American Journal of Men s Health

Published by SAGE Publications
Online ISSN: 1557-9891
Publications
Age-specific incidence rates a for (A) seminoma and (B) nonseminoma testicular germ cell tumors by race/ ethnicity, United States b 1999-2004 Note: Rates are not calculated for cell counts ≤16. a Rates are per 100,000 men. b Data are from population-based statewide cancer registries covering 92.1% of U.S. population.
Age-adjusted incidence rates a for testicular germ cell tumors by SEER summary stage and race/ethnicity, United States 2001-2003 b *Rates are per 100,000 men and age-adjusted to the 2000 U.S. standard population. † Data are from population-based statewide cancer registries covering 92.4% of U.S. population in this time period.
Testicular Germ Cell Tumor Incidence Rates by Race/Ethnicity and Histology, United States 1999-2004 a All Germ Cell Tumors Seminoma Nonseminoma Count Rate (95% CI) b APC Count Rate (95% CI) b APC Count Rate (95% CI) b APC
Testicular Germ Cell Tumor SEER Summary Stage 2000 Distribution by Race/Ethnicity, United States a 2001-2003 (N = 19,704)
Article
Testicular cancer is rare but primarily affects young men. To characterize the current incidence of testicular cancer in the United States, U.S. Cancer Statistics data from 1999 through 2004 were examined. Age-adjusted (2000 U.S. standard) incidence rates were calculated for seminoma and nonseminoma testicular germ cell tumors (TGCTs). Hispanic men had the largest increase in incidence rates for nonseminomas, followed by non-Hispanic White men (annual percentage change of 3.2% and 1.9%, respectively, p < .05). Nonseminomas peaked at a younger age for Hispanic, American Indian/Alaska Native (AIAN), and Asian/Pacific Islander (API) men. Whereas 9.6% of TGCTs were diagnosed at a distant stage in non-Hispanic White men, more Hispanic (16.1%), Black (13.8%), AIAN (16.8%), and API (14.9%) men with TGCTs were diagnosed with distant stage. Monitoring incidence rates for rare cancers by race/ethnicity has improved with national population-based cancer registry coverage. Disparities in diagnosis stage have implications for effective treatment of TGCTs.
 
Audience Characteristics.
Newsstand Price and Number of Issues per Year Published for Popular News Magazines. 
Article
Informed by social constructionism, biomedicalization, and a feminist framework, a discourse analysis was performed on 31 popular news articles published in North America between 2000 and 2010. The magazines construct prostate cancer in a gendered manner. Its construction is rooted in themes that are related to discussions of biology, prostate cancer as a heterosexual problem, the responsibilization of health and masculinity. Through these constructions, the popular news articles reinforce dominant ideals and performances of hegemonic masculinity and male sexuality, traditional femininity, and heteronormativity. While reinforcing such ideals, the prevention, treatment, and knowledge of prostate cancer is constructed as the responsibility of individual men. This study reveals that the articles favor discussions of heteronormativity and hegemonic masculinity over racism, rendering health inequalities silent.
 
Article
Whether the African American race remains a significant predictor of poorer prostate cancer survival after adjusting for other sociodemographic and treatment-related factors remains unclear. We examined whether disparities in survival among 18,900 African American and Caucasian men diagnosed with prostate cancer in Kentucky remained after adjusting for health insurance (payor source), cancer treatment, cancer stage at diagnosis, prostate-specific antigen (PSA) level, smoking status, and Appalachian region. After adjusting for these predictors, African American men living in Kentucky had poorer prostate cancer survival after 5 years (hazard ratio [HR] = 1.33; 95% confidence interval = 1.11, 1.59) and 10 years (HR = 1.39; 95% CI = 1.18, 1.28) of follow-up, and for the entire follow-up period (HR = 1.41; 95% CI = 1.26, 1.65) compared to their Caucasian counterparts. Thus, health insurance status, cancer treatment, cancer stage at diagnosis, PSA level at diagnosis, smoking status, and geographic location did not explain the racial gap in survival in Kentucky.
 
Demographics of Sample.
Article
African American (AA) men remain one of the most disconnected groups from health care. This study examines the association between AA men's rating of health care and rating of their personal physician. The sample included 12,074 AA men aged 18 years or older from the 2003 to 2006 waves of the Consumer Assessment of Healthcare Providers and Systems Adult Commercial Health Plan Survey. Multilevel models were used to obtain adjusted means rating of health care systems and personal physician, and the relationship of ratings with the rating of personal physician. The adjusted means were 80 (on a 100-point scale) for most health ratings and composite health care scores: personal physician (83.9), specialist (83.66), health care (82.34), getting needed care (89.57), physician communication (83.17), medical staff courtesy (86.58), and customer service helpfulness (88.37). Physician communication was the strongest predictor for physician rating. AA men's health is understudied, and additional research is warranted to improve how they interface with the health care system.
 
Article
African American and White men have the highest rates of prostate cancer in the United States. Families represent important social contexts within which illness occurs.The purpose of this study is to explore whether prostate-specific antigen (PSA) testing is associated with instrumental and informational social support from family members among a sample of Black and White men aged 45 and older. Data from the 2005 Health Information National Trends Survey were analyzed using logistic regression. The dependent variable was having a PSA test within the past year or less. The independent variables consisted of selected demographic and family informational and instrumental social support variables. The statistically significant variables included age and having a family member with cancer. Additional studies to elucidate the mechanisms of social support from family for prostate cancer are needed.
 
