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The authors are developing an intake tool based on the Brief International Classification of Functioning Disability and Health Core Set for Hearing Loss, by operationalizing its categories into a Patient Reported Outcome Measure. This study was aimed at identifying enablers and barriers to using this tool as perceived by hearing health professionals (HHPs) and patients. Focus groups and interviews were held with HHPs (ENT surgeons, N = 14; audiologists, N = 8) and patients (N = 18). Interview questions were based on the Capability-Opportunity-Motivation-Behavior (COM-B) model. Using the COM-B model and the Theoretical Domains Framework (TDF), transcript fragments were divided into meaning units, which were then categorized into capability-, opportunity- and motivation-related barriers and enablers. These were further specified into TDF domains. HHP barriers included: lack of time to use the tool (O); and fear of being made responsible for addressing any emerging problems, which may be outside the expertise of the HHP (M). Enablers included integration of the tool in the electronic patient record (O); opportunity for the patient to be better prepared for the intake visit (M); and provision of a complete picture of the patient's functioning via the tool (M). Patient' barriers included fear of losing personal contact with the HHP (M); and fear that use of the tool might negatively affect conversations with the HHP (M). Enablers included knowledge on the aim and relevance of the tool (C); expected better self-preparation (M); and a more focused intake (M). These findings suggest that an intervention is needed to enhance HHPs' knowledge, skills and motivation regarding the relevance and the clinical usefulness of the tool. Providing clear and specific information on the purpose of the tool can also enhance patient motivation. For both HHPs and patients, opportunities relating to the (digital) administration and the design of the tool provide additional targets for successful implementation., Competing Interests: The authors have declared that no competing interests exist.

Objective: People with hearing impairment are likely to experience higher levels of fatigue because of effortful listening in daily communication. This hearing-related fatigue might not only constrain their work performance but also result in withdrawal from major social roles. Therefore, it is important to understand the relationships between fatigue, listening effort, and hearing impairment by examining the evidence from both subjective and objective measurements. The aim of the present study was to investigate these relationships by assessing subjectively measured daily-life fatigue (self-report questionnaires) and objectively measured listening effort (pupillometry) in both normally hearing and hearing-impaired participants., Design: Twenty-seven normally hearing and 19 age-matched participants with hearing impairment were included in this study. Two self-report fatigue questionnaires Need For Recovery and Checklist Individual Strength were given to the participants before the test session to evaluate the subjectively measured daily fatigue. Participants were asked to perform a speech reception threshold test with single-talker masker targeting a 50% correct response criterion. The pupil diameter was recorded during the speech processing, and we used peak pupil dilation (PPD) as the main outcome measure of the pupillometry., Results: No correlation was found between subjectively measured fatigue and hearing acuity, nor was a group difference found between the normally hearing and the hearing-impaired participants on the fatigue scores. A significant negative correlation was found between self-reported fatigue and PPD. A similar correlation was also found between Speech Intelligibility Index required for 50% correct and PPD. Multiple regression analysis showed that factors representing "hearing acuity" and "self-reported fatigue" had equal and independent associations with the PPD during the speech in noise test. Less fatigue and better hearing acuity were associated with a larger pupil dilation., Conclusions: To the best of our knowledge, this is the first study to investigate the relationship between a subjective measure of daily-life fatigue and an objective measure of pupil dilation, as an indicator of listening effort. These findings help to provide an empirical link between pupil responses, as observed in the laboratory, and daily-life fatigue.

Previous research has reported effects of masker type and signal-to-noise ratio (SNR) on listening effort, as indicated by the peak pupil dilation (PPD) relative to baseline during speech recognition. At about 50% correct sentence recognition performance, increasing SNRs generally results in declining PPDs, indicating reduced effort. However, the decline in PPD over SNRs has been observed to be less pronounced for hearing-impaired (HI) compared to normal-hearing (NH) listeners. The presence of a competing talker during speech recognition generally resulted in larger PPDs as compared to the presence of a fluctuating or stationary background noise. The aim of the present study was to examine the interplay between hearing-status, a broad range of SNRs corresponding to sentence recognition performance varying from 0 to 100% correct, and different masker types (stationary noise and single-talker masker) on the PPD during speech perception. Twenty-five HI and 32 age-matched NH participants listened to sentences across a broad range of SNRs, masked with speech from a single talker (-25 dB to +15 dB SNR) or with stationary noise (-12 dB to +16 dB). Correct sentence recognition scores and pupil responses were recorded during stimulus presentation. With a stationary masker, NH listeners show maximum PPD across a relatively narrow range of low SNRs, while HI listeners show relatively large PPD across a wide range of ecological SNRs. With the single-talker masker, maximum PPD was observed in the mid-range of SNRs around 50% correct sentence recognition performance, while smaller PPDs were observed at lower and higher SNRs. Mixed-model ANOVAs revealed significant interactions between hearing-status and SNR on the PPD for both masker types. Our data show a different pattern of PPDs across SNRs between groups, which indicates that listening and the allocation of effort during listening in daily life environments may be different for NH and HI listeners., (Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.)

Objectives: To investigate the occurrence of 27 chronic medical conditions in a cohort of adults with and without hearing impairment, and to examine the association between these conditions and hearing ability., Design: The National Longitudinal Study on Hearing (NL-SH study) is a large prospective study among adults aged 18 to 70 years, conducted via the internet in the Netherlands. Hearing ability was measured with a digits-in-noise test and comorbidity was assessed through self-report., Study Sample: Cross-sectional data of 890 hearing-impaired and 975 normally-hearing adults were analyzed. Both descriptive statistics and multinomial logistic regression analyses were conducted., Results: Of the NL-SH participants with insufficient or poor hearing ability, 78.5% reported to suffer from at least one additional chronic condition. This proportion was larger than in the normally-hearing group (68.6% with one or more chronic conditions and 37.7% with two or more). After adjustment for age and gender, 'dizziness causing falling', 'diabetes' and 'arthritis types other than osteoarthritis and rheumatic arthritis' were significantly associated with poor hearing ability., Conclusions: Our results show that some previously reported associations do not only occur in older age groups, but also in younger cohorts. Comorbidity is relevant in the rehabilitation (multi-disciplinary care) and the clinical encounter.

Purpose: The aim of this study was to improve the quality and applicability of the 6 Dutch scales of the Communication Profile for the Hearing Impaired (CPHI; Demorest & Erdman, 1986, 1987, 1988) using item response theory (IRT). IRT modeling can produce precise, valid, and relatively brief instruments, resulting in minimal response burden (Edelen & Reeve, 2006)., Method: We investigated (a) whether items fit to the graded response model (GRM; Samejima, 1969) using Stone and Zhang's (2003) procedure to test goodness of fit and (b) whether items showed differential item functioning (DIF) with the IRT log-likelihood ratio approach for 5 group variables: gender, age, living arrangement, use of hearing aids, and degree of hearing impairment. We investigated the magnitude of DIF by calculating the maximum difference between expected item scores for subgroups of the group variables of items showing DIF., Results: In a cross-sectional study, 408 consecutive individuals with hearing impairment completed the Dutch CPHI scales. Twelve items were deleted because of misfit to GRMs, 14 items showed uniform DIF, and 2 showed nonuniform DIF. Five items showing DIF were deleted due to large magnitude of DIF. The short form of the Dutch CPHI scales contains 35 items., Conclusions: DIF analyses showed that the short form was relatively free of DIF with respect to the 5 group variables. Hence, there is no need to make adjustments for the calculation of subgroup scores.

