Experiences with the French aging males' symptoms (AMS) scale

Introduction.?The aim of this paper is to report on experiences gained from the application of the French version of the Aging Males' Symptoms (AMS) scale, to show correlations with other relevant scales and to provide population reference values for France.

Methods.?A representative survey based on an existing, representative population panel was performed in France (963 males, aged 15 + years). Other AMS data from Europe were then used for comparison. Mean scores of the French AMS scale do not systematically differ from the data of other European studies. The population reference values obtained for France strongly suggest that the scale measures can appreciate the level of well-being whatever the patients' age; however, some variables, such as age and family income, can influence the total AMS scores. Comparisons with the generic quality-of-life scale, SF-12, and a depression scale, HAD, have shown good correlations, as have comparisons with the ADAM questionnaire.

Conclusion.?The French AMS scale is a standardized, valid and simple health-related quality of life (HRQoL) scale, with results comparable to other published European findings. The results also indicate that the AMS scale can be used to measure and compare HRQoL in those less than 40 years of age.     

Harmonized Italian version of the aging males' symptoms scale

Introduction.?The interest in clinical investigations in health-related quality of life (HRQoL) of aging men has increased over recent years, particularly in the context of partial androgen deficiency. The aim of this paper is to inform the scientific community about a harmonized Italian Aging Males' Symptoms (AMS) scale.

Methods.?There were two slightly different Italian AMS scales, which both underwent an up-to-date linguistic & cultural translation process, i.e., were both valid to be applied in clinical research. However, there are potential long-term problems associated with having two Italian language versions of the scale in the same country. Therefore, an ad hoc committee of key persons related to both versions met with the scale's developer, to create a harmonized single Italian AMS.

Results.?The harmonization meeting came up with a consensus item-by-item and the new Italian reference scale was agreed upon. It was decided that this scale should be published to avoid any confusion among future users.

Conclusion.?The Italian AMS scale published in this paper should be used for future clinical and other research.     

Composite screener for androgen deficiency related to the aging males’ symptoms scale

Objective.?Methodological characteristics of the Aging Males’ Symptoms (AMS) scale point towards a high standard measurement and comparison of health-related quality of life (HRQoL) over time or intervention. However, the scale was neither developed nor standardized as a screening instrument for androgen deficiency.

Methods.?Data of the Austrian ANDROX study suggested to develop a composite screener for androgen deficiency based on AMS, age, and BMI, to determine sensitivity and specificity to detect low total testosterone (TT) levels. The findings were compared with those of an independent sample of urological patients with suspicion of androgen deficiency (AD) from Germany (n = 803).

Results.?A graphical solution for a composite-screening tool was proposed, with three levels of suspicion for AD: positive screening result (high suspicion), equivocal result, and negative screening result (no suspicion, AD unlikely). The percentage of TT values < 4 ng/ml were 18.7%, 40.7% and 58.8% in the three categories: negative, equivocal and positive, respectively. The findings were confirmed in the independent German sample. In both instances, neither sensitivity nor specificity was very high, i.e., between about 50% and 75%.

Conclusion.?The results of the development and initial validation of the new screener are promising. Further information, and experience from the practice, is needed to confirm or refute the hypothesis that this screener is a useful tool for medical practice.     