Summary of Confirmatory Factor Analysis for the CMNI-55 With All 11 Subscales
Summary of Confirmatory Factor Analysis: Standardized Factor Loadings for CMNI-55 for Men and Women
(continued)
Article
The current study examined the psychometric properties of the abbreviated versions, 55- and 22-items, of the Conformity to Masculine Norms Inventory (CMNI). The authors tested the factor structure for the 11 subscales of the CMNI-55 and the global masculinity factor for the CMNI-55 and the CMNI-22. In a clinical sample of men and women (n=522), the results supported the 11-factor model. Furthermore, the factor structure was invariant for men and women. The higher order model, which tested the utility of the global masculine score, demonstrated marginal fit. The factor structures for the global masculinity score for the CMNI-22 demonstrated poor fit. Collectively, the results suggest that the CMNI-55 is better represented in a multidimensional construct. The subscales' alpha levels and factor loadings were, generally, within acceptable limits. Gender and ethnic mean level differences are also reported.
 
Men in Need of Family Planning and Preconception Care. Men not in need Men in need of family planning Men in need of preconception care Contributing variables N a % b N a % b N a % b 
Participants' Background Characteristics, Percentage of Men in Need Among Background Characteristics, and Association Between Background Characteristics With Being in Need. 
Level of Current Partner Hormonal and Condom Use Among Men in Need of Family Planning Who Were Sexually Active in the Past 12 Months (n = 405). 
Article
The Centers for Disease Control and Prevention and Healthy People 2020 call for improvements in meeting men's reproductive health needs but little is known about the proportion of men in need. This study describes men aged 35 to 39 in need of family planning and preconception care, demographic correlates of these needs, and contraception use among men in need of family planning. Using data from Wave 4 (2008-2010) of the National Survey of Adolescent Males, men were classified in need of family planning and preconception care if they reported sex with a female in the last year and believed that they and their partner were fecund; the former included men who were neither intentionally pregnant nor intending future children and the latter included men intending future children. Men were classified as being in need of both if they reported multiple sex partners in the past year. About 40% of men aged 35 to 39 were in need of family planning and about 33% in need of preconception care with 12% in need of both. Current partner's age, current union type, and sexually transmitted infection health risk differentiated men in need of family planning and preconception care (all ps < .01) and participants' race/ethnicity further differentiated men in need of preconception care (p < .01). More than half of men in need of family planning reported none of the time current partner hormonal use (55%) or condom use (52%) during the past year. This study identified that many men in their mid-30s are in need of family planning or preconception care.
 
Article
This study examines the lived experience of myocardial infarction (MI) in younger men. Seven men, aged between 32 and 58, all of whom had suffered MI within the previous 12 months, were interviewed. Thematic analysis of the interview transcripts revealed four main themes. The themes were "disillusionment with life," "tension and stress," "keeping up appearances," and "invincibility." Collectively the four themes reflected the complexities, subtleties, and consensus of the experiences of these younger men who have survived MI. This study reveals that the individuals within the authors' sample appear to allude to the ideal or hegemonic form of masculine identity. Utilization of a qualitative approach with this younger male sample has enabled the authors to elicit the defining features of their experience as identified by themselves. Implications for these findings are discussed.
 
Number of Men 15 to 44 Years of Age and Percent Distribution of Reproductive Health Services Received in the Past 12 Months According to Select Demographic and Socioeconomic Characteristics Reproductive Health Services Received in Past 12 Months 
Percentage of Men Who Received Any Health Care Service, Physical, or Testicular Exam by Receipt of Reproductive Health Care Services in the Past 12 Months Receipt of BC, STH, or Both BC STH Both BC and STH Total 
Article
Men have a significant role in reproductive health decision making and behavior, including family planning and prevention of sexually transmitted diseases (STDs).Yet studies on reproductive health care of men are scarce. The National Survey of Family Growth 2006-2008 provided data that allowed assessment of the predisposing, enabling, and need factors associated with men's receipt of reproductive health services in the United States. Although more than half (54%) of U.S. men received at least one health care service in the 12 months prior to the survey, far fewer had received birth control counseling/methods, including condoms (12%) and STD/HIV testing/STD treatment (12%). Men with publicly funded health insurance and men who received physical exam were more likely to receive reproductive health services when compared with men with private health insurance and men who did not receive a physical exam. Men who reported religion was somewhat important were significantly more likely to receive birth control counseling/ methods than men who stated religion was very important. The pseudo-R (2) (54%), a measure of model fit improvement, suggested that enabling factors accounted for the strongest association with receiving either birth control counseling/ methods or STD/HIV testing/STD treatment.
 
Patients Screened for Osteoporosis Using DXA.
Article
Osteoporosis in men is an underrecognized and undertreated condition. Despite the National Osteoporosis Foundation recommending osteoporosis screening in men aged 70 years and older since 2008, screening rates in the United States remain undefined. In our study, we analyzed dual-energy X-ray absorptiometry (DXA) screening rates in a primary care setting. Overall, screening rates were low (11.3%). Although there was an increase with age in both the 10-year osteoporotic and 10-year hip fracture probabilities, no association was found between increased age and bone mineral density testing using DXA. Only 23.2% of patients were prescribed bone protective treatments. The performance of DXA screening strongly predicted prescription of bone protective treatment. Increased age raised the likelihood of bone protective treatment prescriptions; however, smokers were less likely to be prescribed these medications. As the population in the United States ages, an increased awareness of this major public health problem is warranted.
 
Article
Men are more likely than women to develop an abdominal aortic aneurysm (AAA), a disease that is often asymptomatic and has up to a 90% risk of mortality if the aneurysm ruptures. What many men do not know is that an AAA can easily be identified through an ultrasound screening, and if the aneurysm is >5.5 cm, it can be surgically repaired to prevent a life-threatening rupture. Although current AAA screening recommendations focus on men between the ages of 65 and 75 years, who have ever smoked, recent evidence suggest many men of ages 50 to 80 years, regardless of smoking status, may also be at risk for developing an AAA. This article presents a comprehensive overview of AAA disease and summarizes current evidence-based diagnostic and treatment guidelines, the importance of educating men about this health issue, and the need for more widespread AAA ultrasound screening opportunities.
 
