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PURPOSE: The COVID-19 pandemic led to the implementation of preventive measures that exacerbated communication difficulties for individuals with hearing loss. This study aims to explore the perception of adults with hearing loss about the communication difficulties caused by the preventive measures and about their experiences with communication 1 year after the adoption of these preventive measures. METHOD: Individual semistructured interviews were conducted via videoconference with six adults who have hearing loss from the province of Québec, Canada. Data were examined using qualitative content analysis. RESULTS: The study found that face masks and in-person work (i.e., in opposition to remote work) were important barriers to communication because of hindered lipreading and competing noise in many workplaces. In contrast, preventive measures that allowed visual information transmission (e.g., transparent face masks, fixed plastic partitions) were considered favorable for communication. Communication partners were perceived as playing an important role in communication success with preventive measures: Familiar communication partners improved communication, whereas those with poor attitude or strategies hindered communication. Participants found that videoconferences could provide satisfactory communication but were sometimes hindered by issues such as bad audiovisual quality or too many participants. CONCLUSIONS: This study identified reduced access to speech reading and lack of general awareness about hearing issues as key barriers to communication during the pandemic. The decreased communication capabilities were perceived to be most problematic at work and during health appointments, and tended to cause frustration, anxiety, self-esteem issues, and social isolation. Suggestions are outlined for current and future public health measures to better consider the experience of people with hearing loss.

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BACKGROUND: Hearing loss predicts cognitive decline and falls risk. It has been argued that degraded hearing makes listening effortful, causing competition for higher-level cognitive resources needed for secondary cognitive or motor tasks. Therefore, executive function training has the potential to improve cognitive performance, in turn improving mobility, especially when older adults with hearing loss are engaged in effortful listening. Moreover, research using mobile neuroimaging and ecologically valid measures of cognition and mobility in this population is limited. The objective of this research is to examine the effect of at-home cognitive training on dual-task performance using laboratory and simulated real-world conditions in normal-hearing adults and older hearing aid users. We hypothesize that executive function training will lead to greater improvements in cognitive-motor dual-task performance compared to a wait-list control group. We also hypothesize that executive function training will lead to the largest dual-task improvements in older hearing aid users, followed by normal-hearing older adults, and then middle-aged adults. METHODS: A multi-site (Concordia University and KITE-Toronto Rehabilitation Institute, University Health Network) single-blinded randomized controlled trial will be conducted whereby participants are randomized to either 12 weeks of at-home computerized executive function training or a wait-list control. Participants will consist of normal-hearing middle-aged adults (45-60 years old) and older adults (65-80 years old), as well as older hearing aid users (65-80 years old, ≥ 6 months hearing aid experience). Separate samples will undergo the same training protocol and the same pre- and post-evaluations of cognition, hearing, and mobility across sites. The primary dual-task outcome measures will involve either static balance (KITE site) or treadmill walking (Concordia site) with a secondary auditory-cognitive task. Dual-task performance will be assessed in an immersive virtual reality environment in KITE's StreetLab and brain activity will be measured using functional near infrared spectroscopy at Concordia's PERFORM Centre. DISCUSSION: This research will establish the efficacy of an at-home cognitive training program on complex auditory and motor functioning under laboratory and simulated real-world conditions. This will contribute to rehabilitation strategies in order to mitigate or prevent physical and cognitive decline in older adults with hearing loss. TRIAL REGISTRATION: Identifier: NCT05418998. https://clinicaltrials.gov/ct2/show/NCT05418998.

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OBJECTIVE: To evaluate the Québec Audiological Assessment Protocol for Younger and Older Adults (QAAP-YOA) and its accompanying clinical tool efficacy to assess the needs of individuals with hearing loss in a simulated context. This study is the Phase 2 in the development of the QAAP-YOA. DESIGN: Participants completed two needs assessments with simulated clients and wrote audiological reports, while applying the QAAP-YOA with and without the use of its clinical tool. Interviews were filmed, and reports collected. Both were scored by two independent evaluators. A qualitative analysis of reports was also conducted. STUDY SAMPLE: Eleven audiology students and four early-career audiologists (n = 15). RESULTS: The clinical tool did not influence the interview process since both experimental conditions had similar compliance rates to the protocol (p = 0.114). Compliance rates for assessment reports were higher with the clinical tool (p < 0.001). Participants' conclusions after applying the QAAP-YOA were consistent across participants. The information provided in the reports was more comprehensive and coherent with the client's needs when participants used the clinical tool. CONCLUSIONS: The QAAP-YOA can lead to a greater standardisation of needs assessments and to more comprehensive reports, which may lead to intervention programs more closely aligned with clients' needs.

