Audibility, Cost-Acceptibility and Cosmetic Appearance of IQBuds BOOST in Adults Over the Age of 50

Background: Hearing loss affects 48 million Americans and up to 86% of all adults with hearing loss may not wear hearing aids. Untreated hearing loss is associated with social withdrawal, depression, stress, loss of income, and dementia. Even so, people still tend not to buy or wear hearing aids for a variety of reasons. One recently suggested solution to this problem is low-cost, over the counter (OTC) hearing aids, nicknamed “hearables” This study evaluated the audibility, cost-acceptability and cosmetic appearance of one OTC, IQBuds BOOST. Methods: Fourteen men and 12 women over 50 years with a hearing loss participated in the study. Word recognition testing was conducted by presenting words embedded with a phrase at 40 dBHL through the loudspeakers in four conditions. The participants completed a Visual Analogue Survey, which included listening and non-listening items, once regarding their aided experience and once regarding their everyday listening experience. Analyses: Speech perception was scored using both the phoneme scoring and word scoring methods. Mixed ANOVAs were performed on the % correct phoneme scores and word scores. The t-test was performed on the average scores of the first 12 items of the Visual Analogue scale. Descriptive statistics were used to report data on the questions related to cost and acceptability of the hearable device. Results: For both aided and unaided conditions the word and phoneme recognition scores in noise were significantly poorer than those in quiet. The hearable did not improve the word recognition in quiet or noisy backgrounds. Similarly, there were no significant differences in average listening VAS scores with and without the hearable. On a scale of 1 to 100, participants gave higher than 60 scores for questions regarding the comfort, fit and insertion of the hearable. However, the average scores related to willingness to use, cost, and cosmetic appearance were less than 50. Conclusions: This study suggests that older participants with mild to moderate hearing loss may not benefit from the hearable used in the current study and the appearance of the device may have to be improved

Goal-Focused Emotion-Regulation Therapy (GET) for young adult survivors of testicular cancer: a pilot randomized controlled trial of a biobehavioral intervention protocol.

BackgroundTesticular cancer diagnosis and treatment, especially given its threat to sexuality and reproductive health, can be distressing in the formative period of young adulthood and the majority of young survivors experience impairing, distressing, and modifiable adverse outcomes that can persist long after medical treatment. These include psychological distress, impairment in pursuit of life goals, persistent physical side effects, elevated risk of secondary malignancies and chronic illness, and biobehavioral burden (e.g., enhanced inflammation, dysregulated diurnal stress hormones). However, few targeted interventions exist to assist young survivors in renegotiating life goals and regulating cancer-related emotions, and none focus on reducing the burden of morbidity via biobehavioral mechanisms. This paper describes the methodology of a randomized controlled biobehavioral trial designed to investigate the feasibility and preliminary impact of a novel intervention, Goal-focused Emotion-Regulation Therapy (GET), aimed at improving distress symptoms, emotion regulation, goal navigation skills, and stress-sensitive biomarkers in young adult testicular cancer patients.MethodsParticipants will be randomized to receive six sessions of GET or Individual Supportive Therapy (ISP) delivered over 8 weeks. In addition to indicators of intervention feasibility, we will measure primary (depressive and anxiety symptoms) and secondary (emotion regulation and goal navigation skills, career confusion) psychological outcomes prior to (T0), immediately after (T1), and 12 weeks after (T2) intervention. Additionally, identified biomarkers will be measured at baseline and at T2.DiscussionGET may have the potential to improve self-regulation across biobehavioral domains, improve overall cancer adjustment, and address the need for targeted supportive care interventions for young adult cancer survivors.Trial registrationClinicaltrials.gov, NCT04150848. Registered on 28 October 2019

Allied health video consultation services

Many Australians have limited access to health care services due to a range of barriers including living a considerable distance from health services. Furthermore, there are significant shortages of healthcare workers in many rural and remote areas. Traditionally, many people have had to either travel long distances to access healthcare, or go without. Telehealth is an alternative approach, using telecommunications and information technology to supplement face-to-face delivery of healthcare services

Knowledge is power: improving outcomes for patients, partners, and professionals in the digital age

Purpose The aim of this research was to develop and evaluate methods to address poor knowledge of hearing aids, hearing loss, and communication in patients, partners, and nonaudiologic health and social care professionals. Method An interactive multimedia educational program (C2Hear) has been co-produced with hearing aid users and audiologists to provide high-quality information and demonstrate complex concepts relating to hearing aids and communication. Results A randomized controlled trial showed numerous benefits for first-time hearing aid users that included better knowledge and skill, and increased hearing aid use and satisfaction. Patients reported that C2Hear was highly useful, enjoyable, and preferable to written information. C2Hear Online is now freely available on YouTube and has global reach, well in excess of 150,000 views. Further developments include a version for communication partners, which showed that joint-working between hearing aid users and their communication partners resulted in joint responsibility for communication that facilitated communication behaviors. In addition, a behavior theory-driven version for use with mobile technologies (m2Hear) has been designed to be tailored to the needs of individual hearing aid users. m2Hear includes more activities/interaction to maximize user engagement and learning. Finally, C2Hear has been used to improve hearing-related knowledge in other health and social care professionals, such as carehome assistants. Conclusion This range of educational programs and tools aims to improve knowledge and skills, leading to better outcomes for patients, partners, and health care professionals

Integration of ear and hearing care into primary health care in Malawi with special reference to task-sharing.

