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.     

Solutions and Suggestions from across the Pond: An Interview with Hazel Woodward

In August 2009 Margaret Dull interviewed Hazel Woodward, university librarian and director of the University Press at Cranfield University (Cranfield, Bedfordshire, United Kingdom). Woodward shares her views on the challenges facing librarians regarding e-resources, their licensing, and management. She also shares how the collaborative work of libraries in the UK can offer solutions to similar challenges faced in America and abroad.     

ECLECTIC STRATEGIC PRACTICE: A PROCESS CONSTRUCTIVE PERSPECTIVE

The development of an integrative individual and family therapy approach has been hampered by fundamental differences in philosophy and theoretical conceptualization among approaches. Given these largely irreconcilable differences systemic framework for a technical eclecticism may represent a logical step toward a more flexible consideration of both individual and family approaches. This article will describe an extension of the strategic therapy model that enables and encourages the selective application of content and techniques from individual and family approaches. Three case examples will illustrate a process-oriented, constructivist rationale for eclectic strategic practice as well as a more collaborative and relationship-oriented perspective of strategic therapy.