Sexuality in Young Adult Men Aged 18–24 with Epilepsy

The aim of this study was to determine the extent of sexual dysfunction in young male patients (18–24 years) with epilepsy. Forty-five male patients with epilepsy aged between 18 and 24, and forty-four age- matched healthy male volunteers were included in the study. Participants completed a battery of self-reported tests (ASEX: Arizona Sexual Experiences Scale, HADS: Hospital Anxiety and Depression Scale). Demographic and clinical variables were recorded. Serum total testosterone was measured between 8:00 and 10:00 a.m. in patients with epilepsy. Sexual function scores (sexual drive and penile erection) were higher in patients with epilepsy than those of the control group (p < 0.001 and p = 0.008, respectively). The difference between the mean total ASEX scores, which were 13.9 and 11.4 in patients with epilepsy and controls, respectively, was significant (p = 0.009). HAD anxiety scores were significantly higher in patients with epilepsy than controls (p = 0.01) (Table 2). HAD-depression scores of both groups were similar (p = 0.09). This study demonstrates that young male patients with epilepsy have lower levels of sexual activity and drive and more erectile problems. Impaired sexual function is associated with anxiety scores.     

Normative Values of Muscle Power using Force Plate Jump Tests in Men Aged 77–101 Years: The Osteoporotic Fractures in Men (MrOS) Study

Objective

To determine normative values for weight-bearing, countermovement leg extension (“jump”) tests in the oldest men and characteristics of those not completing vs. completing tests

Design

2014-16 cross-sectional exam.

Setting

Six U.S. sites from the Osteoporotic Fractures in Men (MrOS) Study.

Participants

Community-dwelling men (N=1,841) aged 84.5±4.2 (range: 77-101) years.

Interventions

N/A.

Measurements

Jump tests on a force plate measured lower-extremity muscle peak power/kg, velocity and force/kg at peak power, with normative values for 5-year age groups and by limitations in moderate-intensity activities of daily living (ADLs) and climbing several flights of stairs.

Results

Jump completion was 68.9% (N=1,268/1,841) and 98% (1,242/1,268) had >1 analyzable trial/participant. Exclusions primarily were due to poor mobility and/or balance: 24.8% (456/1,841) prior to and 6.4% (N=117/1,841) after attempting testing. Peak power was 20.8±5.3 W/kg, with 1.2±0.3 m/s for velocity, and 16.7±1.9 N/kg for force at peak power. Each 5-year age group >80 years had subsequently 10% lower power/kg, with 30% lower power/kg at >90 vs. <80 years (all p<0.05). Velocity and force/kg at peak power were 24% and 9% lower respectively, at >90 vs. <80 years (all p<0.05). Limitations in both moderate ADLs and climbing several flights of stairs were associated with 16% lower age-adjusted power/kg, equivalent to 5–10 years of aging, with 11% and 6% lower age-adjusted velocity and force/ kg respectively, vs. those without limitation (all p<0.05). Men not completing vs. completing jumps had older age, higher BMI, lower physical activity, more comorbidities, worse cognition, more IADLs/ADLs and more falls in the past year (all p<0.05). Post-jump pain occurred in 4.6% (58/1,268), with 2 participants stopping testing due to pain. Only 24/1,242 (2%) had all trials/participant without flight (i.e., inability to lift feet), with 323/1,242 having ≥1 trial/participant without flight (total of 28%). No serious adverse safety events (e.g., injury) occurred.

Conclusions

A multicenter cohort of oldest men with a range of function had higher declines in jump power/kg and velocity vs. force/kg across each 5-year age group >80 years. Future research should examine age- and functional-related declines in jump measures related to physical performance decline, falls, fractures, and disability.

     

Ca 19–9 in Seminal Plasma of Infertile Men

Ca 19–9 levels were determined by radioimmunoassay in the seminal plasma of 108 men divided in (a) eight groups according to etiological diagnosis of infertility and (b) two groups on the basis of normal or abnormal spermiogram. The mean Ca 19–9 (or Ca 19–9-like activity) in the seminal plasma was 114.6 times higher than the upper limit in normal serum. A statistically significant difference was noted in the antigen levels between men with normal and those with abnormal spermiograms, although with wide overlapping of the individual values. There was no correlation between Ca 19–9 levels and the variables of the spermiogram. The prostate seems to be the main site of origin of Ca 19–9 or Ca 19–9-like activity in the seminal plasma.     

