Psychosocial interventions to support partners of men with prostate cancer: a systematic and critical review of the literature

Prostate cancer poses many challenges for both the man and his partner. Partners have reported a range of issues that impact their own mental health following their partner's diagnosis of prostate cancer. The aim of this review is to summarise and critically evaluate the current literature reporting psychosocial intervention studies for partners of prostate cancer patients.

Responses and relationship dynamics of men and their spouses during active surveillance for prostate cancer: health literacy as an inquiry framework

BACKGROUND: Early stage prostate cancer patients may be allocated to active surveillance, where the condition is observed over time with no intervention. Living with a cancer diagnosis may impose stress on both the men and their spouses. In this study we explore whether the scores of and verbal responses to a Health Literacy Questionnaire can be used to identify individuals in need of information and support and to reveal differences in perception and understanding in health related situations within couples. METHODS: We used the nine-domain Health Literacy Questionnaire (HLQ) as a framework to explore health literacy in eight couples where the men were on active surveillance for prostate cancer progression. Scores were calculated for each domain for both individuals. For each couple differences in scores were also calculated and related to the informants' self-reported experiences and reflections in relation to participating in an active surveillance program. Also an inductive analysis was performed to identify themes in the responses and these themes were compared to those of HLQ. RESULTS: The men tended to score higher than their spouses. There was no consistent relation between scores and the reported experiences and reflections. However, some interesting patterns emerged, e.g. in two of the three couples with the largest within couple differences in HLQ scores, responses revealed discrepancies in how the men and their spouses perceived their situation. Also, three themes emerged which related to six of the HLQ domains, i.e. involvement of spouses and other people around the men; support from and interaction with healthcare professionals; and use of the Internet for information retrieval. CONCLUSIONS: Using the HLQ as an interview framework provided insight into the differences within couples and provided new perspectives on their experiences, including their contact with health professionals and the patient-spouse interaction when dealing with prostate cancer. The HLQ used as a dialogue tool may be an adjunct to assist healthcare providers to understand the need for support and information of men with prostate cancer on active surveillance and the dynamics within couples.

Children of the market : performativity, neoliberal responsibilisation and the construction of student identities

This paper draws on interview data gathered from a broader studyconcerned with examining issues of social justice, cultural diversityand schooling. The focus is on five students in Years 5 and 6 whoattend a primary school located on the edge of a class-privilegedarea in outer London. The children are all high achievers who are veryinvested in doing well in school and in life within the parametersof neoliberalism. The paper examines the ways in which neoliberaldiscourses of performativity and individual responsibilisationpermeate the children’s talk in relation to their understandings ofeducation and their future, and their worth and value as students.Such examination enriches the findings of important research in thisarea that draws attention to the ways in which neoliberal discourseshave become naturalised and taken-for-granted in what counts asbeing a good student and a good citizen. The paper problematisesthe individualism, competitiveness and anxiety produced by thesediscourses and provides further warrant for supporting students toidentify, challenge and think beyond them.

The effects of mood states on the AIDS-related judgements of gay men

In two studies, the effects of induced mood on the AIDS-related judgements of gay men were investigated. Participants were induced into a positive, neutral, or negative mood by recall of affect-laden autobiographical memories; they then made AIDS-related judgements. In Study 1 (n=30), the men indicated their level of agreement with statements expressing optimism about the efficacy of antiretroviral treatments for HIV/AIDS. Those induced into a positive mood indicated stronger agreement than did those induced into a neutral or negative mood. In Study 2 (n=83), participants read brief descriptions of men they did not know and estimated the likelihood that they were HIV-infected. Each sketch highlighted one characteristic of the man described. There were two versions of each sketch (e.g., the versions of the sketch highlighting intelligence described the man either as very intelligent or as very unintelligent), given to different participants. Stereotype use was inferred if significantly different estimates were given for the two versions of a sketch. Reliance on stereotypes was found most often in the positive mood condition and least often in the negative mood condition. The findings are consistent with, and suggest explanations for, earlier correlational evidence that, in gay men of the age group studied, sexual risk-taking is associated with a positive mood. Suggestions are made for how AIDS educators might address the contributions of mood states to sexual risk-taking.

The movement ABC: a cross-cultural comparison of preschool children from Hong Kong, Taiwan and the USA

The purpose of this study was to evaluate the suitability of the Movement Assessment Battery for Children (M-ABC) for use in Greater China. Chinese children numbering 255 between the ages of 4 and 6 from Hong Kong and 544 from Taiwan were tested individually on the standardized test contained within the M-ABC. Data from these 799 children were compared to that presented in the test manual for the 493 children of the same age comprising the United States standardization sample. Both within-culture and cross-cultural differences were statistically significant when all items of the M-ABC were examined simultaneously, but effect sizes were too low to be considered meaningful. However, descriptive analysis of the cut-off scores used for impairment detection on the test suggested that adjustments to some items would be desirable for these particular Chinese populations.

