Kapitlet fokuserar på vanligt förekommande sätt att beskriva risker i olika medier.

The present study was influenced by existential - and gender aspects on young people's everyday lives with the aim to shed light on the complexity of the phenomenon of risk-taking, the meaning and purpose of adolescent risk-taking in a traditional sense (e.g. smoking and drug using) and in noisy environments (e.g. discotheques and rock concerts). The intention was to identify possible new ways of understanding young people's experiences and apprehensions about different risk behaviours by the use of qualitative method; The Interpretative Phenomenological Analysis (IPA). Sixteen adolescents (8 men/8 women, aged 15-19) were interviewed, 4 in separate interviews and 12 in focus groups. The analysis revealed two dimensions: "Social identity" and "Existential identity" and six superordinate themes of the phenomena of risk-taking. The two dimensions and the six super-ordinate themes were equal for women and men, while the sub-themes were found to be gender-related. The interviewees' responses revealed social (gender) - and existential considerations which affected the participants in many areas of their daily lives. The study implies that one of the challenges for the preventive strategies is to be able to talk about risk-taking in terms of both threat and development, and not as a case of either or. 

Music and high levels of sound have not traditionally been associated with risk-taking behaviors. Loud music may intensify and bring more power and meaning to the musical experience, but it can at the same time be harmful to hearing. The present study aims to increase the knowledge about young women′s and men′s risk judgement and behaviour by investigating patterns in adolescent risk activities among 310 adolescents aged 15-20 (143 women; 167 men). The Australian instrument ARQ was used with additional questions on hearing risks and a factor analysis was conducted. The main results showed that the factor structure in the judgement and behavior scale for Swedish adolescents was rather different from the factor structure in the Australian sample. Also, the factor structure was not similar to the Australian sample split on gender. The results are discussed from a gender- and existential perspective on risk taking, and it is emphasized that research on risk behavior needs to reconceptualize stereotypical ideas about gender and the existential period in adolescence.

Tinnitus is assumed to be the perception of sound that results exclusively from activity within the nervous system without any external stimulation. Approximately 1-2% of the population regard their tinnitus as a serious threat towards their quality of life. The way the patients describe their suffering varies, sometimes also depending on the interest and insight of the clinician to whom they turn to for help. The lack of insightful narratives of someone who is severely annoyed by the presence of a constant tinnitus sound may lead to limited and biased models of tinnitus suffering. In the present case study the participating patient, a woman aged 70, shared her experience of being victimized by tinnitus with the clinician/ researcher during a number of psychotherapeutic sessions. The psychodynamic, narrative approach, made it possible for the client to articulate the unique and specific meaning that she experienced as being part of her suffering. In her words, tinnitus became a tolerable symptom that she managed to work through within psychotherapeutic alliance

Besides considering tinnitus as a complication following a hearing impairment or a sudden noise trauma, it is essential to consider the emotional suffering of the patient as it may be linked to personal experiences in life. Repressed traumatic incidents can manifest itself in the wake of tinnitus onset.  

Objective

In the case of tinnitus suffering psychotherapy resting on psychodynamic foundations has a very remote place in the literature. Naturally, the narrative of the client is of special quality in the psychodynamic psychotherapy approach. The objective of this study was therefore to illustrate how the narrative of a suffering client can be an inherent part of psychotherapy as well as a source of qualitative data in research on tinnitus (Dauman & Erlandsson, 2012). 

Method

The patient was a 70 years old woman with tinnitus (Lucie) who experienced her suffering as life threatening, which at times required psychiatric hospitalization. She participated in 16 psychotherapy sessions taken place over a period of eight months. The interview method building on free associations was judged to be the best way to understand the meaning behind evoked narratives of the patient.

Results

With the purpose to describe the analytical procedure we applied a narrative structure based on the following four labels: Listening to Lucie - Learning from Lucie’s speech - Narrative breakdown and psychotherapy  - Psychodynamic insights on Lucie’s emotional drives. The social dimension of the patient’s suffering was a central theme in her narrative, expressed by others’ reluctance to listen to her despair as well as her own deep sorrow for a broken social bond prior to her psychological brake-down.

Conclusion

The construction of meaning is a human act of self-preservation. In this case, it helped the patient to overcome alienation and made her tinnitus bearable.