The politics of portrait photographs in southern Nigerian newspapers, 1945–1954

This paper focuses on the increasingly important role played by pictorial journalism in the struggle for Nigerian self-rule. From the late 1920s onwards, daily newspapers printed portrait photographs with a pro-colonial slant: members of the colonial administration, international heads of state, foreign ministers and, occasionally, the highest-ranking Nigerian politicians. To challenge a dominance of pro-colonial depictions, the anti-colonial West African Pilot introduced a new style of printed portrait photographs in 1937 that became a role model for other newspapers in the 1940s and the 1950s. This article focuses on the use of these portrait photographs for the political propaganda of party-affiliated newspapers, such as the Daily Service, the West African Pilot and the Southern Nigeria Defender, which were published in the southwest of Nigeria. The technological difficulties of printing photographs in newspapers in the 1940s meant that editors had a limited choice of which portrait photographs to include (mainly photographs of politicians, businessmen and chiefs were available). The editors were further constrained by the scarcity of photographs of ordinary people. In addition, photographs depicting the colonial administration’s personnel or edifices were not in line with the editorial policy of the anti-colonial newspapers. In the 1950s, when Nigerian newspapers were able to afford the technological equipment to reproduce their own photographs, a representative cross-section of Nigerian society was still rarely included in the portrait photographs. The photographs that were printed showed the self-fashioning of Nigerian leaders of democratic parties, ahead of the emergence of a new style of democratic and charismatic leaders in Senegal. Although these anti-colonial images were more democratic than the old colonial images in pro-colonial newspapers, they replaced the imperial hierarchies which editors rejected, with the new social hierarchies of local Nigerian elites foreshadowing the politics of independent Nigeria.     

Prevalence of sarcopenia and its association with functional and nutritional status among male residents in a nursing home in Turkey

Introduction The Aging Male Symptoms' (AMS) scale was designed as a health-related quality of life (QoL) scale and standardized as a self-administered scale, first, to assess symptoms of aging (independent from those which are disease-related) between groups of males under different conditions, second, to evaluate the severity of symptoms/QoL over time, and, third, to measure changes pre- and post-androgen replacement therapy. The scale is in widespread use (17 languages currently available) and a recent review of methodological data documented good psychometric characteristics and ability as a clinical utility. This paper describes test characteristics of the AMS (positive and negative predictive values), taking two internationally established and published screening scales for androgen deficiency as the available standard.

Method A sample of 150 German males aged 40–69 years completed the AMS scale and two screening scales for androgen deficiency: the ADAM scale of Morley and colleagues and the screener of Smith and colleagues. The technique of a computer-assisted telephone interview was applied.

Result The comparison of the AMS with the two screening instruments for androgen deficiency showed sufficiently good compatibility despite conceptual differences. The AMS scale sufficiently predicted the results of the two screening instruments. A positive predictive value of 92% and a negative predictive value of 50% were found regarding the ADAM scale. The respective figures regarding Smith's screener were 65% and 49% for positive and negative predictive values, respectively.

Conclusion The AMS scale obviously measures a similar phenomenon as the two established and widely used screeners for androgen deficiency, although it was not developed as a screening instrument.     

A reliability generalization meta-analysis of coefficient alpha and test–retest coefficient for the aging males’ symptoms (AMS) scale

Purpose: The aging males’ symptoms (AMS) scale is an instrument used to determine the health-related quality of life in adult and elderly men. The purpose of this study was to synthesize internal consistency (Cronbach’s alpha) and test–retest reliability for the AMS scale and its three subscales.

Methods: Of the 123 studies reviewed, 12 provided alpha coefficients which were then used in the meta-analyses of internal consistency. Seven of the 12 included studies provided test–retest coefficients, and these were used in the meta-analyses of test–retest reliability.

Results: The AMS scale had excellent internal consistency [α?=?0.89 (95% CI 0.88–0.90)]; the mean alpha estimates across the AMS subscales ranged from 0.79 to 0.82. The AMS scale also had good test–retest reliability [r?=?0.85 (95% CI 0.82–0.88]; the test–retest reliability coefficients of the AMS subscales ranged from 0.76 to 0.83. There was significant heterogeneity among the included studies.

Conclusions: The AMS scale and the three subscales had fairly good internal consistency and test–retest reliability. Future psychometric studies of the AMS scale should report important characteristics of the participants, details of item scores, and test–retest reliability.     

The impact of age,BMI and sex hormone on aging males’ symptoms and the international index of erectile function scores

Objective: To analyze the impact of age, BMI and sex hormone on aging males’ symptoms (AMS) and the 5-item version of the international index of erectile function (IIEF-5) scores in middle-aged and elderly Chinese men.