Article
The prevalence of abdominal aortic aneurysms (AAAs) and AAA-related deaths are steadily declining in some countries as a result of the reduction in smoking rates. It was thus suggested that screening programs that do not target high-risk populations are likely to have very low AAA detection rates. However, this may not apply to other countries that do not exhibit similar reductions in smoking rates. It was assumed that by using the U.S. Preventive Services Task Force screening criteria (men 65-75 years with smoking history) less than 30% of AAAs would be captured. A more extensive scoring system that includes additional risk factors such as the presence of carotid artery or peripheral arterial disease, obesity, hypertension, and so on, may identify almost 90% of AAAs. This article discusses this and other issues on screening, prevention, and treatment of AAAs.
 
Article
The case of a 35-year-old fisherman who presented in a rural clinic with a sudden onset of painful penile swelling affecting the left lateral side with associated rapid detumescence is reported. He had tried to coerce his wife to a sexual intercourse when she forcefully bent his penis. He was initially managed with cold applications, oral diclofenac potassium, chymoral, and splinting of the penis and then referred to the urological services of a teaching hospital. He defaulted only to re-present about 2 weeks later with some improvement in his symptoms. Further advice to see the urologist was also rebuffed on financial grounds. When he reported about 1 month later, he was assessed to have grade 3 erectile dysfunction. In conclusion, penile fracture is a rare condition which follows unphysiological bending of the tumescent penis during sexual intercourse or masturbation. That following husband abuse is rarer. The sequelae can be devastating.
 
The rejection-abuse cycle (Diagram modified from Brown et al., 2010)
Article
This review article examined the gender symmetry debate in light of recent research relating to the feminist and family research perspectives on intimate partner violence, providing a context for rethinking perpetrator programs. The concept of coercive control is considered as an explanatory factor in an attempt to integrate the feminist and family research perspectives. The limited effectiveness of perpetrator programs is examined. Research highlighting potential factors that could improve the effectiveness of perpetrator programs is introduced, followed by a discussion of the rejection-abuse cycle, one attempt to incorporate current research into a more inclusive program. The rejection-abuse cycle identifies a pattern of perpetrator behavior, which links rejection, threat to self, defense against threat, and abuse. Finally, suggestions for changing perpetrator programs are elaborated, incorporating past research, which would make them appropriate for both male and female perpetrators. These implications are contextualized within a meta-theory to provide greater clarity for the development of future perpetrator programs.
 
Article
Traditionally, sexual abuse of males has not been an issue of priority among politicians or researchers. When addressed, focus is often on context or harmful effects of the abuse. This article is based on the idea of reality as socially constructed, examining possible ways for sexually abused males to come to terms with their experiences. The emphasis is on accessible discursive resources on "the abused male" and how cultural stereotypes of manliness influence and limit individual and societal constructions. An important key to reconstruction of abuse history and selfhood lies in acceptance of the idea of men as suppressed. Sexually abused males tend to feel marginalized and different. However, when given the opportunity, they offer alternative discourses of manliness with the potential for bringing sexually abused males out of the shadows, assisting them in better understanding, dealing with, and explaining their experiences to themselves and others. This article brings out the importance of a gender-sensitive approach to working politically as well as directly with men who have been sexually abused. The horizon of understanding in professional social work needs to include attention to stereotypical constructions of manliness that reject men's experiences of being "victims."
 
Typology of Older Violent Man. 
Article
Most research on intimate partner violence to date has focused on young men. Although interest and research regarding older abused women has increased in recent years, research on the voices and experiences of older abusive men is still scarce. The purpose of this article is to present a typology of older battering men dwelling in lifelong intimate violence relationships. Fifteen older Israeli abusive men, aged 65 to 84 years, were interviewed in depth. Four types were identified: the "Non-quitter," the "Cover-up"-er, the "In-between"-er, and the "Normalizer." These types were constructed based on four dimensions: the construction of violence over the years, the perception of the spouse over the years, losses accompanying the violent relationship, and the meaning of violence in old age. The four types enable an in-depth look at the experiential world of older abusers and paint a complex picture of various ways in which abusive men live with violence over time.
 
Characteristics of Study Participants (N = 105) 
Article
This study examined the perspectives of African American male injection drug users who have sex with both men and women (IDU-MSM/W) and who are involved in sex trade regarding the need for a human sexuality educational model (HSEM) for addiction professionals. Focus groups were conducted involving an exploratory sample (N = 105) of men who met the following parameters: aged 18 to 40 years, African American, engage in injection drug using behavior, have sex with male and female partners, and who frequent parks and other sex working areas in Baltimore City and surrounding areas. Data suggest that an HSEM may be useful for addiction professionals who work with substance abusing Black MSM/W. Moreover, the model should include opportunities for addiction professionals to (a) identify their personal biases about homosexuality in general (acknowledging personal biases so not to allow those personal biases to influence service); (b) understand the diversity within the Black MSM/W community (e.g., challenge assumptions that all Black MSM/W self-identify as gay); (c) understand how to, and the need for, assessing sexual trauma in Black MSM/W; and (d) understand the need to incorporate risk factors and safer sex practices that may be of concern to a subpopulation of Black MSM/W, such as "barebacking." These findings suggest the need for, and topics to include in, an HSEM that assists professionals with exploring their biases about sexuality and MSM/W and better prepares counselors to address HIV prevention and risky behavior using language that is appropriate for the Black IDU-MSM/W population.
 
Characteristics of Elderly Men With Different Inclinations in Seeking a Marriage Partner
Predictors of Elderly Widowers Who Have the Intent to Remarry
Article
To investigate the intent to remarry and the predictors for such intent with psychosocial variables, this study used male interviewers to interview 180 Chinese elderly widowers. A structured questionnaire on singlehood and intent to remarry, which developed out of a pilot in-depth focus-group study, was used. Data were analyzed with nonparametric tests and logistic regression. The intent to remarry was predicted by younger age, inability to meet sexual needs, and dissatisfaction with widowhood. A total of 40% of these widowers who wanted a partner considered finding one from Mainland China. The sex-related findings were very different from previous studies on Chinese men. They showed that there should be professional support to help them to better adjust to late-life marriage. In addition, the study uncovered the need to expand the scope and enhance the sensitivity of current general practitioners and geriatric services to address issues beyond medical concerns.
 
