Structural Gender Inequality and Mental Health among Chinese Men and Women

Little is known about the association between structural gender inequality and health in patriarchal China.This study employed a sample from the Chinese Women’s Social Status,consisting of 26,139 participants aged 18 and 70 years(13,494 women and 12,645 men).Structural gender inequality was assessed at the macro-,meso-,and micro-levels.Mental health was measured by the summed scores of eight questions on depressive symptoms.Multilevel linear regression was applied for analysis.Results showed that total sex ratio at birth was associated with poorer mental health among women and men but sex ratio at birth of the second-born child predicted better mental health.Gender inequality at meso-level resulted in poorer mental health and gender inequality at micro-level was associated with poorer mental health both for men and women.Eliminating structural gender inequality promotes populations’mental health in China.

福州市男男性行为人群HIV暴露前预防需求的影响因素分析

目的通过了解男男性行为(menwhohavesexwithmen,MSM)人群的人类免疫缺陷病毒(human immunodeficiency virus,HIV)暴露前预防(pre-exposure prophylaxis,PrEP)需求及其影响因素,为开展PrEP服务提供相关依据。方法于2022年4—6月通过简单随机抽样的方法,由社会组织在浴池、酒吧、网络招募自愿参与调查的MSM者,对调查对象进行问卷调查,分析福州市MSM人群艾滋病(acquired immune deficiency syndrome,AIDS)PrEP的需求情况及其影响因素。结果福州市MSM人群对于PrEP需求度为73.34%。学历越高的MSM者HIV PrEP需求越高、未婚/离异/丧偶的MSM者HIV PrEP需求高于已婚/同居的、每次发生MSM都使用安全套的HIV PrEP需求高于有时使用和从未使用的、同性恋的MSM者HIV PrEP需求高于其他、最近一个男性性伴的AIDS检测结果为阴性HIV PrEP需求高于阳性或不清楚感染状况、未使用新型毒品的MSM者HIV PrEP需求高于有使用过新型毒品的、最近1年有进行HIV检测的MSM者HIV PrEP需求高于未检测过的(P<0.05)。多因素logistic回归分析模型分析结果显示,新型毒品的使用与被调查人的学历是福州市MSM人群PrEP需求的主要影响因素。结论加大PrEP预防效果宣传,针对学历低、已婚、无检测意识、使用过新型毒品的MSM人群开展专项教育,提高MSM人群对PrEP使用信心,充分认识PrEP对预防AIDS感染效果及其副作用。

上海市青年男男性行为人群焦虑现状及影响因素分析

目的:了解上海市青年男男性行为人群(MSM)焦虑现状,寻找影响其焦虑的主要因素,为MSM健康促进及为艾滋病防控干预提高参考。方法:于2022年6~9月在上海市徐汇区、松江区、长宁区3个地区进行匿名调查,收集有效问卷1689份,并采用多元线性回归模型分析青年男男性行为人群焦虑的主要因素。结果:上海市男男性行为人群焦虑总评分为(44.60±0.40)分,高于国内常模(29.8±10.1)分。检出焦虑症状375人(22.17%),其中,轻度焦虑146人(8.64%),中度焦虑134人(7.93%),重度焦虑95人(5.63%)(t=16.110,P<0.05);多元线性回归结果显示,年龄、配偶、月收入、性取向、固定性伴侣、是否使用过精神类药品、艾滋病防治素养、是否接受预防艾滋病服务、是否定期检测、心理压力、社会态度对焦虑状态的影响具有统计学差异(P均<0.05)。结论:相比于普通人群,上海市MSM队列焦虑水平较高,要重点关注男男性行为人群的心理健康,通过个人-家庭-社会联动,从个人行为、家庭关乎社会支持多方努力,排解MSM焦虑情绪,促进其健康发展。

Awareness, Practice and Intention to Practice Testicular Self-Examination among Professional Working Males in Ghana

