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| 2. |
- Badache, Andreea, 1991-
(författare)
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Beyond the Years : Exploring the role of sensory functions and cognitive abilities in shaping the patterns of old age disabilities and successful aging in an aging population in Sweden and Denmark: An epidemiological perspective of disability
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- AIMS: This research project aims to review the lay perspectives of older adults 75 and above regarding successful aging, as well as estimate the prevalence of sensory difficulties by different subgroups, explore the role of cognition and sensory function in explaining decreasing disability trends over time in Sweden and Denmark and, lastly, longitudinally examine the sensory-cognitive relation in older adults. METHODS: For Study I, a systematic review was conducted, while for Study II the prevalence of sensory functions was estimated. For Study III, the Karlson Holm Breen method was used, whereas Study IV applied a cross-lagged panel model. RESULTS: This research indicates that younger and older adults have different definitions of successful aging, with themes of life, death, and environmental/system influences being important for those aged 75 and above (Study I). Study II shows that the prevalence of sensory difficulties in old age varies among subgroups, and Study III reveals a decreasing prevalence of disability in Sweden and Denmark, attributed to cognitive function, education, reading ability, and hearing ability. Finally, Study IV highlights a reciprocal relationship between sensory functions and cognition among older adults, with better cognitive function associated with better hearing and vision scores over time. DISCUSSION: This research underlines the need for policymakers to cater to the diverse needs of different generations based on gender differences, environmental factors, and access to healthcare and social services. Study II reveals a higher prevalence of sensory difficulties among certain subgroups, which could be targeted by specific interventions. Study III and IV indicate that preserving good sensory functions may mitigate cognitive decline, with interventions including vision and hearing aids and surgeries potentially delaying cognitive decline.
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| 3. |
- Karlsson, Elin, 1990-
(författare)
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Assessment of everyday functioning for adults with hearing loss : Development of Hearing and Functioning in Everyday life Questionnaire (HFEQ)
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The overall aim of the current thesis was to develop a self-assessmentinstrument with a focus on everyday functioning for adults with hearingloss and to investigate its psychometric properties.Methods: Three different methods were applied in the current studies; a scoping review (Study I), two quantitative studies using two different datacollection processes (Study II and IV) and a qualitative study, including anitem-generation workshop and cognitive group interviews (Study III).Results: The scoping review (Study I) showed that the validation process ofICF Core Sets has varied between studies, including studies that used bothqualitative and quantitative methodology. Most of the validation studieshave been conducted in Western, high-income countries and have only useda single population.The validation of the Brief ICF Core Set for Hearing Loss (Study II) was conducted internationally, including four continents and both middle- and high-income countries. The results demonstrated satisfactory content validity and internal consistency. However, two ICF categories (b126 and d810) arerecommended to be specified if they are used in a future instrument. In study III HFEQ was developed by international experts in the field ofaudiology and/or ICF. The HFEQ was then validated in two studies withfocus on the content validity (Study III) and the construct validity (StudyIV). Altogether, the results showed satisfying levels of content and construct validity for the HFEQ, as well as internal consistency reliability, feasibility and comprehensibility. Minor adjustments such as rewording arerecommended in the future. The results of study II-IV strengthen the hypothesis that everyday functioning seems to be a relevant and valid phenomenon to measure within audiology. Conclusion: ICF Core sets have been validated using several methods. The Brief ICF Core Set for Hearing Loss has satisfactory validity for adults with hearing loss and is a relevant foundation for a new self-assessment instrument. The HFEQ is a valid self-assessment measure for assessing everyday functioning for adults with hearing loss.
