Factors affecting older adults' hearing-aid use

Hearing impairment is one of the most common disabilities among Western populations and represents a considerable communication disorder. Increasing human longevity is expected to raise the number of elderly people suffering from hearing loss. A major challenge of audiological rehabilitation has been to encourage those who have fitted hearing aids to use them. The aim of the present study was to describe hearing-aid use among older adults and to identify motivational factors associated with hearing-aid use. A 17-item questionnaire was developed. Ninety participants (=65 years of age) were recruited from a waiting list for hearing-aid refitting. Twenty-two percent had used their previously fitted hearing aids for less than one hour per day. A factor analysis revealed four factors related to hearing-aid use (Cronbach's alpha): ‘accepted need’–defined as the acknowledgement of a need for hearing aids (0.869); ‘follow-up support’–defined as organized check-ups and accessibility to professionals (0.900); ‘social assessment’ (0.552); and ‘consciousness’ (0.505). The first two factors explained 25% and 24% of the variance, respectively. Logistic regression revealed that the use of hearing aids was significantly associated with ‘accepted need’ and ‘follow-up support’, suggesting that these factors are important and should be emphasized in rehabilitation programmes

Migraine and sleep apnea in the general population

Objective is to investigate the relationship between migraine and obstructive sleep apnea in the general population. A cross-sectional population-based study. A random age and gender stratified sample of 40,000 persons aged 20–80 years residing in Akershus, Hedmark or Oppland County, Norway, were drawn by the National Population Register. A postal questionnaire containing the Berlin Questionnaire was used to classify respondents to be of either high or low risk of obstructive sleep apnea. 376 persons with high risk and 157 persons with low risk of sleep apnea aged 30–65 years were included for further investigations. They underwent an extensive clinical interview, a physical and a neurological examination by physicians, and in-hospital polysomnography. Those with apnea hypopnoea index (AHI) ≥5 were classified with obstructive sleep apnea. Migraine without aura (MO) and migraine with aura (MA) was diagnosed according to the International Classification of Headache Disorders. MO and MA occurred in 12.5 and 6.8% of the participants with obstructive sleep apnea. The logistic regression analyses showed no relationship between the two types of migraine and obstructive sleep apnea, with adjusted odds ratios for MO 1.15 (0.65–2.06) and MA 1.15 (0.95–2.39). Further, estimates using cutoff of moderate (AHI ≥ 15) and severe (AHI ≥ 30) obstructive sleep apnea, did not reveal any significant relationship between migraine and the AHI. Migraine and obstructive sleep apnea are unrelated in the general population

Tension-type headache and sleep apnea in the general population

The main objective of this study is to investigate the relationship between tension-type headache and obstructive sleep apnea in the general population. The method involves a cross-sectional population-based study. A random age and gender stratified sample of 40,000 persons aged 20–80 years residing in Akershus, Hedmark or Oppland County, Norway were drawn by the National Population Register. A postal questionnaire containing the Berlin Questionnaire was used to classify respondents to be of either high or low risk of obstructive sleep apnea. Included in this study were 297 persons with high risk and 134 persons with low risk of sleep apnea, aged 30–65 years. They underwent an extensive clinical interview, a physical and a neurological examination by physicians, and in-hospital polysomnography. Those with apnea hypopnoea index (AHI) ≥5 were classified with obstructive sleep apnea. Tension-type headache was diagnosed according to the International Classification of Headache Disorders. Results showed the prevalence of frequent and chronic tension-type headache was 18.7 and 2.1% in the participants with obstructive sleep apnea. The logistic regression analyses showed no significant relationship between tension-type headache and obstructive sleep apnea, with adjusted odds ratios for frequent tension-type headache of 0.95 (0.55–1.62) and chronic tension-type headache of 1.91 (0.37–9.85). The results did not change when using cut-off of moderate (AHI ≥15) and severe (AHI ≥30) obstructive sleep apnea. Thus, we did not find any significant relationship between tension-type headache and the AHI. The presence and severity of sleep apneas seem not to influence presence and attack-frequency of tension-type headache in the general population

The effectiveness of smartphone apps for lifestyle improvement in noncommunicable diseases: Systematic review and meta-analyses

