speech- and noise maskers in the native and nonnative languages. Paper IV examined how well native and non-native stories that were presented unmasked and masked with native and non-native speech were recalled by NH listeners. Paper IV further investigated the role of working memory capacity in the episodic long-term memory of story contents as well as proficiency in native and non-native languages. The results showed that generally, the speech maskers affected performance and perceived disturbance more than the noise maskers did. Regarding the non-native target language, interference from speech maskers in the dominant native language is taxing for speech perception performance, perceived disturbance and memory processes. However, large inter- individual variability between the listeners was observed. Part of this variability relates to non-native language proficiency. Perceptual and cognitive effort may hinder efficient long-term memory encoding, even when stimuli are appropriately identified at a perceptual level. A, Avhandlingens övergripande syfte var att genom ett integrerat tillvägagångssätt undersöka mellan- och inom-individuella skillnader relevanta för normalhörande och hörselskadade vuxna i svenska och engelska språket under ogynnsamma lyssningsförhållanden. Med kognitiva faktorer i fokus, omfattade det integrerade tillvägagångssättet också perceptuella-auditiva och lingvistiska faktorer. Studie I undersökte i vilken utsträckning färdigheter i engelska inverkade på taluppfattning av ett modersmål och ett andra språk som var maskerat med brus jämfört med störande tal på svenska och engelska. Normalhörande vuxna deltog. Arbetsminneskapacitet på svenska och engelska liksom icke-verbal intelligens bedömdes också i studien. Designen i studie II var identisk med designen i studie I, förutom att personer med hörselnedsättning ingick som deltagare. Syftet med studie III var att bedöma hur normalhörande personer och personer med hörselnedsättning subjektivt utvärderade den upplevda störningen från tal- och brus på ett modersmål och ett andra språk. Studie IV undersökte hur väl normalhörande deltagare kom ihåg berättelser på svenska och engelska som presenterades omaskerade eller med störande tal på svenska eller engelska. Studie IV undersökte vidare arbetsminneskapacitet och episodiskt långtidsminne av berättelsernas innehåll liksom också färdighet i svenska och engelska språket. Resultaten visade att generellt var maskeringseffekten större vid störande tal jämfört med andra bruskällor både vad avser taluppfattning såväl som upplevd störning. Vad det gäller det engelska språket som talsignal, är störning från det svenska modersmålet påfrestande för taluppfattning, upplevd störning såväl som för minnesprocesser. Dock har stor inter- och intra-individuell variation mellan deltagarna observerats. En del av denna variation avser engelska språkfärdigheter. Perceptuell och kognitiv påfrestning kan minska möjligheten till att säkra långsiktiga minnesprocesser även om ett stimuli var ko

This thesis employed an integrated approach and investigated intra- and inter-individual differences relevant for normally hearing (NH) and hearing-impaired (HI) adults in native (Swedish) and non-native (English) languages in adverse listening conditions. The integrated approach encompassed the role of cognition as a focal point of interest as well as perceptualauditory and linguistic factors. Paper I examined the extent to which proficiency in a non-native language influenced native and non-native speech perception performance for NH listeners in noise maskers compared to native and non-native speech maskers. Working memory capacity in native and non-native languages and non-verbal intelligence were also assessed. The design of paper II was identical to that of paper I, however the participants in paper II had a hearingimpairment. The purpose of paper III was to assess how NH and HI listeners subjectively evaluated the perceived disturbance from the speech- and noise maskers in the native and nonnative languages. Paper IV examined how well native and non-native stories that were presented unmasked and masked with native and non-native speech were recalled by NH listeners. Paper IV further investigated the role of working memory capacity in the episodic long-term memory of story contents as well as proficiency in native and non-native languages. The results showed that generally, the speech maskers affected performance and perceived disturbance more than the noise maskers did. Regarding the non-native target language, interference from speech maskers in the dominant native language is taxing for speech perception performance, perceived disturbance and memory processes. However, large inter- individual variability between the listeners was observed. Part of this variability relates to non-native language proficiency. Perceptual and cognitive effort may hinder efficient long-term memory encoding, even when stimuli are appropriately identified at a perceptual level. A, Avhandlingens övergripande syfte var att genom ett integrerat tillvägagångssätt undersöka mellan- och inom-individuella skillnader relevanta för normalhörande och hörselskadade vuxna i svenska och engelska språket under ogynnsamma lyssningsförhållanden. Med kognitiva faktorer i fokus, omfattade det integrerade tillvägagångssättet också perceptuella-auditiva och lingvistiska faktorer. Studie I undersökte i vilken utsträckning färdigheter i engelska inverkade på taluppfattning av ett modersmål och ett andra språk som var maskerat med brus jämfört med störande tal på svenska och engelska. Normalhörande vuxna deltog. Arbetsminneskapacitet på svenska och engelska liksom icke-verbal intelligens bedömdes också i studien. Designen i studie II var identisk med designen i studie I, förutom att personer med hörselnedsättning ingick som deltagare. Syftet med studie III var att bedöma hur normalhörande personer och personer med hörselnedsättning subjektivt utvärderade den upplevda störningen från tal- och brus på ett modersmål och ett andra språk. Studie IV undersökte hur väl normalhörande deltagare kom ihåg berättelser på svenska och engelska som presenterades omaskerade eller med störande tal på svenska eller engelska. Studie IV undersökte vidare arbetsminneskapacitet och episodiskt långtidsminne av berättelsernas innehåll liksom också färdighet i svenska och engelska språket. Resultaten visade att generellt var maskeringseffekten större vid störande tal jämfört med andra bruskällor både vad avser taluppfattning såväl som upplevd störning. Vad det gäller det engelska språket som talsignal, är störning från det svenska modersmålet påfrestande för taluppfattning, upplevd störning såväl som för minnesprocesser. Dock har stor inter- och intra-individuell variation mellan deltagarna observerats. En del av denna variation avser engelska språkfärdigheter. Perceptuell och kognitiv påfrestning kan minska möjligheten till att säkra långsiktiga minnesprocesser även om ett stimuli var ko

Background: The paper presents a modularized treatment approach for women with premenstrual symptoms. Many women of reproductive age suffer from physical and/or mental premenstrual complaints, which can significantly reduce the quality of everyday life. Current studies showed positive effects of cognitive-behavioral therapy and lifestyle interventions. Overall, there is a lack of effective treatment approach. Method: The present approach addresses women with a severe premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD). It consists of a detailed psychoeducation, cognitive interventions regarding PMS-related dysfunctional cognitions, strategies to change dysfunctional behaviors, and targets lifestyle issues such as stress, relaxation, balanced diet, and sports. Results: First results of the efficacy as well as the contentment with the treatment program were reported within a case study. Conclusion: The paper presents newly developed treatment guidelines, which can be integrated both, in research and therapeutic practice. The treatment guidelines should be used in further research to optimize the treatment of premenstrual burden.

Objective: The purpose of this paper was to highlight the importance of cultural influence in understanding hearing-help seeking and hearing-aid uptake. Design: Information on audiological services in different countries and theories related to cross-culture is presented, followed by a general discussion. Study sample: Twenty-seven relevant literature reviews on hearing impairment, cross-cultural studies, and the health psychology model and others as secondary resources. Results: Despite the adverse consequences of hearing impairment and the significant potential benefits of audiological rehabilitation, only a small number of those with hearing impairment seek professional help and take up appropriate rehabilitation. Therefore, hearing help-seeking and hearing-aid uptake has recently become the hot topic for clinicians and researchers. Previous research has identified many contributing factors for hearing help-seeking with self-reported hearing disability being one of the main factors. Although significant differences in help-seeking and hearing-aid adoption rates have been reported across countries in population studies, limited literature on the influence of cross-cultural factors in this area calls for an immediate need for research. Conclusions: This paper highlights the importance of psychological models and cross-cultural research in the area of hearing help-seeking and hearing-aid uptake, and consequently some directions for future research are proposed., Funding Agencies|Oticon Foundation

This thesis employed an integrated approach and investigated intra- and inter-individual differences relevant for normally hearing (NH) and hearing-impaired (HI) adults in native (Swedish) and non-native (English) languages in adverse listening conditions. The integrated approach encompassed the role of cognition as a focal point of interest as well as perceptualauditory and linguistic factors. Paper I examined the extent to which proficiency in a non-native language influenced native and non-native speech perception performance for NH listeners in noise maskers compared to native and non-native speech maskers. Working memory capacity in native and non-native languages and non-verbal intelligence were also assessed. The design of paper II was identical to that of paper I, however the participants in paper II had a hearingimpairment. The purpose of paper III was to assess how NH and HI listeners subjectively evaluated the perceived disturbance from the speech- and noise maskers in the native and nonnative languages. Paper IV examined how well native and non-native stories that were presented unmasked and masked with native and non-native speech were recalled by NH listeners. Paper IV further investigated the role of working memory capacity in the episodic long-term memory of story contents as well as proficiency in native and non-native languages. The results showed that generally, the speech maskers affected performance and perceived disturbance more than the noise maskers did. Regarding the non-native target language, interference from speech maskers in the dominant native language is taxing for speech perception performance, perceived disturbance and memory processes. However, large inter- individual variability between the listeners was observed. Part of this variability relates to non-native language proficiency. Perceptual and cognitive effort may hinder efficient long-term memory encoding, even when stimuli are appropriately identified at a perceptual level. A, Avhandlingens övergripande syfte var att genom ett integrerat tillvägagångssätt undersöka mellan- och inom-individuella skillnader relevanta för normalhörande och hörselskadade vuxna i svenska och engelska språket under ogynnsamma lyssningsförhållanden. Med kognitiva faktorer i fokus, omfattade det integrerade tillvägagångssättet också perceptuella-auditiva och lingvistiska faktorer. Studie I undersökte i vilken utsträckning färdigheter i engelska inverkade på taluppfattning av ett modersmål och ett andra språk som var maskerat med brus jämfört med störande tal på svenska och engelska. Normalhörande vuxna deltog. Arbetsminneskapacitet på svenska och engelska liksom icke-verbal intelligens bedömdes också i studien. Designen i studie II var identisk med designen i studie I, förutom att personer med hörselnedsättning ingick som deltagare. Syftet med studie III var att bedöma hur normalhörande personer och personer med hörselnedsättning subjektivt utvärderade den upplevda störningen från tal- och brus på ett modersmål och ett andra språk. Studie IV undersökte hur väl normalhörande deltagare kom ihåg berättelser på svenska och engelska som presenterades omaskerade eller med störande tal på svenska eller engelska. Studie IV undersökte vidare arbetsminneskapacitet och episodiskt långtidsminne av berättelsernas innehåll liksom också färdighet i svenska och engelska språket. Resultaten visade att generellt var maskeringseffekten större vid störande tal jämfört med andra bruskällor både vad avser taluppfattning såväl som upplevd störning. Vad det gäller det engelska språket som talsignal, är störning från det svenska modersmålet påfrestande för taluppfattning, upplevd störning såväl som för minnesprocesser. Dock har stor inter- och intra-individuell variation mellan deltagarna observerats. En del av denna variation avser engelska språkfärdigheter. Perceptuell och kognitiv påfrestning kan minska möjligheten till att säkra långsiktiga minnesprocesser även om ett stimuli var ko

