1. |
- Andin, Josefine, 1979-, et al.
(author)
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Arithmetic in the adult deaf signing brain
- 2020
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In: Journal of Neuroscience Research. - : John Wiley & Sons. - 0360-4012 .- 1097-4547. ; 98:4, s. 643-654
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Journal article (peer-reviewed)abstract
- We have previously shown that deaf signers recruit partially different brain regions during simple arithmetic compared to a group of hearing non-signers, despite similar performance. Specifically, hearing individuals show more widespread activation in brain areas that have been related to the verbal system of numerical processing, i.e., the left angular and inferior frontal gyrus, whereas deaf individuals engaged brain areas that have been related to the quantity system of numerical processing, i.e., the right horizontal intraparietal sulcus. This indicates that compared to hearing non-signers, deaf signers can successfully make use of processes located in partially different brain areas during simple arithmetic. In this study, which is a conceptual replication and extension of the above-presented study, the main aim is to understand similarities and differences in neural correlates supporting arithmetic in deaf compared to hearing individuals. The primary objective is to investigate the role of the right horizontal intraparietal gyrus, the left inferior frontal gyrus, the hippocampus, and the left angular gyrus during simple and difficult arithmetic and how these regions are connected to each other. A second objective is to explore what other brain regions support arithmetic in deaf signers. Up to 34 adult deaf signers and the same amount of hearing non-signers will be enrolled in an functional magnetic resonance imaging study that will include simple and difficult subtraction and multiplication. Brain imaging data will be analyzed using whole-brain analysis, region of interest analysis and connectivity analysis. This is the first study to investigate neural underpinnings of arithmetic of different difficulties in deaf individuals.
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2. |
- Andin, Josefine, 1979-, et al.
(author)
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Arithmetic in the signing brain : Differences and similarities in arithmetic processing between deaf signers and hearing non-signers
- 2023
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In: Journal of Neuroscience Research. - : John Wiley & Sons. - 0360-4012 .- 1097-4547. ; 101:1, s. 172-195
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Journal article (peer-reviewed)abstract
- Deaf signers and hearing non-signers have previously been shown to recruit partially different brain regions during simple arithmetic. In light of the triple code model, the differences were interpreted as relating to stronger recruitment of the verbal system of numerical processing, that is, left angular and inferior frontal gyrus, in hearing non-signers, and of the quantity system of numerical processing, that is, right horizontal intraparietal sulcus, for deaf signers. The main aim of the present study was to better understand similarities and differences in the neural correlates supporting arithmetic in deaf compared to hearing individuals. Twenty-nine adult deaf signers and 29 hearing non-signers were enrolled in an functional magnetic resonance imaging study of simple and difficult subtraction and multiplication. Brain imaging data were analyzed using whole-brain analysis, region of interest analysis, and functional connectivity analysis. Although the groups were matched on age, gender, and nonverbal intelligence, the deaf group performed generally poorer than the hearing group in arithmetic. Nevertheless, we found generally similar networks to be involved for both groups, the only exception being the involvement of the left inferior frontal gyrus. This region was activated significantly stronger for the hearing compared to the deaf group but showed stronger functional connectivity with the left superior temporal gyrus in the deaf, compared to the hearing, group. These results lend no support to increased recruitment of the quantity system in deaf signers. Perhaps the reason for performance differences is to be found in other brain regions not included in the original triple code model.
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3. |
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4. |
- Asp, Filip, et al.
(author)
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A longitudinal study of the bilateral benefit in children with bilateral cochlear implants
- 2015
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In: International Journal of Audiology. - : Taylor & Francis. - 1499-2027 .- 1708-8186. ; 54:2, s. 77-88
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To study the development of the bilateral benefit in children using bilateral cochlear implants by measurements of speech recognition and sound localization.DESIGN: Bilateral and unilateral speech recognition in quiet, in multi-source noise, and horizontal sound localization was measured at three occasions during a two-year period, without controlling for age or implant experience. Longitudinal and cross-sectional analyses were performed. Results were compared to cross-sectional data from children with normal hearing.STUDY SAMPLE: Seventy-eight children aged 5.1-11.9 years, with a mean bilateral cochlear implant experience of 3.3 years and a mean age of 7.8 years, at inclusion in the study. Thirty children with normal hearing aged 4.8-9.0 years provided normative data.RESULTS: For children with cochlear implants, bilateral and unilateral speech recognition in quiet was comparable whereas a bilateral benefit for speech recognition in noise and sound localization was found at all three test occasions. Absolute performance was lower than in children with normal hearing. Early bilateral implantation facilitated sound localization.CONCLUSIONS: A bilateral benefit for speech recognition in noise and sound localization continues to exist over time for children with bilateral cochlear implants, but no relative improvement is found after three years of bilateral cochlear implant experience.
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6. |
- Badache, Andreea, 1991-
(author)
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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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Doctoral thesis (other academic/artistic)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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7. |
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8. |
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9. |
- Badache, Andreea C., 1991-, et al.
(author)
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Why Are Old-Age Disabilities Decreasing in Sweden and Denmark? Evidence on the Contribution of Cognition, Education, and Sensory Functions
- 2022
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In: The journals of gerontology. Series B, Psychological sciences and social sciences. - : Oxford University Press (OUP). - 1079-5014 .- 1758-5368. ; 78:3, s. 483-495
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Journal article (peer-reviewed)abstract
- Objectives: Improvements in educational attainment, cognitive and sensory functions, and a decline in the prevalence of disabilities have been observed in older adults in Sweden and Denmark. In the present study, it was investigated whether better cognition, higher educational attainment, and improved sensory function among older adults aged 60 and older in these countries have contributed to decreasing rates of old-age disabilities.Methods: The analyses were based on repeated cross-sectional data from the Survey of Health, Ageing, and Retirement in Europe for the 2004-2017 period. Descriptive data were used to benchmark the declining prevalence of disabilities, improving cognitive and sensory functions, and increased educational level. The association between time and disabilities was analyzed with logistic regression models, and the contribution of the improved cognitive function, education, and sensory function to the declining prevalence of old-age disabilities was estimated using the Karlson-Holm-Breen method for mediation analysis.Results: The analysis suggests that the declining prevalence of old-age disabilities in Sweden and Denmark between 2004 and 2017 can largely be attributed to improved cognitive function and vision and to a lesser extent by education and hearing ability.Discussion: These findings raise important questions about the causal mechanisms producing the associations between cognition, education, and sensory functions and disability in older age. Future studies should explore the causal nature of the associations between these mediators and old-age disabilities. In addition, they should explore whether these findings differ across regional and cultural contexts and over different time periods.
