Association between sarcopenia and erectile dysfunction in males with type II diabetes mellitus

Background: The prevalence rates for both sarcopenia and erectile dysfunction (ED) gradually increase in middle-aged and elderly diabetic male population and they impair physical functioning, sexual functioning, and quality of life. The aim of the present study was to evaluate the sarcopenia in patients with diabetic ED.

Methods: The study included 98 male patients with type II diabetes mellitus (DM) aged 18–80?years. Blood chemistry and hormone levels were obtained. The International Index of Erectile Function (IIEF-5) questionnaire was administered to the patients. The patients were divided into three groups according to the IIEF-5 score; a score of 5–10 points indicated severe ED, a score of 11–20 indicated moderate ED, and a score of 21–25 points indicated no ED. The muscle mass, handgrip strength, timed up and go test, upper mid-arm circumference, calf circumference, and body mass index were obtained. The statistical analysis was performed using MedCalc Statistical Software version 12.7.7. All parameters were compared between the three groups.

Results: Of 98 patients included in the study, 84 patients had severe sarcopenia, 13 had moderate sarcopenia, while only one patient had normal muscle mass. The mean age was 56.59?±?11.46?years. When patients were divided into three groups according to IIEF-5 score, 38 had severe ED, 39 had moderate ED, and 21 had no ED. There was a significant difference between the three groups in terms of handgrip strength, timed up and go test scores, upper mid-arm circumference, and calf circumference (p?Conclusions: Although muscle mass remains unchanged, muscle strength and physical performance decrease in diabetic ED patients. Diabetic patients with severe and moderate ED have lower muscle strength and physical performance.     

The Multiscale Importance of Road Segments in a Network Disruption Scenario: A Risk‐Based Approach

This article addresses the problem of the multiscale importance of road networks, with the aim of helping to establish a more resilient network in the event of a road disruption scenario. A new model for identifying the most important roads is described and applied on a local and regional scale. The work presented here represents a step forward, since it focuses on the interaction between identifying the most important roads in a network that connect people and health services, the specificity of the natural hazards that threaten the normal functioning of the network, and an assessment of the consequences of three real‐world interruptions from a multiscale perspective. The case studies concern three different past events: road interruptions due to a flood, a forest fire, and a mass movement. On the basis of the results obtained, it is possible to establish the roads for which risk management should be a priority. The multiscale perspective shows that in a road interruption the regional system may have the capacity to reorganize itself, although the interruption may have consequences for local dynamics. Coordination between local and regional scales is therefore important. The model proposed here allows for the scaling of emergency response facilities and human and physical resources. It represents an innovative approach to defining priorities, not only in the prevention phase but also in terms of the response to natural disasters, such as awareness of the consequences of road disruption for the rescue services sent out to local communities.     

Behavioural determinants of perceived managerial and leadership effectiveness in Argentina

The purpose of this empirical study was to explore the perceptions of Argentinean managers and non-managerial employees about managerial and leadership effectiveness, and the extent to which the findings are generalized to other countries. The central research question addressed was as follows: How do people employed in Argentinean companies behaviourally distinguish effective managers from ineffective managers, and to what extent are the findings culture-specific or context-general? A total of 42 employees from private and public sector organizations in Cordoba, Argentina, were interviewed using critical incident technique. The interviews generated 302 critical incidents of which 155 were examples of positive (effective) managerial behaviour, and 147 of negative (ineffective) managerial behaviour. The findings suggest that Argentineans perceive as effective those managers who are supportive, considerate, motivating, caring, good decision makers, approachable, participative, fair-minded, communicative, actively involved, and who act as role models. This challenges the widely held belief that Argentineans prefer authoritarian managers over democratic ones.     

THE PARENTING EXPERIENCES OF MOTHERS WITH DISSOCIATIVE DISORDERS

This article presents a qualitative analysis of the experience of parenting of mothers with dissociative disorders. This analysis was performed to complement the quantitative analysis of problems of mothers with dissociative disorders that Benjamin, Benjamin, and Rind (1996) presented previously. They found that the functioning of these mothers, as well as their subjective experience of mothering, was poorer that that of either clinical or nonclinical control mothers. Our goal was to provide a clearer, richer picture of their problems in parenting. Using the mothers' own words, we describe how the five symptom areas of dissociation (amnesia, depersonalization, derealization, identity confusion, and identity alteration) impeded their parenting efforts. We conclude with a discussion of the necessity of addressing parenting in the treatment of client-mothers with dissociative disorders.