The main aim of the study is to address the relationship between hearing status and need for recovery. In addition, the role of hearing status in the relationship between psychosocial work characteristics (i.e. job demands and job control) and need for recovery was assessed. The sample comprised 925 normally-hearing and hearing-impaired working adults (aged 18-65 years) participating in the National Longitudinal Study on Hearing. Hearing status was determined using the national hearing (speech-in-noise) test over the internet. Psychosocial work characteristics and need for recovery were assessed using the job content questionnaire and the Dutch questionnaire on the experience and assessment of work. Regression models revealed a significant association between hearing status and need for recovery after work, poorer hearing leading to an increasing need for recovery. Additionally, poorer hearing led to a higher odds for risky levels of need for recovery. Hearing status did not influence the significant relationship between psychosocial work characteristics (i.e. job demand and job control) and need for recovery after work. Implications for clinical practice, such as the necessity of having adequate enablement programs for this specific group of patients, are discussed.

Objectives: This study examines the association of hearing impairment and chronic diseases (diabetes mellitus, lung disease, cardiac disease, stroke, cancer, peripheral artery disease, osteoarthritis, rheumatoid arthritis) with psychosocial status (depression, self-efficacy, mastery, loneliness, social network size) in older persons., Methods: The sample consists of 3,107 persons (55 to 85 years) participating in the Longitudinal Aging Study Amsterdam. MANOVA, adjusted for covariates, was used to test the effect of hearing impairment on the combined outcomes. The association of hearing impairment and chronic diseases with psychosocial status was studied using multivariate regression analyses., Results: Hearing impaired elderly report significantly more depressive symptoms, lower self-efficacy and mastery, more feelings of loneliness, and a smaller social network than normally hearing peers. Whereas chronic diseases show significant associations with some outcomes, hearing impairment is significantly associated with all psychosocial variables., Discussion: The findings emphasize the negative effect of hearing impairment on quality of life.

AbstractBackgroundAimMaterials and methodsResultsConclusionHearing-dementia research mainly focuses on determining the causal direction of this association. Little is known about the prevalence of cognitive problems in a representative audiology patient population.To examine the occurrence of self-reported cognitive complaints (SCC) and dementia risk factors (RF) in an audiology patient population.Patients visiting audiology clinics (n = 1100, 51% female and avg. age 61yrs) were administered an online intake tool based on the International Classification of Functioning Disability and Health. Domains extracted for analyses were memory and concentration (SCC) and loneliness, depression, sleep and vision (dementia RF) and self-reported hearing problems (SHP). Prevalence rates and associations with demographic variables and SHP were examined.SCC were highly prevalent, with over half of the patients reporting memory or concentration problems. Regarding dementia RF, 68% reported sleeping problems and > 50% reported sadness, anxiety or depressed mood. SHP correlated significantly with self-reported memory problems, loneliness, and vision problems.This descriptive cohort-study suggests a high risk of cognitive issues within the audiology clinic population, indicated by the high prevalence of SCC and some dementia RF. Our findings underscore the importance of considering closer cooperation between care pathways like audiology and neurology and use of a holistic patient-centered approach. [ABSTRACT FROM AUTHOR]

This study assessed the impact of the COVID-19 pandemic on psychosocial health among individuals with different levels of hearing ability. For this cross-sectional study, adults completed an online digits-in-noise test and survey. Participants were categorised into "good", "insufficient", or "poor" hearing groups. Survey questions included topics on depression, anxiety, distress, somatisation, and loneliness levels. Multiple logistic, linear, and negative binomial regressions examined differences in psychosocial health between hearing groups. Moderation analyses identified vulnerable subgroups. Mediation analyses examined mediating effects of pandemic measures on hearing ability and psychosocial health. Eight-hundred and sixty-five adults with or without hearing impairment. Individuals with poor hearing had a higher odds of having elevated anxiety levels and had higher somatisation levels compared to participants with good hearing. Chronic diseases significantly moderated the relationship between poor hearing ability and loneliness. Difficulties with communicating through facemasks, 1.5 m distance, plastic screens, and during video calls significantly mediated the relationships between hearing ability, anxiety and somatisation. Results highlight the elevated anxiety and somatisation levels experienced among individuals with hearing impairment during the COVID-19 pandemic. More awareness is needed of the negative impact pandemic measures can have on psychosocial health during future health crises. [ABSTRACT FROM AUTHOR]

Background: This study examined the relationship between speech-in-noise recognition and incident/recurrent falls due to balance problems ten years later (RQ-1); 10-year change in speech-in-noise recognition and falls (RQ-2a), as well as the role of dizziness in this relationship (RQ-2b). The association between hearing aid use and falls was also examined (RQ-3). Methods: Data was collected from the Netherlands Longitudinal Study on Hearing between 2006 and December 2022. Participants completed an online survey and digits-in-noise test every five years. For this study, data was divided into two 10-year follow-up time intervals: T0 (baseline) to T2 (10-year follow-up), and T1 (5-years) to T3 (15-years). For all RQs, participants aged ≥ 40 years at baseline, without congenital hearing loss, and non-CI users were eligible (n = 592). Additionally, for RQ-3 participants with a speech reception threshold in noise (SRTn) ≥ -5.5 dB signal-to-noise ratio were included (n = 422). Analyses used survey variables on hearing, dizziness, falls due to balance problems, chronic health conditions, and psychosocial health. Logistic regressions using General Estimating Equations were conducted to assess all RQs. Results: Among individuals with obesity, those with poor baseline SRTn had a higher odds of incident falls ten years later (odds ratio (OR):14.7, 95% confidence interval (CI) [2.12, 103]). A 10-year worsening of SRTn was significantly associated with a higher odds of recurrent (OR: 2.20, 95% CI [1.03, 4.71]) but not incident falls. No interaction was found between dizziness and change in SRTn. Hearing aid use (no use/ < 2 years use vs. ≥ 2 years) was not significantly associated with incident nor recurrent falls. Although there was a significant interaction with sex for this association, the effect of hearing aid use on incident/recurrent falls was not statistically significant among males nor females. Conclusions: A longitudinal association between the deterioration in SRTn and recurrent falls due to balance problems after 10 years was confirmed in this study. This result stresses the importance of identifying declines in hearing earlier and justifies including hearing ability assessments within fall risk prevention programs. Mixed results of hearing aid use on fall risk warrant further investigation into the temporality of this association and possible differences between men and women. [ABSTRACT FROM AUTHOR]

Objective: This study assessed the impact of coronavirus disease-2019 (COVID-19) preventative measures on hearing and communication among individuals with normal and impaired hearing. We also evaluated the use of digital communication tools between these groups. Design: For this cross-sectional study, participants completed an online digits-in-noise test and survey. Survey topics included understanding through masks, behind plastic screens, from a 1.5-m distance, and use of social network sites/apps, direct messaging, and video calling. Logistic regressions assessed the odds of disagreeing versus agreeing with survey statements. Study Sample: A total of 880 adults from the National Longitudinal Study on Hearing completed a survey and hearing test. Based on speech reception threshold scores, participants were categorised into "good" (reference group for all analyses), "insufficient", or "poor" hearing groups. Results: Those with insufficient and poor hearing had more difficulty understanding others through facemasks, plastic screens, and from 1.5 m. Those with poor hearing had a higher odds of video calling more to contact family/friends/acquaintances during the pandemic, but also had more difficulty hearing sufficiently through video calls. Conclusions: This study addresses methodological weaknesses in previous studies. Results strengthen current evidence of the burden COVID-19 measures place on individuals with hearing impairment. [ABSTRACT FROM AUTHOR]