This thesis employed an integrated approach and investigated intra- and inter-individual differences relevant for normally hearing (NH) and hearing-impaired (HI) adults in native (Swedish) and non-native (English) languages in adverse listening conditions. The integrated approach encompassed the role of cognition as a focal point of interest as well as perceptualauditory and linguistic factors. Paper I examined the extent to which proficiency in a non-native language influenced native and non-native speech perception performance for NH listeners in noise maskers compared to native and non-native speech maskers. Working memory capacity in native and non-native languages and non-verbal intelligence were also assessed. The design of paper II was identical to that of paper I, however the participants in paper II had a hearingimpairment. The purpose of paper III was to assess how NH and HI listeners subjectively evaluated the perceived disturbance from the speech- and noise maskers in the native and nonnative languages. Paper IV examined how well native and non-native stories that were presented unmasked and masked with native and non-native speech were recalled by NH listeners. Paper IV further investigated the role of working memory capacity in the episodic long-term memory of story contents as well as proficiency in native and non-native languages. The results showed that generally, the speech maskers affected performance and perceived disturbance more than the noise maskers did. Regarding the non-native target language, interference from speech maskers in the dominant native language is taxing for speech perception performance, perceived disturbance and memory processes. However, large inter- individual variability between the listeners was observed. Part of this variability relates to non-native language proficiency. Perceptual and cognitive effort may hinder efficient long-term memory encoding, even when stimuli are appropriately identified at a perceptual level. A, Avhandlingens övergripande syfte var att genom ett integrerat tillvägagångssätt undersöka mellan- och inom-individuella skillnader relevanta för normalhörande och hörselskadade vuxna i svenska och engelska språket under ogynnsamma lyssningsförhållanden. Med kognitiva faktorer i fokus, omfattade det integrerade tillvägagångssättet också perceptuella-auditiva och lingvistiska faktorer. Studie I undersökte i vilken utsträckning färdigheter i engelska inverkade på taluppfattning av ett modersmål och ett andra språk som var maskerat med brus jämfört med störande tal på svenska och engelska. Normalhörande vuxna deltog. Arbetsminneskapacitet på svenska och engelska liksom icke-verbal intelligens bedömdes också i studien. Designen i studie II var identisk med designen i studie I, förutom att personer med hörselnedsättning ingick som deltagare. Syftet med studie III var att bedöma hur normalhörande personer och personer med hörselnedsättning subjektivt utvärderade den upplevda störningen från tal- och brus på ett modersmål och ett andra språk. Studie IV undersökte hur väl normalhörande deltagare kom ihåg berättelser på svenska och engelska som presenterades omaskerade eller med störande tal på svenska eller engelska. Studie IV undersökte vidare arbetsminneskapacitet och episodiskt långtidsminne av berättelsernas innehåll liksom också färdighet i svenska och engelska språket. Resultaten visade att generellt var maskeringseffekten större vid störande tal jämfört med andra bruskällor både vad avser taluppfattning såväl som upplevd störning. Vad det gäller det engelska språket som talsignal, är störning från det svenska modersmålet påfrestande för taluppfattning, upplevd störning såväl som för minnesprocesser. Dock har stor inter- och intra-individuell variation mellan deltagarna observerats. En del av denna variation avser engelska språkfärdigheter. Perceptuell och kognitiv påfrestning kan minska möjligheten till att säkra långsiktiga minnesprocesser även om ett stimuli var ko

In Sweden 13% of the general adult population (16-84 years), with or without hearing aids (HAs), report that they have difficulties following a conversation when more than two people are involved. This means that more than one million people in Sweden (9 500 000 inhabitants in total) report subjective hearing difficulties. Observations further indicate that that people with hearing impairment (HI) have an unfavorable position in the labor market. Individuals with HI report poorer health more frequently and estimate their own health to be worse than their normally-hearing peers. Increased unemployment, early health-related retirement and sick leaves are also more common for people with hearing loss compared to the population at large. The focus of the present thesis is employees with mild-moderate aided HI in the labor market. The research project had three general aims: 1) to develop knowledge about how HI interacts with cognitive abilities, and different types of work-related sound environments and workrelated tasks, 2) develop tests and assessment methods that allow for the analysis and assessment of perceived problems in clinical settings and 3) to develop knowledge that enables the possibility to provide recommendations of room acoustics and work-related tasks for employees with HI. Four studies were carried out. The studies presented in papers I-III are quantitative laboratory studies focusing on health related quality of life, cognition and effort and disturbance perceived in different types of occupational noise (daycare, office and traffic). Paper IV is a qualitative interview study aiming at exploring the conceptions of working life among employees with mild-moderate aided HI. The results from papers I-IV clearly demonstrate that noise has negative effects on employees with mild-moderate aided HI. In addition to generating significantly greater effort and disturbance, it is further reported from the participants that noise at work in combination with a HI h, Tidigare forskning har visat att yrkesverksamma hörselskadade oftast har en mindre gynnsam position på arbetsmarknaden. Statistik visar att gruppen upplever en högre grad av trötthet och en lägre grad av arbetstillfredställelse. Avhandlingen har tre övergripande syften: 1) att utveckla ny teoretisk kunskap om hur hörselnedsättning samspelar med kognitiva förmågor, arbetsrelaterad ljudmiljö och typ av arbetsuppgifter, och 2) utveckla test- och utredningsmetoder ger möjlighet till analys och diagnos av upplevda problem samt 3) utveckla kunskap som ger möjlighet till åtgärd och anpassning av ljudmiljöer och arbetsuppgifter på arbetsplatser för hörselskadade. Projektets resultat visar på att yrkesverksamma med hörselnedsättning rapporterar en lägre fysisk hälsostatus och att en högre grad av upplevd ansträngning samt störning kan upplevas när de utför olika arbetsuppgifter i buller. Detta beror bland annat på att de kognitiva förmågorna blir mer belastade i en bullrig miljö och att hörselskadade är mer känsliga för höga bullernivåer. Djupintervjuer med gruppen visar även på att fysisk trötthet upplevs även efter jobbet som i sin tur kan leda till psykosociala konsekvenser för individen. Denna avhandling visar att de negativa effekterna av buller redan ses vid en lätt-måttlig hörselnedsättning hos en grupp som redan använder hörapparater. Från ett kliniskt perspektiv innebär det att dagens rehabiliteringsåtgärder bör vara mer omfattande än endast hörapparaturprovning för denna grupp. Tekniska hjälpmedel (FM-system, streamers, hörslinga, etc.) är viktiga för yrkesverksamma med hörselskada och information om konsekvenserna av att leva med en hörselnedsättning bör nås ut till arbetsgivare och kollegor för att underlätta kommunikation på jobbet.

In Sweden 13% of the general adult population (16-84 years), with or without hearing aids (HAs), report that they have difficulties following a conversation when more than two people are involved. This means that more than one million people in Sweden (9 500 000 inhabitants in total) report subjective hearing difficulties. Observations further indicate that that people with hearing impairment (HI) have an unfavorable position in the labor market. Individuals with HI report poorer health more frequently and estimate their own health to be worse than their normally-hearing peers. Increased unemployment, early health-related retirement and sick leaves are also more common for people with hearing loss compared to the population at large. The focus of the present thesis is employees with mild-moderate aided HI in the labor market. The research project had three general aims: 1) to develop knowledge about how HI interacts with cognitive abilities, and different types of work-related sound environments and workrelated tasks, 2) develop tests and assessment methods that allow for the analysis and assessment of perceived problems in clinical settings and 3) to develop knowledge that enables the possibility to provide recommendations of room acoustics and work-related tasks for employees with HI. Four studies were carried out. The studies presented in papers I-III are quantitative laboratory studies focusing on health related quality of life, cognition and effort and disturbance perceived in different types of occupational noise (daycare, office and traffic). Paper IV is a qualitative interview study aiming at exploring the conceptions of working life among employees with mild-moderate aided HI. The results from papers I-IV clearly demonstrate that noise has negative effects on employees with mild-moderate aided HI. In addition to generating significantly greater effort and disturbance, it is further reported from the participants that noise at work in combination with a HI h, Tidigare forskning har visat att yrkesverksamma hörselskadade oftast har en mindre gynnsam position på arbetsmarknaden. Statistik visar att gruppen upplever en högre grad av trötthet och en lägre grad av arbetstillfredställelse. Avhandlingen har tre övergripande syften: 1) att utveckla ny teoretisk kunskap om hur hörselnedsättning samspelar med kognitiva förmågor, arbetsrelaterad ljudmiljö och typ av arbetsuppgifter, och 2) utveckla test- och utredningsmetoder ger möjlighet till analys och diagnos av upplevda problem samt 3) utveckla kunskap som ger möjlighet till åtgärd och anpassning av ljudmiljöer och arbetsuppgifter på arbetsplatser för hörselskadade. Projektets resultat visar på att yrkesverksamma med hörselnedsättning rapporterar en lägre fysisk hälsostatus och att en högre grad av upplevd ansträngning samt störning kan upplevas när de utför olika arbetsuppgifter i buller. Detta beror bland annat på att de kognitiva förmågorna blir mer belastade i en bullrig miljö och att hörselskadade är mer känsliga för höga bullernivåer. Djupintervjuer med gruppen visar även på att fysisk trötthet upplevs även efter jobbet som i sin tur kan leda till psykosociala konsekvenser för individen. Denna avhandling visar att de negativa effekterna av buller redan ses vid en lätt-måttlig hörselnedsättning hos en grupp som redan använder hörapparater. Från ett kliniskt perspektiv innebär det att dagens rehabiliteringsåtgärder bör vara mer omfattande än endast hörapparaturprovning för denna grupp. Tekniska hjälpmedel (FM-system, streamers, hörslinga, etc.) är viktiga för yrkesverksamma med hörselskada och information om konsekvenserna av att leva med en hörselnedsättning bör nås ut till arbetsgivare och kollegor för att underlätta kommunikation på jobbet.

