Behavioral Factors Associated with Disease, Injury, and Death among Men: Evidence and Implications for Prevention

Constructing, Deconstructing or Abolishing? Discourses on Masculinities in Violence Against Women Prevention by Stakeholders in Spain

In the field of violence against women (VAW) prevention, one of the current questions at stake is how to address men's role and masculinities, but it is still an emerging field in Spain. The aim of this study was to analyze the up-to-date discourses on masculinity among stakeholders in the field of VAW prevention and gender equity in Spain. We used a qualitative methodology with semi-structured interviews, conducted between October 2019 and February 2020 in Madrid and Alicante (Spain), with 23 key stakeholders from different areas: in governmental (public health and VAW prevention/intervention, and institutional and policy positioning) and nongovernmental organizations (anti-violence masculinities workers, youth education workers, and feminist and LGBT associations). A discourse analysis was performed with the data collected. Our findings showed that discourses around masculinities among Spanish stakeholders in VAW prevention and gender equity were diverse and presented different layers of critique. Despite a general agreement on the importance of transforming sexist men's practices toward more gender equitable relations, three main interpretive repertoires were identified: "Constructing positive/new masculinities" discourse, focused on promoting men's engagement and egalitarian practices; "Deconstructing hegemonic masculinity" discourse, intended to critically identify and question harmful masculinities norms; and "Abolishing gender" discourse, which aims at dismantling masculinity, and gender in general, as a social structure that generates oppression in itself, advocating for its abolition. Those interpretive repertoires were not mutually exclusive and sometimes stakeholders incorporate in their work more than one approach. The study findings shed light on this current emerging and urgent debate and contributes more broadly to the critical assessment of the concepts used and their implications for VAW prevention.

Gender differences in cardiovascular disease risk: Adolescence to young adulthood

BACKGROUND AND AIMS

Gender differences in cardiovascular disease (CVD) have been well documented but rarely for young adults and the extent to which gender related lifestyle differences may contribute to gender differences in CVD risk experienced by young adults have not been reported.

METHODS AND RESULTS

Data are from a long-running cohort study, the Mater-University of Queensland Study of Pregnancy (MUSP). We track gender differences in CVD related behaviours at 21 and 30 years (consumption of a Western Diet/Health-Oriented Diet, cigarette smoking, vigorous physical exercise, heavy alcohol consumption). At 30 years we compare males and females for CVD risk, and the extent to which lifestyle behaviours at 21 and 30 years contribute to CVD risk. At both 21 and 30 years of age, males more frequently consume a Western Diet and less often a Health Oriented Diet. By contrast, males are also much more likely to report engaging in vigorous physical activity. On most CVD markers, males exhibit much higher levels of risk than do females at both 21 and 30 years. At 30 years of age males have about five times the odds of being at high risk of CVD. Some lifestyle behaviours contribute to this additional risk.

CONCLUSION

Young adult males much more frequently engage in most CVD related risk behaviours and males have a higher level of CVD risk. Gender differences in CVD risk remain high even after adjustment for CVD lifestyles, though dietary factors independently contribute to CVD risk at 30 years.

Impact of Intensity of Vascular Care Preceding Major Amputation Among Patients With Chronic Limb-Threatening Ischemia

BACKGROUND

Lower-limb amputation rates in patients with chronic limb-threatening ischemia vary across the United States, with marked disparities in amputation rates by gender, race, and income status. We evaluated the association of patient, hospital, and geographic characteristics with the intensity of vascular care received the year before a major lower-limb amputation and how intensity of care associates with outcomes after amputation.

METHODS

Using Medicare claims data (2016-2019), beneficiaries diagnosed with chronic limb-threatening ischemia who underwent a major lower-limb amputation were identified. We examined patient, hospital, and geographic characteristics associated with the intensity of vascular care received the year before amputation. Secondary objectives evaluated all-cause mortality and adverse events following amputation.

RESULTS

Of 33 036 total Medicare beneficiaries undergoing major amputation, 7885 (23.9%) were due to chronic limb-threatening ischemia; of these, 4988 (63.3%) received low-intensity and 2897 (36.7%) received high-intensity vascular care. Mean age, 76.6 years; women, 38.9%; Black adults, 24.5%; and of low income, 35.2%. After multivariable adjustment, those of low income (odds ratio, 0.65 [95% CI, 0.58-0.72]; P<0.001), and to a lesser extent, men (odds ratio, 0.89 [95% CI, 0.81-0.98]; P=0.019), and those who received care at a safety-net hospital (odds ratio, 0.87 [95% CI, 0.78-0.97]; P=0.012) were most likely to receive low intensity of care before amputation. High-intensity care was associated with a lower risk of all-cause mortality 2 years following amputation (hazard ratio, 0.79 [95% CI, 0.74-0.85]; P<0.001).

CONCLUSIONS

Patients who were of low-income status, and to a lesser extent, men, or those cared for at safety-net hospitals were most likely to receive low-intensity vascular care. Low-intensity care was associated with worse long-term event-free survival. These data emphasize the continued disparities that exist in contemporary vascular practice.

The Epidemiological Pattern of Skin Cancer from 2011 to 2022 among the Population of the Aseer Region, Kingdom of Saudi Arabia

The overall risk of developing cancer before the age of 75 years in the Kingdom of Saudi Arabia is 9.9%. We aimed to explore the pattern of skin cancer, specifically among the Saudi population residing in the Aseer region. We obtained data from the medical records of Aseer Central Hospital regional histopathological laboratory considering surgical pathology reports from 2011 to 2021. The 61-80-year-old age group represented most of the cases (41.4%), followed by the 41-60-year-old group at 24.1%. Men made up the majority of the cases (59.4%). Furthermore, the dataset predominantly consisted of Saudi nationals (94.3% of the sample). The percentage of cases diagnosed each year relative to the cumulative number of skin cancer cases varied each year, ranging from 1.6% in 2011 to 11.6% in 2017. The most common diagnoses were squamous cell carcinoma (SCC) with 230 cases (41.1%) and basal cell carcinoma (BCC) with 147 cases (26.3%). The majority of cases occurred in the head and neck region (55.4%), followed by the lower limb (16.6%), trunk (13.6%), upper limb (8.2%), and pelvis (2.3%). There was a significant variation in the type of skin cancer across the age groups (p < 0.001) and across different body parts (p < 0.001). The incidence of skin cancer exhibited variability throughout the study period. The predominant diagnoses observed were SSC and BCC. Among the affected areas, the head and neck region displayed the highest prevalence, followed by the lower limb, trunk, upper limb, and pelvis.

Product-related injury morbidity among Americans aged 0-19 years, 2001-2020

INTRODUCTION

This study examined changes in product-related injury morbidity among under-20 Americans between 2001 and 2020.

METHOD

Product-related injury morbidity data came from the National Electronic Injury Surveillance System (NEISS). Using age-standardized morbidity rates, the authors performed Joinpoint regression models to identify time periods with significant changes between 2001 and 2020 and quantified the annual magnitude of morbidity changes with annual percent changes (APCs) in rates and 95 % confidence intervals (CIs).

RESULTS

Age-standardized product-related injury morbidity declined consistently among under-20 Americans from 2001 to 2020 (from 7449.3 to 4023.5 per 100,000 persons; APC = -1.5 %, 95 % CI: -2.3 %, -0.7 %), with the most striking morbidity drop in 2019-2020 (-1576.8 per 100,000 persons). Sports and recreation equipment and home were the most common product and location, respectively, for nonfatal pediatric product-related injuries. Large morbidity differences and varying spectrum by product and by occurring location existed across sex and age groups.

CONCLUSIONS

Product-related injury morbidity declined significantly among under-20 Americans between 2001 and 2020, but large variations remained across sex and age groups.