Background: Qualitative research can help to improve the management of patients, meet their expectations and assist physicians in alleviating their suffering. The perception of moment-to-moment variability in tinnitus annoyance is an emerging field of exploration. This study sought to enlighten variability in tinnitus-induced disablement using a qualitative approach. Methods: Twelve participants (six females, six males, aged 51-79) were recruited via the French Tinnitus Association Journal for participation in recorded semi-structured interviews. Each participant had three interviews lasting 1 h, the sessions being separated one from the other by 2 weeks. Following recommendations of Charmaz (2014), the second and third interviews were aimed at gathering rich data, by enhancing the participants’ reflexivity in the circumstances of distress caused by tinnitus. After transcription, the data (n = 36 interviews) were analyzed using the approach to Grounded Theory proposed by Strauss and Corbin (1998). Results: Tinnitus as persistent frustration emerged as being the core category uniting all the other categories of the study. Hence, the core category accounted for the broader scope in participants’ experience of chronic tinnitus. It is suggested that tinnitus-induced disablement varied according to the degree of frustration felt by the participants in not being able to achieve their goals. The implications of this were analyzed using the following categories: “Losing body ownership,” “ Lacking perspectives,” and “Persevering through difficulties.” Based on these findings, we draw a substantive theory of tinnitus tolerance that promotes an active, disciplined and individualized approach to tinnitus-induced disablement. The model distinguishes pathways from sustained suffering to reduced annoyance (i.e., emerging tolerance). It accounts for difficulties that the participants experienced with a perceived unchanged annoyance over time. Furthermore, this model identifies a set of new attitudes toward oneself and others that tinnitus tolerance would entail. Conclusion: The subjective experience of frustration enlightens tinnitus-induced disablement, offering new perspectives for long-term self-management. Modulation of frustration, rather than moderation of tinnitus interference, is suggested as a new approach to the clinical management of tinnitus-related distress.

Background:

The process of habituation often remains obscure to those patients most disturbed by tinnitus.

Since three decades, the Cognitive-Behavioural Therapy (CBT) has promoted a habituation model (Hallam et al. 1984) founded on experimental data regarding the orienting response (OR) (Horvath 1980). Habituation of the OR is the natural extinction of attention to repeated identical stimuli which lose their ability to trigger orientation. Considering epidemiological data, the habituation model (Hallam & McKenna, 2006) hypothesizes that:

1. tolerance is “a natural and inevitable process” illustrated by three quarter of people with tinnitus;

2. annoyance is “a consequence of a failure to cease attending” to tinnitus, because of psycho-physiological factors that delay a natural process to occur (i.e., extinction of the OR)

Most tinnitus studies have attempted to compare groups of individuals, thus revealing inter-individuals differences, i.e., variations between compared subjects. For methodological reasons, inter-individual studies cannot take into account the variability of tinnitus experience, which has been known for decades to be relevant in daily practice with tinnitus patients. The concept of intra-individual variability has been promoted in the research literature, in order to shed light on this aspect of individual perception. In previous studies, unrelated to hearing, the concept of intra-individual variability implied inclusion of the environment (i.e., physical and social interactions) as a factor of individual performance. In tinnitus research, we believe that the concept of variability (within a person) could find a place beside the concept of variation (between groups of subjects). In this paper, four perspectives of tinnitus experiences from the clinical and research fields are described: (1) ENT consultation; (2) short-term group psychotherapy; (3) psychodynamic psychotherapy; and (4) clinical psychological research. Intra-individual variability stresses the importance of defining tinnitus in a dynamic way, contrary to the current definition of tinnitus as the perception of sound(s). In clinical practice, it is useful to embrace the perspective of the perceiverof tinnitus, and to include social and cultural circumstances as well as audiological/physical changes.

PURPOSE: This study presents a qualitative analysis of information posted on the Internet by two communities of French parents promoting the recognition of ADHD in the context of current health and school practices.

METHOD: Grounded Theory (Strauss & Corbin's approach) was applied to the posted messages, with the aim to discover the main concern and common theme through a constant comparison analysis.

RESULTS: Liberating parents from feeling responsible for their child's misconduct was found to be the core category. From this perspective, we account for the commitment of the digital communities to formalize the child's conduct as a consequence of a neurodevelopmental disorder. This approach helps to account for the promotion of behavioural expertise and conditioning strategies (e.g., positive reinforcement) for handling the child's so-called disorder as appropriate parental responses. Giving evidence for parenting struggles was the third main concern of the communities, in the face of perceived skepticism from professionals towards ADHD as a medical condition.