The present thesis examined the extent to which background noise influences the isolation point (IP, the shortest time from the onset of speech stimulus required for correct identification of that speech stimulus) and accuracy in identification of different types of speech stimuli (consonants, words, and final words in high-predictable [HP] and low-predictable [LP] sentences). These speech stimuli were presented in different modalities of presentation (auditory, visual, and audiovisual) to young normal-hearing listeners (Papers 1, 2, and 5). In addition, the present thesis studied under what conditions cognitive resources were explicitly demanded in identification of different types of speech stimuli (Papers 1 and 2). Further, elderly hearing-aid (EHA) users and elderly normal-hearing (ENH) listeners were compared with regard to the IPs, accuracy, and under what conditions explicit cognitive resources were demanded in identification of auditory speech stimuli in silence (Paper 3). The results showed that background noise resulted in later IPs and reduced the accuracy for the identification of different types of speech stimuli in both modalities of speech presentation. Explicit cognitive resources were demanded in identification of speech stimuli in the auditory-only modality, under the noisy condition, and in the absence of a prior semantic context. In addition, audiovisual presentation of speech stimuli resulted in earlier IPs and more accurate identification of speech stimuli than auditory presentation. Furthermore, a pre-exposure to audiovisual speech stimuli resulted in better auditory speech-in-noise identification than an exposure to auditory-only speech stimuli (Papers 2 and 4). When comparing EHA users and ENH individuals, the EHA users showed inferior performance in the identification of consonants, words, and final words in LP sentences (in terms of IP). In terms of accuracy, the EHA users demonstrated inferior performance only in the identification of con, I denna avhandling undersöktes hur mycket bakgrundsbuller inverkar på isolationspunkten (IP, den tidigaste tidpunkt när ett talat stimulus kan identifieras korrekt) och exakthet i identifikation av olika typer av talade stimuli (konsonanter, ord, och ord i final position i högt predicerbara [HP] respektive lågt predicerbara [LP] meningar). Dessa talade stimuli presenterades i olika modaliteteter (auditivt, visuellt, och audiovisuellt) för unga normalhörande deltagare (Artikel 1, 2 och 5). Dessutom jämfördes under vilka betingelser explicita kognitiva resurser krävdes för identifikation av olika typer av talade stimuli (Artikel 1 och 2). Vidare jämfördes äldre hörapparatsanvändare (EHA) och äldre normalhörande (ENH) personer med avseende på IP, exakthet i identifikation, och under vilka betingelser explicita kognitiva resurser krävdes för auditiv identifikation i tystnad (d.v.s. utan bakgrundsbuller) (Artikel 3). Resultaten visade att bakgrundsbuller gav senare IP och sänkte exaktheten för identifikation av olika typer av talade stimuli och i båda modaliteterna för presentation. Explicita kognitiva resurser krävdes vid identifikation av talade stimuli vid rent auditiv presentation med bakgrundsbuller, och när ingen semantisk förhandsinformation presenterades. Dessutom resulterade audiovisuell presentation i tidigare IP och mer exakt identifikation av talade stimuli, jämfört med rent auditiv presentation. Ett ytterligare resultat var att förexponering av audiovisuella talade stimuli resulterade i bättre identifikation av tal i bakgrundsbrus, jämfört med förexponering av enbart auditiva talade stimuli (Artikel 2 och 4). Vid jämförelse av EHA-användare och ENH-personer, hade EHA-användare senare IP i identifikation av konsonanter, ord, och ord i final position i LP-meningar. Dessutom hade EHA-användare mindre exakt identifikation av konsonanter och ord. Endast identifikation av konsonanter och ord krävde explicita kognitiva resurser hos EHA-användare. Teoretiska predikt

The present thesis examined the extent to which background noise influences the isolation point (IP, the shortest time from the onset of speech stimulus required for correct identification of that speech stimulus) and accuracy in identification of different types of speech stimuli (consonants, words, and final words in high-predictable [HP] and low-predictable [LP] sentences). These speech stimuli were presented in different modalities of presentation (auditory, visual, and audiovisual) to young normal-hearing listeners (Papers 1, 2, and 5). In addition, the present thesis studied under what conditions cognitive resources were explicitly demanded in identification of different types of speech stimuli (Papers 1 and 2). Further, elderly hearing-aid (EHA) users and elderly normal-hearing (ENH) listeners were compared with regard to the IPs, accuracy, and under what conditions explicit cognitive resources were demanded in identification of auditory speech stimuli in silence (Paper 3). The results showed that background noise resulted in later IPs and reduced the accuracy for the identification of different types of speech stimuli in both modalities of speech presentation. Explicit cognitive resources were demanded in identification of speech stimuli in the auditory-only modality, under the noisy condition, and in the absence of a prior semantic context. In addition, audiovisual presentation of speech stimuli resulted in earlier IPs and more accurate identification of speech stimuli than auditory presentation. Furthermore, a pre-exposure to audiovisual speech stimuli resulted in better auditory speech-in-noise identification than an exposure to auditory-only speech stimuli (Papers 2 and 4). When comparing EHA users and ENH individuals, the EHA users showed inferior performance in the identification of consonants, words, and final words in LP sentences (in terms of IP). In terms of accuracy, the EHA users demonstrated inferior performance only in the identification of con, I denna avhandling undersöktes hur mycket bakgrundsbuller inverkar på isolationspunkten (IP, den tidigaste tidpunkt när ett talat stimulus kan identifieras korrekt) och exakthet i identifikation av olika typer av talade stimuli (konsonanter, ord, och ord i final position i högt predicerbara [HP] respektive lågt predicerbara [LP] meningar). Dessa talade stimuli presenterades i olika modaliteteter (auditivt, visuellt, och audiovisuellt) för unga normalhörande deltagare (Artikel 1, 2 och 5). Dessutom jämfördes under vilka betingelser explicita kognitiva resurser krävdes för identifikation av olika typer av talade stimuli (Artikel 1 och 2). Vidare jämfördes äldre hörapparatsanvändare (EHA) och äldre normalhörande (ENH) personer med avseende på IP, exakthet i identifikation, och under vilka betingelser explicita kognitiva resurser krävdes för auditiv identifikation i tystnad (d.v.s. utan bakgrundsbuller) (Artikel 3). Resultaten visade att bakgrundsbuller gav senare IP och sänkte exaktheten för identifikation av olika typer av talade stimuli och i båda modaliteterna för presentation. Explicita kognitiva resurser krävdes vid identifikation av talade stimuli vid rent auditiv presentation med bakgrundsbuller, och när ingen semantisk förhandsinformation presenterades. Dessutom resulterade audiovisuell presentation i tidigare IP och mer exakt identifikation av talade stimuli, jämfört med rent auditiv presentation. Ett ytterligare resultat var att förexponering av audiovisuella talade stimuli resulterade i bättre identifikation av tal i bakgrundsbrus, jämfört med förexponering av enbart auditiva talade stimuli (Artikel 2 och 4). Vid jämförelse av EHA-användare och ENH-personer, hade EHA-användare senare IP i identifikation av konsonanter, ord, och ord i final position i LP-meningar. Dessutom hade EHA-användare mindre exakt identifikation av konsonanter och ord. Endast identifikation av konsonanter och ord krävde explicita kognitiva resurser hos EHA-användare. Teoretiska predikt

In Sweden 13% of the general adult population (16-84 years), with or without hearing aids (HAs), report that they have difficulties following a conversation when more than two people are involved. This means that more than one million people in Sweden (9 500 000 inhabitants in total) report subjective hearing difficulties. Observations further indicate that that people with hearing impairment (HI) have an unfavorable position in the labor market. Individuals with HI report poorer health more frequently and estimate their own health to be worse than their normally-hearing peers. Increased unemployment, early health-related retirement and sick leaves are also more common for people with hearing loss compared to the population at large. The focus of the present thesis is employees with mild-moderate aided HI in the labor market. The research project had three general aims: 1) to develop knowledge about how HI interacts with cognitive abilities, and different types of work-related sound environments and workrelated tasks, 2) develop tests and assessment methods that allow for the analysis and assessment of perceived problems in clinical settings and 3) to develop knowledge that enables the possibility to provide recommendations of room acoustics and work-related tasks for employees with HI. Four studies were carried out. The studies presented in papers I-III are quantitative laboratory studies focusing on health related quality of life, cognition and effort and disturbance perceived in different types of occupational noise (daycare, office and traffic). Paper IV is a qualitative interview study aiming at exploring the conceptions of working life among employees with mild-moderate aided HI. The results from papers I-IV clearly demonstrate that noise has negative effects on employees with mild-moderate aided HI. In addition to generating significantly greater effort and disturbance, it is further reported from the participants that noise at work in combination with a HI h, Tidigare forskning har visat att yrkesverksamma hörselskadade oftast har en mindre gynnsam position på arbetsmarknaden. Statistik visar att gruppen upplever en högre grad av trötthet och en lägre grad av arbetstillfredställelse. Avhandlingen har tre övergripande syften: 1) att utveckla ny teoretisk kunskap om hur hörselnedsättning samspelar med kognitiva förmågor, arbetsrelaterad ljudmiljö och typ av arbetsuppgifter, och 2) utveckla test- och utredningsmetoder ger möjlighet till analys och diagnos av upplevda problem samt 3) utveckla kunskap som ger möjlighet till åtgärd och anpassning av ljudmiljöer och arbetsuppgifter på arbetsplatser för hörselskadade. Projektets resultat visar på att yrkesverksamma med hörselnedsättning rapporterar en lägre fysisk hälsostatus och att en högre grad av upplevd ansträngning samt störning kan upplevas när de utför olika arbetsuppgifter i buller. Detta beror bland annat på att de kognitiva förmågorna blir mer belastade i en bullrig miljö och att hörselskadade är mer känsliga för höga bullernivåer. Djupintervjuer med gruppen visar även på att fysisk trötthet upplevs även efter jobbet som i sin tur kan leda till psykosociala konsekvenser för individen. Denna avhandling visar att de negativa effekterna av buller redan ses vid en lätt-måttlig hörselnedsättning hos en grupp som redan använder hörapparater. Från ett kliniskt perspektiv innebär det att dagens rehabiliteringsåtgärder bör vara mer omfattande än endast hörapparaturprovning för denna grupp. Tekniska hjälpmedel (FM-system, streamers, hörslinga, etc.) är viktiga för yrkesverksamma med hörselskada och information om konsekvenserna av att leva med en hörselnedsättning bör nås ut till arbetsgivare och kollegor för att underlätta kommunikation på jobbet.

Objective: This discussion paper aims to synthesise the literature on patient-centred care from a range of health professions and to relate this to the field of rehabilitative audiology. Through review of the literature, this paper addresses five questions: What is patient-centred care? How is patient-centred care measured? What are the outcomes of patient-centred care? What are the factors contributing to patient-centred care? What are the implications for audiological rehabilitation? Design: Literature review and synthesis. Study sample: Publications were identified by structured searches in PubMed, Cinahl, Web of Knowledge, and PsychInfo, and by inspecting the reference lists of relevant articles. Results: Few publications from within the audiology profession address this topic and consequently a review and synthesis of literature from other areas of health were used to answer the proposed questions. Conclusion: This paper concludes that patient-centred care is in line with the aims and scope of practice for audiological rehabilitation. However, there is emerging evidence that we still need to inform the conceptualisation of patient-centred audiological rehabilitation. A definition of patient-centred audiological rehabilitation is needed to facilitate studies into the nature and outcomes of it in audiological rehabilitation practice.

