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BACKGROUND: Hearing loss is the third most prevalent chronic condition faced by older adults and has been linked to difficulties in speech perception, activities of daily living, and social interaction. Recent studies have suggested a correlation between severity of hearing loss and an individual's cognitive function; however, a causative link has yet to be established. One intervention option for management of the most severe to profound hearing loss in older adults is cochlear implantation. We performed a review to determine the status of the literature on the potential influence of cochlear implantation on cognition in the older adult population. METHODS: Over 3800 articles related to cochlear implants, cognition, and older adults were reviewed. Inclusion criteria were as follows: (1) study population including adults > 65 years, (2) intervention with cochlear implantation, and (3) cognition as the primary outcome measure of implantation. RESULTS: Out of 3,886 studies selected, 3 met inclusion criteria for the review. CONCLUSIONS: While many publications have shown that cochlear implants improve speech perception, social functioning, and overall quality of life, we found no studies in the English literature that have prospectively evaluated changes in cognitive function after implantation with modern cochlear implants in older adults. The state of the current literature reveals a need for further clinical research on the impact of cochlear implantation on cognition in older adults.

Objective: To expand the access to culturally relevant hearing health services in a rural U.S. border community with already limited healthcare resources, community health workers (Promotoras de Salud) were trained to provide peer-facilitated hearing education classes. Design: A specialized three-phase training process for community health workers was developed, implemented, and evaluated. The training process included: 1) Focus groups with community health workers and residents from the community to raise awareness of hearing loss among community health workers and the community; 2) A 3-hour workshop training to introduce basic topics to prepare community health workers to identify signs of hearing loss among community members and utilize effective communication strategies; and 3) A 24-hour multi-session, interactive training over 6 weeks for community health workers who would become facilitators of educational and peer-support groups for individuals with hearing loss and family members. Study Sample: Twelve Spanish-speaking local community health workers employed by a federally qualified health center participated in a focus group, 12 received the general training, and four individuals with prior experience as health educators received further in-person training as facilitators of peer-education groups on hearing loss and communication. Results: Community health workers increased their knowledge base and confidence in effective communication strategies and developed skills in facilitating hearing education and peer support groups. Through case study practice, community health workers demonstrated competencies and applied their learning to specific situations related to effective communication with hearing loss, family support, assistive technology, use of hearing protection, and making referrals for hearing health care. Needs were identified for ongoing training in the area of assistive technology and addressing situations of more severe hearing loss. Conclusions: It is feasible to train community health workers to begin to address hearing loss and facilitate peer health education and support groups for individuals with hearing loss and their family members. In efforts to increase access to audiologic services in rural or hard-to-reach areas, application of the community health worker model with a partnership of audiologists deserves further consideration as a viable approach.

Introduction: This study investigated hearing aid (HA) satisfaction among adult with hearing impairment (HI) in New Zealand. This study aimed to answer three questions: 1) What are the current HA satisfaction levels amongst adult HA users in New Zealand? 2) How do the satisfaction findings of this study compare with other HA satisfaction data? 3) What client factors are related to HA satisfaction? Method: Participants were recruited prospectively. They completed a questionnaire prior to HA fitting and a questionnaire three months post-fitting. Information was collected on: age, gender, HA experience, HI severity, hearing ability, change in hearing ability, hearing handicap, communication self-efficacy, change in communication self-efficacy, HA self-efficacy, HA usage, and number of appointments. HA satisfaction was measured via the Satisfaction with Amplification in Daily Life questionnaire (SADL; Cox & Alexander, 1999). Results: Data were collected for 47 participants. Of these, 91.5% fell within or above the normative range for global satisfaction established by Cox & Alexander (1999). The mean SADL scores were predominantly high compared to previous research. Satisfaction with negative features of HAs was especially high in this study. However satisfaction with the service and cost of HAs was low compared to other research. SADL scores were found to significantly relate to age, gender, change in hearing ability, hearing handicap, communication self-efficacy, change in communication self-efficacy, and HA self-efficacy. Conclusions: Results differed from previous research indicating that HA satisfaction may differ over time and across countries. Assessing HA satisfaction in a comprehensive standardised way, as opposed to with a single-item measure, can help identify important related factors. Targeting identified variables such as communication and HA self-efficacy may lead to improved treatment efficacy.

