Stages of Change Profiles among Adults Experiencing Hearing Difficulties Who Have Not Taken Any Action: A Cross-Sectional Study.
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ABSTRACT:
SUBMITTER: Manchaiah V
PROVIDER: S-EPMC4456172 | biostudies-literature | 2015
REPOSITORIES: biostudies-literature
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Stages of Change Profiles among Adults Experiencing Hearing Difficulties Who Have Not Taken Any Action: A Cross-Sectional Study.
Manchaiah Vinaya V Rönnberg Jerker J Andersson Gerhard G Lunner Thomas T
PloS one 20150604 6
The aim of the current study was to test the hypothesis that adults experiencing hearing difficulties who are aware of their difficulties but have not taken any action would fall under contemplation and preparation stages based on the transtheoretical stages-of-change model. The study employed a cross-sectional design. The study was conducted in United Kingdom and 90 participants completed University of Rhode Island Change Assessment (URICA) scale as well as measures of self-reported hearing dis ...[more]
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Project description:OBJECTIVE:This study developed the Hearing Disability Acceptance Questionnaire (HDAQ) and tested its construct and concurrent validities. DESIGN:Cross-sectional. PARTICIPANTS:A total of 90 participants who were experiencing hearing difficulties were recruited in the UK. OUTCOME MEASURES:The HDAQ was developed based on the Tinnitus Acceptance Questionnaire (TAQ). Participants completed self-report measures regarding hearing disability acceptance, hearing disability, symptoms of anxiety and depression and a measure of stages of change. RESULTS:The HDAQ has a two-factor structure that explains 75.69% of its variance. The factors identified were activity engagement and avoidance and suppression. The scale showed a sufficient internal consistency (Cronbach's ?=0.86). The HDAQ also had acceptable concurrent validity with regard to self-reported hearing disability, self-reported anxiety and depression and readiness to change measures. CONCLUSIONS:Acceptance is likely an important aspect of coping with chronic health conditions. To our knowledge, no previously published and validated scale measures the acceptance of hearing disability; therefore, the HDAQ might be useful in future research. However, the role of acceptance in adjusting to hearing disability must be further investigated.
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Project description:ObjectivesDiet may affect susceptibility of the inner ear to noise and age-related effects that lead to tinnitus and hearing loss. This study used complementary single nutrient and dietary pattern analysis based on statistical grouping of usual dietary intake in a cross-sectional analysis of tinnitus and hearing difficulties in a large population study sample.DesignThe research was conducted using the UK Biobank resource. Tinnitus was based on report of ringing or buzzing in one or both ears that lasts more than five minutes at a time and is currently experienced at least some of the time. Identification of a hearing problem was based on self-reported difficulties with hearing. Usual dietary intake and dietary patterns (involving statistical grouping of intake to account for how foods are combined in real-life diets) were estimated based on between two and five administrations of the Oxford Web-Q 24-hour dietary recall questionnaire over the course of a year for 34,576 UK adult participants aged 40 to 69.ResultsIn a multivariate model, higher intake of vitamin B12 was associated with reduced odds of tinnitus, while higher intakes of calcium, iron, and fat were associated with increased odds (B12, odds ratio [OR] 0.85, 95% confidence interval [CI] 0.75 to 0.97; Calcium, OR 1.20, 95% CI 1.08 to 1.34; Iron, OR 1.20, 95% CI 1.05 to 1.37; Fat, OR 1.33, 95% CI 1.09 to 1.62, respectively, for quintile 5 versus quintile 1). A dietary pattern characterised by high protein intake was associated with reduced odds of tinnitus (OR 0.90, 95% CI 0.82 to 0.99 for quintile 5 versus quintile 1). Higher vitamin D intake was associated with reduced odds of hearing difficulties (OR 0.90, 95% CI 0.81 to 1.00 for quintile 5 versus quintile 1), as were dietary patterns high in fruit and vegetables and meat and low in fat (Prudent diet: OR 0.89, 95% CI 0.83 to 0.96; High protein: OR 0.88, 95% CI 0.82 to 0.95; High fat: OR 1.16, 95% CI 1.08 to 1.24, respectively, for quintile 5 versus quintile 1).ConclusionsThere were associations between both single nutrients and dietary patterns with tinnitus and hearing difficulties. Although the size of the associations was small, universal exposure for dietary factors indicates that there may be a substantial impact of diet on levels of tinnitus and hearing difficulties in the population. This study showed that dietary factors might be important for hearing health.
