Knowledge, attitudes and experience associated with testing for prostate cancer: a comparison between male doctors and men in the community

Background: Debate about testing for prostate cancer using prostate-specific antigen (PSA) and digital rectal examination (DRE) continues. The evidence of benefit from screening for prostate cancer using PSA tests is inconclusive, and it is unclear how PSA can be used most effectively in the detection of prostate cancer. Given the lack of consensus, it is important that consumers understand the issues in a way that will permit them to decide whether or not to have a test and, if symptomatic, how their condition is managed.

Aims: To compare prostate cancer knowledge, attitudes and testing experiences reported by male doctors and men in the community, despite the lack of evidence of a benefit.

Methods : The primary method for ascertaining the attitudes of male doctors (MD) was a telephone survey, with some doctors electing to complete a written survey. Each MD was selected, at random, from a register of male practitioners aged ≥ 49 years of age. A total of 266 MD participated in the survey. The community sample (CS) was accessed using a telephone survey. Five hundred male Victorian residents aged ≥ 49 years of age participated in the study.

Results:
Knowledge − Overall, 55% of the CS indicated ­correctly that prostate disease is sometimes cancer, compared to 83% of MD.

Attitudes − Fifty-five per cent of MD believed men should be tested for prostate disease at least every 2 years, compared to 68% of men in the CS.

Testing experience − Forty-five per cent of MD had been tested for prostate cancer in the past, and 92% of those tests were reported as negative. In the CS, 56% had been tested for prostate cancer in the past, and 78% of the results were reported as negative. The ­significant independent predictors of having had a prostate test among MD were: (i) age (≥ 60 years; odds ratio (OR): 1.59; 95% confidence intervals (CI): 1.30−1.88) and (ii) positive attitudes towards regular testing for prostate cancer (OR: 2.27; 95% CI: 1.98−2.56). The significant independent predictors for the CS were: (i) age (≥ 60 years; OR: 1.65; 95% CI: 1.40−1.89), (ii) being married (OR: 1.30; 95% CI: 1.00−1.60), (iii) knowledge that prostate disease was sometimes cancer (OR: 1.46; 95% CI: 1.26−1.66) and (iv) positive attitudes towards regular testing for prostate cancer (OR: 2.12; 95% CI: 1.90−2.34).

Conclusions: The results highlight that testing for prostate cancer is widespread in the community and in the medical profession. Further research should be undertaken to identify how to help men make fully informed decisions about prostate cancer testing.

Alcohol and drug use in Australian male sex workers: its relationship to the safety outcome of the sex encounter

This paper describes the self-reporting patterns of alcohol and drug consumption among male sex workers (MSWs) in three Australian cities during commercial sex encounters, and examines to what extent alcohol and drugs are used and whether this is related to the safe/unsafe outcome of the commercial sex encounter. One hundred and eighty-six MSWs from Brisbane, Sydney and Melbourne completed a diary following each commercial sex encounter over a two-week period. MSWs reported 2,087 commercial sex encounters during the study period. Alcohol or drug consumption was reported in 50.5% of the encounters.

What`s the story? An exploration of narrative language abilities in male juvenile offenders

This paper is concerned with the narrative language (story telling) abilities of a group of juvenile offenders completing community-based court orders in Melbourne, Australia. A convenience sample of 30 male young offenders was compared with 50 male non-offenders attending government high schools in the same region of Melbourne. Participants provided an audiotaped description of a six-frame cartoon (the “Flowerpot Incident”). Samples were transcribed and subjected to story grammar analysis, to examine differences between groups regarding both structural and qualitative adequacy. Young offenders produced narratives which were significantly poorer than those of controls with respect to the presence and adequacy of the seven story grammar elements described by Stein and Glenn (In R. O. Freedle (Ed.), New Directions in Discourse Processing (pp. 53-120) 1979). Findings are discussed in relation to implications for investigative and evidentiary interviewing.

Species-specific characteristics and individual variation of the bark call produced by male Australian fur seals (Arctocephalus pusillus doriferus)

Australian fur seals Arctocephalus pusillus doriferus are colonial breeding animals forming dense social groups during the breeding season. During this time, males establish and defend territories through physical conflicts, stereotyped posturing and vocalisations. While vocalisations are suggested to play an important role in male recognition systems, it has received little attention. Recordings of nine adult male Australian fur seals were made during the 2000 and 2001 breeding seasons at Kanowna Island (39° 10’S, 146° 18' E), Bass Strait, Australia. The in-air bark vocalisations of territory-holding males were used to characterise the Bark Call and to determine whether males produce individually distinct calls, which could be used as a basis for vocal recognition. Seventeen frequency and temporal variables were measured from a total of 162 barks from nine individual males. The Bark Series was more reliably classified (83%) to the correct caller compared to the Bark Unit. This was assigned with less certainty (68%), although the classification was still relatively high. Findings from this study indicate that there is sufficient stereotypy within individual calls, and sufficient variation between them, to enable vocal recognition in male Australian fur seals.