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10. |
- Badache, Andreea, 1991-, et al.
(author)
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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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In: Archives of gerontology and geriatrics (Print). - : Elsevier. - 0167-4943 .- 1872-6976. ; 121
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Journal article (peer-reviewed)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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11. |
- Badache, Andreea, 1991-, et al.
(author)
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The perspectives of successful ageing among older adults aged 75+ : a systematic review with a narrative synthesis of mixed studies
- 2023
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In: Ageing & Society. - : Cambridge University Press. - 0144-686X .- 1469-1779. ; 43, s. 1203-1239
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Research review (peer-reviewed)abstract
- Older adults 75 and above are a fast-growing segment of the population. However, few studies have investigated what it means to age successfully from their perspective. This group of older adults face challenges that might characteristically differ from younger older adults. Therefore, the aim of this study was to conduct a systematic review of the perspectives of older adults aged 75 and above regarding what it means to age successfully and to summarise the findings through a narrative synthesis. We also aimed to provide a snapshot of inhibitors and facilitators to achieve successful ageing. A systematic review of the 75+ older adults’ perspectives was conducted across PubMed, CINAHL, Scopus, Web of Science and PsycINFO. Qualitative, quantitative and mixed-methods original peer-reviewed studies were included. After reviewing 4,661 articles, 15 articles met the inclusion criteria and 15 themes were identified. They ranged from biomedical components such as physical functioning to psychosocial components such as relationships, reflections on life and past experiences, preparations for death and environmental factors. The findings revealed that as people age, their definition of successful ageing changes, expanding the current conceptualisation of successful ageing by including additional factors that can act as facilitators and/or inhibitors, such as death and environmental factors. The findings also highlight the need for further research on theory development by considering age-related differences and the perspectives of under-studied populations.
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12. |
- Bergman, Pia, et al.
(author)
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The outcome of unilateral cochlear implantation in adults : Speech recognition, health-related quality of life and level of anxiety and depression: a one- and three-year follow up study
- 2020
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In: International Archives of Otorhinolaryngology. - : Thieme Medical Publishers. - 1809-9777 .- 1809-4864. ; 24:3, s. 338-346
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Journal article (peer-reviewed)abstract
- Introduction: Hearing impairment is a common disease worldwide, with a comprehensive impact, and cochlear implantation (CI) is an intervention for profound hearing impairment.Objective: To study the outcome one and three years after unilateral CI on hearing, health-related quality of life and level of depression and anxiety, and the correlation between the outcomes. Second, to study whether age, gender, etiology, operated side, residual hearing or cognitive performance can predict the outcome.Methods: A prospective longitudinal study including adults with profound postlingual hearing impairment, with respect to hearing (speech recognition), health-related quality of life (Health Utilities Index 3) and level of depression and anxiety (Hospital Anxiety and Depression scale), pre-CI, and one and three years post-CI. The total sample was composed of 40 participants (40% of men), with a mean age of 71 years.Results: Speech recognition and the overall health-related quality of life improved one year post-CI (p ¼ 0.000), without correlation (ρ¼ 0.27), and with no difference three years post-CI. The hearing attribute (in the health-related quality of life instrument) improved one and three years post-CI (p ¼ 0.000). The level of anxiety did not change one and three years post-CI. The level of depression improved one year post-CI (p ¼ 0.036), and deteriorated three years post-CI (p ¼ 0.031). Age, etiology, operated side, residual hearing and cognitive performance did not predict the outcome, but the female gender did significantly improve speech recognition compared with men (p ¼ 0.009).Conclusion: The CI significantly improved speech recognition, health-related quality of life and level of depression one year post-CI without mutual correlation, and women performed significantly better than men. There were no further improvements three years post-CI, apart from the hearing attribute.
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13. |
- Drakskog, Cecilia, et al.
(author)
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Extensive qPCR analysis reveals altered gene expression in middle ear mucosa from cholesteatoma patients
- 2020
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In: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 15:9
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Journal article (peer-reviewed)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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14. |
- Elmazoska, Iris, et al.
(author)
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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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In: 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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Research review (peer-reviewed)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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15. |
- Frånlund, Karin, et al.
(author)
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Cortical auditory evoked potentials (P1 latency) in children with cochlear implants in relation to clinical language tests
- 2023
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In: International Journal of Audiology. - : Routledge. - 1499-2027 .- 1708-8186.
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Journal article (peer-reviewed)abstract
- Objective: To study the correlation between P1 latency and the results of clinical language tests (Reynell III and TROG-2), the latter were used as they are recommended for follow-up assessments of children with cochlear implants (Cis) by the Swedish National Quality Register for children with hearing impairment.Design: A clinical cohort study.Study sample - Cross-sectional and consecutive sampling of 49 children with CIs coming for clinical follow-up assessment from March 2017 - December 2019.Results: For all children tested, there was a significant negative correlation (Spearman's rho= -0.403, p = 0.011) between hearing age and P1 latency. A significant correlation between P1 latency and the Reynell III result (Spearman's rho = -0.810, p = 0.015) was found. In the TROG-2 group, there was no significant correlation between their P1 latency and their language test results (Spearman's rho -0.239, p = 0.196).Conclusion: This method seems to be feasible and easily accepted. The study was conducted in a heterogeneous group of children that we meet daily in our clinic. The results indicated that P1 latency has a negative correlation with language development among our youngest patients fitted with CIs and might be a clinical tool to assess the maturation of central auditory pathways.
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16. |
- Hansson, Kristina, et al.
(author)
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Can a 'single hit' cause limitations in language development? A comparative study of Swedish children with hearing impairment and children with specific language impairment.