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Project description:Measurement of outcomes has become increasingly important to assess the benefit of audiologic rehabilitation, including hearing aids, in adults. Data from questionnaires, however, are based on retrospective recall of events and experiences, and often can be inaccurate. Questionnaires also do not capture the daily variation that typically occurs in relevant events and experiences. Clinical researchers in a variety of fields have turned to a methodology known as ecological momentary assessment (EMA) to assess quotidian experiences associated with health problems. The objective of this study was to determine the feasibility of using EMA to obtain real-time responses from hearing aid users describing their experiences with challenging hearing situations.This study required three phases: (1) develop EMA methodology to assess hearing difficulties experienced by hearing aid users; (2) make use of focus groups to refine the methodology; and (3) test the methodology with 24 hearing aid users. Phase 3 participants carried a personal digital assistant 12 hr per day for 2 weeks. The personal digital assistant alerted participants to respond to questions four times a day. Each assessment started with a question to determine whether a hearing problem was experienced since the last alert. If "yes," then up to 23 questions (depending on contingent response branching) obtained details about the situation. If "no," then up to 11 questions obtained information that would help to explain why hearing was not a problem. Each participant completed the Hearing Handicap Inventory for the Elderly (HHIE) both before and after the 2-week EMA testing period to evaluate for "reactivity" (exacerbation of self-perceived hearing problems that could result from the repeated assessments).Participants responded to the alerts with a 77% compliance rate, providing a total of 991 completed momentary assessments (mean = 43.1 per participant). A substantial amount of data were obtained with the methodology. It is important to note that participants reported a "hearing problem situation since the last alert" 37.6% of the time (372 responses). The most common problem situation involved "face-to-face conversation" (53.8% of the time). The next most common problem situation was "telephone conversation" (17.2%) followed by "TV, radio, iPod, etc." (15.3%), "environmental sounds" (9.7%), and "movies, lecture, etc." (4.0%). Comparison of pre- and post-EMA mean HHIE scores revealed no significant difference (p > 0.05), indicating that reactivity did not occur for this group. It should be noted, however, that 37.5% of participants reported a greater sense of awareness regarding their hearing loss and use of hearing aids.Results showed participants were compliant, gave positive feedback, and did not demonstrate reactivity based on pre- and post-HHIE scores. We conclude that EMA methodology is feasible with patients who use hearing aids and could potentially inform hearing healthcare (HHC) services. The next step is to develop and evaluate EMA protocols that provide detailed daily patient information to audiologists at each stage of HHC. The advantages of such an approach would be to obtain real-life outcome measures, and to determine within- and between-day variability in outcomes and associated factors. Such information at present is not available from patients who seek and use HHC services.
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Project description:Early environmental experiences and life histories profoundly influence adult phenotypes via as yet poorly understood mechanisms. We previously showed that wild-type adult C. elegans that transiently passed through the stress-induced dauer larval stage (post-dauers) exhibit different gene expression patterns, genome-wide chromatin structure, and life history traits when compared to adults that bypassed the dauer stage (controls). Here we show that endogenous small inhibitory RNAs (endo-siRNAs) and siRNA pathways may mediate developmental history-dependent phenotypic diversity. Deep sequencing of small RNA libraries show changes in endo-siRNA levels in post-dauer as compared to control animals, and meta analyses indicate that specific endo-siRNA pathways are targets of developmental history-dependent reprogramming. We demonstrate that mutations in specific endo-siRNA pathways affect the expected gene expression and chromatin state changes in post-dauer animals, and also disrupt their increased brood size phenotype. We find that the chromatin state and endo-siRNA distribution in dauers is also distinct and suggest that this remodeling in dauers provides a template for the subsequent establishment of adult post-dauer profiles. Together, our results imply a critical mechanistic role for endo-siRNA pathways in mediating early experience-dependent phenotypic divergence in adults, and suggest that regulation of these pathways contribute to increased fitness via non-genetic mechanisms.
2013-04-05 | GSE33313 | GEO
Project description:OBJECTIVES:While understanding of complex within-person clustering of health behaviors into meaningful profiles of risk is growing, we still know little about whether and how U.S. adults transition from one profile to another as they age. This study assesses patterns of stability and change in profiles of tobacco and alcohol use and body mass index (BMI). METHOD:A nationally representative cohort of U.S. adults 25 years and older was interviewed up to 5 times between 1986 and 2011. Latent transition analysis (LTA) models characterized the most common profiles, patterning of transitions across profiles over follow-up, and assessed whether some were associated with higher mortality risk. RESULTS:We identified 5 profiles: "health promoting" with normal BMI and moderate alcohol consumption; "overweight"; "current smokers"; "obese"; and "nondrinkers". Profile membership was largely stable, with the most common transitions to death or weight gain. "Obese" was the most stable profile, while "smokers" were most likely to transition to another profile. Mortality was most frequent in the "obese" and "nondrinker" profiles. DISCUSSION:Stability was more common than transition, suggesting that adults sort into health behavior profiles relatively early. Women and men were differently distributed across profiles at baseline, but showed broad similarity in transitions.