PRACTICAL APPLICATIONS

Further research is recommended to understand causal factors contributing to the observed decrease in product-related injury morbidity over the past 20 years and to understand product-related injury morbidity disparities across sex and age groups. Understanding of causal factors could lead to implementation of additional interventions to reduce product-related injury among children and adolescents.

It Matters to Whom You Compare Yourself: The Case of Unrealistic Optimism and Gender-Specific Comparisons

Unrealistic Optimism (UO) appears when comparing participants' risk estimates for themselves with an average peer, which typically results in lower risk estimates for the self. This article reports nuanced effects when comparison varies in terms of the gender of the peer. In three studies (total N = 2,468, representative sample), we assessed people's risk estimates for COVID-19 infections for peers with the same or other gender. If a peer's gender is not taken into account, previous studies were replicated: Compared with others, participants perceived themselves as less likely to get infected with COVID-19. Interestingly, this effect was qualified by gender: Respondents perceived women as less threatened than men because women are perceived as more cautious and compliant with medical guidelines.

Mothers of small-bodied children and fathers of vigorous sons live longer

Life-history traits (traits directly related to survival and reproduction) co-evolve and materialize through physiology and behavior. Accordingly, lifespan can be hypothesized as a potentially informative marker of life-history speed that subsumes the impact of diverse morphometric and behavioral traits. We examined associations between parental longevity and various anthropometric traits in a sample of 4,000-11,000 Estonian children in the middle of the 20th century. The offspring phenotype was used as a proxy measure of parental genotype, so that covariation between offspring traits and parental longevity (defined as belonging to the 90th percentile of lifespan) could be used to characterize the aggregation between longevity and anthropometric traits. We predicted that larger linear dimensions of offspring associate with increased parental longevity and that testosterone-dependent traits associate with reduced paternal longevity. Twelve of 16 offspring traits were associated with mothers' longevity, while three traits (rate of sexual maturation of daughters and grip strength and lung capacity of sons) robustly predicted fathers' longevity. Contrary to predictions, mothers of children with small bodily dimensions lived longer, and paternal longevity was not linearly associated with their children's body size (or testosterone-related traits). Our study thus failed to find evidence that high somatic investment into brain and body growth clusters with a long lifespan across generations, and/or that such associations can be detected on the basis of inter-generational phenotypic correlations.

Chronic diseases and health conditions in adolescents: Sex inequalities

OBJECTIVE

To estimate the prevalence of chronic diseases and health conditions in adolescents from Campinas (São Paulo), investigating sex differences according to age group.

METHODS

This population-based study analyzed data from the ISACamp 2014/15 health survey, with a total of 1,022 adolescents interviewed. The interviewees consisted of 517 boys and 505 girls; 492 of them in the ten to 14 age group and 530 in the 15 to 19 age group. We verified the associations using the χ2 test with Rao Scott adjustment and estimated prevalence ratios (PR) with multiple Poisson regression adjusted for age. Analyses were also stratified by age group.

RESULTS

Respiratory diseases, such as rhinitis (25.3%), sinusitis (15.7%), and asthma (10.9%), were the most prevalent among adolescents. Health complaints were high, especially headaches (39.5%), emotional conditions (34.5%), allergies (27.5%), and back pain (21.3%). More than 22.0% of adolescents reported having three or more health conditions. Girls declared a higher number of health conditions (three or more) than boys (PR=2.27).

CONCLUSION

The study showed that adolescents presented a significant number of health conditions, particularly regarding complaints, indicating the need for clinical care and public policies aimed at controlling and preventing these diseases in this age group.

Chronic diseases and health conditions in adolescents: Sex inequalities

ABSTRACT Objective: To estimate the prevalence of chronic diseases and health conditions in adolescents from Campinas (São Paulo), investigating sex differences according to age group. Methods: This population-based study analyzed data from the ISACamp 2014/15 health survey, with a total of 1,022 adolescents interviewed. The interviewees consisted of 517 boys and 505 girls; 492 of them in the ten to 14 age group and 530 in the 15 to 19 age group. We verified the associations using the χ2 test with Rao Scott adjustment and estimated prevalence ratios (PR) with multiple Poisson regression adjusted for age. Analyses were also stratified by age group. Results: Respiratory diseases, such as rhinitis (25.3%), sinusitis (15.7%), and asthma (10.9%), were the most prevalent among adolescents. Health complaints were high, especially headaches (39.5%), emotional conditions (34.5%), allergies (27.5%), and back pain (21.3%). More than 22.0% of adolescents reported having three or more health conditions. Girls declared a higher number of health conditions (three or more) than boys (PR=2.27). Conclusion: The study showed that adolescents presented a significant number of health conditions, particularly regarding complaints, indicating the need for clinical care and public policies aimed at controlling and preventing these diseases in this age group.

Social-contextual factors interact with masculinity to influence college men's HPV vaccination intentions: The role of descriptive norms, prototypes, and physician gender

Men’s low HPV vaccination uptake and HPV-related disease incidence are public health issues; gendered social–contextual factors likely play a role. In Study 1, college men (N = 130; M_age = 19.55; white = 58.1%) reported their social cognitions (male-referent descriptive norms and prototypes), self-reliance masculinity ideology, and vaccination intentions. In Study 2, college men (N = 106; M_age = 19.32; white = 61.3%) were randomly assigned to receive HPV vaccination information from a man or woman physician-avatar. Descriptive norms and favorable prototypes (bs ≥ .337; ps ≤ .016) were associated with higher HPV vaccination intentions. Men with higher self-reliance masculinity had higher HPV vaccination intentions with a man physician and when they perceived greater vaccination among men (ps ≤ .035). Men with higher self-reliance masculinity are more sensitive to gendered social–contextual effects in HPV vaccination decision-making. Gendered social–contextual factors should be integrated into public health interventions to increase college men’s HPV vaccination uptake.

Fertility decline and the emergence of excess female survival in post-reproductive ages in Italy

In Italy, at least in the cohorts born up to the beginning of the twentieth century, women’s mortality in post-reproductive ages was influenced by fertility, with large progenies (and, to a lesser extent, childlessness) leading to markedly lower survival chances. This relationship proved strong enough to affect the female-to-male ratio in old age as fertility declined. In this paper, we show that various measures of extra female survival at high ages are closely connected to the fertility transition in Italy, and to its peculiar historical and geographical evolution.

Effects of COVID-19 Lockdown on Melanoma Diagnosis in Switzerland: Increased Tumor Thickness in Elderly Females and Shift towards Stage IV Melanoma during Lockdown

At the early stages of the COVID-19 outbreak in 2020, Switzerland was among the countries with the highest number of SARS-CoV2-infections per capita in the world. Lockdowns had a remarkable impact on primary care access and resulted in postponed cancer screenings. The aim of this study was to investigate the effects of the COVID-19 lockdown on the diagnosis of melanomas and stage of melanomas at diagnosis. In this retrospective, exploratory cohort study, 1240 patients with a new diagnosis of melanoma were analyzed at five tertiary care hospitals in German-speaking Switzerland over a period of two years and three months. We compared the pre-lockdown (01/FEB/19-15/MAR/20, n = 655) with the lockdown (16/MAR/20-22/JUN/20, n = 148) and post-lockdown period (23/JUN/20-30/APR/21, n = 437) by evaluating patients' demographics and prognostic features using Breslow thickness, ulceration, subtype, and stages. We observed a short-term, two-week rise in melanoma diagnoses after the major lift of social lockdown restrictions. The difference of mean Breslow thicknesses was significantly greater in older females during the lockdown compared to the pre-lockdown (1.9 ± 1.3 mm, p = 0.03) and post-lockdown period (1.9 ± 1.3 mm, p = 0.048). Thickness increase was driven by nodular melanomas (2.9 ± 1.3 mm, p = 0.0021; resp. 2.6 ± 1.3 mm, p = 0.008). A proportional rise of advanced melanomas was observed during lockdown (p = 0.047). The findings provide clinically relevant insights into lockdown-related gender- and age-dependent effects on melanoma diagnosis. Our data highlight a stable course in new melanomas with a lower-than-expected increase in the post-lockdown period. The lockdown period led to a greater thickness in elderly women driven by nodular melanomas and a proportional shift towards stage IV melanoma. We intend to raise awareness for individual cancer care in future pandemic management strategies.

