Alexander B Barker

Coping together with hearing loss: a qualitative meta-synthesis of the psychosocial experiences of people with hearing loss and their communication partners

Abstract Objective: To examine the psychosocial experiences of hearing loss from the perspectives of both the person with hearing loss and their communication partner. Design: A meta-synthesis of the qualitative literature. Study Sample: From 880 records, 12 qualitative papers met the inclusion criteria, (i) adults with hearing loss, communication partners, or both, and (ii) explored psychosocial issues. Results: Four themes related to the psychosocial experience of hearing loss were found, (i) the effect of the hearing loss, (ii) the response to hearing aids, (iii) stigma and identity, and (iv) coping strategies. Hearing loss affected both people with hearing loss and communication partners. Hearing aids resulted in positive effects, however, these were often outnumbered by negative effects. Non-use of hearing aids was often influenced by stigma. Coping strategies used were related to how the person with hearing loss perceived their self and how the communication partner perceived the relationship. Aligned coping strategies appeared to have a positive effect. Conclusions: Hearing loss affects both people with hearing loss and their communication partners. Aligned coping strategies can facilitate adjustment to hearing loss.

Effectiveness of alternative listening devices to conventional hearing aids for adults with hearing loss: a systematic review protocol

Introduction Hearing loss is a major public health concern, affecting over 11 million people in the UK. While hearing aids are the most common clinical intervention for hearing loss, the majority of people that would benefit from using hearing aids do not take them up. Recent technological advances have led to a rapid increase of alternative listening devices to conventional hearing aids. These include hearing aids that can be customised using a smartphone, smartphone-based ‘hearing aid’ apps, personal sound amplification products and wireless hearing products. However, no systematic review has been published evaluating whether alternative listening devices are an effective management strategy for people with hearing loss. Methods and analysis The objective of this systematic review is to assess whether alternative listening devices are an effective intervention for adults with hearing loss. Methods are reported according to the Preferred Reporting Items for Systematic reviews and Meta-analyses Protocols (PRISMA-P) 2015 checklist. Retrospective or prospective studies, randomised controlled trials, non-randomised controlled trials, and before-after comparison studies will be eligible for inclusion. We will include studies with adult participants (≥18 years) with a mild or moderate hearing loss. The intervention should be an alternative listening device to a conventional hearing aid (comparison). Studies will be restricted to outcomes associated with the consequences of hearing loss. We will search relevant databases to identify published, completed but unpublished and ongoing trials. The overall quality of included evidence will be evaluated using the GRADE system, and meta-analysis performed if appropriate. Ethics and dissemination No ethical issues are foreseen. The findings will be reported at national and international conferences, primarily audiology, and ear, nose and throat, and in a peer-reviewed journal using the PRISMA guidelines. Review registration number PROSPERO CRD4201502958.

Population exposure to smoking and tobacco branding in the UK reality show ‘Love Island’

Background Reality television shows are popular with children and young adults; inclusion of tobacco imagery in these programmes is likely to cause smoking in these groups. Series 3 of the UK reality show Love Island, broadcast in 2017, attracted widespread media criticism for high levels of smoking depicted. We have quantified this tobacco content and estimated the UK population exposure to generic and branded tobacco imagery generated by the show. Methods We used 1-min interval coding to quantify actual or implied tobacco use, tobacco paraphernalia or branding, in alternate episodes of series 3 of Love Island, and Census data and viewing figures from Kantar Media to estimate gross and per capita tobacco impressions. Results We coded 21 episodes comprising 1001 min of content. Tobacco imagery occurred in 204 (20%) intervals; the frequency of appearances fell significantly after media criticism. An identifiable cigarette brand, Lucky Strike Double Click, appeared in 16 intervals. The 21 episodes delivered an estimated 559 million gross tobacco impressions to the UK population, predominantly to women, including 47 million to children aged <16 and 44 million gross impressions of Lucky Strike branding, including 4 million to children <16. Conclusion Despite advertising legislation and broadcasting regulations intended to protect children from smoking imagery in UK television, series 3 of Love Island delivered millions of general and branded tobacco impressions both to children and adults in the UK. More stringent controls on tobacco content in television programmes are urgently needed.

