Aging male symptomatology and eating behavior

Objective: The literature on eating disorders in older males is still very limited. We assessed the relationship between aging male symptomatology and eating behavior in middle-aged and older men.

Method: We distributed anonymous questionnaires to men aged 40–75?years living in or near Innsbruck, Austria, covering demographic items, current eating disorder symptoms (as defined by DSM-5), and associated measures of eating pathology, body image, and sports activity (including exercise addiction). We also administered the Aging Males’ Symptoms scale (AMS), and classified respondents as “high-AMS” (AMS score ≥37; N?=?82) or “low-AMS” (AMS score <37; N?=?386).

Results: High-AMS men reported a significantly higher mean current BMI, a greater prevalence of eating disorder symptoms, higher scores on the Eating Disorder Examination Questionnaire, greater risk of exercise addiction, and more negative body image than low-AMS men.

Discussion: We found a marked association between aging-male symptomatology and eating-disorder symptomatology in aging men. Our findings suggest that clinicians should carefully inquire about eating disorder symptoms in men aged 40 and above reporting aging-male symptomatology. Importantly, several men in the study reported “purging” via excessive exercise (as opposed to the more common methods of vomiting or use of laxatives or diuretics), and therefore this should be a subject of inquiry in clinical evaluations. To pursue these findings, subsequent studies of eating disorders in older men should consider assessing endocrinological measures, particularly testosterone levels, and should use longitudinal designs.     

Listening—Ubiquitous Yet Obscure

Service learning continues to evolve as an exciting, innovative teaching tool in education. This paper defines and explains the service learning movement and details a service learning unit applied in an “Effective Listening” classroom and the mutual student, institutional, and educator benefits.     

Adding to the controversy: Pitfalls in the diagnosis of testosterone deficiency syndromes with questionnaires and biochemistry

Purpose. To determine the value of available questionnaires used for the diagnosis of testosterone deficiency syndromes (TDS) by correlating their ratings with a panel of hormonal determinations in a male population.

Materials and methods. Participants completed the ADAM questionnaire and underwent biochemical evaluation at the local site. Assessments determined entry into Group A (symptomatic) or Group B (non-symptomatic). After stratification, subjects provided a morning sample of blood, completed the Aging Male Survey (AMS) and the newly developed Canadian Society for the Study of the Aging Male (CSAM-Q) questionnaires. Serum aliquots were analysed at a central lab for 8 putative markers commonly associated with symptomatic testosterone deficiency associated with aging: total testosterone (T); bioavailable T (BT); dehydroepiandrosterone sulphate (DHEA-S); sex-hormone binding globulin (SHBG); luteinizing hormone (LH), prolactin (PRL); thyroid-stimulating hormone (TSH) and insulin-like growth factor-1 (IGF-1).

Results. 92 men were screened; of these 59 (mean age of 58 ± 11 years) completed the study, 30 (51%) scored positively (mean 61.5 years) to the ADAM while 29 (49%) did not (mean 54.1 years). For the AMS the weight of the three domains (psychological, somato-vegetative and sexual) was significantly greater in Group A (p < 0.001) than in Group B. Equally, for the CAS questionnaire, the scores for the variables energy, global performance, frequency of intercourse, mood and quality of sleep were lower in Group A than in their asymptomatic counterparts (p < 0.001). The domain of memory assessment within the CSSAM-Q was not discriminatory. ADAM and AMS are self-administered and completed within 10 minutes. CSSAM-Q is more time consuming, requires an investigator to administer, and memory domain is biased in favour of specific professional training.

No difference was found between the two groups in 6 of 8 biochemical tests. However, significant lower values (p < 0.001) were found for DHEA-S and IGF-1 in the symptomatic group as compared with the non-symptomatic cohort.

Conclusions. This study confirms that newer, more complex tools perform similarly to the simpler ADAM questionnaire. The lack of correlation between the clinical picture and the most commonly used biochemical confirmatory tests, again, clearly points to the paramount importance of the clinical evaluation. An emphasis and reliance on serum T alone hinders the clinician's ability to manage testosterone deficiency syndromes (TDS).     