The objective of this study is (1) to assess whether the presentation level of the antiphasic digits-in-noise (DIN) test affects the speech recognition threshold (SRT), (2) to evaluate how accurately simulated unilateral and bilateral conductive hearing loss is detected (CHL) and (3) to determine whether increasing the presentation level normalises the antiphasic DIN SRT. Participants performed antiphasic and diotic DINs at different presentation levels with unilateral, bilateral or no earplugs. Twenty-four and twelve normal hearing adults. Without earplugs, antiphasic DIN SRTs did not differ between 60 and 80 dB SPL. At 60 dB SPL, the antiphasic DIN correctly classified 92% of the unilateral earplug cases; the diotic DIN 25%. The binaural intelligibility level difference did not differ between the no-earplug condition and the condition with bilateral earplugs when the presentation was increased with the attenuation level. In normal hearing participants, diotic and antiphasic DIN SRTs are independent of presentation level above a minimum level of 60 dB SPL. The antiphasic DIN is more sensitive than the diotic DIN for detecting unilateral CHL; not for bilateral CHL. The effect of CHL on DIN SRTs can be largely compensated by increasing the presentation level. Audibility plays an important role in the antiphasic and diotic DIN. [ABSTRACT FROM AUTHOR]

Purpose: Current evidence regarding the influence of hearing loss on the pupil response elicited by speech perception is inconsistent. This might be partially due to confounding effects of age. This study aimed to compare pupil responses in age-matched groups of normal-hearing (NH) and hard of hearing (HH) listeners during listening to speech. Method: We tested the baseline pupil size and mean and peak pupil dilation response of 17 NH participants (Mage = 46 years; age range: 20--62 years) and 17 HH participants (Mage = 45 years; age range: 20--63 years) who were pairwise matched on age and educational level. Participants performed three speech perception tasks at a 50% intelligibility level: noise-vocoded speech and speech masked with either stationary noise or interfering speech. They also listened to speech presented in quiet. Results: Hearing loss was associated with poorer speech perception, except for noise-vocoded speech. In contrast to NH participants, performance of HH participants did not improve across trials for the interfering speech condition, and it decreased for speech in stationary noise. HH participants had a smaller mean pupil dilation in degraded speech conditions compared to NH participants, but not for speech in quiet. They also had a steeper decline in the baseline pupil size across trials. The baseline pupil size was smaller for noisevocoded speech as compared to the other conditions. The normalized data showed an additional group effect on the baseline pupil response. Conclusions: Hearing loss is associated with a smaller pupil response and steeper decline in baseline pupil size during the perception of degraded speech. This suggests difficulties of the HH participants to sustain their effort investment and performance across the test session. [ABSTRACT FROM AUTHOR]

To examine the effects of web-based SUpport PRogram (SUPR) for communication partners (CPs) of persons with hearing loss (PHLs) in a HA dispensing setting. Cluster randomised controlled trial (cRCT) with two arms (SUPR: Booklet, online videos; care as usual: no support) plus process evaluation. Measurements: baseline, and immediately-, six, and 12 months post-intervention. Outcomes: Significant Other Scale for Hearing Disability (SOS-HEAR), International Outcome Inventory for HAs/Alternative Interventions for Significant Others (IOI-HA/AI-SO). Process evaluation: dose-received, satisfaction, and benefit. The cRCT included 73 (SUPR) and 57 (care as usual) CPs. In the process evaluation study, 41 CPs (SUPR) participated. There were no significant effects of SUPR for third-party disability (SOS-HEAR), the proxy report (IOI-HA-SO item "use"), and third-party disability (IOI-HA-SO items "satisfaction", and "quality of life"). SUPR-videos were watched by 15-22% of the CPs. SUPR materials were rated as moderately beneficial and useful. Low baseline disability (floor effect) and low intervention dose-received may explain the findings. Directly targeting CPs rather than via their PHLs and providing intervention materials specifically for CPs may improve their engagement and contribute to SUPR's value supplementary to standard HA care. [ABSTRACT FROM AUTHOR]

To investigate the potential association between beta blocker use and hearing ability in adults and to discern whether this effect is dose-dependent. Cross-sectional analyses. Multiple linear regression was performed with hearing ability as the dependent variable and beta blocker use as the independent variable. The independent variable was classified into three dose categories for secondary analysis. Adjustments were made for age, gender, educational level, and tobacco smoking status. 1636 adults, 75 of whom reported being on beta blockers, from the internet-based Netherlands Longitudinal Study on Hearing (NL-SH). No significant association was found between beta blocker use and hearing ability in noise. In the adjusted regressions, beta blocker use changed the speech reception threshold in noise (SRT) by −0.04 dB signal-to-noise ratio (SNR) (95%CI [−0.67 to 0.58], p = 0.890). Medium dose beta blocker use changed SRT by −0.42 dB SNR (95%CI [−1.38 to 0.71], p = 0.433), while a high dose changed it by −0.26 dB SNR (95%CI [−1.74 to 1.4], p = 0.767). No evidence was found for beta blocker-induced changes in hearing ability. Future studies on this topic should favour case-control and cohort study designs, while focussing on a hypertensive population to minimise confounding by indication. [ABSTRACT FROM AUTHOR]

Introduction: Risk factors for cardiovascular disease (CVD) are associated with sensorineural hearing loss. CVD risk factors are known to cluster and interact, thereby increasing the cumulative risk for CVD. Previously, using the database of the Netherlands Longitudinal Study on Hearing (NL-SH), an association was found between a history of smoking and an increased decline in speech recognition in noise over 10 years of follow-up. Prospectively limited data are available on the association between CVD risk factors, interactions of these risk factors, and hearing loss. In this study, data from the NL-SH were used to study the association between CVD risk factors and speech recognition in noise longitudinally. Methods: Baseline, 5-year, and 10-year follow-up data of the NL-SH were included. The NL-SH is a web-based prospective cohort study which started in 2006. Participants were aged 18–70 years at baseline. Speech recognition in noise was determined with an online digit-triplet speech-in-noise test. In addition, participants completed online questionnaires on demographic, lifestyle, and health-related characteristics. The association of the ability to recognize speech in noise with CVD risk factors (i.e., obesity, rheumatoid arthritis [RA], hypertension, diabetes mellitus, and dyslipidemia) was analyzed longitudinally. We also analyzed the interaction between these risk factors (including age, sex, and history of smoking) and speech recognition in noise. Results: None of the CVD risk factors or interactions of 2 CVD risk factors was significantly associated with a decline in SRT over time. Obesity (p = 0.016), RA (p = 0.027), and hypertension (p = 0.044) were associated with overall higher (more unfavorable) SRTs. No overall interactions between CVD risk factors were found. Conclusion: Obesity, RA, and hypertension were overall associated with a higher SRT, but no longitudinal associations between these or other CVD factors with SRTs were found. Also, no interactions between 2 CVD risk factors and SRTs were found. Although no longitudinal associations between CVD risk factors and decline in SRTs were found, clinicians should be alert about the concurrent association between CVD risk factors and hearing loss. [ABSTRACT FROM AUTHOR]