Background: The aetiology of Testicular Cancer (TC) is still unknown to researchers but many of the associated risk factors have been identified. These include family history, age, racial origin, cryptorchidism, urogenital malformations, testicular atrophy, and infertility. Given the lack of scientific data on the causes of the disease, it has been asserted in previous studies that the promotion of awareness and early detection are prerequisites to mitigating risks of metastasis as well as improving survival. This study is to assess the awareness, practice, and intention to practice testicular self-examination among professional working males in Accra. Methods: A quantitative cross-sectional design with a structured research instrument was used to collect data from respondants. The purposive and convenience sampling techniques were used to collect data from 300 men at Accra in Ghana. The study was conducted at two (2) Universities and a Senior High school at Accra in Ghana. The data was then analysed using descriptive statistics, logistic regression, multiple linear regression, and structural equation modeling. Results: From the study findings, 37% of male participants rated their knowledge of testicular self-examination and related symptoms as good, 28% of participants practised testicular self-examination monthly, while 65% of respondents expressed their intention to practice monthly testicular self-examination. The findings from logistic regression demonstrated that level of education, age, and marital status of participants had a significant influence on testicular self-examination. Additionally, the multiple linear regression results revealed knowledge and self-efficacy significantly predict testicular self-examination intention. The path coefficient results from the structural equation model are consistent with results from the regression models. Conclusion: This research is the first to investigate testicular self-examination among men in Ghana. The findings revealed awareness and practice of TSE are low among participants. Therefore, the research findings would improve the expertise of physicians and nurses in providing counsel, intervention, and support for patients at risk of testicular cancer.

Thai men＇s health and sexual attitude

Men＇s health awareness, including the research and study of quality of life, sexual desires and risk factors, has increased worldwide. In Thailand, this advancement is made possible by cooperation, research and sponsorship from the local Thai community. This article aims to illustrate the sexual attitudes of Thai people, to determine the degree of erectile dysfunction （ED） and to investigate how to manage and cope with ED in a Thai community. We reviewed the relevant literature from Thai-based articles and surveys in regard to men＇s health, sexual attitudes, the prevalence of ED and common risk factors in the Thai community. The primary risk factor for ED in Thai men was age-related health decline and the presence of vascular disease. Most Thai men will seek consultation from their partner in regard to ED. The main presentation of metabolic disease in Thai patients was dyslipidemia. New selective serotonin reuptake inhibitors are not available for premature ejaculation in Thai communities. The debate in regard to malpractice compensation is an issue that should be closely monitored. There is currently a shortage of home care for the elderly in Thailand. The insights provided by the articles helped recruit the study patients and in turn, helped us gain knowledge that can be translated into improved men＇s health care in Thailand.

Profile of men＇s health in Malaysia： problems and ：hallenges

Men＇s health concerns have evolved from the traditional andrology and male sexual health to a more holistic approach that encompasses male psychological, social and physical health. The poor state of health in men compared to their female counterparts is well documented. A review of the epidemiological data from Malaysia noted a similar trend in which men die at higher rates in under 1 and above 15 years old groups and most disease categories compared to women. In Malaysia, the main causes of death in men are non-communicable diseases and injuries. Risk factors, such as risk-taking behaviour, smoking and hypertension, are prevalent and amenable to early interventions. Erectile dysfunction, premature ejaculation and prostate disorders are also prevalent. However, many of these morbidities go unreported and are not diagnosed early; therefore, opportunities for early intervention are missed. This reflects poor health knowledge and inadequate health-care utilisation among Malaysian men. Their health-seeking behaviour has been shown to be strongly influenced by family members and friends. However, more research is needed to identify men＇s unmet health-care needs and to develop optimal strategies for addressing them. Because the Malaysian population is aging and there is an increase in sedentary lifestyles, optimizing men＇s health will remain a challenge unless effective measures are implemented. The existing male-unfriendly health-care system and the negative influence of masculinity on men＇s health behaviour must be addressed. A national men＇s health policy based on a male-friendly approach to health-care delivery is urgently needed to provide a framework for addressing these challenges.

Men＇s health in South Korea

Over the last four decades, rapid industrialisation and a Westernized lifestyle have changed disease patterns in South Korea. This study was conducted to review the current state of men＇s health in South Korea. By reviewing reports of government authorities and domestic and foreign studies related to men＇s health, we found that in men ~〉 65 years of age, 28.4% considered their health status good, whereas 38.3% considered their health status poor. The prevalence of moderate-to-severe lower urinary tract symptoms was similar to that in Caucasians. The prevalence of erectile dysfunction was higher than the global average. The incidence of cryptorchidism and hypospadias showed a tendency towards increase. The prevalence of diabetes mellitus continuously increased by 10.8% in 2008 and was the fifth leading cause of death in 2008. The prevalence of obesity increased from 26.0% in 1998 to 31.7% in 2007. The prevalence of ischaemic heart disease has continuously increased, with heart diseases causing one of every 12 deaths. The prevalence of chronic obstructive pulmonary disease in 2005 was 17.2% among adults 〉~ 45 years of age. The top five prevalent cancers in men, in descending order, were cancers of the stomach, lung, liver, large bowel and prostate, among which the incidence of stomach, lung and liver cancers decreased by 0.7%, 0.6% and 2.2%, respectively, from 1999 to 2007, whereas the incidence of large bowel and prostate cancers increased by 7.0% and 13.2%, respectively. The prevalence of depression, dementia and sleep disorders was estimated as 17.3%, 4.21% and 20.2%, respectively. Together, these findings suggest that disease patterns in South Korean men are becoming Westernized.

