Aging and sexual health: getting to the problem

Erectile dysfunction (ED) is one of the most common disorders in male and is often associated with other age-related comorbidities. The aging process affects the structural organization and function of penile erectile components such as smooth muscle cell and vascular architecture. These modifications affect penile hemodynamics by impairing cavernosal smooth muscle cell relaxation, reducing penile elasticity, compliance and promoting fibrosis. This review aims to identify the mechanisms of ED in the penile aging process in experimental and clinical data. It also highlights areas that are in need of more research. The search strategies yielded total records screened from PubMed. Clarification of the molecular mechanisms that accompanies corpus cavernosum aging and aging-associated ED will aid new perspectives in the development of novel mechanism-based therapeutic approaches. Age is not a limiting factor for ED medical management, and it is never too late to treat. Hypogonadism should be managed regardless of age, and synergistic effects have been found during testosterone (T) replacement therapy when used along with oral phosphodiesterase-5 (PDE-5) inhibitors. Therefore, the clinical management of ED related to aging can be done by therapeutic interventions that include PDE-5 inhibitors, and other pharmacological treatments.     

Attention to Threat as a Predictor of Shyness in the Context of Internalizing and Externalizing Behavior

The duration of children's attention to putative threat has been documented as a consistent predictor of later anxiety in inhibited children across childhood (Fox, New Directions for Child and Adolescent Development, 127, 2010, 33; Pérez‐Edgar & Fox, Child and Adolescent Psychiatric Clinics of North America, 14, 2005, 681). However, attention to threat has not been broadly examined within existing behavioral contexts and has seldom been studied in very early childhood. Whereas toddlers with high levels of internalizing behavior may view fear‐inducing stimuli as a threat, toddlers with high levels of externalizing behavior may demonstrate attention out of interest or sensation seeking. Thus, attention to threat was expected to predict increased toddler shyness in the context of either high internalizing problems or low externalizing behavior. We examined 117 twenty‐four‐month‐old toddlers to determine whether attention to threat interacted with internalizing and externalizing behavior at 24 months of age to predict toddler shyness one year later. Results indicated that attention to threat predicted toddlers' lower shyness at 36 months when toddlers’ externalizing behavior at age 24 months were high, but there was no significant interaction between toddlers’ internalizing behavior and their attention to threat in predicting later shyness. These results expand our understanding of the contexts in which attention to threat in early childhood is a viable predictor of later shyness.     

Maternal Lifetime Trauma Exposure,Prenatal Cortisol,and Infant Negative Affectivity

Little research has examined the impact of maternal lifetime trauma exposure on infant temperament. We examined associations between maternal trauma history and infant negative affectivity and modification by prenatal cortisol exposure in a sociodemographically diverse sample of mother–infant dyads. During pregnancy, mothers completed measures of lifetime trauma exposure and current stressors. Third‐trimester cortisol output was assessed from maternal hair. When infants were 6 months old, mothers completed the Infant Behavior Questionnaire‐Revised. In analyses that controlled for infant sex and maternal age, education, race/ethnicity, and stress during pregnancy, greater maternal trauma exposure was associated with increased infant distress to limitations and sadness. Higher and lower prenatal cortisol exposure modified the magnitude and direction of association between maternal trauma history and infant rate of recovery from arousal. The association between maternal trauma history and infant distress to limitations was somewhat stronger among infants exposed to higher levels of prenatal cortisol. The analyses suggested that maternal lifetime trauma exposure is associated with several domains of infant negative affectivity independently of maternal stress exposures during pregnancy and that some of these associations may be modified by prenatal cortisol exposure. The findings have implications for understanding the intergenerational impact of trauma exposure on child developmental outcomes.     

Family Caregiver Communication in the ICU: Toward a Relational View of Health Literacy

We interviewed 18 family caregivers about their communication experiences in the ICUs at an urban hospital. Analysis of their narratives suggests health literacy is important in family caregiver/healthcare provider communication, especially as complicated illnesses move the caregiver deeper into decision making. Using the domains of Yuen et al.’s conceptual model of caregiver health literacy (2015), we identified three themes within the context of ICU communication: agency, coordinated communication, and caregiver’s evolving role. We saw family caregivers negotiating domains of health literacy as they built upon knowledge of the patient’s needs, their rights as family caregivers, and the hierarchy of the professional staff. We found that these narratives represent co-created, or relational communication, rather than individual health literacy skills. Conceptualized in the transaction of relationship, health literacy is enacted; it is socially constructed and is the scaffolding upon which family caregivers make decisions, care for their loved one, and care for themselves.     