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BACKGROUND: Single-dose intrathecal opiates (ITO) could shorten the length of hospital stay compared to thoracic epidural analgesia (TEA). This study aimed to compare TEA with TIO in terms of length of hospital stay, pain control, and parenteral opioid consumption in patients undergoing gastrectomy for cancer. METHODS: The patients who underwent gastrectomy for cancer in 2007-2018 at the CHU de Québec-Université Laval were included. The patients were grouped as TEA and intrathecal morphine (ITM). The primary outcome was the length of hospital of stay (LOS). The secondary outcomes were numeric rating scales (NRS) for pain and parenteral opioid consumption. RESULTS: A total of 79 patients were included. There were no differences in preoperative characteristics between the two groups (all P > 0.05). The median LOS was shorter in the ITM group than in the TEA group (median, 7.5 vs. 10 days, P = 0.049). The opioids consumption at 12, 24, and 48 h postoperatively was significantly lower in the TEA group at all time points. The NRS score for pain was lower in the TEA group than in the ITM group at all time points (all P < 0.05). CONCLUSIONS: Patients with ITM analgesia undergoing gastrectomy presented shorter LOS than those with TEA. ITM had an inferior pain control that did not have a clinical impact on recovery in the cohort studied. Given the limitations of this retrospective study, further trials are warranted.

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Despite international recognition as an important coastal wetland, Tunis Lagoon is still subjected to anthropogenic pressures. This article provides valuable data on the spatio-temporal distribution, toxicity, and origins of polycyclic aromatic hydrocarbons (PAHs) in the Tunis Lagoon complex. PAHs' concentrations were measured in Marphysa sanguinea body and excrements, as well as in surface sediments. Total mean PAHs' concentrations reached a maximum of 2398 ng/g dry weight (DW) in sediments, 1007.19 ng/g DW in M. sanguinea, and 2602.05 ng/g DW in excrements. Diagnostic PAHs' ratios were used to determine whether PAHs' origins were pyrogenic or petrogenic. Our data showed a predominance of PAHs with a pyrogenic source. Principal component analysis showed PAHs isolated from polychaetes clearly separated from those measured in sediment and excrement. We believe that sediments are not the main source of bioaccumulation by M. sanguinea. Moreover, the toxicity of PAHs in sediments is moderate to high for benthic organisms.

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PURPOSE: Laparoscopic right hemicolectomy (LRH) can be performed with an intracorporeal anastomosis (IA) or extracorporeal anastomosis (EA). It is not clear which technique is best. This study evaluated the impact of each anastomosis technique on perioperative safety and postoperative evolution. METHODS: We performed a retrospective study at a tertiary colorectal surgery center. All patients who had an elective LRH from 2015 to 2019 were analyzed according to the anastomosis technique used. RESULTS: In total, 285 patients were included in the study. IA was performed in 64 patients (22.5%). Mean operative time was longer in the patients with IA (IA, 160±31 minutes vs. EA, 138±42 minutes; P<0.001). No differences were observed in intraoperative complications, time to first bowel movement, length of stay, reoperation, or rehospitalization. Time to first flatus was longer in the patients with IA (P=0.049). At 30 days after surgery, there were no differences in the frequency of anastomotic leak (IA, 0% vs. EA, 2.3%; P=0.59), bleeding (IA, 3.1% vs. EA, 2.7%; P>0.99), or intraabdominal abscess (IA, 0% vs. EA, 0.5%; P>0.99). During follow-up, we noted more incisional hernias in patients with EA (IA, 1.6% vs. EA, 11.3%; P=0.01) and a trend toward more hernia in patients with EA in multivariate analysis (hazard ratio, 7.13; P=0.06). Anastomosis technique had no influence on recurrence. CONCLUSION: For LRH, both IA and EA are safe, with a low incidence of complications when performed by experienced surgeons. IA may be associated with a lower incidence of incisional hernia.

