Social representation of "hearing loss": cross-cultural exploratory study in India, Iran, Portugal, and the UK

B. A Survey of Knowledge and Attitude of College Students Toward Hearing Loss Prevention

BACKGROUND

College students risk hearing loss due to loud sound exposure during leisure activities. Hearing loss prevention is possible by reducing the noise from the source, using hearing protection devices and increasing their knowledge and awareness on the effects of loud sound exposure.

OBJECTIVE

The study aims to assess the knowledge and attitude of college students regarding hearing loss and its prevention.

STUDY DESIGN

A cross-sectional study design with a survey method was adopted. A total of 94 college students (mean age: 22 years; range: 18 to 26) who were pursuing an undergraduate and postgraduate degree (50 males and 44 females) formed the part of the study. The researcher administered a standardized self-reported Knowledge, Attitude and Behaviour questionnaire. The knowledge score in percentage and absolute scores for attitude were estimated.

RESULTS

The mean knowledge score was 35.8 (SD ± 12.18; range: 12.5-75), and the attitude score was + 9.8 (SD ± 7.1; range: - 4 to + 30). Chi square test revealed no significant association between knowledge and attitude to sociodemographic characteristics.

CONCLUSION

 The study indicated that though college students lack knowledge, they had a positive attitude regarding hearing health and its protection. These findings implicate the importance of creating awareness and encouraging hearing protection strategies for college students.

Patient and public involvement in hearing research: opportunities, impact and reflections with case studies from the Manchester Centre for Audiology and Deafness

OBJECTIVE

Patient and public involvement (PPI) in research improves relevance to end users and improves processes including recruitment participants. PPI in our research has gone from being non-existent to ubiquitous over a few years. We provide critical reflections on the benefits and challenges of PPI.

DESIGN

Case studies are reported according to a modified GRIP2 framework; the aims, methodology, impact of PPI and critical reflections on each case and our experiences with PPI in general.

STUDY SAMPLE

We report five UK projects that included PPI from teenagers, families, people living with dementia, autistic people, and people from South Asian and d/Deaf communities.

RESULTS

Our experience has progressed from understanding the rationale to grappling methodologies and integrating PPI in our research. PPI took place at all stages of research, although commonly involved input to design including recruitment and development of study materials. Methodologies varied between projects, including PPI co-investigators, advisory panels and online surveys.

CONCLUSION

On-going challenges include addressing social exclusion from research for people that lack digital access following increasing on-line PPI and involvement from underserved communities. PPI was initially motivated by funders; however the benefits have driven widespread PPI, ensuring our research is relevant to people living with hearing loss.

Hearing and Functioning in Everyday Life Questionnaire: Development and Validation of an ICF-Based Instrument

OBJECTIVES

Self-assessment instruments are commonly used in audiological rehabilitation. However, several studies highlight the lack of multidimensionality in existing outcome measures, with the consequence that they only partially capture aspects of functioning in everyday life for people living with hearing loss. This study aimed to develop and investigate the content validity of a self-assessment instrument based on the validated Brief International Classification of Functioning, Disability, and Health Core Set for Hearing Loss.

DESIGN

The design was a two-part instrument development study. The first part focused on the item-generation process of the instrument, named the Hearing and Functioning in Everyday Life Questionnaire (HFEQ) during an experts' workshop. The second part focused on international content validation of the instrument using group interviews. Strategic sampling was used and 30 adults with hearing loss from India, South Africa, and the United States participated in the group interviews.

RESULTS

The expert's workshop resulted in the first version of the HFEQ containing 30 items. The results from group interviews show that the content of the HFEQ was considered to be valid concerning its relevance, comprehensiveness, and comprehensibility. A majority (73%) of the HFEQ items were perceived by the participants as relevant and easy to comprehend. For the remaining 27% of the items, the content was perceived to be relevant in all countries, but some terms and expressions were reported to require rewording or clearer examples. These modifications will be made in the next step of the development process.

CONCLUSION

Content validation of the HFEQ demonstrates promising results, with participants perceiving the content as relevant and comprehensible. Further psychometric validation is required to investigate other psychometric properties, such as construct validity and reliability. The HFEQ has the potential to become a valuable new instrument for assessing everyday functioning in people with hearing loss in audiological rehabilitation and in research.

Barriers to hearing aid adoption among older adults in mainland China

OBJECTIVE

This study aimed to explore barriers to hearing aid adoption amongst older adults in mainland China.

DESIGN

Semi-structured interviews were audio-recorded and analysed using qualitative thematic analysis.

STUDY SAMPLE

The study included 12 older adults who had seen ENTs and had not adopted hearing aids.

RESULTS

Three overarching themes and ten subthemes were generated to explain why older adults in mainland China do not adopt hearing aids: (1) Desire a cure for hearing loss, (2) Lack of a perceived need for hearing aids, and (3) Negative impressions of, and misconceptions about, hearing aids.

