Cognitive Functions and Subjective Hearing in Cochlear Implant Users.

BACKGROUND AND OBJECTIVES: A cochlear implant (CI) is an effective prosthetic device used to treat severe-to-profound hearing loss. The present study examined cognitive function in CI users by employing a web-based cognitive testing platform, i.e., BrainCheck, and explored the correlation between cognitive function and subjective evaluation of hearing. SUBJECTS AND METHODS: Forty-two CI users (mean age: 58.90 years) were surveyed in the subjective evaluation of hearing, and 20/42 participated in the BrainCheck cognitive tests (immediate recognition, Trail Making A, Trail Making B, Stroop, digit symbol substitution, and delayed recognition). As controls for cognitive function, young normal-hearing (YNH, mean age=23.83 years) and older normal-hearing (ONH, mean age=52.67 years) listener groups were subjected to Brain-Check testing. RESULTS: CI users exhibited poorer cognitive function than the normal hearing groups in all tasks except for immediate and delayed recognition. The highest percentage of CI users who had "possible" and "likely" cognitive impairment, based on BrainCheck scores (ranging from 0-200), was observed in tests assessing executive function. The composite cognitive score across domains tended to be related to subjective hearing (p=0.07). CONCLUSIONS: The findings of the current study suggest that CI users had a higher likelihood of cognitive impairment in the executive function domain than in lower-level domains. BrianCheck online cognitive testing affords a convenient and effective tool to self-evaluate cognitive function in CI users.

Managing Concealable Sexual Health Stigma Through Disclosure.

Individuals with concealable stigma continually decide whether, and if so, how to disclose to others. These complex decision-making processes are evident across various stigmatized sexual health contexts, including sexually transmitted diseases and infections, LGBTQ+ identities, and sexual trauma, among others. One context that has received less attention within communication scholarship is difficulty orgasming among women. Due to the stigma associated with this experience, women are often reluctant to disclose their orgasm difficulties to others, especially their sexual and/or relational partners. However, the motivations women have for, and the factors they consider prior to disclosure have yet to be identified. Building upon extant sexual health communication, concealable stigma, and disclosure research, this study used semi-structured interviews (N = 31) to examine how women disclose orgasm difficulties within their sexual and/or romantic relationships. Our findings highlight several motivations women have for (non)disclosure, and various contextual and situational factors that complicate their disclosure processes. This study contributes to our theoretical understanding of the disclosure processes model (DPM) and the disclosure of concealable (sexual health) stigma. This study also offers practical insights for improving disclosure and experiences with stigma within this context.

Skin Deep Disclosures: Motivations Driving Visible Forms of Disclosure among People Living with a Concealable Stigmatized Identity.

Individuals with invisible disabilities continually undergo decision-making processes regarding whether or not, and if so, how to disclose their disability to others. While a great deal of theorization exists regarding disclosure processes, less work has considered how and why individuals with invisible disabilities forgo the disclosure process by making the invisible visible. This study examines motivations for using tattoos as a mechanism for invisible disability disclosure among the single-sided deaf (SSD) community. Interviews with 41 individuals with SSD across the U.S. reveal a complex set of motivations for permanently and visibly disclosing invisible disability through the use of tattoos. Motivations ranged from being (1) functionally driven, such as normalizing and naturalizing disability disclosures in mixed interactions (2) identity driven, such as showing pride in their condition with the goal of de-stigmatizing SSD (3) community driven, such as educating others about SSD and increasing camaraderie within the hard-of-hearing community to (4) personally driven, such as memorializing a loss, marking the legitimacy of deafness to the self and to others, and increasing disability identification. This study contributes to existing disclosure models by considering how this emerging form of disclosure bypasses and complicates some of the foundational assumptions of disclosure decision-making processes regarding whether, to whom, and how individuals with disabilities disclose. This provides important insights regarding how disclosure decisions can be predetermined and made independent of context, situation, and relationship(s), which has several theoretical and practical implications.

How Older Adults with Chronic Pain Manage Social Support Interactions with Mobile Media.

Mobile media offer new ways for older adults to access and interact with their social support networks. While mobile media usage has been increasing among older adults, less is known about why older adults with chronic pain prefer to select members of their existing social network for quality social support interactions, what types of communication mechanisms they engage in when utilizing mobile media, and how they use their mobile media to manage their interactions and relationships. The analysis of 25 semi-structured interviews with older adults with chronic pain reveals that a sense of camaraderie and shared meaning of pain experiences underlie their preferences for communicating with similar others about chronic pain. On the other hand, having to take on a role reversal of comforting and receiving unsolicited advice are the main reasons for avoiding social support interactions with dissimilar others. Additionally, older adults strategically utilize specific features of mobile media such as SMS text messaging for short forms of validation and encouragement, staccato social support, and management of interaction coordination or avoidance. This study demonstrates how mobile technology can be adopted and appropriated to meet social, emotional, and interpersonal needs of older adults' lives. It also provides important insights into communicative dynamics of pain-related social support interactions and communication channel selection of older adults. The way mobile media are used to leverage social interactions and support networks can contribute to self-management, health-promoting behavior, and overall quality of life for older adults with chronic pain.