CONCLUSIONS: By using examples from countries that are found to have a more pro-medical approach to ADHD, the communities aim at improving such medical practices in France. Issues surrounding the claim that ADHD would require a specific style of parenting are also discussed.

Den neuropsykiatriska diagnosmanualen är ett trubbigt verktyg och saknar dessutom – i de flesta fall – ett individuellt perspektiv på de drabbade barnens situation. Att inte erkänna att människors erfarenheter och upplevelser skiljer sig åt, riskerar att marginalisera barn och unga. Vi behöver förstå att unga som försöker leva upp till vuxensamhällets förväntningar äger förmågor och egenskaper som behöver vårt skydd.

Tyvärr lägger psykologer inom barn- och ungdomspsykiatrin (BUP) och andra privata mottagningar för ADHD en stor del av sin tid på att utreda de lidande barnen, istället för att erbjuda terapi och stöd till både barn och vårdgivare. Föräldrar som i stället erbjuds hjälp att se sitt barn som en unik individ, utan den normativa bilden av önskvärt beteende, kan öka sin empatiska förmåga och sin tillit till barnet.

Objectives 

Tinnitus is a condition that almost entirely belongs to the field of audiological medicine, predominately regarded as a disorder of the ear. The purpose of this study was to explore the state of the art concerning the scientific discourse on tinnitus. Our main interest was to find the answers to: Who are involved in the research; i.e. within a disciplinary context? What approaches have been most influential?  How much influence does one specific perspective have on the discourse compared to another perspective?

Methods

 A selection of articles with tinnitus as the main objective, published in international journals between 1930-2013, were analyzed according to Critical discourse analysis and influenced by concepts deriving from (Laclau and Mouffe, 1985). Collected articles were representative, disciplinarily seen.

Results

Discourse analysis showed to be an appropriate method for studying the discourses on tinnitus within a time period of more then 80 years. The most influential discourse on the definition of tinnitus states that tinnitus is the perception of a sound (s) in the absence of an external sound source. It is clear that this definition has been adopted regardless of disciplinary field. Philosophical and existential aspects of tinnitus suffering are not prevalent in the discourses on tinnitus, a somewhat understandable result, as the influence of medical science is exceptional. 

Conclusion

Generally seen, the dominance of one discourse in a field of research can lead to an inhibition of other valuable discourses from the periphery (the field of discursivity). The most productive scientific strategy would be to allow several discourses to exist side by side. A significant point to stress, since no epidemiological data so far have demonstrated that the populations of tinnitus patients in any way are homogeneous.

The foremost, dominant, and influential scientific discourse of how to define tinnitus states that tinnitus is the perception of sound(s) in the absence of an external sound source. This is the most common statement among researchers in audiology and related fields, stemming from basic neurosciences (Kaltenbach, 2011) to applied psychophysiology (Kropp et al., 2012), audiology (Caffier et al., 2006), and behavioural psychology (Westin et al., 2008). It is puzzling that scientific affiliation and paradigms have had no influence on how the condition is defined as for instance one would expect psychologists and neurologists to have their own viewpoint on this issue.

The association between silence and powerlessness is one reason behind rape victims’ decision to remain silent about the assault. Rape victims, who most often are traumatized, face a wide array of negative experiences as a consequence of the violence. At the heart of this trauma narrative is the case of a female patient, 70 years old, suffering from tinnitus, for which she was offered psychotherapy. During one of the last therapy sessions the patient disclosed that she was raped at the age of 22 by a man she met when searching for a job. This case study explores the complex relationship between sensory fragments (i.e., hallucinations and tinnitus) and the disclosure of a hidden trauma that occurred half a century earlier. It also illustrates how establishing a confidential therapeutic alliance can contribute to a sustained integration of fragmented experiences of the trauma into a personal history.

