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

Absorptive transport of amino acids by the rat colon.

The capacity of the colon to absorb microbially produced amino acids (AAs) and the underlying mechanisms of AA transport are incompletely defined. We measured the profile of 16 fecal AAs along the rat ceco-colonic axis and compared unidirectional absorptive AA fluxes across mucosal tissues isolated from the rat jejunum, cecum, and proximal colon using an Ussing chamber approach, in conjunction with 1H-NMR and ultra-performance liquid chromatography-mass spectrometry chemical analyses. Passage of stool from cecum to midcolon was associated with segment-specific changes in fecal AA composition and a decrease in total AA content. Simultaneous measurement of up to 16 AA fluxes under native luminal conditions, with correction for endogenous AA release, demonstrated absorptive transfer of AAs across the cecum and proximal colon at rates comparable (30-80%) to those across the jejunum, with significant Na+-dependent and H+-stimulated components. Expression profiling of 30 major AA transporter genes by quantitative PCR revealed comparatively high levels of transcripts for 20 AA transporters in the cecum and/or colon, with the levels of 12 exceeding those in the small intestine. Our results suggest a more detailed model of major apical and basolateral AA transporters in rat colonocytes and provide evidence for a previously unappreciated transfer of AAs across the colonic epithelium that could link the prodigious metabolic capacities of the luminal microbiota, the colonocytes, and the body tissues.NEW & NOTEWORTHY This study provides evidence for a previously unappreciated transfer of microbially generated amino acids across the colonic epithelium under physiological conditions that could link the prodigious metabolic capacities of the luminal microbiota, the colonocytes, and the body tissues. The segment-specific expression of at least 20 amino acid transporter genes along the colon provides a detailed mechanistic basis for uniport, heteroexchange, Na+-cotransport, and H+-cotransport components of colonic amino acid absorption

Spinal anesthesia for cesarean delivery in a woman with neuromyelitis optica.

Neuromyelitis optica (NMO), or Devic's disease, is an idiopathic severe demyelinating disease that preferentially affects the optic nerve and spinal cord. Neuraxial anesthesia in women with multiple sclerosis is widely accepted, but reports of the use of neuraxial anesthesia in patients with NMO are scarce. We report the case of a morbidly obese primigravida undergoing a planned cesarean delivery at 32 weeks' gestation due to an acute exacerbation of NMO, managed with spinal anesthesia. Other than increased intraoperative hyperalgesia requiring inhaled nitrous oxide/oxygen, the mother experienced no apparent anesthetic-related complications

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

Staphylococcal Superantigen (TSST-1) Mutant Analysis Reveals that T Cell Activation Is Required for Biological Effects in the Rabbit Including the Cytokine Storm

Staphylococcal superantigens (sAgs), such as toxic shock syndrome toxin 1 (TSST-1), induce massive cytokine production, which may result in toxic shock syndrome (TSS) and sepsis. Recently, we reported that in vitro studies in human peripheral blood mononuclear cells (PBMC) do not reflect the immunological situation of the host, because after exposure to superantigens (sAgs) in vivo, mononuclear cells (MNC) leave the circulation and migrate to organs, e.g., the spleen, liver and lung. Our experimental model of choice is the rabbit because it is comparable to humans in its sensitivity to sAg. T cell activation has been assessed by lymphocyte proliferation and IL-2 gene expression after in vivo challenge with TSST-1 and the mutant antigens; expression of the genes of proinflammatory cytokines were taken as indicators for the inflammatory reaction after the combined treatment with TSST-1 and LPS. The question as to whether the biological activities of TSST-1, e.g., lymphocyte extravasation, toxicity and increased sensitivity to LPS, are mediated by T cell activation or activation by MHC II-only, are unresolved and results are contradictory. We have addressed this question by studying these reactions in vivo, with two TSST-1 mutants: one mutated at the MHC binding site (G31R) with reduced MHC binding with residual activity still present, and the other at the T cell binding site (H135A) with no residual function detectable. Here, we report that the mutant G31R induced all the biological effects of the wild type sAg, while the mutant with non-functional TCR binding did not retain any of the toxic effects, proving the pivotal role of T cells in this system

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

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

Laboratory Exposures to Staphylococcal Enterotoxin B

First report of symptoms after ocular exposure to staphylococcal enteroxin B in the laboratory is detailed