Guidelines for treatment of osteoporosis in men

BACKGROUND: Osteoporosis is associated with significant morbidity and mortality in men. Published randomised controlled trials assessing the benefits of therapy in men with osteoporosis are limited, but those available need to be used to develop management guidelines.

OBJECTIVE: To present evidence based guidelines for the treatment of osteoporosis in men.

DISCUSSION: It is estimated that 30-60% of men presenting with spinal fractures have another illness contributing to their bone disease. Therefore assessment and treatment of coexisting medical conditions is a vital part of management of osteoporosis. While primary prevention of fractures remains crucial, treatment to ensure further fractures do not occur is equally important. Alendronate is the treatment of choice for men with osteoporosis and fractures, with cyclical etidronate an appropriate alternative and testosterone replacement therapy is indicated in hypogonadal men presenting with osteoporosis.

"Sins of their fathers" : culturally at risk children and the colonial state in Asia

In contact with their foreign surroundings, European enclaves throughout imperial Asia and Africa formed new cultural communities. Nevertheless, over time as Cooper and Stoler (1997) have argued, such colonial communities became subject to the same bourgeois project as experienced in the metropolitan centres to which they remained connected. If, in terms of that project, metropolitan European society was deemed vulnerable from a brutish and unruly working class, these colonial outposts of Western society were even more vulnerable to what was deemed to be the more insidious dangers of miscegenation and cultural hybridity. Where nineteenth century educators typically suggested that working class children were “at risk” of not being able to benefit from, and simultaneously representing “a risk to”, the emerging opportunities of bourgeois capitalist society, this “risk” was accentuated in the colonies by the additional category of race. Focussing on the question of children of mixed parentage as a category of “children at risk”, this paper examines the way educationists and politicians responded to what was perceived as “civilisational decline” in four such communities - the Dutch East Indies, British India, (British) Australia and French Indo-China - to demonstrate the universality of these concerns in Imperial Asia.

Theorising men's violence towards women in refugee families : towards in intersectional feminist framework

Violence against women perpetrated by male partners, or ex-partners. is one of the most concerning and prevalent public health issues in the world today and is a major cause of injury and mental illness among women and children. Violence against women occurs in most societies irrespective of culture, socio-economic status or religion. Nevertheless, it has been identified that immigrant and refugee women are particularly at risk in cases of domestic violence (Easteal 1996: Narayan 1997; Human Rights Watch 2000; Walter 2001: Perilla 2003: Kang Kahler & Tesar 2003:). To make sense of this issue. we articulate an intersectional feminist framework that we used to analyse the results of an empirical investigation of men's violence against women in refugee families in Melbourne. II)

Although this research has investigated the complex field of domestic violence, culture. trauma and historical and contemporary disadvantage, it has a fundamental prerequisite standing that regardless of past and current experiences; men must take responsibility for their violence against women. Our concern is to understand how male domination manifests itself within each culture and emerging, changing cultures in the diaspora, to explore the connections with men's violence against women within the unique domain of the refugee experience.

Prevalence and correlates of three types of pelvic pain in a nationally representative sample of Australian men

Introduction: Recent international prevalence studies of pelvic pain in men have estimates ranging between 2% and 10%. These studies conclude that it is an important international health problem.

Aims: The aims of this study were to establish the first population-based study of pelvic pain in Australian men, and identify correlates with men's sexual and reproductive histories and other health conditions.

Methods: A representative household sample of 4,290 Australian men aged 16–64 years completed a computer-assisted telephone interview. They were asked about their experiences of pain in the pelvic region during the past 12 months.

Main Outcome Measures: Prevalence of correlates of pain associated with sexual intercourse, pain associated with urination, and pelvic pain not associated with intercourse or urination.

Results: Five percent of men reported pain during urination, 5% reported pain related to sexual intercourse, and 12% of men reported other chronic pelvic pain. There was little overlap in reporting any of the three types of pelvic pain, with 18% of men reporting some form of pelvic pain. Men reporting any of the pain conditions were significantly more likely than other men to report a sexual experience when they had felt forced or frightened. Men reporting pain during intercourse and/or chronic pelvic pain were significantly more likely than other men to report same sex experience. All three groups of men with pelvic pain were more likely than other men to report some form of sexual difficulties. A report of ever receiving a diagnosis of depression or a report of anxiety was significantly associated with all forms of pelvic pain.

Conclusions: More than one man in six report having some form of pelvic pain in the past 12 months. It is likely that men would benefit from a discussion about possible symptoms during consultations with their physicians.

Double disadvantage : the influence of ethnicity over socioeconomic position on childhood overweight and obesity: findings from an inner urban population of primary school children

Objective: To examine the relationship between overweight/obesity in children, socioeconomic status and ethnicity/cultural background.