In Sweden 13% of the general adult population (16-84 years), with or without hearing aids (HAs), report that they have difficulties following a conversation when more than two people are involved. This means that more than one million people in Sweden (9 500 000 inhabitants in total) report subjective hearing difficulties. Observations further indicate that that people with hearing impairment (HI) have an unfavorable position in the labor market. Individuals with HI report poorer health more frequently and estimate their own health to be worse than their normally-hearing peers. Increased unemployment, early health-related retirement and sick leaves are also more common for people with hearing loss compared to the population at large. The focus of the present thesis is employees with mild-moderate aided HI in the labor market. The research project had three general aims: 1) to develop knowledge about how HI interacts with cognitive abilities, and different types of work-related sound environments and workrelated tasks, 2) develop tests and assessment methods that allow for the analysis and assessment of perceived problems in clinical settings and 3) to develop knowledge that enables the possibility to provide recommendations of room acoustics and work-related tasks for employees with HI. Four studies were carried out. The studies presented in papers I-III are quantitative laboratory studies focusing on health related quality of life, cognition and effort and disturbance perceived in different types of occupational noise (daycare, office and traffic). Paper IV is a qualitative interview study aiming at exploring the conceptions of working life among employees with mild-moderate aided HI. The results from papers I-IV clearly demonstrate that noise has negative effects on employees with mild-moderate aided HI. In addition to generating significantly greater effort and disturbance, it is further reported from the participants that noise at work in combination with a HI h, Tidigare forskning har visat att yrkesverksamma hörselskadade oftast har en mindre gynnsam position på arbetsmarknaden. Statistik visar att gruppen upplever en högre grad av trötthet och en lägre grad av arbetstillfredställelse. Avhandlingen har tre övergripande syften: 1) att utveckla ny teoretisk kunskap om hur hörselnedsättning samspelar med kognitiva förmågor, arbetsrelaterad ljudmiljö och typ av arbetsuppgifter, och 2) utveckla test- och utredningsmetoder ger möjlighet till analys och diagnos av upplevda problem samt 3) utveckla kunskap som ger möjlighet till åtgärd och anpassning av ljudmiljöer och arbetsuppgifter på arbetsplatser för hörselskadade. Projektets resultat visar på att yrkesverksamma med hörselnedsättning rapporterar en lägre fysisk hälsostatus och att en högre grad av upplevd ansträngning samt störning kan upplevas när de utför olika arbetsuppgifter i buller. Detta beror bland annat på att de kognitiva förmågorna blir mer belastade i en bullrig miljö och att hörselskadade är mer känsliga för höga bullernivåer. Djupintervjuer med gruppen visar även på att fysisk trötthet upplevs även efter jobbet som i sin tur kan leda till psykosociala konsekvenser för individen. Denna avhandling visar att de negativa effekterna av buller redan ses vid en lätt-måttlig hörselnedsättning hos en grupp som redan använder hörapparater. Från ett kliniskt perspektiv innebär det att dagens rehabiliteringsåtgärder bör vara mer omfattande än endast hörapparaturprovning för denna grupp. Tekniska hjälpmedel (FM-system, streamers, hörslinga, etc.) är viktiga för yrkesverksamma med hörselskada och information om konsekvenserna av att leva med en hörselnedsättning bör nås ut till arbetsgivare och kollegor för att underlätta kommunikation på jobbet.

The present thesis examined the extent to which background noise influences the isolation point (IP, the shortest time from the onset of speech stimulus required for correct identification of that speech stimulus) and accuracy in identification of different types of speech stimuli (consonants, words, and final words in high-predictable [HP] and low-predictable [LP] sentences). These speech stimuli were presented in different modalities of presentation (auditory, visual, and audiovisual) to young normal-hearing listeners (Papers 1, 2, and 5). In addition, the present thesis studied under what conditions cognitive resources were explicitly demanded in identification of different types of speech stimuli (Papers 1 and 2). Further, elderly hearing-aid (EHA) users and elderly normal-hearing (ENH) listeners were compared with regard to the IPs, accuracy, and under what conditions explicit cognitive resources were demanded in identification of auditory speech stimuli in silence (Paper 3). The results showed that background noise resulted in later IPs and reduced the accuracy for the identification of different types of speech stimuli in both modalities of speech presentation. Explicit cognitive resources were demanded in identification of speech stimuli in the auditory-only modality, under the noisy condition, and in the absence of a prior semantic context. In addition, audiovisual presentation of speech stimuli resulted in earlier IPs and more accurate identification of speech stimuli than auditory presentation. Furthermore, a pre-exposure to audiovisual speech stimuli resulted in better auditory speech-in-noise identification than an exposure to auditory-only speech stimuli (Papers 2 and 4). When comparing EHA users and ENH individuals, the EHA users showed inferior performance in the identification of consonants, words, and final words in LP sentences (in terms of IP). In terms of accuracy, the EHA users demonstrated inferior performance only in the identification of con, I denna avhandling undersöktes hur mycket bakgrundsbuller inverkar på isolationspunkten (IP, den tidigaste tidpunkt när ett talat stimulus kan identifieras korrekt) och exakthet i identifikation av olika typer av talade stimuli (konsonanter, ord, och ord i final position i högt predicerbara [HP] respektive lågt predicerbara [LP] meningar). Dessa talade stimuli presenterades i olika modaliteteter (auditivt, visuellt, och audiovisuellt) för unga normalhörande deltagare (Artikel 1, 2 och 5). Dessutom jämfördes under vilka betingelser explicita kognitiva resurser krävdes för identifikation av olika typer av talade stimuli (Artikel 1 och 2). Vidare jämfördes äldre hörapparatsanvändare (EHA) och äldre normalhörande (ENH) personer med avseende på IP, exakthet i identifikation, och under vilka betingelser explicita kognitiva resurser krävdes för auditiv identifikation i tystnad (d.v.s. utan bakgrundsbuller) (Artikel 3). Resultaten visade att bakgrundsbuller gav senare IP och sänkte exaktheten för identifikation av olika typer av talade stimuli och i båda modaliteterna för presentation. Explicita kognitiva resurser krävdes vid identifikation av talade stimuli vid rent auditiv presentation med bakgrundsbuller, och när ingen semantisk förhandsinformation presenterades. Dessutom resulterade audiovisuell presentation i tidigare IP och mer exakt identifikation av talade stimuli, jämfört med rent auditiv presentation. Ett ytterligare resultat var att förexponering av audiovisuella talade stimuli resulterade i bättre identifikation av tal i bakgrundsbrus, jämfört med förexponering av enbart auditiva talade stimuli (Artikel 2 och 4). Vid jämförelse av EHA-användare och ENH-personer, hade EHA-användare senare IP i identifikation av konsonanter, ord, och ord i final position i LP-meningar. Dessutom hade EHA-användare mindre exakt identifikation av konsonanter och ord. Endast identifikation av konsonanter och ord krävde explicita kognitiva resurser hos EHA-användare. Teoretiska predikt

In Sweden 13% of the general adult population (16-84 years), with or without hearing aids (HAs), report that they have difficulties following a conversation when more than two people are involved. This means that more than one million people in Sweden (9 500 000 inhabitants in total) report subjective hearing difficulties. Observations further indicate that that people with hearing impairment (HI) have an unfavorable position in the labor market. Individuals with HI report poorer health more frequently and estimate their own health to be worse than their normally-hearing peers. Increased unemployment, early health-related retirement and sick leaves are also more common for people with hearing loss compared to the population at large. The focus of the present thesis is employees with mild-moderate aided HI in the labor market. The research project had three general aims: 1) to develop knowledge about how HI interacts with cognitive abilities, and different types of work-related sound environments and workrelated tasks, 2) develop tests and assessment methods that allow for the analysis and assessment of perceived problems in clinical settings and 3) to develop knowledge that enables the possibility to provide recommendations of room acoustics and work-related tasks for employees with HI. Four studies were carried out. The studies presented in papers I-III are quantitative laboratory studies focusing on health related quality of life, cognition and effort and disturbance perceived in different types of occupational noise (daycare, office and traffic). Paper IV is a qualitative interview study aiming at exploring the conceptions of working life among employees with mild-moderate aided HI. The results from papers I-IV clearly demonstrate that noise has negative effects on employees with mild-moderate aided HI. In addition to generating significantly greater effort and disturbance, it is further reported from the participants that noise at work in combination with a HI h, Tidigare forskning har visat att yrkesverksamma hörselskadade oftast har en mindre gynnsam position på arbetsmarknaden. Statistik visar att gruppen upplever en högre grad av trötthet och en lägre grad av arbetstillfredställelse. Avhandlingen har tre övergripande syften: 1) att utveckla ny teoretisk kunskap om hur hörselnedsättning samspelar med kognitiva förmågor, arbetsrelaterad ljudmiljö och typ av arbetsuppgifter, och 2) utveckla test- och utredningsmetoder ger möjlighet till analys och diagnos av upplevda problem samt 3) utveckla kunskap som ger möjlighet till åtgärd och anpassning av ljudmiljöer och arbetsuppgifter på arbetsplatser för hörselskadade. Projektets resultat visar på att yrkesverksamma med hörselnedsättning rapporterar en lägre fysisk hälsostatus och att en högre grad av upplevd ansträngning samt störning kan upplevas när de utför olika arbetsuppgifter i buller. Detta beror bland annat på att de kognitiva förmågorna blir mer belastade i en bullrig miljö och att hörselskadade är mer känsliga för höga bullernivåer. Djupintervjuer med gruppen visar även på att fysisk trötthet upplevs även efter jobbet som i sin tur kan leda till psykosociala konsekvenser för individen. Denna avhandling visar att de negativa effekterna av buller redan ses vid en lätt-måttlig hörselnedsättning hos en grupp som redan använder hörapparater. Från ett kliniskt perspektiv innebär det att dagens rehabiliteringsåtgärder bör vara mer omfattande än endast hörapparaturprovning för denna grupp. Tekniska hjälpmedel (FM-system, streamers, hörslinga, etc.) är viktiga för yrkesverksamma med hörselskada och information om konsekvenserna av att leva med en hörselnedsättning bör nås ut till arbetsgivare och kollegor för att underlätta kommunikation på jobbet.

The present thesis examined the extent to which background noise influences the isolation point (IP, the shortest time from the onset of speech stimulus required for correct identification of that speech stimulus) and accuracy in identification of different types of speech stimuli (consonants, words, and final words in high-predictable [HP] and low-predictable [LP] sentences). These speech stimuli were presented in different modalities of presentation (auditory, visual, and audiovisual) to young normal-hearing listeners (Papers 1, 2, and 5). In addition, the present thesis studied under what conditions cognitive resources were explicitly demanded in identification of different types of speech stimuli (Papers 1 and 2). Further, elderly hearing-aid (EHA) users and elderly normal-hearing (ENH) listeners were compared with regard to the IPs, accuracy, and under what conditions explicit cognitive resources were demanded in identification of auditory speech stimuli in silence (Paper 3). The results showed that background noise resulted in later IPs and reduced the accuracy for the identification of different types of speech stimuli in both modalities of speech presentation. Explicit cognitive resources were demanded in identification of speech stimuli in the auditory-only modality, under the noisy condition, and in the absence of a prior semantic context. In addition, audiovisual presentation of speech stimuli resulted in earlier IPs and more accurate identification of speech stimuli than auditory presentation. Furthermore, a pre-exposure to audiovisual speech stimuli resulted in better auditory speech-in-noise identification than an exposure to auditory-only speech stimuli (Papers 2 and 4). When comparing EHA users and ENH individuals, the EHA users showed inferior performance in the identification of consonants, words, and final words in LP sentences (in terms of IP). In terms of accuracy, the EHA users demonstrated inferior performance only in the identification of con, I denna avhandling undersöktes hur mycket bakgrundsbuller inverkar på isolationspunkten (IP, den tidigaste tidpunkt när ett talat stimulus kan identifieras korrekt) och exakthet i identifikation av olika typer av talade stimuli (konsonanter, ord, och ord i final position i högt predicerbara [HP] respektive lågt predicerbara [LP] meningar). Dessa talade stimuli presenterades i olika modaliteteter (auditivt, visuellt, och audiovisuellt) för unga normalhörande deltagare (Artikel 1, 2 och 5). Dessutom jämfördes under vilka betingelser explicita kognitiva resurser krävdes för identifikation av olika typer av talade stimuli (Artikel 1 och 2). Vidare jämfördes äldre hörapparatsanvändare (EHA) och äldre normalhörande (ENH) personer med avseende på IP, exakthet i identifikation, och under vilka betingelser explicita kognitiva resurser krävdes för auditiv identifikation i tystnad (d.v.s. utan bakgrundsbuller) (Artikel 3). Resultaten visade att bakgrundsbuller gav senare IP och sänkte exaktheten för identifikation av olika typer av talade stimuli och i båda modaliteterna för presentation. Explicita kognitiva resurser krävdes vid identifikation av talade stimuli vid rent auditiv presentation med bakgrundsbuller, och när ingen semantisk förhandsinformation presenterades. Dessutom resulterade audiovisuell presentation i tidigare IP och mer exakt identifikation av talade stimuli, jämfört med rent auditiv presentation. Ett ytterligare resultat var att förexponering av audiovisuella talade stimuli resulterade i bättre identifikation av tal i bakgrundsbrus, jämfört med förexponering av enbart auditiva talade stimuli (Artikel 2 och 4). Vid jämförelse av EHA-användare och ENH-personer, hade EHA-användare senare IP i identifikation av konsonanter, ord, och ord i final position i LP-meningar. Dessutom hade EHA-användare mindre exakt identifikation av konsonanter och ord. Endast identifikation av konsonanter och ord krävde explicita kognitiva resurser hos EHA-användare. Teoretiska predikt