Article
African American (AA) men are significantly more likely to die of prostate cancer (PrCA) than other racial groups, and there is a critical need to identify strategies for providing information about PrCA screening and the importance of informed decision making (IDM). To assess whether a computer-based IDM intervention for PrCA screening would be appropriate for AA men, this formative evaluation study examined their (1) PrCA risk and screening knowledge; (2) decision-making processes for PrCA screening; (3) usage of, attitudes toward, and access to interactive communication technologies (ICTs); and (4) perceptions regarding a future, novel, computer-based PrCA education intervention. A purposive convenience sample of 39 AA men aged 37 to 66 years in the Southeastern United States was recruited through faith-based organizations to participate in one of six 90-minute focus groups and complete a 45-item descriptive survey. Participants were generally knowledgeable about PrCA. However, few engaged in IDM with their doctor and few were informed about the associated risks and uncertainties of PrCA screening. Most participants used ICTs on a daily basis for various purposes including health information seeking. Most participants were open to a novel, computer-based intervention if the system was easy to use and its animated avatars were culturally appropriate. Because study participants had low exposure to IDM for PrCA, but frequently used ICTs, IDM interventions using ICTs (e.g., computers) hold promise for AA men and should be explored for feasibility and effectiveness. These interventions should aim to increase PrCA screening knowledge and stress the importance of participating in IDM with doctors. © The Author(s) 2015.
 
Article
Recent findings suggest that men have higher mortality rates than women after a hip fracture. Although the risk of osteoporotic fractures in men is increasing, male osteoporosis still remains underdiagnosed and undertreated. In general, male osteoporosis is given low priority by policy makers in public health initiatives. The purpose of this study is to examine the patterns of use and gender distribution of DXA (dual-energy X-ray absorptiometry) scan usage at a university medical center in the United States. The total number of DXA scans increased during the study period while the percentage of men studied actually declined. The results of this study may lead to heightened awareness among providers who are caring for male patients at risk for osteoporosis.
 
Article
Appalachia is a geographic region with several disparities related to human papillomavirus (HPV) infection, yet little is known about acceptability of HPV vaccine for males among Appalachian residents. HPV vaccine acceptability and preferences for future HPV vaccine education programs were examined among residents of Appalachian Ohio. Focus groups and in-depth interviews were conducted with Appalachian Ohio residents between July and October 2011. Participants (n = 102 from 24 focus groups and 5 in-depth interviews) included four key stakeholder groups: health care providers, community leaders, parents with adolescent sons, and young adult men ages 18 to 26 years. Support for vaccinating males against HPV was high among participants, despite low awareness and knowledge about HPV vaccine for males. Participants reported three categories of potential barriers to vaccinating males against HPV: concerns about vaccine safety and side effects, access to care and vaccination logistics, and gender and cultural issues. Participants reported that HPV vaccine was viewed as being only for females in their communities and that receiving the vaccine may be emasculating or embarrassing to males. Participants suggested that future HPV vaccine education programs mainly target parents, include basic information about HPV-related diseases and HPV vaccine (e.g., number of doses, cost), and present the vaccine as having the potential to prevent cancer (as opposed to preventing genital warts). Acceptability of HPV vaccine for males was high among residents of Appalachian Ohio. Future HPV vaccine education programs in Appalachia should address common potential barriers to vaccination and help destigmatize vaccination among males.
 
Participant Characteristics Heterosexual males (13-18 years), N = 45 Men who have sex with men (13-21 years), N = 41 All males, N = 86
Article
The human papillomavirus (HPV) vaccine was recently approved for use in males. Certain groups, such as men who have sex with men (MSM), are at increased risk of HPV infection. The purpose of the study was to understand perceptions of HPV and the vaccine among adolescent and young adult males, both heterosexual and MSM. Seventy-six males (45 heterosexual, 31 MSM) completed a questionnaire and participated in a focus group. Overall, 42% had heard of HPV and 39% had heard of the HPV vaccine. Males had moderate to favorable attitudes toward vaccination, although intentions to vaccinate were more neutral. MSM were more knowledgeable, aware, and in control of the decision to vaccinate than heterosexual males. Increasing awareness and knowledge about HPV and the vaccine may be necessary to encourage vaccination; certain subgroups of males may be more receptive to HPV vaccination than others.
 
Article
In Peru, the HIV epidemic is concentrated in men who have sex with men (MSM) and transgender women (TGW). Multiple studies correlate alcohol use disorders (AUDs) with risky sexual behaviors among Peruvian MSM. Qualitative research was used to inform a clinical trial on the acceptability of medication-assisted therapies to assist management of AUDs and improve antiretroviral therapy (ART) adherence among MSM/TGW in Peru. Three focus groups involving HIV-infected or HIV-uninfected MSM/TGW (n = 26) with AUDs (AUDIT ≥ 8) were transcribed, translated from Spanish into English, and analyzed using thematic content analysis. Despite having an AUD, participants considered themselves "social" drinkers, minimized their drinking behaviors, and differed about whether or not alcohol problems could be treated. Participants expressed skepticism about medication for treating AUDs. Three concepts emerged as necessary components of a treatment program for alcohol problems: cost, family support, and the potential to drink less alcohol without attaining total abstinence. This study reveals important areas of education to increase potential acceptability of a medication for treating AUDs among MSM/TGW. Given the social conditions and knowledge base of the participants, medication-assisted therapies using naltrexone may be a beneficial strategy for MSM with AUDs. © The Author(s) 2015.
 
