Hormone profiles,body mass index and aging male symptoms: results of the Androx Vienna Municipality study

Aging in the male is accompanied by steroid hormonal decline, and men may develop symptoms associated with hypogonadism. Increased awareness of ‘andropause’ in recent years has led to greater demand for hormonal assessments, resulting in a rising burden for health economics. We conducted a cross-sectional study to define men at risk for hypogonadism, in whom further hormonal investigation should be performed.

We examined 664 blue-collar workers aged 40–60 years at their workplace and determined hormonal status and body mass index (BMI). Men with an abnormal urogenital status and those on medication that might affect endocrine status were excluded from the study. All participants completed the validated Aging Male Symptom (AMS) questionnaire and obtained scores for psychological symptoms, somatovegetative symptoms, and sexual symptoms.

Multiple logistic regression analyses revealed a significantly increased risk (represented by the odds ratio) of psychological symptoms for men with low levels of testosterone and/or bioavailable testosterone (BAT). Increased BMI as well as low testosterone levels and/or low BAT levels raised the risk of somatovegetative symptoms. Each decrease of BAT by 1?ng/ml caused an approximately 1.8-fold increase of the risk (odds ratio?=?1.832, p?=?0.005). Additional independent risk factors were increased age and low luteinizing hormone (LH) level. Men aged 55 years with BMI >?28?kg/m² and with somatovegetative symptoms and moderate or severe psychological symptoms had a 7.2-fold increase in the risk of a BAT level <?1.5?ng/ml compared to men without these risk factors (p <?0.001). Sensitivity and specificity were 75% and 71%, respectively.

The AMS score combined with age and BMI provides an easy and convenient method to identify men with probable androgen deficiency who require hormonal assessment.     

A State-in-Society Approach to the Nonprofit Sector: Welfare Services in Japan

This article uses the case of Japan to advocate for a new theoretical approach to the study of the nonprofit sector. In particular, it examines how theoretical models based on the European and North American experiences have difficulty explaining the relationship between the nonprofit sector and the state in Japan, and argues that a state-in-society approach is better suited to explaining complex state–society relations in diverse cultural contexts. It does this by examining the evolution of social welfare service provision in Japan. This article is motivated to explain an apparent paradox: Japan’s recent efforts toward greater government decentralization and privatization of services have empowered and enlarged the nonprofit sector even as they have also expanded the scope of state authority and enhanced its legitimacy.     

Correlates of Homophobic Attitudes in Lebanon: Results of a Cross-Sectional Study

ABSTRACT

To assess homophobic attitudes toward gay and lesbian persons and examine how those negative attitudes contributed to risk factors that may impact gay and lesbian persons among a sample of Lebanese individuals. A cross-sectional study, conducted between March and July 2017, enrolled 400 participants aged between 15 and 80 years. 129 (32.3%) of the participants had severe homophobic attitudes. An increase in intense homophobia would significantly increase the odds of emotion focused engagement and decrease the problem focused engagement (Beta = 1.05 and Beta = ?1.19, respectively). A stepwise linear regression, using the total homophobia score as the dependent variable showed that knowing someone gay (Beta = ?12.97), university education level (Beta = ?14.93), high monthly income (Beta = ?4.33), and higher problem-focused engagement subscale (Beta = ?0.54) would significantly decrease the total homophobic score. Our study supports the prevalence of homophobia among people in Lebanon. Understanding the correlation factors and predict discriminative attitudes can be of great help for policymakers when it comes to approaching the problem of homophobia with evidence-based solutions.