Effectiveness of a Training Program for Improving Public Health Nurses’ Attitudes and Confidence in Dealing with Men Who Have Sex with Men

Objective: This study examined the effect of an educational intervention on public health nurses’ attitudes and confidence in dealing with men who have sex with men (MSM). In Japan, HIV is primarily transmitted through sexual contact between men, and free HIV testing and counseling are provided by public health nurses. However, because of a lack of education, public health nurses do not often recognize the existence of MSM in daily life. Thus, improving public health nurses’ understanding of MSM is crucial. Methods: This study used a quasi-experimental design to examine public health nurses’ homophobia, confidence in dealing with MSM, and low awareness of MSM in daily life at pre-test, post-test, and 1 and 3 months follow-ups. The intervention comprised a 3-hour training session conducted between November 2012 and September 2013 in the Kinki region. Results: A total of 124 public health nurses participated in the training, 117 of which were allocated to the intervention group;182 public health nurses who did not participate in the training session were allocated to a control group. Homophobia scores had significantly decreased at post-test, and remained at that low level by the follow-up at 3 months (pre-test to post-test;p = 0.00, post-test to 1 month;p = 0.83, 1 month to 3 months;p = 0.64, pre-test to 3 months;p = 0.00). Confidence in dealing with MSM and recognition of MSM had significantly increased by post-test;these were also maintained by the follow-up at 3 months (pre-test to post-test;p = 0.0, post-test to 1month;p = 0.18, 1 to 3 months;p = 0.44, pre-test to 3 months;p = 0.0). Discussion: While the three-hour training session was short, it was effective for improving attitudes toward MSM and building confidence in dealing with them.

The men’s health center:Disparities in gender specific health services among the top 50“best hospitals”in America

Objective:Gender-specific integrated health services have long existed in the arena of women’s health care,but men’s health centers(MHCs)have only recently emerged as a novel practice model.Here,we seek to evaluate the prevalence and format of MHCs found in the leading academic medical centers in the United States.Methods:The US News&World Report’s Top 50 Ranked Hospitals for Urology was used as our cohort.Data were gathered on the presence of MHCs and types of providers and conditions treated.An equivalent search was performed for women’s health centers(WHCs).Results:Sixteen of 50(32%)promoted some type of MHC,compared to 49 of 50(98%)offering a WHC.Eight of the top 15 ranked institutions(53%)had an MHC compared to eight of 35(23%)remaining programs.Six of 16 MHCs incorporated providers from a variety of medical disciplines,including urologists,internists,endocrinologists,cardiologists,and psychologists,while another six of 16 MHCs were staffed solely by urologists.Eight of 16 provided services for exclusively urologic issues,four of 16 offered additional services in treatment of other medical conditions,and four of 16 did not specify.

Exploring the Perspectives of Healthcare Providers on Providing HIV Prevention and Treatment Services for Key Populations in Rwanda: A Qualitative Study

Background: The overall HIV prevalence and incidence in Rwanda have decreased significantly in the past decade. However, opposite trends are seen among key populations (KP). The HIV prevalence among sex workers is as high as 51% and continues to rise. While the HIV prevalence among KP remains high, their adherence to treatment is low. Healthcare providers play a vital role in KP’s access and adherence to HIV treatment. This study aimed to explore the perspectives of healthcare providers on providing HIV services to key populations in Rwanda. Methods: An exploratory qualitative study was conducted with nurses, doctors, social workers, and psychologists who provide HIV services to KP in public health facilities in Rwanda. In-depth interviews were conducted using a semi-structured interview guide. All data were analyzed thematically using Dedoose. Results: Interviews were conducted with 18 healthcare providers. Three overarching themes emerged from the interviews: healthcare providers’ intrinsic feelings affect the ways they provide HIV services to key populations, key populations face a multitude of challenges related to accessing treatment and preventing the spread of HIV, and a more comprehensive and sensitive approach should be used to improve HIV services for key populations. Conclusion: Healthcare providers expressed difficulties in providing services to key populations and identified a lack of adherence to treatment and prevention guidelines, structural barriers, KP’s lack of trust in the healthcare system, and the discrimination and abuse KP face as challenges to effective HIV prevention and treatment. More comprehensive services including clinical, financial, and psychosocial support from trusted sources are needed. Some important policy changes are essential to facilitate access to HIV services for KP.

