What is Men's Health? A definition

© 2017 The Dougmar Publishing Group. Target of the study Men's Health is increasingly coming into force within health research, epidemiology, health care organisation, and health policy. Over the past 10-15 years the EU Men's Health Report and reports within some countries have publicised problems of health in men. A starting point for the study of men's health is the defi nition of "Men's Health". A group of German experts in the fi eld of men's health has taken on this task. Methodology A literature review in international and national databases was performed for the years 1990-2014 by selected MeSH terms and for "experts in men's health". Further research concerned "grey literature" in Germany, especially health reports and web pages. This was followed by a conference of experts to defi ne "Men's Health" using a modifi ed Delphi method according to W. Zinn. From the expert group, minimum criteria for a defi nition of "Men's Health", which must comply with the new defi nition of men's health, were created and discussed. The fi nal defi nition was created in the third round of the Delphi method. Results The international literature review yielded seven defi nitions of "Men's Health" in the English literature and fi ve defi nitions in the German literature including within the "grey" literature. The expert group identifi ed seven minimum criteria and fi fteen relevant topics that were needed for a strong defi nition, of which, by weighting, eight criteria were considered relevant for a new defi nition. None of the existing defi nitions could fulfi l these eight criteria. Therefore, in the next step of the expert group a new defi nition "Men's Health" was elaborated. The defi nition has reference to the WHO concept of "health" and includes dimensions of health and disease, risk and protective factors that require special prevention and care services for all phases of life. All participants in the expert group agreed on the defi nition developed. Conclusions The defi nition of Men's Health is a basis for further research and practice to improve men's health in Germany and other countries

Poor Sleep and Impaired Self-Care: Towards a Comprehensive Model Linking Sleep, Cognition, and Heart Failure Outcomes

Background: Persons with heart failure (HF) have significantly lower sleep quantity and quality than persons without HF. The purpose of this article is to propose a conceptual model describing how poor sleep may contribute to inadequate self-care and untoward outcomes in persons with HF. Aims: Our overarching hypothesis is that sleep affects self-care and outcomes through its effects on cognition. Building on the work of others, we outline a conceptual model that illustrates that even transient sleep disruption prevents sleep-related restorative processes and contributes to cognitive dysfunction—especially in the 25–50% of HF patients with existing cognitive impairment. Poor sleep may be sufficient to impair cognition to a level that interferes with higher order functions involved in effective HF self-care practices. Through these mechanisms, inadequate sleep may contribute to poor outcomes such as low health-related quality of life and greater risk of unplanned hospitalization. Conclusion: The proposed model (1) bridges physical, neuropsychological and behavioral phenomena, (2) suggests a mechanism by which poor sleep affects daytime behavior, and (3) is empirically testable. Exploring factors that interfere with sleep may improve self-care and outcomes in persons with HF

Was ist Männergesundheit? Eine Definition [What is Men's Health? A definition].