A Content Analysis of Tobacco Content in UK Television

Aims Exposure to audiovisual tobacco content in media is a risk factor for smoking in young people. While tobacco content in films has been extensively documented, content in mainstream television has received relatively little attention. We report an analysis of tobacco content in a sample of UK free-to-air prime-time television broadcasts in 2015, and compare this with a similar analysis from 2010. Design Content analysis of all programmes and advertisements or trailers broadcast on the five national UK free-to-air channels in the UK between 18:00 and 22:00 during three separate weeks in September, October and November 2015. Setting Great Britain. Participants None (media analysis only). Measurements Occurrence of any tobacco, tobacco use, implied use, other tobacco reference/related objects and branding in every 1 min coding interval. Findings Tobacco content occurred in 33% of all programmes and 8% of all adverts or programme trailer breaks. Actual tobacco use occurred in 12% of all programmes broadcast. Tobacco-related objects, primarily no smoking signs, occurred in 2% of broadcasts; implied tobacco use and tobacco branding were also rare. The majority of tobacco content occurred after the 21:00 watershed. Conclusions These findings are virtually unchanged from our earlier analysis of programme content from 2010. Audiovisual tobacco content remains common in UK television programmes.

Recovery is no laughing matter – or is it?

Purpose - The purpose of this paper is to describe an exploratory pilot study to assess the methods used to evaluate an innovative programme of comedy workshops for a small cohort of people recovering from substance misuse problems. The comedy workshops involved participants working with a professional comedian-to explore, develop, write and finally perform a stand-up comedy routine drawing from their own personal experiences. Design/methodology/approach - The impact of the programme was gauged using questionnaires; the Warwick-Edinburgh Mental Well-being Scale, the Rosenberg Self-Esteem Scale, the General Self-Efficacy, Scale and the Life Orientation Test-Revised and Eco-Mapping Tool. Findings - Ten participants began the programme with four participants following through to public performance at an evening showcase event. The quantitative measures showed favourable results on three positive outcome measures; psychological well-being, self-esteem and self-efficacy. Participants number of social relationships and strength of relationships decreased following the intervention, however, relationships were more mutual and were characterized by less conflict following the workshop. Research limitations/implications - The small sample limits generalization of this study, but the methods for data collection were found to be feasible. Preliminary findings suggest that the workshops have a positive impact on recovery. Originality/value - This paper describes an evaluation of an innovative programme of comedy workshops for people recovering from substance abuse problems. The preliminary findings point to a new hypothesis about recovery, that successful recovery might be characterized by a smaller social network, with stronger mutual bonds.

Comparing individual and group intervention for psychological adjustment in people with multiple sclerosis: A feasibility randomised controlled trial

Objective: To modify a published group intervention for adjustment to multiple sclerosis (MS) to suit an individual format, and to assess the feasibility of a randomised controlled trial (RCT) to compare individual and group intervention for people with multiple sclerosis and low mood. Design: Feasibility randomised controlled trial. Setting: Participants were recruited through healthcare professionals at a hospital-based multiple sclerosis service and the MS Society. Subjects: People with multiple sclerosis. Interventions: Adjustment to multiple sclerosis in individual or group delivery format. Main measures: Participants completed mood and quality of life assessments at baseline and at four-month follow-up. Measures of feasibility included: recruitment rate, acceptability of randomisation and the intervention (content and format), and whether the intervention could be adapted for individual delivery. Participants were screened for inclusion using the General Health Questionnaire-12 and Hospital Anxiety and Depression Scale, and were randomly allocated to receive either individual or group intervention, with the same content. Results: Twenty-one participants were recruited (mean age 48.5 years, SD 10.5) and were randomly allocated to individual (n=11) or group (n=10) intervention. Of those offered individual treatment, nine (82%) completed all six sessions. Of those allocated to group intervention, two (20%) attended all six sessions and three (30%) attended five sessions. There were no statistically significant differences between the groups on the outcome measures of mood and quality of life. Conclusions: The intervention could be provided on an individual basis and the trial design was feasible. There were lower attendance rates at group sessions compared to individual sessions.