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| 4. |
- Westerberg, Johanna, 1971-
(författare)
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Middle ear cholesteatoma : Surgical outcome and aspects of the innate immunity
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Cholesteatomas are bone destructive expansions of keratinizing squamous epithelium in the middle ear and temporal bone. Today, surgery is the only treatment. There are several controversies regarding cholesteatomas, including the definition, the pathogenesis and the surgical method. Intense efforts have been made searching for a comprehension of the cholesteatoma process at a cellular and molecular level. Recurrent infections and inflammation seem to be contributing factors for the cholesteatomas to expand. The innate immunity, essential to keep a healthy middle ear environment and to protect the middle ear from intruding pathogens, is therefore a matter of interest.In this thesis, results are presented from a cohort of cholesteatoma surgeries in Östergötland from a 16-year period. A group of patients also filled in a questionnaire to assess changes in health-related quality of life (HRQoL) after surgery. According to the findings in this thesis, the residual and recurrence frequencies are low, and the hearing and HRQoL are improved in the majority of cases.This thesis also presents an investigation of the innate immunity in ears with acquired cholesteatoma, in comparison with healthy controls. The expression of mRNA of toll-like receptors 2 and 4, participants of the Janus kinase/signal transducer and activator of transcription pathway, and nitric oxide synthases in middle ear mucosa, were investigated with quantitative polymerase chain reaction. An investigation of nitric oxide (NO) in the middle ear, with chemiluminescence measurements, is also presented.A derangement of the innate immune system is seen in ears with cholesteatoma, which supports the idea that the innate immunity participates in the cholesteatoma process, though the underlying mechanisms are still unclear. The suggestion of NO production in the middle ear sheds light on NOs possible participation in the healthy middle ear environment.
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| 5. |
- Witte, Erik, 1979-
(författare)
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The development of the Situated Phoneme (SiP) test : A Swedish test of phonemic discrimination in noise for adultpeople with hearing loss
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In the current thesis, a Swedish phoneme-level speech-audiometric test in natural background noise was developed. The test is called the Situated Phoneme (SiP) test. In the first study, different types of word metrics thought to influence lexical access were developed and calculated for more than 800 000 phonetically transcribed Swedish words, which were then assembled in a database called the AFC-list. In the second study, groups of monosyllabic AFC-list words with minimal phonemic contrast were selected as linguistic stimuli for the SiP-test, using a method by which the influence of word frequency, neighborhood density, phonotactic probability and orthographic transparency was controlled. All test words were recorded to sound files, of which the accuracy was validated in a listening experiment with 28 normal-hearing adult native speakers of Swedish. In the third study, a method was developed by which realistic masker sounds, spectrally matched to each set of test phonemes in the SiP-test material, were generated for the SiP-test based on a database of urban outdoor sound events. In the fourth study, the validity of six statistical methods for significance testing of observed score differences applicable to the SiP-test were investigated. Analyses were based both on computer simulated test sessions and on SiP-test sessions with human participants. In the latter, the SiP-test speech material was presented against the urban outdoor masker sounds at different difficulty levels to 74 people with normal hearing to severe hearing loss in a listening experiment using a multiple-alternative forced choice paradigm. Based on the results, a computational prediction model for the SiP test was developed, by which the underlying success probability of specific SiP-test trials could be estimated. In turn, this enabled the use of significance-test methods based on the Poisson’s binomial distribution, resulting in improved significance-test validity. In addition, the human SiP-test results were analyzed in terms of test-retest reliability, learning effects, content-, construct- and criterion validity within the remains of the thesis.
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| 6. |
- Badache, Andreea, 1991-, et al.
(författare)
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Longitudinal associations between sensory and cognitive functioning in adults 60 years or older in Sweden and Denmark
- 2024
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier. - 0167-4943 .- 1872-6976. ; 121
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The objective of this study is to explore the bidirectional, longitudinal associations between self-reported sensory functions (hearing/vision) and cognitive functioning among older adults in Sweden and Denmark during the period 2004-2017.METHODS: The study is based on data from The Survey of Health, Ageing and Retirement in Europe and consists of 3164 persons aged 60 to 93 years. Within-person associations between sensory and cognitive functions were estimated using random intercept cross-lagged panel models.RESULTS: The results indicated that cognitive and sensory functions were associated within their respective domains over time. The results on the bidirectional associations between sensory functions and cognition over time showed weak and statistically non-significant estimates.CONCLUSION: Our study showed no clear evidence for cross-lagged effects between sensory functions and cognitive functioning. Important to note, however, is that using longitudinal data to estimate change within persons is a demanding statistical test and various factors may have contributed to the absence of conclusive evidence in our study. We discuss several of these factors.
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| 7. |
- Drakskog, Cecilia, et al.
