Estrogen has been identified as playing a key role in many organ systems. Recently, estrogen has been found to be produced in the human brain and is believed contribute to central auditory processing. After menopause, a low estrogen state, many women report hearing loss but demonstrate no deficits in peripheral hearing sensitivity, which support the notion that estrogen plays an effect on central auditory processing. Although animal research on estrogen and hearing loss is extensive, there is little in the literature on the human model.The aim of this study was to evaluate relationships between hormonal changes and hearing as it relates to higher auditory function in pre- and postmenopausal (Post-M) females.A prospective, group comparison study.Twenty eight women between the ages of 18 and 70 at the University of Kentucky were recruited.Participants were separated into premenopausal and peri-/Post-M groups. Participants had normal peripheral hearing sensitivity and underwent a behavioral auditory processing battery and electrophysiological evaluation. An analysis of variance was performed to address the aims of the study.Results from the study demonstrated statistically significant difference between groups, where Post-M females had difficulties in spatial hearing abilities as reflected on the Listening in Spatialized Noise Test–Sentences test. In addition, measures on the auditory brainstem response and the middle latency response reflected statistically significant differences between groups with Post-M females having longer latencies.Results from the present study demonstrated significant differences between groups, particularly listening in noise. Females who present with auditory complaints in spite of normal hearing thresholds should have a more extensive audiological evaluation to further evaluate possible central deficits.
BackgroundDespite improved biological understanding and lay education about HIV disease, a stigma persists for persons living with HIV (PLWH). Fears of contamination, assumptions of promiscuity, insurance concerns, and even condemnation by the medical profession are likely contributors to this psychological burden. Not surprisingly, social support has been inversely associated with depression, suicide, and disease outcomes. The purpose of this study is to determine the extent and characteristics of feelings of discrimination in a sample of PLWH.MethodsA voluntary, IRB-approved questionnaire was offered to patients presenting to the University of Kentucky HIV clinic. In addition to demographic information, participants were asked, "Do you ever feel discriminated against? If so, how? " The anonymous responses were then analyzed with regard to offered demographic variables and classified into themes using grounded response theory. Two independent reviewers (A.R.H., D.B.) initially classified responses with disparities resolved by a third reviewer (M.J.L.).ResultsOf the 123 surveys delivered, 102 (82.9%) were returned. Demographic information finds: mean age 40.6 6 9.1 (22-67); 83% men; 80% Caucasian, 15% African American, 3% Hispanic, and 1% Asian; 67% are men who have sex with men (MSM), 14% indicate high-risk heterosexual activity (HRH), 4 (4%) intravenous drug use, 2% report blood exposure, and 13% do not know their HIV risk factor; 50% have depression, and 28.4% have anxiety. Eighty-eight completed the discrimination item, with 35 (40%) answering affirmatively. Major themes to emerge (examples) include societal ("third-class citizen "), institutional ("the court systems don't understand "), ignorance ("only if people are uneducated "), medical ("nurses act weird "), interpersonal ("some are afraid to touch you "), and self-imposed feelings ("I feel like a leper "). Of the 53 negative responses, 15 (28%) suffer no discrimination because no one is aware of their disease. There were no significant correlations between demographics and feelings of discrimination.ConclusionsThe data suggest that feelings of discrimination indeed persist but may actually be less than previously reported. Many who do not harbor such feelings attribute this to nondisclosure. Possible explanations of these findings are both improved societal acceptance and advances in HIV treatment. Further research is needed to better understand and eradicate discrimination against PLWH.
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