In Sweden 13% of the general adult population (16-84 years), with or without hearing aids (HAs), report that they have difficulties following a conversation when more than two people are involved. This means that more than one million people in Sweden (9 500 000 inhabitants in total) report subjective hearing difficulties. Observations further indicate that that people with hearing impairment (HI) have an unfavorable position in the labor market. Individuals with HI report poorer health more frequently and estimate their own health to be worse than their normally-hearing peers. Increased unemployment, early health-related retirement and sick leaves are also more common for people with hearing loss compared to the population at large. The focus of the present thesis is employees with mild-moderate aided HI in the labor market. The research project had three general aims: 1) to develop knowledge about how HI interacts with cognitive abilities, and different types of work-related sound environments and workrelated tasks, 2) develop tests and assessment methods that allow for the analysis and assessment of perceived problems in clinical settings and 3) to develop knowledge that enables the possibility to provide recommendations of room acoustics and work-related tasks for employees with HI. Four studies were carried out. The studies presented in papers I-III are quantitative laboratory studies focusing on health related quality of life, cognition and effort and disturbance perceived in different types of occupational noise (daycare, office and traffic). Paper IV is a qualitative interview study aiming at exploring the conceptions of working life among employees with mild-moderate aided HI. The results from papers I-IV clearly demonstrate that noise has negative effects on employees with mild-moderate aided HI. In addition to generating significantly greater effort and disturbance, it is further reported from the participants that noise at work in combination with a HI h, Tidigare forskning har visat att yrkesverksamma hörselskadade oftast har en mindre gynnsam position på arbetsmarknaden. Statistik visar att gruppen upplever en högre grad av trötthet och en lägre grad av arbetstillfredställelse. Avhandlingen har tre övergripande syften: 1) att utveckla ny teoretisk kunskap om hur hörselnedsättning samspelar med kognitiva förmågor, arbetsrelaterad ljudmiljö och typ av arbetsuppgifter, och 2) utveckla test- och utredningsmetoder ger möjlighet till analys och diagnos av upplevda problem samt 3) utveckla kunskap som ger möjlighet till åtgärd och anpassning av ljudmiljöer och arbetsuppgifter på arbetsplatser för hörselskadade. Projektets resultat visar på att yrkesverksamma med hörselnedsättning rapporterar en lägre fysisk hälsostatus och att en högre grad av upplevd ansträngning samt störning kan upplevas när de utför olika arbetsuppgifter i buller. Detta beror bland annat på att de kognitiva förmågorna blir mer belastade i en bullrig miljö och att hörselskadade är mer känsliga för höga bullernivåer. Djupintervjuer med gruppen visar även på att fysisk trötthet upplevs även efter jobbet som i sin tur kan leda till psykosociala konsekvenser för individen. Denna avhandling visar att de negativa effekterna av buller redan ses vid en lätt-måttlig hörselnedsättning hos en grupp som redan använder hörapparater. Från ett kliniskt perspektiv innebär det att dagens rehabiliteringsåtgärder bör vara mer omfattande än endast hörapparaturprovning för denna grupp. Tekniska hjälpmedel (FM-system, streamers, hörslinga, etc.) är viktiga för yrkesverksamma med hörselskada och information om konsekvenserna av att leva med en hörselnedsättning bör nås ut till arbetsgivare och kollegor för att underlätta kommunikation på jobbet.

The present thesis examined the extent to which background noise influences the isolation point (IP, the shortest time from the onset of speech stimulus required for correct identification of that speech stimulus) and accuracy in identification of different types of speech stimuli (consonants, words, and final words in high-predictable [HP] and low-predictable [LP] sentences). These speech stimuli were presented in different modalities of presentation (auditory, visual, and audiovisual) to young normal-hearing listeners (Papers 1, 2, and 5). In addition, the present thesis studied under what conditions cognitive resources were explicitly demanded in identification of different types of speech stimuli (Papers 1 and 2). Further, elderly hearing-aid (EHA) users and elderly normal-hearing (ENH) listeners were compared with regard to the IPs, accuracy, and under what conditions explicit cognitive resources were demanded in identification of auditory speech stimuli in silence (Paper 3). The results showed that background noise resulted in later IPs and reduced the accuracy for the identification of different types of speech stimuli in both modalities of speech presentation. Explicit cognitive resources were demanded in identification of speech stimuli in the auditory-only modality, under the noisy condition, and in the absence of a prior semantic context. In addition, audiovisual presentation of speech stimuli resulted in earlier IPs and more accurate identification of speech stimuli than auditory presentation. Furthermore, a pre-exposure to audiovisual speech stimuli resulted in better auditory speech-in-noise identification than an exposure to auditory-only speech stimuli (Papers 2 and 4). When comparing EHA users and ENH individuals, the EHA users showed inferior performance in the identification of consonants, words, and final words in LP sentences (in terms of IP). In terms of accuracy, the EHA users demonstrated inferior performance only in the identification of con, I denna avhandling undersöktes hur mycket bakgrundsbuller inverkar på isolationspunkten (IP, den tidigaste tidpunkt när ett talat stimulus kan identifieras korrekt) och exakthet i identifikation av olika typer av talade stimuli (konsonanter, ord, och ord i final position i högt predicerbara [HP] respektive lågt predicerbara [LP] meningar). Dessa talade stimuli presenterades i olika modaliteteter (auditivt, visuellt, och audiovisuellt) för unga normalhörande deltagare (Artikel 1, 2 och 5). Dessutom jämfördes under vilka betingelser explicita kognitiva resurser krävdes för identifikation av olika typer av talade stimuli (Artikel 1 och 2). Vidare jämfördes äldre hörapparatsanvändare (EHA) och äldre normalhörande (ENH) personer med avseende på IP, exakthet i identifikation, och under vilka betingelser explicita kognitiva resurser krävdes för auditiv identifikation i tystnad (d.v.s. utan bakgrundsbuller) (Artikel 3). Resultaten visade att bakgrundsbuller gav senare IP och sänkte exaktheten för identifikation av olika typer av talade stimuli och i båda modaliteterna för presentation. Explicita kognitiva resurser krävdes vid identifikation av talade stimuli vid rent auditiv presentation med bakgrundsbuller, och när ingen semantisk förhandsinformation presenterades. Dessutom resulterade audiovisuell presentation i tidigare IP och mer exakt identifikation av talade stimuli, jämfört med rent auditiv presentation. Ett ytterligare resultat var att förexponering av audiovisuella talade stimuli resulterade i bättre identifikation av tal i bakgrundsbrus, jämfört med förexponering av enbart auditiva talade stimuli (Artikel 2 och 4). Vid jämförelse av EHA-användare och ENH-personer, hade EHA-användare senare IP i identifikation av konsonanter, ord, och ord i final position i LP-meningar. Dessutom hade EHA-användare mindre exakt identifikation av konsonanter och ord. Endast identifikation av konsonanter och ord krävde explicita kognitiva resurser hos EHA-användare. Teoretiska predikt

This thesis examined phonological processing in adults with postlingually acquired moderate-to-severe hearing impairment (HI) and whether explicit working memory processing of phonology and individual working memory capacity (WMC) can compensate for degraded phonological representations in this group (papers I-III). A second aim was to provide reference data for a test of WMC, the reading span test, and to examine the relation between reading span test performance and speech recognition in noise in a larger sample of 50-89 year olds with HI (paper IV). Non-auditory tasks of phonological processing, episodic long-term memory and WMC were used in papers I-III, and both behavioral and electrophysiological measures were collected. Results showed that phonological processing was impaired in the group with HI but that WMC and explicit working memory processing of phonology could be employed to compensate for degraded phonological representations. However, this compensation may come at the cost of interfering with episodic memory encoding. An electrophysiological marker of HI in text-based rhyme judgments was found. Paper IV presented reference data for reading span test performance in two versions of the test in individuals with HI, and results suggesting that WMC may be differentially predictive of speech recognition in noise in different age groups of older adults with HI. The clinical implications of the present results concerns the double disadvantage of individuals with lower WMC and HI. A structured assessment of WMC in rehabilitative settings would help to identify these individuals and tailor treatment to their needs. The reading span test is suggested as a suitable future candidate for clinical WMC assessment., I denna avhandling undersöktes fonologiska processer hos personer med postlingualt förvärvad, måttlig till mycket grav hörselnedsättning (HNS) och om inkoppling av explicit bearbetning av fonologi eller individuell arbetsminneskapacitet kan kompensera för försämrade ljudminnen i denna grupp (studie I-III). Ett andra syfte var att sammanställa referensdata för ett test av arbetsminneskapacitet, lässpann, och undersöka relationen mellan prestation på lässpann ochigenkänning av tal-i-brus i en större grupp av 50-89 åriga personer med HNS (studie IV). Icke-auditiva test av fonologisk förmåga, episodiskt långtidsminne och arbetsminneskapacitet användes i studie I-III och både beteendedata och elektrofysiologiska data samlades in. Resultaten visade på försämrad fonologisk förmåga i gruppen med HNS men också att explicit bearbetning av fonologi och arbetsminneskapacitet kunde användas för att kompensera för försämrade fonologiska representationer i denna grupp. Denna kompensation kan dock ske på bekostnad av att inkodning i episodiska långtidsminnet störs. Vidare identifierades en elektrofysiologisk markör för HNS i en textbaserad rimuppgift. I studie IV presenterades referensdata i två versioner av lässpanntestet för personer med mild till mycket grav HN och resultat som pekar mot möjliga skillnader mellan olika åldersgrupper i hur väl arbetsminneskapacitet predicerar igenkänning av tal-i-brus. Kliniska implikationer rör den dubbla belastning det innebär att ha både en HN och relativt sänkt arbetsminneskapacitet. En strukturerad bedömning av arbetsminneskapacitet i samband med rehabilitering skulle kunna bidra till att synliggöra dessa personer och anpassa insatser efter deras behov. Lässpanntestet är ett test som i framtiden skulle kunna vara användbart i det sammanhanget.