Methods: A population-based cross-sectional study was conducted in Jiashan County. A total of 969 men, aged between 40 and 80 years old, were admitted. Physical examination and the sex hormones were measured, and AMS and IIEF-5 scores were assessed.

Results: The oneway ANOVA analysis indicated older age groups had higher AMS total-scores, somatic and sexual sub-scores, and lower IIEF5 scores (all p?r_pairwise) analyses showed the significant associations between AMS and age or sex hormone (cFT, Bio-T, SHBG, and LH) levels, and similar for IIEF5. However, when age was adjusted, the correlation coefficients (r_partial) weakened, and correlation significance disappeared, except LH (for AMS: r_partial?=?0.096, p?=?.009; for IIEF-5: r_partial?= ?0.140, p?=?.001). Multiple linear regressions confirmed the influence of increased age and LH on the AMS and IIEF5 scores.

Conclusion: CFT, Bio-T and SHBG failed to yield any additional predicting information when age was adjusted. To improve the male reproductive health, future research should pay more attention on aging-related comorbidities and how to improve general wellness.     

The aging male in Malaysia

Interest in clinical investigations about the health-related quality of life (HRQoL) of aging men has increased in recent years. The aim of this paper is to inform the scientific community about a harmonized French Aging Males' Symptoms (AMS) Scale. There were two slightly different French AMS Scales, which both underwent an up-to-date linguistic and cultural translation process, i.e. were valid to be applied in research. However, it was felt to be unfortunate that two versions of one language in one country existed. Therefore, an ad hoc committee of both translation teams were asked to develop a harmonized single French AMS Scale. The harmonization meeting developed a consensus item-by-item and the new French reference scale was agreed upon. It was agreed that only this scale should be published to avoid confusion among future users. The French AMS Scale published in this paper should be used for future research and necessary cultural/linguistic adaptations in the French-speaking world.     

Poster Abstracts

Objectives. To analyse the relation between results of the Aging Males' Symptoms (AMS) questionnaire for aging males, and of quality of life (QOL) questionnaire SF-12 and cardiovascular risk factors.

Methods. 1,927 men aged 55–85 years were interviewed by 56 general practitioners. During the interview the men were asked to fill in the AMS scale and the QOL questionnaire SF-12.

Results. Of 1,927 men 1,806 men filled correctly the AMS questionnaire. The mean SF-12 mental index was respectively 55.9 in men with a total AMS score indicating no impairment, 50.9 mild, 42.8 moderate, and 32.8 severe impairment. The corresponding values for the physical index were 51.2, 46.7, 40.8 and 32.3.

A history of diabetes was associated with an increased risk of reporting moderate/severe impairment: in relation to the total AMS score the odds ratio, (OR), of moderate/severe impairment in comparison with no impairment was 1.6 (95%CI 1.2–2.1). A history of myocardial infarction and hypertension increased the risk (respectively OR 1.4 (95%CI 1.1–18) and 1.7 (95%CI 1.2–2.4)).

Conclusions. This study shows that higher AMS scores are associated with lower SF-12 indices and suggests that elevated values of the AMS score are associated with cardiovascular risk factors or diseases.     

The efficacy and safety of short-acting testosterone ointment (Glowmin) for late-onset hypogonadism in accordance with testosterone circadian rhythm

Introduction: It is well known that there is a reduction of circadian rhythm in blood testosterone levels with aging. Our previous report revealed that 3?mg of short-acting testosterone ointment (Glowmin: GL) elevated serum testosterone levels to within the physiological range for 4–6?h. The aim of this study was to clarify the clinical efficacy and safety of GL used topically once every morning, to enhance the circadian rhythm of testosterone, for late-onset hypogonadism (LOH).

Methods: A total of 61 LOH patients received 3?mg of GL topically once a day in the morning on scrotal skin for 24 weeks. The clinical efficacy of GL was evaluated by the aging males symptoms (AMS) scale, and blood sampling tests were measured before and after GL treatment.

