American Journal of Men's Health最新文献

Expectant fathers who struggle to cope with the fear of childbirth often develop negative attitudes toward attending birth. This study aimed to compare fear of childbirth and attitudes toward participation in birth among expectant fathers with primiparous and multiparous partners. The researchers conducted this prospective comparative study with 142 expectant fathers, including 70 fathers with primiparous partners and 72 fathers with multiparous partners. The study used a Personal Information Form, the Fathers' Fear of Childbirth Scale (FFCS), and the Attitude Scale Toward Participation in Birth for Father Candidates (ASTPBFC) to collect data. Fathers with primiparous partners reported significantly higher levels of fear of childbirth than fathers with multiparous partners (p < .05). In addition, fathers with multiparous partners demonstrated more positive attitudes toward attending birth than fathers with primiparous partners (p < .05). Age explained 22.20% of the variance in the positive emotions subdimension of the ASTPBFC among fathers with primiparous partners and 34.99% among fathers with multiparous partners. Overall, fathers reported moderate levels of fear of childbirth, with first-time fathers experiencing higher fear than fathers with multiparous partners. Fathers with primiparous partners also showed more negative attitudes toward participation in birth. Furthermore, increasing fear of childbirth negatively affected fathers' attitudes toward attending birth.

While prostate-specific antigen (PSA) testing can reduce mortality, there is potential for over-detection of indolent prostate cancer that would never become clinically important. Thus, research is needed to understand individual genetic risk profiles among unaffected men to help guide personalized PSA screening. This pilot study explored recruitment outcomes, genetic risk perceptions, and willingness to provide a biospecimen (saliva sample) for prostate cancer genetic risk testing among unaffected men. Recruitment approaches included: (1) active (in-person) recruitment that entailed face-to-face communications with men at different community settings, such as health fairs, senior centers, and barbershops and (2) passive (contactless) recruitment-flyers posted at various community locations, such as libraries and laundromats, and online including Facebook pages and other social media. Consenting participants completed a structured questionnaire and provided a saliva sample. A total of 154 individuals were reached and 100 consented (62 of whom were Black). In-person recruitment was associated with higher enrollment. Participants reported high genetic susceptibility beliefs in terms of perceived lifetime risk and comparative risk. Black males reported greater perceived risk compared with white men, but saliva sample return was comparable (89% and 90%, respectively). Overall, the saliva sample return rate was 85%, with an in-person return rate of 95%, and a mail return rate of 69%. This pilot study demonstrated high feasibility of enrollment, high perceived genetic risk and willingness to submit a saliva sample for prostate cancer genetic risk testing. Multimodal approaches are beneficial to reach racially diverse participants in various community settings.

The ubiquitin-proteasome system (UPS) is intricately linked to the growth and metastasis of numerous types of cancer. However, current analysis on the function and impact of UPS in bladder cancer (BLCA) is still sparse. First, univariate Cox regression analysis was applied to screen survival-associated UPS-related genes (UPSGs). Then, based on the expression of survival-related UPSGs, BLCA patients were divided into three clusters through unsupervised cluster analysis, and the overall survival rate of Cluster 1 and Cluster 3 was higher than that of Cluster 2, but there was no survival difference between Cluster 1 and Cluster 3. Therefore, Cluster 1 + Cluster 3 (Cluster A) and Cluster 2 (Cluster B) were selected for subsequent analysis. The differentially expressed genes of the two clusters were predominantly enriched in signaling pathways such as the Calcium signaling pathway and Cytokine-cytokine receptor interaction. An immune microenvironment analysis revealed that Cluster B patients were characterized by highly infiltrated immunosuppressive cells (M2 macrophages and Tregs) as well as high expression of immune checkpoint genes (such as BTLA and CTLA4). Furthermore, Cluster B exhibited a higher TIDE score. Somatic mutations demonstrated that the mutation rate of Cluster B was higher than that of Cluster A. In addition, candidate drugs for two clusters of patients were predicted, with Lapatinib, Doramapimod, and SCH772984 may be potential drugs for Cluster A patients. Luminespib, Staurosporine, and Dasatinib may be more suitable for Cluster B patients. The study provides a reference for guiding the clinical treatment of BLCA patients.

