American Journal of Men's Health最新文献

For fathers, the transition to parenthood can be experienced as an emotional phase. Fathers often state feeling overlooked and unsupported during their transition to parenthood. This study addressed this issue by exploring what it means to become a father-a qualitative design with a phenomenological hermeneutical approach. Data were collected through open-ended interviews with 19 fathers living in Sweden. The participants were encouraged to reflect on the meaning of becoming a father. Becoming a father means feeling connectedness to their child, their partner, and their friends, as well as creating strategies entailing flexibility, engagement, management, support, and solitude in their new situation. Fathers use digital media for support to create strategies, but it can evoke anxiety. The meaning of becoming a father concludes that they are deeply affected by the new situation. To support fathers during their transition to parenthood, midwives and child healthcare nurses should facilitate reflective conversations with them about their experiences of becoming a father. This study was guided by the Consolidated Criteria for Reporting Qualitative Research Checklist.

This research utilizes Coronary Artery Risk Development in Young Adults (CARDIA) cohort study data to examine whether financial strain is associated with subsequent lower urinary tract symptoms among men and whether healthcare barriers, health risk behaviors, and comorbid conditions explain this association. CARDIA recruited Black and White participants aged 18 to 30 years at baseline (1985-1986) from four United States cities. The analytic sample was comprised of men with complete data for analyses involving financial strain trajectories across 7 assessments (n = 602) and mediation tests of data collected at 4 assessments (n = 634). The outcome variable, assessed when the mean age of men was 50 years, was the American Urologic Association Symptom Index score, recoded into four symptom categories: none (6.3%); mild (62.6%), moderate (28.5%), and severe (2.6%). Symptom category was regressed on financial strain variables, adjusting for age, race, education, and self-reported benign prostatic hyperplasia. Regression analyses and structural equation modeling tested potential mediators. Compared to not being financially strained across early and midlife adulthood, experiencing more than one shift in financial strain was associated with 84% greater odds (95% confidence interval [1.24, 2.75]) of being categorized into a worse symptom category. Structural equation modeling showed that both difficulty receiving healthcare and depressive symptoms explained an association between difficulty paying for medical care and worse symptoms. Additional research is needed to confirm findings and examine other mechanisms that may further explain associations between financial strain and symptoms, such as stress responses. Accumulated evidence may inform future prevention interventions, including integrated healthcare approaches.

The 1,000-m run is a key component of university physical fitness assessments. Effective supplementation strategies to enhance performance and recovery in this test remain underexplored. This study aimed to evaluate the effects of caffeine (CAF) and beetroot juice (BJ) on 1,000-m performance and used SHapley Additive exPlanations (SHAP) analysis to identify key influencing factors. A randomized crossover design compared the effects of CAF (6 mg/kg body weight), BJ (70 mL providing 6.4 mmol of ${\mathrm{NO}}_3^{-}$), and their combination with placebo (PLA) on 1,000-m running performance. Twenty healthy male participants took part in the study. Physiological, nutritional, and behavioral data were collected during each condition. SHAP analysis of a multilayer perceptron model quantified the relative importance of various performance determinants, providing a clear assessment of their contribution to the outcome. The CAF + BJ group performed significantly better than PLA (p < .01) in the first 1,000-m run and outperformed both PLA and BJ in the second run (p < .01). Performance declined after recovery in BJ (p < .01) and PLA (p < .01) but improved in CAF + BJ (p < .01). Post-exercise heart rate and blood lactate were highest in CAF + BJ and CAF, with CAF showing significantly higher lactate levels at 10, 15, and 20 min post-exercise compared to CAF + BJ (p < .01). SHAP analysis ranked body fat percentage > weight > age > nighttime sleep duration > nutritional strategy > average vertical jump height > grip strength > resting heart rate > time since last meal > alcohol consumption > height > smoking frequency. This study suggests that CAF and BJ supplementation may improve 1,000-m performance. SHAP analysis introduced a novel framework for identifying key factors, offering insights for targeted interventions. Tailored dietary supplement strategies that address critical physiological and lifestyle factors are important. Combining supplementation with these approaches can further enhance performance and recovery.