Objectives: Many older adults with visual impairment also have significant hearing loss. The aim was to investigate the effectiveness of a newly developed Dual Sensory Loss (DSL) protocol on communication and wellbeing of older persons with DSL and their communication partners (e.g., spouse or child) in the Netherlands and Belgium. Methods: Participants (N = 131) and their communication partners (n = 113) were randomized in the "DSL-protocol" intervention group or a waiting-list control group. The intervention took 3 to 5 weeks. Occupational therapists focused on optimal use of hearing aids, home-environment modifications and effective communication strategies. The primary outcome was the Communication Strategies domain of the Communication Profile for the Hearing Impaired (CPHI). Secondary outcomes measured in participants were the Low Vision Quality Of Life Adjustment subscale, the Center for Epidemiological Studies - Depression Scale, De Jong Gierveld Loneliness Scale and the Fatigue Assessment Scale. The Hearing Handicap and Disability Inventory (HHDI) - Reaction of Others subscale and the Care-related Quality of Life - 7 Dimensions was measured in communication partners. Measurements were taken at baseline and 3-month follow-up. Linear mixed models (LMM) were used to analyze effects between groups over time for every outcome measure. Results: Intention-to-treat analyses showed a significant effect of the DSL-protocol on the use of verbal strategies (effect size SMD = 0.60, 95% CI: 0.25 to 0.95) in favor of the control group, however, this effect was non-significant after adjustment for confounding. Effect sizes of other outcomes varied between −0.23 [−0.57, 0.12] and 0.30 [−0.05, 0.64]. The LMM showed a significant effect on the HHDI-Reaction of others scale in favor of communication partners in the treatment group, however, the effect did not remain significant at a 0.01 significance level and the effect size was very small and non-significant 0.12, 95% CI [−0.27 to 0.51]. Adjusted analyses did not reveal treatment effects. Conclusion: The DSL-protocol did not clearly contribute to the enhancement of communication and wellbeing in DSL-patients. Possible reasons for the lack of effects are OTs not being comfortable giving advice on communication and psychosocial issues or the short-term treatment and follow-up period. Further study is warranted to find out how the protocol may be adapted or whether it is necessary to involve mental healthcare professionals. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NTR2843. [ABSTRACT FROM AUTHOR]

Purpose: The pupil dilation response is sensitive not only to auditory task demand but also to cognitive conflict. Conflict is induced by incompatible trials in auditory Stroop tasks in which participants have to identify the presentation location (left or right ear) of the words “left” or “right.” Previous studies demonstrated that the compatibility effect is reduced if the trial is preceded by another incompatible trial (conflict adaptation). Here, we investigated the influence of hearing status on cognitive conflict and conflict adaptation in an auditory Stroop task. Method: Two age-matched groups consisting of 32 normal-hearing participants (Mage = 52 years, age range: 25–67 years) and 28 participants with hearing impairment (Mage = 52 years, age range: 23–64 years) performed an auditory Stroop task. We assessed the effects of hearing status and stimulus compatibility on reaction times (RTs) and pupil dilation responses. We furthermore analyzed the Pearson correlation coefficients between age, degree of hearing loss, and the compatibility effects on the RT and pupil response data across all participants. Results: As expected, the RTs were longer and pupil dilation was larger for incompatible relative to compatible trials. Furthermore, these effects were reduced for trials following incompatible (as compared to compatible) trials (conflict adaptation). No general effect of hearing status was observed, but the correlations suggested that higher age and a larger degree of hearing loss were associated with more interference of current incompatibility on RTs. Conclusions: Conflict processing and adaptation effects were observed on the RTs and pupil dilation responses in an auditory Stroop task. No general effects of hearing status were observed, but the correlations suggested that higher age and a greater degree of hearing loss were related to reduced conflict processing ability. The current study underlines the relevance of taking into account cognitive control and conflict adaptation processes. [ABSTRACT FROM AUTHOR]

Objective: To examine the construct validity, reliability and responsiveness of the Otology Questionnaire Amsterdam (OQUA). Design: Multicentre, longitudinal study in 2 separate cohorts of patients visiting an ENT surgeon via an online survey programme. Setting: Tertiary ENT clinics. Participants: Cohort 1 consisted of patients at their first visit at an ENT outpatient clinic with an ear complaint. Cohort 2 consisted of patients who underwent surgery, with a 3‐month follow‐up post‐surgery. Main outcome measures: Construct validity: Hypothesis testing, internal consistency and inter‐item correlation. Reliability: Test‐retest reliability. The construct approach was used for assessing responsiveness. Hypotheses were formulated based on the association between the OQUA and Glasgow Health Status Inventory (GHSI) or Global Rating Scale (GRS). Results: Construct validity: The correlation between the individual items in the impact domain ranged from 0.424 to 0.737. Confirmatory factor analysis showed a good fit. As expected, the OQUA impact showed strong relationships with GHSI total and general scale. Reliability: The test‐retest reliability coefficient ranged from 0.541 to 0.838. Responsiveness: All hypotheses were conformed. As expected, the change score of the OQUA showed good correlation between OQUA impact and GHSI and moderate correlation between the GRS and OQUA complaints. Conclusion: The OQUA has 8 complaint domains (earache, pressure sensation, itching, tinnitus, hearing loss, ear discharge, loss of taste and dizziness) and 1 impact domain. Each domain results in one score of 0‐100. The OQUA shows good results for construct validity, (test‐retest) reliability and responsiveness, supporting the potential benefit for the patient with an ear complaint visiting the ENT surgeon. The extensive validation furthermore confirms a certified generic otology PROM with an impact and a complaints' part, to be used in different types of otologic interventions and patient groups. [ABSTRACT FROM AUTHOR]

Objective: To develop an intervention for the implementation of an ICF-based e-intake tool in clinical oto-audiology practice. Design: Intervention design study using the eight-stepped Behaviour Change Wheel. Hearing health professionals' (HHPs) and patients' barriers to and enablers of the use of the tool were identified in our previous study (steps 1–4). Following these steps, relevant intervention functions and policy categories were selected to address the reported barriers and enablers (steps 5–6); and behaviour change techniques and delivery modes were chosen for the selected intervention functions (steps 7–8). Results: For HHPs, the intervention functions education, training, enablement, modelling, persuasion and environmental restructuring were selected (step 5). Guidelines, service provision, and changes in the environment were identified as appropriate policy categories (step 6). These were linked to nine behaviour change techniques (e.g. information on health consequences), delivered through educational/training materials and workshops, and environmental factors (steps 7–8). For patients, the intervention functions education and enablement were selected, supported through service provision (steps 5–6). These were linked to three behaviour change techniques (e.g. environmental factors), delivered through their incorporation into the tool (steps 7–8). Conclusions: A multifaceted intervention was proposed to support the successful implementation of the intake tool. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the effectiveness of a vocational enablement protocol (VEP) on need for recovery (NFR) after work as compared with usual care for employees with hearing difficulties. In a randomized controlled trial design, 136 employees with hearing impairment were randomly assigned to either the VEP or the control group. VEP is a multidisciplinary program integrating audiological and occupational care for individuals experiencing difficulties in the workplace due to hearing loss. The primary outcome measure was NFR. Secondary outcome measures were communication strategy subscales (e.g., self-acceptance and maladaptive behavior), distress, and self-efficacy. Data were collected using questionnaires at baseline and at 3, 6, 9, and 12 months follow-up. No significant difference over the complete follow-up period was found between the intervention and control group for NFR. However, we observed a significant difference for one of the secondary outcomes after 12 months. ‘‘Self-acceptance’’ increased significantly in the VEP group, compared with the controls. The mean difference between the two groups was small, being only 0.24 (95% CI [0.04, 0.44]) on a scale of 1 to 5. The results do not support the use of VEP if the aim is to reduce NFR after work at 12 months follow-up. It may be that NFR does not adequately capture what is covered in the VEP. Although marginal, the effect on self-acceptance was significant. This is encouraging given that positive effects on self-acceptance have rarely been shown for audiological rehabilitation programs. Suggestions for further improvement of the VEP are discussed. [ABSTRACT FROM AUTHOR]