Occupational Therapy in Diabetic Care—Areas of Need Perceived by Older Adults with Diabetes

This study explored the perception of older adults with diabetes regarding the areas of service considered helpful to their daily activities and routines. A survey questionnaire was designed and given to 52 community-dwelling older adults with diabetes. Results showed that cholesterol control, managing blood sugar, foot care, fatigue management and pacing, and pain management/reduction were the areas of most concern that deserve services. The findings suggest that, in providing holistic client-centered interventions to individuals with diabetes, occupational therapists need to be able to prioritize clients' concerns and help them incorporate diabetes management into their routines and lifestyle.     

Menu Planning in Residential Aged Care—The Level of Choice and Quality of Planning of Meals Available to Residents

Background: Choice of food is an imperative aspect of quality of life for residents in Residential Aged Care Homes (RACHs), where overall choice and control is diminished upon entering a home to receive care. The purpose of this study was to examine the current strategies of menu planning in a range of RACHs in Australia, and whether this facilitated appropriate levels of choice for residents receiving texture modified and general diets. Methods: The study comprised a National Menu Survey using a new survey instrument collecting general information about the RACH and foodservice system, menu information and staffing information (n = 247); a national menu analysis (n = 161) and an observational case study of 36 meal environments. Results: Choice was low for the entire sample, but particularly for those receiving pureed texture modified diets. Evidence of menu planning to facilitate the inclusion of choice and alternatives was limited. Discussion: Regulation and monitoring of the Australian Aged Care Accreditation Standards needs to be strengthened to mandate improvement of the choice and variety offered to residents, particularly those on pureed texture modified diets. Further research on how menu choice and a lack of variety in meals affects the quality of life residents is needed in this context, but current evidence suggests the effect would be detrimental and undermine resident autonomy and nutritional status.     

“Being-in-the-World-of-Care”: The Lived Experiences of Older People Receiving Community Aged Care Packages in Queensland

The lived experiences of older people living in Queensland who were receiving a Community Aged Care Package (CACP) were explored using Heidegger's interpretive hermeneutical phenomenological approach. A number of key themes were identified including the importance these older people placed on personal autonomy and the central significance of relationships. The comprehensive understanding developed revealed that the meanings of care experiences can significantly alter the older person's lived experiences and personal identity. This understanding can enhance the development of care practices that are more likely to support the older person's active participation in care and their own life choices.     

Copper for the Prevention of Outbreaks of Health Care–Associated Infections in a Long-term Care Facility for Older Adults

ObjectiveWe aimed to study the efficacy of copper as an antimicrobial agent by comparing incidence rates during outbreaks in areas equipped vs not equipped with copper surfaces in a long-term facility for dependent older adults (nursing home).DesignProspective observational pilot study in a nursing home.Setting and participantAll persons resident in the nursing home belonging to Reims University Hospital, from February 1, 2015 to June 30, 2016, were included.MethodsIncidence rates for health care–related infections during outbreaks occurring during the study period were compared between the wing that was equipped and the wing that was not equipped with copper surfaces. Results are expressed as relative risks (RRs) and 95% confidence intervals (95% CIs).ResultsDuring the study period, 556 residents were included; average age was 85.4 ± 9.2 years, and 76% were women. Four outbreaks occurred during the study period: 1 influenza, 1 keratoconjunctivitis, and 2 gastroenteritis outbreaks. The risk of hand-transmitted health care–associated infection was significantly lower in the area equipped with copper surfaces (RR 0.3, 95% CI 0.1-0.5).Conclusions and implicationsIn our study, copper was shown to reduce the incidence of hand-transmitted health care–associated infections and could represent a relatively simple measure to help prevent HAIs in nursing homes.     

The Association Between Preconception Care Receipt and the Timeliness and Adequacy of Prenatal Care: An Examination of Multistate Data from Pregnancy Risk Assessment Monitoring System (PRAMS) 2009–2011

Objectives Prenatal care (PNC) is a critical preventive health service for pregnant women and infants. While timely PNC has been associated with improved birth outcomes, improvements have slowed since the late 1990s. Therefore, focus has shifted to interventions prior to pregnancy. Preconception care is recommended for all women of reproductive age. This study aimed to examine preconception care and its association with timeliness and adequacy of PNC. Methods This retrospective cohort study used data from a large sample of United States first-time mothers (n?=?13,509) who participated in the 2009–2011 Pregnancy Risk Assessment Monitoring System in ten states. Timeliness and adequacy of PNC data came from birth certificates, while preconception care receipt was self-reported. Logistic regression provided odds ratios (ORs) and 95% confidence intervals (CIs) to model the association between preconception care receipt and the two PNC outcomes. Results After adjustment, women who received preconception care had statistically significant increased odds of timely (OR 1.30, 95% CI 1.08, 1.57), but not adequate PNC (OR 1.08, 95% CI 0.94, 1.24) as compared to women who did not receive preconception care. Pregnancy intention modified these associations. Associations were strongest among women with intended pregnancies (timely PNC: OR 1.63 and adequate PNC: OR 1.22). Conclusions for Practice Given that untimely PNC is associated with adverse birth outcomes, the observed association warrants increased focus on implementing preconception care. Future studies should investigate how specific components of preconception care are associated with PNC timeliness/adequacy, health behaviors during pregnancy, and birth outcomes.     