- 2007
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In: International Journal of Language & Communication Disorders. - : Wiley. - 1368-2822 .- 1460-6984. ; 42:3, s. 307-323
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Journal article (peer-reviewed)abstract
- Studies of language in children with mild-to-moderate hearing impairment ( HI) indicate that they often have problems in phonological shortterm memory (PSTM) and that they have linguistic weaknesses both in vocabulary and morphosyntax similar to children with specific language impairment (SLI). However, children with HI may be more likely than children with SLI to acquire typical language skills as they get older. It has been suggested that the more persisting problems in children with SLI are due to a combination of factors: perceptual, cognitive and/or linguistic. Aims: The main aim of this study was to explore language skills in children with HI in comparison with children with SLI, and how children with both HI and language impairment differ from those with non-impaired spoken language skills. Methods & Procedures: PSTM, output phonology, lexical ability, receptive grammar and verb morphology were assessed in a group of children with mild-to-moderate HI ( n=11) and a group of children with SLI (n=12) aged 5 years 6 months to 9 years 0 months. Outcomes & Results: The HI group tended to score higher than the SLI group on the language measures, although few of the differences were significant. The children with HI had their most obvious weaknesses in PSTM, vocabulary, receptive grammar and inflection of novel verbs. The subgroup of children with HI ( five out of 10) who also showed evidence of grammatical output problems was significantly younger than the remaining children with HI. Correlation analysis showed that the language variables were not associated with age, whereas hearing level was associated with PSTM. Conclusions: Children with HI are at risk for at least a delay in lexical ability, receptive grammar and grammatical production. The problems seen in the HI group might be explained by their low-level perceptual deficit and weak PSTM. For the SLI group the impairment is more severe. From a clinical perspective an important conclusion is that the language development in children with even mild-to-moderate HI deserves attention and support.
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17. |
- Hendrickx, Jan-Jaap, et al.
(author)
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Familial aggregation of pure tone hearing thresholds in an aging European population
- 2013
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In: Otology and Neurotology. - : Lippincott Williams & Wilkins. - 1531-7129 .- 1537-4505. ; 34:5, s. 838-844
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To investigate the familial correlations and intraclass correlation of age-related hearing impairment (ARHI) in specific frequencies. In addition, heritability estimates were calculated.STUDY DESIGN: Multicenter survey in 8 European centers.SUBJECTS: One hundred ninety-eight families consisting of 952 family members, screened by otologic examination and structured interviews. Subjects with general conditions, known to affect hearing thresholds or known otologic cause were excluded from the study.RESULTS: We detected familial correlation coefficients of 0.36, 0.37, 0.36, and 0.30 for 0.25, 0.5, 1, and 2 kHz, respectively, and correlation coefficients of 0.20 and 0.18 for 4 and 8 kHz, respectively. Variance components analyses showed that the proportion of the total variance attributable to family differences was between 0.32 and 0.40 for 0.25, 0.5, 1, and 2 kHz and below 0.20 for 4 and 8 kHz. When testing for homogeneity between sib pair types, we observed a larger familial correlation between female than male subjects. Heritability estimates ranged between 0.79 and 0.36 across the frequencies.DISCUSSION: Our results indicate that there is a substantial shared familial effect in ARHI. We found that familial aggregation of ARHI is markedly higher in the low frequencies and that there is a trend toward higher familial aggregation in female compared with male subjects.
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18. |
- Hesser, Hugo, 1982-, et al.
(author)
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A Randomized Controlled Trial of Internet-Delivered Cognitive Behavior Therapy and Acceptance and Commitment Therapy in the Treatment of Tinnitus
- 2012
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In: Journal of Consulting and Clinical Psychology. - Washington, DC, USA : American Psychological Association (APA). - 0022-006X .- 1939-2117. ; 80:4, s. 649-661
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Journal article (peer-reviewed)abstract
- Objective:Our aim in this randomized controlled trial was to investigate the effects on global tinnitus severity of 2 Internet-delivered psychological treatments, acceptance and commitment therapy (ACT) and cognitive behavior therapy (CBT), in guided self-help format.Method: Ninety-nine participants (mean age 48.5 years; 43% female) who were significantly distressed by tinnitus were recruited from the community. Participants were randomly assigned to CBT (n 32), ACT (n 35), or a control condition (monitored Internet discussion forum; n 32), and they were assessed with standardized self-report measures (Tinnitus Handicap Inventory; Hospital Anxiety and Depression Scale; Quality of Life Inventory; Perceived Stress Scale; Tinnitus Acceptance Questionnaire) at pre-, posttreatment (8 weeks), and 1-year follow-up.Results: Mixed-effects linear regression analysis of all randomized participants showed significant effects on the primary outcome (Tinnitus Handicap Inventory) for CBT and for ACT compared with control at posttreatment (95% CI [17.03, 2.94], d 0.70, and 95% CI [16.29, 2.53], d 0.68, respectively). Within-group effects were substantial from pretreatment through 1-year-follow-up for both treatments (95% CI [44.65, 20.45], d 1.34), with no significant difference between treatments (95% CI [14.87, 11.21], d 0.16).Conclusions: Acceptance-based procedures may be a viable alternative to traditional CBT techniques in the management of tinnitus. The Internet can improve access to psychological interventions for tinnitus.
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19. |
- Hjertman, Heléne, et al.
(author)
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The Swedish hearing in noise test for children, HINT-C
- 2021
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In: International Journal of Pediatric Otorhinolaryngology. - : Elsevier. - 0165-5876 .- 1872-8464. ; 141
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The aim of this study was to develop and evaluate a Swedish version of the Hearing In Noise Test for Children (HINT-C).DESIGN: In the first part, the Swedish HINT lists for adults was evaluated by children at three signal to noise ratios (SNRs), -4, -1 and +2 dB. Lists including sentences not reaching 50% recognition at +2 dB SNR were excluded and the rest constituted the HINT-C. In the second part, HINT-C was evaluated in children and adults using an adaptive procedure to determine the SNR for 50% correctly repeated sentences. Study Sample In the first part, 112 children aged 6-11 years participated while another 28 children and 9 adults participated in the second part.RESULTS: Eight out of 24 tested adult HINT lists did not reach the inclusion criteria. The remaining 16 lists formed the Swedish HINT-C which was evaluated in children 6-11 years old. A regression analysis showed that the predicted SNR threshold (dB) was 0.495-0.365*age (years + months/12) and the children reached the mean adult score at an age of 10.5 years.CONCLUSIONS: A Swedish version of HINT-C was developed and evaluated in children six years and older.