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OBJECTIVE: To understand the communicational and psychosocial effects of COVID-19 protective measures in real-life everyday communication settings. DESIGN: An online survey consisting of close-set and open-ended questions aimed to describe the communication difficulties experienced in different communication activities (in-person and telecommunication) during the COVID-19 pandemic. STUDY SAMPLE: 172 individuals with hearing loss and 130 who reported not having a hearing loss completed the study. They were recruited through social media, private audiology clinics, hospitals and monthly newsletters sent by the non-profit organisation "Audition Quebec." RESULTS: Face masks were the most problematic protective measure for communication in 75-90% of participants. For all in-person communication activities, participants with hearing loss reported significantly more impact on communication than participants with normal hearing. They also exhibited more activity limitations and negative emotions associated with communication difficulties. CONCLUSION: These results suggest that, in times of pandemic, individuals with hearing loss are more likely to exhibit communication breakdowns in their everyday activities. This may lead to social isolation and have a deleterious effect on their mental health. When interacting with individuals with hearing loss, communication strategies to optimise speech understanding should be used.

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This work assessed the impact of polycyclic aromatic hydrocarbons (PAHs) on the polychaeta Marphysa sanguinea in Tunis Lagoon. Highest PAHs concentrations were accumulated at station E with maximum Σ PAH of 6028,87 ng/g DW. Changes in animal physiology were clearly related to bioaccumulated PAH. In fact, high levels of immune biomarkers (cyclooxygenase [COX] and lysozyme activity with maximum of 44631,10 FU/mn/mg protein and 0,017 lysozyme activity/mn/mg protein, respectively) were recorded at stations B and E. Triacylglycerol (TAG), the energy source, was lowest at the most polluted stations (E and B), while phospholipids (PL) were highest at the control station. Statistical analysis revealed a probable effect of both low and high molecular weight PAHs on variations in energy storage lipids (TAG and sterol and wax esters [SE/WE]) and membrane lipids, particularly PL. Our results encourage the use of M. sanguinea to assess pollution levels in coastal ecosystems.

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OBJECTIVE: To develop a protocol and a clinical tool to assess the audiological needs of younger and older adults with hearing loss. DESIGN: A needs assessment protocol was developed based on recommendations of an expert panel, existing literature, the International Classification of Functioning, Disability and Health, client-centered care and goal setting. The protocol was reviewed by the expert panel. Semi-structured interviews were conducted with clinical audiologists to validate its content and explore its clinical applicability. A clinical tool was developed to make the administration of the protocol more uniform. STUDY SAMPLE: 15 experts and 14 clinical audiologists. RESULTS: Feedback received from the participants (experts and clinicians) supported the content validity of the needs assessment protocol and clinical tool. The topics covered within the protocol and tool include: Audiological needs (activity limitations, participation restrictions, environmental factors), Living conditions (social networks, living environment), Personal factors, Discussion with the client to define the intervention plan, and Recommendations. CONCLUSIONS: A protocol and a clinical tool were developed to help audiologists and clients undertake a comprehensive audiological needs assessment. The content validity of the protocol and tool were demonstrated. Their use can facilitate the delivery of a client-centered assessment using a uniform and comprehensive approach.

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In order to limit the spread of the coronavirus, several protective measures have been put in place in the community, in private and public residences and in health care centers. Some measures have a negative impact on communication. They include physical distancing, the use of face masks and shields as well as the increased use of telephone and videoconferencing for distance communication. The effects of COVID-19 are particularly harsh on older adults. Consequently, older adults, especially those with hearing loss, are particularly at risk of experiencing communication breakdowns and increased social isolation. Health care professionals should learn about and be encouraged to use communication strategies to maintain good interactions with their patients. This article proposes practical suggestions to health professionals who interact with older adults, especially those who have difficulty understanding speech. The goal of this article is to inform on the prevalence of hearing loss, the hearing difficulties experienced by older adults, the manifestations of hearing problems, the effects of pandemic protection measures on communication and the strategies that can be used to optimize professional-patient communication during a pandemic.

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Spillages at sea of diluted bitumen (dilbit) from oil sands have received little attention until now. To our best knowledge, there are no reports on the impact of a severe exposure to dilbit on the Blue mussel (Mytilus edulis). In this study, adult Blue mussels were exposed to one conventional crude oil (Heidrun) and two dilbits (Cold Lake Blend and Access Western Blend) for a period of 7 days in an ice-covered environment and then maintained for three months until the spawning season. The exposed mussels were monitored for aromatic hydrocarbon bioaccumulation, physiological energetic budget, cellular stress, byssus production and gametogenesis. In spring, spawning was induced to characterize breeding success. Bioaccumulation of polycyclic aromatic hydrocarbons (PAHs) was detected after three days of exposure, with higher concentrations of PAHs associated to the conventional oil (5.49 ± 0.12 µg·g-1 d.w.) compared to both dilbits (0.91 ± 0.02 µg·g-1; 0.51 ± 0.03 µg·g-1 d.w.). Despite a fast depuration rate and a good resilience of the exposed mussels, significant negative effects were observed at the cellular, physiological and fitness levels, especially in offspring. Our results suggest a higher toxicity of the diluted bitumen compared to the conventional crude despite the lower bioaccumulation of total PAHs. Dilbit treatments caused evident negative transgenerational effects on unexposed F1 generation.