Factors Associated with Vaccination Status of Children Aged 12–48 Months in India, 2012–2013

Objectives India has more unvaccinated children than any other country despite provision of free vaccines through the government’s Universal Immunization Program. In this study, we calculated the proportion of children aged 12–48 months who were fully vaccinated, under-vaccinated, or who had not received any vaccines. Childhood, household, and sociocultural factors associated with under-vaccination and non-vaccination were evaluated. Methods Using data from India’s 4th District-level Health and Facility Survey, 2012–2013 (DLHS-4) and the 2012–2013 Annual Health Survey (AHS), we calculated the proportion of children who were non-vaccinated, under-vaccinated, or fully vaccinated with 1 dose of Bacillus Calmette–Guérin, 3 doses of oral polio vaccine, 3 doses of diphtheria–pertussis–tetanus, and 1 dose of measles-containing vaccine. The odds of full vaccination compared to non-vaccination and under-vaccination relative to various factors was assessed using a multivariable, multinomial logistic regression which accounted for survey design. Results Of 1,929,580 children aged 12–48 months, 59% were fully vaccinated, 34% were under-vaccinated, and 7% were non-vaccinated. Compared to children born in government institutions, children delivered in non-institutional settings with a skilled birth attendant present had higher odds of non-vaccination (OR 1.66) and those without a skilled attendant present had still greater odds of non-vaccination (OR 2.39) and under-vaccination (OR 1.11). Conclusions for Practice India’s vaccination rates among children aged 12–48 months remains unacceptably low. The Indian government should encourage institutional delivery or birthing with a skilled attendant to ensure women receive adequate health education through antenatal care that includes the importance of childhood vaccination.     

What Constitutes Preferred Long-Term Care Provided in Residential Aged Care Facilities? An Empirical Comparison of the Preferences of the General Population,Residents, and Family Members

ObjectivesRelatively few studies to date have examined the preferences of members of the general population as potential future consumers of long-term aged care services. This study aimed to use discrete choice experiment methodology to compare the preferences of 3 groups: the general population, residents, and family members of people living in long-term aged care.MethodsA total of 6 salient attributes describing the physical and psychosocial care in long-term residential aged care were drawn from qualitative research with people with a lived experience of aged care and were used to develop the discrete choice experiment questionnaire. The 6 attributes included: the level of time care staff spent with residents, homeliness of shared spaces, the homeliness of their own rooms, access to outside and gardens, frequency of meaningful activities, and flexibility with care routines. The questionnaire was administered to 1243 respondents including consumers (residents [n = 126], family member carers [n = 416]), and members of the general population (n = 701).ResultsFor both the general population and resident samples, having their own room feeling “home-like” exhibited the largest impact upon overall preferences. For the family member sample, care staff being able to spend enough time exhibited the largest impact. Tests of poolability indicated that the resident and general population samples estimates could be pooled. The null hypothesis of equal parameters between the groups was rejected for the family members, indicating significant differences in preferences relative to the resident and the general population samples.ConclusionsThis study illustrates that preferences for residential aged care delivery may vary depending upon perspective and experience.     

Gender Stereotypes and Preconception Health: Men’s and Women’s Expectations of Responsibility and Intentions to Engage in Preventive Behaviors

Maternal and Child Health Journal - Introduction As mounting evidence underscores the importance of both men and women taking steps before pregnancy to improve reproductive outcomes, public health...     

Adolescent Experiences of Clinician–Patient HIV/STI Communication in Primary Care

Effective clinician–patient communication is linked to positive patient health outcomes in adults, yet the research on adolescent populations remains limited. We describe adolescent experiences of clinician–patient HIV/STI communication through qualitative interviews with predominantly African-American adolescent women from a youth-centered primary care clinic. Participants described acknowledging clinicians are professionals, the importance of confidentiality to foster clinician–adolescent communication, and calling for clinician-initiated HIV/STI communication. Adolescents expressed the necessity for clinicians to engage youth in these challenging conversations through an open and understanding approach. Additionally, adolescents described experiences of perceived judgment and uncomfortableness from clinicians, and non-disclosure of HIV/STI risk behaviors to their clinician. Findings underscore the adolescents’ desire to engage in HIV/STI communication with healthcare providers, while highlighting important strategies for clinicians. Results can inform health communication research and practice, and the development of interventions aimed at increasing clinician–adolescent HIV/STI communication.