An analysis of online content related to testosterone supplementation

Objective: To describe the quality of online information on testosterone replacement therapy (TRT) in men.

Methods: A quantitative content analysis was conducted on websites providing patient-directed information on TRT for the purpose of treating late onset hypogonadism (LOH). Websites were identified through Google in March 2017. The DISCERN instrument was used to determine the quality of health information.

Results: A total of 20 websites met inclusion criteria. Websites were primarily from the United States (45%), United Kingdom (25%), and Australia (15%). Sources of information were cited by 40% of websites. Several websites (40%) claimed that TRT had benefits, with 25% claiming that TRT was effective for treating LOH. TRT was described as a safe therapy by one website (5%), with gynecomastia (35%) and increased hematocrit (35%) representing the most commonly described side effects. Prostate specific antigen (35%) and serum testosterone monitoring (30%) were the most commonly described monitoring parameters. The mean DISCERN score was 46.4, indicating fair quality information. The Flesh–Kincaid Grade Level was 12.2.

Conclusion: Online TRT information is incomplete, often failing to describe important safety information and the need for regular monitoring.     

Housing in Old Age: Dynamical Interactions Between Neighborhood Attachment,Neighbor Annoyance,and Residential Satisfaction

Objective: Residential satisfaction and neighborhood quality play major roles in aging well. However, longitudinal research about the interplay between such factors is still sparse. Our 1-year study examined whether change in residential satisfaction was associated with change in two indicators of neighborhood quality: neighborhood attachment and neighbor annoyance.

Methods: Findings come from a longitudinal study with 85 community-dwelling German older adults (age range: 60 to 92 years). Participants filled out questionnaires at two measurements that were 1 year apart. The interplay between residential satisfaction and neighborhood was explored using a cross-path model.

Results: Higher levels of residential satisfaction predicted enhanced attachment and reduced annoyance over time. Moreover, attachment predicted positive change in residential satisfaction over the course of 1 year.

Conclusion: Results suggest that older adults may apply adaptive behaviors and strategies to optimize their neighborly experiences. Such findings have implications for improving residential satisfaction in community-dwelling older adults.     

Factors Influencing Family-Member Perception of “Homelikeness” in Long-Term Care Homes

Background: A number of long-term care homes in Nova Scotia, Canada, have been built or redesigned with new models of care with expanded care aide scope of practice and neighborhood-style layouts. Our objective was to examine what physical characteristics (bed size, owner-operator), model of care, and relational (family–staff relationship, perceived staff–resident relationship) factors were associated with increased family-member perception of homelikeness in long-term care homes.

Methods: We analyzed surveys collected from 273 family members from 23 long-term care homes in Nova Scotia, Canada. We conducted a multivariate linear regression to assess variables associated with increased family-member perception of homelikeness.

Results: We found that relationships between family and staff, perceived resident-to-resident relationships, and family involvement in decision making were positively associated with increased family perception of homelikeness. We found no significant associations between model of care or physical characteristics and increased family perception of homelikeness.

Conclusion: Relationships among family members, residents, and staff are integral to family members feeling at home in their loved one's long-term care home. Feeling at home in long-term care is largely related to family-member perception of meaningful social interactions between family and staff, and between residents.     

Reference database of hematological parameters for growing and aging rats

The normal hematological values in various phases of the rat life provide a valuable guide to researchers and could be useful for experimental works. However, database information available on the literature are incomplete. Aim: This study aimed to present normal hematological parameters of young and aged rats.

Methods: Male and female rats were distributed into seven experimental groups with 1, 2, 3, 6, 12, 18, and 24 months of age. Blood samples taken from the tails were analyzed. Normal hematological values were determined for each age group.

Results: Rats showed a progressive weight gain with advancing age, predominantly after 3 months of life. With advancing age, differences were found on hematological parameters: some of them showed a progressive rise with age and others did not. Hemoglobin levels and hematocrit did not change while the number of circulating red blood cells suffered slight increase.