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OBJECTIVE: Current evidence suggests that an enhanced right ear advantage (REA) in dichotic listening (DL) among older adults may originate from age-related structural changes in the corpus callosum and age-related decline in cognitive processes. Less is known about the effect of information processing at lower portions of the auditory system on DL performance. The present study investigates whether interaural differences (ID) in sensory processing at lower levels of the auditory system are associated with the magnitude of the REA in DL among older adults. DESIGN: Sixty-eight older adults participated in the study. Participants were assessed with a DL test using nonforced (NF) and forced attention paradigms. Hearing sensitivity, transient-evoked otoacoustic emission (TEOAE), contralateral suppression of TEOAE, a proxy measure of medial olivocochlear activation, and auditory brainstem response to speech stimuli (speech-ABR) were tested in both ears separately. The ID in sensory processing at lower levels of the auditory system was derived by calculating the difference between the RE and LE for each auditory measure. Bivariate and multivariate regression models were performed. One multivariate model for each DL paradigm (NF and forced attention) was independently constructed. Measures of cognitive speed of processing and cognitive flexibility were accounted for in the regression models. RESULTS: For both multivariate regression models, ID in pure-tone thresholds and ID in MOC suppression of TEOAE were significantly associated with the magnitude of the REA for DL among older adults. Cognitive measures of speed of processing and cognitive flexibility also contributed to the magnitude of the REA. CONCLUSION: These results suggest that ID in sensory processing at lower levels of the auditory system account, at least in part, for the increased magnitude of the REA in DL among older adults.

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BACKGROUND: Some evidence suggests that young adults exhibit a selective laterality of auditory brainstem response (ABR) elicited with speech stimuli. Little is known about such an auditory laterality in older adults. OBJECTIVE: The aim of this study was to investigate possible asymmetric auditory brainstem processing between right and left ear presentation in older adults. METHODS: Sixty-two older adults presenting with normal hearing thresholds according to their age and who were native speakers of Quebec French participated in this study. ABR was recorded using click and a 40-ms /da/ syllable. ABR was elicited through monaural right and monaural left stimulation. Latency and amplitude for click-and speech-ABR components were compared between right and left ear presentations. In addition, for the /da/ syllable, a fast Fourier transform analysis of the sustained frequency-following response (FFR) of the vowel was performed along with stimulus-to-response and right-left ear correlation analyses. RESULTS: No significant differences between right and left ear presentation were found for amplitudes and latencies of the click-ABR components. Significantly shorter latencies for right ear presentation as compared to left ear presentation were observed for onset and offset transient components (V, A and O), sustained components (D and E), and voiced transition components (C) of the speech-ABR. In addition, the spectral amplitude of the fundamental frequency (F0) was significantly larger for the left ear presentation than the right ear presentation. CONCLUSIONS: Results of this study show that older adults with normal hearing exhibit symmetric encoding for click stimuli at the brainstem level between the right and left ear presentation. However, they present with brainstem asymmetries for the encoding of selective stimulus components of the speech-ABR between the right and left ear presentation. The right ear presentation of a /da/ syllable elicited reduced neural timing for both transient and sustained components compared to the left ear. Conversely, a stronger left ear F0 encoding was observed. These findings suggest that at a preattentive, sensory stage of auditory processing, older adults lateralize speech stimuli similarly to young adults.

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OBJECTIVE: To discuss the steps necessary to facilitate hearing health care in the context of well-being and healthy living. DESIGN: Common themes among the articles in this special supplement of the International Journal of Audiology were used to identify issues that must be addressed if audiology is to move from being hearing-focussed to taking a holistic perspective of hearing care in the context of healthy aging. These are discussed within the context of other published literature. RESULTS AND CONCLUSIONS: Three needs were identified: (i) Increased interdisciplinary education to raise awareness of the interplay between hearing and health. (ii) Increased emphasis on counselling education in audiology programs so that audiologists are equipped with the knowledge, competence and confidence to provide counselling and emotional support to their patients, beyond care. (iii) Redefinition of therapeutic goal setting and hearing outcomes to include aspects of well-being, so that audiologists can capture and patients realise that that good hearing outcomes can have a direct positive impact on a person's quality of life that extends beyond their improved ability to hear. It was emphasised that each of these needs to be considered within the context of the audiologists' scope of practice and audiologists' well-being.

