Associations Between Hearing Performance and Physiological Measures - An Overview and Outlook

The current paper summarises the research investigating associations between physiological data and hearing performance. An overview of state-of-the-art research and literature is given as well as promising directions for associations between physiological data and data regarding hearing loss and hearing performance. The physiological parameters included in this paper are: electrodermal activity, heart rate variability, blood pressure, blood oxygenation and respiratory rate. Furthermore, the environmental and behavioural measurements of physical activity and body mass index, alcohol consumption and smoking have been included. So far, only electrodermal activity and heart rate variability are physiological signals simultaneously associated with hearing loss or hearing performance. Initial findings suggest blood pressure and respiratory rate to be the most promising physiological measures that relate to hearing loss and hearing performance

Plasticity in the sensorimotor system and innovative sensorimotor training in frailty

This dissertation presents two studies, in which the relationship of impairment in sensory and motor systems with frailty was investigated from a conceptual point of view (Study 1) and as a potential target for innovative treatment to reduce frailty (Study 2). The aim of Study 1 was to identify sensory and motor determinants of frailty as assessed by two common frailty instruments, the frailty phenotype (FP) and the frailty index (FI). Performance measures of sensory and motor function were assessed in 44 pre-frail and frail subjects. Separate multiple logistic regression analyses revealed that frailty as defined by the FP was associated with reduced upper extremity function, while frailty as defined by the FI was independently associated with higher hearing thresholds, reduced lower extremity performance and higher depression scores. This suggests that reduced sensory and motor function contributes to the syndrome of frailty, thereby offering a potential target for treatment, and that different frailty instruments may be differentially sensitive to capture functional impairment in frail populations. In Study 2, the effectiveness of a 90-day tablet-based sensorimotor training (n=24) targeting the reversal of age-related maladaptive neuroplasticity in the sensorimotor system to counteract frailty was evaluated, compared to a tablet-based relaxation control training (n=24). After 60 days of training, a reduction in frailty as determined by the FP was found for both groups, while the effect tended to be stronger for the sensorimotor training condition. A non-significant reduction in the FI was found irrespective of the group. No training effects were found for sensorimotor brain activity assessed by functional magnetic resonance imaging and corticomotor excitability assessed by transcranial magnetic stimulation. The results suggest that a neuroplasticity-based training may alter frailty, yet the significance of the postulated neuroplastic mechanisms and the specific training characteristics underlying the effect remain to be determined. Together, the two studies provide evidence that impairment in sensory and motor systems may represent a target mechanism to better understand pathophysiology of frailty and to develop novel, innovative treatment approaches. Longitudinal studies are needed to determine the influence of sensory and motor decline in the development of frailty. The present work may also inspire future large-scale interventional studies to validate the present preliminary, yet promising results and to examine the efficacy and mechanistic principles that approaches targeting the reversal of age-related maladaptive neuroplasticity may have in the treatment of frailty

Clinical validation of a public health policy-making platform for hearing loss (EVOTION): protocol for a big data study

INTRODUCTION: The holistic management of hearing loss (HL) requires an understanding of factors that predict hearing aid (HA) use and benefit beyond the acoustics of listening environments. Although several predictors have been identified, no study has explored the role of audiological, cognitive, behavioural and physiological data nor has any study collected real-time HA data. This study will collect ‘big data’, including retrospective HA logging data, prospective clinical data and real-time data via smart HAs, a mobile application and biosensors. The main objective is to enable the validation of the EVOTION platform as a public health policy-making tool for HL. METHODS AND ANALYSIS: This will be a big data international multicentre study consisting of retrospective and prospective data collection. Existing data from approximately 35 000 HA users will be extracted from clinical repositories in the UK and Denmark. For the prospective data collection, 1260 HA candidates will be recruited across four clinics in the UK and Greece. Participants will complete a battery of audiological and other assessments (measures of patient-reported HA benefit, mood, cognition, quality of life). Patients will be offered smart HAs and a mobile phone application and a subset will also be given wearable biosensors, to enable the collection of dynamic real-life HA usage data. Big data analytics will be used to detect correlations between contextualised HA usage and effectiveness, and different factors and comorbidities affecting HL, with a view to informing public health decision-making. ETHICS AND DISSEMINATION: Ethical approval was received from the London South East Research Ethics Committee (17/LO/0789), the Hippokrateion Hospital Ethics Committee (1847) and the Athens Medical Center’s Ethics Committee (KM140670). Results will be disseminated through national and international events in Greece and the UK, scientific journals, newsletters, magazines and social media. Target audiences include HA users, clinicians, policy-makers and the general public. TRIAL REGISTRATION NUMBER: NCT03316287; Pre-results