Background: Noncommunicable diseases (NCDs) account for 70% of all deaths in a year globally. The four main NCDs are cardiovascular diseases, cancers, chronic pulmonary diseases, and diabetes mellitus. Fifty percent of persons with NCD do not adhere to prescribed treatment; in fact, adherence to lifestyle interventions is especially considered as a major challenge. Smartphone apps permit structured monitoring of health parameters, as well as the opportunity to receive feedback. Objective: The aim of this study was to review and assess the effectiveness of app-based interventions, lasting at least 3 months, to promote lifestyle changes in patients with NCDs. Methods: In February 2017, a literature search in five databases (EMBASE, MEDLINE, CINAHL, Academic Research Premier, and Cochrane Reviews and Trials) was conducted. Inclusion criteria was quantitative study designs including randomized and nonrandomized controlled trials that included patients aged 18 years and older diagnosed with any of the four main NCDs. Lifestyle outcomes were physical activity, physical fitness, modification of dietary habits, and quality of life. All included studies were assessed for risk of bias using the Cochrane Collaboration`s risk of bias tool. Meta-analyses were conducted for one of the outcomes (glycated hemoglobin, HbA1c) by using the estimate of effect of mean post treatment with SD or CI. Heterogeneity was tested using the I2 test. All studies included in the meta-analyses were graded. Results: Of the 1588 records examined, 9 met the predefined criteria. Seven studies included diabetes patients only, one study included heart patients only, and another study included both diabetes and heart patients. Statistical significant effect was shown in HbA1c in 5 of 8 studies, as well in body weight in one of 5 studies and in waist circumference in one of 3 studies evaluating these outcomes. Seven of the included studies were included in the meta-analyses and demonstrated significantly overall effect on HbA1c on a short term (3-6 months; P=.02) with low heterogeneity (I2=41%). In the long term (10-12 months), the overall effect on HbA1c was statistical significant (P=.009) and without heterogeneity (I2=0%). The quality of evidence according to Grading of Recommendations Assessment, Development and Evaluation was low for short term and moderate for long term

Sustained Reduction of Tinnitus Several Years after Sequential Cochlear Implantation

Objective This study aimed to explore the short- and long-term effects of a second cochlear implant (CI-2) on the reduction of tinnitus annoyance and tinnitus handicap. Design In a combined retrospective and prospective cohort study, tinnitus annoyance was measured before receiving the CI-2 (Pre), more than two years after (Post1) and more than seven years after (Post2), using the Tinnitus Handicap Inventory (THI), the Visual Analog Scale for the assessment of perceived tinnitus loudness (VAS-L) and annoyance (VAS-A), and a self-report questionnaire. Study sample Twenty sequentially bilaterally implanted adults with bothersome tinnitus. Results CI-2 implantation resulted in a statistically significant reduction of tinnitus handicap from severe at Pre to mild at Post1 (THI mean score reduced from 61.3 [SD = 19.4] to 29.3 [SD = 23.5]). The reduction in tinnitus annoyance was statistically significant from Pre to Post 2 (VAS-A reduced from 7.1 [SD = 1.5] to 3.4 [SD = 2.2]). The reduction in tinnitus loudness was not statistically significant. Conclusions The provision of a CI-2 for severely and profoundly hearing-impaired individuals with bothersome tinnitus is an effective method of providing long-term tinnitus relief

Sustained Reduction of Tinnitus Several Years after Sequential Cochlear Implantation

Objective This study aimed to explore the short- and long-term effects of a second cochlear implant (CI-2) on the reduction of tinnitus annoyance and tinnitus handicap. Design In a combined retrospective and prospective cohort study, tinnitus annoyance was measured before receiving the CI-2 (Pre), more than two years after (Post1) and more than seven years after (Post2), using the Tinnitus Handicap Inventory (THI), the Visual Analog Scale for the assessment of perceived tinnitus loudness (VAS-L) and annoyance (VAS-A), and a self-report questionnaire. Study sample Twenty sequentially bilaterally implanted adults with bothersome tinnitus. Results CI-2 implantation resulted in a statistically significant reduction of tinnitus handicap from severe at Pre to mild at Post1 (THI mean score reduced from 61.3 [SD = 19.4] to 29.3 [SD = 23.5]). The reduction in tinnitus annoyance was statistically significant from Pre to Post 2 (VAS-A reduced from 7.1 [SD = 1.5] to 3.4 [SD = 2.2]). The reduction in tinnitus loudness was not statistically significant. Conclusions The provision of a CI-2 for severely and profoundly hearing-impaired individuals with bothersome tinnitus is an effective method of providing long-term tinnitus relief