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Background: Two members from an academic tertiary hospital went to the National Cancer Institute in Tokyo, Japan, to learn how to perform an adequate D2 lymphadenectomy and to then introduce this technique in the surgical care of patients undergoing surgery for gastric cancer at a Western hospital. We aimed to compare the perioperative outcomes and long-term survival of Western patients who underwent gastric resection, performed by these 2 surgeons, before and after the surgeons' shortcourse technical training in Japan. Methods: We conducted a retrospective comparative study of all patients (n = 27 before training and n = 79 after training) who underwent gastric resection for cancer by the same 2 surgeons between September 2007 and December 2017 at the Centre Hospitalier Universitaire de Québec - Université Laval (Québec, Canada). We collected data on patient demographic, clinical, surgical, pathological and treatment characteristics, as well as long-term survival and complications. Results: In the post-training group, the number of sampled lymph nodes was higher (median 33 v. 14, p < 0.0001), but this increase did not result in a higher number of histologically positive lymph nodes (p = 0.35). The rate of complications was lower in the post-training group (15.2% v. 48.2%, p = 0.002). The hospital stay was shorter in the post-training group (11 [standard deviation (SD) 7] v. 23 [SD 45] d, p = 0.03). The median survival was higher in the post-training group (47 v. 29 mo, p = 0.03). Conclusion: These results suggest that a short-course technical training in D2 lymphadenectomy, completed in Japan, improved lymph node sampling, decreased postoperative complications and improved survival of patients undergoing surgery for gastric cancer in a Western setting.

Contexte: Deux membres d'un centre hospitalier universitaire en soins tertiaires se sont rendus à l'Institut national du cancer de Tokyo, au Japon, pour apprendre à effectuer une lymphadénectomie de type D2 et ensuite intégrer cette technique aux interventions chirurgicales visant à contrer un cancer de l'estomac dans un hôpital occidental. L'objectif était de comparer les issues périopératoires et la survie à long terme des patients qui ont subi une gastrectomie réalisée par les 2 chirurgiens, avant et après leur formation technique de courte durée au Japon. Méthodes: Nous avons mené une étude rétrospective comparative portant sur tous les patients (n = 27 avant la formation, et n = 79 après la formation) qui, entre septembre 2007 et décembre 2017, ont subi une gastrectomie pour un cancer réalisée par les 2 chirurgiens au Centre hospitalier universitaire de Québec ­ Université Laval (Québec, Canada). Nous avons recueilli des données démographiques, cliniques, chirurgicales et pathologiques ainsi que des données sur les traitements, la survie à long terme et les complications. Résultats: Dans le groupe de patients opérés après la formation, un plus grand nombre de ganglions lymphatiques a été prélevé (médiane 33 c. 14; p < 0,0001), mais cette augmentation n'était pas accompagnée d'un plus grand nombre d'analyses histologiques positives (p = 0,35). Le taux de complication était plus faible dans ce groupe (15,2 % c. 48,2 %; p = 0,002), et l'hospitalisation, plus courte (11 jours [écart type (É.-T.) 7] c. 23 jours [É.-T. 45]; p = 0,03). De plus, la durée de survie médiane était plus élevée dans ce groupe (47 mois c. 29 mois; p = 0,03). Conclusion: Ces résultats laissent croire qu'une courte formation technique sur la lymphadénectomie de type D2, réalisée au Japon, améliore le prélèvement de ganglions lymphatiques, diminue les complications postopératoires et prolonge la survie des patients qui subissent une chirurgie pour un cancer de l'estomac en Occident.

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Coastal lagoons are among the most vulnerable ecosystems as they are often exposed to different anthropogenic activities. The Polychaetes, which are dominant components in macrobenthic community, are particularly exposed to contamination. The current study was designed to assess and compare the sensitivity of different polychaetes species towards urban pollution. To do this, three polychaete species: Perinereis cultrifera, Diopatra neapolitana, and Marphysa sanguinea, were collected from the Tunis South Lagoon during summer 2013. A set of biomarkers indicative of genotoxicity (DNA damage), biotransformation, and oxidative stress (glutathione S-transferase, GST) as well as immune response (cyclooxygenase activity (COX), lysozyme activity, and nitric oxide level (NOx)), was used. The results revealed that D. neapolitana and P. cultrifera exhibited higher genetic alteration and GST activity and more prominent immune response when compared with M. sanguinea. These findings denote of the higher sensitivity of D. neapolitana and P. cultrifera to urban pollution and suggest their possible use in environmental biomonitoring programs.

