The male menopause and mood: testosterone decline and depression in the aging male -is there a link?

Reproduced with permission from BC Decker Inc     

Is Swedish pension reform the right medicine for aging Europe?

Following the Second World War, the idea of the life course with distinct periods of education, work, and retirement became popular as a result of the alliance of interests of unions and management, with politicians seizing the opportunity to accommodate them. These "social partners" implemented benefit rules and created practices for using old age and disability to ease the exit of older workers. Although justifiable at the time, now those rules and practices hinder individual and employer incentives to invest in human capital and work environments that enable older workers to remain in the workforce. The article argues that the workforce environment of the coming half-century, which is relevant for persons born around 2000, is much different from that a hundred years earlier, which determined the opportunities for people born around 1900. People are healthier and live much longer and work environments are friendlier. The article argues that it is no longer justifiable to subsidize exit from the workforce around the age of 60 for healthy workers, especially in view of the coming labor shortage in Europe. It also argues that the introduction of the principles of the Swedish NDC pension reform in Europe would provide possibilities for flexible exit from the workforce and remove impediments to labor mobility in Europe, which are embedded in many of Europe's present pension arrangements.     

Gray and green?: Stewardship and sustainability in an aging society

The natural environment has been a missing part of the context in public policy forums and educational programs when discussing the implications of an aging society. We believe that stewardship and the sustainability of natural resources should be considered in addition to economics and health care when addressing the themes of well-being and quality of life for future generations. This article presents on overview of the usage of the concept environment in aging studies and presents critically important concepts such as sustainability, stewardship, natural capital, carrying capacity, and ecological footprint in recognizing the relevancy of including the natural environment in discussions about our aging society. Also we propose directions for future research and discuss advocacy and organizational activities related to ecology and aging studies.     

How to help the aging male? Current approaches to hypogonadism in primary care

Hypogonadism is a common condition which occurs more frequently in older men. It is characterized by low testosterone (T) and is associated with symptoms which are often nonspecific. A key symptom is low libido, but it can also be associated with erectile dysfunction, reduced muscle mass and strength, increased body fat, reduced bone mineral density and osteoporosis, reduced vitality, and depressed mood. Hypogonadism is linked with a variety of comorbid conditions including erectile dysfunction, metabolic syndrome, diabetes, obesity, and osteoporosis. However, the condition is often underdiagnosed. T supplementation in hypogonadism is associated with a range of benefits including improved sexual function, increased lean body mass and/or reduced fat mass, and improved bone mineral density. A variety of T supplementation formulations are available. Although there is no evidence of increased risk of initiating prostate cancer with T supplementation, it is contraindicated in men with prostate cancer. It is important that primary care physicians are aware of both the signs and symptoms of hypogonadism, the monitoring and testing that is required and the merits and advantages of the various T preparations to ensure optimal management of the condition with a treatment approach that best suits patients’ needs.     

Endothelial progenitor cell therapy for atherosclerosis: the philosopher's stone for an aging population?

Much of the increased risk for atherosclerosis progression with age may be a result of age-related declines in the capacity of precursor cells to repair damage in the arterial endothelium. To estimate the impact of progenitor cell therapy for atherosclerosis on cardiovascular disease (CVD) mortality, life expectancy, and survival, as compared with the lifetime control of conventional risk factors, we modeled the health effects of bone marrow-derived endothelial progenitor cell therapy using data from the 1950 to 1996 follow-up of the Framingham Heart Study. To model cardiovascular disease mortality, we assumed that progenitor cell therapy was applied at age 30, with the effect assumed to be a 10-year delay in atherosclerosis progression. Age projections were constructed analytically using the stochastic process model for risk factor dynamics and mortality and microsimulation techniques. We considered three types of interventions: (i) keeping risk factors within selected limits to model current clinical recommendations; (ii) an age shift of 10 years to model the effects of progenitor cell therapy; and (iii) elimination of a competing risk (such as cancer). Our study suggests that progenitor cell therapy might increase life expectancy in the population as much as the complete elimination of cancer (in females, an additional 3.67 versus 3.37 years; in males, an additional 5.94 versus 2.86 years, respectively).     