CONCLUSION

Although barriers are similar to those reported in Western societies, the under-developed hearing healthcare infrastructure, Chinese health beliefs, Chinese culture, and low health literacy play important roles in preventing older adults to adopt hearing aids in mainland China. To identify barriers to hearing aid adoption and address them, hearing health practitioners should learn what older adults know about their hearing loss, how they perceive the effects of hearing loss, and how they feel about hearing aids.

Community Perspectives on Hearing Loss in Rural Alaska

OBJECTIVES

The aim of this study is to present an explanatory model of hearing loss in the Bering Strait region of Alaska in order to contextualize the results of a cluster randomized trial and propose implications for regional hearing-related health care.

DESIGN

To promote ecological validity, or the generalizability of trial findings to real world experiences, qualitative methods (focus groups and interviews) were used within a mixed methods cluster randomized trial evaluating school hearing screening and follow-up processes in 15 communities in the Bering Strait region of Alaska. Focus groups were held between April and August 2017, and semistructured interviews were conducted between December 2018 and August 2019. Convenience sampling was used for six of the 11 focus groups to capture broad community feedback. Purposive sampling was used for the remaining five focus groups and for all interviews to capture a variety of experiences with hearing loss. Audio recordings of focus groups and interviews were transcribed, and both notes and transcripts were deidentified. All notes and transcripts were included in the analysis. The constant comparative method was used to develop a codebook by iteratively moving between transcripts and preliminary themes. Researchers then used this codebook to code data from all focus groups and interviews using qualitative analysis software (NVIVO 12, QSR International) and conducted thematic analyses to distill the findings presented in this article.

RESULTS

Participants in focus groups (n = 116) and interviews (n = 101) shared perspectives in three domains: etiology, impact, and treatment of hearing loss. Regarding etiology, participants emphasized noise-induced hearing loss but also discussed infection-related hearing loss and various causes of ear infections. Participants described the impact of hearing loss on subsistence activities, while also detailing social, academic, and economic consequences. Participants described burdensome treatment pathways that are repetitive and often travel and time intensive. Communication breakdowns within these pathways were also described. Some participants spoke positively of increased access via onsite hearing health care services in "field clinics" as well as via telemedicine services. Others described weaknesses in these processes (infrequent field clinics and communication delays in telemedicine care pathways). Participants also described home remedies and stigma surrounding the treatment for hearing loss.

CONCLUSIONS

Patient-centered health care requires an understanding of context. Explanatory models of illness are context-specific ways in which patients and their networks perceive and describe the experience of an illness or disability. In this study, we documented explanatory models of hearing loss to foster ecological validity and better understand the relevance of research findings to real-life hearing-related experiences. These findings suggest several areas that should be addressed in future implementation of hearing health care interventions elsewhere in rural Alaska, including management of repetitious treatments, awareness of infection-mediated hearing loss, mistrust, and communication breakdowns. For hearing-related health care in this region, these findings suggest localized recommendations for approaches for prevention and treatment. For community-based hearing research, this study offers an example of how qualitative methods can be used to generate ecologically valid (i.e., contextually grounded) findings.

Years lived with disability of cancer in China: findings from disability weights measurement with a focus on the effect of disease burden

Disability weights are crucial for quantifying health loss associated with non-fatal outcomes and were not well assessed in different countries, especially for specific cancer. Therefore, this study aimed to identify disability weights with a focus on specific cancer in a large Chinese population. Two types of web surveys were conducted, and 254 health states, including 30 new states for specific cancer, were investigated using paired comparison methods. The years lived with disability (YLDs) of cancer were calculated as the sum of the prevalence of each sequela of cancer multiplied by its relative disability weight. In total, 44,069 participants were eligible for the disability weights study. The disability weights of 254 health states were estimated. Among those, the disability weights of 18 specific cancer types varied greatly at diagnosis and primary treatment stage, with the value ranging from 0.619 (95% uncertainty interval (UI) 0.606-0.632) for brain cancer to 0.167 (95% UI 0.158-0.176) for oropharyngeal cancer. The discrepancy in YLDs calculated by different disability weights was high, and the largest gap for all cancer combined was approximately 30.14%. When calculated using the cancer-specific disability weights, a total of 1,967,830 (95% UI 1,928,880-2,008,060) YLDs of cancer were recorded in China. The disability weights of cancer varied greatly among cancer types and populations, which had considerable influence on the estimation of the disease burden. Cancer-specific disability weights could provide a more accurate evaluation of the cancer burden.

Can global or national disability weights represent provincial level?

