Abby McCormack

Why do people fitted with hearing aids not wear them

Abstract Objective: Age-related hearing loss is an increasingly important public health problem affecting approximately 40% of 55–74 year olds. The primary clinical management intervention for people with hearing loss is hearing aids, however, the majority (80%) of adults aged 55–74 years who would benefit from a hearing aid, do not use them. Furthermore, many people given a hearing aid do not wear it. The aim was to collate the available evidence as to the potential reasons for non-use of hearing aids among people who have been fitted with at least one. Design: Data were gathered via the use of a scoping study. Study sample: A comprehensive search strategy identified 10 articles reporting reasons for non-use of hearing aids. Results: A number of reasons were given, including hearing aid value, fit and comfort and maintenance of the hearing aid, attitude, device factors, financial reasons, psycho-social/situational factors, healthcare professionals attitudes, ear problems, and appearance. Conclusions: The most important issues were around hearing aid value, i.e. the hearing aid not providing enough benefit, and comfort related to wearing the hearing aid. Identifying factors that affect hearing aid usage are necessary for devising appropriate rehabilitation strategies to ensure greater use of hearing aids.

Hearing loss and cognition: the role of hearing AIDS, social isolation and depression.

Hearing loss is associated with poor cognitive performance and incident dementia and may contribute to cognitive decline. Treating hearing loss with hearing aids may ameliorate cognitive decline. The purpose of this study was to test whether use of hearing aids was associated with better cognitive performance, and if this relationship was mediated via social isolation and/or depression. Structural equation modelling of associations between hearing loss, cognitive performance, social isolation, depression and hearing aid use was carried out with a subsample of the UK Biobank data set (n = 164,770) of UK adults aged 40 to 69 years who completed a hearing test. Age, sex, general health and socioeconomic status were controlled for as potential confounders. Hearing aid use was associated with better cognition, independently of social isolation and depression. This finding was consistent with the hypothesis that hearing aids may improve cognitive performance, although if hearing aids do have a positive effect on cognition it is not likely to be via reduction of the adverse effects of hearing loss on social isolation or depression. We suggest that any positive effects of hearing aid use on cognition may be via improvement in audibility or associated increases in self-efficacy. Alternatively, positive associations between hearing aid use and cognition may be accounted for by more cognitively able people seeking and using hearing aids. Further research is required to determine the direction of association, if there is any direct causal relationship between hearing aid use and better cognition, and whether hearing aid use results in reduction in rates of cognitive decline measured longitudinally.

An Empirical Study of Gender Differences in Online Gambling

Gambling has typically been considered a predominately male activity. However, recent prevalence surveys have shown greater numbers of females are now gambling. Much of the gambling literature suggests online gamblers are more likely to be male, and that problem gamblers are more likely to be male. Males and females are also likely to be gambling for different reasons and have a preference for different gambling activities. Little is known about the pattern of play among female online gamblers. The aim of this survey was to develop a better profile of female online gamblers and to examine any gender differences between males and females in terms of how and why they gamble online, their frequency of online gambling, patterns of play, as well as attitudes to online gambling. The survey was posted on 32 international online gambling websites and was completed by 975 online gamblers (including 175 female online gamblers). Chi-square tests of association were conducted to examine the association between gender and a range of variables. The results showed that females had been gambling online for a shorter duration of time than males, had much shorter online gambling sessions, different motivations for gambling online (i.e., to practice for free, to spend less money and out of boredom), and experienced online gambling differently to males, with increased feelings of guilt and shame for gambling online. This suggests there is still a stigma around gambling particularly evident among females in this study. The findings indicate that clinicians and treatment providers need to be aware of these potential gender differences in online gambling to develop appropriately tailored interventions.