Men account for the majority of suicides in the United Kingdom, yet many delay seeking help due to gendered norms that discourage emotional disclosure and position vulnerability as socially risky. Everyday environments where men routinely engage in familiar, informal conversation may, therefore, offer opportunities for earlier intervention. This evaluation examined the Mind in Bexley Ambassador Project, which trained barbers, hair stylists, and tattoo artists to recognize emotional distress, initiate supportive dialogue, and signpost to local services. A total of 61 ambassadors completed training, including 24 barbers, 32 hair stylists, and 5 tattoo artists. Quantitative confidence measures, activity logs, and qualitative interviews assessed feasibility, acceptability, and early outcomes. Ambassadors reported increased confidence in recognizing distress, asking directly about suicide, and referring to support, with 1,818 mental health-related conversations and 265 signposting interactions (including provision of service-information leaflets) recorded over 7 months. Emotional disclosure typically emerged gradually across repeat appointments, where trust and familiarity were already established. Brief, evidence-informed training supported ambassadors to respond more intentionally and confidently to distress without altering the informal character of these grooming environments. The intervention legitimized and strengthened existing relational practices, positioning barbershops, salons, and tattoo studios as low-threshold, socially safe settings where distress may be recognized and voiced before reaching a crisis point. Embedding proportionate training, reflective supervision, and clear referral pathways into such everyday spaces offers a scalable and culturally congruent approach to suicide prevention for men.

This study examined the associations between andropause symptoms, perceived stress, and sleep quality, and determined the indirect pathway of perceived stress and sleep quality in the relationship between andropause symptoms and quality of life (QoL) among middle-aged men. This cross-sectional study employed a quantitative mediation analysis design. In total, 186 middle-aged men completed questionnaires, including the Androgen Deficiency in Aging Males Scale, Perceived Stress Scale, Pittsburgh Sleep Quality Index, and World Health Organization Quality of Life. Data were analyzed using binary logistic regression, Baron and Kenny mediation analysis, and Hayes PROCESS macro. In total, 83.3% of the participants screened positive for andropause symptoms, and 58.6% reported poor sleep quality. Andropause syndrome and perceived stress were significantly associated with an increased risk of poor sleep quality (odds ratio [OR] = 6.168, 95% confidence interval [CI] = [2.013, 18.896], p = .001; OR = 1.279, 95% CI = [1.159, 1.410], p < .001). Statistical mediation analysis indicated perceived stress and poor sleep quality explained the link between andropause symptoms and QoL (B = -0.033, p < .001; B = -0.060, p < .001; B = -0.052, p < .001). Bootstrapped mediation analysis revealed two significant indirect associations between andropause symptoms and QoL: perceived stress (B = -0.861, 95% CI = [-1.210, -0.514]) and sleep quality (B = -1.566, 95% CI = [-2.054, -1.035]). These findings provide empirical evidence that acute and sustained psychosocial burdens associated with andropause symptoms contribute substantially to a decline in overall well-being and health.

Idiopathic nonobstructive azoospermia (iNOA) is defined as the absence of sperm in the ejaculate with no identifiable cause after thorough physical, hormonal, and genetic evaluations. This study aimed to investigate the differential gene expression of key epigenetic regulators-DNA methyltransferase (DNMT) 1 (DNMT1), DNMT3A, DNMT3B, and Zinc Finger CCHC-Type Containing 13 (ZCCHC13)-in patients with iNOA compared with those with obstructive azoospermia (OA). Sixty infertile men diagnosed with azoospermia were equally divided into iNOA (case group) and OA (control group). Participants with iNOA were further subdivided into iNOA⁺ (successful sperm retrieval, n = 10) and iNOA⁻ (unsuccessful retrieval, n = 20) based on microdissection testicular sperm extraction (micro-TESE) outcomes. The relative expression of DNMT1, DNMT3A, DNMT3B, and ZCCHC13 was analyzed in testicular tissue samples using quantitative real-time PCR. Expression levels of DNMT1 and ZCCHC13 were significantly lower in the iNOA group compared with OA (p = .01), while DNMT3B expression was significantly higher in iNOA, particularly in the iNOA⁻ subgroup (p < .0001). Receiver operating characteristic (ROC) analysis revealed DNMT3B had the highest diagnostic accuracy (AUC = 0.84, p < .0001), followed by ZCCHC13 (Area under the curve (AUC) = 0.69) and DNMT1 (AUC = 0.68). Our findings indicate that epigenetic dysregulation contributes to impaired spermatogenesis in iNOA, which can be molecularly distinguished from OA. Epigenetic biomarkers such as DNMT3B and ZCCHC13 may offer reliable diagnostic tools for idiopathic cases of azoospermia and serve as potential targets for future epigenetic therapies.

