Estimates of the number of adults in England, Wales, and Scotland with a hearing loss

No abstract available

Investigations into the impact of hearing loss and hearing device fitting on daily-life fatigue

For many years, anecdotal evidence has suggested that people with hearing loss experience disproportionate levels of fatigue. The aetiology of fatigue associated with hearing loss was also thought to be uncomplicated. The basic energy depletion theory states that decreased audibility and fidelity result in an increased need for listening effort to maintain conversational performance. This, in turn, drains finite cognitive resources and results in increased fatigue. By the same logic, hearing device fitting should decrease fatigue by improving audibility and reducing the need for listening effort. However, recent research has not entirely supported this reasoning. Moreover, issues pertaining to the conceptualisation and measurement of fatigue have complicated efforts to measure its effects. Therefore, the research presented here was conducted to investigate the impact of hearing loss and hearing aid fitting on daily-life fatigue. Daily-life fatigue includes transient and long-term fatigue, and is contingent on the activities undertaken in everyday life. To investigate what is already known regarding the aforementioned relationships, a systematic review of the existing literature was conducted. Although the available literature was relatively small, there was evidence to support a link between hearing loss and increased fatigue and, to a lesser extent, hearing device fitting and reduced fatigue. As fatigue is generally a result of activity, it was hypothesised that the relationships between hearing loss, hearing aid fitting and fatigue may be more complex than originally believed, due to the potential influence of hearing loss and/or hearing aid fitting on lifestyle. A narrative synthesis was conducted to examine the influence of hearing loss and hearing device fitting on activity levels, and consequently to determine whether any potential changes in activity could influence fatigue. It was noted that, to varying extents for work, social and physical activity, changes in activity level due to compromised hearing ability could potentially influence fatigue. In order to fully conceptualise the relationship between hearing loss and fatigue, previous relevant models were examined, and a new framework of listening-related daily-life fatigue was proposed. To build upon the review results, the real-world impact of hearing impairment and hearing device fitting on daily-life fatigue was investigated using semi-structured interviews. Hearing loss-related fatigue affected most, but not all, participants. Fatigue was driven by effort in line with traditional theories, but also by negative emotions, a finding that has been less commonly documented. A wide and varied utilisation of coping strategies was exhibited. Hearing aid fitting was associated with reductions in fatigue, though the importance and magnitude of the reduction was unclear. The insights gained from the results provided new findings, support for previous research, and evidence for the different pathways involved in the proposed framework of listening-related daily-life fatigue. Following the semi-structured interview study, an experimental study was carried out to investigate directly whether hearing aid fitting had any impact on fatigue. This was a longitudinal study of participants before, and at three time points after, first ever hearing aid fitting, compared to a control group who had no change in hearing aid status. This enabled analysis of both group and individual changes across time. In order to investigate the potential role of activity and other potential predictors, variables such as social activity, hearing handicap and need for cognition were also measured. Results showed that long-term general fatigue measures were not sensitive to any change after hearing aid fitting. However, hearing loss-related fatigue improved over time post fitting, with baseline hearing handicap score a significant predictor of hearing loss-related fatigue. While baseline social activity was not a significant predictor of fatigue, social activity scores did increase significantly over time in the intervention group when compared to the control group. Overall, the thesis offers unique insights into the impact of hearing loss and hearing device fitting on daily-life fatigue, including the first ever longitudinal study to investigate experimentally the impact of hearing aid fitting on daily-life fatigue. The research has demonstrated the presence of hearing loss-related fatigue, the important role of activity in daily-life fatigue, and the positive impact of hearing aid fitting on fatigue and social activity. In light of the results, it is recommended that future research into daily-life fatigue takes account of activity, and that consistent terminology and measurement scales are utilised to address the correct components of fatigue

A comprehensive survey of hearing questionnaires: how many are there, what do they measure, and how have they been validated?

