Healthcare Professionals’ Knowledge, Skills, and Information Needs Pertaining to Hearing Loss and Hearing Aids in Swedish Nursing Homes: A Cross-Sectional Study and Psychometric Evaluation

Kaisa Bjuresäter,1 Mattias Bergström Andrén,2,3 Elina Mäki-Torkko,4,5 Agneta Anderzén-Carlsson,6 Per-Inge Carlsson2,5 1Institution of Health Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden; 2Department of Audiology, Central Hospital, Region Värmland, Karlstad, Sweden; 3School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; 4Audiological Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; 5School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; 6University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, SwedenCorrespondence: Kaisa Bjuresäter, Email [email protected]: Hearing loss increases with age and due to increased life expectancy there is an increase in the number of individuals living with hearing loss. Older people with hearing loss residing in nursing homes are often dependent on healthcare professionals to help them with their hearing aids.Objective: The aim of the study was to translate and test the psychometric properties of a Swedish version of a Norwegian questionnaire and to assess healthcare professionals’ self-reported knowledge, experience, skills, competence, and information needs pertaining to residents’ hearing loss and hearing aids in the Swedish context.Materials and Methods: A Norwegian questionnaire was translated and adapted, and thereafter distributed to healthcare professionals in nine nursing homes in mid Sweden between 2020 and 2021, and 313 questionnaires were returned.Results: An exploratory factor analysis demonstrated adequate factorial structure in six factors, satisfying construct validity and internal consistency for the Swedish version. A confirmatory factor analysis showed a satisfactory model fit. Healthcare professionals reported having the skills required for handling hearing aids, but reported lower scores for having received information about hearing aids, taking initiatives to refer residents to hearing healthcare units, and checking for earwax. Registered nurses generally reported lower perceived knowledge and practical skills concerning hearing aids. Seventy-seven percent of the total group reported a need for information regarding hearing aid maintenance.Conclusion: Healthcare professionals reported that the majority of nursing home residents need help with their hearing aids, but only a minority of these professionals had received education on hearing loss and training in hearing aid maintenance. Enrolled nurses and care assistants demonstrated higher levels of competence in handling hearing aids compared to registered nurses. In order to ensure safe and effective care, as well as facilitate communication among older adults with hearing loss, healthcare professionals need appropriate education and training.Keywords: hearing loss, nursing homes, health care professionals, competence, instrument translation, psychometric testin

Cancer Biomarker Discovery: The Entropic Hallmark

Background: It is a commonly accepted belief that cancer cells modify their transcriptional state during the progression of the disease. We propose that the progression of cancer cells towards malignant phenotypes can be efficiently tracked using high-throughput technologies that follow the gradual changes observed in the gene expression profiles by employing Shannon's mathematical theory of communication. Methods based on Information Theory can then quantify the divergence of cancer cells' transcriptional profiles from those of normally appearing cells of the originating tissues. The relevance of the proposed methods can be evaluated using microarray datasets available in the public domain but the method is in principle applicable to other high-throughput methods. Methodology/Principal Findings: Using melanoma and prostate cancer datasets we illustrate how it is possible to employ Shannon Entropy and the Jensen-Shannon divergence to trace the transcriptional changes progression of the disease. We establish how the variations of these two measures correlate with established biomarkers of cancer progression. The Information Theory measures allow us to identify novel biomarkers for both progressive and relatively more sudden transcriptional changes leading to malignant phenotypes. At the same time, the methodology was able to validate a large number of genes and processes that seem to be implicated in the progression of melanoma and prostate cancer. Conclusions/Significance: We thus present a quantitative guiding rule, a new unifying hallmark of cancer: the cancer cell's transcriptome changes lead to measurable observed transitions of Normalized Shannon Entropy values (as measured by high-throughput technologies). At the same time, tumor cells increment their divergence from the normal tissue profile increasing their disorder via creation of states that we might not directly measure. This unifying hallmark allows, via the the Jensen-Shannon divergence, to identify the arrow of time of the processes from the gene expression profiles, and helps to map the phenotypical and molecular hallmarks of specific cancer subtypes. The deep mathematical basis of the approach allows us to suggest that this principle is, hopefully, of general applicability for other diseases

FEM-analysis of a concrete dam in northern Sweden

Krångfors is a concrete dam located in northern Sweden that was constructed in three stages from 1928 to 1973. This expansion in different stages resulted in a complicated structural design. Extensive cracks have been noticed in parts of the structure. Two main hypotheses for the cause of these cracks were initially established; 1) alkali-silica reaction (ASR) and 2) large temperature variations in the structure. Petrographic analyses of concrete cores showed that the concrete ballast consisted of greywacke with potential for ASR. However, accelerated testing of concrete cores showed that the potential for expansion due to ASR was limited. To analyze the effect from temperature variations, three dimensional FEManalyses were performed. The results from these FEM-analyses are the main focus of this paper. These analyses showed that adding the annual temperature variation and possible shrinkage to the FEM-model gave results that could explain the observed cracks.</p

The influence of genetic variation in oxidative stress genes on human noise susceptibility

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