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20. |
- Huttunen, Kerttu, et al.
(author)
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The impact of permanent early-onset unilateral hearing impairment in children : A systematic review
- 2019
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In: International Journal of Pediatric Otorhinolaryngology. - : Elsevier. - 0165-5876 .- 1872-8464. ; 120, s. 173-183
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Research review (peer-reviewed)abstract
- Background: Decision-making on treatment and (re)habilitation needs to be based on clinical expertise and scientific evidence. Research evidence for the impact of permanent unilateral hearing impairment (UHI) on children's development has been mixed and, in some of the reports, based on fairly small, heterogeneous samples. Additionally, treatment provided has been highly variable, ranging from no action taken or watchful waiting up to single-sided cochlear implantation. Published information about the effects of treatment has also been heterogeneous. Moreover, earlier reviews and meta-analyses published on the impact of UHI on children's development have generally focused on select areas of development.Objectives: This systematic review aimed to summarize the impact of children's congenital or early onset unilateral hearing impairment on listening and auditory skills, communication, speech and language development, cognitive development, educational achievements, psycho-social development, and quality of life.Methods: Literature searches were performed to identify reports published from inception to February 16th, 2018 with the main electronic bibliographic databases in medicine, psychology, education, and speech and hearing sciences as the data sources. PubMed, CINALH, ERIC, LLBA, PsychINFO, and ISI Web of Science were searched for unilateral hearing impairment with its synonyms and consequences of congenital or early onset unilateral hearing impairment. Eligible were articles written in English, German, or Swedish on permanent unilateral hearing impairments that are congenital or with onset before three years of age. Hearing impairment had to be of at least a moderate degree with PTA >= 40 dB averaged over frequencies 0.5 to 2 or 0.5-4 kHz, hearing in the contralateral ear had to have PTA(0.5-2 kHz) or PTA(0.5-4 kHz) <= 20 dB, and consequences of unilateral hearing impairment needed to be reported in an unanimously defined population in at least one of the areas the review focused on.Four researchers independently screened 1618 abstracts and 566 full-text articles for evaluation of study eligibility. Eligible full-text articles were then reviewed to summarize the results and assess the quality of evidence. Additionally, data from 13 eligible case and multi-case studies, each having less than 10 participants, were extracted to summarize their results.Quality assessment of evidence was made adapting the Grades of Recommendations, Assessment, Development, and Evaluation (GRADE) process, and reporting of the results adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards.Results: Three articles with the quality of evidence graded as very-low to low, fulfilled the eligibility criteria set. Due to the heterogeneity of the articles, only a descriptive summary could be generated from the results. Unilateral hearing impairment was reported to have a negative impact on preverbal vocalization of infants and on sound localization and speech perception both in quiet and in noise.Conclusions: No high-quality studies of consequences of early-onset UHI in children were found. Inconsistency in assessing and reporting outcomes, the relatively small number of participants, low directness of evidence, and the potential risk of confounding factors in the reviewed studies prevented any definite conclusions. Further well-designed prospective research using larger samples is warranted on this topic.
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21. |
- Huyghe, Jeroen R., et al.
(author)
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Genome-wide SNP analysis reveals no gain in power for association studies of common variants in the Finnish Saami
- 2010
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In: European Journal of Human Genetics. - : Nature Publishing Group. - 1018-4813 .- 1476-5438. ; 18:5, s. 569-574
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Journal article (peer-reviewed)abstract
- The Saami from Fennoscandia are believed to represent an ancient, genetically isolated population with no evidence of population expansion. Theoretical work has indicated that under this demographic scenario, extensive linkage disequilibrium (LD) is generated by genetic drift. Therefore, it has been suggested that the Saami would be particularly suited for genetic association studies, offering a substantial power advantage and allowing more economic study designs. However, no study has yet assessed this claim. As part of a GWAS for a complex trait, we evaluated the relative power for association studies of common variants in the Finnish Saami. LD patterns in the Saami were very similar to those in the non-African HapMap reference panels. Haplotype diversity was reduced and, on average, levels of LD were higher in the Saami as compared with those in the HapMap panels. However, using a 'hidden' SNP approach we show that this does not translate into a power gain in association studies. Contrary to earlier claims, we show that for a given set of common SNPs, genomic coverage attained in the Saami is similar to that in the non-African HapMap panels. Nevertheless, the reduced haplotype diversity could potentially facilitate gene identification, especially if multiple rare variants play a role in disease etiology. Our results further indicate that the HapMap is a useful resource for genetic studies in the Saami.
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22. |
- Huyghe, Jeroen R., et al.
(author)
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Genome-wide SNP-based linkage scan identifies a locus on 8q24 for an age-related hearing impairment trait
- 2008
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In: American Journal of Human Genetics. - : Cell Press. - 0002-9297 .- 1537-6605. ; 83:3, s. 401-407
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Journal article (peer-reviewed)abstract
- Age-related hearing impairment (ARHI), or presbycusis, is a very common multifactorial disorder. Despite the knowledge that genetics play an important role in the etiology of human ARHI as revealed by heritability studies, to date, its precise genetic determinants remain elusive. Here we report the results of a cross-sectional family-based genetic study employing audiometric data. By using principal component analysis, we were able to reduce the dimensionality of this multivariate phenotype while capturing most of the variation and retaining biologically important features of the audiograms. We conducted a genome-wide association as well as a linkage scan with high-density SNP microarrays. Because of the presence of genetic population substructure, association testing was stratified after which evidence was combined by meta-analysis. No association signals reaching genome-wide significance were detected. Linkage analysis identified a linkage peak on 8q24.13-q24.22 for a trait correlated to audiogram shape. The signal reached genome-wide significance, as assessed by simulations. This finding represents the first locus for an ARHI trait.
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23. |
- Karlsson, Elin, 1990-
(author)
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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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Doctoral thesis (other academic/artistic)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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24. |
- Karlsson, Elin, 1990-, et al.