Conclusion: The present study determined the normal values for absolute and relative hematological parameters in Wistar rats from 2 to 24 months for male and female rats. The results can be used in studies of effects of aging, feeding, and medications on growing and aging rats.     

Examining the effect of the computer-based educational package on quality of life and severity of hypogonadism symptoms in males

Objective: The objective of this study was to determine the effect of the computer-based educational package on men’s QoL and the severity of their hypogonadism symptoms.

Methods: A quasi-experimental study was conducted on 80 male employees. The data collection tool included the ‘Aging Male Symptoms’ (AMS) and ‘Short Form-36’ (SF36) questionnaires. Four sessions were held for the intervention group over a period of 4 weeks. Two months after training, QoL and the severity of hypogonadism symptoms were measured in both the intervention and control groups. The data were analyzed with SPSS 22 software and statistical tests, such as χ², independent t-test, Fisher’s exact test, and paired t-tests.

Results: Significant statistical changes were observed in the intervention group before and 2 months after the training in the QoL score in the overall dimensions of physical–psychological health and all its domains except for three domains of emotional role, social function, and pain. Furthermore, the paired t-tests showed significant differences between 2 months before and after the training in all the domains and the overall hypogonadism score in the intervention group.

Conclusions: Based on our findings, the computer-based educational package has a positive effect on QoL and reduction of hypogonadism symptoms.     

Feasibility of intervention in elder self-neglecters: Setting the stage for future research

Objectives: Interventions are critical to improving clinical outcomes in elder self-neglecters. This study assessed feasibility of a randomized controlled trial of oral vitamin D in Adult Protective Services-substantiated self-neglect clients ≥65 years.

Methods: Participants were directly observed to consume ergocalciferol 50,000 IU (treatment) or ergocalciferol 400 IU (control), once a month, for 10 months. For months 6–10, half the control group randomly crossed into the treatment group (crossover). Intervention feasibility was measured by number of potential participants who agreed to participate and by retention rates during the study.

Results: Ninety-four referrals were received and 59 (63%) agreed to participate. Forty-nine participants were enrolled after prescreening and 35 completed the two-phase trial for a 72% retention rate. The participants’ average age was 75.2 ± 6.8 years, mainly female (59%), African-American (47%), and living alone (41%).

Discussion: Despite assumptions that self-neglecters are resistant to care, we have successfully conducted the first clinical intervention in this vulnerable population.     

Effect of warning placement on the information processing of college students reading an OTC drug facts panel

Objective: To compare three over-the-counter (OTC) Drug Facts panel versions for information processing optimization among college students.

Participants: University of Houston students (N = 210) participated in a cross-sectional survey from January to May 2010.

Methods: A current FDA label was compared to two experimental labels developed using the theory of CHREST to test information processing by re-positioning the warning information within the Drug Facts panel. Congruency was defined as placing like information together. Information processing was evaluated using the OTC medication Label Evaluation Process Model (LEPM): label comprehension, ease-of-use, attitude toward the product, product evaluation, and purchase intention.

Results: Experimental label with chunked congruent information (uses-directions-other information-warnings) was rated significantly higher than the current FDA label and had the best average scores among the LEPM information processing variables.

Conclusion: If replications uphold these findings, the FDA label design might be revised to improve information processing.     

Life after loss: Comparing student service member/veteran and civilian mental health characteristics among individuals exposed to death by suicide

Objective: This study evaluated the mental health characteristics and beliefs of student service members/veterans (SSM/Vs) who have been exposed to another’s death by suicide.

Participants: A total of 39 SSM/Vs exposed to suicide and 32 SSM/Vs not exposed to suicide were sampled from a larger, epidemiological survey. An age- and gender-matched group of 39 civilian (C) students was drawn from a larger sample of individuals exposed to suicide.

Methods: Data were collected as part of an Internet-based, campus needs survey that occurred in Fall 2014. Participants were asked to complete measures about suicide-related behaviors, suicide prevention, help-seeking, and demographics.