Knowledge, Health Beliefs and Screening Status of Prostate Cancer among Middle-Aged and Elderly Men

Purpose: The aim of this study was to examine and evaluate the level of prostate cancer knowledge and health beliefs among middle-aged and elderly men. Methods: In this descriptive study carried out in December 20, 2015 through January 20, 2016, we enrolled 147 men aged 50 - 70 years old. Data were collected by using three questionnairs including knowledge, health beliefs, and screening status of prostate cancer. Results: Our findings showed that only 20.4% of interviewers had experience of digital rectal examination or prostatic specific antigen test for prostate cancer screening. The prostate cancer knowledge was found to be significantly high in prostate cancer examinees compared to non-examinees. The correct answer rate of prostate cancer knowledge was only 44.7% at average. Despite of good perceived seriousness about prostate cancer, the screening rate was only 20.4% and the examinees indicated significantly high perceived sensitivity compared to non-examinees. The level of the perceived barrier was lower in men who had experience in health examination or prostate cancer examination than without experience. Conclusion: The significant factors including age, educational level, income and cancer insurance status need to be considered in nursing education program in order to deliver accurate knowledge about prostate cancer. Also, the effective interventions are necessary to increase sensitivity and reduce barriers of prostate cancer and screening.

60-69岁老年男性体力活动水平对健康体适能的影响

为了解不同水平体力活动对老年男性健康体适能的影响,采用以芜湖市200名60-69岁的老年男性为调查和测试对象,调查其体力活动水平和健康体适能状况的方法。得到以下结果:1)在200名老年男性中,高体力活动者58人(占29%),中体力活动者91人(占45.5%),低体力活动者51人(占25.5%)。2)不同年龄段老年男性的MET值存在显著差异,高龄组的MET值为2445.49±1236.13,低龄组MET值为2823.63±1261.98,高龄组显著低于低龄组(p<0.05);不同身高、体重、职业人群的MET值不存在显著差异(P>0.05)。3)不同年龄段老年男性健康体适能存在显著差异;低、高年龄组老年男性坐站起(次/30s)平均值分别为22.01次和20.40次,优于参考标准,手臂卷起(手持8磅哑铃,次/30s)平均值分别为19.79次和18.21次,稍高于参考标准;低、高年龄组老年男性原地踏步(2min)平均值分别为101.95次和98.30次,低于参考标准,闭目单足站立的平均值分别为5.54s和3.95s,稍低于参考标准。认为老年男性体力活动总体以中水平为主;体力活动总量主要受年龄影响,随年龄增长活动总量下降。老年男性低年龄组健康体适能各指标均优于高年龄组;老年男性健康体适能与参考标准比较,上、下肢肌肉力量保持较好,但耐力和平衡能力略显不足。老年男性体力活动水平对健康体适能影响显著,中、高水平体力活动可以提高上下肢肌力、上下肢柔韧、平衡能力以及有氧耐力。

2019—2021年成都市农村地区中老年男性艾滋病预防社区干预试验效果评价

目的评价基于健康信念模式的农村地区≥50岁男性人群艾滋病社区干预后1年的试验效果,以期探索出针对性艾滋病健康教育模式。方法采用整群抽样,在成都市某县级市2个乡镇随机抽取1个村,以基线调查高危性行为发生率较高的A村为干预组,在常规干预基础上,接受基于健康信念模式的面对面一对一干预;B村为对照组,仅接受常规干预。基线和终末均采用面对面访谈式问卷调查,并进行HIV抗体检测。结果两组基线基本信息、艾滋病相关知识知晓与近1年高危性行为发生情况可比。基线和终末均未检出HIV(+)者。过去1年,25.24%的干预组接受过入户面对面一对一宣传讲解。干预组获取艾滋病相关知识的多种途径和多种方式均高于对照组(P<0.05)。干预后,干预组“一个感染了艾滋病病毒的人能否从外表上看出来”(58.33%)和“蚊虫叮咬是否会传播艾滋病”(34.38%)等知识的知晓率高于对照组(41.18%和21.18%)(P<0.05)。干预后,干预组近1年“商业性行为”的发生率(1.94%)低于对照组(7.84%)(P<0.05)。结论基于健康信念模式的面对面一对一社区干预能提高农村地区中老年男性艾滋病关键知识水平,降低高危性行为发生率。