(författare)
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Extensive qPCR analysis reveals altered gene expression in middle ear mucosa from cholesteatoma patients
- 2020
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Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 15:9
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Tidskriftsartikel (refereegranskat)abstract
- The middle ear is a small and hard to reach compartment, limiting the amount of tissue that can be extracted and the possibilities for studying the molecular mechanisms behind diseases like cholesteatoma. In this paper 14 reference gene candidates were evaluated in the middle ear mucosa of cholesteatoma patients and two different control tissues. ACTB and GAPDH were shown to be the optimal genes for the normalisation of target gene expression when investigating middle ear mucosa in multiplex qPCR analysis. Validation of reference genes using c-MYC expression confirmed the suitability of ACTB and GAPDH as reference genes and showed an upregulation of c-MYC in middle ear mucosa during cholesteatoma. The occurrence of participants of the innate immunity, TLR2 and TLR4, were analysed in order to compare healthy middle ear mucosa to cholesteatoma. Analysis of TLR2 and TLR4 showed variable results depending on control tissue used, highlighting the importance of selecting relevant control tissue when investigating causes for disease. It is our belief that a consensus regarding reference genes and control tissue will contribute to the comparability and reproducibility of studies within the field.
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| 8. |
- Elmazoska, Iris, et al.
(författare)
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Associations Between Recreational Noise Exposure and Hearing Function in Adolescents and Young Adults : A Systematic Review
- 2024
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Ingår i: Journal of Speech, Language and Hearing Research. - : American Speech-Language-Hearing Association. - 1092-4388 .- 1558-9102. ; 67:2, s. 688-710
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Forskningsöversikt (refereegranskat)abstract
- PURPOSE: There is an increasing concern regarding hazardous recreational noise exposure among adolescents and young adults. Daily exposure to loud sound levels over a long period of time can increase the risk of noise-induced hearing loss. The full extent of the impact of recreational noise on hearing is not yet fully understood. The purpose of this review was to synthesize research that investigated hearing function in relation to recreational noise exposure in adolescents and young adults.METHOD: A systematic literature search of five databases covering the years 2000-2023 was performed. The articles included investigated audiological measurements of hearing function in relation to recreational noise exposure.RESULTS: Four hundred sixty records were identified, of which 20 met the inclusion criteria and were included in the results. This review showed that although some recreational noise activities can be potentially harmful, there is an unclear relationship between exposure and outcome. Some findings indicated hearing threshold shifts or reduced otoacoustic emission amplitudes after recreational noise exposure, but most changes were short term and in the extended high-frequency range.CONCLUSIONS: There seemed to be inconsistencies regarding the utilization of methods of measuring exposure and outcome between studies. This might be one reason for the differing results in studies on the reported impact on hearing function from recreational noise exposure. To draw more certain conclusions about long-term effects, there is a need for longitudinal research that utilizes sound level measurements to assess low and high degrees of recreational noise exposure in relation to hearing function.SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25114193.
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| 9. |
- Karlsson, Elin, 1990-, et al.
(författare)
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Hearing and Functioning in Everyday Life Questionnaire : Psychometric Evaluation and Revision
- 2024
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Ingår i: American Journal of Audiology. - : American Speech-Language-Hearing Association. - 1059-0889 .- 1558-9137.
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of the current study was to explore the construct validity and internal consistency reliability of the International Classification of Functioning, Disability and Health (ICF)-based original English version of the Hearing and Functioning in Everyday Life Questionnaire (HFEQ) and to revise the HFEQ based on the results.METHOD: This study used a cross-sectional survey design. The data were collected using an online survey. Adults with self-reported hearing disability (n = 513) from the United States were included. The ICF components of body functions, activity and participation, and environmental factors were tested as the underlying structure of the HFEQ using confirmatory factor analysis and then adjusted by triangulation with previous content validation.RESULTS: The results of the current study confirmed the ICF components of body functions, activity and participation, and environmental factors as underlying constructs of the HFEQ. However, after triangulation with previous content validation, fine adjustments were made. The revised version of the HFEQ includes two removed items and a fine-tuned factor structure.CONCLUSION: The results confirm that the structure of the HFEQ aligns with the ICF, and the overall results indicate that HFEQ has acceptable construct validity and internal consistency.
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