Studies suggest that hourly digital screen time increases adolescents' depressive symptoms and emotional regulation difficulties. However, causal mechanisms behind such associations remain unclear. We hypothesized that problem-focused and/or emotion-focused engagement coping moderates and possibly mediates this association over time. Questionnaire data were collected in three waves from a representative sample of Swedish adolescents (0, 3 and 12 months; n = 4793; 51% boys; 99% aged 13-15). Generalized Estimating Equations estimated the main effects and moderation effects, and structural regression estimated the mediation pathways. The results showed that problem-focused coping had a main effect on future depression (b = 0.030; p < 0.001) and moderated the effect of screen time (b = 0.009; p < 0.01). The effect size of this moderation was maximum 3.4 BDI-II scores. The mediation results corroborated the finding that future depression was only indirectly correlated with baseline screen time, conditional upon intermittent problem-coping interference (C'-path: Std. beta = 0.001; p = 0.018). The data did not support direct effects, emotion-focused coping effects, or reversed causality. We conclude that hourly screen time can increase depressive symptoms in adolescent populations through interferences with problem-focused coping and other emotional regulation behaviors. Preventive programs could target coping interferences to improve public health. We discuss psychological models of why screen time may interfere with coping, including displacement effects and echo chamber phenomena.

Background: eHealth systems have been increasingly used to manage depressive symptoms in patients with somatic illnesses. However, understanding the factors that drive their use, particularly among patients with breast and prostate cancer, remains a critical area of research.

Objective: This study aimed to determine the factors influencing use of the NEVERMIND eHealth system among patients with breast and prostate cancer over 12 weeks, with a focus on the Technology Acceptance Model.

Methods: Data from the NEVERMIND trial, which included 129 patients with breast and prostate cancer, were retrieved. At baseline, participants completed questionnaires detailing demographic data and measuring depressive and stress symptoms using the Beck Depression Inventory–II and the Depression, Anxiety, and Stress Scale–21, respectively. Over a 12-week period, patients engaged with the NEVERMIND system, with follow-up questionnaires administered at 4 weeks and after 12 weeks assessing the system’s perceived ease of use and usefulness. Use log data were collected at the 2- and 12-week marks. The relationships among sex, education, baseline depressive and stress symptoms, perceived ease of use, perceived usefulness (PU), and system use at various stages were examined using Bayesian structural equation modeling in a path analysis, a technique that differs from traditional frequentist methods.

Results: The path analysis was conducted among 100 patients with breast and prostate cancer, with 66% (n=66) being female and 81% (n=81) having a college education. Patients reported good mental health scores, with low levels of depression and stress at baseline. System use was approximately 6 days in the initial 2 weeks and 45 days over the 12-week study period. The results revealed that PU was the strongest predictor of system use at 12 weeks (βuse at 12 weeks is predicted by PU at 12 weeks=.384), whereas system use at 2 weeks moderately predicted system use at 12 weeks (βuse at 12 weeks is predicted by use at 2 weeks=.239). Notably, there were uncertain associations between baseline variables (education, sex, and mental health symptoms) and system use at 2 weeks, indicating a need for better predictors for early system use.

Conclusions: This study underscores the importance of PU and early engagement in patient engagement with eHealth systems such as NEVERMIND. This suggests that, in general eHealth implementations, caregivers should educate patients about the benefits and functionalities of such systems, thus enhancing their understanding of potential health impacts. Concentrating resources on promoting early engagement is also essential given its influence on sustained use. Further research is necessary to clarify the remaining uncertainties, enabling us to refine our strategies and maximize the benefits of eHealth systems in health care settings.

This paper investigates noise annoyance from wind turbines of different sizes and in different acoustic surroundings. A listening test was conducted where wind turbine noises were rated alone and together with background sounds from a deciduous forest, a busy city and road traffic. A magnitude production procedure was implemented which showed high correlation between repeated measurements and the results were analysed using A-weighted sound levels, signal-to-noise ratios and time varying loudness and partial loudness. Ratings for wind turbine sound heard alone showed no coherent statistically significant differences between wind turbine types, neither for A-weighted sound levels nor loudness. The masking test indicate that road traffic noise is a superior masker compared to forest sound. However, these effects where only statistically significant at low sound levels, below the range 35–45 dB(A), where noise guidelines for wind turbine noise usually are stipulated.

Forskning visar att buller orsakar ohälsa för många medborgare både i Europa generellt, och i Sverige. De två viktigaste negativa hälsoeffekterna av buller är försämrad sömn och bullerstörning. Trafikbuller är den främsta orsaken till dessa effekter.

I denna studie användes enkäter samt data från bullerkartor för att undersöka bullerstörning från trafik. Av de 1168 personerna i urvalet deltog 678 personer. Deltagarna svarade på 39 frågor rörande: buller, hälsa, rekreationsbeteende, luftkvalitéupplevelse samt demografi.