Body mass index and functional status in community dwelling older Turkish males

Abstract

Objectives: To assess sex hormones in men with obesity and prostate cancer (PCa) and to study association between androgens and the pathogenesis biology of PCa in vitro.

Subjects and methods: One hundred and eighty-one men older than 45?years selected from of a population attending to Urology departments screening for PCa, (78 participants without PCa and 103 patients with PCa). All participants were assessed for body mass index (BMI), age, Gleason score, and PSA. Endocrine profile was determined for LH, total testosterone (TT), 17β-estradiol (E2), prolactin and leptin. Biochemical profile (HbA1c, triacylglycerols and lipoproteins) was also determined. In vitro experiments were also performed, involving the study of 5α-dihydrotestosterone (DHT) and E2 in the presence of adipocyte-conditioned medium (aCM).

Results: All variables were continuous and described a Gaussian distribution unless mentioned. To determine the relation of aggressiveness, variable were transformed into categories. Thus, PCa aggressiveness is associated with the increase of age and BMI (p?<?.0001) but with is decreased with TT and E2 (p?<?.05). Moreover, adipocyte-secreted molecules increase aggressiveness of PCa cells in vitro. Lastly, DTH but not E2 enables invasiveness in vitro.

Conclusions: It was observed a coexistence of hormone axis profile alteration with sex hormones and BMI in PCa patients, in accordance with the new perspective of PCa pathogenesis.     

Can a Diamond Ever Be Gay?

This article is a first-person narrative/reflection that explores the contradictions and paradoxes of a personal decision to marry in light of a political critique that recognizes and names the ways that marriage creates and replicates stultifying and restrictive notions of normalcy. The author grapples with her own ambivalences: support for the critique of marriage's power to define normal and its simultaneous marginalization of anyone living outside its construct on the one hand, and an understanding of the ways we remain deeply psychologically tied to the social structures that shape our own longings and desires. Within the context of a political movement to protect the rights of same-sex couples to marry, the author articulates a wish for a radically transformed culture that decouples social legitimacy and economic benefits from family structure or choices. Can a feminist queer activist and psychoanalyst have everything?     

Social Context of Smoking Hookah Among College Students: Scale Development and Validation

Abstract

Objective: To develop an instrument that measures the social context of hookah use among college students. Participants: A pool of 50 potential items, based on 44 in-depth interviews with regular college hookah smokers, was administered to a sample of 274 hookah users between October and December 2011. Methods: Participants were approached in hookah bars and asked to complete the survey. Results: A principle components analysis revealed 3 reliable factors: social facilitation, family/cultural influence, and alternative to smoking cigarettes and drinking. These were examined across different categories of hookah use: Weekly hookah users were more likely to smoke in a context of social facilitation than the other 2 groups. Similar effects were observed for family/cultural influence. Asians were more likely to smoke in a context of family and cultural influence than non-Asians. Conclusions: This scale has potential for identifying situation-specific contexts of hookah use that may help in designing effective interventions for college students.     

“Did I just do that?”—Six-month-olds learn the contingency between their vocalizations and a visual reward in 5 minutes

It has been shown that infants can increase or modify a motorically available behavior such as sucking, kicking, arm waving, etc., in response to a positive visual reinforcement (e.g., DeCasper & Fifer, 1980; Millar, 1990; Rochat & Striano, 1999; Rovee-Collier, 1997; Watson & Ramey, 1972). We tested infants to determine if they would also change their vocal behavior in response to contingent feedback, which lacks the social, emotional, and auditory modeling typical of parent-child interaction. Here, we show that in a single five-minute session infants increase the rate of their vocalizations in order to control the appearance of colorful shapes on an iPad screen. This is the first experimental study to demonstrate that infants can rapidly learn to increase their vocalizations, when given positive reinforcement with no social element. This work sets the foundations for future studies into the causal relationship between the number of early vocalizations and the onset of words. In addition, there are potential clinical applications for reinforcing vocal practice in infant populations who are at risk for poor language skills.