BACKGROUND

A universal set of disability weights(DWs) is mainly based on the survey of North America, Australia and Europe, whereas the participants in Asia was limited. The debate hasn't yet settled whether a universal DW is desirable or useful.The focus of the debate is its representativenes-s.After all, the DWs come from people's subjective evaluation of pain, and they may vary according to cultural background.The differences of the DWs could have implications for the magnitude or ranking of disease burdens.The DWs of Anhui Province has not been completely presented.This paper aims to obtain the DWs suitable for the general population of Anhui Province of China, and attempts to explore the differences between different DWs by comparing the DWs with the similar-cultural background and the DWs with cross-cultural background.

METHODS

A web-based survey was conducted to estimate the DWs for 206 health states of Anhui province in 2020. Paired comparison (PC) data were analyzed and anchored by probit regression and fitting loess model. We compared the DWs in Anhui with other provinces in China and those in Global burden of disease (GBD) and Japan.

RESULTS

Compared with Anhui province, the proportion of health states which showed 2 times or more differences ranged from 1.94% (Henan) to 11.17% (Sichuan) in China and domestic provinces. It was 19.88% in Japan and 21.51% in GBD 2013 respectively. In Asian countries or regions, most of the health states with top 15 DWs belonged to the category of mental, behavioral, and substance use disorders. But in GBD, most were infectious diseases and cancer. The differences of DWs in neighboring provinces were smaller than other geographically distant provinces or countries.

CONCLUSION

PC responses were largely consistent across very distinct settings,but the exceptions do need to be faced squarely.The differences of DWs among similar-cultural regions were smaller than cross-cultural regions. There is an urgent need for relevant gold standards.

Social Representations of "Tinnitus" and "Health" among Individuals with Tinnitus Seeking Online Psychological Interventions

(1) Objective: Social representations theory (SRT) is a body of theory within social psychology concerned with how individuals, groups, and communities collectively make sense of socially relevant or problematic issues, ideas, and practices. SRT has been increasingly sued in the area of health and disability. The current study examined the social representations of "tinnitus" and "health" among individuals with tinnitus who are seeking online psychological interventions. (2) Materials/Method: The data were gathered using a free association task about their "tinnitus" and "health" from 399 individuals with tinnitus. The data were analyzed using both qualitative and quantitative analyses methods. (3) Results: The responses resulted in 39 and 30 categories respectively, for "tinnitus" and "health". The most commonly occurring categories for tinnitus included: descriptions of tinnitus (18%), annoying (13.5%), persistent (8%), and distracting (5%). The most commonly occurring categories for health included: content (12%), conditions (8%), active (7%), take control (6%), and overweight (5%). The responses to tinnitus had predominantly negative connotations (i.e., 76.9%) whereas a larger proportion of responses toward their health was related to positive connotations (i.e., 46.4%). These frequently occurring items were also dominant in similarities analysis. Prototypical analysis of tinnitus responses identified categories horrible and bothersome to be key items in the central zone. The categories in central zone of health responses included: content, active, healthy, grateful, and overweight. (4) Conclusions: Individuals with tinnitus have very negative view of their tinnitus impacting their psychological status. Tinnitus management should focus on reducing the negative associations toward their tinnitus and strengthen the positive aspects related to their general health.

Self-reported hearing loss and cognitive impairment: a cross-sectional analysis of the EpiFloripa Aging study

This study aimed to investigate the association between self-reported hearing loss and cognitive impairment in older adults in a city in Southern Brazil. In this cross-sectional, population-based cohort study of older adults, data were collected in the third wave of the EpiFloripa Aging study (2017/2019), which had been performed since 2009 in the city of Florianópolis, Santa Catarina State. Cognitive impairment was the dependent variable analyzed by the Mini-Mental State Examination (MMSE), and self-reported hearing loss, which was included in the cohort only in the last wave, was the main exposure variable. Logistic regression analyses were conducted, considering the study design and sample weights. Data from 1,335 older adults were evaluated. The prevalence was 20.5% for cognitive impairment and 10.7% for hearing loss. Older adults with hearing loss were 2.66 (95%CI: 1.08-6.54) times more likely to have cognitive impairment than older adults without hearing loss. The association between hearing loss and cognitive impairment highlights the need to integrate the early identification of these problems into primary care, as both are risk factors for healthy aging and potentially preventable and/or treatable conditions.

Experiential Characteristics among Individuals with Tinnitus Seeking Online Psychological Interventions: A Cluster Analysis

OBJECTIVE

This study was designed to gain insights regarding patterns of social representations (values, ideas, beliefs) of tinnitus and their relation to demographic and clinical factors.

METHOD

A cross-sectional survey design was used including 399 adults seeking help and reporting interest in internet-based cognitive behavior therapy for tinnitus. Data were collected using a free association task and analysis used qualitative (content analysis) and quantitative (cluster analysis and chi-square analysis) using the Iramuteq software.