Ungrateful slaves? An examination of job quality and job satisfaction for male part-time workers in the UK

Research on part-time work has concentrated over many decades on the experiences of women but male part-time employment is growing in the UK. This article addresses two sizable gaps in knowledge concerning male part-timers: are men's part-time jobs of lower quality than men's full-time jobs? Are male part-timers more or less job-satisfied compared to their full-time peers? A fundamental part of both interrogations is whether men's part-time employment varies by occupational class. The article is motivated by the large body of work on female part-timers. Its theoretical framework is rooted in one of the most controversial discussions in the sociology of women workers: the “grateful slave” debate that emerged in the 1990s when researchers sought to explain why so many women expressed job satisfaction with low-quality part-time jobs. Innovatively, this article draws upon those contentious ideas to provide new insights into male, rather than female, part-time employment. Based upon analysis of a large quantitative data set, the results provide clear evidence of low-quality male part-time employment in the UK, when compared with men's full-time jobs. Men working part-time also express deteriorating satisfaction with jobs overall and in several specific dimensions of their jobs. Male part-timers in lower occupational class positions retain a clear “lead” both in bad job quality and low satisfaction. The article asks whether decreasingly satisfied male part-time workers should be termed “ungrateful slaves?” It unpacks the “grateful slave” metaphor and, after doing so, rejects its value for the ongoing analysis of part-time jobs in the formal labor market.     

Where is the border? Current issues in the diagnosis and treatment of the borderline

Differential diagnosis of subtypes of individuals meeting criteria for borderline personality disorder has received only limited attention in the recent social work literature on the borderline. Whether the borderline disturbance is moderate or severe, the condition may overlap with several borders, suggesting that borderline personality disorders are a heterogeneous group of conditions. Discrimination between different subtypes is necessary in order to help clients obtain the optimum combination of treatments.     

Are urge incontinence and aging risk factors of erectile dysfunction in patients with male lower urinary tract symptoms?

Introduction: Several studies have indicated that erectile dysfunction (ED) patients also suffer from lower urinary tract symptoms (LUTS). We investigated a group of men with LUTS and assessed their sexual function with the aim of being able to predict ED risk factors and introduce ED treatments earlier for this patient group.

Methods: International Prostate Symptom Score (IPSS), Overactive Bladder Symptoms Score (OABSS) and Sexual Health Inventory for Men (SHIM) score were obtained from 236 men with LUTS at their first out-patients visit. Clinical parameters such as body mass index, prostate volume, residual urine volume and prostate specific antigen were also evaluated. The relationship between the SHIM score and other clinical data was analyzed.

Results: According to the SHIM score, ED in men with LUTS was severe 15%, moderate 19%, moderate to mild 28%, mild 17%, normal 7% and data was incomplete in 14%. Based on the results of a multivariate analysis, aging (p?p?=?0.024) were significantly correlated to severe and moderate ED. Furthermore, among OAB symptoms score items, urge urinary incontinence was a risk factor for severe and moderate ED (p?=?0.005).

Conclusion: Aging and OAB (notably urinary urge incontinence) are risk factors for severe and moderate ED in men with LUTS.     

Is there an Intermarriage Premium for Male Immigrants? Exogamy and Earnings in Sweden 1990–2009

This paper analyzes the impact of intermarriage on the economic integration of immigrants in Sweden, measured by annual earnings. We use longitudinal register data for the period 1990–2009 for the total population of immigrant men born 1960–1974. The results reveal large intermarriage premiums, but overall this seems to be a result of selection effects as most of the premium is visible already at the time of marriage. For the most economically marginalized immigrants, however, an intermarriage premium arises within marriage implying that forming a union with a native triggers a more rapid earnings growth among them.     

Empowered and self-managing users in methadone treatment?

Empowerment is a keyword in treatment. Users should have the means and possibilities to influence their treatment and become self-managing. Drawing on ethnographic fieldwork in a Danish methadone treatment project, we find that the practices of users and staff are often not carried out in accordance with governmental intentions. We identify a gap between the official notions of treatment and practices. We analyse the notions and practices of empowerment by applying two analytical perspectives. First, we apply a constructionist perspective in which empowerment is analysed as wanting to set users ‘free’ but also as ways to govern. We elaborate the analysis by applying a more practice-oriented focus. Drawing on this perspective, we analyse the ways in which staff and users constantly produce, construct and negotiate institutional practices that differ from the governmental intentions for treatment.     

From these roots: The role of historically Black colleges and universities in preparing the nation’s gerontologists for an aging society

ABSTRACT

The aging of the United States population is creating an increased need for social workers and other helping professionals with training in gerontology. Recent estimates indicate that less than 3% of MSW students are enrolled in an aging concentration, as compared to 19% enrolled in children/youth concentrations. In addition, the phenomenon of a diverse baby boomer generation joining the ranks of persons age 65 and older has created a plethora of scholarship and curriculum development aimed at readying the aging network for the unprecedented growth of older persons. Social work can make unique professional contributions to the field of gerontology and older persons. This study asserts, however, that social work is not adequately prepared to practice in an increasingly diverse aging society. The social work profession has articulated commitments to acknowledging and affirming how diversity and culture shape the human experience and to developing social workers who can competently engage in research-informed practice and practice-informed research. However, there remains a need in social work education for more widespread use of culturally relevant pedagogies that can help achieve these goals. Informed by both the Afrocentric and Black perspectives, this study presents a content analysis of the curricula infused at two historically Black universities. The nature and extent of the contributions of historically Black universities to social work education is the focus of this article. The scope of this investigation also includes the identification of prominent Black social work educators and discusses the implications of these perspectives for more culturally informed gerontology curricula that promote culturally competent gerontological social workers.     