Studiens första syfte var att undersöka bullerstörning från vägtrafik och spårtrafik, hos boende i Silverdal. Resultatet visade att de boende i Silverdal är mer störda av buller än genomsnittet i Sverige, men även jämfört med de beräknade störningsnivåerna från bullerkartorna. Faktorerna som starkast påverkade störning från vägtrafik var: upplevda vibrationer, den upplevda luftkvalitén hemma, utbildningsnivå, om sovrumsfönstret vette mot en lokalgata samt attityd till vägtrafik. Motsvarande faktorer för spårtrafik var: upplevda vibrationer, sovrumsfönster mot spår samt utbildningsnivå.

Studiens andra syfte undersökte upplevelse av rekreationsmöjligheter och rekreationsbeteende. Resultatet visade att majoriteten av deltagarna upplever mycket bra möjligheter till rekreation. Områden, nära hemmet, med natur samt med lägre nivåer av bullernivåer, var mest besökta.

Studiens tredje syfte var att undersöka hur boende i Silverdal upplevde luftkvalitén. Resultatet visar att utomhusluften är det som upplevs mest problematiskt, medan färre upplever inomhusluften som dålig.

Studien visar att många boende i Silverdal är störda av buller, både jämfört med nationella undersökningar, men även i relation till den beräknade bullerstörningsnivån från bullerkartor. Rekreationsmiljön i området upplevs som relativt god och lufkvalitén upplevs som ett relativt mindre problem jämfört med bullret. Utomhusmiljön är den miljö som upplevs som är mest problematiskt för boende. Bulleråtgärder utomhus längs bullerkällornas sträckning rekommenderas, dels eftersom de efterfrågas av de boende, del för att de  minskar bullret både utomhus och inomhus.

Studies of effects on speech intelligibility from aircraft noise in outdoor places are currently lacking. To explore these effects, first-order ambisonic recordings of aircraft noise were reproduced outdoors in a pergola. The average background level was 47 dB L-Aeq. Lists of phonetically balanced words (L-ASmax,L- word = 54 dB) were reproduced simultaneously with aircraft passage noise (L-ASmax,L- noise = 72-84 dB). Twenty individually tested listeners wrote down each presented word while seated in the pergola. The main results were (i) aircraft noise negatively affects speech intelligibility at sound pressure levels that exceed those of the speech sound (signal-to-noise ratio, S/N < 0), and (ii) the simple A-weighted S/N ratio was nearly as good an indicator of speech intelligibility as were two more advanced models, the Speech Intelligibility Index and Glasberg and Moore's [J. Audio Eng. Soc. 53, 906-918 (2005)] partial loudness model. This suggests that any of these indicators is applicable for predicting effects of aircraft noise on speech intelligibility outdoors.

The Swedish guideline value for aircraft noise of 70 dB LAmax (time-weighting Slow) is intended to protect residential outdoor living spaces, such as balconies, patios and terraces. To provide empirical foundation for a revision of this policy, a questionnaire study was conducted among residents living close to seven Swedish airports. The questionnaire included questions on aircraft noise annoyance as experienced the dwelling’s outdoor living space. About 3100 persons answered the questionnaire (response rate 65%). Annoyance responses were linked to aircraft noise exposure, LAmax and Lden, calculated  using the Integrated Noise Model (INM 7.0). A consistent relationship was found between, on the one hand, the number of aircraft events &#8805; 70 dB LAmax, and, on the other hand, the proportion of residents annoyed by aircraft noise at their outdoor living space. The proportion of annoyed residents increased rapidly from exposures greater than 3-5 events per day and evening. The same trend was found for activity disturbances at outdoor living spaces, in particular for disturbances related to speech communication, such as conversatiobn or radio listening. In the present sutdy, a large majority of residents exposed to 3-5 aircraft events &#8805; 70 dB LAmax were exposed to less than 50 dB Lden (outdoor at the façade), which suggest that Lden-guideline-values exceeding 50 dB may not protect against noise annoyance at outdoor living spaces.

Forskningsprogrammet MAXFLYG har undersökt hur vi störs av flygbuller på uteplats i anslutning till bostäder och hälsoeffekter som bullret orsakar. Programmet har bland annat studerat bullerstörning i relation till bullernivåer och i relation till antal flyghändelser, samt undersökt effekter av flygbuller på stressnivåer och sömnsvårigheter.

Background: Many intensive care unit (ICU) patients describe noise as stressful and precluding sleep. No previous study in the adult setting has investigated whether room size impacts sound levels or the frequency of disruptive sounds. Methods: A-frequency S-time weighted equivalent continuous sound (L(AS)eq), A-frequency S-time weighted maximum sound level (L(AS)max) and decibel C peak sound pressure (L(C)peak) were measured during five 24-h periods in each of the following settings: three-bed room with nursing station (NS) alcove, single-bed room with NS alcove (1-BR with NSA) and single-bed room with bedside NS. Cumulative restorative time (CRT) (>5min with L(AS)max <55dB and L(C)peak <75dB) was calculated to describe calm periods. Two 8-h bedside observations were performed in each setting in order to note the frequency and sources of disruptive sounds. Results: Mean sound pressure levels (L(AS)eq) ranged between 52 and 58dBA, being lowest during night shifts. There were no statistically significant differences between the room types in mean sound levels or in CRT. However, disruptive sounds were 40% less frequent in the 1-BR with NSA than in the other settings. Sixty-four percent of disruptive sounds were caused by monitor alarms and conversations not related to patient care. Conclusions: Single-bed rooms do not guarantee lower sound levels per se but may imply less frequent disruptive sounds. Sixty-four percent of disruptive sounds were avoidable. Our findings warrant sound reducing strategies for ICU patients.