RESULTS

The social representations identified the negative impact of tinnitus and included the way it sounded (descriptions of the way tinnitus sounds (18%), annoyance (13.5%), and persistence (8%)). Four clusters were identified representing four levels of tinnitus severity, namely debilitating tinnitus (24%), distressing tinnitus (10%), annoying tinnitus (46%), and accepting tinnitus (20%). Cluster identity was associated with demographic and clinical variables.

DISCUSSION

The identified clusters represented tinnitus severity experience in four stages, ranging from debilitating tinnitus to acceptance of tinnitus. These findings are important for clinical practice where tinnitus descriptions can indicate the stage of the tinnitus experience and which intervention pathway may be most appropriate.

Eliciting national and subnational sets of disability weights in mainland China: Findings from the Chinese disability weight measurement study

BACKGROUND

The disability weight (DW) quantifies the severity of health states from disease sequela and is a pivotal parameter for disease burden calculation. We conducted a national and subnational DW measurement in China.

METHODS

In 2020-2021, we conducted a web-based survey to assess DWs for 206 health states in 31 Chinese provinces targeting health workers via professional networks. We fielded questions of paired comparison (PC) and population health equivalence (PHE). The PC data were analysed by probit regression analysis, and the regression results were anchored by results from the PHE responses on the DW scale between 0 (no loss of health) and 1 (health loss equivalent to death).

FINDINGS

We used PC responses from 468,541 respondents to estimate DWs of health states. Eight of 11 domains of health had significantly negative coefficients in the regression of the difference between Chinese and Global Burden of Disease (GBD) DWs, suggesting lower DW values for health states with mention of these domains in their lay description. We noted considerable heterogeneity within domains, however. After applying these Chinese DWs to the 2019 GBD estimates for China, total years lived with disability (YLDs) increased by 14·9% to 177 million despite lower estimates for musculoskeletal disorders, cardiovascular diseases, mental disorders, diabetes and chronic kidney disease. The lower estimates of YLDs for these conditions were more than offset by higher estimates of common, low-severity conditions.

INTERPRETATION

The differences between the GBD and Chinese DWs suggest that there might be some contextual factors influencing the valuation of health states. While the reduced estimates for mental disorders, alcohol use disorder, and dementia could hint at a culturally different valuation of these conditions in China, the much greater shifts in YLDs from low-severity conditions more likely reflects methodological difficulty to distinguish between health states that vary a little in absolute DW value but a lot in relative terms.

FUNDING

This work was supported by the National Natural Science Foundation of China [grant number 82173626], the National Key Research and Development Program of China [grant numbers 2018YFC1315302], Wuhan Medical Research Program of Joint Fund of Hubei Health Committee [grant number WJ2019H304], and Ningxia Natural Science Foundation Project [grant number 2020AAC03436].

Barriers to Equity in Pediatric Hearing Health Care: A Review of the Evidence

Purpose

We review the evidence regarding barriers to hearing health care for children who are deaf or hard of hearing.

Background

There are considerable data to suggest that hearing health care disparities constitute a major factor in loss to follow-up or documentation for children going through the Early Hearing Detection and Intervention process. Families are affected by a combination of factors underlying these disparities, resulting in delayed care and suboptimal developmental outcomes for children who are deaf or hard of hearing.

Conclusions

To address the socioeconomic, cultural, and linguistic inequities seen in the diagnosis and management of childhood hearing loss, pediatric audiologists and speech-language pathologists have a responsibility to provide culturally responsive practice to their individual clients and their families, as well as advocate for substantive changes at the policy level that impact their clients' daily lives.

Representation and resistance: A qualitative study of narratives of Deaf cultural identity

This qualitative study examines narratives of identity among deaf adults in Denmark who were raised within the Bilingual–Bicultural programme of education. At a time of threat to sign language and the Deaf community, the study explores the distinctiveness of a minority cultural identity rooted in sign language and elaborated through Deaf norms and values. Applying the social psychological theories of social identity and social representations, the analysis shows that while Deaf identity is developed through and against forces of marginalisation and the medicalising system of representation that cochlear implants reify, it both celebrates Deaf culture and embraces cross-cultural dialogue and exchange. The findings run against existing models of deaf identity that posit discrete Deaf (immersive) and bicultural identities. They also disclose the importance of studies of social identity that retrieve the theory’s original emphasis on cultural systems and context to explain identities and intergroup dynamics. Finally, the study has resonances for disability and other minority studies and movements that seek to pay attention to socially creative processes of critiquing normativity and enlarging understandings of culture and identity.

Social Representation of 'Vocal Hygiene' in India and Bhutan: A Cross-Sectional Survey

BACKGROUND

The study aimed to explore the professional and recreational and/or personal voice use patterns and social representation of 'vocal hygiene' in two culturally and geographically diverse societies: India and Bhutan.

