The relationship of salivary testosterone and male sexual dysfunction in opioid-associated androgen deficiency (OPIAD)

Background: Opioids are an effective treatment for chronic non-malignant pain (CNP). Long-term use risks and side effects such as opioid-induced androgen deficiency (OPIAD) exist. This could be measured by saliva testosterone (Sal-T).

Objectives: To evaluate OPIAD in long-term opioid use in CNP patients.

Methods: A cross-sectional study included CNP male outpatients under opioid treatment. Total-Testosterone (Total-T), Free-Testosterone (Free-T), Bio-Testosterone (Bio-T) and Sal-T were measured. Correlations were calculated by Spearman’s rho (SPSS 20).

Results: From 2012 to 2014, 134 from 249 (54%) consecutive male outpatients reported erectile dysfunction (ED), 37% of them related to opioids and 19% evidenced OPIAD. A total of 120 subjects (94 cases and 26 matched-controls) were included. A significantly lower luteinizing hormone, Total-T and Free-T were found, as well as, a significant correlation between Sal-T and Total-T (r?=?0.234, p?=?0.039), Bio-T (r?=?0.241, p?=?0.039), IIEF (r?=?0.363, p?=?0.003) and HAD-anxiety (r =??0.414, p?=?0.012) in OPIAD patients. Sal-T levels were significantly lower in patients with severe–moderate ED versus mild ED (p?=?0.045) and in patients with severe ED versus moderate–mild ED (p?=?0.036).

Conclusions: These data demonstrate the high prevalence of ED in long-term use of opioids, part of this is associated to OPIAD, which can be tested by Sal-T as a non-invasive approach.     

Home Environment,But Not Socioeconomic Status,is Linked to Differences in Early Phonetic Perception Ability

Infants perceptually tune to the phonemes of their native languages in the first year of life, thereby losing the ability to discriminate non‐native phonemes. Infants who perceptually tune earlier have been shown to develop stronger language skills later in childhood. We hypothesized that socioeconomic disparities, which have been associated with differences in the quality and quantity of language in the home, would contribute to individual differences in phonetic discrimination. Seventy‐five infants were assessed on measures of phonetic discrimination at 9 months, on the quality of the home environment at 15 months, and on language abilities at both ages. Phonetic discrimination did not vary according to socioeconomic status (SES), but was significantly associated with the quality of the home environment. This association persisted when controlling for 9‐month expressive language abilities, rendering it less likely that infants with better expressive language skills were simply engendering higher quality home interactions. This suggests that infants from linguistically richer home environments may be more tuned to their native language and therefore less able to discriminate non‐native contrasts at 9 months relative to infants whose home environments are less responsive. These findings indicate that home language environments may be more critical than SES in contributing to early language perception, with possible implications for language development more broadly.     

An Interpretive Phenomenological Inquiry of Family and Friend Reactions to Suicide Disclosure

Suicide attempt survivors’ interpretations of reactions to attempts are understudied, yet could inform prevention efforts concerning subsequent attempts. Interviews with 40 attempt survivors about family and friend reactions were analyzed using interpretive phenomenological techniques. Three distinct patterns emerged as follows: (a) Stigmatizing statements and emphasis on reactor's feelings were interpreted as signs that attempt survivors were a burden to others, (b) avoidant reactions and excessive monitoring were interpreted as cues that suicidal behavior must remain hidden to not be a burden, and (c) asking questions and projecting strength were interpreted as signs that attempt survivors belonged and were not a burden. These findings highlight the importance of working with family and friends to encourage reactions that reduce the risk of future attempts.     

Giving birth: Expectations of first time mothers in Switzerland at the mid point of pregnancy

Problem and background

Despite a generally affluent society, the caesarean section rate in Switzerland has steadily climbed in recent years from 22.9% in 1998 to 33.7% in 2014. Speculation by the media has prompted political questions as to the reasons. However, there is no clear evidence as to why the Swiss rate should be so high especially in comparison with neighbouring countries.