(author)
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Hearing and Functioning in Everyday Life Questionnaire : Development and Validation of an ICF-Based Instrument
- 2023
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In: Ear and Hearing. - : Lippincott Williams & Wilkins. - 0196-0202 .- 1538-4667. ; 44:6, s. 1498-1506
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Journal article (peer-reviewed)abstract
- OBJECTIVES: Self-assessment instruments are commonly used in audiological rehabilitation. However, several studies highlight the lack of multidimensionality in existing outcome measures, with the consequence that they only partially capture aspects of functioning in everyday life for people living with hearing loss. This study aimed to develop and investigate the content validity of a self-assessment instrument based on the validated Brief International Classification of Functioning, Disability, and Health Core Set for Hearing Loss.DESIGN: The design was a two-part instrument development study. The first part focused on the item-generation process of the instrument, named the Hearing and Functioning in Everyday Life Questionnaire (HFEQ) during an experts' workshop. The second part focused on international content validation of the instrument using group interviews. Strategic sampling was used and 30 adults with hearing loss from India, South Africa, and the United States participated in the group interviews.RESULTS: The expert's workshop resulted in the first version of the HFEQ containing 30 items. The results from group interviews show that the content of the HFEQ was considered to be valid concerning its relevance, comprehensiveness, and comprehensibility. A majority (73%) of the HFEQ items were perceived by the participants as relevant and easy to comprehend. For the remaining 27% of the items, the content was perceived to be relevant in all countries, but some terms and expressions were reported to require rewording or clearer examples. These modifications will be made in the next step of the development process.CONCLUSION: Content validation of the HFEQ demonstrates promising results, with participants perceiving the content as relevant and comprehensible. Further psychometric validation is required to investigate other psychometric properties, such as construct validity and reliability. The HFEQ has the potential to become a valuable new instrument for assessing everyday functioning in people with hearing loss in audiological rehabilitation and in research.
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25. |
- Karlsson, Elin, 1990-, et al.
(author)
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Hearing and Functioning in Everyday Life Questionnaire : Psychometric Evaluation and Revision
- 2024
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In: American Journal of Audiology. - : American Speech-Language-Hearing Association. - 1059-0889 .- 1558-9137. ; 33:2, s. 330-342
-
Journal article (peer-reviewed)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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26. |
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27. |
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28. |
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29. |
- Karlsson, Elin, 1990-, et al.
(author)
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Validation of the Brief International Classification of Functioning, Disability and Health (ICF) core set for hearing loss : an international multicentre study
- 2021
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In: International Journal of Audiology. - : Routledge. - 1499-2027 .- 1708-8186. ; 60:6, s. 412-420
-
Journal article (peer-reviewed)abstract
- Objective: Hearing loss (HL) affects the everyday functioning of millions of people worldwide. The Brief International Classification of Functioning Disability and Health (ICF) core sets for HL was developed to meet the complex health care needs of adults with HL. Because the brief core set for HL has not yet been validated internationally, this study aimed to investigate its validity from an international perspective. Design: A cross-sectional validation study based on data from structured interviews with adults with HL. Study sample: Participants (n = 571) from India, South Africa, Sweden and the US were included. Results: A six-factor solution explained 71% of the variance, focussing on issues related to communication, the social environment, participation in society, health care services, support, relationships and emotions (α = 0.915). Three ICF categories demonstrated low reliability - temperament and personality functions, seeing functions and school education.Conclusion: The Brief ICF core set for HL is valid for adults with HL internationally. However, to further increase its international validity, we recommend adding the categories d920 recreation and leisure and replacing d850 school education with the more inclusive block, d810-d839 education.
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30. |
- Kytövuori, Laura, et al.
(author)
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A nonsynonymous mutation in the WFS1 gene in a Finnish family with age-related hearing impairment
- 2017
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In: Hearing Research. - Amsterdam, Netherlands : Elsevier. - 0378-5955 .- 1878-5891. ; 355, s. 97-101
-
Journal article (peer-reviewed)abstract
- Wolfram syndrome (WS) is caused by recessive mutations in the Wolfram syndrome 1 (WFS1) gene. Sensorineural hearing impairment (HI) is a frequent feature in WS and, furthermore, certain mutations in WFS1 cause nonsyndromic dominantly inherited low-frequency sensorineural HI. These two phenotypes are clinically distinct indicating that WFS1 is a reasonable candidate for genetic studies in patients with other phenotypes of HI. Here we have investigated, whether the variation in WFS1 has a pathogenic role in age-related hearing impairment (ARHI). WFS1 gene was investigated in a population sample of 518 Finnish adults born in 1938-1949 and representing variable hearing phenotypes. Identified variants were evaluated with respect to pathogenic potential. A rare mutation predicted to be pathogenic was found in a family with many members with impaired hearing. Twenty members were recruited to a segregation study and a detailed clinical examination. Heterozygous p.Tyr528His variant segregated completely with late-onset HI in which hearing deteriorated first at high frequencies and progressed to mid and low frequencies later in life. We report the first mutation in the WFS1 gene causing late-onset HI with audiogram configurations typical for ARHI. Monogenic forms of ARHI are rare and our results add WFS1 to the short list of such genes.
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31. |
- Laugen, Nina Jakhelln, et al.
(author)
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Newborn Hearing Screening and Intervention in Children with Unilateral Hearing Impairment : Clinical Practices in Three Nordic Countries
- 2021
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In: Journal of Clinical Medicine. - Basel : MDPI. - 2077-0383. ; 10:21
-
Journal article (peer-reviewed)abstract
- Studies have limitedly considered children with early-identified unilateral hearing impairment (UHI), and clinical practices regarding screening, diagnostics and habilitation in this group are rarely documented. In this study, routines for newborns with UHI from screening to diagnostics and habilitation were explored in Norway, Sweden and Finland. An online survey was sent to hospitals responsible for the hearing diagnostics of children requesting information about their practices regarding congenital UHI. Responses covered 95% of the children born in the three included countries. The results revealed large variations in ways of organising healthcare and in clinical decisions regarding hearing screening, diagnostics and habilitation of children with congenital UHI. Finally, implications for policy making and research are also discussed.
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32. |
- Lohi, Venla, et al.