METHODS

A total of 339 volunteers of Indian and Bhutanese nationality participated through snowball sampling. The responses were elicited using multiple-choice questions and a free association task. The data from the multiple-choice questions were analyzed using descriptive statistical methods. The free association task's responses underwent content and co-occurrence analysis to identify the most frequently occurring response categories.

RESULTS

The professional voice use pattern differed between the two populations but not the recreational and/or personal voice use pattern. The results also revealed diverse social representations of 'vocal hygiene' in India and Bhutan.

CONCLUSIONS

The present study sheds light on the voice use patterns and how the concept of vocal hygiene is represented in the two countries. These findings may have implications for developing and executing society specific awareness programs about vocal hygiene and its importance.

How do Japanese rate the severity of different diseases and injuries?-an assessment of disability weights for 231 health states by 37,318 Japanese respondents

Background

Disability weights (DWs) are weight factors that reflect the severity of health states for estimates of disability-adjusted life years. A new set of global DWs was published for the Global Burden of Diseases and Injuries (GBD) 2013 study, which relied on sampling from various world regions, but included little data for countries in East Asia. This study aimed to measure DWs in Japan using comparable methods, and compare the results with previous estimates from the GBD 2013 DW study.

Methods

We conducted a web-based survey in 2019 to estimate DWs for 231 health states for the Japanese population. The survey included five new health states but otherwise followed the method of the GBD DW measurement study. The survey consisted of 15 paired comparison (PC) questions and 3 population health equivalence questions (PHE) per respondent. We analyzed PC data using probit regression and rescaled results to DW units between 0 (equivalent to full health) and 1 (equivalent to death).

Findings

We considered 37,318 nationally representative respondents. The values of the resulting DWs ranged from 0.707 (95% uncertainty interval (UI) 0.527–0.842) for spinal cord injury at neck level (untreated) to 0.004 (UI 0.001–0.009) for mild anemia. High correlation between Japanese DW and GBD 2013 DW was observed, but there was considerable disagreement. Out of 226 comparable health states, 55 (24.3%) showed more than a factor-of-two difference, of which 41 (74.6%) had a higher value in Japanese DW. Many of the health states with higher DW in the Japan study were injuries, including amputation and fracture, and hearing and vision loss, while mental, behavioral, and substance use disorders generally tended to be lower.

Conclusions

This study has created an empirical basis for assessment of Japanese DWs of health status. The findings from this study based on the Japanese population suggest that there might be contextual differences in rating the severity of health states compared to previous surveys conducted elsewhere.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12963-021-00253-4.

Social representation of hearing aids among people with hearing loss: an exploratory study

OBJECTIVE

The aim of the current study was to examine the social representation (SR) of hearing aids in people with hearing loss (PHL) in India, the Republic of Korea (ROK), the United Kingdom (UK), and the United States of America (US).

DESIGN

The study used a cross-sectional survey design. The data collected by using a free association task were analysed qualitatively (i.e. content analysis) and quantitatively (i.e. chi-square analysis, similarities analysis, prototypical analysis).

STUDY SAMPLE

424 participants with hearing loss.

RESULTS

The most commonly reported categories across all countries were "beneficial," "cost and time," and "appearance and design." Approximately 50% of the associations reported were negative. There were variations in terms of the categories that were predominant in the SR of each country. "Others actions and attitude" category was predominantly reported by PHL in India. "Disturbance" and "dissatisfaction" of hearing aids and the "repairs and maintenance of hearing aids" categories were mainly reported from the ROK and the US, respectively.

CONCLUSIONS

The current results highlight the main aspects that PHL report spontaneously when they think about hearing aids. The findings will help to further inform public health campaigns and will contribute to develop culturally appropriate media materials regarding hearing aids.

Social Representation of "Hearing Loss" Among People with Hearing Loss: An Exploratory Cross-Cultural Study

BACKGROUND

Hearing loss can have an effect on the physical, psychosocial, and cognitive wellbeing of an individual. Despite the research on attitudes and stigma associated with hearing loss, people with hearing loss (PHL) continue to delay seeking help. Thus, it is vital to look at alternative theories which have been successfully used in disability research to better understand how PHL perceive hearing loss.

PURPOSE

The aim of the current exploratory study was to examine the social representation (SR) of "hearing loss" in PHL in India, Republic of Korea (ROK), United Kingdom (UK), and the United States (US).

RESEARCH DESIGN

The study used a cross-sectional survey design.

STUDY SAMPLE

In this study, 424 participants were recruited using a consecutive sampling method in four countries (India, Republic of Korea, United Kingdom, and United States).

DATA COLLECTION AND ANALYSIS

Data collection was conducted using a questionnaire. Data were analyzed using content analysis, similarities analysis, prototypical analysis, and chi-square analysis.