Sweden and the United States: is the challenge of an aging society leading to a convergence of policy?

The aging of the population is one of many forces behind a current reconstruction of welfare benefits in both Sweden and the United States. While both countries represent ideological polarities regarding social policy, they are struggling to meet their welfare goals with limited resources, and both are adopting similar strategies, for example, decentralization, targeting, and an increased emphasis on privatization and evaluation. This paper summarizes some of the differences between Sweden and the United States and describes some of the forces at work that are lessening the differences between the two countries in strategies and policy regarding care services for elderly people.     

Is WTP an attitudinal measure? Empirical analysis of the psychological explanation for contingent values

Contingent valuation has been given a psychological interpretation, by Kahneman and colleagues, that claims willingness to pay bids represent psychological attitudes rather than personal economic valuations. Evidence reported here shows the need to qualify the role of this attitudinal explanation. In contradiction to the attitudinal hypothesis, the decision to bid zero or positive appears to represent a complex psychological appraisal. Furthermore, evidence of bid clustering on currency denominations implies fundamental differences concerning how people respond to a monetary scale. Whether interpreted as charitable contributions or imprecise welfare estimates there are serious implications for how economists interpret and use stated preference responses.     

Is there a place within academic journals for articles presented in an accessible format?

This article addresses some of the difficulties inherent in disseminating emancipatory research findings in academic journals in a way that is empowering to people with learning difficulties in the UK. It calls for academics to challenge the editorial criteria of academic journals to consider accepting articles written in a more accessible style. It argues that from a social model point of view the products of the research, as well as the process, should be accessible to people with learning difficulties. It looks at what an accessible article is and why it is important, the editorial criteria of some academic journals, different models of presenting emancipatory research and suggests some innovative ways forward that highlight the need to ‘get involved’ in the world of people with learning difficulties and to consider accessible information as a rights‐based issue.     

Reconsidering the ‘idea’ of evidence in evidence-based policy and practice

Evidence-based policy and practice (EBP) has become an important social work conceptual framework. Yet, the core EBP concept, the concept of evidence, remains ill-defined. I propose a modification of the concept of evidence as applied to EBP effectiveness questions. As a basis for this reformulation ideas about evidence are examined from cross-disciplinary and multidisciplinary perspectives including epistemology, philosophy of science, evidence-science, and law. I propose that for EBP effectiveness questions: (1) to be considered ‘relevant evidence’ an explanatory connection between an intervention and an outcome must be established rather than a mere association; (2) the EBP definition of ‘best available evidence’ should include total available evidence (rather than a subset) about effectiveness, causal roles (i.e., mechanisms), and support factors and be inclusive of high-quality experimental and observational studies as well as high-quality mechanistic reasoning; (3) the familiar five-step EBP process should be expanded to include formulation of warranted, evidence-based arguments and that evidence appraisal be guided by three high level criteria of relevance, credibility, and strength rather than rigid evidence hierarchies; (4) comparative effectiveness research strategies, especially pragmatic controlled studies, hold promise for providing relevant and actionable evidence needed for policy and practice decision-making and successful implementation.     

Is the future of unionism in cyberspace?

V. Conclusions Cyber technology has been proposed as the panacea for the troubled Old Unionism, the expansion of the New Unionism, and to promote the political power of the Labor Movement. In furtherance of those objectives, the AFL-CIO created a web site on December 1, 2000, workingfamilies.com. The site is intended to provide 17 million union members and retirees access to the Internet; the Federation also offers them computers at low cost. The AFL-CIO’s web is intended to link the union’s members to each other, offer discussion forums, chat rooms, and e-mail networks which will allow workers to talk to each other regularly and mobilize their workplaces and communities for causes endorsed by the Federation (World Future Society, February, 2000). The new service is an extension of the Union Privilege Benefit Programs set up by the Federation during the 1980s as a way of reversing the unions’ faltering membership. Those programs include reduced attorney fees, lower cost life and accident insurance, participation in a motor-club, car-repair, and travel-club services, a Walt Disney World Hotel Discount, a parents’ college advisor, reduced cost for educational books and software, mortgage and real estate advice, and a dental program. The original package was offered to nonmembers for a small fee who become "associate members." It was hoped that the associate participants would become full members. A number of affiliated unions adopted similar programs. In 1995, the Federation added a credit card issued by Household International and for which it received $75 million each year for five years ending in 2000. The card has no annual fee and low monthly interest charges. How the Federation spent these sums is unknown.