The impact of values of men and women on their life expectancy

The female advantage in life expectancy (LE) is found throughout the world, despite differences in living conditions. However, this advantage has diminished in recent years in countries with low mortality rates. In Russia, according to data for 2020, the difference in life expectancy at birth between women and men is 10 years (according to Rosstat) and is one of the highest in the world. The aim of our study is to find out what contribution to the gender gap in life expectancy can be made by the difference between men and women in terms of the value of health and the practice of self-caring behavior. To do this, we used data from the Sample Survey of Behavioral Factors Affecting the Health of the Population conducted by Rosstat in 2013, namely, the respondents' answers to a number of questions related to self-caring and health-preserving behavior. Using these questions, the level of the gap in the value of their own health and health-preserving behavior between Russian men and women is quantified according to the microdata of the survey using OLS regression and ordinal logit regression, where the respondent's answer to the question is used as a dependent variable, and the main independent variable is the gender of the respondent. The results showed that value attitudes to healthy lifestyle significantly affect health-preserving behavior. Correlations between the value of health and various aspects of health-preserving behavior turned out to be in the predicted direction. At the same time, at the level of the subjects of the Russian Federation, the analysis showed a high statistical significance of the following predictors of the gender gap in life expectancy: high levels of consumption of strong alcoholic beverages and tobacco smoking. The increase in the value of health among Russian men is here only of very limited importance for reducing the gender gap in life expectancy.

Pandemic prevention and personality psychology: Gender differences in preventive health behaviors during COVID-19 and the roles of agreeableness and conscientiousness

One of the greatest public health crises in recent times, the COVID-19 pandemic, has come with a myriad of challenges in terms of health communication and public cooperation to prevent the spread of the disease. Understanding which are the key determinants that make certain individuals more cooperative is key in effectively tackling pandemics and similar future challenges. In the present study (N = 800), we investigated whether gender differences in compliance with preventive health behaviors (PHB) at the onset of the COVID-19 pandemic could be established, and, if so, whether the personality traits of agreeableness and conscientiousness could help explain this presumed relationship. Consistent with our theorizing, we found women to score higher than men on agreeableness and conscientiousness, and to be more willing to comply with a set of PHB. Importantly, both personality traits were found to mediate the gender-compliance link. This means that women's greater compliance levels with PHB could, at least in part, be attributed to their higher agreeableness and conscientiousness scores. A greater understanding of the determinants of PHB in terms of gender and associated personality traits may help identify options for developing more effective communication campaigns, both in terms of communication channel selection and message content.

Human studies of mitochondrial biology demonstrate an overall lack of binary sex differences: A multivariate meta-analysis

Mitochondria are maternally inherited organelles that play critical tissue-specific roles, including hormone synthesis and energy production, that influence human development, health, and aging. However, whether mitochondria from women and men exhibit consistent biological differences remains unclear, representing a major gap in knowledge. This meta-analysis systematically examined four domains and six subdomains of mitochondrial biology (total 39 measures), including mitochondrial content, respiratory capacity, reactive oxygen species (ROS) production, morphometry, and mitochondrial DNA copy number. Standardized effect sizes (Hedge's g) of sex differences were computed for each measure using data in 2258 participants (51.5% women) from 50 studies. Only two measures demonstrated aggregate binary sex differences: higher mitochondrial content in women's WAT and isolated leukocyte subpopulations (g = 0.20, χ² p = .01), and higher ROS production in men's skeletal muscle (g = 0.49, χ² p < .0001). Sex differences showed weak to no correlation with age or BMI. Studies with small sample sizes tended to overestimate effect sizes (r = -.17, p < .001), and sex differences varied by tissue examined. Our findings point to a wide variability of findings in the literature concerning possible binary sex differences in mitochondrial biology. Studies specifically designed to capture sex- and gender-related differences in mitochondrial biology are needed, including detailed considerations of physical activity and sex hormones.

Reassessing Gender Differences in COVID-19 Risk Perception and Behavior

OBJECTIVE

This article reassesses the gender differences in COVID-19 attitudes and behavior found in previous studies by examining to what extent the gender gap in the adoption of COVID-19 preventive behaviors is dependent on women's and men's perceptions of risk.

METHODS

The data utilized in this study were obtained from the "Understanding America Study Coronavirus in America ('COVID') Survey," conducted by the Center for Economic and Social Research (CESR), at the University of Southern California.

RESULT

This study shows that women are more risk averse than men, but that the gender gap in risk behavior depends on the level of risk that is associated with COVID-19.

CONCLUSION

Risk perception is a stronger driver of risk behavior for men than for women, who generally tend to adopt safe measures to protect themselves and others. Different messages should be delivered to women and men to increase compliance with norms.

An updated report on the incidence and epidemiological trends of keratinocyte cancers in the United Kingdom 2013-2018

Introduction

The most common cancers in the UK are keratinocyte cancers (KCs): the combined term for basal cell carcinomas (BCCs) and cutaneous squamous cell carcinomas (cSCCs). Registration of KC is challenging due to high numbers and multiplicity of tumours per person.

Methods

We provide an updated report on the descriptive epidemiology of trends in KC incidence for the resident populations of UK countries (England, Northern Ireland, Scotland and Wales) using population-based cancer registry and pathology report data, 2013-18.

Results

Substantial increases in cSCC incidence in England, Scotland and Northern Ireland can be detected for the period of 2013-18, and the incidence of cSCC also increased in Wales from 2016 to 2018. In contrast, however, the pattern of annual change in the incidence of BCC across the nations differs. In England, the incidence of BCC declined slightly from 2016 to 2018, however, the overall trend across 2013-18 is not statistically significant. In Scotland, the incidence of BCC shows some variability, declining in 2017 before increasing in 2018, and the overall trend across 2013-18 was also not statistically significant. In Northern Ireland, the incidence of BCC increased significantly over the study period, and in Wales, the incidence of BCC increased from 2016 to 2018. One in five people will develop non-melanoma skin cancers (NMSC) in their lifetime in England. This estimate is much higher than the lifetime risk of melanoma (1 in 36 males and 1 in 47 females born after 1960 in the UK), which further highlights the burden of the disease and importance of early prevention strategies.

Conclusions

We highlight how common these tumours are by publishing the first ever lifetime incidence of NMSC. Additionally, the first time reporting of the age standardised incidence of KC in Wales further confirms the scale of the disease burden posed by these cancers in the UK. With approximately one in five people developing NMSC in their lifetime, optimisation of skin cancer prevention, management and research are essential.

Trends and causes of adult mortality from 2007 to 2017 using verbal autopsy method, Addis Ababa, Ethiopia

OBJECTIVES

We aim to analyse the trends and causes of mortality among adults in Addis Ababa.

SETTING

This analysis was conducted using verbal autopsy data from the Addis Ababa Mortality Surveillance in Addis Ababa, Ethiopia.

PARTICIPANTS

All deceased adults aged 15 years and above between 2007-2012 and 2015-2017 were included in the analysis.

OUTCOME MEASURES

We collected verbal autopsy and conducted physician review to ascertain cause of death.

RESULT

A total of 7911 data were included in this analysis. Non-communicable disease (NCD) accounted for 62.8% of adult mortality. Mortality from communicable diseases, maternal conditions and nutritional deficiencies followed this by accounting for 30.3% of total mortality. Injury accounted for 6.8% of total mortality. We have observed a significant decline in mortality attributed to group one cause of death (43.25% in 2007 to 12.34% in 2017, p<0.001). However, we observed a significant increase in mortality attributed to group II cause of death (from 49.95% in 2007 to 81.17% in 2017, p<0.001). The top five leading cause of death in 2017 were cerebrovascular disease (12.8%), diabetes mellitus (8.1%), chronic liver disease (6.3%), hypertension (5.7%), ischaemic heart disease (5.7%) and other specified neoplasm (5.2%).