Prior disparities in obesity research emphasize socioeconomic status as a potential driver of White-Black differences in obesity prevalence, but there is a paucity of research examining the influence of education on the observed racial difference among men. The objective of this study was to determine whether the relationship between race and obesity varies by education level among Non-Hispanic White (NHW) and Non-Hispanic Black (NHB) men. We used 1999 to 2016 National Health and Nutrition Examination Survey data consisting of a sample of 13,583 men (9,459 NHW and 4,124 NHB). Race and Ethnicity were determined by self-reports of whether they were Hispanic or not and their racial group. Education was based on self-reporting of the highest grade level or level of school completed and categorized as: less than high school, high school diploma or General Equivalency Diploma, some college or associate degree, and college degree or above. Thirty-four percent of the men were obese (body mass index [BMI] > 30 kg/m²); a higher proportion of NHB men reported being obese than NHW men (36.0%, n = 1,508, vs. 33.8%, n = 3,140; p = .049). Adjusting for age, marital status, income, insurance status, smoking status, drinking status, self-rated health, physical inactivity, and the number of chronic conditions, NHB men with a college degree or above had a higher prevalence of obesity (prevalence ratio: 1.21, confidence interval [1.06, 1.39]) than NHW men. Findings suggest that among college-educated NHW and NHB men, there is a relationship between race/ethnicity and obesity prevalence.

This study investigates the multifaceted factors influencing adjustment to prostate cancer among older men in Esfahan, Iran, using the social ecological model (SEM) as a guiding framework. We employed a qualitative approach, conducting semistructured interviews with 19 men diagnosed with prostate cancer, aged 63 to 92 years (mean age = 71), and six key informants, including spouses and health care professionals. We thematically analyzed the data to identify challenges and facilitators in the intrapersonal, interpersonal, and environmental domains of the SEM. The findings revealed a dynamic interplay of factors shaping the adjustment process. Intrapersonal challenges included physical degeneration, psychological distress, stigma, and role reversal, countered by coping strategies such as adopting healthy habits and spirituality. Interpersonal dynamics encompassed family strain and denial, yet the presence of familial support and self-care significantly enhanced adjustment. On an environmental level, financial burdens and health care barriers posed significant challenges. The study furthermore highlighted critical issues like "dysmedication" and "body occupation" which impede effective coping. A complex network of personal, relational, and systemic factors influences the adjustment to prostate cancer among older Iranian men. We urgently need tailored, culturally sensitive interventions to address health care inequities, alleviate economic pressures, and enhance psychosocial support networks, thereby empowering older adults to navigate this challenging journey with greater resilience and dignity.

There is growing consensus for upskilling the health care workforce on gender-responsive strategies to more effectively connect and respond to men during health care encounters. To inform health practitioner education, the primary aim of this study was to gain insights from a diverse sample of men in Australia on their experiences and expectations when engaging with health care practitioners. Thirty-two men (18-70 years, median 33) participated in eight online focus group discussions. A combined deductive and inductive thematic analysis was undertaken to reconcile their expectations with prior published approaches for practitioners to engage men in care and identify new themes. Participants desired a genuine relationship, signaled by upfront and informal communication, active listening, and enquiry. In structuring treatment, participants sought transparency and respect for autonomy. Regarding the therapeutic alliance, avoiding gender stereotyping and empathetic, sensitive, and holistic care were valued by men. These expectations for how practitioners engage with men in care were reflected in their advice for health practitioner student training and aligned with approaches published previously. Participant insights were synthesized into four outcomes, for men, of successful engagement: legitimize the relationship to build trust, create a safe space to facilitate disclosure, empower men, and assess and treat the whole man through a biopsychosocial lens. In conclusion, men seek authentic connection and a caring style that allows them to legitimize and forge an ongoing relationship with their practitioner. These outcomes of successful engagement are key to developing consumer-informed health practitioner education and competencies on gender-responsive health care for men.