The Nottingham Health Profile (NHP) has been used to investigate the health profiles in different medical conditions. It has, however, never been applied to tinnitus sufferers. The present study aimed at investigating relationships between the perceived severity of tinnitus, audiometric data, age, gender and non-disease specific health-related quality of life measured with the NHP divided into two sections; NHP I (topics related to health status) and NHP II (health induced problems in daily life). These parameters were statistically analysed to identify predictive factors to the perceived severity of tinnitus, described by the Tinnitus Severity Questionnaire (TSQ). A total of 186 consecutive tinnitus patients (57 females and 129 males) attending an audiological specialist clinic in Sweden were included in the study. The stepwise regression model used explained 37.8 per cent of the variance in the perceived severity of tinnitus, and the significant predictors were: "Emotions", "Sleep", and "Pain", three of the six dimensions of the NHP I. Differences between gender were found in NHP II and age-related differences emerged in NHP I when male and female patients were compared to normal controls.

Background:

The prevalent, neuropsychiatric, deficit perspective on childrenand youth diagnosed with ADHD prohibits a multidimensional approach wheresocio-economic status, family stress and relationships within the familiesare relevant factors to examine. Assessments of ADHD through the use ofrating scales and short-term interventions may lead not only to overdiagnosis but also to a reductionistic approach in the psychiatric field. This literaturereview aims to address research outside the prevailing discourse on ADHD as an organic brain dysfunction and broaden the perspectives on children’s behavioral difculties.

Methods:

The articles included in this applied, mixed-method, systematic review includes 26 peer-reviewed articles, both English and French, with a search focus on ADHD in children and youth related to Attachment stylesand relationships.

Results:

In the studies reported, researchers approached correlations between ADHD and attachment in different ways, and in most cases, there was a caution to address causality. The role of parents was found to be both buffering and aggravating for the appearance of ADHD. In the French case studies, the diagnosis was conceptualized as a relational phenomenon where the child’s behavior was inseparable from family member’s suffering.

Discussion:

This review article illustrates how children’s difficulties in terms of ADHD symptoms can be addressed through a paradigm where emotional and cognitive dysregulation is understood through psychosocial factors rather than as a neurological condition. In our view, to avoid an overly reductionistic and medicalized approach to children’s behavioral difficulties, it is time to reiterate the value of the biopsychosocial perspective.

Conclusion:

Professionals and researchers need to acknowledge that becoming diagnosed with ADHD has a strong connection to economic disadvantage, social status, and familial care. The academic discourse of addressing brain dysfunctions might serve the unintended purpose of masking emotional stress and social disadvantage that manifests across generations. A biopsychosocial approach to ADHD including family, emotional history, and socio-economic issues could imply a lesser focus on medical treatment as a first choice.

Objectives

Alleviating tinnitus is a challenging project for professionals within audiology and related fields. Meeting a suffering patient can be challenging as it demands a special interest for the patient as a complex living system. One perspective that risks being placed in the background, is the experience of the patient – the inside perspective.

Focus of the present study was to describe tinnitus through the eyes of the sufferer reflecting two aspects: Why is tinnitus accompanied by a psychological suffering? Can the personal life history contribute in making the relationship between tinnitus and the experienced suffering more comprehensible?

Methods

The unique meaning structure of patients’ reflections on their life with tinnitus was explored by the use of the narrative psychological approach. Participants were women and men in the age between 40-60 years and for whom tinnitus was experienced as a major problem. Individual, tape-recorded, deep interviews (3 – 4 for each patient) took place over a period of 3 to 4 months. The ethical committee in the West region of Sweden approved the study.

Results

In resemblance with how people suffering from a severe illness construct their stories (Gergen & Gergen, 1983) the analysis of the study samples’ narratives emanated from three plot dimensions: stability, progression and regression. Patients who in their passed had been faced with several serious challenges seemed to have a particularly pessimistic undertone. This may reflect how the construction of life stories interacts with previous experiences and interpretations. Tinnitus may thus pose a particularly great challenge for individuals who have experienced accumulative trauma in their past.

Conclusion

By allowing different voices to be heard increased understanding can be gained about how tinnitus interacts with unique life histories.