Results: SSM/Vs exposed to suicide had more positive mental health/suicide prevention beliefs than SSM/Vs not exposed to suicide. Cs exposed to suicide were not significantly different from either group. Unique help-seeking patterns were also identified.

Conclusions: The current study identifies unique characteristics of SSM/Vs exposed to suicide that may inform prevention programming.     

Effects of resistance training on liver structure and function of aged rats

The aging process may cause negative physiological changes. However, exercises as resistance training (RT) have been considered an important intervention to attenuate these changes. Additionally, liver plays an important role in blood glucose homeostasis in exercise.

Aim: This study aimed to analyze the effects of RT on the liver components of aged animals.

Methods: Male Wistar rats were divided into two groups: 24 months’ group (CONTROL); and group submitted to a progressive RT protocol for 16 weeks (EXERCISE). Both groups were sacrificed at 24 months.

Results: We observed a decrease in blood flow due to the practice of resistance exercises. Besides, our results showed that hepatic tissue plays an important role in glycemic homeostasis during RT. In addition, RT increased mitogen capacity of hepatocytes.

Conclusions: Our study showed many implications for the knowledge about the effects of strength training on old animals’ liver.     

Gene expression of insulin receptor,insulin-like growth factor increases and insulin-like growth factor-binding protein-3 reduces with increase in prostate size in benign prostatic hyperplasia

Introduction: Although the role of insulin in the development of benign prostatic hyperplasia (BPH) is well established, there are no studies regarding alteration in the gene expression of components of insulin-signaling pathway and their association with prostate size in BPH. Hence, the study was designed to analyze the gene and protein expression of insulin receptor and its related components in patients with BPH.

Materials and methods: Twenty-seven BPH patients aged between 55 and 75 years were recruited in the study and prostatic tissues were obtained after transurethral resection of the prostate. Gene expression levels of Insulin receptor (IR), insulin receptor substrate (IRS), insulin-like growth factor (IGF) and insulin-like growth factor-binding protein-3 (IGFBP-3) were assessed by q-PCR.

Results: Insulin receptor (IR-A and B) and insulin-like growth factors (IGF-1 and IGF-2) gene expression were significantly increased and IGFBP-3 gene expression was reduced in BPH patients with larger prostate size. Also, serum insulin was significantly increased and IGFBP-3 was significantly reduced in patients with larger prostate size.

Conclusion: Increased expression of IR-A, B and IGF-1, 2 genes and reduced IGFBP-3 gene expression was associated with larger prostate size in BPH.     

Grandiose and vulnerable narcissism: Associations with alcohol use,alcohol problems and problem recognition

Objective: This study fills a gap in the literature by examining the relationship between two types of narcissism, vulnerable and grandiose, and five alcohol-related outcomes (ie, alcohol use, alcohol problems, evaluation and expectancies of problems, and readiness to change).

Participants: 345 college students (28% men, 72% women) from a Midwestern university were recruited from undergraduate psychology courses from April 2015 to October 2016.

Methods: Participants completed an online survey with questionnaires measuring the variables of interest. Multiple regression analyses were used to test the hypotheses.

Results: Grandiose narcissism was a positive predictor of alcohol consumption and a positive (ie, good) evaluation of alcohol-related problems. Vulnerable narcissism was a positive predictor of alcohol-related problems, problem recognition (ie, readiness to change), and problem expectancies.

Conclusions: The results speak to the effects that different types of narcissism have on alcohol use, alcohol problems and attitudes towards alcohol problems among young adults.     

Heart checks in college-aged students link poor sleep to cardiovascular risk

Objective: To describe the relationships between the cardiovascular health, lifestyle behaviors, and lifestyle beliefs among college-aged students.

Participants: Seven hundred and twenty-nine college-aged students participated between October 2016 and April 2017.

Methods: Heart checks, consisting of a cross-sectional survey and biometric screening, were conducted on a large Midwestern university campus.