The treatment of erectile dysfunction (ED) remains a significant challenge. Mendelian randomization (MR) is being increasingly utilized to identify novel therapeutic targets. In this study, we carried out a genome-wide MR analysis on druggable targets with the aim of pinpointing latent therapeutic alternatives for ED. We collected data on the druggable genes and filtered out those associated with blood eQTLs, then performed two-sample MR and colocalization analyses using ED genome-wide association data to screen genes significantly linked to the condition. In addition, we carried out phenome-wide studies, enrichment analysis, protein network modeling, drug prediction, and molecular docking. We screened 3,953 druggable genes from the DGIdb and 4,463 from a review. Following data integration, 74 potential druggable genes were found to potentially regulate corpus cavernosum fibrosis. MR analysis of eQTL data uncovered five drug targets (TGFBR2, ABCC6, ABCB4, EGF, and SMAD3) significantly associated with ED risk. Colocalization analysis suggested a shared causal variant between ED susceptibility and TGFBR2, with a posterior probability (PPH4) exceeding 80%. Drug predictions utilizing DSigDB identified nolone phenylpropionate, sorafenib, and NVP-TAE684 as significantly associated with TGFBR2. Finally, molecular docking indicated strong binding affinities between these candidate drugs and the protein encoded by TGFBR2 (Vina score < -50). Through MR and colocalization analyses, the present study identified five potential drug targets for ED, with TGFBR2 showing remarkable relevance in blood. These findings offer valuable insights and potential leads for the development of more effective ED therapies, which may also contribute to cutting down the expenses involved in drug development.

Botulinum toxin A (BoNT/A) injections into the bulbospongiosus muscle have emerged as a novel treatment for lifelong premature ejaculation (PE), though efficacy remains controversial. This study evaluates BoNT/A's efficacy and safety through a comprehensive search of PubMed, Embase, Cochrane Library, Web of Science, ClinicalTrials.gov, and ISRCTN registry. We included randomized controlled trials, prospective, and retrospective studies, focusing on intravaginal ejaculation latency time (IELT) and adverse events. Four studies (three meta-analyzed) involving 263 patients were analyzed. BoNT/A increased IELT by 37.87 s at 1 month (MD, 37.87; 95% CI, -2.86 to 78.59; p = .07; I² = 96%), 11.52 s at 3 months (MD, 11.52; 95% CI, -16.91 to 39.94; p = .43; I² = 95%), and 2.41 s at 6 months (MD, 2.41; 95% CI, -9.19 to 14.00; p = 0.68; I² = 77%). Short-term IELT improvement was observed but lacked statistical significance (p > .05), with high heterogeneity (I² = 96%). Long-term effects diminished, suggesting declining efficacy. Adverse events occurred in 10.9% of patients, primarily erectile dysfunction (n = 5), and urinary disorders (n = 5). While current evidence does not definitively support BoNT/A's efficacy, limited studies and methodological heterogeneity suggest that further research is warranted. Future studies should employ larger, multicenter designs, optimize injection methods, doses, and protocols, and identify suitable patient populations to validate BoNT/A's clinical benefits.

Prostate cancer (PCa) is a significant global health concern, with its incidence and mortality rates projected to rise due to population aging. In this study, we utilized PCa transcriptome data from public databases and applied bioinformatics methods to identify three prognostic genes (CDC20, RAD51, and TTK) related to centrosome duplication in PCa. CDC20 is involved in cell cycle regulation, RAD51 in deoxyribonucleic acid double-strand break repair, and TTK in spindle assembly checkpoint function and cell proliferation. We constructed a risk model and a nomogram model, both demonstrating moderate to good predictive performance with area under the curve values ranging from 0.611 to 0.765 at different time points. Gene set enrichment analysis revealed that these genes were enriched in 64 pathways, including the cell cycle pathway, which is dysregulated in cancer. Furthermore, we analyzed the immune microenvironment and identified 13 differential immune cells and 13 differential immune checkpoints between high- and low-risk groups, providing insights into potential immunotherapy targets for PCa. In conclusion, this study contributes to a deeper understanding of PCa pathogenesis and lays important theoretical and experimental foundations for developing new diagnostic markers and treatment strategies. Future research requires more clinical samples and continued monitoring of the mechanism of these genes in PCa.