This thesis examined phonological processing in adults with postlingually acquired moderate-to-severe hearing impairment (HI) and whether explicit working memory processing of phonology and individual working memory capacity (WMC) can compensate for degraded phonological representations in this group (papers I-III). A second aim was to provide reference data for a test of WMC, the reading span test, and to examine the relation between reading span test performance and speech recognition in noise in a larger sample of 50-89 year olds with HI (paper IV). Non-auditory tasks of phonological processing, episodic long-term memory and WMC were used in papers I-III, and both behavioral and electrophysiological measures were collected. Results showed that phonological processing was impaired in the group with HI but that WMC and explicit working memory processing of phonology could be employed to compensate for degraded phonological representations. However, this compensation may come at the cost of interfering with episodic memory encoding. An electrophysiological marker of HI in text-based rhyme judgments was found. Paper IV presented reference data for reading span test performance in two versions of the test in individuals with HI, and results suggesting that WMC may be differentially predictive of speech recognition in noise in different age groups of older adults with HI. The clinical implications of the present results concerns the double disadvantage of individuals with lower WMC and HI. A structured assessment of WMC in rehabilitative settings would help to identify these individuals and tailor treatment to their needs. The reading span test is suggested as a suitable future candidate for clinical WMC assessment., I denna avhandling undersöktes fonologiska processer hos personer med postlingualt förvärvad, måttlig till mycket grav hörselnedsättning (HNS) och om inkoppling av explicit bearbetning av fonologi eller individuell arbetsminneskapacitet kan kompensera för försämrade ljudminnen i denna grupp (studie I-III). Ett andra syfte var att sammanställa referensdata för ett test av arbetsminneskapacitet, lässpann, och undersöka relationen mellan prestation på lässpann ochigenkänning av tal-i-brus i en större grupp av 50-89 åriga personer med HNS (studie IV). Icke-auditiva test av fonologisk förmåga, episodiskt långtidsminne och arbetsminneskapacitet användes i studie I-III och både beteendedata och elektrofysiologiska data samlades in. Resultaten visade på försämrad fonologisk förmåga i gruppen med HNS men också att explicit bearbetning av fonologi och arbetsminneskapacitet kunde användas för att kompensera för försämrade fonologiska representationer i denna grupp. Denna kompensation kan dock ske på bekostnad av att inkodning i episodiska långtidsminnet störs. Vidare identifierades en elektrofysiologisk markör för HNS i en textbaserad rimuppgift. I studie IV presenterades referensdata i två versioner av lässpanntestet för personer med mild till mycket grav HN och resultat som pekar mot möjliga skillnader mellan olika åldersgrupper i hur väl arbetsminneskapacitet predicerar igenkänning av tal-i-brus. Kliniska implikationer rör den dubbla belastning det innebär att ha både en HN och relativt sänkt arbetsminneskapacitet. En strukturerad bedömning av arbetsminneskapacitet i samband med rehabilitering skulle kunna bidra till att synliggöra dessa personer och anpassa insatser efter deras behov. Lässpanntestet är ett test som i framtiden skulle kunna vara användbart i det sammanhanget.

This thesis examined phonological processing in adults with postlingually acquired moderate-to-severe hearing impairment (HI) and whether explicit working memory processing of phonology and individual working memory capacity (WMC) can compensate for degraded phonological representations in this group (papers I-III). A second aim was to provide reference data for a test of WMC, the reading span test, and to examine the relation between reading span test performance and speech recognition in noise in a larger sample of 50-89 year olds with HI (paper IV). Non-auditory tasks of phonological processing, episodic long-term memory and WMC were used in papers I-III, and both behavioral and electrophysiological measures were collected. Results showed that phonological processing was impaired in the group with HI but that WMC and explicit working memory processing of phonology could be employed to compensate for degraded phonological representations. However, this compensation may come at the cost of interfering with episodic memory encoding. An electrophysiological marker of HI in text-based rhyme judgments was found. Paper IV presented reference data for reading span test performance in two versions of the test in individuals with HI, and results suggesting that WMC may be differentially predictive of speech recognition in noise in different age groups of older adults with HI. The clinical implications of the present results concerns the double disadvantage of individuals with lower WMC and HI. A structured assessment of WMC in rehabilitative settings would help to identify these individuals and tailor treatment to their needs. The reading span test is suggested as a suitable future candidate for clinical WMC assessment., I denna avhandling undersöktes fonologiska processer hos personer med postlingualt förvärvad, måttlig till mycket grav hörselnedsättning (HNS) och om inkoppling av explicit bearbetning av fonologi eller individuell arbetsminneskapacitet kan kompensera för försämrade ljudminnen i denna grupp (studie I-III). Ett andra syfte var att sammanställa referensdata för ett test av arbetsminneskapacitet, lässpann, och undersöka relationen mellan prestation på lässpann ochigenkänning av tal-i-brus i en större grupp av 50-89 åriga personer med HNS (studie IV). Icke-auditiva test av fonologisk förmåga, episodiskt långtidsminne och arbetsminneskapacitet användes i studie I-III och både beteendedata och elektrofysiologiska data samlades in. Resultaten visade på försämrad fonologisk förmåga i gruppen med HNS men också att explicit bearbetning av fonologi och arbetsminneskapacitet kunde användas för att kompensera för försämrade fonologiska representationer i denna grupp. Denna kompensation kan dock ske på bekostnad av att inkodning i episodiska långtidsminnet störs. Vidare identifierades en elektrofysiologisk markör för HNS i en textbaserad rimuppgift. I studie IV presenterades referensdata i två versioner av lässpanntestet för personer med mild till mycket grav HN och resultat som pekar mot möjliga skillnader mellan olika åldersgrupper i hur väl arbetsminneskapacitet predicerar igenkänning av tal-i-brus. Kliniska implikationer rör den dubbla belastning det innebär att ha både en HN och relativt sänkt arbetsminneskapacitet. En strukturerad bedömning av arbetsminneskapacitet i samband med rehabilitering skulle kunna bidra till att synliggöra dessa personer och anpassa insatser efter deras behov. Lässpanntestet är ett test som i framtiden skulle kunna vara användbart i det sammanhanget.

This paper considers evidence of plasticity resulting from congenital and acquired hearing impairment as well as technical and language interventions. Speech communication is hindered by hearing loss. Individuals with normal hearing in childhood may experience hearing loss as they grow older and use technical and cognitive resources to maintain speech communication.The short- and medium-term effects of hearing aid interventions seem to be mediated by individual cognitive abilities and may be specific to listening conditions including speech content, type of background noise and type of hearing aid signal processing. Furthermore, some aspects of cognitive function may decline with age and there is evidence that age-related hearing impairment is associated with poorer long-term memory. It is not yet clear whether improving audition through hearing aid intervention can prevent cognitive decline. Profound deafness from an early age implicates a set of critical choices relating to possible restoration of the auditory signal through the use of prostheses including cochlear implants and hearing aids as well as tomode of communication, sign or speech. These choices have an influence on the organization of the developing brain. In particular, while the cortex may display sensory reorganization in response the linguistic modality of choice, cognitive organization seems to prevail.

This thesis examined phonological processing in adults with postlingually acquired moderate-to-severe hearing impairment (HI) and whether explicit working memory processing of phonology and individual working memory capacity (WMC) can compensate for degraded phonological representations in this group (papers I-III). A second aim was to provide reference data for a test of WMC, the reading span test, and to examine the relation between reading span test performance and speech recognition in noise in a larger sample of 50-89 year olds with HI (paper IV). Non-auditory tasks of phonological processing, episodic long-term memory and WMC were used in papers I-III, and both behavioral and electrophysiological measures were collected. Results showed that phonological processing was impaired in the group with HI but that WMC and explicit working memory processing of phonology could be employed to compensate for degraded phonological representations. However, this compensation may come at the cost of interfering with episodic memory encoding. An electrophysiological marker of HI in text-based rhyme judgments was found. Paper IV presented reference data for reading span test performance in two versions of the test in individuals with HI, and results suggesting that WMC may be differentially predictive of speech recognition in noise in different age groups of older adults with HI. The clinical implications of the present results concerns the double disadvantage of individuals with lower WMC and HI. A structured assessment of WMC in rehabilitative settings would help to identify these individuals and tailor treatment to their needs. The reading span test is suggested as a suitable future candidate for clinical WMC assessment., I denna avhandling undersöktes fonologiska processer hos personer med postlingualt förvärvad, måttlig till mycket grav hörselnedsättning (HNS) och om inkoppling av explicit bearbetning av fonologi eller individuell arbetsminneskapacitet kan kompensera för försämrade ljudminnen i denna grupp (studie I-III). Ett andra syfte var att sammanställa referensdata för ett test av arbetsminneskapacitet, lässpann, och undersöka relationen mellan prestation på lässpann ochigenkänning av tal-i-brus i en större grupp av 50-89 åriga personer med HNS (studie IV). Icke-auditiva test av fonologisk förmåga, episodiskt långtidsminne och arbetsminneskapacitet användes i studie I-III och både beteendedata och elektrofysiologiska data samlades in. Resultaten visade på försämrad fonologisk förmåga i gruppen med HNS men också att explicit bearbetning av fonologi och arbetsminneskapacitet kunde användas för att kompensera för försämrade fonologiska representationer i denna grupp. Denna kompensation kan dock ske på bekostnad av att inkodning i episodiska långtidsminnet störs. Vidare identifierades en elektrofysiologisk markör för HNS i en textbaserad rimuppgift. I studie IV presenterades referensdata i två versioner av lässpanntestet för personer med mild till mycket grav HN och resultat som pekar mot möjliga skillnader mellan olika åldersgrupper i hur väl arbetsminneskapacitet predicerar igenkänning av tal-i-brus. Kliniska implikationer rör den dubbla belastning det innebär att ha både en HN och relativt sänkt arbetsminneskapacitet. En strukturerad bedömning av arbetsminneskapacitet i samband med rehabilitering skulle kunna bidra till att synliggöra dessa personer och anpassa insatser efter deras behov. Lässpanntestet är ett test som i framtiden skulle kunna vara användbart i det sammanhanget.