Context: Although the pupil light reflex has been widely used as a clinical diagnostic tool for autonomic nervous system dysfunction, there is no systematic review available to summarize the evidence that the pupil light reflex is a sensitive method to detect parasympathetic dysfunction. Meanwhile, the relationship between parasympathetic functioning and hearing impairment is relatively unknown. Objectives: To 1) review the evidence for the pupil light reflex being a sensitive method to evaluate parasympathetic dysfunction, 2) review the evidence relating hearing impairment and parasympathetic activity and 3) seek evidence of possible connections between hearing impairment and the pupil light reflex. Methods: Literature searches were performed in five electronic databases. All selected articles were categorized into three sections: pupil light reflex and parasympathetic dysfunction, hearing impairment and parasympathetic activity, pupil light reflex and hearing impairment. Results: Thirty-eight articles were included in this review. Among them, 36 articles addressed the pupil light reflex and parasympathetic dysfunction. We summarized the information in these data according to different types of parasympathetic-related diseases. Most of the studies showed a difference on at least one pupil light reflex parameter between patients and healthy controls. Two articles discussed the relationship between hearing impairment and parasympathetic activity. Both studies reported a reduced parasympathetic activity in the hearing impaired groups. The searches identified no results for pupil light reflex and hearing impairment. Discussion and Conclusions: As the first systematic review of the evidence, our findings suggest that the pupil light reflex is a sensitive tool to assess the presence of parasympathetic dysfunction. Maximum constriction velocity and relative constriction amplitude appear to be the most sensitive parameters. There are only two studies investigating the relationship between parasympathetic activity and hearing impairment, hence further research is needed. The pupil light reflex could be a candidate measurement tool to achieve this goal. [ABSTRACT FROM AUTHOR]

Purpose: We reevaluated the psychometric properties of the Amsterdam Inventory for Auditory Disability and Handicap (AIADH; Kramer, Kapteyn, Festen, & Tobi, 1995) using item response theory. Item response theory describes item functioning along an ability continuum. Method: Cross-sectional data from 2,352 adults with and without hearing impairment, ages 18-70 years, were analyzed. They completed the AIADH in the web-based prospective cohort study "Netherlands Longitudinal Study on Hearing." A graded response model was fitted to the AIADH data. Category response curves, item information curves, and the standard error as a function of self-reported hearing ability were plotted. Results: The graded response model showed a good fit. Item information curves were most reliable for adults who reported having hearing disability and less reliable for adults with normal hearing. The standard error plot showed that self-reported hearing ability is most reliably measured for adults reporting mild up to moderate hearing disability. Conclusions: This is one of the few item response theory studies on audiological self-reports. All AIADH items could be hierarchically placed on the self-reported hearing ability continuum, meaning they measure the same construct. This provides a promising basis for developing a clinically useful computerized adaptive test, where item selection adapts to the hearing ability of individuals, resulting in efficient assessment of hearing disability. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine whether hearing ability in adults is associated with medication use in general, the use of specific types of medication, or polypharmacy. In this exploratory study, data of the National Longitudinal Study on Hearing (NL-SH; n = 2,160) were used. In total, 62% of the participants reported using any medication in the past 28 days. Hearing ability in noise, as determined with an online digit-triplet speech-in-noise test, was significantly associated with (1) medication acting on the alimentary tract and metabolism (including diabetes and acid-related disorders), (2) use of calcium blockers, and (3) medication used for sensory organs. [ABSTRACT FROM AUTHOR]

Objective: A multidisciplinary vocational rehabilitation programme, the Vocational Enablement Protocol (VEP) was developed to address the specific needs of employees with hearing difficulties. In the current study we evaluated the process of implementing the VEP in audiologic care among employees with hearing impairment. Design: In conjunction with a randomized controlled trial, we collected and analysed data on seven process parameters: recruitment, reach, fidelity, dose delivered, dose received and implemented, satisfaction, and perceived benefit. Study sample: Sixty-six employees with hearing impairment participated in the VEP. The multidisciplinary team providing the VEP comprised six professionals. Results: The professionals performed the VEP according to the protocol. Of the recommendations delivered by the professionals, 31% were perceived as implemented by the employees. Compliance rate was highest for hearing-aid uptake (51%). Both employees and professionals were highly satisfied with the VEP. Participants rated good perceived benefit from it. Conclusions: Our results indicate that the VEP could be a useful treatment for employees with hearing difficulties from a process evaluation perspective. Implementation research in the audiological setting should be encouraged in order to further provide insight into parameters facilitating or hindering successful implementation of an intervention and to improve its quality and efficacy. [ABSTRACT FROM AUTHOR]

Objective: To explore areas of functioning, disability, and environmental factors of adults with hearing loss (HL) by using the ICF classification as a tool to determine and document each element. Design: A qualitative study applying mainly focus-group methodology was applied. Study sample: Thirty-six Dutch and South African adults (≥ 18 years of age) with HL (20-95 dB HL) who used oral communication as first communication. Summative content analysis was performed on the transcripts by linkage to appropriate ICF categories. Results: 143 ICF categories were identified, most of which belonged to the Activities & Participation (d) component, closely followed by the Environmental factors component. Participants specifically mentioned categories related to oral communication and interaction. Assistive technology (such as hearing aids), noise, and support by and attitudes of others in the environment of the participants were considered highly influential for functioning and disability. Conclusions: The present study illustrates the complex and encompassing nature of aspects involved in functioning and disability of adults with HL. Findings highlight the necessity of using a multidimensional tool, such as the ICF, to map functioning and disability with hearing loss, allowing consideration and evaluation of aspects that are both internal and external. [ABSTRACT FROM AUTHOR]

Purpose: This introduction overviews this special issue on the Hearing Across the Lifespan (HEAL) conference, which was held in Cernobbio, Italy, June 2-4, 2016. [ABSTRACT FROM AUTHOR]

Objective: This study investigates whether the rate of decline in older persons’ hearing status is associated with the rate of decrease in their psychosocial health and explores moderation by baseline hearing status, health-related factors, and sociodemographic factors. Method: Multilevel analyses were applied to data of 1,178 older participants from the Longitudinal Aging Study Amsterdam (LASA), covering 3 to 7 years of follow-up. Results: Faster decrease in speech-in-noise recognition was significantly associated with more increase in loneliness for persons with a moderate baseline speech-in-noise recognition (emotional and social loneliness) and for persons who recently lost their partner (emotional loneliness). No relationship was found with depression. Discussion: The results indicate that faster hearing decline results in more increase in loneliness in specific subgroups of older persons: in persons with an already impaired hearing and in widow(er)s. Monitoring older persons’ hearing seems important and may be a relevant starting point for targeted loneliness prevention efforts. [ABSTRACT FROM PUBLISHER]