Deaf in one ear: Communication and social challenges of patients with single-sided deafness post-diagnosis.

OBJECTIVE: To understand the communication and social challenges that individuals with SSD face post diagnosis. METHODS: Fifty-two single-sided deaf patients from all over the world participated in semi-structured interviews. Interviews were digitally recorded, transcribed verbatim, and coded using a thematic analysis approach. RESULTS: Patients with single sided deafness identified challenges including: increased reliance on family members, decreased sense of autonomy, communication quality changes with family members, information discrepancy across family members and various emotional responses, conflicting information from interactions with multiple medical professionals, and lack of knowledge regarding what to anticipate post diagnosis. CONCLUSION: This study provides insights into patients' perspectives around single-sided deafness and its challenges, and the various health care approaches (e.g., patient- and family-centered care, third party disability, patient navigation) that could be implemented post diagnosis to decrease negative experiences and outcomes associated with SSD. PRACTICAL IMPLICATIONS: This study has practical implications for improving our understanding of what single-sided deaf patients need and for health professionals to offer better care to current and future populations impacted by single-sided deafness.

Keppi: A Tangible User Interface for Self-Reporting Pain.

Motivated by the need to support those self-managing chronic pain, we report on the development and evaluation of a novel pressure-based tangible user interface (TUI) for the self-report of scalar values representing pain intensity. Our TUI consists of a conductive foam-based, force-sensitive resistor (FSR) covered in a soft rubber with embedded signal conditioning, an ARM Cortex-M0 microprocessor, and Bluetooth Low Energy (BLE). In-lab usability and feasibility studies with 28 participants found that individuals were able to use the device to make reliable reports with four degrees of freedom as well map squeeze pressure to pain level and visual feedback. Building on insights from these studies, we further redesigned the FSR into a wearable device with multiple form factors, including a necklace, bracelet, and keychain. A usability study with an additional 7 participants from our target population, elderly individuals with chronic pain, found high receptivity to the wearable design, which offered a number of participant-valued characteristics (e.g., discreetness) along with other design implications that serve to inform the continued refinement of tangible devices that support pain self-assessment.

Breaking the sound barrier: exploring parents' decision-making process of cochlear implants for their children.

OBJECTIVE: To understand the dynamic experiences of parents undergoing the decision-making process regarding cochlear implants for their child(ren). METHODS: Thirty-three parents of d/Deaf children participated in semi-structured interviews. Interviews were digitally recorded, transcribed, and coded using iterative and thematic coding. RESULTS: The results from this study reveal four salient topics related to parents' decision-making process regarding cochlear implantation: 1) factors parents considered when making the decision to get the cochlear implant for their child (e.g., desire to acculturate child into one community), 2) the extent to which parents' communities influence their decision-making (e.g., norms), 3) information sources parents seek and value when decision-making (e.g., parents value other parent's experiences the most compared to medical or online sources), and 4) personal experiences with stigma affecting their decision to not get the cochlear implant for their child. CONCLUSION: This study provides insights into values and perspectives that can be utilized to improve informed decision-making, when making risky medical decisions with long-term implications. PRACTICAL IMPLICATIONS: With thorough information provisions, delineation of addressing parents' concerns and encompassing all aspects of the decision (i.e., medical, social and cultural), health professional teams could reduce the uncertainty and anxiety for parents in this decision-making process for cochlear implantation.

Self-monitoring practices, attitudes, and needs of individuals with bipolar disorder: implications for the design of technologies to manage mental health.

OBJECTIVE: To understand self-monitoring strategies used independently of clinical treatment by individuals with bipolar disorder (BD), in order to recommend technology design principles to support mental health management. MATERIALS AND METHODS: Participants with BD (N = 552) were recruited through the Depression and Bipolar Support Alliance, the International Bipolar Foundation, and WeSearchTogether.org to complete a survey of closed- and open-ended questions. In this study, we focus on descriptive results and qualitative analyses. RESULTS: Individuals reported primarily self-monitoring items related to their bipolar disorder (mood, sleep, finances, exercise, and social interactions), with an increasing trend towards the use of digital tracking methods observed. Most participants reported having positive experiences with technology-based tracking because it enables self-reflection and agency regarding health management and also enhances lines of communication with treatment teams. Reported challenges stem from poor usability or difficulty interpreting self-tracked data. DISCUSSION: Two major implications for technology-based self-monitoring emerged from our results. First, technologies can be designed to be more condition-oriented, intuitive, and proactive. Second, more automated forms of digital symptom tracking and intervention are desired, and our results suggest the feasibility of detecting and predicting emotional states from patterns of technology usage. However, we also uncovered tension points, namely that technology designed to support mental health can also be a disruptor. CONCLUSION: This study provides increased understanding of self-monitoring practices, attitudes, and needs of individuals with bipolar disorder. This knowledge bears implications for clinical researchers and practitioners seeking insight into how individuals independently self-manage their condition as well as for researchers designing monitoring technologies to support mental health management.