Social identity in people with multiple sclerosis: a meta-synthesis of qualitative research

Purpose – Many aspects of the self are lost as a consequence of having multiple sclerosis (MS). A persons identity can be altered by negative self-concepts, which are associated with poor psychological wellbeing and can lead individuals to reconstruct their sense of self. The Social Identity Model of Identity Change argues that previously established identities form a basis of continued social support, by providing grounding and connectedness to others to facilitate the establishment of new identities. Family support is a salient factor in adjustment to MS and may enable the establishment of new identities. The purpose of this paper is to investigate identity reconstruction following a diagnosis of MS. Design/methodology/approach – A meta-synthesis of the qualitative literature was conducted to examine the relationship between identity change and family identity of people with MS and other family members. Findings – In all, 16 studies were identified that examined identity change and the family following a diagnosis of MS. Coping strategies used by people with MS and their wider family groups, affect the reconstruction of peoples identity and the adjustment to MS. Receiving support from the family whilst a new identity is constructed can buffer against the negative effects of identity loss. Practical implications – The family base is strengthened if MS-related problems in daily life are adapted into the individual and family identity using positive coping styles. Originality/value – This review provides an interpretation and explanation for results of previous qualitative studies in this area.

A systematic review and meta-analysis assessing the effectiveness of alternative listening devices to conventional hearing aids in adults with hearing loss

Abstract Recent technological advances have led to a rapid increase in alternative listening devices to conventional hearing aids. The aim was to systematically review the existing evidence to assess the effectiveness of alternative listening devices in adults with mild and moderate hearing loss. A systematic search strategy of the scientific literature was employed, reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) checklist. Eleven studies met eligibility for inclusion: two studies evaluated personal sound amplification products, and nine studies assessed remote microphone systems (frequency modulation, Bluetooth, wireless). The evidence in this review suggests that alternative listening devices improve behavioural measures of speech intelligibility relative to unaided and/or aided conditions. Evidence for whether alternative listening devices improve self-reported outcomes is inconsistent. The evidence was judged to be of poor to good quality and subject to bias due to limitations in study design. Our overall recommendation is that high-quality evidence (i.e. randomised controlled trials) is required to demonstrate the effectiveness of alternative listening devices. Such evidence is not currently available and is necessary to guide healthcare commissioners and policymakers when considering new service delivery models for adults with hearing loss. Review registration: Prospective Register of Systematic Reviews (PROSPERO), CRD42015029582

A content analysis of alcohol content in UK television

Abstract Background Exposure to audio-visual alcohol content in media is associated with subsequent alcohol use in young people, but the extent of exposure contained in UK free-to-air prime-time television has not been explored since 2010. We report an analysis of alcohol content in a sample of UK free-to-air prime-time television broadcasts in 2015 and compare this with a similar analysis from 2010. Methods Content analysis of all programmes and advertisement/trailer breaks broadcast on the five national UK free-to-air channels in the UK between 6 and 10 pm during three separate weeks in September, October and November 2015. Results Alcohol content occurred in over 50% of all programmes broadcast and almost 50% of all advert/trailer periods between programmes. The majority of alcohol content occurred before the 9 pm watershed. Branding occurred in 3% of coded intervals and involved 122 brands, though three brands (Heineken, Corona and Fosters) accounted for almost half of all brand appearances. Conclusion Audio-visual alcohol content, including branding, is prevalent in UK television, and is therefore a potential driver of alcohol use in young people. These findings are virtually unchanged from our earlier analysis of programme content from 2010.

Social identity in people with Multiple Sclerosis: an examination of family identity and mood

Background Mood disorders are highly prevalent in people with multiple sclerosis (MS). MS causes changes to a persons sense of self. The Social Identity Model of Identity Change posits that group membership can have a positive effect on mood during identity change. The family is a social group implicated in adjustment to MS. The objectives of this study were to investigate whether family identity can predict mood in people with MS and to test whether this prediction was mediated by social support and connectedness to others. Methods This cross-sectional survey of 195 participants comprised measures of family identity, family social support, connectedness to others, and mood. Results Family identity predicted mood both directly and indirectly through parallel mediators of family social support and connectedness to others. Conclusions Family identity predicted mood as posited by the Social Identity Model of Identity Change. Involving the family in adjustment to MS could reduce low mood.