Results: Mean patients age was 55.3?±?9.2 years old. Total AMS scores at 4, 12, and 24 weeks after GL treatments significantly decreased. The results of sub-analysis of AMS, including psychological, physical, and sexual factors also significantly improved after GL treatments. No severe adverse reactions or abnormal laboratory data were reported.

Conclusions: This study shows that TRT for LOH with once daily GL treatment supports testosterone circadian rhythm and should be considered to be an effective and safe therapy for LOH.     

Development of a short version of the Aging Males’ Symptoms scale: Mokken scaling analysis and Rasch analysis

The aim of this study was to develop a psychometrically sound short version of the 17-item Aging Males’ Symptoms (AMS) scale using Mokken scale analysis (MSA) and Rasch analysis. We recruited a convenient sample of 1787 men (age: mean (SD)?=?43.8 (11.5) years) who visited a men’s health polyclinic in Taiwan and completed the AMS scale. The scale was first assessed using MSA. The remaining items were assessed using Rasch analysis. We used a stepwise approach to remove items with χ² item statistics and mean square values while monitoring unidimensionality. The item reduction process resulted in a 6-item version of the AMS scale (AMS-6). The AMS-6 scale included a 5-item psychosomatic subscale (original items 1, 4, 5, 8, and 9) and a 1-item sexual subscale (original item 16). Analyses confirmed that the 5-item psychosomatic subscale was a Rasch scale. The AMS-6 correlated well with the AMS scales: the 5-item psychosomatic subscale correlated with the AMS scale (r between 0.50 and 0.92); the 1-item sexual subscale correlated with the sexual subscale of the AMS scale (r?=?0.81). A 6-item short form of the AMS scale had satisfactory measurement properties. This version may be useful for estimating psychosomatic and sexual symptoms as well as health-related quality of life with a minimal burden on respondents.     

Correlation between the Japanese Aging Male Questionnaire (JAMQ) and Aging Male’s Symptom (AMS) scale in Japanese male

Abstract

Objectives: To clarify the correlation between the Japanese Aging Male Questionnaire (JAMQ) and the Aging Males’ Symptoms (AMS) scale through the factor analysis in Japanese male.

Materials and methods: In 61 male patients who visited the LOH outpatient clinic of Teikyo University Hospital, subjective symptoms featuring LOH were evaluated using the JAMQ and AMS. Factor analysis was performed on each questionnaire to clarify the LOH-related factors. Correlational analysis between the subscale scores representing such factors and the serum hormone profiles was also performed.

Results: Factor analysis of the JAMQ revealed an internal structure consisting of three subgroups: somatic, psychological and sexual factors with good categorization of the indicators to the appropriate subgroup. In contrast, the indicators of the AMS showed incomplete conformity to the subgroups of the JAMQ. Correlational analysis showed that each score on the JAMQ subgroups had the highest coefficient of correlation with the corresponding AMS subgroup (p?<?0.001). There was no significant association between total and free serum testosterone levels and the total and subscale scores on either AMS or JAMQ.

Conclusions: The results of factor analysis suggest that the sexual perceptions of Japanese populations might differ from those of Caucasian populations. JAMQ would be useful to separately assess individual aspects of somatic, psychological and sexual symptoms related to LOH among Japanese males.     

Attitudinal and Behavioral Factors Associated with Extramarital Sex Among Nigerian Men: Findings from a National Survey

ABSTRACT

Using couple data from a national survey, this article examines couple's characteristics associated with extramarital sex among Nigerian men. We found 15.4% of married men had extramarital sex in the past 12 months. Extramarital sex was significantly associated with men's attitude toward extramarital sex (OR = 1.7 [1.4–3.0]), early sexual debut (OR = 1.9 [1.6–2.3]), alcohol use (OR = 1.7 [1.4–2.1]), and intimate partner violence against wife (IPV) (OR = 1.4 [1.2–1.7]). Increased wife's education was associated with decreased husband's extramarital sex. Men living in rural areas and in the Central and Southern regions were also more likely to have extramarital sex. The findings suggest useful implications for HIV prevention programs in Nigeria. Interventions should focus on influencing social norms around protective behaviors for men to avoid risks associated with extramarital sex and IPV, helping men to change attitudes toward extramarital sex and IPV, and promoting delay in age at first sex among young men.     