Background: The challenges facing people with chronic tinnitus include finding relief and rebuilding quality of life. However, previous traumatic episodes may influence adjustment and prolong suffering. Recovery implies reducing aggravating reactions and improving social roles, relationships and interests. Self-narratives about living with tinnitus have not yet received the attention they deserve in the research literature. Thus, the main goal of the present study was to illustrate how tinnitus suffering interacts with the participants’ unique life histories. Method: Four women and one man (ages 52–58) took part in the study after consulting a special hearing clinic for annoying tinnitus. Criteria for inclusion were that tinnitus was regarded as a problem with negative consequences for quality of life. The participants should be willing to share how the experience of tinnitus suffering interacts with their previous life story. Narrative methodology was employed in order to achieve the goals of the study. We used unstructured interviews with free conversation, which allowed for rich narratives with full contextual meaning. Results: The findings, based on the narrative analysis, revealed that three out of five participants presented a regressive form of narrative indicating ongoing struggles beyond tinnitus itself, which they were unable to bring to closure. For them, valued goals were continuously thwarted by frustrating circumstances in their lives, either past events or current unresolved issues. Progressive and stable narratives, as identified in the other two participants, demonstrated values that rely on others’ attitude and understanding toward their suffering, in sharp contrast to the regressive narratives. We suggest that a central issue in tinnitus rehabilitation should be to help suffering patients to overcome unresolved conflicts and thereby extend their ability for a fuller commitment in life. Conclusion: Considering enduring tinnitus as a chronic condition, whose course is likely to vary depending on the patient’s general health status, an alteration of progressive and stable narratives is likely to occur during the lifespan. A progressive narrative shows similarities to the core construct of the salutogenesis model of health promotion (1). In conclusion, a narrative approach in tinnitus rehabilitation can be health promoting by offering the patient the opportunity to engage in storytelling, which in turn can increase comprehensibility and a sense of coherence. © Copyright © 2020 Erlandsson, Lundin and Dauman.

A discourse analysis was performed based on an online document under the headline: "What is Attention Deficit Hyperactivity Disorder (ADHD, ADD)?" published by the National Institute of Mental Health (NIMH), USA. Three parts of the document were analysed: (1) The introductory part, as this sets the tone of the whole text. (2) Parts of the text that were specifically addressed to parents. (3) Etiology and pathology of "ADHD" with reference to a number of different symptoms and behaviors. Inattention and hyperactivity are presented in the document as a floating spectrum of symptoms caused by "ADHD." Other factors of importance for children's development, that is, early attachment, close relationships, previous experiences, culture, and contexts are ignored. Children who are perceived as inattentive and hyperactive are portrayed as having inherent difficulties with no reference to their emotions or efforts to communicate. The child is viewed as suffering from a lifelong disorder that might not be cured but controlled by a diagnosis and subsequent medication. Parents are advised to control their child's behavior and to strive for early diagnosis in order to receive treatment provided by experts. Those who are presented as experts rely on a biomedical model, and in the document, detailed descriptions of medication to correct the undesired behaviors are provided. The value of judgment in the assessment of different symptoms and behaviors that signifies "ADHD" is absent, rather taken-for-granted beliefs were identified throughout the document. A heterogeneous set of behaviors is solely described as a disorder and hereafter it is stressed that the same behaviors are caused by the disorder. In this manner, cause and effects of "ADHD" are intertwined through circular argumentation.

The nature of affective components seen in relation to tinnitus suffering was investigated in 70 patients consulting at an audiological clinic. They were interviewed and answered the Spielberger's State and Trait Anxiety Inventory (STAI) and the Beck's Depression Inventory (BDI). It was hypothesized that an anxious and depressed mood might be a sign of a serious psychiatric illness and, therefore, diagnostic interviews including the Structural Clinical Interview for DSM-III-R (Diagnostic and Statistical Manual of Mental Disorders), Axis II (personality) disorders (SCID-II), the BDI, the Montgomery A?sberg Depression Rating Scale (MADRS) and the Hopelessness Scale (HS), as well as biomedical tests, were conducted in a subgroup of 18 individuals. Fifty per cent (two women and seven men) were diagnosed as suffering from a personality disorder. No significant relationships were revealed when various biochemical markers were analysed. One and a half years later, 16 subjects were interviewed a third time and answered the STAI and the BDI. There was a clear trend in the data showing that patients having a personality disorder did not change their distress profile from the first to the third period of assessment. In these patients, a vicious circle caused by pronounced intolerance to life stress seems to operate in a more serious way than in patients who do not suffer from a personality disorder. © 2006 Taylor & Francis.