Purpose: In May 2001, to integrate biological, psychological, and social aspects of human functioning, the World Health Assembly endorsed the International Classification of Functioning, Disability and Health (ICF). The aim of this article is to describe the creation of Comprehensive and Brief ICF Core Sets for Hearing Loss. The core sets consist of the most relevant ICF categories for hearing loss. Method and Results: Four preparatory studies were carried out and presented at a consensus conference, resulting in a Comprehensive ICF Core Set for Hearing Loss, consisting of 117 ICF categories, and a Brief ICF Core Set for Hearing Loss, consisting of 27 categories (of the 117). Conclusion: The Comprehensive ICF Core Set for Hearing Loss can be a user-friendly tool for conducting comprehensive, multidisciplinary assessments. The Brief ICF Core Set can be used for many purposes, such as research and population studies. However, its most common use is by individuals seeking to provide a brief description and assessment of functioning of a person with hearing loss. [ABSTRACT FROM AUTHOR]

Purpose: In this explorative study, the authors investigated the relationship between auditory and cognitive abilities and self-reported hearing disability. Method: Thirty-two adults with mild to moderate hearing loss completed the Amsterdam Inventory for Auditory Disability and Handicap (AIADH; Kramer, Kapteyn, Festen, & Tobi, 1996) and performed the Text Reception Threshold (TRT; Zekveld, George, Kramer, Goverts, & Houtgast, 2007) test as well as tests of spatial working memory (SWM) and visual sustained attention. Regression analyses examined the predictive value of age, hearing thresholds (pure-tone averages [PTAs]), speech perception in noise (speech reception thresholds in noise [SRTNs]), and the cognitive tests for the 5 AIADH factors. Results: Besides the variance explained by age, PTA, and SRTN, cognitive abilities were related to each hearing factor. The reported difficulties with sound detection and speech perception in quiet were less severe for participants with higher age, lower PTAs, and better TRTs. Fewer sound localization and speech perception in noise problems were reported by participants with better SRTNs and smaller SWM. Fewer sound discrimination difficulties were reported by subjects with better SRTNs and TRTs and smaller SWM. Conclusions: The results suggest a general role of the ability to read partly masked text in subjective hearing. Large working memory was associated with more reported hearing difficulties. This study shows that besides auditory variables and age, cognitive abilities are related to self-reported hearing disability. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The goal of this review was to list and summarize work-related health programs for employees with hearing difficulties and to summarize the statistical evidence of the effectiveness of these programs.METHODS: A systematic review was performed by searching the PubMed, EMBASE, PsycINFO, CINAHL, and The Cochrane Library databases for relevant citations. From 2313 unique citations retrieved from the search strategy, we included nine programs that met all inclusion criteria. The authors assessed the methodological quality of studies which evaluated the program's effectiveness, using the Downs and Black checklist.RESULTS: Nine vocational rehabilitation programs for people with hearing difficulties were described. The programs differed in procedure, duration, setting, and content. In four studies, the effectiveness of the program was explored statistically. Measurements showed an improvement in general health (SF-36), communication strategies, and the degree of work readiness, but none of these studies included a control group, a power calculation, nor adjusted for confounding. Hence, the methodological quality to provide evidence of effectiveness was assessed as poor.DISCUSSION: Existing vocational programs for employees with hearing difficulties provide relevant information to demonstrate how to implement the appropriate content of the programs. Future research is required to improve the strength of evidence of the effectiveness of vocational rehabilitation for workers with hearing difficulties. [ABSTRACT FROM AUTHOR]

Background: Dual sensory loss (DSL) has a negative impact on health and wellbeing and its prevalence is expected to increase due to demographic aging. However, specialized care or rehabilitation programs for DSL are scarce. Until now, low vision rehabilitation does not sufficiently target concurrent impairments in vision and hearing. This study aims to 1) develop a DSL protocol (for occupational therapists working in low vision rehabilitation) which focuses on optimal use of the senses and teaches DSL patients and their communication partners to use effective communication strategies, and 2) describe the multicenter parallel randomized controlled trial (RCT) designed to test the effectiveness and cost-effectiveness of the DSL protocol. Methods/design: To develop a DSL protocol, literature was reviewed and content was discussed with professionals in eye/ear care (interviews/focus groups) and DSL patients (interviews). A pilot study was conducted to test and confirm the DSL protocol. In addition, a two-armed international multi-center RCT will evaluate the effectiveness and cost-effectiveness of the DSL protocol compared to waiting list controls, in 124 patients in low vision rehabilitation centers in the Netherlands and Belgium. Discussion: This study provides a treatment protocol for rehabilitation of DSL within low vision rehabilitation, which aims to be a valuable addition to the general low vision rehabilitation care. [ABSTRACT FROM AUTHOR]

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Objectives: This descriptive summary of the literature provides an overview of the available studies (published between January 1980 and January 2009) on correlates of help-seeking behavior for hearing loss, hearing-aid uptake, hearing-aid use, and satisfaction with the device. Methods: Publications were identified by structured searches in Pubmed and Cinahl and by inspecting the reference lists of relevant articles. The articles covered different stages that a person with hearing impairment may go through: prior to hearing aid fitting, the period covering the fitting and the period post hearing aid fitting. Inclusion of articles occurred according to strict inclusion and exclusion criteria. Data were extracted by two independent researchers. Thirty-nine papers were included that identified 31 factors examined in relation to the four outcome measures. These covered personal factors (e.g., source of motivation, expectation, attitude), demographic factors (e.g., age, gender) and external factors (e.g., cost, counseling). Only two studies covered the actual fitting process. There was only one factor positively affecting all four outcome variables. This was self-reported hearing disability. The vast majority of studies showed no relationship of age and gender with any of the outcome domains. Discussion and conclusion: Whereas research of the last 28 years yielded valuable information regarding relevant and irrelevant factors in hearing aid health care, there are still many relevant issues that have never been investigated in controlled studies. These are discussed. [ABSTRACT FROM PUBLISHER]

Abstract The World Health Organization’s International Classification of Functioning, Disability and Health (ICF) has adopted a multifactorial understanding of functioning and disability, merging a biomedical paradigm with a social paradigm into a wider understanding of human functioning. Altogether there are more than 1400 ICF-categories describing different aspects of human functioning and there is a need to developing short lists of ICF categories to facilitate use of the classification scheme in clinical practice. To our knowledge, there is currently no such standard measuring instrument to facilitate a common validated way of assessing the effects of hearing loss on the lives of adults. The aim of the project is the development of an internationally accepted, evidence-based, reliable, comprehensive and valid ICF Core Sets for Hearing Loss. The processes involved in this project are described in detail and the authors invite stakeholders, clinical experts and persons with hearing loss to actively participate in the development process. Sumario La Clasificación sobre Funcionalidad, Discapacidad y Salud de la Organización Mundial de la Salud (ICF) ha adoptado un acercamiento multifactorial de la funcionalidad y la discapacidad, fusionando un paradigma biomédico con un paradigma social de una forma más amplia. En su conjunto hay más de 1400 categorías ICF que describen diferentes aspectos de la funcionalidad humana y existe la necesidad de desarrollar una lista corta de categorías ICF para facilitar el uso de la clasificación en un esquema para la práctica clínica. Es de nuestro conocimiento que actualmente no existe un instrumento de medición estándar que facilite una forma válida y cómoda para evaluar los efectos de la hipoacusia en la vida de los adultos. El propósito de este proyecto es desarrollar un conjunto básico de condiciones de salud ICF para la hipoacusia que sea internacionalmente aceptado, basado en evidencia, confiable e integral. Se describen en detalle los procesos implicados en este proyecto y los autores invitan a las personas interesadas, a los expertos clínicos y a las personas con hipoacusia a participar activamente en el desarrollo de este proceso. [ABSTRACT FROM AUTHOR]