RESULTS

The free associations of the PHL were grouped into 37 categories. The most commonly reported categories were communication difficulties, negative mental state, aging, assessment and management, causes of hearing loss, hearing ability or disability, hearing instruments, and symptoms of hearing loss. Similarities analysis and prototypical analysis highlighted two main negative categories (negative mental state and communication difficulties) which form the central elements of SR of hearing loss. PHL associated hearing loss mainly as a negative phenomenon, but with some positive and neutral aspects. Respondents from ROK reported a greater number of neutral associations compared with other countries. There were cross-cultural similarities and differences in terms of PHL's SR of hearing loss, but there were more similarities than differences.

CONCLUSION

The study provides an insight into how PHL collectively view their "hearing loss" and helps to develop our understanding of the influence of culture on the SR of "hearing loss." The results will aid the development of culturally appropriate public education campaigns, marketing material, and appropriate rehabilitation for PHL.

Prevalence of and Characteristics Associated With Self-reported Good Hearing in a Population With Elevated Audiometric Thresholds

Importance

Audiometric evidence of hearing loss does not always relate to self-reported hearing loss.

Objective

To determine the prevalence of self-reported good hearing in a population with audiometrically defined hearing loss and identify associated factors.

Design, Setting, and Participants

We analyzed audiometric data from adults aged 20 to 69 years from the 1999 to 2002 cycles of the US National Health and Nutrition Examination Survey, a cross-sectional, nationally representative interview and examination survey of the civilian, noninstitutionalized population. Logistic regression was used to examine unadjusted and multivariable-adjusted relationships between demographic, hearing health, and general health factors related to self-perceived hearing status. Analysis was conducted between September 4, 2018, and November 30, 2018.

Interventions

Audiometry and questionnaires.

Main Outcomes and Measure

The prevalence of persons reporting good hearing among those with audiometrically defined hearing loss and the variables associated with this population.

Results

The mean (SD) age was 47.0 (0.4) years for hearing loss defined by any frequency >25 dB HL and 52.5 (1.1) years for hearing loss defined by PTA >25 dB HL. For the sample with hearing loss defined by any frequency >25 dB HL, 744 (56.1%) were men and 629 (43.9%) were women. For the sample with hearing loss defined by PTA >25 dB HL 251 (68.5%) were men and 114 (31.5%) were women. Of the 1373 participants who were found to have hearing loss (at least 1 individual frequency >25 dB HL in either ear) 993 (68.5%) reported good hearing. Younger age, nonwhite race, and women were all more likely to report good hearing. When the definition of hearing loss was made more stringent (pure-tone average >25 dB HL), 365 participants had audiometric hearing loss, but 174 (43%) continued to report good hearing. We observed that better self-perceived general health status (OR, 1.90; 95% CI, 1.25-2.90) and higher dietary quality (OR, 1.01; 95% CI, 1.00-1.02) were significantly associated with increased self-report of good hearing, whereas tinnitus (OR, 0.25; 95% CI, 0.14-0.44), noise exposure (OR, 0.39; 95% CI, 0.26-0.58), and several comorbid conditions were associated with decreased self-report of good hearing.

Conclusions and Relevance

A significant proportion of the study population reported good hearing despite having audiometric evidence of hearing loss; the prevalence was related to how hearing loss was defined. The report of good hearing was significantly associated with demographics and general health status. The high prevalence of mild hearing loss and self-reported good hearing was associated with the low reported use of hearing aids.

Young Adults' Knowledge and Attitudes Regarding "Music" and "Loud Music" Across Countries: Applications of Social Representations Theory

Exposure to loud music, especially by young people, has significantly increased in recent years as a result of (a) advancements in technology in terms of personal music players and smart mobile phones, and (b) streaming of music through these devices. The World Health Organization (WHO) estimates that some 1.1 billion teenagers and young adults are at risk of developing hearing loss due to exposure to recreational noise such as music. It is suggested that knowledge and attitude of young adults toward music has bearing upon their music listening habits and thereby influences who is at risk of developing music induced hearing loss. Hence, researchers from various fields have tried to understand the knowledge and attitude of young adults regarding loud music. However, there is some criticism of attitude studies as there is little relation between expressed attitude and behavior. Some recent studies have explored the social representations of music and loud music using the Social Representations Theory (SRT). It has been suggested that social representation is more fundamental than attitude (or in other words social representation informs attitude), hence, it has a better relation to behavior. The current paper: (1) provides an overview of studies on knowledge and attitude of young adults toward loud music, (2) discusses the limitations of attitude theories and introduces SRT, and (3) provides a summary of social representation studies on “music” and “loud music” in young adults from different countries.

What Keeps Older Adults With Hearing Impairment From Adopting Hearing Aids?