Managing Stigma: Disclosure-Response Communication Patterns in Pro-Anorexic Websites.

Pro-anorexic websites are a popular online venue for individuals with anorexia, but recent research suggests that they play a role of "online negative enabling support groups" because they can undermine recovery and encourage negative behaviors by validating pro-anorexic views. By analyzing 22,811 messages from 5,590 conversations from the Pro-Ana Nation online discussion board forum, this study examines communicative mechanisms of online negative enabling support through language analysis of disclosure-response sequences, changes in the language of the initial discloser within an interaction exchange, and the role of responses in eliciting those changes. The findings show that initiating disclosures containing stigma-related emotion words, anorexia-specific content, and sociorelational content are typically met with negatively valenced responses from other members of the pro-anorexic community. Moreover, although the act of revealing stigmatized information has some cathartic effects, disclosers use more, not fewer, stigma-related emotion words when they receive negatively valenced responses. These results provide insight into communicative dynamics and effects of online negative enabling support through validation of the pro-anorexic identity and the dangerous cycle of stigma escalation in disclosure-response exchanges on pro-anorexic online communities.

Automatic Archiving versus Default Deletion: What Snapchat Tells Us About Ephemerality in Design.

Unlike most social media, where automatic archiving of data is the default, Snapchat defaults to ephemerality: deleting content shortly after it is viewed by a receiver. Interviews with 25 Snapchat users show that ephemerality plays a key role in shaping their practices. Along with friend-adding features that facilitate a network of mostly close relations, default deletion affords everyday, mundane talk and reduces self-consciousness while encouraging playful interaction. Further, although receivers can save content through screenshots, senders are notified; this selective saving with notification supports complex information norms that preserve the feel of ephemeral communication while supporting the capture of meaningful content. This dance of giving and taking, sharing and showing, and agency for both senders and receivers provides the basis for a rich design space of mechanisms, levels, and domains for ephemerality.

Piloting a Text Message-based Social Support Intervention for Patients With Chronic Pain: Establishing Feasibility and Preliminary Efficacy.

OBJECTIVES: To examine preliminarily the effectiveness of a short message service (SMS) text message-based social support intervention for reducing daily pain and pain interference levels, improving affect and perceptions of social support in patients with chronic noncancer pain, and exploring the feasibility of a novel mobile application to track perceptions of pain and pain interference. MATERIALS AND METHODS: Participants (17 men, 51 women) from 2 pain clinics in New York City downloaded a pain tracking application (App) on their Smartphone and used it to record twice-daily pain, pain interference, and affect scores over the 4-week study period. Participants were randomly assigned to receive standard care (control) or standard care along with receipt of twice-daily supportive SMS text messages delivered during the second and third week of the study (intervention). Demographic and clinical data were obtained at baseline, and social support measures were administered at baseline and at 4 weeks. Statistical analysis was carried out using general linear mixed models, taking into account variances associated with time of assessments and with patients. RESULTS: The social support intervention reduced perceptions of pain and pain interference and improved positive affect for chronic noncancer pain patients assigned to the intervention condition in comparison with controls. Participants completed approximately 80% of the daily measurements requested. DISCUSSION: These findings establish the feasibility of collecting daily pain data using a mobile tracking App and provide significant implications and insight into a nuanced approach to reducing the daily experience of pain through mobile technology, especially because of its accessibility.

MoodLight: Exploring Personal and Social Implications of Ambient Display of Biosensor Data.

MoodLight is an interactive ambient lighting system that responds to biosensor input related to an individual's current level of arousal. Changes in levels of arousal correspond to fluctuations in the color of light provided by the system, altering the immediate environment in ways intimately related to the user's private internal state. We use this intervention to explore personal and social implications of the ambient display of biosensor data. This study provides greater understanding of the ways in which the representations of personal informatics, with a focus on ambient feedback, influence our perceptions of ourselves and those around us.

Age Differences in Online Social Networking: Extending Socioemotional Selectivity Theory to Social Network Sites.

This article extends socioemotional selectivity theory to online social networking by examining age differences in the size and composition of Facebook networks across a wide age range of Facebook users (18 to 93 years old) in a nationally representative sample. Findings suggest increasing selectivity of Facebook social partners with age. Compared to younger adults, friend networks of older adults are smaller but contain a greater proportion of individuals who are considered to be actual friends. Moreover, a higher proportion of actual to total Facebook friends is associated with lower levels of social isolation and loneliness across the life span.