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OBJECTIVES: Audiologists and hearing aid users (HAUs) generally agree that an adaptation period is needed following the first hearing aid (HA) experience. The main purpose of this study is to investigate the acclimatization of older adult listeners with hearing loss to HAs using listening effort and behavioral measures. DESIGN: Participants (N=47) were older adults with mild to moderately severe sensorineural hearing loss. Thirty-two participants were new HAUs and 15 participants were experienced HAUs. New HAUs were randomly assigned to one of two groups: noise reduction algorithms and directional microphones activated or noise reduction algorithms and directional microphones deactivated. Speech recognition in noise and listening effort were assessed on 8 different occasions during a 10-month period. A dual-task paradigm was used to measure the listening effort deployed to recognize speech in noise. The primary task consisted of the Hearing in Noise Test which also served as the behavioral speech in noise measure. The secondary task was a tactile pattern-recognition task in which participants had to identify a sequence of three tactile stimuli that varied in duration. The two listening effort outcomes were the proportional dual-task cost and the response time on the secondary task. Cognitive abilities, including working memory and speed of processing, were evaluated using the Reading Span Test and the Digit Symbol Substitution Test, respectively. RESULTS: Results show a significant time*group interaction. Both groups of new HAUs showed improvement over time in speech in noise performances (change of ~2 dB signal to noise ratio) and the experienced HAUs did not improve over time. The acclimatization effect was observed over a period of 4 weeks. There was no significant change over time on both measures of listening effort. There was no association between amplitude of acclimatization and the cognitive abilities measured. CONCLUSION: An acclimatization effect following HA experience was observed. Specifically, the new HAUs displayed a clinically significant change of 2 dB in signal to noise ratio on the Hearing in Noise Test 4 weeks following their initial fitting. The acclimatization effect is not correlated to cognitive abilities.

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Research involving the general population of people who use a spoken language to communicate has demonstrated that older adults experience cognitive and physical changes associated with aging. Notwithstanding the differences in the cognitive processes involved in sign and spoken languages, it is possible that aging can also affect cognitive processing in deaf signers. This research aims to explore the impact of aging on spatial abilities among sign language users. Results showed that younger signers were more accurate than older signers on all spatial tasks. Therefore, the age-related impact on spatial abilities found in the older hearing population can be generalized to the population of signers. Potential implications for sign language production and comprehension are discussed.

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Objective: To develop a web-based application for a colour pattern memory recognition task as the secondary task of a dual-task paradigm and to compare the listening effort required by adolescents with hearing loss (HL) under two conditions (HA and HA + FM system), to adolescents with normal hearing (NH).Design: Cohort study. The participants underwent a dual-task paradigm, including the Hearing in Noise Test as the primary task and a colour memory task as the secondary task. A platform, PALETA, was developed to assess the secondary task.Study sample: In total, 31 adolescents were enrolled, of which 13 adolescents had HL and 18 adolescents had NH (mean age, 14 years).Results: Adolescents with NH scored significantly better on the secondary task compared to participants with HL using a HA. However, on analysing response time, no significant differences were observed among the groups.Conclusion: PALETA is proposed as a test procedure for the secondary task. The results revealed that the use of an FM system reduces the listening effort that adolescents with HL deploy to recognise speech in noise, and that listening effort data by number of correct responses is a way of investigating the benefits of using FM system.

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In this study the Polychaeta Marphysa sanguinea, was tested to investigate the impact of metal pollution on the environmental state of a coastal Mediterranean lagoon, Tunis Lagoon (Tunisia). A multi-biomarker approach comprising glutathione-stransferase, cyclooxygenase, lysozyme activity, and lipid class composition of the Polychaeta was employed on a seasonal basis in the present investigation. The multivariate statistical approach (principal component analysis and Pearson correlation) clearly demonstrated different spatial patterns in biomarker values and lipid class concentrations. The phospholipids were the dominant lipid class in M. sanguinea, with the highest value found at the control station. The impact of pollution was most clearly observed on the main storage lipid class, triacylglycerol, which was lowest in the most impacted sites. Our work suggests that M. sanguinea can be used in warmer Mediterranean costal habitats as a sentinel species of contaminated ecosystems.

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