The aim of this study was to compare elderly individuals who are hearing impaired but inexperienced in using hearing aids (hearing aid non-users; HA-NU) with their aided counterparts (hearing aid users; HA-U) across various auditory and non-auditory measures in order to identify differences that might be associated with the low hearing aid uptake rate. We have drawn data of 72 HA-NU and 139 HA-U with a mild-to-moderate hearing loss, and matched these two groups on the degree of hearing impairment, age, and sex. First, HA-NU and HA-U were compared across 65 auditory, cognitive, health-specific, and socioeconomic test measures as well as measures assessing technology commitment. Second, a logistic regression approach was performed to identify relevant predictors for using hearing aids. Finally, we conducted a sensitivity analysis for the matching approach. Group comparisons indicated that HA-NU perceive their hearing problem as less severe than their aided counterparts. Furthermore, HA-NU showed worse technology commitment and lower socioeconomic status than HA-U. The logistic regression revealed self-reported hearing performance, technology commitment, and the socioeconomic and health status as the most important predictors for using hearing aids.

Representation of Hearing Loss and Hearing Aids in the U.S. Newspaper Media: Cross-Sectional Analysis of Secondary Data

Purpose News media plays an important role in formulating people's knowledge and opinions about various aspects of life, including health. The current study explored how hearing loss and hearing aids are represented in the U.S. newspaper media. Method A cross-sectional study design was selected to analyze publicly available newspaper media data. The data sets were generated from the database, the U.S. Major Dailies by ProQuest, by searching key words for newspapers published during 1990-2017. Cluster analysis (i.e., text pattern analysis) and chi-square tests were performed using Iramuteq software. Results The hearing loss data set had 1,527 texts (i.e., articles). The cluster analysis resulted in 7 clusters, which were named as (1) causes and consequences (26.1%), (2) early identification and diagnosis (9%), (3) health promotion and prevention (22.1%), (4) recreational noise exposure (10.4%), (5) prevalence (14.3%), (6) research and development (12.4%), and (7) cognitive hearing science (5.6%). The hearing aids data set had 2,667 texts. The cluster analysis resulted in 8 clusters, which were named as (1) signal processing (20.2%), (2) insurance (8.9%), (3) prevalence (12.4%), (4) research and development (5.4%), (5) activities and relation (16.2%), (6) features to address background noise (13.8%), (7) innovation (12%), and (8) wireless and connectivity (11.1%). Time series analysis of clusters in both "hearing loss" and "hearing aids" data sets indicated changes in the pattern of information presented in the newspaper media during 1990-2016 (e.g., Cluster 7 focuses on cognitive hearing science in a hearing loss data set emerging only since the year 2012 and growing rapidly). Conclusions The text pattern analysis showed that the U.S. newspaper media focuses on a range of issues when considering hearing loss and hearing aids and that patterns or trends change over time. The study results can be helpful for hearing health care professionals to understand what presuppositions society in general may have as the media has the ability to influence societal perception and opinions.

Optimism and Well-Being Among Institutionalized Older Adults

Abstract. Institutionalization is often related to the psychologically negative outcomes of old age. Optimism could alleviate suffering, but little is known about its role in institutionalized settings. We sought to explore optimism correlates and to determine whether it predicts emotional well-being variables, after controlling for potential covariates, by assessing 66 institutionalized elderlies. Optimism was low and associated with failure to do physical exercise, urinary incontinence, increased anxiety, depressive symptoms and feelings of loneliness, and reduced satisfaction with life and positive affect. Optimism predicted emotional well-being, albeit not over and above some covariates. Given the low optimism levels and the correlates, we suggest that intrapersonal resources could be intervention targets. It is our hope that our findings will inspire research to analyze interventions promoting optimism-beneficial combinations of well-being among institutionalized older adults.

Examination of Previously Published Data to Identify Patterns in the Social Representation of 'Hearing Aids' Across Countries

Background and Objectives

Societal factors seem to exercise a strong influence on hearing aid uptake, use, and satisfaction. In particular, knowledge, perception, and attitude of people will have bearing towards their and others health behavior and decisions. The current study aimed at understanding the perception of hearing aids by adults belonging to the general population in different countries.

Subjects and Methods

The study employed a crosssectional design. A sample of 404 adults from India, Iran, Portugal, and the United Kingdom were recruited by relying on a convenience sampling. Previously published data was re-analyzed but it was applied for different approach. Free association task was used to collect the data. They were asked to provide up to five words or phrases that come to mind when thinking about “hearing aids.” The data was initially analyzed based on qualitative content analysis. This was followed by quantitative cluster analysis and chi square analysis.