Background: eHealth and social media could be of particular benefit to adults with hearing impairment, but it is unknown whether their use of smart devices, apps, and social media is similar to that of the general population.Objective: Our aim is to study whether adults with normal hearing and those with impaired hearing differ in their weekly use of smart devices, apps, and social media; reasons for using social media; and benefits from using social media.Methods: We used data from a Dutch cohort, the National Longitudinal Study on Hearing. Data were collected from September 2016 to April 2020 using a web-based questionnaire and speech-in-noise test. The results from this test were used to categorize normal hearing and hearing impairment. Outcomes were compared using (multiple) logistic regression models.Results: Adults with impaired hearing (n=384) did not differ from normal hearing adults (n=341) in their use of a smartphone or tablet. They were less likely to make use of social media apps on a smartphone, tablet, or smartwatch (age-adjusted odds ratio [OR] 0.67, 95% CI 0.48-0.92; P=.02). Use of social media on all devices and use of other apps did not differ. Adults with hearing impairment were more likely to agree with using social media to stay in touch with family members (OR 1.54, 95% CI 1.16-2.07; P=.003) and friends (age-adjusted OR 1.35, 95% CI 1.01-1.81; P=.046). Furthermore, they were more likely to agree with using social media to perform their work (age-adjusted OR 1.51, 95% CI 1.04-2.18; P=.03). There were no differences in the experienced benefits from social media.Conclusions: The potential for eHealth is confirmed because adults with hearing impairment are not less likely to use smart devices than their normal hearing peers. Adults with hearing impairment are less likely to use social media apps on a smart device but not less likely to use social media on all types of internet-connected devices. This warrants further research on the types of social media platforms that adults with hearing impairment use and on the type of device on which they prefer to use social media. Given that participants with hearing impairment are more likely than their normal hearing peers to use social media to perform their work, use of social media may be seen as an opportunity to enhance vocational rehabilitation services for persons with hearing impairment. [ABSTRACT FROM AUTHOR]

Within the International Classification of Functioning, Disability, and Health (ICF; WHO), participation in work is acknowledged as one of the major areas in life (D8). Difficulties that make it impossible for the person to optimally partake in work result in participation restriction. An increasing number of people with hearing loss are seeking help for occupational problems. Various studies identified issues that should be addressed in the management of employees with hearing loss and emphasized the importance of a tailored vocational enablement program. This paper describes a recently developed vocational enablement protocol (VEP) addressing the specific needs of those with hearing loss in the workforce. It is characterized by an integrated approach (occupational physician, otolaryngologist, audiologist, social worker/psychologist, speech-language pathologist). The goal is to facilitate participation in, and retention of, work. The protocol is currently implemented in a few audiological centers in the Netherlands. This paper presents data collected at the audiological center of the VU University Medical Center, Amsterdam. Thus far, 86 patients, aged 19 to 64 years (mean 48, SD 23), have completed the protocol. Experiences with the procedure are described, and recommendations for future practice and research are discussed. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the relationship between hearing loss and memory and attention when nonverbal, visually presented cognitive tests are used. Method: Hearing loss (pure-tone audiometry) and IQ were measured in 30 participants with mild to severe hearing loss. Participants performed cognitive tests of pattern recognition memory, sustained visual attention, and spatial working memory. All cognitive tests were selected from the Cambridge Neuropsychological Test Automated Battery (CANTAB expedio; Cambridge Cognition Ltd., 2002). Regression analyses were performed to examine the relationship between hearing loss and these cognitive measures of memory and attention when controlling for age and IQ. Results: The data indicate that hearing loss was not associated with decreased performance on the memory and attention tests. In contrast, participants with more severe hearing loss made more use of an efficient strategy during performance on the spatial working memory subtest. This result might reflect the more extensive use of working memory in daily life to compensate for the loss of speech information. Conclusions: The authors conclude that the use of nonverbal tests is essential when testing cognitive functions of individuals with hearing loss. [ABSTRACT FROM AUTHOR]

This study compares the occupational performance of employees with and without hearing impairment, and aims to identify occupational difficulties specifically related to hearing loss. The Amsterdam Checklist for Hearing and Work was administered to 150 hearing-impaired employees and 60 normally-hearing colleagues. A multivariate analysis of variance was performed to test group effects, and to examine differences between means. Factors predicting sick-leave were identified by regression analyses. A significant group effect (p < 0.01) was found. Hearing-impaired employees differed from normallyhearing colleagues in their perception of ‘environmental noise’, ‘job control’ and the ‘necessity to use hearing activities’ at work. Also, sick-leave due to distress occurred significantly more often in the hearing impaired group (p < 0.05). ‘Hearing impairment’, ‘job demand’, and the requirement to ‘recognize/distinguish between sounds’ were the strongest risk-factors for stress related sick-leave. The importance of hearing functions besides speech communication is discussed. Implications for rehabilitation are suggested. In future research, hearing loss should be considered as a risk factor for fatigue and mental distress which may lead to sick-leave. [ABSTRACT FROM AUTHOR]

The objective of the study was to investigate the effects of a family history of hearing impairment on those people with the hearing impairment themselves. The subjects were 102 consecutive patients with a family history of hearing impairment, seen in an audiological rehabilitation clinic. Each was given an open-ended questionnaire asking whether such a family history had any effects on them and, if so, to list any effects. Results were qualitatively analysed. 57 subjects indicated effects. Of those listed, 57% were positive, 19% negative, and 24% neutral. The most common positive effects concerned realising the importance of hearing aids and early help-seeking. Common negative effects were concern for the future of themselves and their children. Neutral effects were a reported ignorance or denial of a family history. The results emphasize the importance of asking patients about any family history when planning their rehabilitative programme. [ABSTRACT FROM AUTHOR]

The present paper presents an alternative method to calculate hearing disability. As opposed to existing models to calculate hearing disability, the present method is not just based on the pure-tone audiogram. Hearing activities playing an important role in daily listening are taken into account: detection of sounds, distinction of sounds, intelligibility in quiet and in noise, auditory localization. Psycho-acoustical tests to measure each of these activities are described. Test scores are used to calculate overall hearing disability. A comparison is made between the present model and the method of the American Medical Association (AMA). Calculations are based on theoretical cases only. Further study has to be undertaken to verify the calculations by examining the scores of real cases to improve the validity and internal consistency of the present model. [ABSTRACT FROM AUTHOR]

The article discusses the project, Assessment of Hearing in the Elderly: Aging and Degeneration -- Integration through Immediate Intervention, 2008-2011, funded by the European Commission. One of the aims of the project is to increase awareness of early detection, the crucial role of population screening, and the need for effective interventions for hearing impairment in the elderly. It also involves a survey of international experts about non-hearing aid interventions.