Systematic review of randomised controlled trials of sildenafil (Viagra®) in the treatment of male erectile dysfunction.

Background: Sildenafil (Viagra®), a new oral drug for the treatment of erectile dysfunction, was licensed for use across Europe in 1998. Aim: To examine the effectiveness and safety of sildenafil as an oral treatment for erectile dysfunction. Design of study: Systematic review and meta-analysis.
Setting: All published or unpublished randomised controlled trials comparing sildenafil with a placebo or alternative therapies. Method: Published studies were sought by computerised searches of electronic databases using the keywords ‘sildenafil’ and ‘Viagra’. A hand search was also done of the British Medical Journal, Lancet, Journal of the American
Medical Association, New England Journal of Medicine, British Journal of General Practice, Drug, Inpharma and Scrip. An assessment of quality of all identified studies and data extraction was undertaken independently by two researchers. Results were combined in a meta-analysis where appropriate, using RevMan version 3. Results: Twenty-one trials were identified. All trials showed a statistically significant improvement in erectile or sexual function in patients using sildenafil compared with a placebo. A meta-analysis of 16 trials reporting a global efficacy response showed that men were 3.57 (95% CI = 2.93–4.43) times as likely to have improved erections on sildenafil compared with those on a placebo. The number needed to treat to have one man with improved erections was two. The drug has a relatively safe side-effect profile. Conclusions: Available research shows that sildenafil is an effective treatment for male erectile dysfunction. Many trial participants had some baseline erectile function and it is probable that in clinical practice, where the erectile function tends to be more impaired, the number needed to treat may be higher.

Differential Habituation of Male Betta Splendens to Qualitatively Different Stimuli

Habituation is a learning mechanism that functions to decrease the amount of energy and attention focused on a certain stimuli. Male Siamese Fighting Fish, Betta splendens, are territorial animals that defend their territories using a number of aggressive displays. Male Bettas have previously shown the ability to habituate to the presence of a conspecific male when visually exposed to each other. Due to the costly nature of many of the male Betta’s displays, I hypothesized that male Bettas should differentially habituate to qualitatively different stimuli. I presented each of three groups of male Betta splendens with a different stimulus, each presenting a different level of interactivity. I predicted that the Bettas would be more likely to habituate to a less interactive stimulus than a more interactive one. No significant habituation was observed in any of the groups and no significant differences in latency to display or length of display between all three groups were observed. However, overall data trends suggest that habituation was indeed occurring and that the three different stimuli elicited different levels of display. The limited amount of visual exposure to the stimuli in this experiment might account for why results were insignificant.

The influence of fish, meat and polyunsaturated fat intakes on platelet phopholipid polyunsaturated fatty acid in male Melbourne Chinese and Caucasian

Objective: The aims of this study were to investigate (1) platelet phospholipid (PL) polyunsaturated fatty acid (PUFA) composition in subjects who were the Melbourne Chinese migrants, compared with those who were the Melbourne Caucasians and (2) the relationship between platelet PL PUFA and intake of fish, meat and PUFA.

Design: Cross-sectional comparison of the Melbourne Chinese and Caucasians.

Setting: Free-living male subjects.

Subjects: Ninety-seven Melbourne Chinese migrants and 78 Melbourne Caucasians who were recruited in Melbourne.

Outcome measures: Dietary intake was assessed using a semi-quantitative food frequency questionnaire. The platelet PUFA was measured by gas-liquid chromatography.