Article
We know little about men's beliefs about human papillomavirus (HPV) vaccine and willingness to receive it. In January 2009, the authors recruited 296 heterosexual men and 312 gay and bisexual men from a national panel of U.S. households to complete an online survey about HPV and HPV vaccine. The authors analyzed data using logistic regression, controlling for age, education, number of lifetime sexual partners, and urban residence. More gay and bisexual men than heterosexual men were willing to receive HPV vaccine (73% vs. 37%; adjusted odds ratio = 4.99; 95% confidence interval = 3.36, 7.49). Gay and bisexual men reported greater awareness of HPV vaccine, perceived worry about HPV-related diseases, perceived effectiveness of HPV vaccine, and anticipated regret if they declined vaccination and later developed HPV-related disease compared with heterosexual men (all ps < .05). The lower acceptability and different beliefs among heterosexual men suggest that novel interventions for this group may be needed.
 
Effect of standard ACh at successive doses of 1, 2, and 4 µg/mL on cardiorespiratory parameters and neuromuscular transmission
Effect of shilajit (400 µg/mL) on cardiorespiratory parameters and neuromuscular transmission
Effects of ACh (10 −8 to 10 −4 M) on tension of NAd-precontracted rat cavernous smooth muscle strips (A) and after inhibition by incubation with atropine (B)
Effect of ACh and Shilajit on Cardiorespiratory Parameters and Neuromuscular Transmission in Anesthetized Rats
Article
Previous studies have reported an enhancement of central cholinergic signal cascade by shilajit. For the present study, it was hypothesized that parasympathomimetic effect of shilajit accounting for relaxation of rat corpus cavernosum may be one of the major mechanisms attributing to its traditional role as an aphrodisiac. To test this hypothesis, the acute peripheral effect of standard acetylcholine (ACh), shilajit, and their combination was evaluated on cardiorespiratory parameters such as mean arterial blood pressure (MABP), heart rate (HR), respiratory rate (RR), and neuromuscular transmission (NMT). Furthermore, in vitro effect of standard ACh, shilajit, and their combination was tested on the rat corpus cavernosum. Six groups were used for the in vivo study (N = 5): Group I (control-saline), Group II (ACh), Group III (Sh), Group IV (Sh followed by ACh), Group V (Atropine followed by ACh), and Group VI (Atropine followed by Sh). The in vitro study included four groups: Group I (control-saline), Group II (ACh), Group III (Sh), and Group IV (Sh followed by ACh). The results of the in vivo study confirmed the peripheral parasympathomimetic effect of shilajit (400 µg/mL). The in vitro results revealed that shilajit (400 and 800 µg/mL) relaxed cavernous strips' concentration dependently and enhanced ACh-mediated relaxations. The peripheral parasympathomimetic effects of shilajit were confirmed by blockade of shilajit-induced relaxations (in vitro) and shilajit-induced lowering of MABP and HR (in vivo) by atropine.
 
Chronological plot
Article
Acculturation is defined as cultural changes and consequences of long contact between two different cultural groups. A total of 10 Kurdish men, aged from 24 to 60 years, were interviewed face-to-face to explore the acculturation pattern reported by them through their individual life stories during the whole migration process. The analysis was based on the narrative methodology. The adjustment strategies identified were contributing to Kurdish culture and the home country, getting an education, creating one's own society/building a family, achieving inner security and balance, being active and occupied, and coping with ongoing political instability in the country of origin. The majority of them respond actively to stressful situations in their lives, and it is important for these Kurdish men to be included and acknowledged as individuals.
 
Article
Inaccurate estimations of energy intake (EI) and energy expenditure (EE) may ultimately affect body weight. The purpose of this study was to evaluate accuracy of estimated EI and EE among males in reference to exercise and rest using a counterbalanced, crossover, repeated-measures design. Participants (N = 80) were recruited from a large, urban university in South Florida. Exercise consisted of walking on a treadmill for 60 min at 65% age-predicted maximum heart rate. Food intake was evaluated immediately following exercise and rest. Participants underestimated EI (kcal) on both the exercise (M = 435, SEM = 69) and rest days (M = 439, SEM = 54), overestimated EE (kcal) for exercise (M = 129, SEM = 44), and underestimated EE for rest (M = 54, SEM = 10). Greater accuracy in estimating EE for exercise was significantly (p < .05) associated with higher dietary restraint. The findings suggest that among sedentary males, there is an inability to accurately estimate calories, which has the potential to influence behaviors that affect weight management.
 
Themes and Subthemes Impact of Spinal Cord Injury on Body Image and Self-Concept for Men
Characteristics of Participants
Article
Qualitative research has rarely explored gender-based concerns of men with disabilities. Accordingly, this research investigates body image and self-concept for men with an acquired spinal cord injury (SCI). Modified grounded theory analysis was conducted for secondary, qualitative interview data of 64 male participants from a study of community dwellers living with SCI. Three major themes related to body image and self-concept emerged: consequences for self due to bodily changes, interactions with the public, and decisions and actions people take. Findings indicate that rehabilitation services should include ongoing research to explore the unique needs of male clients. Findings also have implications for rehabilitation therapists and their roles in addressing gender-based concerns of the male client.
 
Incarceration, Drug Offending, and HIV/AIDS 
Article
Incarceration and HIV/AIDS disproportionately affect African American men compared to the U.S. population as a whole. Disparities in relation to crime and HIV/AIDS for Black men suggest that these phenomena have elements in common, particularly given the mediating role of illicit drug use or drug activities in both cases. A socioecological exploration of how and why these twin epidemics intersect (and the role of drug-related activities as mediating variables) is needed illicit drug use or to address the impact of these epidemics on the health and well-being of communities of color. This article critically reviews relevant articles, research reports, and official statistics, as well as conceptual frames of reference for information on the socioecological synergies between crime, drugs, and HIV/AIDS. The article recommends five calls for action for policies to mitigate the cumulative negative effects of these epidemics and for interventions to enhance the life chances of at-risk Black men.
 