CONCLUSION

We documented an epidemiological shift in cause of mortality from communicable diseases to NCD over 10 years. There is a great progress in reducing mortality due to communicable diseases over the past years. However, the burden of NCDs call for actions for improving access to quality health service, improved case detection and community education to increase awareness. Integrating NCD intervention in to a well-established and successful programme targeting communicable diseases in the country might be beneficial for improving provision of comprehensive healthcare.

Football and Ice Hockey Fans' Experience of a 12-Week Training and Weight-Loss Pilot Intervention (ViSiT) in Sweden-A Focus Group Study

Background: Excess weight is associated with an increased risk of poor health and premature mortality. This is more problematic for men than for women because men have a lower life expectancy and a higher prevalence of several lifestyle-related diseases. A concept whereby overweight male supporters of professional football clubs are recruited and offered a weight-loss intervention has been developed in Scotland. In the present study, we explore participants' experiences of a similar pilot intervention, called ViSiT, conducted with supporters in one ice hockey club and one football club in Sweden to assess the feasibility of using the intervention in a Swedish context.

Methods: In this user centered evaluation, focus groups were conducted with 12 men who had completed the 12-week ViSiT intervention. Participants discussed reasons for participating in and completing the intervention, effects of the intervention, advantages, and areas of improvement of the intervention, and thoughts on the club's involvement. The material was analyzed using thematic analysis according to Braun and Clarke.

Results: The analyses revealed four themes: reasons to participate, motivation and reinforcement, change of habit, and areas for improvement. The intervention was seen as an opportunity to change daily lifestyle behaviors. The group format, as well as the involvement of a prestigious sports club, was important for signing up to the intervention and for motivating continued involvement. The intervention had also resulted in increased knowledge on health and changed mindsets about being more attentive to regulating day-to-day behavior. Although the overall feedback on the intervention was positive, the participants suggested that possibilities to have more individual coaching should be added.

Conclusions: The ViSiT weight loss and lifestyle intervention may be feasible in a Swedish context to reach overweight men at risk of poor health. The ice hockey and football club supporters expressed similar experiences from participating in the intervention. ViSiT seem to have a potential to be adopted by many sports clubs for a widespread reach to a group normally considered reluctant to participate in lifestyle change programs.

Sex Differences in Attitudes Toward Casual Sex: Using STI Contraction Likelihoods to Assess Evolved Mating Strategies

Previous work shows that males are more likely to pursue casual sex if given the opportunity, compared to females, on average. One component of this strategy is risk-taking, and males have been shown to take more risks than females in a variety of contexts. Here, we investigate the extent to which sex differences exist considering casual sexual encounters involving sexually transmitted infections (STIs) using a hypothetical sexual scenario which attempts to circumvent several factors that may contribute to a female's hesitancy to engage in casual sex encounters. Two hundred and forty-six college students rated their willingness to engage in a satisfying casual sexual encounter with someone judged to be personable as a function of sex, varying STI contraction likelihoods, several STI types, and two levels of hypothetical partner attractiveness. We also assess how individual levels of sociosexuality (as measured by the SOI-R) impact findings. Our findings show that males report higher likelihoods of sexual engagement compared to females in general. This trend continued for lower likelihoods of STI contraction in all four STI types (Cold, Chlamydia, Herpes, HIV), with larger effects shown in the high attractiveness partner condition. For higher STI contraction likelihoods and more severe STI types, along with lower partner attractiveness levels, sex differences shrank. Factoring in participant SOI-R scores attenuated the effects somewhat, although it failed to alter findings substantially with predicted sex differences continuing to exist. These results offer further insight into evolved sex differences in human mating systems and provide an additional framework to test sexual risk-taking among males and females.

Gender effects on outcomes of psychosomatic rehabilitation are reduced

OBJECTIVE

The study examined whether psychiatric/psychosomatic rehabilitation continues to have a better course of treatment for women than men.

METHODS

We compared the course of global symptom severity, health-related quality of life and functioning between admission and discharge in patients (848 men, 1412 women) at an Austrian psychiatric/psychosomatic rehabilitation clinic.

RESULTS

Gender-specific differences in the course of treatment were all too small to be clinically relevant. The differences were smallest in the middle-aged cohort. However, at the time of admission, women reported a slightly higher symptom burden.

CONCLUSION

Overall, the results show a gender-fair effectiveness of the rehabilitation. The new findings could be explained by changes in living conditions, gender roles, or better treatment methods.

Health-care resource utilization associated with peanut allergy management under allergen avoidance among commercially insured individuals

Background: Until recently, the standard approach to care for individuals with peanut allergy (PA) was limited to allergen avoidance and treatment of reactions with emergency medicines. Objectives: To assess health-care resource utilization (HRU) and costs associated with PA management under allergen avoidance and to identify risk factors associated with peanut reactions that resulted in inpatient (IP) and/or emergency department (ED) visits. Methods: Privately insured individuals with PA diagnosis codes were identified from a large U.S. administrative claims data base (January 1, 1999, to March 31, 2017). PA-related HRU, indicated by a PA diagnosis and/or diagnostic procedure codes and by epinephrine autoinjectors (EAI) prescription fills in medical and pharmacy claims, respectively, and all-cause costs were described per patient-year (PPY). Risk factors associated with peanut reactions in an IP and/or ED setting were identified by using a multivariable logistic regression model. Results: A total of 86,483 patient-years from 14,136 individuals with PA were included. At the patient-year level, 28.1% were ages 0-3 years, 43.6% were ages 4-11 years, 13.7% were ages 12-17 years, and 14.5% were ages ≥ 18 years; 35.6% had PA-related outpatient visits; 50.6% had EAI fills; and 2.4% had PA-related IP and/or ED visits PPY. Younger individuals had more PA-related outpatient visits and EAI fills, with peak intensive use at ages 4-11 years. The proportion of individuals with PA-related IP and/or ED visits was highest among those aged ≥ 18 years. Mean all-cause costs were $3084 PPY; individuals with PA-related IP and/or ED visits incurred $8902 PPY ($17,451 for those with one or more IP visits). Risk factors associated with peanut reactions that resulted in IP and/or ED visits included young adults (odds ratio [OR] 3.19 [95% confidence interval {CI}, 2.66-3.83]), previous peanut reaction(s) (OR 1.66 [95% CI, 1.23-2.24]), asthma (OR 1.33 [95% CI, 1.18-1.51]), and male sex (OR 1.14 [95% CI, 1.01-1.28]). Conclusion: Individuals with PA and under allergen avoidance had significant HRU that varied across all age groups, with more PA-related outpatient visits during preschool and/or school age and PA-related urgent care among adults. Individuals with previous peanut reaction(s), asthma, and males had a higher risk of peanut reactions that resulted in IP and/or ED visits.

Biomarkers for Diagnosis, Prognosis and Response to Immunotherapy in Melanoma

Simple Summary

Cutaneous Melanoma is a form of skin cancer characterized by an elevated mutational load that favors high spread to distant organs and resistance to therapies. The identification of biomarkers, able to dissect normal and pathogenic biological processes and response to therapeutic intervention, is necessary to describe melanoma as accurately as possible, having a positive impact on early diagnosis, in turn selecting the best therapeutic option. Recently, a great number of new biomarkers were evaluated, in order to identify those patients who may have clinical benefit from a therapeutic choice, particularly for immunotherapy. At present, these new biomarkers wait to be validated before clinical use. Hence, the requirement to look at and periodically update the advances in this field.