This thesis examined phonological processing in adults with postlingually acquired moderate-to-severe hearing impairment (HI) and whether explicit working memory processing of phonology and individual working memory capacity (WMC) can compensate for degraded phonological representations in this group (papers I-III). A second aim was to provide reference data for a test of WMC, the reading span test, and to examine the relation between reading span test performance and speech recognition in noise in a larger sample of 50-89 year olds with HI (paper IV). Non-auditory tasks of phonological processing, episodic long-term memory and WMC were used in papers I-III, and both behavioral and electrophysiological measures were collected. Results showed that phonological processing was impaired in the group with HI but that WMC and explicit working memory processing of phonology could be employed to compensate for degraded phonological representations. However, this compensation may come at the cost of interfering with episodic memory encoding. An electrophysiological marker of HI in text-based rhyme judgments was found. Paper IV presented reference data for reading span test performance in two versions of the test in individuals with HI, and results suggesting that WMC may be differentially predictive of speech recognition in noise in different age groups of older adults with HI. The clinical implications of the present results concerns the double disadvantage of individuals with lower WMC and HI. A structured assessment of WMC in rehabilitative settings would help to identify these individuals and tailor treatment to their needs. The reading span test is suggested as a suitable future candidate for clinical WMC assessment., I denna avhandling undersöktes fonologiska processer hos personer med postlingualt förvärvad, måttlig till mycket grav hörselnedsättning (HNS) och om inkoppling av explicit bearbetning av fonologi eller individuell arbetsminneskapacitet kan kompensera för försämrade ljudminnen i denna grupp (studie I-III). Ett andra syfte var att sammanställa referensdata för ett test av arbetsminneskapacitet, lässpann, och undersöka relationen mellan prestation på lässpann ochigenkänning av tal-i-brus i en större grupp av 50-89 åriga personer med HNS (studie IV). Icke-auditiva test av fonologisk förmåga, episodiskt långtidsminne och arbetsminneskapacitet användes i studie I-III och både beteendedata och elektrofysiologiska data samlades in. Resultaten visade på försämrad fonologisk förmåga i gruppen med HNS men också att explicit bearbetning av fonologi och arbetsminneskapacitet kunde användas för att kompensera för försämrade fonologiska representationer i denna grupp. Denna kompensation kan dock ske på bekostnad av att inkodning i episodiska långtidsminnet störs. Vidare identifierades en elektrofysiologisk markör för HNS i en textbaserad rimuppgift. I studie IV presenterades referensdata i två versioner av lässpanntestet för personer med mild till mycket grav HN och resultat som pekar mot möjliga skillnader mellan olika åldersgrupper i hur väl arbetsminneskapacitet predicerar igenkänning av tal-i-brus. Kliniska implikationer rör den dubbla belastning det innebär att ha både en HN och relativt sänkt arbetsminneskapacitet. En strukturerad bedömning av arbetsminneskapacitet i samband med rehabilitering skulle kunna bidra till att synliggöra dessa personer och anpassa insatser efter deras behov. Lässpanntestet är ett test som i framtiden skulle kunna vara användbart i det sammanhanget.

This paper considers evidence of plasticity resulting from congenital and acquired hearing impairment as well as technical and language interventions. Speech communication is hindered by hearing loss. Individuals with normal hearing in childhood may experience hearing loss as they grow older and use technical and cognitive resources to maintain speech communication. The short- and medium-term effects of hearing aid interventions seem to be mediated by individual cognitive abilities and may be specific to listening conditions including speech content, type of background noise and type of hearing aid signal processing. Furthermore, some aspects of cognitive function may decline with age and there is evidence that age-related hearing impairment is associated with poorer long-term memory. It is not yet clear whether improving audition through hearing aid intervention can prevent cognitive decline. Profound deafness from an early age implicates a set of critical choices relating to possible restoration of the auditory signal through the use of prostheses including cochlear implants and hearing aids as well as to mode of communication, sign or speech. These choices have an influence on the organization of the developing brain. In particular, while the cortex may display sensory reorganization in response, Invited

Objective: Hearing impairment is known to have various effects upon both the person with hearing impairment (PHI) and their communication partners (CPs). In addition, CPs are reported to play an important role in making the decision to seek a consultation and the acceptance of intervention by the PHI. The overall aim of this paper is to provide a comprehensive overview of the role of the CP in the audiological enablement/rehabilitation of the PHI keeping clinical practice in focus. Method: A literature review was conducted using a number of resources including electronic databases, books and websites. Results: An overview of the literature was presented in the following sections: 1) Factors influencing the audiological enablement/rehabilitation of the PHI; 2) Effect of the PHI's hearing impairment on their CPs; 3) CPs’ influence on their PHI's audiological enablement/rehabilitation; 4) Positive experiences reported by CPs of the PHI; 5) Models to represent CPs within the social network context of the PHI; and 6) CP involvement in the audiological enablement/rehabilitation. This paper also identifies gaps in the literature and provides recommendations for further research. Conclusion: It is clear that involvement of the CP in the audiological enablement/rehabilitation can result in mutual advantages for both the PHI and their CPs.

Avhandlingen handlar om prospektivt minne (PM) hos personer med utvecklingsstörning. PM syftar på att formulera intentioner och genomföra dessa någon gång i framtiden, antingen inom en definierad tidsram eller i samband med en specifik händelse. Frågeställningar: 1. Finns det en kvalitativ och kvantitativ skillnad mellan prospektivt minne hos personer med utvecklingsstörning och en kontrollgrupp? (Artikel I – II) 2. Hur ser sambandet mellan prospektivt minne, arbetsminne och episodiskt minne ut hos personer med utvecklingsstörning och, skiljer sig detta åt jämfört med kontrollgruppen? (Artikel II) 3. Vilka förutsättningar vid inkodning och hågkomst är kompatibla? (Artikel III) 4. På vilket sätt kan svag association mellan olika delar av information bidra till prospektiva minnesfel? (Artikel IV) 5. Går det att särskilja en hög- respektive lågpresterande grupp personer med utvecklingsstörning med avseende på prospektiv minnesprestation? (Artikel II) Personer med utvecklingsstörning begår fler prospektiva minnesfel än personer i kontrollgruppen. Motsvarande gruppskillnad finns inte för självskattat minne. Prospektiv minnesprestation är bättre med bilder jämfört med ord som prospektiva ledtrådar, mest tydligt för personer med utvecklingsstörning. Arbetsminneskapacitet visade ett samband med både prospektivt minne och antalet falska minnen i kognitivt krävande situationer, till exempel, situationer med flera parallella prospektiva minnesuppgifter. Falska minnen och prospektivt minne hade ett samband hos personer med utvecklingsstörning. Att felaktigt känna igen bilder med bara delvis bekanta delar och att känna igen prospektiva ledtrådar utan att komma ihåg själva intentionen hade ett samband hos personer med utvecklingsstörning. Personer med utvecklingsstörning var också sämre än kontrollgruppen på att upprepa tidsintervall. Detta kan till exempel bero på bristande episodiskt minne och begränsade strategier för att lösa den här typen av uppgifter. Resultaten diskuteras, This thesis deals with prospective memory (PM) in individuals with intellectual disability. The term refers to planning and executing actions that cannot be performed immediately and have to be stored in memory and retrieved either within a specified timeframe or to be associated with a specific event. Following research questions were explored: 1. Does prospective memory performance in the intellectual disability group differ quantitatively and qualitatively compared to a control group of individuals without intellectual disability? (Paper I – II) 2. What are the relations between prospective memory, working memory and episodic memory in individuals with intellectual disability, and how are these relations different from the relations found in individuals without intellectual disability? (Paper II) 3. What conditions constitute compatibility between encoding and retrieval of prospective memory tasks? (Paper III) 4. In what way might weak binding contribute to PM failure? (Paper IV) 5. Is it possible to identify high and low PM-performing groups of individuals with intellectual disability? (Paper II) The results of the studies demonstrated that individuals with intellectual disability commit more PM errors than individuals in the control group, despite similarities in self-rated memory. Pictures as PM cues improved PM performance in comparison to words in both groups. This may be important primarily for recognition of the PM cue, particularly in the intellectual disability group. As to working memory capacity, it also shows a relation to both PM performance and binding performance in cognitively demanding situations (e.g., tasks with multiple parallel PM tasks). Furthermore, it was found that binding is related to PM performance in the intellectual disability group as there is a relationship between feature errors and recognition of cues, though not retrieving the correct intention. Finally, time reproduction was found to be weak in the intellectual disability group

Avhandlingen handlar om prospektivt minne (PM) hos personer med utvecklingsstörning. PM syftar på att formulera intentioner och genomföra dessa någon gång i framtiden, antingen inom en definierad tidsram eller i samband med en specifik händelse. Frågeställningar: 1. Finns det en kvalitativ och kvantitativ skillnad mellan prospektivt minne hos personer med utvecklingsstörning och en kontrollgrupp? (Artikel I – II) 2. Hur ser sambandet mellan prospektivt minne, arbetsminne och episodiskt minne ut hos personer med utvecklingsstörning och, skiljer sig detta åt jämfört med kontrollgruppen? (Artikel II) 3. Vilka förutsättningar vid inkodning och hågkomst är kompatibla? (Artikel III) 4. På vilket sätt kan svag association mellan olika delar av information bidra till prospektiva minnesfel? (Artikel IV) 5. Går det att särskilja en hög- respektive lågpresterande grupp personer med utvecklingsstörning med avseende på prospektiv minnesprestation? (Artikel II) Personer med utvecklingsstörning begår fler prospektiva minnesfel än personer i kontrollgruppen. Motsvarande gruppskillnad finns inte för självskattat minne. Prospektiv minnesprestation är bättre med bilder jämfört med ord som prospektiva ledtrådar, mest tydligt för personer med utvecklingsstörning. Arbetsminneskapacitet visade ett samband med både prospektivt minne och antalet falska minnen i kognitivt krävande situationer, till exempel, situationer med flera parallella prospektiva minnesuppgifter. Falska minnen och prospektivt minne hade ett samband hos personer med utvecklingsstörning. Att felaktigt känna igen bilder med bara delvis bekanta delar och att känna igen prospektiva ledtrådar utan att komma ihåg själva intentionen hade ett samband hos personer med utvecklingsstörning. Personer med utvecklingsstörning var också sämre än kontrollgruppen på att upprepa tidsintervall. Detta kan till exempel bero på bristande episodiskt minne och begränsade strategier för att lösa den här typen av uppgifter. Resultaten diskuteras, This thesis deals with prospective memory (PM) in individuals with intellectual disability. The term refers to planning and executing actions that cannot be performed immediately and have to be stored in memory and retrieved either within a specified timeframe or to be associated with a specific event. Following research questions were explored: 1. Does prospective memory performance in the intellectual disability group differ quantitatively and qualitatively compared to a control group of individuals without intellectual disability? (Paper I – II) 2. What are the relations between prospective memory, working memory and episodic memory in individuals with intellectual disability, and how are these relations different from the relations found in individuals without intellectual disability? (Paper II) 3. What conditions constitute compatibility between encoding and retrieval of prospective memory tasks? (Paper III) 4. In what way might weak binding contribute to PM failure? (Paper IV) 5. Is it possible to identify high and low PM-performing groups of individuals with intellectual disability? (Paper II) The results of the studies demonstrated that individuals with intellectual disability commit more PM errors than individuals in the control group, despite similarities in self-rated memory. Pictures as PM cues improved PM performance in comparison to words in both groups. This may be important primarily for recognition of the PM cue, particularly in the intellectual disability group. As to working memory capacity, it also shows a relation to both PM performance and binding performance in cognitively demanding situations (e.g., tasks with multiple parallel PM tasks). Furthermore, it was found that binding is related to PM performance in the intellectual disability group as there is a relationship between feature errors and recognition of cues, though not retrieving the correct intention. Finally, time reproduction was found to be weak in the intellectual disability group