Results: A small proportion of students (24.5%) engaged in the recommended 150+ minutes of physical activity per week and 7.9% consumed 5+ servings of fruit/vegetables daily. Half (49.6%) slept 7 hours or less per night. Biometric screenings found that 26.4% of the students had high stress, 31.9% were overweight or obese, and 17.3% had prehypertension or hypertension. Less sleep was significantly associated with higher risks of being stressed, being overweight/obese, and having elevated blood pressure.

Conclusions: Early detection, treatment, and education is critical to identify individuals at risk for cardiovascular disease and to promote healthy lifestyle changes before heart disease develops or progresses.     

Prostate-specific antigen decline pattern in advanced prostate cancer receiving androgen deprivation therapy and relationship with prostate-specific antigen progression

Introduction: The aim of this study is to evaluate prostate-specific antigen decline pattern including prostate-specific antigen kinetics following androgen deprivation therapy on prostate-specific antigen progression in the patients with advanced prostate cancer.

Materials and methods: Ninety-seven advanced prostate cancer patients receiving maximum androgen deprivation therapy were enrolled in case–control study. Baseline prostate-specific antigen, Gleason Score, bone metastase, nadir prostate-specific antigen, time to nadir prostate-specific antigen, declining slope to nadir prostate-specific antigen, estimated baseline prostate-specific antigen half-time, current prostate-specific antigen, post-nadir prostate-specific antigen time, estimated prostate-specific antigen, estimated decline of baseline prostate-specific antigen as quantitative, and ratio were recorded and calculated.

Results: The ratio of prostate-specific antigen progression was significantly lower at the patients who had slower declining slope to prostate-specific antigen, longer time to nadir prostate-specific antigen, and lower estimated decline ratio of baseline prostate-specific antigen (p: .016, p: .020, and p: .026, respectively).

Conclusions: The shorter time to nadir prostate-specific antigen following androgen deprivation therapy, faster declining slope to nadir prostate-specific antigen and higher estimated decline ratio of baseline prostate-specific antigen are associated with higher risk of disease progression in patients with hormone-sensitive prostate cancer.     

A systematic review of the association between lower urinary tract symptoms and falls,injuries, and fractures in community-dwelling older men

Background: Lower urinary tract symptoms (LUTS) have been associated with falls in studies either exclusively or predominantly of women. It is, therefore, less clear if LUTS are risk factors for falls in men.

Methods: We conducted a systematic review of the literature on the association between LUTS and falls, injuries, and fractures in community-dwelling older men. Medline, Embase, and Cinahl were searched for any type of observational study that has been published in a peer-reviewed journal in English language. Studies were excluded if they did not report male-specific data or targeted specific patient populations. Results were summarized qualitatively.

Results: Three prospective cohort studies and six cross-sectional studies were identified. Incontinence, urgency, nocturia, and frequency were consistently shown to have weak to moderate association with falls (the point estimates of odds ratio and relative risk ranged from 1.31 to 1.67) in studies with low risk of bias for confounding. Only frequency was shown to be associated with fractures.

Conclusions: Urinary incontinence and lower urinary tract storage symptoms are associated with falls in community-dwelling older men. The circumstances of falls in men with LUTS need to be investigated to generate hypotheses about what types of interventions may be effective in reducing falls.     

The Impact of the Physical Home Environment for Family Carers of People with Dementia: A Qualitative Study

Background: The majority of people with dementia are cared for by their families at home. This study aimed to elicit family carers' perceptions on home environmental aspects and strategies with the view to identify barriers and facilitators when caring for a person with dementia at home.

Design and methods: Thirteen co-resident family carers were engaged in semi-structured in-depth walking interviews. Interviews were recorded, transcribed and analysed using thematic analysis.

Results: Home environments can pose a number of challenges and opportunities. Aspects of the architectural and interior environment (e.g. size, condition, layout and accessibility, familiarity) are perceived as important (Theme 1) as well as a plethora of environmental strategies that encourage independence and comfort at home (Theme 2). Carers' scepticism, timing, costs, property characteristics and mistrust to services are some barriers to implementing environmental strategies (Theme 3).

Conclusions: Carers improvised solutions via trial and error and need further education on strategies to create an enabling and comfortable home environment.     

