Changes in Psychoacoustic Recognition and Brain Activity by Types of Fire Alarm.

In public, the role of a fire alarm is to induce a person to a certain recognition of potential danger, resulting in that person taking appropriate evacuation action. Unfortunately, the sound of the fire alarm is not internationally standardized yet, except for recommending the use of a signal with a regular temporal pattern (or T-3 pattern). To identify the effective alarm sound, the present study investigated a relationship between acoustic characteristics of the fire alarm and its subjective psychoacoustic recognition and objective electroencephalography (EEG) responses for 50 young and older listeners. As the stimuli, six different types of alarms were applied: bell, slow whoop, T-3 520 Hz, T-3 3100 Hz, and two simulated T-3 sounds (i.e., 520 and 3100 Hz) to which older adults with age-related hearing loss seemed to hear. While listening to the sounds, the EEG was recorded by each individual. The psychoacoustic recognition was also evaluated by using a questionnaire consisting of three subcategories, i.e., arousal, urgency, and immersion. The subjective responses resulted in a statistically significant difference between the types of sound. In particular, the fire alarms had acoustic features of high frequency or gradually increased frequencies such as T-3 3100 Hz, bell, and slow whoop, representing effective sounds to induce high arousal and urgency, although they also showed a limitation in being widely transmitted and vulnerable to background noise environment. Interestingly, there was a meaningful interaction effect between the sounds and age groups for the urgency and immersion, indicating that the bell was quite highly recognized in older adults. In general, EEG data showed that alpha power was decreased and gamma power was increased in all sounds, which means a relationship with negative emotions such as high arousal and urgency. Based on the current findings, we suggest using fire alarm sounds with acoustic features of high frequencies in indoor and/or public places.

Development of the Hearing Rehabilitation for Older Adults (HeRO) Healthcare Mobile Application and Its Likely Utility for Elderly Users.

The present study aimed to develop a healthcare application for the elderly who suspect or know they have a hearing loss, namely, the Hearing Rehabilitation for Older Adults (HeRO), which is available in a mobile device, and then to confirm its probability of acceptance among elderly users. Under a web server system, HeRO which had four types of tailored training for the aged auditory system (i.e., syllable, sentence, discourse, working memory) and a self-reported questionnaire to screen amount of the hearing loss was completed for the elderly. To verify whether the HeRO contents and functions were user-friendly to the elderly users, the technology acceptance model (TAM) was used. Forty-four older adults were asked to use the developed application for 10 days and then respond to a TAM questionnaire with 25 items. The Cronbach's α coefficient of each subcategory was very high. The construct validity of all subcategories showed high eigenvalues using principal component analysis. Furthermore, our regression model statistically supported a persuasive intention to use the healthcare application because the elderly readily accept it and find it easy to manipulate. We expect the current technology to be applied to the general public as well as the elderly who want to explore digital health.

Use of Personal Listening Devices and Knowledge/Attitude for Greater Hearing Conservation in College Students: Data Analysis and Regression Model Based on 1009 Respondents.

Given the concern regarding increased hearing loss in young people who use personal listening devices (PLDs), the present study analyzes the experience of PLDs among college students to identify their knowledge of and attitude toward hearing conservation. It also explains their relationship between knowledge of hearing loss and attitude-related hearing conservation as a questionnaire response using a regression model. A total of 1009 Korean college students responded to an online questionnaire. As a survey tool, the Personal Listening Device and Hearing Questionnaire was adapted as a Korean version with 78 modified items under 9 categories. Using principal component analysis, specific factors were extracted, and their relationships and paths were confirmed using multiple regression analysis. The results of the knowledge category of the questionnaire indicate that most respondents knew how to maintain healthy hearing and understood the signs of hearing loss. Regardless, many college students habitually use PLDs at high levels in noisy environments; they do not recognize how to prevent hearing loss. Even though they continue their current use pattern for PLDs, they also had a positive attitude toward receiving more information about hearing conservation. According to the regression model, the students' self-reported hearing deficits were due to the volume rather than the frequent use. Interestingly, knowledge about hearing loss may encourage students to develop a positive attitude toward reasonable restriction of PLD use. When PLD users have detailed knowledge about the hearing loss provided by professionals, we believe that most will avoid serious hearing problems and its risks and maintain a judicious attitude toward their own conservation.

The Effects of Short-Term and Long-term Hearing Changes on Music Exposure: A Systematic Review and Meta-Analysis.