Abstract

Cutaneous Melanoma classification is constantly looking for specific and sensitive biomarkers capable of having a positive effect on diagnosis, prognosis and risk assessment, eventually affecting clinical outcome. Classical morphological, immunohistochemical and the well-known BRAF and NRAS genetic biomarkers do not allow the correct categorization of patients, being melanoma conditioned by high genetic heterogeneity. At the same time, classic prognostic methods are unsatisfactory. Therefore, new advances in omics and high-throughput analytical techniques have enabled the identification of numerous possible biomarkers, but their potentiality needs to be validated and standardized in prospective studies. Melanoma is considered an immunogenic tumor, being the first form of cancer to take advantage of the clinical use of the immune-checkpoint blockers. However, as immunotherapy is effective only in a limited number of patients, biomarkers associated with different responses are essential to select the more promising therapeutic approach and maximize clinical benefits. In this review, we summarize the most utilized biomarkers for Cutaneous Melanoma diagnosis, focusing on new prognostic and predictive biomarkers mainly associated with immunotherapy.

A Structural Equation Model of the Effect of Masculinity and Avoidant Coping on Gay and Bisexual Men's Sexual Risk-Taking

This study aims to extend the scientific knowledge base on the association between masculine norm adherence and sexual risk-taking, in the context of gay and bisexual men, by examining emotional suppression, social support seeking, and avoidant coping as potential mediating pathways. A sample of 482 gay and bisexual men was recruited. Structural equation modeling was used to assess for mediation. Findings revealed that although gender role conflict and conformity to masculine norms (i.e., the two masculine norm adherence predictor variables) did not have a direct effect on sexual risk-taking, a significant indirect effect was observed for gender role conflict on sexual risk-taking via increased avoidant coping. Accordingly, gender role conflict and avoidant coping may create a unique effect on sexual risk-taking whereby the effect of gender role conflict on sexual risk-taking is not transmitted directly but only indirectly through the mediating role of avoidant coping. Future research directions are discussed.

The association between childhood socioeconomic status and adult health behavior: The role of locus of control

The socioeconomic environment in childhood is a powerful determinant for health behavior in adulthood, subsequently influencing health outcomes. However, the underlying mechanisms are insufficiently understood. This study assesses locus of control (LOC) as a mediator linking childhood socioeconomic status (SES) with health behavior (smoking, regular alcohol consumption, unhealthy diet and low physical activity). Drawing on a representative sample from Germany (SOEP), we investigated these relations using structural equations modelling. Results show that externally oriented LOC explains up to 6% of the relationship between childhood SES and health behavior in adulthood, independently from adult SES. Stratification indicates that these results hold in women but not in men, in younger and middle-aged individuals but not in older ones. Hence, control beliefs play a modest yet significant role in shaping the socioeconomic gradient in health behavior and might have far-reaching consequences on how morbidity and mortality arise and persist across generations.

The Role of the Medicaid Expansion in the Use of Preventive Health Care Services in California Men

Men’s use of preventive care services may be constrained due to a number of factors including lack of health care insurance. California used the Medicaid expansion provisions of the Affordable Care Act (ACA) to enroll low-income men between the ages of 18 and 64 years in publicly funded health insurance. Most studies on the effect of the ACA on health care services have focused on racial/ethnic differences rather than gender. Data from the California Health Interview Survey for the 2015–2016 survey period were used to model the use of preventive health care services in the year prior to interview. Population weights were used in the analysis which was done using PROC SURVEY LOGISTIC in SAS software, version 9.4. The sample consisted of men between the ages of 18 and 64 years (N = 6,180). Of these 66% (n = 4,088) reporting receiving any preventive care services in the year prior to interview. The largest proportions of respondents fell into the youngest group aged 18–25 (17%) followed by the oldest group aged 60–64 (16.9%); 43% reported they were married, 57% had incomes at greater than 300% of the federal poverty level. There was no effect of race or ethnicity on receiving preventive care services. Having a chronic condition such as hypertension or diabetes was associated with a greater odds of receiving preventive care. Expanding Medicaid to include low-income men below the age of 65 is associated with increased use of preventive health care, especially among those with chronic conditions.

"I went in there, had a bit of an issue with those folks": everyday challenges of heterosexual African, Caribbean and black (ACB) men in accessing HIV/AIDS services in London, Ontario

BACKGROUND

In Canada, heterosexual African, Caribbean, and Black (ACB) men's heightened risk of HIV infection has been linked to behavioral characteristics, including practices of hegemonic masculinity that discourage the use of HIV preventive services. However, this framing is bereft of the role of structural factors that may be contributing to new HIV infections. This paper examined the underlying factors limiting access to health services among heterosexual ACB men in London, Ontario Canada.

METHODS

A convenient sampling technique was used to recruit thirty-seven (n = 37) self-identified heterosexual ACB men and service providers. Four focus groups (FG) were conducted; three with ACB participants of similar age category (i.e., 16-24; 25-38; 39+), and one with service providers. The FGs focused on the barriers to using health services and interrogated the ease of access to HIV intervention programs by ACB men respectively. Recurring themes from the FGs were probed further using in-depth interviews (n = 13). FGs and in-depth interviews complemented each other in reducing uneven power dynamics, fact checking, and allowing for detail discussion of the topic under study. Data analyses were done in NVivo using a mixed inductive-deductive thematic analyses approach.

RESULTS

Most ACB men lacked information on HIV and were unaware of their increased risk of infection. Contrary to the notion that behavioral characteristics keep ACB men away from health services, we found that most ACB men were unaware of the availability of these services. Those that had some knowledge about the services reported that they were not appropriately tailored to their needs. In addition, stereotypes and stigma about the etiology of HIV among Blacks, and systemic neglect served as significant barriers to ACB men's use of services.

CONCLUSION

The findings suggest that, to enhance preventive health service use among heterosexual ACB men, there is the need to remove structural barriers. Engaging ACB men in the design and implementation of policies may be useful at improving access to HIV information, testing, and treatment services. Increased information dissemination to ACB men would create awareness of the availability of HIV services. Finally, service providers should be conscious of ACB men's concern about experiences of discrimination and racism at service centers.

A thematic analysis of men's help-seeking on an Australian health helpline

AIMS AND OBJECTIVES

The current study aimed to qualitatively explore men's help-seeking behaviours by analysing male callers' talk on an Australian health helpline. Analysis focused on identifying the ways in which men positioned themselves as help-seekers and the extent to which help-seeking behaviours deviated or conformed to the narrative commonly reported on in men's health literature which, generally speaking, positions men as reluctant help-seekers and health service users.

METHODS

The present study utilised naturally occurring instances of men's help-seeking during 196 calls to the helpline, Healthdirect Australia. Thematic analysis was used to explore recurrent themes in help-seeking interactions.

FINDINGS

The analysis yielded three broad themes, which were formulated as caller archetypes. These themes included the 'reluctant caller', the 'unwell patient' and the 'concerned carer', as well as a number of associated sub-themes within these broad categories.

CONCLUSIONS

The findings demonstrated that male callers sought help in a variety of different ways, rather than prescribing to a homogenous pattern of help-seeking. However, it was acknowledged that some data did align with help-seeking behaviour which indicated men's reluctance to engage with their own health. SO WHAT?: The present study contributes to men's health promotion by identifying the various social devices used by men to facilitate help-seeking. The findings highlight the changing and flexible landscape of contemporary masculinity and its impact on health engagement. Recognising the versatility in men's health behaviour is important for ensuring that men have positive experiences during healthcare encounters which, in turn, may facilitate future health service uptake and engagement.

Dimensionality, variance composition, and development of a brief form of the duke health profile, and its measurement invariance across five gender identity groups

OBJECTIVE

To conduct advanced psychometric analyses on the Duke Health Profile, a popular measure of health-related quality of life.

DESIGN

Online survey. Data (N = 1233, 34.3% transgender) were from community and college participants. Dimensionality was assessed for the first time using exploratory factor analysis (EFA) with part of the sample, followed by single- and multi-group confirmatory factor analyses (CFA) with the balance of the sample.