Zusammenfassung Ziel der Studie: Männergesundheit gerät immer stärker in den Fokus von Gesundheitsforschung, Epidemiologie, Gesundheitspflegeorganisation und Gesundheitspolitik. In den vergangenen 10–15 Jahren wurden von einigen Ländern und der EU Männergesundheitsberichte publiziert, in denen auf Probleme der Gesundheit beim Mann hingewiesen wurden. Ausgangspunkt für eine wissenschaftliche Untersuchung von Männergesundheit ist die Definition des Begriffs „Männergesundheit“. Eine Gruppe von deutschen Experten auf dem Gebiet von Männergesundheit hat sich dieser Aufgabe angenommen. Methodik: Eine Literaturrecherche in internationalen und nationalen Datenbanken erfolgte für die Jahre 1990–2014 nach ausgewählten MeSH Terms und nach „Experten für Männergesundheit“, nach „grauer Literatur“, in Gesundheitsberichten und Webseiten. Es folgte eine Expertenkonferenz zur Definitionsfindung mittels modifizierter Delphi Methode nach W. Zinn. Von der Expertengruppe wurden Mindestkriterien für eine Definition Männergesundheit erstellt und diskutiert, denen die neue Definition von Männergesundheit genügen muss. Daraus wurde in der dritten Runde schrittweise eine Definition erstellt. Ergebnisse: Die internationale Literaturrecherche ergab 7 Definitionen zu „Men’s Health“ in der englischsprachigen und 5 Definitionen in der deutschen inkl. in der „grauen“ Literatur. Aufgrund der von der Expertengruppe erarbeiteten 7 Mindestkriterien wurden 15 relevante Themengebiete gelistet, von denen durch Gewichtung 8 Themengebiete als relevant für eine neue Definition angesehen wurden. Im Abgleich mit den bisherigen Definitionen konnte keine diese 8 Kriterien erfüllen. Deshalb wurde im nächsten Arbeitsschritt von der Expertengruppe eine neue Definition Männergesundheit ausgearbeitet. Die Definition hat Bezug zum WHO-Begriff „Gesundheit“ und beinhaltet Dimensionen von Gesundheit und Krankheit, Risiko- und Schutzfaktoren, die spezielle Präventions- und Versorgungsangebote über alle Lebensphasen erfordern. Alle Teilnehmer der Expertengruppe stimmten der erarbeiteten Definition zu. Schlussfolgerung: Die Definition von Männergesundheit stellt eine Basis für weitere wissenschaftliche Arbeiten und die Praxis dar, um Männergesundheit in Deutschland und weiteren Ländern zu verbessern. ______________________________________________________________________________________ Summary Target of the study: Men’s Health is increasingly coming into focus of health research, epidemiology, health care organization, and health policy. Over the past 10–15 years have been published by some countries and the EU Men’s Health reports where problems of health noted in men. Starting point for a scientific study of men’s health is the definition of “Men’s Health”. A group of German experts in the field of men’s health has taken on this task. Methodology: A literature review in international and national databases was performed for the years 1990–2014 by selected MeSH terms and for “experts for men’s health”. Another research concerned “gray literature” in Germany, especially health reports and web pages. This was followed by a conference of experts to define “Men’s Health” using a modified Delphi method according to W. Zinn. From the expert group minimum criteria for a definition “Men’s Health” were created and discussed, which must comply with the new definition of men’s health. This definition was created in the third round of the Delphi method. Results: The international literature review yielded 7 definitions of “Men’s Health” in the English-speaking and 5 definitions in the German inkl. in the “gray” literature. Due to the developed by the Expert Group 7 minimum criteria 15 relevant topics were listed, of which by weighting 8 subject areas were considered relevant for a new definition. In comparison with the previous definitions none could fulfill these 8 criteria. Therefore, in the next step of the expert group a new definition “Men’s Health” was elaborated. The definition has reference to the WHO concept of “health” and includes dimensions of health and disease, risk and protective factors that require special prevention and care services for all phases of life. All participants in the expert group agreed on the definition developed. Conclusions: The definition of Men’s Health is a basis for further scientific work and practice to improve men’s health in Germany and other countries. Schlüsselwörter Männergesundheit - Gesundheitsressourcen - Lebensstil - Lebensqualität - Gesundheitsangebote für Männer Key words men’s health - health resources - lifestyle - quality of life - delivery of health services for me

Developing an objective indicator of fatigue: An alternative mobile version of the Psychomotor Vigilance Task (m-PVT)

Approximately 20% of the working population report symptoms of feeling fatigued at work. The aim of the study was to investigate whether an alternative mobile version of the ‘gold standard’ Psychomotor Vigilance Task (PVT) could be used to provide an objective indicator of fatigue in staff working in applied safety critical settings such as train driving, hospital staffs, emergency services, law enforcements, etc., using different mobile devices. 26 participants mean age 20 years completed a 25-min reaction time study using an alternative mobile version of the Psychomotor Vigilance Task (m-PVT) that was implemented on either an Apple iPhone 6s Plus or a Samsung Galaxy Tab 4. Participants attended two sessions: a morning and an afternoon session held on two consecutive days counterbalanced. It was found that the iPhone 6s Plus generated both mean speed responses (1/RTs) and mean reaction times (RTs) that were comparable to those observed in the literature while the Galaxy Tab 4 generated significantly lower 1/RTs and slower RTs than those found with the iPhone 6s Plus. Furthermore, it was also found that the iPhone 6s Plus was sensitive enough to detect lower mean speed of responses (1/RTs) and significantly slower mean reaction times (RTs) after 10-min on the m-PVT. In contrast, it was also found that the Galaxy Tab 4 generated mean number of lapses that were significant after 5-min on the m-PVT. These findings seem to indicate that the m-PVT could be used to provide an objective indicator of fatigue in staff working in applied safety critical settings such as train driving, hospital staffs, emergency services, law enforcements, etc

Cooperative secretions facilitate host range expansion in bacteria

The majority of emergent human pathogens are zoonotic in origin, that is, they can transmit to humans from other animals. Understanding the factors underlying the evolution of pathogen host range is therefore of critical importance in protecting human health. There are two main evolutionary routes to generalism: organisms can tolerate multiple environments or they can modify their environments to forms to which they are adapted. Here we use a combination of theory and a phylogenetic comparative analysis of 191 pathogenic bacterial species to show that bacteria use cooperative secretions that modify their environment to extend their host range and infect multiple host species. Our results suggest that cooperative secretions are key determinants of host range in bacteria, and that monitoring for the acquisition of secreted proteins by horizontal gene transfer can help predict emerging zoonoses