Article
Recent data from the Centers for Disease Control and Prevention demonstrate that 1 in 16 Black men in the United States will be infected with HIV in their lifetime. Furthermore, the long-standing HIV disparity in Black communities is actually increasing for Black men. National efforts to curb the epidemic among U.S. Black men focus primarily on men who have sex with men and injection drug users. Black men at heterosexual risk for HIV have largely been neglected by research, program, and policy. This article presents epidemiologic data documenting that heterosexual risk for HIV among Black men is a major concern for Black communities and is likely additional evidence among growing indications of a generalized epidemic in low-income and urban Black communities. The authors offer a call to action to increase support for research, program, and policies that can improve HIV prevention and testing among heterosexual Black men in the United States, as part of the national agenda to reduce rates of HIV in Black communities.
 
Article
Preventing suicide has been identified as a national priority by recent commissions in the United States. Despite increased awareness of suicide as a public health problem, suicide in older adults remains a neglected topic in prevention strategies and research. This is especially true regarding elderly White men, who in terms of suicide rates have represented the most at-risk age group for the past half century. In light of the unprecedented aging of the United States as the baby boom generation enters late adulthood, suicide prevention initiatives that focus on aging males are needed to prevent a national crisis in geriatric mental health. This article provides a brief review of the perennially under-recognized reality of suicide in older men and prevention strategies that, if implemented, might help stem this rising tide of suicide in this vulnerable population.
 
Sample Demographics (N = 15). Fathers n (%) 
Article
Unintentional injuries are a leading public health problem for children, particularly among those living at lower socioeconomic levels. Parents play an important preventive role, and the aim of this study was to examine fathers' views on the role of their family financial situation in preventing children's injuries. In-depth interviews were conducted with 15 fathers of children 2 to 7 years living in western Canada. Questions solicited fathers' views about their financial situation and their child injury prevention efforts. Data analysis was underpinned by masculinity theory and guided by constant comparative grounded theory methods. Findings included that fathers living with fewer financial limitations emphasized use of safety equipment and aligned themselves with provider and protector masculine ideals. Fathers with moderate financial constraint described more child-centered safety efforts and efforts to manage finances. Those facing greatest constraint demonstrated aspects of marginalized masculinities, whereby they acknowledged their economic provider limitations while strongly aligning with the protector role. These findings hold relevance for development of interventions aimed at reducing child injury risk inequities. Taking into account how masculinities may shape their beliefs and practices can inform design of father-centered interventions for men living at different points on the socioeconomic spectrum.
 
Article
Acute appendicitis presents typically with periumbilical pain that in a few hours settles at the right lower quadrant of the abdomen. Atypical presentations are common but association with acute scrotum is an extreme rarity. A 30-year-old fisherman presented at a rural medical facility with a 2-day complaint of severe pain at the right hemiscrotum followed about 24 hours later with mild diffuse abdominal pain. There was associated mild fever and nausea but no vomiting. There were no urinary symptoms and no recent sexual exposure. Initial physical examination revealed mild generalized tenderness worse at the right lower quadrant but the scrotum was not remarkable, and cremasteric sign was negative. He was admitted as a case of acute abdomen for close observation. Abdominal and scrotal ultrasound scan were normal. By the second day of admission, pain became marked at the right lower abdomen with associated vomiting. There was also marked tenderness at the right lower quadrant with rebound. A diagnosis of acute appendicitis was thus made and appendicectomy done after proper workup. The abdominal and scrotal pain stopped after surgery and the patient was discharged on the seventh postoperative day. Patients with unusual abdominal and scrotal pain should be admitted and closely observed and evaluated to prevent unnecessary scrotal exploration or negative appendicectomy.
 
Total, frequency, and duration mean Davidson Trauma Scale scores in prostate cancer and benign prostate hyperplasia (BPH) patients 
Article
Psychological morbidity is increasingly reported in cancer survivors. The authors' objective was to determine the presence of acute posttraumatic stress disorder (PTSD) symptoms in prostate cancer (PC) patients following radical prostatectomy. Fifteen patients who underwent radical prostatectomy for localized prostate cancer were assessed for the presence of PTSD-related symptoms by completing the Davidson Trauma Scale (DTS), a month following the procedure. A group of 20 patients who underwent surgery for benign prostate hyperplasia (BPH) served as the control group. PTSD total scores were significantly higher in PC patients when compared with BPH patients, whose PTSD scores did not differ from those reported in the general population (32.6 ± 18.5 vs. 11.3 ± 9.7, p = .001). PTSD did not vary among PC patients when adjusted for educational status. PTSD symptoms are common among patients undergoing radical prostatectomy and independent of their educational level. Research investigating these aspects of posttreatment psychological adjustment is needed for developing well-targeted psychological interventions.
 
Demographic Characteristics of Fathers
Regression of Family Environment and Paternal Self-Efficacy on Psychological Well-Being
Article
The purpose of this study was to examine the role of family cohesion, adaptability, and paternal self-efficacy in psychological well-being of fathers of children with and without disabilities and whether the effects of these variables on psychological well-being were the same for both groups of fathers. In addition, the potential differences in perceived well-being between the two groups of fathers were examined. Sixty-three fathers of children with disabilities and 217 fathers of typically developing children participated in this study. Fathers of children with disabilities scored significantly higher on the self-acceptance dimension of psychological well-being compared with fathers of children without disabilities. After controlling for the demographic factors, family cohesion and paternal self-efficacy significantly and positively predicted well-being of fathers; the effects of these variables on well-being were the same for both groups of fathers.
 