The self-report questionnaire is a popular tool for measuring outcomes in trials of interventions for hearing impairment. Many have been designed over the last fifty years, and there is no single standard questionnaire that is widely accepted and used. We felt it would be a valuable resource to have a comprehensive collection of all adult hearing-loss questionnaires (excluding those wholly devoted to tinnitus, children, or cochlear implants) and to survey their degree of validation. We collated copies of every published hearing difficulty questionnaire that we could find. The search was primarily done by iterative reference searching. Questionnaire topics were obtained by mapping the text of each questionnaire onto a set of categories; reports of validation methods were taken from the primary paper(s) on each questionnaire. In total we found 139 hearing-specific questionnaires (though many others were found that were primarily about something else). Though not formally systematic, we believe that we have included every questionnaire that is important, most of those of some notice, and a fair fraction of those obscure. We classified 111 as “primary” and the remaining 28 as “contractions”, being shortened versions of a primary without any new questions. In total, there were 3618 items across all the primary questionnaires. The median number of items per questionnaire was 20; the maximum was 158. Across all items, about one third were concerned with the person’s own hearing, another third with the repercussions of it, and about a quarter with hearing aids. There was a wide range in validation methods, from only using items chosen statistically from wider pools and with formal validation against independent measures of clinical outcomes, to just reporting a correlation with an audiogram measure of hearing loss. The “state of play” of the field of hearing questionnaires will be discussed

Detection and Interpretation Of Long-Lived X-Ray Quasi-Periodic Pulsations in the X-Class Solar Flare On 2013 May 14

Quasi-periodic pulsations (QPP) seen in the time derivative of the GOES soft X-ray light curves are analyzed for the near-limb X3.2 event on 14 May 2013. The pulsations are apparent for a total of at least two hours from the impulsive phase to well into the decay phase, with a total of 163 distinct pulses evident to the naked eye. A wavelet analysis shows that the characteristic time scale of these pulsations increases systematically from $\sim$25 s at 01:10 UT, the time of the GOES peak, to $\sim$100 s at 02:00 UT. A second ridge in the wavelet power spectrum, most likely associated with flaring emission from a different active region, shows an increase from $\sim$40 s at 01:40 UT to $\sim$100 s at 03:10 UT. We assume that the QPP that produced the first ridge result from vertical kink-mode oscillations of the newly formed loops following magnetic reconnection in the coronal current sheet. This allows us to estimate the magnetic field strength as a function of altitude given the density, loop length, and QPP time scale as functions of time determined from the GOES light curves and RHESSI images. The calculated magnetic field strength of the newly formed loops ranges from about $\sim$500 G at an altitude of 24 Mm to a low value of $\sim$10 G at 60 Mm, in general agreement with the expected values at these altitudes. Fast sausage mode oscillations are also discussed and cannot be ruled out as an alternate mechanism for producing the QPP

Hearing Aids Reduce Daily-Life Fatigue and Increase Social Activity: A Longitudinal Study

People with hearing loss experience fatigue, and it is unknown whether this is alleviated by treatment with hearing aids. The objective of this study was to address this issue and to investigate the possible concomitant effect of hearing-aid fitting on activity levels. An intervention group (n = 53) who were due to be fitted with their first-ever hearing aid(s) and a control group (n = 53) who had hearing loss but no change in hearing aid status–completed a battery of self-report outcome measures four times: once before fitting, and at 2 weeks, 3 months, and 6 months post fitting. Self-report outcome measures at each assessment captured fatigue, listening effort, hearing handicap, auditory lifestyle, social participation restrictions, and work, social and physical activity levels. Hearing-aid fitting led to a significant reduction in listening-related fatigue, but not general fatigue, in the intervention group compared to the control group. Additionally, social activity level increased and social participation restriction decreased significantly after hearing aid fitting in the intervention group compared to the control group. No significant interaction was found between working status and change in listening-related fatigue score. This study is the first to make a longitudinal measurement of fatigue before and after first-ever hearing aid fitting and to identify an increase in social activity level after hearing aid fitting. These findings have important implications for future research and the clinical practice of hearing aid fitting

Estimating the properties of hard X-ray solar flares by constraining model parameters

We compare four different methods of calculating uncertainty estimates in fitting parameterized models to RHESSI X-ray spectra, considering only statistical sources of error. Three of the four methods are based on estimating the scale-size of the minimum in a hypersurface formed by the weighted sum of the squares of the differences between the model fit and the data as a function of the fit parameters, and are implemented as commonly practiced. The fourth method uses Bayesian data analysis and Markov chain Monte Carlo (MCMC) techniques to calculate an uncertainty estimate. Two flare spectra are modeled: one from the GOES X1.3 class flare of 19 January 2005, and the other from the X4.8 flare of 23 July 2002. The four methods give approximately the same uncertainty estimates for the 19 January 2005 spectral fit parameters, but lead to very different uncertainty estimates for the 23 July 2002 spectral fit. This is because each method implements different analyses of the hypersurface, yielding method-dependent results that differ greatly depending on the shape of the hypersurface. For the 23 July 2002 flare data, there is a 95% probability that the low energy cutoff lies below approximately 40 keV, and a 68% probability that it lies in the range 7-36 keV. The low-energy cutoff for the 19 January 2005 flare is more tightly constrained to 107+/-4 keV (68% probability). Using the Bayesian/MCMC approach, we also estimate for the first time probability density functions (PDFs) for the total number of flare accelerated electrons and the energy they carry. For the 23 July 2002 event, these PDFs are asymmetric with long tails orders of magnitude higher than the most probable value, caused by the poorly constrained value of the low-energy cutoff. For the 19 January 2005 flare spectrum, the PDFs for the total number of flare accelerated electrons and their energy are much more symmetric and narrow