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Project description:ObjectivesChildren presenting at audiology services with caregiver-reported listening difficulties often have normal audiograms. The appropriate approach for the further assessment and clinical management of these children is currently unclear. In this Sensitive Indicators of Childhood Listening Difficulties (SICLiD) study, we assessed listening ability using a reliable and validated caregiver questionnaire (the Evaluation of Children's Listening and Processing Skills [ECLiPS]) in a large (n = 146) and heterogeneous sample of 6- to 13-year-old children with normal audiograms. Scores on the ECLiPS were related to a multifaceted laboratory assessment of the children's audiological, psycho- and physiological-acoustic, and cognitive abilities. This report is an overview of the SICLiD study and focuses on the children's behavioral performance. The overall goals of SICLiD were to understand the auditory and other neural mechanisms underlying childhood listening difficulties and translate that understanding into clinical assessment and, ultimately, intervention.DesignCross-sectional behavioral assessment of children with "listening difficulties" and an age-matched "typically developing" control group. Caregivers completed the ECLiPS, and the resulting total standardized composite score formed the basis of further descriptive statistics, univariate, and multivariate modeling of experimental data.ResultsAll scores of the ECLiPS, the SCAN-3:C, a standardized clinical test suite for auditory processing, and the National Institutes of Health (NIH) Cognition Toolbox were significantly lower for children with listening difficulties than for their typically developing peers using group comparisons via t-tests and Wilcoxon Rank-Sum tests. A similar effect was observed on the Listening in Spatialized Noise-Sentences (LiSN-S) test for speech sentence-in-noise intelligibility but only reached significance for the Low Cue and High Cue conditions and the Talker Advantage derived score. Stepwise regression to examine the factors contributing to the ECLiPS Total scaled score (pooled across groups) yielded a model that explained 42% of its variance based on the SCAN-3:C composite, LiSN-S Talker Advantage, and the NIH Toolbox Picture Vocabulary, and Dimensional Change Card Sorting scores (F[4, 95] = 17.35, p < 0.001). High correlations were observed between many test scores including the ECLiPS, SCAN-3:C, and NIH Toolbox composite measures. LiSN-S Advantage measures generally correlated weakly and nonsignificantly with non-LiSN-S measures. However, a significant interaction was found between extended high-frequency threshold and LiSN-S Talker Advantage.ConclusionsChildren with listening difficulties but normal audiograms have problems with the cognitive processing of auditory and nonauditory stimuli that include both fluid and crystallized reasoning. Analysis of poor performance on the LiSN-S Talker Advantage measure identified subclinical hearing loss as a minor contributing factor to talker segregation. Beyond auditory tests, evaluations of children with complaints of listening difficulties should include standardized caregiver observations and consideration of broad cognitive abilities.
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Project description:BACKGROUND: There is evidence that physical activity (PA) interventions tailored to individual's stages of change (SoC) are more effective in promote behavior change than "one-size-fits-all" interventions. However, only a few researches have investigated these stages towards PA behavior in representative samples of the population. Thus, the purpose of this study was to determine the prevalence and factors associated with the SoC for PA in a probabilistic sample of adults aged 20 years or over. METHODS: A population-based survey was undertaken in Pelotas, Southern Brazil, in 2005. An algorithm was applied to evaluate the SoC for PA, and PA was defined as being engaged in moderate-to-vigorous PA for at least 20 minutes on three times per week. The covariates collected in the questionnaire were: sex, age, skin color, marital status, education level, economic status, family income, smoking, body mass index (BMI) and self-reported health status. Data analyses were performed through Poisson and multinomial regression, taking the sampling design into account. RESULTS: Face-to-face interviews were applied to 3136 individuals, corresponding to a response rate of 93.5%. The prevalence across the stages was as follows: 38.3% in precontemplation, 13.0% in contemplation, 19.5% in preparation, 5.2% in action and 24.0% in maintenance. The elderly, married, smokers, and those with lower socioeconomic status were less likely to adopt, initiate and maintain regular PA. CONCLUSION: Despite the all benefits of PA, a high proportion of adults from Southern Brazil are physically inactive and do not present intention to engage in regular PA. The profile of those who are inactive but intend to do PA resembles those who are physically active. The findings of the present study can contribute to improve health behaviors and to plan health promotion strategies aimed at increasing the level of PA in the community.
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Project description:Climate change is primarily driven by human-caused greenhouse gas (GHG) emissions, and may therefore be mitigated by changes to human behavior (Clayton et al., 2015; IPCC, 2018). Despite efforts to raise awareness and concern about climate change, GHG emissions continue to rise (IPCC, 2018). Climate change seems to be at odds with the immediate, present threats to which humans are adapted to cope (Gifford et al., 2009; Schultz, 2014; van Vugt et al., 2014). In contrast to immediate dangers, climate change is typically abstract, large scale, slow and often unrelated to the welfare of our daily lives (e.g., Ornstein and Ehrlich, 1989; Gifford, 2011). But there are moments when the consequences of climate change are readily apparent, such as extreme weather events. In the current paper, we examine the impact of personal experience with an extreme weather event, and the impact of this experience on beliefs about climate change, and intentions to take actions that can help prepare for and mitigate the consequences of climate change.
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