What Differentiates Professional Poker Players from Recreational Poker Players? A Qualitative Interview Study

The popularity of poker (and in particular online poker) has increasingly grown worldwide in recent years. This increase in the popularity of poker has led to the increased incidence of the ‘professional poker player’. However, very little empirical research has been carried out into this relatively new group of gamblers. The aim was to determine how professional poker players are able to make a living from playing poker and what differentiates them from recreational poker players. This research comprised a grounded theory study involving the analysis of data from three professional poker players, one semi-professional poker player and five recreational poker players. Using a process of open coding, focused coding and theoretical sampling, in addition to constant comparison of the data, a number of themes and categories emerged. The central theme as to what distinguishes professional poker players from recreational players was that professional poker players were much more disciplined in their gambling behaviour. They treated their poker playing as work, and as such were more likely to be logical and controlled in their behaviour, took less risks, and were less likely to chase losses. Recreational players were more likely to engage in chasing behaviour, showed signs of lack of control, took more risks, and engaged in gambling while under the influence of alcohol or drugs. Also of importance was the number of games and time spent playing online. Recreational players only played one or two games at a time, whereas professional poker players were much more likely to engage in multi-table poker online, and played longer sessions, thus increasing the potential amount of winnings. Playing poker for a living is very possible for a minority of players but it takes a combination of talent, dedication, patience, discipline and disposition to succeed.

Relation between Speech-in-Noise Threshold, Hearing Loss and Cognition from 40–69 Years of Age

Background Healthy hearing depends on sensitive ears and adequate brain processing. Essential aspects of both hearing and cognition decline with advancing age, but it is largely unknown how one influences the other. The current standard measure of hearing, the pure-tone audiogram is not very cognitively demanding and does not predict well the most important yet challenging use of hearing, listening to speech in noisy environments. We analysed data from UK Biobank that asked 40–69 year olds about their hearing, and assessed their ability on tests of speech-in-noise hearing and cognition. Methods and Findings About half a million volunteers were recruited through NHS registers. Respondents completed ‘whole-body’ testing in purpose-designed, community-based test centres across the UK. Objective hearing (spoken digit recognition in noise) and cognitive (reasoning, memory, processing speed) data were analysed using logistic and multiple regression methods. Speech hearing in noise declined exponentially with age for both sexes from about 50 years, differing from previous audiogram data that showed a more linear decline from <40 years for men, and consistently less hearing loss for women. The decline in speech-in-noise hearing was especially dramatic among those with lower cognitive scores. Decreasing cognitive ability and increasing age were both independently associated with decreasing ability to hear speech-in-noise (0.70 and 0.89 dB, respectively) among the population studied. Men subjectively reported up to 60% higher rates of difficulty hearing than women. Workplace noise history associated with difficulty in both subjective hearing and objective speech hearing in noise. Leisure noise history was associated with subjective, but not with objective difficulty hearing. Conclusions Older people have declining cognitive processing ability associated with reduced ability to hear speech in noise, measured by recognition of recorded spoken digits. Subjective reports of hearing difficulty generally show a higher prevalence than objective measures, suggesting that current objective methods could be extended further.

Motivating and Inhibiting Factors in Online Gambling Behaviour: A Grounded Theory Study

To date, there has been very little empirical research examining why people gamble online or—just as importantly—why they do not gamble online. A grounded theory study examining the motivating and inhibiting factors in online gambling was carried out. The sample comprised 15 online gamblers, 14 offline gamblers, and 11 non-gamblers, and resulted in the identification of one major theme as to why participants were motivated to gamble online (i.e., greater opportunity to gamble) and four sub-themes (i.e., convenience, value for money, the greater variety of games, and anonymity). The main reason that inhibited online gambling was that the authenticity of gambling was reduced when gambling online. Four further sub-themes were identified as inhibitors of online gambling (i.e., the reduced realism, the asocial nature of the internet, the use of electronic money, and concerns about the safety of online gambling websites). Results also indicated that the participants’ perception was that online gambling was more addictive than offline gambling and that online gambling would exacerbate gambling problems in society.

Individuals With Eating Disorders and the Use of Online Support Groups as a Form of Social Support

The increase in Internet use in recent years has fostered the development of online support groups to help individuals cope with a number of conditions. Individuals with eating disorders may particularly benefit from such groups as they provide a means of sharing experiences, knowledge, and support with like-minded individuals without the anxiety and worry of others negatively evaluating their appearance. The aim of this study was to examine the nature and types of social support that took place on an anorexia discussion forum. The deductive thematic analysis of 325 messages indicates that the primary function of the group was the communication of encouragement and esteem and information support notably in terms of diagnosis, treatment, and interaction with healthcare specialists. Considering the high rate of relapse among individuals with eating disorders, it is imperative that some form of support is available when they leave treatment centers. Regulated computer-mediated support groups provide a low-cost, easily accessible self-help service to individuals with eating disorders.