Ergonomic evaluation of laparoendoscopic single-site surgery ports in a validated laparoscopic training model

Although laparoendoscopic single-site surgery (LESS) is feasible among expert laparoscopic surgeons, it poses many technical challenges not seen in conventional laparoscopy (CL). Recent technological advancements in single-incision instrumentation have created more interest and widespread usage of LESS. However, neither LESS nor its novel instrumentation have been thoroughly studied or evaluated using human factors and ergonomics techniques. Consequently, the aim of this study was to compare the physical performance of LESS to CL using a standardized task. Wrist and elbow angular movements, range of motion and physical discomfort were assessed for 24 novice participants. There were no significant differences for physical comfort/discomfort ratings or elbow and wrist flexion/extension range of motion between CL and LESS. However, wrist radial/ulnar range of motion was significantly greater in LESS compared to CL (p < 0.05). Additionally, wrist radial/ ulnar range of motion was significantly greater using the SILS Port compared to the GelPOINT (p < 0.05). Although further investigation is needed, LESS resulted in greater wrist deviation and range of motion due to the close proximity of the instruments, restrictive nature of the single-port devices, and the need to achieve adequate instrument triangulation and visualization.     

Occupational stress and biomechanical risk in a high fashion clothing company

Psychosocial discomfort may amplify job-related risk factors. The aim of this study is to evaluate job stress in a high fashion clothing company with upper limb biomechanical overload due to repetitive and forceful manual activities. Biomechanical risk was analyzed and in part reduced using the OCRA Check list. A total of 518 workers (433 females and 85 males) were investigated to determine anxiety (by STAI 1 and 2), occupational stress (using the Italian version of the Karasek Job Content Questionnaire) and perception of symptoms. Final biomechanical assessment did not reveal high risk jobs, except for cutting. Although the perception of anxiety and job insecurity was within the normal range, all the workers showed a high level of job strain (correlated with the perception of symptoms) due, probably, to very low decision latitude. It was suggested that job strain may increase the perception of symptoms. Moreover, the result of this study indicates that musculoskeletal overload has to be further analyzed since its low level is not in agreement with the level of discomfort due to the repetitive tasks.     

Service learning from the supply side: Community capacity to engage students

The rapid increase in the use of service learning raises important public policy questions about who is being served and whether partner agencies have the capacity to meet student demand for community‐based experiences. This article uses a large sample of nonprofit organizations and a comparative framework to examine the characteristics of partner agencies and the scope and nature of college student community involvement. Multivariate analysis tests these factors on a community agency's ability to engage more students, particularly service learners. The findings are generally optimistic about agency willingness to involve students, suggesting widespread community benefits from their involvement. While organizational size and capacity predict current student engagement, an agency's past experience with students and its perceptions of student benefits have the greatest impact on its willingness to take on future students.     

Fair Trade: Social regulation in global food markets

This article analyzes the theoretical and empirical parameters of social regulation in contemporary global food markets, focusing on the rapidly expanding Fair Trade initiative. Fair Trade seeks to transform North/South relations by fostering ethical consumption, producer empowerment, and certified commodity sales. This initiative joins an array of labor and environmental standard and certification systems which are often conceptualized as “private regulations” since they depend on the voluntary participation of firms. I argue that these new institutional arrangements are better understood as “social regulations” since they operate beyond the traditional bounds of private and public (corporate and state) domains and are animated by individual and collective actors. In the case of Fair Trade, I illuminate how relational and civic values are embedded in economic practices and institutions and how new quality assessments are promoted as much by social movement groups and loosely aligned consumers and producers as they are by market forces. This initiative's recent commercial success has deepened price competition and buyer control and eroded its traditional peasant base, yet it has simultaneously created new openings for progressive politics. The study reveals the complex and contested nature of social regulation in the global food market as movement efforts move beyond critique to institution building.     

An Index of the Condition of Children: The Ideal and a Less-than-Ideal U.S. Example

This paper uses recent data on U.S. children from the National Survey of America’s Families (NSAF) to create indices that tally the number of problems or risks that individual children experience. We compare results with those from indices developed elsewhere that assess the change across sets of population-level indicators. While the two types of indices show similar trends over time, specific changes, as well as trends, depend on the specific domain of well-being or context examined, highlighting the importance of the distinction between well-being and context. Children with problems in multiple domains tend to be socio-economically and demographically disadvantaged compared with other children. We preface this work by providing an overview of the history of child well-being indicators and distinguish indices of child well-being from indices of the condition of children.