基于事业单位招聘选拔的卫生人才培养分析及建议

目的分析湖南省卫生健康委直属事业单位公开招聘人才需求,提出卫生人才培养建议。方法选取2018—2022年湖南省卫生健康委官网招聘数据,采用Excel表格对数据进行筛选和处理,采用描述性统计分析,讨论卫生事业单位人才需求特征变化。结果湖南省卫生健康委直属事业单位卫生人才需求逐年增加,其中专科医院增长率达83.22%;招聘学历要求整体上升,逐渐倾向硕士、博士研究生层次;招聘年龄要求适当放宽,基本限制35岁以下,特殊岗位或者高层次人才岗位可接受40岁以下;高层次人才比重逐渐增加。结论合理改善医学人才培养模式,培养符合现代医疗发展的适应性人才;完善医学专科培养指导意见,培养既有临床技能又具有全科公共视野的新型应用型人才;强化高层次人才培养体系和扩大人才聚集效应。

基于达标理论的跟进教育对男男性行为者HIV预防健康认知、行为特征的影响

目的 探讨基于达标理论的跟进教育对男男性行为者(MSM)关于人类免疫缺陷病毒(HIV)预防的干预效果。方法 将476名MSM随机分为试验组与对照组,分别给予常规健康教育、基于达标理论的跟进教育。采用χ^(2)检验比较HIV预防健康认知及行为特征。结果 干预3个月,试验组总体知晓改善率(28.57%)较对照组(19.75%)高(χ^(2)=5.056,P<0.05);干预结束后6个月,试验组近6个月每次肛交安全套使用、近6个月每次阴道交安全套使用、最近一次肛交安全套使用、最近一次阴道交安全套使用、从未通过交友软件寻找性伴侣、近6个月无商业性服务、近6个月未与3个以上男性伴侣发生性行为的改善率分别为57.32%、46.58%、45.12%、47.95%、32.31%、3.93%和15.28%,均高于对照组的41.03%、27.54%、32.05%、30.43%、23.32%、0.45%和6.73%,差异均有统计学意义(χ^(2)分别为8.489、5.497、5.755、4.554、4.548、4.823、8.409,P均<0.05)。结论 基于达标理论的跟进教育可有效改善MSM对HIV的预防健康认知与行为。

成都市13468名育龄男性孕前优生健康检查分析

目的:分析成都市育龄男性孕前优生健康检查结果。方法:收集2014年1月至2016年12月在成都市龙泉驿区、双流区、郫都区参加孕前优生健康检查的13 468名育龄男性的孕前健康风险暴露资料,并对其孕前健康风险的影响因素进行分析。结果:13 468名育龄男性中,孕前健康风险总检出率为73.98%,其中行为风险最高(35.66%)。不同年龄、户口类型、职业和文化程度的男性人群孕前健康风险比较差异有统计学意义(P<0.05)。结论:成都市育龄男性孕前健康风险较高,建议提高男性孕前优生健康检查参检率,加强高风险人群管理,以减少出生缺陷。

军队特勤人员心理健康与临床中医体质关系

目的研究军队特勤人员的心理健康及与中医体质之间关系。方法使用症状自评量表(SCL-90)和中医体质分类与判定自测表对129名军队特勤人员进行调查。结果中医体质与心理健康的分析表明,中医体质与心理健康存在一定的关系,心理健康8个因素与平和质的相关系数都达到了0.5以上(r>0.5,P<0.05),8个因素与阴虚质的相关系数都达到了0.5以上(r>0.5,P<0.05),9个因素与气虚质、阳虚质、痰湿质、湿热质、血瘀质、气郁质、特禀质的相关系数都达到了0.5以上(r>0.5,P<0.05)。具有10年以上特勤工作的人员和10年以下人员在心理健康的所有方面和总体上t检验差异均未达到显著水平(t=0.04～0.64,P>0.05)。结论军队特勤人员中医体质与心理健康存在一定的关系,工作年限对特勤人员的心理健康无影响。

社会支持网对农民健康的影响——基于“差序格局”的视角

利用2010年山西省农村人口发展状况调查数据,基于关系的差序格局,分析了社会支持网对农民心理和生理健康的影响。单因素分析结果表明,在实际支持、情感支持、社交支持网中,混合性关系均最有利于农民健康,情感性关系次之,最后是工具性关系。多元回归分析结果表明,在实际支持网中,与工具性关系相比,情感性关系更不利于农民健康;而在社交支持网中,与工具性关系相比,混合性关系更有利于农民健康。研究结果显示了不同类型的社会互动关系对于农民身心健康的重要性。