Trends in cardiovascular diseases and associated risks in sub-Saharan Africa: a review of the evidence for Ghana,Nigeria, South Africa,Sudan and Tanzania

Background: Sub-Saharan Africa (SSA) countries are facing an epidemiological shift from infectious disease to chronic diseases, such as cardiovascular diseases (CVDs). CVDs incidence in SSA are frequently attributed to the prevalence of hypertension, diabetes, and overweight/obesity. Nevertheless, some researchers contend that CVDs are not a priority public health problem in SSA.

Method: This paper systematically reviews the evidence on CVDs and their relation with hypertension, diabetes mellitus and obesity/overweight in Ghana, Nigeria, South Africa, Sudan and Tanzania. The publication’s content was analyzed qualitatively using the directed content analysis method and the results were presented in a tabular format.

Result: The paper illustrates the rising prevalence of CVDs as well as the three related risk conditions in the selected SSA countries.

Conclusion: The review indicates a poor health system response to the increasing risk of CVDs in SSA. The conditions and major drivers that contribute to this underlying increasing trend need to be further studied.     

A meta-analysis of effectiveness of E-interventions to reduce alcohol consumption in college and university students.

Objective: To evaluate the effectiveness and moderators of E-Interventions versus assessment only (AO) controls in the reduction of alcoholic drinks per week (DPW) in university students.

Study design and methods: Cochrane library, CINAEL, ERIC, MEDLINE, PsycINFO, PubMed, and Web of Science were searched up to June 2017. Studies were included if they were: an RCT, assessed the effectiveness of E-Interventions at reducing DPW, and employed university/college students. 23 studies (N = 7,614) were included and quality was assessed using the JADAD scale.

Results: Weighted mean effect sizes were calculated using random-effects models. These showed a small, significant effect of E-Interventions at reducing the number of alcoholic DPW. Moderator analysis found a significant advantage for web-based personalised feedback interventions compared to other E-Interventions.

Conclusions: E-Interventions show a small, significant effect at reducing mean alcoholic DPW. Personalised feedback E-Interventions showed the strongest effect.     

Recantation of Sexual Abuse Disclosure Among Child Victims: Accommodation Syndrome

Background: Disclosing the sexual abuse may be related on many individual and/or environmental factors in all age groups. The sociocultural context is the most influential factor of the disclosing process especially for those living in patriarchal cultural values. This study compares the impacts of sexual abuse and other sociodemographic variables between recanting and non-recanting victimized groups in Adana city from Turkey.

Methods: The samples attending our department were divided into two groups: group 1 comprised victims who recanted their first abuse disclosure, and group 2 comprised victims who insisted on the veracity of their first report at further evaluations. The characteristics of the child, family, and abuser were compared between recanting victims and non-recanting victims by retrospective data.

Results: Each group included 27 children, for a total of 54 subjects. All adverse social reactions after the sexual abuse, including keeping secrets and a repressive family attitude, were higher among group 1 victims than group 2 victims (p < 0.0001).

Conclusions: Although they are victimized by protecting family integrity, victims may show a tendency to keep secrets and to not immediately disclose an abuse event.     

Measuring characteristics of e-cigarette consumption among college students

Objective: E-cigarette use among college students has increased drastically in recent years. This study aims to inform development of a comprehensive measure of e-cigarette consumption for this population.

Participants and Methods: This mixed-method study collected both quantitative and qualitative data from a sample of 43 experienced e-cigarette users from two college campuses, using a self-reported questionnaire and a semi-structured interview, in March–September of 2017.

Results: College student users found some of the consumption questions in national surveys difficult to answer. Switching nicotine levels, mixing flavors, co-using with alcohol and marijuana, using with others who were vaping or drinking, and vaping in a car or indoor space were all common. The participants defined “regular user” based on ownership of a device rather than on quantity/frequency.

Conclusions: A comprehensive e-cigarette consumption measure should cover the complex characteristics that are potentially associated with negative health consequences such as flavorings, co-use and social contexts.