Descriptive Demographic Characteristics of Latino Gay Couples. M ± SD or n (%) 
Some of the research staff and community partners getting ready for the intervention adaptation sessions. 
Latinos en Pareja-adapted conceptual model. Note. STI = sexually transmitted infection; PrEP, preexposure prophylaxis. 
Other Descriptive Characteristics of Latino Gay Couples. M ± SD or n (%) 
Characteristics and Observations From Health Service Providers. Characteristics M ± SD or n (%)Characteristics M ± SD or n (%) 
Article
Predominantly Spanish-speaking Latino men who have sex with men (MSM) and their same-sex partners continue to be at high risk for HIV and STIs. Behavioral research has identified how relationship dynamics for male couples are associated with sexual risk behavior. Connect 'n Unite (CNU), an evidence-based HIV/STI prevention intervention originally created for Black MSM and their same-sex partners, was adapted for predominantly Spanish-speaking Latino MSM and their same-sex partners on the assumption that its key elements would be translatable while its efficacy would be retained. A systematic adaptation process utilizing qualitative methods was used, including intervention adaptation sessions with 20 predominantly Spanish-speaking Latino gay couples and 10 health service providers. The process included five steps: (1) engaging community stakeholders, (2) capturing the lived experiences of Latino gay couples, (3) identifying intervention priorities, (4) integrating the original intervention's social cognitive theory into a relationship-oriented, ecological framework for Latino gay couples, and (5) adapting intervention activities and materials. The adapted intervention, which we called Latinos en Pareja or Latinos in a Relationship, incorporates elements that effective HIV prevention interventions share, including: a solid theoretical foundation; emphasis on increasing risk reduction norms, sexual communication skills and social support for protection; and guidance on how to utilize available, culturally and linguistically appropriate services. The systematic adaptation approach used for a couples-based HIV prevention intervention also can be employed by other researchers and community stakeholders to adapt evidence-based interventions that promote wellness, linkage to care, and disease prevention for populations not originally targeted. © The Author(s) 2015.
 
Responses to Knowledge Items Among Study Participants Before and After the Education Session
Article
African American men are disproportionately affected by prostate cancer. This project adopted a community-based participatory approach to design and pilot test an educational outreach strategy that promotes informed decision making about screening among African American men in community settings in St. Louis, Missouri. Interviews with local subject matter experts informed the design of the strategy. The revised curriculum was pilot tested in 2009 with 63 men who completed pre- and posttest surveys that measured knowledge, norms, beliefs, decision self-efficacy, and screening intention. The intervention resulted in statistically significant improvement in prostate cancer knowledge, decreased perceived risks and barriers, and increased screening decision self-efficacy. The educational outreach strategy offered in community settings was effective in improving knowledge, beliefs, and decision self-efficacy related to prostate cancer screening. This project sought to devise a screening outreach strategy that struck a balance between the imperatives of informed decision-making goals and the pragmatics of community settings. The findings suggest the need for further research to assess the effectiveness of community-based outreach efforts in enhancing engagement of men in decision making related to screening, diagnostics, and treatment.
 
Article
Men constitute 82% of the approximately 250,000 people in the United States living with a spinal cord injury. Unfortunately, however, little is known about the impact of men's adherence to gender norms on their adjustment to such injuries. The present investigation examined the utility of masculine norms in explaining variance in depression beyond that accounted for by commonly identified predictors of men's adjustment following spinal cord injury. As hypothesized, results suggested that men's adherence to masculine norms accounted for unique variance in their depression scores beyond that contributed by social support, environmental barriers/access, and erectile functioning. Respondents who adhered to norms stressing the primacy of men's work demonstrated lower rates of depression, whereas those who conformed to norms for self-reliance demonstrated higher depression scores. The authors discuss future research directions and potential psychotherapeutic strategies for working with men with spinal cord injuries.
 
Article
Men's enactment of traditional masculine norms may contribute to their adjustment to changes in sexual functioning following treatment for prostate cancer. In the present investigation, the authors test this hypothesis by examining the moderating role of sexual functioning on the relationship between men's adherence to masculine norms and their social, role, and mental health functioning. Results of regression analyses indicate that men with poor sexual functioning evince poor social, role, and mental health functioning when they more strongly adhere to traditional masculine norms. Participants with good sexual functioning, in contrast, exhibit positive social, role, and mental health functioning when they more strongly adhere to traditional norms of masculinity. Directions for future clinical research and treatment interventions are provided.
 
Article
Prostate cancer is the most prevalent solid tumor malignancy and second-leading cause of death from cancer for American men. As a consequence of treatment-related side effects, men living with prostate cancer experience various obstacles to positive mental health. Unfortunately, relatively little is known about factors that promote or impede men's adjustment to these obstacles. In this article, the authors identify three masculine gender scripts that may contribute to men's adjustment following treatment for prostate cancer. To organize the discussion, the authors review related literature and, through case examples, illustrate how masculine gender scripts may influence men's adjustment. Directions for gender-sensitive interventions and future clinical research are provided.
 
Main effects model of predictor variables Note. χ 2 (1) = 1.20, p = .27, comparative fit index = .99, root mean squared error of approximation = .03. R 2 = amount of variance predicting relationship satisfaction and posttraumatic stress disorder symptoms, respectively. Numbers outside parentheses are standardized and numbers inside parentheses are unstandardized. *p < .05. **p < .01. ***p < .001.  
Problem-focused coping interaction model Note. χ 2 (1) = .87, p = .35, comparative fit index = 1.0, root mean squared error of approximation = .00. R 2 = amount of variance predicting relationship satisfaction and posttraumatic stress disorder symptoms, respectively. Numbers outside parentheses are standardized and numbers inside parentheses are unstandardized. Covariances are not presented for clarity purposes. *p < .05. **p < .01. ***p < .001.  
Problem-focused coping interaction model Note. χ 2 (1) = .80, p = .36, comparative fit index = 1.0, root mean squared error of approximation = .00. R 2 = amount of variance predicting relationship satisfaction and posttraumatic stress disorder symptoms, respectively. Numbers outside parentheses are standardized and numbers inside parentheses are unstandardized. Covariances are not presented for clarity purposes *p < .05. **p < .01. ***p < .001.  
Article
Dating violence is a prevalent problem. Research demonstrates that males and females are victimized at comparable rates in their dating relationships and experience a number of mental health and relationship problems. Less research has examined male dating violence victimization, its association to mental health and relationship satisfaction, and whether coping styles influence mental health symptoms and relationship satisfaction among victims. The current study examined physical and psychological aggression victimization, adjustment (posttraumatic stress disorder symptoms and relationship satisfaction), and problem-focused and emotion-focused coping among heterosexual college males in a current dating relationship (n = 184). Results identified that psychological victimization was associated with posttraumatic stress and relationship discord above and beyond physical victimization. Interaction findings identified that psychological victimization was associated with increased posttraumatic stress disorder symptoms at high levels of problem-focused coping, whereas psychological victimization was associated with less relationship satisfaction at low levels of emotion-focused coping. Implications of these findings for future research are discussed.
 