“Family? … Not Just Blood”: Discursive Constructions of “Family” in Adult,Former Foster Children’s Narratives

Framed by Relational Dialectics Theory, this study explores the ways adult, former foster children discursively construct meanings of “family.” Contrapuntal analysis of 24 interviews revealed two discourses as competing to constitute family: the Discourse of Family as Irreplaceable and Inescapable (Permanence) and the Discourse of Family as Performative Kinning (Performance). Permanence was constituted by themes of biology and historical connection, reifying normative understandings. Performance, comprised of role enactment, need for tolerance, and unconditional love, challenged the Permanence discourse. Throughout the narratives, Performance competed with Permanence for dominance, illustrating the cultural pervasiveness and power of Permanence yet, in some moments, privileging the marginalized Performance discourse. This discursive competition constructed meanings of family in narratives of life before, during, and after foster care. Overall, participant’s talk constructed complex webs of family relationships, allowing access to an important social institution—family—regardless of the presence/absence of culturally valued markers of family (e.g., biology, legality).     

Family Communication and Adolescent Alcohol Use in Nicaragua,Central America: A Test of Primary Socialization Theory

ABSTRACT

Applying primary socialization theory to a sample of early adolescents from Nicaragua, this study examines direct and indirect associations between family bonding and adolescent alcohol use via substance specific prevention communication (SSPC) and adolescent efficacy. Early adolescents in 7th and 8th grades completed a self-report, cross-sectional survey. Structural equation modeling revealed that family expressiveness was significantly indirectly related to adolescent lifetime alcohol use through SSPC. Results are discussed in relation to primary socialization theory, family communication, and international substance use prevention efforts. This study provides supportive evidence for the important role of positive family communication as a protective factor for early adolescents in Nicaragua.     

Kinship care and issues in permanency planning

Kinship caregivers are a child-care resource for families experiencing stress or temporary parenting due to illness, incarceration, or death of a parent. This article examines whether and how felt caregiver burden influences the reported propensity of caregivers to want to adopt the children in their care. Kinship caregivers who were enrolled in KinNET completed the survey (N = 102) and the data were entered anonymously into SPSS for analysis. Their mean age was 57.51 years (SD = 10.13), 95% were female (SD = .19), and two-thirds were non-white (SD = .73). Using “likelihood of adopting the child in my care,” as the outcome variable in the linear regression analysis, caregiver’s age, monthly income, and total hours employed were significant predictors. Total pressures, family service needs, and physical problems scales were not statistically significant predictors. The adjusted R square was .439 and significant (.006). Understanding the factors that are predictive of adopting children in kinship care will help programs target services more effectively. Helping kinship caregivers and the children in their care is also important in promoting their health and social well-being.     

Availability of Mental Health Services for Individuals Who Are Deaf or Deaf-Blind

A survey of state mental health agencies found that a majority have no specific policy or procedure regarding how to provide mental health services to persons who are deaf or who are deaf-blind. Agency representatives report that staff lack knowledge of how to provide mental health services to persons who are deaf-blind and the agencies lack qualified interpreters. They recommend training for social workers and counselors to address best practices in working with people who are deaf-blind concerning communication methods and strategies, physical interaction, cultural issues, everyday life, sensory deprivation, ethics, use of an interpreter, and other general issues.     

“Friendly” Initiatives: An Emerging Approach to Improve Communities for Vulnerable Populations

A growing number of cities and towns are implementing “friendly” initiatives to change the community’s social and physical infrastructure to address the needs of a particular vulnerable segment of their population. Three prominent examples are aging-friendly, child-friendly, and immigrant-friendly initiatives. Although the limited but growing literature describes these initiatives as promising strategies to improve the quality of life of the targeted population, to date there has been little written about the underlying goals, values, and assumptions of these efforts. Using the value-critical approach, this article aims to better understand these aspects of population-friendly initiatives by examining the scholarly and grey literature. Social workers engaged in community and policy practice can play a key role in these efforts and call attention to the ways they may alleviate or exacerbate inequities. Future research is needed to assess the effects of these initiatives on their targeted population as well as other community residents.