Results

The content analysis suggested 39 main categories of responses related to hearing aids. The cluster analysis resulted in five main clusters, namely: 1) positive attitude, 2) external factors, 3) hearing aid use and satisfaction, 4) etiology, and 5) benefits and limitations of technology. A few demographic factors (i.e., education, occupation type, country) showed association with different clusters, although country of origin seemed to be associated with most clusters.

Conclusions

The study provides us with unique insights into the perception of hearing aids by the general public, and additionally, the way demographic variables may influence these perceptions.

Examination of previously published data to identify patterns in the social representation of "Loud music" in young adults across countries

Purpose:

The current study was aimed at understanding the patterns in the social representation of loud music reported by young adults in different countries.

Materials and Methods:

The study included a sample of 534 young adults (18–25 years) from India, Iran, Portugal, United Kingdom, and United States. Participants were recruited using a convince sampling, and data were collected using the free association task. Participants were asked to provide up to five words or phrases that come to mind when thinking about “loud music.” The data were first analyzed using the qualitative content analysis. This was followed by quantitative cluster analysis and chi-square analysis.

Results:

The content analysis suggested 19 main categories of responses related to loud music. The cluster analysis resulted in for main clusters, namely: (1) emotional oriented perception; (2) problem oriented perception; (3) music and enjoyment oriented perception; and (4) positive emotional and recreation-oriented perception. Country of origin was associated with the likelihood of participants being in each of these clusters.

Conclusion:

The current study highlights the differences and similarities in young adults’ perception of loud music. These results may have implications to hearing health education to facilitate healthy listening habits.

Establishing the standard method of cochlear implant in Rongchang pig

CONCLUSIONS

In this investigation, a large mammal, Rongchang pigs were used to successfully establish a research platform for cochlear implant study on the routine use of it in clinic.

OBJECTIVE

The aim of this study was to establish a standard method of cochlear implant in a large mammal-pig.

METHODS

Rongchang pigs were selected, then divided into two groups: normal-hearing group (Mitf +/+) and mutation group with hearing loss (Mitf -/-). Cochlear implants were used and ABR and EABR were recorded. The implanted electrodes were observed by X-ray and HE stains.

RESULTS

The success with cochlear implant and the best electrode position could be defined in all animals, the coiling of the cochlea reached 1.5-1.75 turns. Immediately after the operation of cochlear implants, the ABR threshold of the operated ear (right) could not be derived for each frequency at 120 dB SPL. Moreover, 7 days after surgery, the low-frequency ABR threshold of the operated ear (right) could be derived partly at 100 dB SPL, but the high-frequency ABR threshold could not be derived at 120 dB SPL. Immediately or 1 week after cochlear implants, the EABR threshold was 90 CL in the Mitf +/+ group. This was obviously lower than the 190 CL in the Mitf -/- group.

Social representation of "music" in young adults: a cross-cultural study

OBJECTIVE

This study was aimed to explore perceptions of and reactions to music in young adults (18-25 years) using the theory of social representations (TSR).

DESIGN

The study used a cross-sectional survey design and included participants from India, Iran, Portugal, USA and UK. Data were analysed using various qualitative and quantitative methods.

STUDY SAMPLE

The study sample included 534 young adults.

RESULTS

The Chi-square analysis showed significant differences between the countries regarding the informants' perception of music. The most positive connotations about music were found in the responses obtained from Iranian participants (82.2%), followed by Portuguese participants (80.6%), while the most negative connotations about music were found in the responses obtained from Indian participants (18.2%), followed by Iranian participants (7.3%). The participants' responses fell into 19 main categories based on their meaning; however, not all categories were found in all five countries. The co-occurrence analysis results generally indicate that the category "positive emotions or actions" was the most frequent category occurring in all five countries.

CONCLUSIONS

The results indicate that music is generally considered to bring positive emotions for people within these societies, although a small percentage of responses indicate some negative consequences of music.

Positive, Neutral, and Negative Connotations Associated with Social Representation of 'Hearing Loss' and 'Hearing Aids'

Background and Objectives

In our previous studies we explored the social representation of hearing loss and hearing aids. In this study we aimed at exploring if the positive, neutral and negative connotations associated with the social representation of 'hearing loss' and 'hearing aids' for the same categories vary across countries. In addition, we also looked at if there is an association between connotations and demographic variables.

Subjects and Methods

A total of 404 individuals from four countries were asked to indicate the words and phrases that comes to mind when they think about 'hearing loss' and 'hearing aids'. They also indicated if the words and phrases they reported had positive, neutral or negative association, which were analyzed and reported in this paper.

Results

There are considerable differences among the countries in terms of positive, neutral and negative associations report for each category in relation to hearing loss and hearing aids. However, there is limited connection between demographic variables and connotations reported in different countries.

Conclusions

These results suggesting that the social representation about the phenomenon hearing loss and hearing aids are relatively stable within respondents of each country.