Introduction: The prevalence of hearing impairment has increased rapidly over the last two decades. The burden is higher in Africa and South East Asia than in richer parts of the world. The majority of this hearing impairment is preventable and can be managed at primary care level. However, the primary care level is generally weak in the provision of ear and hearing services. In recognition of this gap, the overall aim of the present thesis is to investigate the need for and feasibility of integrating ear and hearing care into primary health care in Malawi, specifically through task-sharing. Methods: The thesis is composed of five sub-studies. Apart from the first two studies which were trans-national, all the other studies took place in Malawi. The first study aimed to synthesise the available data on the prevalence and causes of hearing impairment in Africa through a systematic review of literature. The second study aimed at assessing availability and progress of ENT, Audiology and Speech Therapy services in Africa. It was a cross sectional study and a questionnaire was distributed by email to an ad hoc group of ENT Surgeons and Audiologists across Africa. The third study aimed at assessing the outcome of children with ear and hearing disorders, three years after diagnosis, in terms of uptake of referral to hospital, treatment given and satisfaction, and their participation in different aspects of life (school enrolment, ability to make friends, and ability to communicate needs). This was a longitudinal analysis of a population-based sample of children with hearing disorders, screened clinically and through questionnaires at baseline (2013) and follow-up (2016). The fourth study aimed to assess the uptake of and barriers to referrals to ear and hearing services for children in Thyolo District, Malawi. This was a mixed methods study, using both quantitative and qualitative methods. The fifth study was a cluster randomised control trial and was aimed at assessing the feasibility and accessibility of training community health workers (CHWs) in ear and hearing care and their ability to identify participants with ear and hearing disorders. . CHWswere given a pre-test and post-test to assess the effect of training on their knowledge of ear and hearing care. Results: The thesis showed that sub-Saharan Africa bears a high burden of ear and hearing disorders and that there are gaps in resources available to address these ear and hearing disorders. In Africa, the estimated prevalence for hearing impairment in children was 7.7% (2.4%–21.3%) using a cut-off of 25 dB HL and 17% for the general population of all ages. Our study II indicated that there are between 0.1 and 4.6 ENT surgeons per million persons across the region. Apart from South Africa, there is less than one audiologist for every million persons in sub-Saharan African countries. The impact of ear and hearing disorders often goes unnoticed and has not been explored adequately in low and middle income countries (LMICs). Study III showed that school enrolment among children with hearing loss was associated with ability to communicate and ability to make friends. Among children with hearing loss, those with speech impairment were more likely to report difficulties in making friends and in communicating needs. Among children with hearing loss, older children, girls and those with an illiterate caregiver were less likely to be enrolled in school. Training of CHWs in ear and hearing disorders proved feasible and acceptable and that CHWs were able to identify patients with ear and hearing disorders, and make referrals to a tertiary hospital as appropriate. A follow-up study on the uptake of referrals showed that there was a low uptake and the thesis has highlighted that while caregivers appeared to be motivated to seek care for their child, several often-interacting factors prevented them from doing so. These included location of/distance to the hospital, indirect costs, lack of transportation, procedural challenges in camps, awareness and understanding of ear and hearing issues, fear and uncertainty about the referral hospital, and lack of availability/visibility of hearing health services. Conclusion: There is high prevalence of ear and hearing disorders in Africa. The majority of the causes are avoidable and these conditions have significant impact on the people affected. There are low levels of services available for people with ear and hearing disorders and low uptake due to difficulties with accessing services. Task-sharing at primary level is feasible and acceptable and could help to fill gaps in service provision

A randomized controlled trial to evaluate the benefits of a multimedia educational program for first-time hearing aid users