RESULTS

EFA resulted in a 14-item three factor structure: mental, physical and social health. CFA estimated four models (common factors, bifactor, hierarchical, unidimensional), none demonstrated adequate fit. From another EFA specifying one factor, the 6-item Duke Health Profile-Brief Form was developed based on updated guidelines for shortening composite measurement scales, which was assessed using CFA, finding good fit to the data. Measurement invariance by gender was assessed across the diverse gender spectrum, finding evidence for configural, metric, and partial scalar invariance.

CONCLUSIONS

There is insufficient evidence to use the general, mental, social and physical health scores of the DUKE Health Profile. However, there is evidence supporting the use of the unidimensional DUKE-BF, which is largely invariant between cisgender men and women, transgender men and women, and transgender men and non-binary participants.

Sexual Violence and Chemsex among Substance-Using Sexual and Gender Minorities in Texas

Chemsex is the use of methamphetamine or other substances to enhance sexual experiences, and is most often associated with sexual minority men. Within the chemsex literature, questions of sexual violence emerge due, in part, to ambiguity about what constitutes consent within sexualized environments with co-occurring substance use. To understand the context in which sexual violence occurs, data from an online survey of sexual and gender minority Texans were analyzed using bivariate and logistic regression (N = 1273), and qualitative interviews with substance-using sexual minority men from a separate sample were thematically analyzed (N = 22). Among survey participants, 12.8% experienced a form of sexual violence (10.1% experienced intimate partner violence and 7.6% experienced sexual assault). When participants were categorized based on past year substance use and sex party attendance, 48.0% of participants who used drugs and attended sex parties (a proxy for chemsex) experienced sexual violence (41.6% experienced intimate partner violence and 41.0% experienced sexual assault). When variables statistically significant at the bivariate-level were entered into logistic regression models, participants in the chemsex category were 12.5 [95% CI: 6.9, 22.8] times more likely to experience sexual violence. Substance-using sexual minority men experiencing sexual violence describe situations in which consent is difficult to revoke and sexual exploitation is likely to occur. Studies which more deeply explore the relationship between sexual and relationship violence and chemsex among sexual and gender minorities are needed. Particularly, the notion of consent needs further conceptualization in the context of drug use and sex parties.

HIGHLIGHTS

Measures of recent substance use and sex party attendance were combined to create a proxy measure for chemsex, which is the use of substances to enhance sexual experiences.Substance-using sexual and gender minorities engaging in chemsex were at increased risk of sexual violence.In addition to engaging in chemsex, variables associated with an increased odds of sexual violence among sexual and gender minorities were younger age, having a non-monosexual sexual identity, and receiving a mental health diagnoses.Studies on sexual and gender minorities engaging in chemsex should be developed to further explore sexual exploitation.

Knowledge as Determinant of Healthy-Eating Among Male Postgraduate Public Health Students in a Nigerian Tertiary Institution

Unhealthy eating, which is quite prevalent among the adult population globally, is a major risk factor for Non-Communicable Diseases. Men have the tendency to visit food vendors without recourse to body nutrients requirement, health and expectations as potential change agents. The study was thus designed to investigate the knowledge and practices of healthy eating among male public health students in a Nigerian tertiary institution. Data was collected from 161 consenting respondents. Knowledge of healthy eating was assessed on a 25-point knowledge scale; score ≥19 was rated good, <19≥12 fair and <12 poor. Practices of healthy eating were assessed using a 34-point practice scale; score ≥26 was rated good and <26 poor. Patterns of eating was determined using food frequency questionnaire; descriptive and inferential statistics were carried out at α=0.05. Respondents' age was 28.9 ± 5.5 years; they were mostly Christian (87.0%), Yoruba (69.6%) and 21.1% were married. Their body mass index was 23.1 ± 3.1kg/m², monthly income ranged between N5000 and N300,000, 2.5% smoked tobacco/cigarette and 28.0% consumed alcohol. Good knowledge was observed among 52.2% of the respondents, 37.9% had good healthy eating practices, 49.7% did not eat breakfast everyday while only 13.7% consumed fruits and vegetables daily. The most reported factors influencing choice of food included health maintenance and food availability. Respondents' knowledge and practices relating to healthy eating was significant. Knowledge of healthy eating was average and practice was poor among the study population. Strategic health education and behaviour change communication could motivate male students for healthy eating.

Educational Attainment and Health Behaviors Among Young Adult Men: Racial/Ethnic Disparities

Although promoting health behaviors are important for sustaining physical and mental health, little is known about young adult men’s health behaviors or how they vary across race and ethnicity. This study examines the impact of educational attainment on health behaviors across young adult men, and differences in the association across race/ethnicity. This study used data from the National Longitudinal Survey of Youth 1979 Children and Young Adults. The final sample consists of 3,115 non-Hispanic White males, 1,617 African American males, and 1,144 Hispanic males. The average age of the participants was about 27 years old. Multiple linear regression and logistic regression analyses were conducted. Educational attainment was associated with both food intake and preventive health care visits. Those who received a higher education were less likely to eat fast food than those who did not (β = –.37, p < .001) and were more likely to eat fruits and vegetables (β = .77, OR = 2.15, p < .01; β = 6.44, OR = 1.91, p < .10). Higher education was also positively associated with routine eye exams and health check-ups (β = .50, OR = 1.64, p < .01); β = 1.84, OR = 6.29, p < .01). This study identified interaction effects between educational attainment and African Americans for predicting fast food intake (β = .57, p < .05). Education is one way to improve health behaviors and to lessen racial/ethnic disparities in health behaviors. Specifically, promoting health behaviors in education should target African American men to improve their perception toward the importance of healthy food intake.

Sex and Gender Disparities in Melanoma

Worldwide, the total incidence of cutaneous melanoma is higher in men than in women, with some differences related to ethnicity and age and, above all, sex and gender. Differences exist in respect to the anatomic localization of melanoma, in that it is more frequent on the trunk in men and on the lower limbs in women. A debated issue is if-and to what extent-melanoma development can be attributed to gender-specific behaviors or to biologically intrinsic differences. In the search for factors responsible for the divergences, a pivotal role of sex hormones has been observed, although conflicting results indicate the involvement of other mechanisms. The presence on the X chromosome of numerous miRNAs and coding genes playing immunological roles represents another important factor, whose relevance can be even increased by the incomplete X chromosome random inactivation. Considering the known advantages of the female immune system, a different cancer immune surveillance efficacy was suggested to explain some sex disparities. Indeed, the complexity of this picture emerged when the recently developed immunotherapies unexpectedly showed better improvements in men than in women. Altogether, these data support the necessity of further studies, which consider enrolling a balanced number of men and women in clinical trials to better understand the differences and obtain actual gender-equitable healthcare.

Injury related adult deaths in Addis Ababa, Ethiopia: analysis of data from verbal autopsy

Background

Injury related deaths are causing huge impact on families and communities throughout the world. Reports show that developing countries are highly affected by injury deaths. Ethiopia is among the countries that are highly affected by injury deaths especially road traffic accident. Previous studies in Ethiopia concerning injury deaths were mostly based on hospital records. However, in the context of Ethiopia, where majority of the deaths are happening outside health facilities, hospital-based studies cannot give the exact proportion of injury deaths. This study aimed to assess the proportion and types of injury deaths in Addis Ababa and the distribution with different socio-demographic characteristics using data from verbal autopsy.

Methods

We used verbal autopsy data of Addis Ababa Mortality Surveillance Program. The basic source of data for Addis Ababa Mortality Surveillance is burial surveillance from all cemeteries of Addis Ababa. We analyzed causes of injury mortality by different characteristics and tried to show the trends.