Bakgrund: Studier visar att hörselskador kan uppstå till följd av yttre påfrestningar så som exponering av buller och kraftiga tryckförändringar. Fallskärmshoppare exponeras för bägge dessa faktorer, vilket skulle kunna innebära en ökad risk för att utveckla hörselskador. Trots detta är området mycket sparsamt studerat. En ökad kunskap inom området medför att eventuella behov av preventiva åtgärder kan identifieras. Syfte: Syftet med studien var att undersöka förekomsten av upplevda hörselbesvär hos fallskärmshoppare, samt om det finns något samband mellan upplevda hörselbesvär och antal hopp, användning av öronproppar eller akustiska höjdvarnare. Metod: Studien genomfördes i form av en kvantitativ tvärsnittsstudie. En webbenkät skickades ut till samtliga aktiva fallskärmshoppare med registrerad e-postadress i två fallskärmsklubbar i Mellansverige. Totalt 244 fallskärmshoppare deltog i studien (svarsfrekvens 47,6 %). Resultat: Hörselrelaterade besvär i form av hörselnedsättning, tinnitus och smärta/obehag i öronen förekom hos 20-30 % av de studerade fallskärmshopparna. Det fanns däremot inga statistiskt signifikanta samband mellan upplevda hörselbesvär och antal fallskärmshopp, användning av öronproppar eller användning av akustiska höjdvarnare. Andelen som uppgav att de upplevde svårigheter att höra vad som sägs i ett samtal mellan flera personer var högre bland de studerade fallskärmshopparna jämfört med en åldersmatchad population i SCB:s befolkningsundersökning. Slutsats: Inga samband mellan antal fallskärmshopp och hörselrelaterade besvär kan ses, men resultatet tyder på att fallskärmshoppare upplever hörselnedsättning i större utsträckning jämfört med övriga befolkningen. Vidare studier krävs för att med säkerhet kunna avgöra om fallskärmshoppning innebär en risk för att utveckla hörselskador. / Background: Studies have shown that hearing loss can be caused by environmental factors like noise and changes in the pressure. Skydivers are exposed to several risk factors for hearing impairment, but there is a lack of studies investigating hearing loss among skydivers. More knowledge among the phenomena is needed to identify potential need of preventive work.  Aims: The aim of the study was to investigate the prevalence of self-perceived hearing symptoms among skydivers. The study also examined the relationship between self-perceived hearing symptoms and the use of earplugs and audible altimeters. Methods: The study was executed as a quantitative cross-sectional study. Webb-based questionnaires were sent out to all skydivers with registered e-mail in two skydiving clubs in Sweden. A total of 244 skydivers were studied (response rate 47.6 %) Results: Hearing symptoms such as hearing loss, tinnitus and ear pain was found in 20-30 % of the skydivers. The proportion who experienced difficulty in hearing was higher among the skydivers than an age-matched population from a SCB survey. However, no statistically significant correlations between self-perceived hearing symptoms and number of parachute jumps, use of earplugs or use of audible altimeters were found. Conclusion: No relationship between amount of skydiving and hearing symptoms could be found, but the results indicate that hearing loss is more common among skydivers compared to the general population. Further studies are required to investigate if skydivers are in risk of developing hearing loss.

The purpose of the study was to determine whether hearing aids with binaural processing improve performance during a localization and a hearing in noise task. The study included 16 participants, ages 29 – 67, with bilateral, essentially symmetrical, sensorineural hearing loss who had no prior hearing aid experience. Participants were fit with Oticon Epoq XW hearing aids bilaterally and completed the localization and the hearing in noise task with three listening conditions: (1) without hearing aids (NO), (2) with hearing aids that were not linked (BIL), and (3) with hearing aids that were linked (BIN). For the localization task, 1.5 second pink noise bursts at 75 dB SPL were used as the stimulus. A 180° 11-speaker array was set up to the right or left side of the participants. A twelfth speaker on the contralateral side of the array introduced constant background pink noise at 65 dB SPL. Results revealed that participants performed the best with the NO condition, followed by BIL, then BIN. There was a significant difference between NO and BIL and NO and BIN. For the hearing in noise (HIN) task, sentences from the Hearing in Noise Test (HINT) were used as target stimuli. Continuous discourse by one male and two female talkers were used as maskers. There were four masker conditions for this task: (1) signal at 0°, masker at 90° (S0-N90), (2) signal at 0°, masker at 180° (S0-N180), (3) signal at 0°, masker at 270° (S0-N270), and (4) signal at 0°, maskers at 90°, 180°, and 270° (S0-N90, 180, 270). Results revealed that there was no significant difference between listening conditions when all masker conditions were considered. When the one-masker conditions were included, there was a significant difference between the NO and BIL and the NO and BIN conditions with the best performance for BIL, followed by BIN, then NO. Results also revealed a significant difference between masker conditions with the best performance for S0-N270, next best for S0-N90, followed by S0-N180, then S0-N90, 180, 270. / text

This study investigated the incidence of peripheral hearing loss in sickle cell anemia and the possibility of central auditory nervous system involvement. Nine Black subjects with sickle cell disease and nine with normal hemoglobin were administered an auditory test battery. There appeared to be no correlation between number of crisis episodes, duration of symptoms, severity of symptoms, and audiologic manifestations. Acoustic reflex testing suggested the possibility of "aired neural function in the sickle cell group. Whether impaired function was due to peripheral VIIIth nerve or to central brain stem involvement could not be determined. Results of the central auditory test battery suggested the possibility of impaired or reduced central auditory function in subjects with sickle cell anemia.