(author)
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Hearing impairment among adults : the impact of cardiovascular diseases and cardiovascular risk factors
- 2015
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In: International Journal of Audiology. - : Taylor & Francis. - 1499-2027 .- 1708-8186. ; 54:4, s. 265-73
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To investigate the influence of cardiovascular diseases on hearing impairment (HI) among adults. Furthermore, to seek other potential risk factors for HI, such as smoking, obesity, and socioeconomic class.DESIGN: A cross-sectional, unscreened, population-based, epidemiological study among adults.STUDY SAMPLE: The subjects (n = 850), aged 54-66 years, were randomly sampled from the population register. A questionnaire survey, an otological examination, and pure-tone audiometry were performed.RESULTS: Cardiovascular diseases did not increase the risk for HI in a propensity-score adjusted logistic regression model: OR 1.24, 95% CI 0.79 to 1.96 for HI defined by better ear hearing level (BEHL), and OR 1.48, 95% CI 0.96 to 2.28 for HI defined by worse ear hearing level (WEHL), in the 0.5-4 kHz frequency range. Heavy smoking is a risk factor for HI among men (BEHL: OR 1.96, WEHL: OR 1.88) and women (WEHL: OR 2.4). Among men, obesity (BEHL, OR 1.85) and lower socioeconomic class (BEHL: OR 2.79, WEHL: OR 2.28) are also risk factors for HI.CONCLUSION: No significant association between cardiovascular disease and HI was found.
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33. |
- Lohi, Venla, et al.
(author)
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Hearing impairment is common among Saami adults in Northern Finland
- 2017
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In: International Journal of Circumpolar Health. - : Taylor & Francis. - 1239-9736 .- 2242-3982. ; 76:1
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Journal article (peer-reviewed)abstract
- The Saami are the only indigenous population in Europe and their traditional living area is northern Scandinavia. Hearing impairment (HI) among Saami has not been studied before. The objective was to investigate the presence and type of HI among Saami adults, aged 49-77 years (median age 61 years), living in northern Finland. In addition, the presence of self-reported hearing difficulties, difficulties to hear in background noise and tinnitus were studied. An epidemiological, cross-sectional study encompassing a structured interview, otological examination and audiometry was performed. Bilateral HI was present in 42.9% of men and 29.4% of women, when HI was defined as a pure tone average (PTA) of at least 20 dB hearing level (HL) or more at the frequencies of 0.5, 1, 2 and 4 kHz. In one or both ears (worse ear hearing level, WEHL0.5,1,2,4≥20 dB HL) HI was present in 61.8% of men and 42.2% of women. Sensorineural high frequency hearing impairment was found to be most common. Nearly half (46.9%) of the study subjects reported hearing problems and more than half (55.6%) reported difficulties in following conversation in background noise. Measured HI and subjective hearing difficulties are common among the Saami adults. The healthcare personnel working in this area should be aware of the hearing problems of the Saami population.ABBREVIATIONS: ARHI, Age-related hearing impairment; PTA, Pure tone average; HI, Hearing impairment; HL, Hearing level; BEHL, Better ear hearing level; WEHL, Worse ear hearing level; CI, Confidence interval.
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34. |
- Lohi, Venla, et al.
(author)
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Prevalence and incidence of hearing impairment among adults : a 13-year follow-up study
- 2021
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In: International Journal of Audiology. - : Routledge. - 1499-2027 .- 1708-8186. ; 60:9, s. 687-694
-
Journal article (peer-reviewed)abstract
- OBJECTIVE: The aim of this study was to investigate the prevalence and incidence of hearing impairment (HI) in a longitudinal setting among adults.DESIGN: An unscreened, population-based epidemiological 13-year follow-up study. Study sample: 850 randomly sampled 54 to 66-year-old baseline participants, of whom 559 participated in the follow-up study at the age of 68 to 79 years. A questionnaire-based interview, an otological examination and pure-tone audiometry were performed.RESULTS: The overall prevalence of HI was 70.3%, defined by better ear hearing level (BEHL) ≥ 20 dB in the 0.5-4 kHz frequency range. The prevalence was higher among men (78.6%) than among women (63.7%). The overall incidence rate for HI was 45.8 per 1000 person years and the 13-year cumulative incidence was 60.9%. The incidence was higher among men and older participants.CONCLUSION: HI is highly prevalent and incident among older adults in Northern Finland.
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35. |
- Lohi, Venla, et al.
(author)
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The impact of cardiovascular diseases on hearing deterioration : a 13-year follow-up study
- 2022
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In: International Journal of Audiology. - : Routledge. - 1499-2027 .- 1708-8186. ; 61:10, s. 826-831
-
Journal article (peer-reviewed)abstract
- OBJECTIVE: To study the impact of cardiovascular diseases (CVDs) on hearing deterioration among ageing adults in a longitudinal setting. Furthermore, to describe the pure tone threshold changes at the 0.125-8 kHz frequency range over 13 years.DESIGN: A population-based follow-up study.STUDY SAMPLE: A random sample of 850 adults, of whom 559 participated in the follow-up study. Otological examination, a structured interview, and pure tone audiometry were conducted. Multivariate regression models were used to estimate the effect of CVD (participants had at least one cardiovascular condition) on hearing deterioration of the better ear hearing level (BEHL), defined as a change in the pure-tone average (PTA) of the frequencies 0.5, 1, 2, and 4 kHz and separately at the lower (0.125, 0.25, and 0.5 kHz) and higher (4, 6, and 8 kHz) frequencies.RESULTS: In the multivariable-adjusted analysis, the BEHL change at 13 years was 0.7 dB greater among participants with CVD (p = 0.3). The mean BEHL change during the 13-year follow-up was 12.0 dB (95% CI 11.4-12.6) among all participants.CONCLUSIONS: No significant association between CVD and hearing threshold changes was found.
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36. |
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37. |
- Lyxell, Björn, et al.
(author)
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Cognitive development, reading and prosodic skills in children with cochlear implants
- 2009
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In: Scandinavian Journal of Psychology. - : Wiley. - 1467-9450 .- 0036-5564. ; 50:5, s. 463-474
-
Journal article (peer-reviewed)abstract
- This report summarizes some of the results of studies in our laboratory exploring the development of cognitive, reading and prosodic skills in children with cochlear implantation (CI). The children with CI performed at significantly lower levels than the hearing comparison group on the majority of cognitive tests, despite showing levels of nonverbal ability. The differences between children with CI and hearing children were most pronounced on tasks with relatively high phonological processing demands, but they were not limited to phonological processing. Impairment of receptive and productive prosody was also evident in children with CI. Despite these difficulties, 75% of the children with CI reached a level of reading skill comparable to that of hearing children. The results are discussed with respect to compensation strategies in reading.