Results

Over the 8 years period of time injury has contributed about 7 % of the total deaths. Majority of injury related deaths were among males. Traffic accidents were the major injury related deaths for both sexes; intentional self-harm was highly observed among males compared with females. The findings of this study showed that the proportion of injury related deaths decreased with increasing age.

Conclusions

This study witnessed that deaths resulting from injuries are substantial health challenges in Addis Ababa. Road traffic accident is the most common cause of injury related deaths in the study area. The findings also indicated that males and the productive age groups are highly affected by injury deaths.

Longitudinal Association of Telomere Attrition with the Effects of Antihypertensive Treatment and Blood Pressure Lowering

Leukocytes telomere length has been associated with hypertension, but, whether longitudinal telomeres change could serve as a useful predictive tool in hypertension remains uncertain. This study aimed to examine the longitudinal trajectory of leukocytes telomere length in a population-based prospective study of 1,108 individuals with hypertension. Leukocytes telomere length were measured at baseline and again after a median 2.2 (range 1.5-2.4) years of follow-up. Age as an independent predictor was inversely associated with baseline telomeres and follow-up telomeres. Annual telomere attrition rate was calculated as (follow-up telomeres-baseline telomeres)/follow-up years, and participants were categorized into the shorten and the lengthen groups. Results showed that telomere lengthening was significantly correlated with decreased systolic blood pressure (SBP) (β=-3.28; P=0.02) and pulse pressure (PP) (β=-2.53; P=0.02), and the differences were respectively -3.3 mmHg (95%CI, -6.2 to -0.3; P=0.03) in ∆SBP and -2.4 mmHg (95%CI, -4.9 to -0.1; P=0.04) in ∆PP between two groups after adjustment for vascular risk factors and baseline blood pressures. When stratified by age and gender, the correlations were observed in women and patients ≤60 years. Furthermore, among patients using calcium channel blocker (CCB) and angiotensin receptor blocker (ARB), those with telomeres lengthening showed a significantly lower level of ∆SBP and ∆PP. There was no correlation between telomere attrition and incidence of cardiovascular events. Our data indicated that increased telomere length of leukocytes was associated with decreased SBP and PP, particularly for patients who received CCB and ARB, supporting that telomere attrition may provide new sight in clinical intervention for hypertension.

Understanding Access to and Utilisation of Sexual Health Services by South Asian Immigrant Men in Western Countries: A Scoping Review

South Asian communities comprise one of the fastest growing populations in Western countries. However, the sexual health of immigrant men in particular remains vastly understudied and little is known about how and if men access these services. Four multi-disciplinary electronic databases were searched to between 1998 and 2018. The search yielded 586 articles; 407 duplicate articles were removed, and 376 did not meet the inclusion criteria. A total of 10 articles were included in this review. Herein we report the factors shaping sexual health service access and use, namely: (1) cultural and psychological factors; (2) sexual health service accessibility; (3) personal beliefs and patterns in service use; (4) social perspectives and conflicting values on sexual health. We identify the gaps in research needed for policymakers, formal healthcare providers, and South Asian community stakeholders to develop effective and inclusive sexual health programs for South Asian men in Western countries.

A Bidimensional Examination of Machismo in Relation to Risky Sexual Cognitions and Behavior among Latino College Men

Objective: College students and Latina/o individuals are disproportionately affected by adverse consequences related to risky sex, highlighting the importance of examining sociocultural factors related to risky sexual variables among Latina/o college students. We explored the link between machismo (a bidimensional form of masculinity often ascribed to Latino men) and risky sexual outcomes among Latino college men. Methods: Latino college men responded to an online study assessing two dimensions of machismo, and risky sexual cognitions (eg, risky sexual intentions) and behavior (eg, condom use). Results: Among our findings, a hypermasculine dimension of machismo predicted greater intentions to engage in risky sex, and more positive condom use attitudes. A dimension of machismo characterized by respect and chivalry predicted more frequent condom use. Conclusions: These findings indicate the relation between machismo and risky sex among Latino college men is complex, underscoring the need for sociocultural considerations in culturally tailored collegiate sexual-risk prevention programs.

The Role of Attitude Toward Own Aging for Fluid and Crystallized Functioning: 12-Year Evidence From the ILSE Study

Objectives

Aging attitudes have been shown to affect a variety of important developmental outcomes in old age, including memory. Extending previous research, the present study examined long-term effects of attitudes toward own aging (ATOA), relying on a broader range of cognitive abilities in later life.

Method

Data came from the Interdisciplinary Longitudinal Study of Adult Development and Aging (ILSE), with three measurement waves (1993/1994, 1997/1998, and 2005/2006) covering a 12-year interval. Drawing on the older of two available birth cohorts (1930-1932; n = 500), we analyzed the relationship between ATOA and change in fluid versus crystallized abilities based on overall and gender-specific latent change score models, while controlling for education and objective health.

Results

As expected, ATOA predicted change in fluid functioning-but not in crystallized performance-over 12 years. Gender-specific analyses revealed a stronger association between ATOA and decline in fluid abilities for men, even after controlling for health and education.

Discussion

This study adds to the understanding of long-term implications of aging attitudes for cognitive decline trajectories and shows that negative aging attitudes are a risk factor for age-vulnerable cognitive abilities, particularly among men. Further research is needed to better understand the underlying mechanisms of observed relationships.

A Population Dynamic Model to Assess the Diabetes Screening and Reporting Programs and Project the Burden of Undiagnosed Diabetes in Thailand

Diabetes mellitus (DM) is rising worldwide, exacerbated by aging populations. We estimated and predicted the diabetes burden and mortality due to undiagnosed diabetes together with screening program efficacy and reporting completeness in Thailand, in the context of demographic changes. An age and sex structured dynamic model including demographic and diagnostic processes was constructed. The model was validated using a Bayesian Markov Chain Monte Carlo (MCMC) approach. The prevalence of DM was predicted to increase from 6.5% (95% credible interval: 6.3-6.7%) in 2015 to 10.69% (10.4-11.0%) in 2035, with the largest increase (72%) among 60 years or older. Out of the total DM cases in 2015, the percentage of undiagnosed DM cases was 18.2% (17.4-18.9%), with males higher than females (p-value < 0.01). The highest group with undiagnosed DM was those aged less than 39 years old, 74.2% (73.7-74.7%). The mortality of undiagnosed DM was ten-fold greater than the mortality of those with diagnosed DM. The estimated coverage of diabetes positive screening programs was ten-fold greater for elderly compared to young. The positive screening rate among females was estimated to be significantly higher than those in males. Of the diagnoses, 87.4% (87.0-87.8%) were reported. Targeting screening programs and good reporting systems will be essential to reduce the burden of disease.

Psychopathy Traits and Violent Assault Among Men With and Without History of Arrest

Although research suggests that the antisocial behavior (ASB) facet of psychopathy generally carries the greatest predictive power for future violence, these findings are drawn primarily from forensic samples and may reflect criterion contamination between historical violence and future violence perpetration. Likewise, these findings do not negate the association of other psychopathy facets to violence or their role in the development of violence, nor do they offer practical utility in the primary prevention of violence. There are a number of empirical and theoretical reasons to suspect that the callous affect (CA) facet of psychopathy may demonstrate stronger statistical association to violence in nonforensic populations. We tested the association of CA to severe acts of violence (e.g., assault with intent to harm, injure, rape, or kill) among men with and without history of arrest ( N = 600) using both the three- and four-facet models of psychopathy. CA was robustly associated with violence outcomes across the two groups in the three-facet model. When testing the four-facet model, CA was strongly associated with violence outcomes among men with no history of arrest, but only moderately associated with assaults causing injury among men with history of arrest. These results are consistent with data from youth populations that implicate early emotional deficits in later aggressive behavior and suggest CA may help to identify individuals at risk for violence before they become violent. Implications for the public health system and the primary prevention of violence are discussed.