Flight controller alertness and performance during MOD shiftwork operations

Decreased alertness and performance associated with fatigue, sleep loss, and circadian disruption are issues faced by a diverse range of shiftwork operations. During STS operations, MOD personnel provide 24 hr. coverage of critical tasks. A joint JSC and ARC project was undertaken to examine these issues in flight controllers during MOD shiftwork operations. An initial operational test of procedures and measures was conducted during STS-53 in Dec. 1992. The study measures included a background questionnaire, a subjective daily logbook completed on a 24 hr. basis (to report sleep patterns, work periods, etc.), and an 8 minute performance and mood test battery administered at the beginning, middle, and end of each shift period. Seventeen Flight controllers representing the 3 Orbit shifts participated. The initial results clearly support further data collection during other STS missions to document baseline levels of alertness and performance during MOD shiftwork operations. These issues are especially pertinent for the night shift operations and the acute phase advance required for the transition of day shift personnel into the night for shuttle launch. Implementation and evaluation of the countermeasure strategies to maximize alertness and performance is planned. As STS missions extend to further extended duration orbiters, timelines and planning for 24 circadian disruption will remain highly relevant in the MOD environment

Using functional genomics to decipher the complexity of microbial pathogenicity

From the first identification of bacteria as a causative agent of disease, researchers have been developing methods and techniques to understand their pathogenic processes. For decades, this work has been limited to looking at a small number of genetically manipulatable isolates in in vitro assays or animal models of infection. Despite these limitations such work has facilitated the development of successful therapeutic strategies, most notably vaccines that target specific virulence-related features. There are however many antimicrobial resistant pathogens for which vaccination strategies have not worked, as we simply do not know enough about how they cause disease. We are however at the dawn of a new era in the study of microbial pathogenicity, where large collections of bacteria isolated directly from human infections can be sequenced and assayed to identify the bacterial features that affect disease severity in humans. Here, we describe our attempt to perform such a study focussed on the major human pathogen Staphylococcus aureus, which demonstrates the step changes such approaches can make to understanding microbial pathogenicity

Superantigens from Staphylococcus aureus induce procoagulant activity and monocyte tissue factor expression in whole blood and mononuclear cells via IL-1beta.

Background: Staphylococcus aureus is one of the most common bacteria in human sepsis, a condition in which the activation of blood coagulation plays a critical pathophysiological role. During severe sepsis and septic shock microthrombi and multiorgan dysfunction are observed as a result of bacterial interference with the host defense and coagulation systems. Objectives: In the present study, staphylococcal superantigens were tested for their ability to induce procoagulant activity and tissue factor (TF) expression in human whole blood and in peripheral blood mononuclear cells. Methods and results: Determination of clotting time showed that enterotoxin A, B and toxic shock syndrome toxin 1 from S. aureus induce procoagulant activity in whole blood and in mononuclear cells. The procoagulant activity was dependent on the expression of TF in monocytes since antibodies to TF inhibited the effect of the toxins and TF was detected on the surface of monocytes by flow cytometry. In the supernatants from staphylococcal toxin-stimulated mononuclear cells, interleukin (IL)-1beta was detected by ELISA. Furthermore, the increased procoagulant activity and TF expression in monocytes induced by the staphylococcal toxins were inhibited in the presence of IL-1 receptor antagonist, a natural inhibitor of IL-1beta. Conclusions: The present study shows that superantigens from S. aureus activate the extrinsic coagulation pathway by inducing expression of TF in monocytes, and that the expression is mainly triggered by superantigen-induced IL-1beta release

Dopaminergic Polymorphisms Associated with Time-on-Task Declines and Fatigue in the Psychomotor Vigilance Test

Prolonged demands on the attention system can cause a decay in performance over time known as the time-on-task effect. The inter-subject differences in the rate of this decline are large, and recent efforts have been made to understand the biological bases of these individual differences. In this study, we investigate the genetic correlates of the time-on-task effect, as well as its accompanying changes in subjective fatigue and mood. N = 332 subjects performed a 20-minute test of sustained attention (the Psychomotor Vigilance Test) and rated their subjective states before and after the test. We observed substantial time-on-task effects on average, and large inter-individual differences in the rate of these declines. The 10-repeat allele of the variable number of tandem repeats marker (VNTR) in the dopamine transporter gene and the Met allele of the catechol-o-methyl transferase (COMT) Val158Met polymorphism were associated with greater vulnerability to time-on-task. Separately, the exon III DRD4 48 bp VNTR of the dopamine receptor gene DRD4 was associated with subjective decreases in energy. No polymorphisms were associated with task-induced changes in mood. We posit that the dopamine transporter and COMT genes exert their effects by increasing dopaminergic tone, which may induce long-term changes in the prefrontal cortex, an important mediator of sustained attention. Thus, these alleles may affect performance particularly when sustained dopamine release is necessary