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38. |
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39. |
- Mackey, Allison R., et al.
(author)
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Protocol and programme factors associated with referral and loss to follow-up from newborn hearing screening : a systematic review
- 2022
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In: BMC Pediatrics. - : BioMed Central (BMC). - 1471-2431. ; 22:1
-
Research review (peer-reviewed)abstract
- BACKGROUND: An effective newborn hearing screening programme has low referral rate and low loss to follow-up (LTFU) rate after referral from initial screening. This systematic review identified studies evaluating the effect of protocol and programme factors on these two outcomes, including the screening method used and the infant group.METHODS: Five databases were searched (latest: April 2021). Included studies reported original data from newborn hearing screening and described the target outcomes against a protocol or programme level factor. Studies were excluded if results were only available for one risk condition, for each ear, or for < 100 infants, or if methodological bias was observed. Included studies were evaluated for quality across three domains: sample, screening and outcome, using modified criteria from the Ottawa-Newcastle and QUADAS-2 scales. Findings from the included studies were synthesised in tables, figures and text.RESULTS: Fifty-eight studies reported on referral rate, 8 on LTFU rate, and 35 on both. Only 15 studies defined LTFU. Substantial diversity in referral and LTFU rate was observed across studies. Twelve of fourteen studies that evaluated screening method showed lower referral rates with aABR compared to TEOAE for well babies (WB). Rescreening before hospital discharge and screening after 3 days of age reduced referral rates. Studies investigating LTFU reported lower rates for programmes that had audiologist involvement, did not require fees for step 2, were embedded in a larger regional or national programme, and scheduled follow-up in a location accessible to the families. In programmes with low overall LTFU, higher LTFU was observed for infants from the NICU compared to WB.CONCLUSION: Although poor reporting and exclusion of non-English articles may limit the generalisability from this review, key influential factors for referral and LTFU rates were identified. Including aABR in WB screening can effectively reduce referral rates, but it is not the only solution. The reported referral and LTFU rates vary largely across studies, implying the contribution of several parameters identified in this review and the context in which the programme is performed. Extra attention should be paid to infants with higher risk for hearing impairment to ensure their return to follow-up.
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40. |
- Mackey, Allison, et al.
(author)
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Revisiting the transient-evoked otoacoustic emissions passing criteria used for newborn hearing screening
- 2024
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In: International Journal of Audiology. - : Taylor & Francis. - 1499-2027 .- 1708-8186.
-
Journal article (peer-reviewed)abstract
- Objective: To assess transient-evoked otoacoustic emissions (TEOAE) data from 15 years of a newborn hearing screening program and evaluate how well various criteria separate ears with and without hearing loss.Design: Retrospective review of TEOAE data using logistic regression, receiver operating characteristic curves, and cumulative percentage graphs.Study sample: Children with hearing loss who passed TEOAE screening as a newborn were compared to children who failed TEOAE screening and normal hearing children who either passed or failed. Exclusions were applied for acquired hearing loss or auditory neuropathy.Results: Ears with hearing loss that passed screening had significantly lower TEOAE response levels compared to ears with normal hearing. Noise levels, test times, and number of sweeps were also lower. Most of these ears had mild hearing loss. Logistic regression results showed that high-frequency TEOAE response level is the best predictor of hearing loss. A multivariate "logit" score calculated from the regression was the best indicator for separating ears with hearing loss from ears with normal hearing.Conclusions: TEOAE response levels or an algorithm which incorporates logit scores should be considered as a minimum passing criterion to increase the sensitivity of the TEOAE screening.
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41. |
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42. |
- Mäki-Torkko, Elina, 1961-, et al.
(author)
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Hearing impairment among adults : extent of the problem and scientific evidence on the outcome of hearing aid rehabilitation
- 2001
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In: Scandinavian audiology. Supplementum. - : Taylor & Francis. - 0107-8593 .- 0105-0397. ; 30:54
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Journal article (peer-reviewed)abstract
- Scientific surveys on current and estimated prevalence of hearing impairment (HI) in adult populations (> or = 18 years of age) in Denmark, Finland, Norway, Sweden and the United Kingdom, and scientific reports on the outcome of hearing aid (HA) rehabilitation worldwide were reviewed. Only a few of the studies meet strict scientific criteria, and many locally clinically relevant studies cannot be generalized to larger populations. Population-based studies indicate an increase in prevalence of HI with age, but because of differences in study populations and available national population statistics, the studies do not allow reliable comparisons between countries or estimation of future prevalence of HI. Studies on HA prescription or outcomes do not provide uniform data in favour of non-linear amplification, but they do show some subject preference for the newer technology. No conclusions can be drawn regarding the degree of HI and the effects of amplification. The literature review alone gives only limited information regarding the extent of the problem of HI in adult populations in the target countries. Similarly, only a few studies on HA outcome meet strict scientific criteria and even fewer studies correlate rehabilitation outcome with the degree of HI, disability or handicap.
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44. |
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45. |
- Mäki-Torkko, Elina, 1961-, et al.
(author)
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Ikääntyvän kuulo
- 2006
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In: Suomen lääkärilehti. - 0039-5560. ; 61, s. 1337-1341
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Journal article (pop. science, debate, etc.)abstract
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46. |
- Mäki-Torkko, Elina Margareetta, 1961-, et al.
(author)
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From isolation and dependence to autonomy - expectations before and experiences after cochlear implantation in adult cochlear implant users and their significant others
- 2015
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In: Disability and Rehabilitation. - : Informa Healthcare. - 0963-8288 .- 1464-5165. ; 37:6, s. 541-547
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Journal article (peer-reviewed)abstract
- Purpose: The aim of the study was to examine pre-operative expectations and the postoperative experiences related to cochlear implants (CI) in CI-users and their significant others.Methods: A questionnaire was used and the responses were analysed by means of The Qualitative Content Analysis. All adults implanted between 1992 and 2010, who had had their implants for a minimum of 12 months (n = 120) were contacted. Response rate was high (90.8%), and all-inclusive answers were received from 101 CI-users (84.2%).Results: The overall sense of increased well-being and life satisfaction was described as having lived in two different worlds, one with the auditory stimulation and one without. In the overall sense of increased well-being and satisfaction three interwoven subcategories, alienation - normality, fear - autonomy, and living a social life emerged. When CI-users and their significant others recalled the time prior to receiving the CI, a sense of fear was present with origins in the concern for the respondents' (CI-users) ability to cope and care independently in society. Conversely, after the implantation both parties emphasized the notion of a distinct transformation within the CI-user towards autonomy. Communication was highlighted as a large part of living social life.Conclusion: The CI increases well-being and satisfaction for both CI-users and their significant others, which is especially evident regarding enhanced autonomy, normality and living social life.