Poor theory and the art of plastic pollution in Nigeria: relational aesthetics,human ecology,and “good housekeeping”

ABSTRACT

The art of plastic pollution from Nigeria marks more than an environmental consciousness. It also marks an ecological consciousness based on contemporary plastic-waste artists’ commitment to advocating the recovery of traditions of repurposing materials and of skilled craft work. These contemporary artists are proposing that Nigeria negotiate its own modern identity by recuperating creative traditions of object making that combine the values of utility and of artistry in the practice of craft. The emphasis on plastic specifically as an artistic medium highlights the clash of what eco-artist Bright Eke calls a “bottled life” – entrapped, wasteful, unhealthy, ego-centric – with a traditional ethos of interconnectedness and eco-consciousness. Drawing together data from personal interviews, filmed documentaries, and museum talks, this essay argues that the current generation of artists is using salvaged plastic as a primary medium to rethink Nigerian ecology in terms of “good housekeeping” – a specifically Nigerian oikos.     

Clinical assessment and validation of an Arabic Aging Male Symptoms questionnaire in patients with androgen deficiency

Aim.?To develop and to validate an Arabic Aging Male Symptoms (AMS) tool and to clinically assess patients with hypoganadism after hormonal treatment.

Methods.?The tool was translated into Arabic and tested on 15 Saudi men. During a period of 9 months all males presented to the andrology clinic of the main University Hospital, King Saud University, Saudi Arabia with signs and symptoms of hypogonadism, were included in the study. Arabic AMS scale was applied in the base line visit, then 12 weeks after treatment. Testosterone was monitored before treatment, 4 weeks and after 12 weeks.

Results.?Ninety-two subjects were included, Cronbach's α of 0.91 showed a very good internal consistency of the Arabic AMS questionnaire. The corresponding α for the subscales were 0.83, 0.84 and 0.73. There was a significant improvement in the mean level of TT after hormonal therapy (HT), this was reflected on the mean differences of improvement in the total Arabic AMS scores and subscales scores after HT, ranged from 31 to 35%.

Conclusion.?The present study revealed a significant association between testosterone levels and AMS tool manifested by a its good ability to measure the effect of treatment on quality of life for patients with hypogonadism.     

Team Training for Community Change: Concepts,Goals, Strategies,and Skills,by Eva Schindler-Rainman and Ronald Lippitt. University of California Extension,Riverside, California, 1973. $2.50. 83 Pages

Abstract

Social work education in Nigeria is taught only in polytechnic schools and in-service training institutes. Only recently have social work course units been introduced at the university level; no Nigerian university offers a degree in the field, yet. The social work courses available are offered toward degrees in sociology.

This paper describes how social work students at Ahmadu Bello University, Zaria, Nigeria, built a dispensary as part of their fieldwork in a newly-introduced social work methodology course. It discusses implications for social work education in Nigeria.     

Investigating the Timing of First Sexual Intercourse Among Youth in EDO State,Nigeria in the Context of the Aids Epidemic

ABSTRACT

Objectives: This study examined the timing of sexual debut among youth in Edo state, Nigeria given the role that sexual abstinence plays in HIV prevention in sub-Saharan Africa. Methods: Survey data were collected from rural youth aged 11 to 17 years old enrolled in Junior Secondary Schools in Edo State, Nigeria. Discrete-time hazard techniques were used to examine the effects of theoretically relevant covariates on the timing of sexual debut among youth in Edo State. Results: Results indicate strong, significant relationships between psychosocial predictors and age at first sex for boys and girls. Youth with higher levels of knowledge about HIV as well as those who rejected common myths about HIV transmission delayed first sexual intercourse. Early sexual intercourse was strongly associated with experiencing pressure to engage in sex, while delay was associated with greater confidence that one could decline to participate in sex. On the other hand, youth with higher condom use self-efficacy engaged in first sexual intercourse at an earlier age. Conclusions: These results support the relevance of programs such as Nigeria's Family Life and HIV Education to contribute to delaying sexual intercourse focusing precisely on the forms of knowledge, myth rejection, motivation, and behavioral self-efficacy measured here. They provide policymakers with concrete evidence to increase support for such programming as a means to combat the spread of HIV among youth.     