This paper reports on the comparison of the performance of fourteen normal hearing listeners and fourteen individuals with sensorineural hearing loss on the Synthetic Sentence Identification (SSI) and the Northwestern Auditory Test No. 6 (NU 6) in order to determine whether there are differences in performance of the two groups of listeners on the SSI and NU 6 and whether either test better reflects aided improvement and residual deficit. Both measures demonstrated significant aided improvement. The results of this study do not suggest a single best discrimination test which can reflect a real-life listening situation. The primary consideration in the hearing aid evaluation is flexibility in determining the appropriate level for the primary signal and the listening conditions.

The Stenger Principle describes the observation that when two tones of the same frequency are presented simultaneously, a single tone is perceived only in the ear in which the tone is louder. This principle underlies the Stenger Test, which is used to identify the presence of unilateral nonorganic hearing loss (NOHL). Minimum contralateral interference levels (MCILs), which can be used to estimate true hearing thresholds in individuals with unilateral NOHL, are also based on this principle. In this study, the Stenger Principle is used to examine MCILs and the correspondence of the MCILs to true hearing thresholds in 16 adults with normal hearing. In Part I of the study, subjects were asked to feign a unilateral hearing loss. Average MCILs were 12.5, 15.1, and 13.5 dB HL for 1.0, 2.0, and 4.0 kHz, respectively. These were obtained with nearly equal interaural stimulus levels. The average difference between MCIL and true hearing threshold was 7.6, 9.7, and 8.9 dB, respectively. In Part II of this study, subjects were asked to make lateralization judgments for simultaneously presented tones with varying interaural intensity differences. Individual subject ratings were compared to MCILs obtained in Part I. Although most subjects showed the Stenger Effect with a midline percept of the two tones, variability between subjects existed. In some cases the Stenger Effect was not apparent until the tonal image was pulled nearly to the "poor" ear. Because of the potential differences in response bias (a client may show the Stenger Effect with a small shift in the tonal signal away from the "good" ear or may require the tonal signal to be fully lateralized to the "poor" ear), clinicians cannot predict exact hearing thresholds. Rather, it is useful to describe a range within which the true threshold will be. The 90% ranges (5th and 95th percentiles) calculated in this study were approximately 1 and 17 dB. That is, the MCILs for the majority of the subjects were within ~ 1 and 17 dB of true hearing thresholds.

Doctor Educationis / Ototoxic induced hearing loss is a common adverse event related to aminoglycosides used in Multi Drug Resistant -Tuberculosis treatment. Exposure to ototoxic drugs damages the structures of the inner ear. Symptomatic hearing loss presents as tinnitus, decreased hearing, a blocked sensation, difficulty understanding speech, and perception of fluctuating hearing, dizziness and hyperacusis/recruitment. The World Health Organization (1995) indicated that most cases of ototoxic hearing loss globally could be attributed to treatment with aminoglycosides. The aim of the study was to determine the proportion of DR-TB patients initiated on treatment at three decentralized sites during a defined period (1st October to 31st December 2015) who developed ototoxic induced hearing loss and the corresponding risk factors, whilst receiving audiological monitoring with an extended high frequency audiometer (KUDUwave). A retrospective cross-sectional study was conducted. Cumulatively across the three decentralized sites, 69 patient records were reviewed that met the inclusion criteria of the study. The mean age of the patients was 36.1, with a standard deviation (SD) of 10.7 years; more than half (37) were female. Ototoxicity , a threshold shift, placing patients at risk of developing a hearing loss was detected in 56.5% (n=39)of patients and not detected in 30.4%(n=21).The remaining 13,1% (n=9)is missing data. As a result, the regimen was adjusted in 36.2% of patients. . From the 53 patients who were tested for hearing loss post completion of the injectable phase of treatment, 22.6% (n=12) had normal hearing, 17.0 % (n=9) had unilateral hearing loss, and 60.4% (n=32) had bilateral hearing loss. Therefore, a total of 41 patients had a degree of hearing loss: over 30% (n=22)had mild to moderate hearing loss, and only about 15% (n=11)had severe to profound hearing loss. Analysis of risk factors showed that having ototoxicity detected and not adjusting regimen significantly increases the risk of patients developing a hearing loss. The key findings of the study have shown that a significant proportion of DR-TB patients receiving an aminoglycoside based regimen are at risk of developing ototoxic induced hearing loss, despite receiving audiological monitoring with an extended high frequency audiometer that allows for early detection of ototoxicity (threshold shift).