Article
Sexual activity is an important aspect of life in patients with spinal cord injury (SCI), rated as one of the top priorities for recovery of function. This study was conducted to establish an understanding of the severity of erectile dysfunction (ED), a major component of male sexual activity, and its correlates in patients with SCI in our community. In a cross-sectional study, 37 male veterans with SCI admitted for regular follow-up at our center were recruited. Demographic and SCI-related descriptive information was gathered through a self-administered questionnaire. Sexual Health Inventory for Men was used to assess the presence and severity of ED. Euro Quality of Life questionnaire and General Health Questionnaire (GHQ-12) were also administered. The mean age of the participants was 45.7 ± 6.5 years with injury duration of 24.7 ± 6.2 years. Mean GHQ-12 score of 3.65 ± 3.38 and mean Sexual Health Inventory for Men score of 11.57 ± 5.28 were measured. All participants had ED, and 27% were suffering from severe ED. Sleep deprivation, worse GHQ-12 score, and hypertension were significantly associated with higher risk of much severe ED (p < .05). In conclusion, ED is a common problem in veterans with SCI and is inversely associated with their general health status. © The Author(s) 2014.
 
Sample Description and IPV Status (N = 296).
Article
Veterans comprise 10% of the population, and suicide among Veterans has garnered national media and policy attention. Existing research suggests that intimate partner violence (IPV) is a risk factor for suicidal behaviors among some high-risk populations. This report offers a new perspective: the intersection between Veterans' suicidal thoughts and IPV, both victimization and perpetration. The data were obtained from a northeast telephone survey of Veterans (n = 296) using Veterans Health Administration services and yielded a 27% participation rate. Findings suggest male Veterans who are IPV involved have increased odds of suicidal thoughts and behaviors.
 
Article
Drawing on interview data from rural Nigeria, the article explores male youth perceptions of the risks and benefits of multiple sexual partnerships. Participants associated having multiple sexual partners with several harmful health and nonhealth outcomes, including sexually transmitted infections, and frequently confirmed that the practice also bolsters their sense of maleness and boosts their acceptance and ranking among peers. Young males' involvement in multiple sexual partnerships should not be seen as always consequent on their ignorance of and/or indifference to the risks inherent in the behavior. It could also result from the integrality of the behavior to the social processes through which male youths validate their masculinity, mark their transition from boyhood to malehood, and configure their identities to gain acceptance into a local male peer community. Sexuality education curricula that ignore adolescents' understandings of the benefits of their sexual practices may not deliver expected objectives.
 
Article
The purpose of this article is to explore idiom of distress and its application to overweight and obese adolescent boys. This case study suggests that avoidance, as an idiom of distress, offers self-protection from suffering among this population. Fieldwork included 55 face-to-face contact hours, 25 virtual contact hours (i.e., text messaging, e-mails, phone calls), and 16 person-centered interviews. The daily suffering experienced by this group of boys, and their collective enactment of avoidance as a self-protective strategy, offer an understanding of their lives beyond their obese bodies. Avoidance behaviors, however, can result in negative social consequences such as isolation. Recognizing avoidance as an idiom of distress permits parents, teachers, health professionals, and researchers to interact with overweight and obese adolescent boys in a profoundly different way. Attending to the personhood of these vulnerable boys was an important finding of this qualitative study.
 
Article
This study uses a mixed-method approach to examine the relationship between body image and sexual health among adolescent boys. In Study 1, eight 12th-grade boys participated in semistructured interviews focusing on dating and sexuality. Qualitative analyses revealed several differences between boys who were satisfied with their bodies and boys who were not. Specifically, boys who were satisfied with their bodies indicated that they were clear about what they wanted sexually and were comfortable communicating those wants with partners. In contrast, boys with low body satisfaction were often unclear about their sexual choices and resisted talking about sexuality with partners. Study 2 examined these same themes using quantitative data from 149 boys from the 12th grade who completed surveys assessing body image, sexual experiences, and sexual attitudes. Body satisfaction was significantly associated with sexual agency and with clarity of personal sexual values. Implications for promoting adolescent sexual health are discussed.
 
Chlamydia, Gonorrhea, and Syphilis Rates per 100,000 Males Aged 15-19 by Race/Ethnicity, United States, 2001-2005 
Article
Adolescent males are practicing safer sexual behaviors and experiencing healthier outcomes than their predecessors. In recent years, adolescent males have tended to start having sex later in life, have fewer sexual partners, use condoms and other contraceptive methods more often, and father fewer children. Yet sexual activity during adolescence remains the norm, and thus adolescent sexual and reproductive health (SRH) remains an important concern. Moreover, large disparities remain in risk and outcomes according to race/ethnicity, sexual orientation, social connectivity, and where men live. Policy and program advances have been limited. Adolescent males are less likely than they were a decade ago to be receiving broad-based SRH information in school, and their access to clinical services has increased only marginally. Most new funding has been provided for ineffective abstinence-only education programs. Prerequisites for continued progress include research to fill in gaps in our knowledge, arriving at societal consensus around key controversies, and new tactics and allies in the political arena.
 
Top-cited authors
John L Oliffe
  • University of British Columbia - Vancouver
Joan L. Bottorff
  • University of British Columbia - Okanagan
Derek M Griffith
  • Georgetown University
David Gregory
  • University of Regina
Jose Arturo Bauermeister
  • University of Pennsylvania