A new ‘aging males’ symptoms' rating scale

Unlike in women, where instruments are available to measure the severity of symptoms, standardized instruments are lacking for aging males. However, a new ‘aging males’ symptoms' (AMS) rating scale has been developed in the present study, as well as reference values.

A total of 116 medically well-characterized males (aged over 40 years) were recruited to complete a questionnaire of symptoms, the prevalence of which commonly changes with increasing age. Factor analysis was used to establish the raw scale and to identify the dimensions of the scale. This raw scale was applied to a large representative population sample of 992 German males, to establish reference values for the severity of symptoms in males over 40 years.

Three dimensions of symptoms were identified in the patient group: a psychological, a somatovegetative and a sexual factor, that explained 51.6% of the total variance. Reference values of the three dimensions were defined to be used in daily practice. The severity of symptoms assessed using the AMS scale was found to be related to the clinically defined ‘male climacteric’ in the patient group.

The AMS scale is a new and valuable tool for assessing aging males' symptomsc and can be easily used in practice.     

E.H. Duckworth’s Clean-Up Lagos Campaigns: the political use of ex-centric colonial discourse on African dirt

Abstract

On April 3 1952, former colonial Inspector of Education, Edward Harland Duckworth (1894–1972) – founding editor of the cultural magazine Nigeria – announced the birth of a sanitation venture he christened “The Clean-Up Lagos Campaign” in a Nigerian Broadcasting Corporation radio programme. The initiative declared war on “squalor and filth” in Nigeria’s colonial capital, Lagos. Duckworth urged Nigerian citizens to join his army of “volunteers” to wipe Lagos clean of literal dirt, and by extension, eliminate the moral stench exhaled by advertising bills plastered on buildings and monuments. The short-lived campaign was amply disseminated in the Nigerian press and (alongside its two encore performances of 1960 and 1967) featured in confidential Commonwealth Office papers of enormous political import at the height of the Nigerian Civil War. However, it was not Duckworth’s first intrusion into Lagos’ sanitary arena. This article examines Duckworth’s ex-centric discourse on dirt as a remarkable permutation of more generalised colonial standpoints. While Duckworth’s ambivalently enunciated views on dirt respond to his personal eccentricity and undisguised quest for power and recognition, his campaigns, rather than mere asides to an eccentric colonial life, shed light on one of the most understudied dimensions of Nigerian colonial history – the political use of deviance.     

Symptomatic change in Japanese hypogonadal patients several years after androgen replacement therapy

Objective.?There are few reports on the prognosis of patients receiving androgen replacement therapy (ART). In this study, we evaluated the subsequent symptoms of Japanese hypogonadal patients who had received ART, within several years previously by mail-in survey.

Methods.?Thirty-three aged men with symptoms of hypogonadism and testosterone deficiency who had received ART for 6 months responded to this survey. The survey consisted of questions associated with present physical and mental status and desire to resume ART. The Aging male’s symptoms (AMS) scale, IIEF-5 and SF-36 were also evaluated at pre-initiation, termination of ART and the time of the survey.

Results.?The mean duration from the last treatment was 55 months. Compared with the treatment period, more than half of patients (57.5%) answered that their present condition was better. Scores on the AMS scale, IIEF and SF-36 were all improved significantly in the early stages of treatment and not worsened a long period of time after ART was discontinued.

Conclusions.?For symptomatic Japanese hypogonadal patients, subjective effects of treatment were observed during the early treatment period and remained unchanged after discontinuation of ART. A short treatment period may thus be adequate in Japanese hypogonadal patients as regards symptomatic changes.