This study aims to evaluate the strengths, opportunities, and facilitators in the implementation of the National Policy for Comprehensive Men's Health Care (PNAISH) in Brazil in response to user demands. A mixed-method approach was applied to residents across Brazil between April and July 2024 through a web survey using a semi-structured questionnaire addressing sociodemographic characteristics, engagement, and critiques of the PNAISH. The qualitative analysis employed the Collective Subject Discourse method. A total of 144 individuals participated, primarily young cisgender men, with 80.5% holding postgraduate degrees and 75.7% engaged in male health initiatives. Progress has been observed in the implementation of the PNAISH, particularly in primary care, yet challenges persist regarding policy dissemination and managerial involvement. Most respondents (77.8%) recognized strengths and facilitators in PNAISH, with 43.8% reporting its implementation at both state and municipal levels. Qualitative narratives revealed that participants perceive PNAISH as a strategic opportunity not only to engage men in preventive care but also to foster reflection on masculinities, self-care, and health promotion. Many highlighted that the policy helps to overcome cultural stigmas that traditionally distance men from health services, especially through educational actions and intersectoral strategies. While the policy has advanced access and male participation in health services, structural barriers and limited visibility still constrain its broader impact and effective engagement.

Using the Health and Retirement Study (HRS), this article explores the association between military service and mortality among American men over age 50 between 1992 and 2020. Cox regressions show veterans who served during wartime have consistently higher mortality than nonveterans across major conflicts of the 20th century. Peacetime service does not increase mortality significantly, but Hispanic peacetime veterans have lower mortality than other Hispanic veterans and nonveterans. Using a much larger set of survey data than has been used previously, the findings here reveal a different age profile than found in some previous research. In particular, the 50s and 60s are particularly sensitive life stages for wartime veterans, especially for the Vietnam-era veterans. Finally, this analysis suggests some potential health benefits from military service-even in wartime-but, on balance, the negative consequences of warmaking are stronger and extend well into later life.

Prostate cancer is the second most common cancer in U.S. men, with higher incidence and mortality among African Americans and those with genetic or familial risk. Despite guidelines promoting early detection, prostate-specific antigen (PSA) screening in primary care remains inconsistent. We assessed PSA screening patterns and the association between risk factors and testing.A retrospective analysis was conducted on men aged ≥40 seen at primary care clinics from 2020 to 2022. Risk scores were created based on the number of prostate cancer risk factors. Univariate and multivariate analyses assessed associations between the risk scores, PSA screening, and cancer diagnosis. Of 176,326 patients, 31.4% underwent PSA testing, rising to 78.1% with a risk score of 4. The predictive model was significant (χ² = 19,527.021, df = 11, p < .001). PSA testing odds were higher with Medicaid or commercial insurance (vs. Medicare) and lower for self-pay patients. Former and never smokers were more likely to be tested than current smokers. Age, African American race, and family history increased the odds of receiving PSA testing. Prostate cancer diagnosis reached 25% at a risk score of 5, with significant predictors including older age, African American race, family history, and mention of "prostate" in clinical notes. PSA screening remains underused in primary care, even among high-risk patients. More risk factors were linked to higher testing rates, but African American and low-income groups were under-tested. Provider education and decision-support tools may improve guideline adherence and equity.