Purpose: To estimate the prevalence of perceived hearing loss, tinnitus, and temporary threshold shift (TTS) in community college students and to see whether those students' attitudes toward noise affected their perception of their own possible hearing loss, tinnitus, and TTS. Method: Young adults (N = 245; age 18-27) completed 3 questionnaires: the Hearing Symptom Description, Youth Attitude to Noise Scale, and Adolescents' Habits and Hearing Protection Use. Results: Perceived TTS and pain associated with loud noise were the most common hearing related factors, followed by perceived tinnitus and hearing loss. The students' attitudes toward noise in their daily environment showed the most negative response, whereas attitudes toward noise and concentration indicated a more positive, or less harmful, response. Chi-square analysis indicated a significant correlation between perceived hearing loss and respondents' overall attitudes toward noise exposure. Hearing protection use was limited for all participants, with the majority reporting never having used hearing protection. Conclusion: Approximately 6% of respondents reported perceived hearing loss, and 13.5% reported prolonged tinnitus. In general, participants had neutral attitudes toward noise. Over 20% of participants reported ear pain, tinnitus, and/or TTS after noise exposure at least sometimes. Coincidentally, few participants reported consistent use of hearing protection. © American Speech-Language-Hearing Association.

Forskning om rektors ledarskap är omfattande, men studier som undersöker gymnasierektors arbetssituation och ledarskap är mer sällsynta. Avsikten med den föreliggande studien var att bidra till att denna kunskapslucka fylls igen. Semistrukturerade intervjuer med tio gymnasierektorer genomfördes med fokus på rektors arbetsuppgifter, möjlighet att planera och styra arbetet, förväntningar kring ledarskapet, samt möjlighet att utvecklas och lära i arbetet. I resultaten av den tematiska analysen framträdde fyra teman: (1) ledarskapsideal, (2) kollegialt stöd, (3) ledarskap i en förändringsbenägen organisation, och (4) begränsat utrymme för reflektion. Ett övergripande, gemensamt tema: ”Ledarskapsparadox” speglar de högst varierande omständigheter och förhållanden i vardagen som en gymnasierektor ska kunna hantera, vilka också präglar resultatet av analysen. Ett något oväntat resultat var att gymnasierektor upplevde stort, eget ansvar för elevernas bästa. Studien kastar nytt ljus på gymnasierektorers ledarskap, och bidrar till ökad förståelse för vad rollen som ledare för en komplex organisation som gymnasieskolan kan innebära. Genom att knyta an till en arbetspsykologisk ledarskapsteori och formulera en arbetspsykologisk hypotes kan studien bidra till forskningen om arbetsintegrerat lärande (AIL).

Background: Adolescence is a period in life characterized by major neurobiological, physiological, and psychological changes. Those changes may give rise to worsened mental health and an increased prevalence of somatic complaints combined with a negative psychosocial environment. Rapid changes in society, which may also affect young people in several ways, call for a renewed screening of today's adolescents' mental and somatic well-being. Aim: The present study's primary aim was to measure the level of self-rated psychological distress and the prevalence of somatic complaints in a sample of Swedish high school students. As a secondary aim, it identifies gender-specific patterns and examines mental and somatic health in relation to negative psychosocial factors (such as parental alcohol use problems or the experience of physical or psychological abuse). Method: Two hundred and eighty-seven Swedish high school students completed a survey including the Brief Symptom Inventory (BSI) and a questionnaire about the presence of defined somatic complaints. In order to examine the relationship between negative psychosocial factors and mental and somatic health, three groups were formed: those reporting (i) parental substance use problems, (ii) previous experience of abuse, (iii) none of these problems. Results: The majority of the Swedish high-school students (>80%) reported no or only a few problems with psychological distress and no or only one somatic complaint. Female students disclosed a significantly higher psychological distress level captured by each BSI domain. The number of somatic complaints was similarly distributed between the genders. The students rarely reported parental substance use problems, but almost 40% of the male and 50% of the female students indicated the experience of physical and/or psychological abuse. Such negative psychosocial circumstances were related to an increased level of anxiety in the male and an increased general level of psychological distress in female students. Conclusions: The study confirmed female students' higher psychological distress level. Gender differences in the type of somatic complaints, but not in the number were detected. The experience of physical and/or psychological abuse was found to significantly worsen psychological distress in students of both genders.