Hearing in middle age: A population snapshot of 40- to 69-year olds in the united kingdom

Objectives: To report population-based prevalence of hearing impairment based on speech recognition in noise testing in a large and inclusive sample of U.K. adults aged 40 to 69 years. The present study is the first to report such data. Prevalence of tinnitus and use of hearing aids is also reported. Design: The research was conducted using the UK Biobank resource. The better-ear unaided speech reception threshold was measured adaptively using the Digit Triplet Test (n = 164,770). Self-report data on tinnitus, hearing aid use, noise exposure, as well as demographic variables were collected. Results: Overall, 10.7% of adults (95% confidence interval [CI] 10.5–10.9%) had significant hearing impairment. Prevalence of tinnitus was 16.9% (95%CI 16.6–17.1%) and hearing aid use was 2.0% (95%CI 1.9–2.1%). Odds of hearing impairment increased with age, with a history of work- and music-related noise exposure, for lower socioeconomic background and for ethnic minority backgrounds. Males were at no higher risk of hearing impairment than females. Conclusions: Around 1 in 10 adults aged 40 to 69 years have substantial hearing impairment. The reasons for excess risk of hearing impairment particularly for those from low socioeconomic and ethnic minority backgrounds require identification, as this represents a serious health inequality. The underuse of hearing aids has altered little since the 1980s, and is a major cause for concern.

An examination of participation in online gambling activities and the relationship with problem gambling

Background and aims Online gambling participation is increasing rapidly, with relatively little research about the possible effects of different gambling activities on problem gambling behaviour. The aim of this exploratory study was to examine the participation in online gambling activities and the relationship with problem gambling among an international sample of online gamblers. Methods An online gambling survey was posted on 32 international gambling websites and resulted in 1,119 respondents over a four-month period. Results Poker was the most popular gambling activity online. A number of online activities were associated with problem gambling, including: roulette, poker, horse race betting, sports betting, spread betting and fruit (slot) machines. Not surprisingly, those that gambled on these activities regularly (except poker) were more likely to be a problem gambler, however, what is interesting is that the reverse is true for poker players; those that gambled regularly on poker were less likely to be a problem gambler compared to the non-regular poker players. The majority of the players also gambled offline, but there was no relationship between problem gambling and whether or not a person also gambled offline. Discussion Problem gambling is associated more with certain online gambling activities than others, and those gambling on two or more activities online were more likely to be a problem gambler. Conclusion This paper can help explain the impact different online gambling activities may have on gambling behaviour. Consideration needs to be given to the gambling activity when developing and implementing treatment programmes.

Investigating the association between tinnitus severity and symptoms of depression and anxiety, while controlling for neuroticism, in a large middle-aged UK population.

Abstract Objective: Clinical studies indicate increased risk for depression and anxiety among tinnitus patients. However population data are scarce, and no studies have controlled for neuroticism. We examined associations between tinnitus and symptoms of depression and anxiety in a large UK population, controlling for neuroticism, to explore whether neuroticism, as previously reported, fully explains the association between symptoms of depression and anxiety, and tinnitus. Design: We used the UK Biobank resource. Study sample: 171 728 participants answered hearing questions. Results: Using generalized linear modelling, we examined associations between tinnitus (mild to severe) and symptoms of depression and anxiety. Controlling for neuroticism, patients with severe tinnitus were at increased risk of depression (odds ratio (OR) = 1.27) and anxiety (OR = 1.11) symptoms, compared to those without tinnitus. Conclusions: Although it is not possible to determine whether tinnitus is a predisposing factor to depression, these results suggest an association. We suggest further exploration to determine the clinical significance of this association. Early psychosocial intervention aimed at reducing anxiety and depression in patients at increased risk might influence the extent to which tinnitus is experienced as troubling, and therefore psychological distress associated with it. Likewise, with tinnitus patients, assessment for anxiety/depression should be considered.