Childhood Hearing Loss in the Developing World

Globally, unidentified hearing loss is the largest and most significant childhood disability impacting on development. Of the babies born annually with hearing loss, 90% come from developing countries. Less than 2.5% of these babies will get hearing aids and less than 10% will ever have access to early intervention. With the dearth of services available to this largely marginalized paediatric community, the EHDI pathway has been established with significant buy in from the World Bank, WHO and UNESCO. This paper will explore the EHDI pathway and how it is currently being implemented in the developing world

ICBEN review of research on the biological effects of noise 2011-2014

The mandate of the International Commission on Biological Effects of Noise (ICBEN) is to promote a high level of scientific research concerning all aspects of noise-induced effects on human beings and animals. In this review, ICBEN team chairs and co-chairs summarize relevant findings, publications, developments, and policies related to the biological effects of noise, with a focus on the period 2011-2014 and for the following topics: Noise-induced hearing loss; nonauditory effects of noise; effects of noise on performance and behavior; effects of noise on sleep; community response to noise; and interactions with other agents and contextual factors. Occupational settings and transport have been identified as the most prominent sources of noise that affect health. These reviews demonstrate that noise is a prevalent and often underestimated threat for both auditory and nonauditory health and that strategies for the prevention of noise and its associated negative health consequences are needed to promote public health

Upper extremity biomechanics in native and non-native signers

abstract: Individuals fluent in sign language who have at least one deaf parent are considered native signers while those with non-signing, hearing parents are non-native signers. Musculoskeletal pain from repetitive motion is more common from non-natives than natives. The goal of this study was twofold: 1) to examine differences in upper extremity (UE) biomechanical measures between natives and non-natives and 2) upon creating a composite measure of injury-risk unique to signers, to compare differences in scores between natives and non-natives. Non-natives were hypothesized to have less favorable biomechanical measures and composite injury-risk scores compared to natives. Dynamometry was used for measurement of strength, electromyography for ‘micro’ rest breaks and muscle tension, optical motion capture for ballistic signing, non-neutral joint angle and work envelope, a numeric pain rating scale for pain, and the modified Strain Index (SI) as a composite measure of injury-risk. There were no differences in UE strength (all p≥0.22). Natives had more rest (natives 76.38%; non-natives 26.86%; p=0.002) and less muscle tension (natives 11.53%; non-natives 48.60%; p=0.008) for non-dominant upper trapezius across the first minute of the trial. For ballistic signing, no differences were found in resultant linear segment acceleration when producing the sign for ‘again’ (natives 27.59m/s2; non-natives 21.91m/s2; p=0.20). For non-neutral joint angle, natives had more wrist flexion-extension motion when producing the sign for ‘principal’ (natives 54.93°; non-natives 46.23°; p=0.04). Work envelope demonstrated the greatest significance when determining injury-risk. Natives had a marginally greater work envelope along the z-axis (inferior-superior) across the first minute of the trial (natives 35.80cm; non-natives 30.84cm; p=0.051). Natives (30%) presented with a lower pain prevalence than non-natives (40%); however, there was no significant difference in the modified SI scores (natives 4.70 points; non-natives 3.06 points; p=0.144) and no association between presence of pain with the modified SI score (r=0.087; p=0.680). This work offers a comprehensive analysis of all the previously identified UE biomechanics unique to signers and helped to inform a composite measure of injury-risk. Use of the modified SI demonstrates promise, although its lack of association with pain does confirm that injury-risk encompasses other variables in addition to a signer’s biomechanics.Dissertation/ThesisDoctoral Dissertation Exercise and Nutritional Sciences 201

Sick building syndrome: are we doing enough?

Health and well-being are vitally important aspects of people centric building design and are the roots of productivity. Sick building syndrome (SBS) is a collection of factors that can negatively affect physical health in several ways. Besides physical health is also related to psychological well-being because the human body is one interactive biological system. This paper focuses on reviewing the current state of knowledge on building sickness syndrome which has been prevalent as a building illness since the 1970s especially in offices and schools. While the concepts of intelligent, smart and sustainable buildings have gained considerable attention during recent decades, there is now increasing attention being given to designing healthy buildings. This study provides a review about SBS symptoms. Several negative effects of SBS are identified and potential solutions are advocated. Finally, the study stresses the role of built environment and concludes that ongoing research towards tackling SBS and developing healthy indoor environments should not be limited to a single formula as any health-related building design approach is dependent on several interacting factors