The present study explores the scientific evidence on whether music exposure temporarily or permanently affects hearing sensitivity in young adults. Six electronic databases were searched using related keywords for the four categories of personal listening devices, listening habits, hearing outcomes, and age. The Hedges' g and its 95% confidence intervals (CIs) were estimated. A Higgins I2 was also used to check for heterogeneity. To test for publication bias, funnel plots were drawn using Egger's regression. Based on the inclusion criteria, 16 studies were divided into two groups to identify short-term hearing changes (n = 7) and long-term hearing changes (n = 9). In the short term, there was no significant immediate change in the thresholds or amplitudes after the music exposure, although pure-tone thresholds (PTAs) and distortion product otoacoustic emissions (DPOAEs) did show the highest effect size (-0.344, CI -0.727 to 0.038) and (0.124, CI -0.047 to 0.296) at 4 kHz. On the other hand, for long-term hearing changes, the PTA provided the highest effect size at 6 kHz (-0.525, CI -0.897 to -0.154) and 8 kHz (-0.486, CI -0.819 to -0.152), while also implying that habitual and repeated personal listening device (PLD) usage can act on some significant hearing changes in audiological tests. We conclude that the use of a PLD produces a few temporary hearing changes at 4 kHz after its use but that the changes are then reversed. However, it is important to note heavy PLD users' experience regarding permanent changes in their hearing thresholds at high frequencies, and the public should be educated on this issue.

Reliability and Validity of Self-Screening Tool for Hearing Loss in Older Adults.

OBJECTIVE: The present study aimed to identify the reliability and validity of a screening tool for the elderly who wish to check their level of hearing loss by themselves. DESIGN: A total of 170 older adults with different hearing levels participated. The Self-Assessment for Hearing Screening of the Elderly-Revised (SHSE-R) consisted of 20 questions measured on a 5-point scale and developed in terms of characteristics of age-related hearing loss. For reliability, the subjects responded to SHSE-R twice with a three-week interval. They also took various subjective and objective hearing tests and a working memory test and filled out two other questionnaires for validation. RESULTS: SHSE-R showed a high internal consistency and a high reliability when comparing test-retest scores. Its content validity was as high as 0.88-1. Convergent validity supported SHSE-R and its subcategories while showing either a positive or negative correlation with pure-tone average, word recognition scores, and otoacoustic emission tests. Construct validity was proved by a moderate negative correlation with the tests of speech in noise, speech with fast speed, and working memory. In criterion validity, a strong positive correlation existed between SHSE-R and the other questionnaires, except for a group with severe hearing loss. The factor analysis showed similar results to the original version of SHSE having three factors, although some items were interchanged. CONCLUSION: We confirmed that SHSE-R was well developed with both excellent internal consistency and test-retest reliability and valuable convergent, construct, and criterion validities, consequently making SHSE-R useful for self-checking hearing loss in the elderly.

Approaching Knowledge, Attitudes, and Practices Model for Elderly with Dementia Who are Suspected to Have Hearing Impairment in Korea.

Because the psychophysical symptoms of hearing loss and dementia in the elderly are very similar, untrained healthcare professionals in dementia facilities can easily overlook a severity of hearing loss in their patients. The present study identifies their knowledge, attitudes, and practices (KAP) on hearing loss using a survey whether they may help hearing problem of the patients with dementia. A total of 29 health-care professionals responded to the KAP survey. Also, 2 family members participated. The results showed that most of the nurses and caregivers in elderly medical welfare facilities who worked with dementia patients did not have knowledge of their hearing loss. Even the facility managers did not know how to conduct hearing tests for their patients although they did recognize that some of their patients had a hearing loss. Eventually, actual practice was not possible at this moment by the professionals. However, our respondents did have a positive attitude toward screening for hearing loss and help their patients with dementia wear hearing aids if a clinical guideline was provided. We suggest to develop clear and precise clinical guidelines of the hearing screening test for the dementia patients due to the interrelationship between dementia and hearing loss. When these guidelines apply to elderly residents in a medical welfare facility, early diagnosis and treatment of their sensory loss will help alleviate their dementia as well.

Better Understanding of Direct Bone-Conduction Measurement: Comparison with Frequency-Specific Bone-Conduction Tones and Brainstem Responses.

BACKGROUND AND OBJECTIVES: The present study aimed to compare thresholds of direct bone-conduction (BC direct) with those of behaviorally measured BC pure-tone audiometry (PTA) and objectively measured BC auditory brainstem response (ABR) to confirm the clinical feasibility of their relationships. Subjects and. METHODS: Young adults with normal hearing participated in the study to determine the thresholds from three measurements at four testing frequencies. In the BC direct, the vibrator of a bone-anchored hearing aid softband was placed on the right mastoid of each subject. In both PTA and ABR, a B71 bone oscillator was placed on the subject's right mastoid. While the subject's thresholds of BC direct and BC PTA were determined with a clinically routine 5-dB step procedure, BC ABR was conducted to determine the individual's hearing sensitivity by a peak V of the waveform using tone-burst and click stimuli. RESULTS: The BC direct showed a different pattern between low and high frequencies. Precisely, its thresholds were 13.25 and 12.25 dB HL at 0.5 and 1 kHz, respectively, but 19 and 19.75 dB HL at 2 and 4 kHz, respectively. A significant positive correlation existed between BC direct and PTA at 1 kHz, which was also correlated with ABR. CONCLUSIONS: Based on the current data, the thresholds of BC direct were similar to BC PTA at low frequencies and BC ABR at high frequencies. The thresholds of BC direct might be predictable at approximately 5 dB higher (or lower) than that in PTA, although a large data set is required for standardization.