Background: Hearing aid (HA) use is known to improve health outcomes for people with hearing loss. Despite that, HA use is suboptimal, and communication issues and hearing-related activity limitations and participation restrictions often remain. Web-based self-management communication programs may support people with hearing loss to effectively self-manage the impact of hearing loss in their daily lives.Objective: The goal of the research is to examine the short- and long-term effects of a web-based self-management SUpport PRogram (SUPR) on communication strategy use (primary outcome) and a range of secondary outcomes for HA users aged 50 years and older.Methods: Clients of 36 HA dispensing practices were randomized to SUPR (SUPR recipients; n=180 HA users) and 34 to care as usual (controls; n=163 HA users). SUPR recipients received a practical support booklet and online materials delivered via email over the course of their 6-month HA rehabilitation trajectory. They were encouraged to appoint a communication partner and were offered optional email contact with the HA dispensing practice. The online materials included 3 instruction videos on HA handling, 5 videos on communication strategies, and 3 testimonial videos. Care as usual included a HA fitting rehabilitation trajectory only. Measurements were carried out at baseline, immediately postintervention, 6 months postintervention, and 12 months postintervention. The primary outcome measure was self-reported use of communication strategies (3 subscales of the Communication Profile for the Hearing Impaired [CPHI]). Secondary outcome measures included self-reported personal adjustment to hearing loss (CPHI); use, satisfaction and benefit of HAs and SUPR (use questionnaire; International Outcome Inventory for Hearing Aids [IOI-HA], Alternative Interventions [IOI-AI]); recommendation of HA dispensing services; self-efficacy for HA handling (Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids [MARS-HA]); readiness to act on hearing loss (University of Rhode Island Change Assessment adapted for hearing loss [URICA-HL]); and hearing disability (Amsterdam Inventory for Auditory Disability and Handicap [AIADH]).Results: Linear mixed model analyses (intention to treat) showed no significant differences between the SUPR and control group in the course of communication strategy use (CPHI). Immediately postintervention, SUPR recipients showed significantly higher self-efficacy for advanced HA handling than the controls, which was sustained at 12 months (MARS-HA; mean difference immediately postintervention: 5.3, 95% CI 0.3 to 10.4; P=.04). Also, SUPR recipients showed significantly greater HA satisfaction than controls immediately postintervention (IOI-HA; 0.3, 95% CI 0.09 to 0.5; P=.006), which was sustained at 12 months, and significantly greater HA use than the controls immediately postintervention (IOI-HA; 0.3, 95% CI 0.02 to 0.5; P=.03), which was not sustained at 12 months.Conclusions: This study provides ground to recommend adding SUPR to standard HA dispensing care, as long-term, modest improvements in HA outcomes were observed. Further research is needed to evaluate what adjustments to SUPR are needed to establish long-term effectiveness on outcomes in the psychosocial domain.Trial Registration: ISRCTN77340339; http://www.isrctn.com/ISRCTN77340339.International Registered Report Identifier (irrid): RR2-10.1136/bmjopen-2016-015012. [ABSTRACT FROM AUTHOR]

In recent years, the fields of Audiology and Cognitive Sciences have seen a burgeoning of research focusing on the assessment of the effort required during listening. Among approaches to this question, the pupil dilation response has shown to be an informative nonvolitional indicator of cognitive processing during listening. Currently, pupillometry is applied in laboratories throughout the world to assess how listening effort is influenced by various relevant factors, such as hearing loss, signal processing algorithms, cochlear implant rehabilitation, cognitive abilities, language competency, and daily-life hearing disability. The aim of this special issue is to provide an overview of the state of the art in research applying pupillometry, guidance for those considering embarking on pupillometry studies, and to illustrate the diverse ways in which it can be used to answer—and raise—pertinent research questions. [ABSTRACT FROM AUTHOR]

Recently, the measurement of the pupil dilation response has been applied in many studies to assess listening effort. Meanwhile, the mechanisms underlying this response are still largely unknown. We present the results of a method that separates the influence of the parasympathetic and sympathetic branches of the autonomic nervous system on the pupil response during speech perception. This is achieved by changing the background illumination level. In darkness, the influence of the parasympathetic nervous system on the pupil response is minimal, whereas in light, there is an additional component from the parasympathetic nervous system. Nineteen hearing-impaired and 27 age-matched normal-hearing listeners performed speech reception threshold tests targeting a 50% correct performance level while pupil responses were recorded. The target speech was masked with a competing talker. The test was conducted twice, once in dark and once in a light condition. Need for Recovery and Checklist Individual Strength questionnaires were acquired as indices of daily-life fatigue. In dark, the peak pupil dilation (PPD) did not differ between the two groups, but in light, the normal-hearing group showed a larger PPD than the hearing-impaired group. Listeners with better hearing acuity showed larger differences in dilation between dark and light. These results indicate a larger effect of parasympathetic inhibition on the pupil dilation response of listeners with better hearing acuity, and a relatively high parasympathetic activity in those with worse hearing. Previously observed differences in PPD between normal and impaired listeners are probably not solely because of differences in listening effort. [ABSTRACT FROM AUTHOR]

Previous research has shown the effects of task demands on pupil responses in both normal hearing (NH) and hearing impaired (HI) adults. One consistent finding is that HI listeners have smaller pupil dilations at low levels of speech recognition performance (≤50%). This study aimed to examine the pupil dilation in adults with a normal pure-tone audiogram who experience serious difficulties when processing speech-in-noise. Hence, 20 adults, aged 26 to 62 years, with traumatic brain injury (TBI) or cerebrovascular accident (CVA) but with a normal audiogram participated. Their pupil size was recorded while they listened to sentences masked by fluctuating noise or interfering speech at 50% and 84% intelligibility. In each condition, participants rated their perceived performance, effort, and task persistence. In addition, participants performed the text reception threshold task—a visual sentence completion task—that measured language-related processing. Data were compared with those of age-matched NH and HI participants with no neurological problems obtained in earlier studies using the same setup and design. The TBI group had the same pure-tone audiogram and text reception threshold scores as the NH listeners, yet their speech reception thresholds were significantly worse. Although the pupil dilation responses on average did not differ between groups, self-rated effort scores were highest in the TBI group. Results of a correlation analyses showed that TBI participants with worse speech reception thresholds had a smaller pupil response. We speculate that increased distractibility or fatigue affected the ability of TBI participants to allocate effort during speech perception in noise. [ABSTRACT FROM AUTHOR]

Speech comprehension depends on the successful operation of a network of brain regions. Processing of degraded speech is associated with different patterns of brain activity in comparison with that of high-quality speech. In this exploratory study, we studied whether processing degraded auditory input in daily life because of hearing impairment is associated with differences in brain volume. We compared T1-weighted structural magnetic resonance images of 17 hearing-impaired (HI) adults with those of 17 normal-hearing (NH) controls using a voxel-based morphometry analysis. HI adults were individually matched with NH adults based on age and educational level. Gray and white matter brain volumes were compared between the groups by region-of-interest analyses in structures associated with speech processing, and by whole-brain analyses. The results suggest increased gray matter volume in the right angular gyrus and decreased white matter volume in the left fusiform gyrus in HI listeners as compared with NH ones. In the HI group, there was a significant correlation between hearing acuity and cluster volume of the gray matter cluster in the right angular gyrus. This correlation supports the link between partial hearing loss and altered brain volume. The alterations in volume may reflect the operation of compensatory mechanisms that are related to decoding meaning from degraded auditory input. [ABSTRACT FROM AUTHOR]