In the present study the research objective was to gain insights into parental communication on an open Internet forum where parents had the opportunity to discuss issues related to ADHD. In order for clinicians to help troubled children brought to the health clinic it may be important to learn more about the life situations of these troubled families as treatment options can require complex interventions for the whole family. Our aim was thus to go beyond the neurobiological medical model of ADHD, which does not take into account contextual factors. In today’s society specialized online discussion forums are available for parents who seek support for various difficulties that arise in the family. The online forums are sources of research data. As research tools we used the narrative psychological approach for the analysis of 72 online naratives. These narratives provided support for that the parents embraced medical explanations for the difficulties experienced when raising children, despite obvious challenging life circumstances, such as for example being a single parent without social support. Even very young children had been given serious psychiatric medical diagnoses such as ADHD, Bipolar disorder, Mood disorders and Obsessive Compulsive Disorder. Some of them had been diagnosed with more than one of these disorders. The complexity of the parental nnarratives in the present study indicates that the neurobiological model is not sufficient enough to form the basis of a personalized and comprehensive care for vulnerable families.

Avhandlingsarbetet övergripande syfte är att synliggöra hur barns aktörskap i form av ett teoretiskt begrepp kan förstås i relation till förskolans undervisningspraktik. Data till studien genereras från: ljudinspelning av arbetslagets planering inför och efter undervisningen, videoupptagning av undervisningstillfället, ljudupptagning från video-stimulated reflection tillsammans med förskolläraren; a) enskilt b) med förskolläraren tillsammans med arbetslaget och c) med förskolläraren tillsammans med arbetslaget och förskolans rektor. Avsikten att genomföra video-stimulated reflection i tre steg och sedan genomföra en re-analys tillsammans med förskolläraren och arbetslaget grundar sig på att skapa en metodologisk triangulering över hur barns aktörskap förstås och hanteras i den undervisning som observerats. För att förtydliga en analys har gjorts och utdrag av analysen visas för deltagarna i studien. Deras synpunkter på den analys som gjorts leder analysarbetet framåt samt blir en del av resultatet.

Since somatic or somatosensory tinnitus (ST) was first described as a subtype of subjective tinnitus, where altered somatosensory afference from the cervical spine or temporomandibular area causes or changes a patient's tinnitus perception, several studies in humans and animals have provided a neurophysiological explanation for this type of tinnitus. Due to a lack of unambiguous clinical tests, many authors and clinicians use their own criteria for diagnosing ST. This resulted in large differences in prevalence figures in different studies and limits the comparison of clinical trials on ST treatment. This study aimed to reach an international consensus on diagnostic criteria for ST among experts, scientists and clinicians using a Delphi survey and face-to-face consensus meeting strategy. Following recommended procedures to gain expert consensus, a two-round Delphi survey was delivered online, followed by an in-person consensus meeting. Experts agreed upon a set of criteria that strongly suggest ST. These criteria comprise items on somatosensory modulation, specific tinnitus characteristics, and symptoms that can accompany the tinnitus. None of these criteria have to be present in every single patient with ST, but in case they are present, they strongly suggest the presence of ST. Because of the international nature of the survey, we expect these criteria to gain wide acceptance in the research field and to serve as a guideline for clinicians across all disciplines. Criteria developed in this consensus paper should now allow further investigation of the extent of somatosensory influence in individual tinnitus patients and tinnitus populations.

It seems to be a common opinion among researchers within the field of audiology that the prevalence of tinnitus will increase as a consequence of environmental factors, for example exposure to loud noise. Young people are exposed to loud sounds, more than any other age group, especially during leisure time activities, i.e. at pop concerts, discotheques and gyms. A crucial factor for the prevention of hearing impairments and hearing-related symptoms in the young population is the use of hearing protection. The focus of the present study is use of hearing protection and self-reported hearing-related symptoms, such as tinnitus and noise sensitivity in a young population of high-school students (N=1285), aged 13 to 19 years. The results show that the prevalence of permanent tinnitus and noise sensitivity, reported in the total group, was 8.7% and 17.1% respectively. Permanent tinnitus was not significantly related to level of socio-economic status, but age-related differences in the prevalence rates of experienced tinnitus and noise sensitivity were found to be significant. Older students reported such symptoms to a greater extent than younger students did. Those who reported tinnitus and other hearing-related symptoms protected their hearing to the highest extent and were the ones most worried.