Objectives: The aims of this study were to (1) develop a series of short interactive videos (or reusable learning objects [RLOs]) covering a broad range of practical and psychosocial issues relevant to the auditory rehabilitation for first-time hearing aid users; (2) establish the accessibility, take-up, acceptability and adherence of the RLOs; and (3) assess the benefits and cost-effectiveness of the RLOs. Design: The study was a single-center, prospective, randomized controlled trial with two arms. The intervention group (RLO+, n = 103) received the RLOs plus standard clinical service including hearing aid(s) and counseling, and the waitlist control group (RLO−, n = 100) received standard clinical service only. The effectiveness of the RLOs was assessed 6-weeks posthearing aid fitting. Seven RLOs (total duration 1 hr) were developed using a participatory, community of practice approach involving hearing aid users and audiologists. RLOs included video clips, illustrations, animations, photos, sounds and testimonials, and all were subtitled. RLOs were delivered through DVD for TV (50.6%) and PC (15.2%), or via the internet (32.9%). Results: RLO take-up was 78%. Adherence overall was at least 67%, and 97% in those who attended the 6-week follow-up. Half the participants watched the RLOs two or more times, suggesting self-management of their hearing loss, hearing aids, and communication. The RLOs were rated as highly useful and the majority of participants agreed the RLOs were enjoyable, improved their confidence and were preferable to written information. Postfitting, there was no significant between-group difference in the primary outcome measure, overall hearing aid use. However, there was significantly greater hearing aid use in the RLO+ group for suboptimal users. Furthermore, the RLO+ group had significantly better knowledge of practical and psychosocial issues, and significantly better practical hearing aid skills than the RLO− group. Conclusions: The RLOs were shown to be beneficial to first-time hearing aid users across a range of quantitative and qualitative measures. This study provides evidence to suggest that the RLOs may provide valuable learning and educational support for first-time hearing aid users and could be used to supplement clinical rehabilitation practice

EHealth and Its Role in Supporting Audiological Rehabilitation: Patient Perspectives on Barriers and Facilitators of Using a Personal Hearing Support System With Mobile Application as Part of the EVOTION Study

BACKGROUND: Hearing loss is a major public health challenge. Audiology services need to utilise a range of rehabilitative services and maximise innovative practice afforded by technology to actively promote personalized, participatory, preventative and predictive care if they are to cope with the social and economic burden placed on the population by the rapidly rising prevalence of hearing loss. Digital interventions and teleaudiology could be a key part of providing high quality, cost-effective, patient-centred management. There is currently very limited evidence that assesses the hearing impaired patient perspective on the acceptance and usability of this type of technology. AIM: This study aims to identify patient perceptions of the use of a hearing support system including a mobile smartphone app when used with Bluetooth-connected hearing aids across the everyday life of users, as part of the EVOTION project. METHODS: We applied a questionnaire to 564 participants in three countries across Europe and analysed the following topics: connectivity, hearing aid controls, instructional videos, audiological tests and auditory training. KEY FINDINGS: Older users were just as satisfied as younger users when operating this type of technology. Technical problems such as Bluetooth connectivity need to be minimised as this issue is highly critical for user satisfaction, engagement and uptake. A system that promotes user-controllability of hearing aids that is more accessible and easier to use is highly valued. Participants are happy to utilise monitoring tests and auditory training on a mobile phone out of the clinic but in order to have value the test battery needs to be relevant and tailored to each user, easy to understand and use. Such functions can elicit a negative as well as positive experience for each user. CONCLUSION: Older and younger adults can utilise an eHealth mobile app to complement their rehabilitation and health care. If the technology works well, is tailored to the individual and in-depth personalised guidance and support is provided, it could assist maximisation of hearing aid uptake, promotion of self-management and improving outcomes

A Review on Usability and User Experience of Assistive Social Robots for Older Persons

In the advancement of human-robot interaction technology, assistive social robots have been recognized as one of potential technologies that can provide physical and cognitive supports in older persons care. However, a major challenge faced by the designers is to develop an assistive social robot with prodigious usability and user experience for older persons who were known to have physical and cognitive limitations. A considerable number of published literatures was reporting on the technological design process of assistive social robots. However, only a small amount of attention has been paid to review the usability and user experience of the robots. The objective of this paper is to provide an overview of established researches in the literatures concerning usability and user experience issues faced by the older persons when interacting with assistive social robots. The authors searched relevant articles from the academic databases such as Google Scholar, Scopus and Web of Science as well as Google search for the publication period 2000 to 2021. Several search keywords were typed such as ‘older persons’ ‘elderly’, ‘senior citizens’, ‘assistive social robots’, ‘companion robots’, ‘personal robots’, ‘usability’ and ‘user experience’. This online search found a total of 215 articles which are related to assistive social robots in elderly care. Out of which, 54 articles identified as significant references, and they were examined thoroughly to prepare the main content of this paper. This paper reveals usability issues of 28 assistive social robots, and feedbacks of user experience based on 41 units of assistive social robots. Based on the research articles scrutinized, the authors concluded that the key elements in the design and development of assistive social robots to improve acceptance of older persons were determined by three factors: functionality, usability and users’ experience. Functionality refers to ability of robots to serve the older persons. Usability is ease of use of the robots. It is an indicator on how successful of interaction between the robots and the users. To improve usability, robot designers should consider the limitations of older persons such as vision, hearing, and cognition capabilities when interacting with the robots. User experience reflects to perceptions, preferences and behaviors of users that occur before, during and after use the robots. Combination of superior functionality and usability lead to a good user experience in using the robots which in the end achieves satisfaction of older persons