Parents of early-maturing girls die younger

According to the life-history theory, rates of sexual maturation have coevolved with mortality rates so that individuals who mature faster tend to die younger. We used two data sets, providing different markers for the speed of pubertal development to test whether rates of sexual maturation of women predict the age at death of their parents. In the data set of Estonian schoolgirls born between 1936 and 1961, the rate of breast development predicted lifespan of both mothers and fathers (irrespectively of their socio-economic position), so that parents of rapidly maturing girls died at younger age. This finding supports the view that fast maturation rates in humans have coevolved with short lifespans and that such trade-offs can be detected as intergenerational phenotypic correlations in modern populations. Menarcheal age of participants of Estonian Biobank (born between 1925 and 1996) did not predict the age of death of their mothers; however, it did predict survival of their fathers, but only in environment where the genetic variation is exposed (families where at least one parent had tertiary education). In such families (where girls also matured 0.2-0.4 years earlier than in poorly educated families), 1-year delay in daughter's menarche corresponded to 9% lower hazard of father's death. Heritability of menarcheal age was also highest in well-educated families. The latter findings are consistent with the idea that genetic differences in the rate of pubertal maturation may be expressed most clearly in well-off families because in such families, the contribution of environmental variance to total phenotypic variance in menarcheal age is smallest. Our findings suggest that with global improvement and equalization of growth conditions, reductions of environmental variation in the rate of maturation increasingly expose the genetic differences in menarcheal age to selection. Under such conditions, selection on menarcheal age has a potential to affect the evolution of lifespan.

Hispanic Male Cancer Survivors’ Coping Strategies

Cancer survivors manage their new status using a multitude of coping mechanisms. Coping strategies vary by individual, but are also socioculturally mediated. Scarce evidence on coping strategies adopted by Hispanic male cancer survivors (HMCS) is available to date. The purpose of this study was to explore the reaction to diagnosis and subsequent coping strategies employed by HMCS. Data were gathered through focus groups ( n = 18), cognitive interviews ( n = 12), and phone interviews ( n = 84). Coping strategies included positive attitudes, humor, optimism and social support, use of home remedies, lifestyle changes, and faith. Findings are consistent with research on non-cancer-related coping showing that HMCS use active coping strategies, such as religion and support from family and friends. The analysis of existing strategies and needs points to the need to develop evidence-based psychosocial services that build on strengths and coping behaviors already employed by HMCS.

Weight and social comparison: Does the weight of a stranger affect a person's perception of their own weight?

Research suggests that social context affects individuals’ perception of their own weight. Using face-to-face interviews as the social context, we analyze the effect of interviewers’ (N = 90) body mass index on respondents’ (N = 3068) self-perceived weight level. Respondents reported a higher weight level when the interviewer had a higher body mass index (absolute social comparison). Female respondents reported a lower weight level if interviewers had a higher body mass index than they did (relative social comparison). Results suggest that weight perception reflects both absolute and relative social comparison, especially among women. Future research should consider causation and self-selection when studying social context and body image.

Potential roles of masculine role discrepancy, discrepancy stress, and self-esteem in affecting addictive use of social networking sites among Chinese men: A random population-based study

BACKGROUND AND AIMS

Masculine role discrepancy (i.e., men perceiving themselves not living up to the ideal manhood and being less masculine than the typical "man") and related discrepancy stress were associated with some risk behaviors. No study has looked at their relationships with addictive use of social networking sites (SNSs), an emerging potential public health concern. The study constructed a moderated mediation model to test whether masculine role discrepancy would be positively associated with discrepancy stress, which would, in turn, be positively associated with addictive use of SNS, and whether self-esteem would buffer (moderate) the association between masculine role discrepancy and discrepancy stress.

METHODS

A random population-based cross-sectional telephone survey interviewed 2,000 Hong Kong male adults in the general population.

RESULTS

Currently unmarried and non-cohabiting, younger, and better educated participants reported higher addictive use of SNS scores than others. Adjusted for these variables, masculine role discrepancy and discrepancy stress were positively associated, and self-esteem was negatively associated with addictive use of SNS scores. Path analysis indicated that masculine role discrepancy was associated with addictive use of SNS through discrepancy stress (mediation); self-esteem buffered (moderated) the association between masculine role discrepancy and discrepancy stress; self-esteem was not significantly associated with addictive use of SNS in this model with good fit.

DISCUSSION

The findings support the general strain theory's postulation that strain is associated with stress, which is in turn associated with addictive use of SNS sites. Implications, potential interventions, and future studies are discussed in this study.

Working Men's Constructions of Visiting the Doctor

To understand influences on medical help seeking in men from traditionally masculine occupations, semistructured interviews with 12 men employed in manual and industrial labor were conducted. The semistructured interview format explored participant men's understanding and experiences of annual exams and medical help seeking, their own and others' reactions to seeking medical help, and influences on their own care and understanding of what it means to seek medical care. Utilizing consensual qualitative research methodology, five domains emerged: Social norms around medical care, managing threat, getting medical help is gendered, work-related influences, and pragmatic contributors to medical help seeking. Results extended the literature by situating men's understanding of physician visits within a gendered and social context, and highlighting the influence of work and coworkers, where messages are often contradictory and inconsistent about medical help seeking. Future research should examine additional contextual factors influencing men's attitudes toward seeking health care, including race, culture, and sexual orientation, as well as seek to develop and evaluate interventions that promote men's utilization of medical services.

Feminine Discrepancy Stress and Psychosocial Maladjustment Among Adolescent Girls

Discrepancy stress, stress about being perceived to not conform to one's gender role (i.e., gender role discrepancy), has demonstrated effects on risky sexual and violent behaviors. However, evidence of these effects has been limited to men and boys, neglecting the impact gender role discrepancy and discrepancy stress may have on girls. In addition, no study to date, has assessed the mental health correlates of gender role discrepancy and discrepancy stress. In the current study, we sought to elucidate the relationship between perceived feminine discrepancy and feminine discrepancy stress and psychosocial maladjustment while controlling for trauma symptoms stemming from the potential repercussions of feminine discrepancy. Maladjustment was measured by creating a second-order latent factor derived from four first-order latent constructs: sexual behavior, substance use, mood disorder symptoms, and hopelessness. Data are drawn from a cross-sectional sample of female students in middle and high school (N = 643) who completed self-report questionnaires. Using structural equation modeling, we found girls reporting feminine discrepancy (i.e., less feminine than the average girl) were more likely to report feminine discrepancy stress and trauma symptomatology. Controlling for feminine discrepancy and trauma symptoms, the relationship between discrepancy stress and maladjustment was positive and significant. Additionally, girls reporting feminine discrepancy scored higher on trauma symptomatology, and trauma demonstrated a strong direct effect on psychosocial maladjustment. These data suggest that developing trauma focused prevention strategies that incorporate social norms around gender socialization may have an impact on multiple behavioral and mental health problems.

Physical activity and masculinity in rural men: a qualitative study of men recruited from churches

The majority of rural US men fail to meet physical activity (PA) guidelines and are at risk for chronic diseases. This study sought to understand rural men's perceptions about PA and PA engagement and the influence of masculinity and social norms. From 2011 to 2014, 12 focus groups were conducted with men prior to a church-based health promotion intervention. Men were recruited from Illinois' rural, southernmost seven counties, where 40% of men report no exercise in the past 30 days. We used inductive content analysis methods to identify PA-related themes, and subsequently used elements of the Health, Illness, Men, and Masculinities framework as a lens to explore subthemes. We identified four themes: (i) knowledge of the positive impact of PA on health, (ii) perceptions of appropriate types of PA for men, (iii) the importance of purposeful PA and (iv) the desire to remain strong and active, particularly during aging. These findings can inform strategies for messaging and interventions to promote PA among rural men. Health promotion efforts should consider the intersections between rurality and masculinity as it relates to rural men's perceptions of PA, include information about purposeful PA and encourage them to engage in PA with a support person.