The focus of the present study, of 1285 adolescents, was young people's attitudes towards noise and their use of hearing protection at discos and pop concerts. Comparisons were made between adolescents from different age groups, and with different socio-economic status. Logistic regressions indicated that "worry before attending noisy activities" and "hearing symptoms" such as tinnitus and noise sensitivity could, to some degree, explain the use of hearing protection in noisy environments. Another conclusion to be drawn from this study was that adolescents' attitudes and behaviors regarding hearing protection use differed between levels of socio-economic status. Individuals with high SES expressed more negative attitudes and used ear protection to a greater extent than those with lower SES. This result might indicate differences in the development of future auditory problems among individuals with different levels of socio-economic status. The cause of hearing impairment and tinnitus may not be restricted merely to noise exposure. Psychological aspects, such as attitudes towards noisy environments and the individual's behavior regarding the use of hearing protection may be considered as important factors in the understanding of why the prevalence of hearing­ related problems has increased among adolescents.

The foetal environment is filled with a variety of noises. Among the manifold sounds of the maternal respiratory, gastrointestinal and cardiovascular systems, the intonation properties of the maternal language are well perceived by the foetus, whose hearing system is already functioning during the last trimester of gestation. These intonation (melodic) features, reflecting native-language prosody, have been found to shape vocal learning. Having had ample opportunity to become familiar with their mother's language in the womb, newborns have been found to exhibit salient pitch-based elements in their own cry melodies. An interesting issue is whether an intrauterine exposure to a maternal pitch accent language, such as Swedish, in which emphatic syllables are pronounced typically on a higher pitch relative to other syllables will affect newborns' cry melody (fundamental frequency contour). The present study aimed to answer this question by quantitatively analysing and comparing the melody structure in 52 Swedish compared with 79 German newborns. In accordance with previous approaches, cry melody structure was analysed by calculating a melody complexity index (MCI) expressing the share of cries exhibiting two or more (well-defined) arc-like substructures uttered during the recording sessions. A low MCI reflects a dominance of cries with a 'simple', i.e. single-arc melody. A significantly higher MCI was found in the Swedish infant group, which further corroborates the assumption that the well-known foetal sensitivity for musical (melodic) stimuli seems to shape infants' cry melody.

The purpose of the present study was to investigate possible associations between college students' attitudes, risk-taking behaviour related to noisy activities, and hearing problems such as threshold shifts or self-experienced hearing symptoms. The sample included 258 students aged between 17 and 21 enrolled at the University of Pennsylvania, USA. A questionnaire measuring attitudes towards noise, use of hearing protection, and self-reported hearing symptoms was distributed among the students. After completing the questionnaire a hearing screening, including pure-tone audiometry and tympanometry, was conducted. The result revealed that 26% had thresholds poorer than the screening level of 20 dBHL. Attitudes were significantly related to self-experienced hearing symptoms, but not to threshold shifts. Attitudes and noise sensitivity was, significantly related to use of hearing protection. Hearing protection use was found in activities such as using firearms, mowing lawns, and when using noisy tools but was less reported for concerts and discotheques. It can be concluded that the young adults in this study expose themselves to hearing risks, since the use of hearing protection is in general very low. © 2009 Informa UK Ltd All rights reserved.

It seems to be a common opinion among researchers within the field of audiology that the prevalence of tinnitus will increase as a consequence of environmental factors, for example exposure to loud noise. Young people are exposed to loud sounds, more than any other age group, especially during leisure time activities, i.e. at pop concerts, discotheques and gyms. A crucial factor for the prevention of hearing impairments and hearing-related symptoms in the young population is the use of hearing protection. The focus of the present study is use of hearing protection and self-reported hearing-related symptoms, such as tinnitus and noise sensitivity in a young population of high-school students (N=1285), aged 13 to 19 years. The results show that the prevalence of permanent tinnitus and noise sensitivity, reported in the total group, was 8.7% and 17.1% respectively. Permanent tinnitus was not significantly related to level of socio-economic status, but age-related differences in the prevalence rates of experienced tinnitus and noise sensitivity were found to be significant. Older students reported such symptoms to a greater extent than younger students did. Those who reported tinnitus and other hearing-related symptoms protected their hearing to the highest extent and were the ones most worried.