Avhandlingen handlar om prospektivt minne (PM) hos personer med utvecklingsstörning. PM syftar på att formulera intentioner och genomföra dessa någon gång i framtiden, antingen inom en definierad tidsram eller i samband med en specifik händelse. Frågeställningar: 1. Finns det en kvalitativ och kvantitativ skillnad mellan prospektivt minne hos personer med utvecklingsstörning och en kontrollgrupp? (Artikel I – II) 2. Hur ser sambandet mellan prospektivt minne, arbetsminne och episodiskt minne ut hos personer med utvecklingsstörning och, skiljer sig detta åt jämfört med kontrollgruppen? (Artikel II) 3. Vilka förutsättningar vid inkodning och hågkomst är kompatibla? (Artikel III) 4. På vilket sätt kan svag association mellan olika delar av information bidra till prospektiva minnesfel? (Artikel IV) 5. Går det att särskilja en hög- respektive lågpresterande grupp personer med utvecklingsstörning med avseende på prospektiv minnesprestation? (Artikel II) Personer med utvecklingsstörning begår fler prospektiva minnesfel än personer i kontrollgruppen. Motsvarande gruppskillnad finns inte för självskattat minne. Prospektiv minnesprestation är bättre med bilder jämfört med ord som prospektiva ledtrådar, mest tydligt för personer med utvecklingsstörning. Arbetsminneskapacitet visade ett samband med både prospektivt minne och antalet falska minnen i kognitivt krävande situationer, till exempel, situationer med flera parallella prospektiva minnesuppgifter. Falska minnen och prospektivt minne hade ett samband hos personer med utvecklingsstörning. Att felaktigt känna igen bilder med bara delvis bekanta delar och att känna igen prospektiva ledtrådar utan att komma ihåg själva intentionen hade ett samband hos personer med utvecklingsstörning. Personer med utvecklingsstörning var också sämre än kontrollgruppen på att upprepa tidsintervall. Detta kan till exempel bero på bristande episodiskt minne och begränsade strategier för att lösa den här typen av uppgifter. Resultaten diskuteras, This thesis deals with prospective memory (PM) in individuals with intellectual disability. The term refers to planning and executing actions that cannot be performed immediately and have to be stored in memory and retrieved either within a specified timeframe or to be associated with a specific event. Following research questions were explored: 1. Does prospective memory performance in the intellectual disability group differ quantitatively and qualitatively compared to a control group of individuals without intellectual disability? (Paper I – II) 2. What are the relations between prospective memory, working memory and episodic memory in individuals with intellectual disability, and how are these relations different from the relations found in individuals without intellectual disability? (Paper II) 3. What conditions constitute compatibility between encoding and retrieval of prospective memory tasks? (Paper III) 4. In what way might weak binding contribute to PM failure? (Paper IV) 5. Is it possible to identify high and low PM-performing groups of individuals with intellectual disability? (Paper II) The results of the studies demonstrated that individuals with intellectual disability commit more PM errors than individuals in the control group, despite similarities in self-rated memory. Pictures as PM cues improved PM performance in comparison to words in both groups. This may be important primarily for recognition of the PM cue, particularly in the intellectual disability group. As to working memory capacity, it also shows a relation to both PM performance and binding performance in cognitively demanding situations (e.g., tasks with multiple parallel PM tasks). Furthermore, it was found that binding is related to PM performance in the intellectual disability group as there is a relationship between feature errors and recognition of cues, though not retrieving the correct intention. Finally, time reproduction was found to be weak in the intellectual disability group

Avhandlingen handlar om prospektivt minne (PM) hos personer med utvecklingsstörning. PM syftar på att formulera intentioner och genomföra dessa någon gång i framtiden, antingen inom en definierad tidsram eller i samband med en specifik händelse. Frågeställningar: 1. Finns det en kvalitativ och kvantitativ skillnad mellan prospektivt minne hos personer med utvecklingsstörning och en kontrollgrupp? (Artikel I – II) 2. Hur ser sambandet mellan prospektivt minne, arbetsminne och episodiskt minne ut hos personer med utvecklingsstörning och, skiljer sig detta åt jämfört med kontrollgruppen? (Artikel II) 3. Vilka förutsättningar vid inkodning och hågkomst är kompatibla? (Artikel III) 4. På vilket sätt kan svag association mellan olika delar av information bidra till prospektiva minnesfel? (Artikel IV) 5. Går det att särskilja en hög- respektive lågpresterande grupp personer med utvecklingsstörning med avseende på prospektiv minnesprestation? (Artikel II) Personer med utvecklingsstörning begår fler prospektiva minnesfel än personer i kontrollgruppen. Motsvarande gruppskillnad finns inte för självskattat minne. Prospektiv minnesprestation är bättre med bilder jämfört med ord som prospektiva ledtrådar, mest tydligt för personer med utvecklingsstörning. Arbetsminneskapacitet visade ett samband med både prospektivt minne och antalet falska minnen i kognitivt krävande situationer, till exempel, situationer med flera parallella prospektiva minnesuppgifter. Falska minnen och prospektivt minne hade ett samband hos personer med utvecklingsstörning. Att felaktigt känna igen bilder med bara delvis bekanta delar och att känna igen prospektiva ledtrådar utan att komma ihåg själva intentionen hade ett samband hos personer med utvecklingsstörning. Personer med utvecklingsstörning var också sämre än kontrollgruppen på att upprepa tidsintervall. Detta kan till exempel bero på bristande episodiskt minne och begränsade strategier för att lösa den här typen av uppgifter. Resultaten diskuteras, This thesis deals with prospective memory (PM) in individuals with intellectual disability. The term refers to planning and executing actions that cannot be performed immediately and have to be stored in memory and retrieved either within a specified timeframe or to be associated with a specific event. Following research questions were explored: 1. Does prospective memory performance in the intellectual disability group differ quantitatively and qualitatively compared to a control group of individuals without intellectual disability? (Paper I – II) 2. What are the relations between prospective memory, working memory and episodic memory in individuals with intellectual disability, and how are these relations different from the relations found in individuals without intellectual disability? (Paper II) 3. What conditions constitute compatibility between encoding and retrieval of prospective memory tasks? (Paper III) 4. In what way might weak binding contribute to PM failure? (Paper IV) 5. Is it possible to identify high and low PM-performing groups of individuals with intellectual disability? (Paper II) The results of the studies demonstrated that individuals with intellectual disability commit more PM errors than individuals in the control group, despite similarities in self-rated memory. Pictures as PM cues improved PM performance in comparison to words in both groups. This may be important primarily for recognition of the PM cue, particularly in the intellectual disability group. As to working memory capacity, it also shows a relation to both PM performance and binding performance in cognitively demanding situations (e.g., tasks with multiple parallel PM tasks). Furthermore, it was found that binding is related to PM performance in the intellectual disability group as there is a relationship between feature errors and recognition of cues, though not retrieving the correct intention. Finally, time reproduction was found to be weak in the intellectual disability group

Purpose: The successful design and innovation of eHealth solutions directly involve end users in the process to seek a better understanding of their needs. This article presents user-innovated eHealth solutions targeting older persons with hearing impairment. Our research question was: What are the key users needs, expectations, and visions within future hearing rehabilitation service delivery? Method: We applied a participatory design approach to facilitate the design of future eHealth solutions via focus groups. We involved older persons with hearing impairment (n = 36), significant others (n = 10), and audiologists (n = 8) following 2 methods: (a) human-centered design for interactive systems and (b) user innovation management. Through 3 rounds of focus groups, we facilitated a process progressing from insights and visions for requirements phase 1), to app such as paper version wireframes (Phase 2), and to digital prototypes envisioning future eHealth solutions (Phase 3). Each focus group was video-recorded and photographed, resulting in a rich data set that was analyzed through inductive thematic analysis. Results: The results are presented via (a) a storyboard envisioning future client journeys, (b) 3 key themes for future eHealth solutions, (c) 4 levels of interest and willingness to invest time and effort in digital solutions, and (d) 2 technical savviness types and their different preferences for rehabilitation strategies. Conclusions: Future eHealth solutions must offer personalized rehabilitation strategies that are appropriate for every person with hearing impairment and their level of technical savviness. Thus, a central requirement is anchoring of digital support in the clients everyday life situations by facilitating easy access to personalized information, communication, and leaning milieus. Moreover, the participants visions for eHealth solutions call for providing both traditional analogue and digital services., Funding Agencies|Ministry of Higher Education and Science; Danish Agency for Science and Innovation [6163-00010B]; National Institute on Deafness and Other Communication Disorders [1R13DC016547]; Oticon Foundation

Objective: This paper presents a summary of web-based data collection, impact evaluation, and user evaluations of an Internet-based peer support program for Menieres disease (MD). Design: The program is written in html-form. The data are stored in a MySQL database and uses machine learning in the diagnosis of MD. The program works interactively with the user and assesses the participants disorder profile in various dimensions (i.e., symptoms, impact, personal traits, and positive attitude). The inference engine uses a database to compare the impact with 50 referents, and provides regular feedback to the user. Data were analysed using descriptive statistics and regression analysis. Study sample: The impact evaluation was based on 740 cases and the user evaluation on a sample of 75 cases of MD respectively. Results: The web-based system was useful in data collection and impact evaluation of people with MD. Among those with a recent onset of MD, 78% rated the program as useful or very useful, whereas those with chronic MD rated the program 55%. Conclusions: We suggest that a web-based data collection and impact evaluation for peer support can be helpful while formulating the rehabilitation goals of building the self-confidence needed for coping and increasing social participation., Funding Agencies|Finnish Slot Machine Association, RAY

The objective of this study was to translate and adapt five English self-report health measures to a South Indian language Kannada. Currently, no systematically developed questionnaires assessing hearing rehabilitation outcomes are available for clinical or research use in Kannada. The questionnaires included for translation and adaptation were the hearing handicap questionnaire, the international outcome inventory- hearing aids, the self-assessment of communication, the participation scale, and the assessment of quality of life 4 dimensions. The questionnaires were translated and adapted using the American Association of Orthopedic Surgeons (AAOS) guidelines. The five stages followed in the study included: i) forward translation; ii) common translation synthesis; iii) backward translation; iv) expert committee review; v) pre-final testing. In this paper, in addition to a description of the process, we also highlight practical issues faced while adopting the procedure with an aim to help readers better understand the intricacies involved in such processes. This can be helpful to researchers and clinicians who are keen to adapt standard self-report questionnaires from other languages to their native language.

The objective of this study was to translate and adapt five English self-report health measures to a South Indian language Kannada. Currently, no systematically developed questionnaires assessing hearing rehabilitation outcomes are available for clinical or research use in Kannada. The questionnaires included for translation and adaptation were the hearing handicap questionnaire, the international outcome inventory- hearing aids, the self-assessment of communication, the participation scale, and the assessment of quality of life 4 dimensions. The questionnaires were translated and adapted using the American Association of Orthopedic Surgeons (AAOS) guidelines. The five stages followed in the study included: i) forward translation; ii) common translation synthesis; iii) backward translation; iv) expert committee review; v) pre-final testing. In this paper, in addition to a description of the process, we also highlight practical issues faced while adopting the procedure with an aim to help readers better understand the intricacies involved in such processes. This can be helpful to researchers and clinicians who are keen to adapt standard self-report questionnaires from other languages to their native language.

The objective of this study was to translate and adapt five English self-report health measures to a South Indian language Kannada. Currently, no systematically developed questionnaires assessing hearing rehabilitation outcomes are available for clinical or research use in Kannada. The questionnaires included for translation and adaptation were the hearing handicap questionnaire, the international outcome inventory- hearing aids, the self-assessment of communication, the participation scale, and the assessment of quality of life 4 dimensions. The questionnaires were translated and adapted using the American Association of Orthopedic Surgeons (AAOS) guidelines. The five stages followed in the study included: i) forward translation; ii) common translation synthesis; iii) backward translation; iv) expert committee review; v) pre-final testing. In this paper, in addition to a description of the process, we also highlight practical issues faced while adopting the procedure with an aim to help readers better understand the intricacies involved in such processes. This can be helpful to researchers and clinicians who are keen to adapt standard self-report questionnaires from other languages to their native language.