Design: Cross-sectional survey of children aged 4–13 years.

Setting: A total of 23 primary (elementary) schools in an inner urban municipality of Melbourne, Australia.

Participants: A total of 2685 children aged 4–13 years and their parents.

Main exposure measures: Ethnicity/cultural background – maternal region of birth; socioeconomic position (SEP) indicators – maternal and paternal educational attainment, family employment status, possession of a healthcare card, ability to buy food, indicator of disadvantage (Socioeconomic Index for Areas, SEIFA) score for school; parental weight status.

Main outcome measure: Prevalence of overweight/obesity.

Results: Prevalence of overweight/obesity approached 1 in 3 (31%) in this sample. Prevalence of overweight/obesity was greater for children of both North Africa and Middle Eastern background and children of Southern, South Eastern and Eastern European background compared with children of Australian background. This difference remained after adjusting for age, sex, height, clustering by school, SEP indicators and parental weight status; odds ratio, OR=1.57 (95% confidence interval, CI 1.12–2.19) and 1.88 (95%CI 1.24–2.85), respectively.

Conclusions: There is a clear independent effect of ethnicity above and beyond the effect of socioeconomic status on overweight and obesity in children. Further research is required to explore the mediators of this gradient.

Programs for men who perpetrate domestic violence : an examination of the issues underlying the effectiveness of intervention programs

This review paper seeks to explore some of the reasons why rehabilitation programs for male perpetrators of domestic violence appear to be less effective in reducing recidivism than programs for other offender groups. It is argued that while the model of systems response to domestic violence has predominated at the inter-agency level, further consideration might be given to way in which men’s intervention groups are both designed and delivered. It is concluded that the program logic of men’s domestic violence programs is rarely articulated leading to low levels of program integrity, and that one way to further improve program effectiveness is to incorporate some of the approaches evident in more general violence prevention programs and from what is know about good practice in general about offender rehabilitation.

Cost-effectiveness of adult circumcision in a resource-rich setting for HIV prevention among men who have sex with men

Background.  We examined the effects and cost‐effectiveness of 4 strategies of circumcision in a resource‐rich setting (Australia) in a population of men who have sex with men (MSM).

Method.  We created a dynamic mathematical transmission model and performed an economic analysis to estimate the costs, outcomes, and cost‐effectiveness of different strategies, compared with those of the status quo. Strategies included circumcision of all MSM at age 18 years, circumcision of all MSM aged 35–44 years, circumcision of all insertive MSM aged 18 years, and circumcision of all MSM aged 18 years . All costs are reported in US dollars, with a cost‐effectiveness threshold of $42,000 per quality‐adjusted life‐year.

Results.  We find that 2%–5% of human immunodeficiency virus (HIV) infections would be averted per year, with initial costs ranging from $3.6 million to $95.1 million, depending on the strategy. The number of circumcisions needed to prevent 1 HIV infection would range from 118 through 338. Circumcision of predominately insertive MSM would save $21.7 million over 25 years with a $62.2 million investment. Strategies to circumcise 100% of all MSM and to circumcise MSM aged 35–44 years would be cost‐effective; the latter would require a smaller investment. The least cost‐effective approach is circumcision of young MSM close to their sexual debut. Results are very sensitive to assumptions about the cost of circumcision, the efficacy of circumcision, sexual preferences, and behavioral disinhibition.

Conclusions.  Circumcision of adult MSM may be cost‐effective in this resource‐rich setting. However, the intervention costs are high relative to the costs spent on other HIV prevention programs.

Effect of deer velvet on sexual function in men and their partners: a double-blind, placebo-controlled study

The use of alternative medicines and herbal remedies is an increasing trend in Western societies. For years, people have taken products made of deer velvet for their alleged beneficial effects on sexual function. There has been no scientific investigation of the effects of deer velvet powder on the sexual functioning of human males. This study investigated sexual function in men during a 12-week double-blind, placebo-controlled trial of deer velvet. Thirty-two volunteer male participants, aged 45–65 years, and their partners, were randomly assigned to either the deer velvet or placebo study group. The males took capsules containing ground deer velvet or placebo everyday for 12 weeks. Two sexual function questionnaires (the International Index of Erectile Function and the Brief Index of Sexual Function for Women) used at pre- and posttreatment assessed changes in sexual functioning in males and their partners. Blood tests at baseline, and end of study, determined levels of sex-related hormones in male participants. There were no significant differences in the sexual behavior of the men taking deer velvet compared with the men taking placebo capsules. There were no significant hormone changes from baseline to the end of the study in either group of men. We conclude that in normal males there was no advantage in taking deer velvet to enhance sexual function. All alternative health products or nutritional supplements should be subjected to randomized placebo-controlled trials to determine efficacy.