A qualitative investigation of the hearing and hearing-aid related emotional states experienced by adults with hearing loss

Objective: Despite previous research into the psychosocial impact of hearing loss, little detail is known regarding the hearing and hearing-aid-related emotional states experienced by adults with hearing loss in everyday life, and how they occur. Design: Individual remote semi-structured interviews were audio-recorded, transcribed verbatim and qualitatively analysed with reflexive and inductive thematic analysis. Study sample: Seventeen participants (9 female) with hearing loss (age range 44–74 years) participated. Ten used bilateral hearing aids, four unilateral and three used no hearing aids at the time of interviews. Results: The four main themes which emerged from the data were: identity and self-image, autonomy and control, personality and dominant emotional states and situational cost/benefit analysis with respect to use of hearing aids. Conclusions: This study goes beyond previous literature by providing a more detailed insight into emotions related to hearing and hearing-aids in adults. Hearing loss causes a multitude of negative emotions, while hearing aids generally reduce negative emotions and allow for more positive emotions. However, factors such as lifestyle, personality, situational control, the relationship with those in conversation and the attribution of blame are key to individual emotional experience. Clinical implications include the important role of social relationships in assessment and counselling

Hearing impairment and daily-life fatigue: a qualitative study

Objective: Hearing impairment is linked to increased fatigue, yet little is known about the real-world impact of this fatigue. This qualitative study investigated the experience of daily-life fatigue in people with a hearing impairment. Design: Individual face-to-face semi-structured interviews were conducted. Thematic analysis was then used to analyse the data. Study Sample: Fourteen hearing impaired participants (aged 44-70 years) who varied in terms of hearing loss, hearing aid status, age, and gender. Results: The themes and sub-themes that emerged from the transcripts were: Fatigue (effort-driven fatigue, emotion-driven fatigue, breaks and recovery, the perceived relationship between hearing impairment and fatigue and sleep), Effort (cognitive effort and physical effort), Coping Strategies (withdrawal, avoidance and planning), Relationships and Emotions, Hearing Aid Impact. Conclusions: The study highlights that hearing impairment-related fatigue is experienced by many but not all, and to different extents. Hearing aids were weakly linked to a beneficial effect on fatigue. In addition to the more widely researched effort-driven fatigue, participants described fatigue linked to the negative emotions related to having a hearing impairment. These findings, in conjunction with the widespread utilisation of different coping strategies, demonstrate that the experience of fatigue is varied and likely dependent on personal factors and lifestyle

Hearing aid validation

Validation provides quality assurance that a hearing aid wearer’s needs are being met—that the solution meets not only their technical requirements (i.e., verification) but also their requirements for everyday communication. In the past 50 years, there have been repeated calls for better measures of hearing aid performance, with a general shift in validation toward the self-report of hearing, communication, and well-being through questionnaires. This chapter looks at these measures, examining the domains of hearing aid validation and how despite the growth in number of questions—a total of more than 1,000 questions on hearing aids—the domains have evolved only slightly. The chapter then considers the ways in which a fundamental domain, “benefit,” is calculated. A large data set shows how different forms of benefit can lead to different systematic interpretations. While most objective measures for hearing aids are by definition verifications, the chapter discusses those objective measurements that approach validation by attempting to mimic aspects of everyday communication. The issues raised by these myriad forms of validation suggest that a viable measure of hearing aid benefit must incorporate measures of expectations and burdens for listener-specific conditions

Winter 1970

A Closer Look at Watering by Holman M. Griffin (page 3) Sulphur in Turfgrass Fertilization by J.D. Beaton (5) Those Extras on a Golf Course by Jack Fairhurst (9) Turf Bulletin\u27s Photo Quiz by Fred Cheney (9) Progress in Research on Live Oak Decline by E.P. Van Arsdel and Robert S. Halliwell (10) Editorial (15) The Perfermance Characteristics of Kentucky Bluegrass Mixtures by F.V. Juska and A.A. Hanson (16) Moss (23