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47. |
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48. |
- Schart-Morén, Nadine
(author)
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The Human Cochlea and Cochlear Implantation : Morphological Characteristics and Clinical Correlations
- 2018
-
Doctoral thesis (other academic/artistic)abstract
- The most common sensory deficit in the world is sensorineural hearing loss. Cochlear implantation (CI) can majorly contribute to restore hearing, not only in patients with severe to profound hearing loss, but also in hearing-impaired patients with residual low-frequency hearing. The overall aims of the present thesis were to study human cochlear anatomy in order to improve structural preservation during CI surgery. An archival collection of temporal bones underwent micro-computer tomography and synchrotron radiation phase-contrast imaging (SR-PCI) with 3D reconstructions, new techniques to digitally image and reproduce the human inner ear. Studying the anatomy of the facial nerve and its interaction with the cochlea revealed that a fusion of the two was found in 1.4 % of the specimens (cochlear-facial dehiscence). This may cause facial nerve excitation after CI. CT-scans and intraoperative electrically auditory brainstem response (e-ABR) measurements were analyzed in patients with cochlear-facial dehiscence. A large evoked late myogenic potential at low stimulation levels during intraoperative e-ABR measurements, can foresee excitation at CI activation. The 3D anatomy of the fundus of the inner acoustic canal was also studied, helping to interpret preoperative imaging of the VIIIth nerve before CI. In a subsequent study, SR-PCI reproduced the soft tissue anatomy at the round window region. Results indicated a high risk for trauma at cochleostomy. For optimal preservation, the round window approach was recommended. In a long-term follow-up the first 21 consecutively operated patients in Uppsala, that underwent hearing preservation CI-surgery, data could be retrieved in 15 patients. Pure tone audiometry was assessed preoperatively and at one, three and >5 years following surgery. Insertion angle, number of electrodes inside the cochlea, user-time of the processor, and stimulation strategies were documented. Results showed that long-term preservation of hearing is possible in most cases. There was a high correlation between insertion depth and preservation of residual hearing. Also, patients with complete hearing loss experienced good performance in speech discrimination and user time.
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49. |
- Uusimaa, Johanna, et al.
(author)
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Prevalence, segregation, and phenotype of the mitochondrial DNA 3243A>G mutation in children
- 2007
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In: Annals of Neurology. - : John Wiley & Sons. - 0364-5134 .- 1531-8249. ; 62:3, s. 278-287
-
Journal article (peer-reviewed)abstract
- OBJECTIVE: We studied the prevalence, segregation, and phenotype of the mitochondrial DNA 3243A>G mutation in children in a defined population in Northern Ostrobothnia, Finland.METHODS: Children with diagnoses commonly associated with mitochondrial diseases were ascertained. Blood DNA from 522 selected children was analyzed for 3243A>G. Children with the mutation were clinically examined. Information on health history before the age of 18 years was collected from previously identified adult patients with 3243A>G. Mutation segregation analysis in buccal epithelial cells was performed in mothers with 3243A>G and their children whose samples were analyzed anonymously.RESULTS: Eighteen children were found to harbor 3243A>G in a population of 97,609. A minimum estimate for the prevalence of 3243A>G was 18.4 in 100,000 (95% confidence interval, 10.9-29.1/100,000). Information on health in childhood was obtained from 37 adult patients with 3243A>G. The first clinical manifestations appearing in childhood were sensorineural hearing impairment, short stature or delayed maturation, migraine, learning difficulties, and exercise intolerance. Mutation analysis from 13 mothers with 3243A>G and their 41 children gave a segregation rate of 0.80. The mothers with heteroplasmy greater than 50% tended to have offspring with lower or equal heteroplasmy, whereas the opposite was true for mothers with heteroplasmy less than or equal to 50% (p = 0.0016).INTERPRETATION: The prevalence of 3243A>G is relatively high in the pediatric population, but the morbidity in children is relatively low. The random genetic drift model may be inappropriate for the transmission of the 3243A>G mutation.
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50. |
- Van Laer, Lut, et al.
(author)
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A genome-wide association study for age-related hearing impairment in the Saami
- 2010
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In: European Journal of Human Genetics. - : BMJ Publishing Group Ltd. - 1018-4813 .- 1476-5438. ; 18:6, s. 685-693
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Journal article (peer-reviewed)abstract
- This study aimed at contributing to the elucidation of the genetic basis of age-related hearing impairment (ARHI), a common multifactorial disease with an important genetic contribution as demonstrated by heritability studies. We conducted a genome-wide association study (GWAS) in the Finnish Saami, a small, ancient, genetically isolated population without evidence of demographic expansion. The choice of this study population was motivated by its anticipated higher extent of LD, potentially offering a substantial power advantage for association mapping. DNA samples and audiometric measurements were collected from 352 Finnish Saami individuals, aged between 50 and 75 years. To reduce the burden of multiple testing, we applied principal component (PC) analysis to the multivariate audiometric phenotype. The first three PCs captured 80% of the variation in hearing thresholds, while maintaining biologically important audiometric features. All subjects were genotyped with the Affymetrix 100 K chip. To account for multiple levels of relatedness among subjects, as well as for population stratification, association testing was performed using a mixed model. We summarised the top-ranking association signals for the three traits under study. The top-ranked SNP, rs457717 (P-value 3.55 x 10(-7)), was associated with PC3 and was localised in an intron of the IQ motif-containing GTPase-activating-like protein (IQGAP2). Intriguingly, the SNP rs161927 (P-value 0.000149), seventh-ranked for PC1, was positioned immediately downstream from the metabotropic glutamate receptor-7 gene (GRM7). As a previous GWAS of a European and Finnish sample set already suggested a role for GRM7 in ARHI, this study provides further evidence for the involvement of this gene.
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