An acoustic environment contains sounds from various sound sources, some generally perceived as wanted, others as unwanted. This thesis examines the effects of wanted and unwanted sounds in acoustic environments, with regard to masking, stress recovery, and speech intelligibility.

In urban settings, masking of unwanted sounds by sounds from water structures has been suggested as a way to improve the acoustic environment. However, Study I showed that the unwanted (road traffic) sound was better at masking the wanted (water) sound than vice versa, thus indicating that masking of unwanted sounds with sounds from water structures may prove difficult. Also, predictions by a partial loudness model of the auditory periphery overestimated the effect of masking, indicating that centrally located informational masking processes contribute to the effect. Some environments have also been shown to impair stress recovery; however studies using only auditory stimuli is lacking. Study II showed that a wanted (nature) sound improve stress recovery compared to unwanted (road traffic, ambient) sounds. This suggests that the acoustic environment influences stress recovery and that wanted sounds may facilitate stress recovery compared to unwanted sounds. An additional effect of unwanted sounds is impeded speech communication, commonly measured with speech intelligibility models. Study III showed that speech intelligibility starts to be negatively affected when the unwanted (aircraft sound) masker have equal or higher sound pressure level as the speech sound. Three models of speech intelligibility (speech intelligibility index, partial loudness and signal–to–noise ratio) predicted this effect well, with a slight disadvantage for the signal–to–noise ratio model. Together, Study I and III suggests that the partial loudness model is useful for determining effects of wanted and unwanted sounds in outdoor acoustic environments where variations in sound pressure level are large. But, in environments with large variations in other sound characteristics, models containing predictions of central processes would likely produce better results.

The thesis concludes that wanted and unwanted characteristics of sounds in acoustic environments affect masking, stress recovery, and speech intelligibility, and that auditory perception models can predict these effects.

Auralization of road-traffic noise may be a useful tool for city planning, for instance as a support to decisions regarding noise mitigation. However, to be useful, the auralizations need to be perceptually valid. That is, the auralized sounds should be perceptually indistinguishable from real sounds or, at least, similar with respect to perceptual factors crucial for correct decisions. For this reason, the auralization methodology developed in the Swedish LISTEN-project was perceptually evaluated. In four listening experiments, listeners assessed recordings and auralizations of the same car passages. Although real and auralized sounds were not completely indistinguishable, perfect discrimination was not possible. Moreover, good agreements between auralized and real sounds were found for perceived similarity, perceived annoyance and perceived speed. The results illustrate the usefulness of psychoacoustic methods and multivariate statistics for perceptual evaluation of auralizations and provide support for the validity of the LISTEN-approach to auralization.

Auditory masking of unwanted sounds by wanted sounds has been suggested as a tool for outdoor acoustic design. Anecdotal evidence exists for successful applications, for instance the use of fountain sounds for masking road traffic noise in urban parks. However, basic research on auditory masking of environmental sounds is lacking. Therefore, we conducted two listening experiments, using binaural recordings from a city park in Stockholm exposed to traffic noise from a main road and sound from a large fountain located in the center of the park. In the first experiment, 17 listeners assessed the loudness of the road traffic noise and fountain sounds from recordings at various distances from the road, with or without the fountain turned on. In the second experiment, 16 listeners assessed the loudness of systematic combinations of a singular fountain sound and a singular road traffic noise. The results of the first experiment showed that the fountain sound reduced the loudness of road traffic noise close to the fountain, and that the fountain sound was equally loud or louder than the road traffic noise in a region 20-30 m around the fountain. This suggests that the fountain added to the quality of the city park soundscape by reducing the loudness of the (presumably unwanted) traffic noise. On the other hand, results from the second experiment showed that road traffic noise was harder to mask than fountain sound, and that the partial loudness of both sources was considerably less than expected from a model of energetic masking. This indicates that auditory processes, possibly related to target-masker confusion, may reduce the overall masking effect of environmental sounds.

Research suggests that visual impressions of natural compared with urban environments facilitate recovery after psychological stress. To test whether auditory stimulation has similar effects, 40 subjects were exposed to sounds from nature or noisy environments after a stressful mental arithmetic task. Skin conductance level (SCL) was used to index sympathetic activation, and high frequency heart rate variability (HF HRV) was used to index parasympathetic activation. Although HF HRV showed no effects, SCL recovery tended to be faster during natural sound than noisy environments. These results suggest that nature sounds facilitate recovery from sympathetic activation after a psychological stressor.