Results: The Melbourne Chinese had significantly higher proportions of platelet PL 20:5n-3 (P=0.006), 22:6n-3 (P<0.0001), total n-3 (P=0.027) and 22:5n-6 (P=0.0002), and a significantly higher intake of fish (P=0.012) and white meat (P=0.0045) compared with the Melbourne Caucasians. In addition, the Melbourne Chinese had significantly lower proportions of 20:3n-6 (P=0.023), 20:4n-6 (P<0.002), 22:4n-6 (P<0.0001), total n-6 (P=0.037), 22:5n-3 (P<0.0001) and ratio of n-6/n-3 (P=0.011), and a significantly lower intake of red and total meat (P<0.0001) than the Melbourne Caucasians. Fish consumption was significantly positively correlated with platelet PL 20:5n-3 and 22:6n-3, and significantly negatively correlated with 22:5n-3 (P<0.05). Meat consumption was significantly positively correlated with 22:5n-3 and significantly negatively correlated with 22:5n-6, 20:5n-3 and 22:6n-3 (P<0.05). Dietary PUFA intake was significantly positively correlated with 20:3n-6, 22:4n-6 and 22:5n-3, and significantly negatively correlated with 22:5n-6, 20:5n-3 and 22:6n-3 (P<0.05).

Conclusions: Compared with Caucasians, the Melbourne Chinese had a significantly higher level of platelet PL n-3 PUFA, which might contribute to the low CVD mortality in this population. Platelet PL 20:5n-3 and 22:6n-3 were significantly positively correlated with fish intake, and negatively significantly correlated with dietary intake of meat and PUFA, while 22:5n-3 was significantly positively correlated with dietary meat and PUFA intake, and significantly negatively correlated with fish intake. Dietary intake of PUFA and fish are potential confounding factors for assessing the effects of meat consumption on platelet PL individual PUFA. Dietary intake of PUFA and meat did not influence the incorporation of fish long chain n-3 PUFA to platelet PL in this study population.

A significant inverse relationship between concentrations of plasma hoocysteine and phospholipid docosahexaenoic acid in healthy male subjects

The aim of this study was to investigate the possibility of a relationship between plasma homocysteine (Hcy) and phospholipid FA (PUFA) in healthy Australian males. One hundred thirty six healthy male subjects aged 20–55 yr were recruited from the Melbourne metropolitan area. Each volunteer completed a semiquantitative food frequency questionnaire and gave a blood sample. Plasma Hcy concentrations were determined by an established HPLC method; the plasma phospholipid FA were determined by standard methods. Plasma Hcy concentration was significantly negatively correlated with plasma phospholipid concentration of the PUFA 20∶5n−3 (r=−0.226, P=0.009), 22∶5n−3 (r=−0.182, P=0.036), 22∶6n−3 (r=−0.286, P=0.001), total n−3 (r=−0.270, P=0.002) and the ratio n−3/n−6 PUFA (r=−0.265, P=0.002), and significantly positively correlated with 20∶4n−6 (r=0.180, P=0.037). In the partial correlation analysis, after controlling for serum vitamin B12 and folate concentration, plasma Hcy was significantly negatively correlated with the plasma phospholipid concentration of 22∶6n−3 (r=−0.205, P=0.019), total n−3 (r=−0.182, P=0.038) and the ratio n−3/n−6 PUFA (r=−0.174, P=0.048). Evidence indicates that an increased concentration of n−3 PUFA in tissues has a beneficial effect on cardiovascular health. Our findings provide further evidence that increased consumption of dietary n−3 PUFA increases the concentration of n−3 PUFA in plasma phospholipid, which is associated with a protective effect on cardiovascular diseases and lower plasma Hcy levels. The mechanism that might explain the association between plasma 22∶6n−3 and Hcy levels is not clear.

Male social workers in child family welfare : new directions for research

Gillingham reflects on the developments in theory and research about male social workers in child and family welfare. The position of male social workers in direct practice in child and family welfare is contentious given that men commit a majority of the physical and sexual assaults against women and children.

Investigation of the factors responsible for the superior performance of male students in standardised testing at one primary school

The project set out to investigate one primary school where, for four years or more, boys have outperformed girls in standardized Year 3 and 5 Basic Skills Tests in literacy and numeracy, which contradicts general findings on male and female performance in standardized literacy and numeracy testing. The school placed a heavy emphasis on literacy programs, which appear to be making a difference to the boys. Over time, there has been a slight improvement in boys’ literacy performance but the greatest area of growth is generally boys’ numeracy, rather than boys’ literacy.

Further aims of the study were to isolate school-based factors, which are potentially responsible for this phenomenon, from community-based factors and to explore the possibility that, rather than boys being advantaged, girls were actually being disadvantaged by practices at the school. The approach adopted by the research team employed intensive case-study methods and ethnographic approaches, including interviews, document analysis, and structured and unstructured observation of a range of school activities.

This paper describes how the school has transformed itself, the effects that this has had upon the teaching and learning environment and the results that have been achieved in the key areas of numeracy and literacy.