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RADERMACHER, HARRIET, and SUSAN FELDMAN. "‘Health is their heart, their legs, their back’: understanding ageing well in ethnically diverse older men in rural Australia." Ageing and Society 35, no. 5 (November 17, 2014): 1011–31. http://dx.doi.org/10.1017/s0144686x14001226.
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ABSTRACTOlder men from ethnic minority communities living in a regional town in Australia were identified by a government-funded peak advocacy body as failing to access local health and support services and, more broadly, being at risk of not ageing well. A qualitative study was undertaken to explore the health and wellbeing of ethnic minority men growing older in a rural community, and to identify the barriers they faced in accessing appropriate services from a range of different perspectives. Individual interviews were conducted with key informants (service providers and community leaders), followed by focus groups with older men from four ethnic minority communities. The men in this study showed signs that they were at risk of poor mental and physical health, and experienced significant barriers to accessing health and support services. Furthermore, environmental, technological, social and economic changes have brought challenges for the older men as they age. Despite these challenges, this study demonstrated how work, family and ethnic identity was integral to the lives of these older men, and was, in many ways, a resource. Key informants' perspectives mostly confirmed the experiences of the older men in this study. The discrepancies in their views about the extent of health-promoting behaviour indicate some key areas for future health intervention, services and research.
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Heine, Chyrisse, Cathy Honge Gong, Susan Feldman, and Colette Browning. "Older Women in Australia: Facing the Challenges of Dual Sensory Loss." International Journal of Environmental Research and Public Health 17, no. 1 (December 30, 2019): 263. http://dx.doi.org/10.3390/ijerph17010263.
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With the increase in longevity, the number of women living into old age is rising and higher than that of men. Data was derived from the Melbourne Longitudinal Studies on Healthy Ageing Program, which included 533 women and 467 men aged 65 years and older, in Australia, over 10 years. Logistic regression modeling was used to investigate the prevalence of dual sensory loss and the unmet needs for vision and hearing devices in older women (compared to men) over time, as well as its impacts on self-reported general health, depression, perceived social activities, community service use and ageing in place. Results suggested that the prevalence of dual sensory loss increased for women from the age of 75 years and over. Dual sensory loss was higher for older women and men who were living alone, with government benefits as their main income source or were divorced, separated or widowed. Dual sensory loss had significant impacts on poor general health, perceived inadequate social activities and community service use for women and men and on depression for women only. Early identification of dual sensory loss is essential to minimize its effects, ensuring continued well-being for this population.
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Ramanathan, Vijayasarathi, Gomathi Sitharthan, Karen Pepper, and Kevan Wylie. "Sexual health of Indian immigrant men in Australia: an exploratory research on help-seeking attitudes." Sexual Health 10, no. 4 (2013): 380. http://dx.doi.org/10.1071/sh12199.
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The help-seeking attitudes for sexual health of Indian men living in Australia was explored. Of all survey respondents (n = 225), many preferred to seek help from medical doctors. Young (18–25 years) Indian men were three times more likely to prefer a specialist medical doctor than older men. Ethnicity and gender of the medical doctor was ‘not important’ for the majority of men. Most men preferred to seek help from their regular general practitioner.
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Le Couteur, David G., Fiona Stanaway, Louise M. Waite, John Cullen, Richard I. Lindley, Fiona M. Blyth, Vasi Naganathan, Robert G. Cumming, and David J. Handelsman. "Apolipoprotein E and Health in Older Men: The Concord Health and Ageing in Men Project." Journals of Gerontology: Series A 75, no. 10 (April 28, 2020): 1858–62. http://dx.doi.org/10.1093/gerona/glaa105.
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Abstract APOE genotype has been associated with various age-related outcomes including Alzheimer’s disease, frailty, and mortality. In this study, the relationship between health, particularly cognitive function, and APOE was investigated in older men from the Concord Health and Ageing in Men Project (n = 1,616; age 76.9 ± 5.5 years [range 70–97 years]; Australia). Baseline characteristics and survival up to 12 years were determined. Frailty was measured using Cardiovascular Health study (CHS) criteria and Rockwood frailty index, and cognition using Mini-Mental State Examination (MMSE) and Addenbrookes Cognitive Examination. APOE ε4 was less common in the oldest men and those born in Mediterranean countries. APOE ε2 was beneficially associated with cholesterol, creatinine, gamma-glutamyl transaminase, glucose, and HDL cholesterol while APOE ε4 was adversely associated with cholesterol and albumin. APOE ε4 was associated with a clinical diagnosis of Alzheimer’s disease when adjusted for age and region of birth (ε4 homozygotes Odds ratio (OR) 7.0; ε4 heterozygotes OR 2.4, p < .05), and APOE ε2 had a small positive association with cognition. On multivariate regression, overall cognitive function in the entire cohort was associated with age, country of birth, education, and frailty (all p < .001). APOE was not associated with frailty or survival. In conclusion, age and region of birth influenced distribution of APOE genotype in older men. Although APOE ε4 was associated with Alzheimer’s disease, overall cognitive function in the cohort was associated more strongly with frailty than APOE genotype.
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Stanaway, Fiona F., Fiona M. Blyth, Vasi Naganathan, David G. Le Couteur, Rosilene Ribeiro, Vasant Hirani, Louise M. Waite, David J. Handelsman, Markus J. Seibel, and Robert G. Cumming. "Mortality Paradox of Older Italian-Born Men in Australia: The Concord Health and Ageing in Men Project." Journal of Immigrant and Minority Health 22, no. 1 (March 6, 2019): 102–9. http://dx.doi.org/10.1007/s10903-019-00874-w.
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Hatanaka, Yukiko, Junichi Furuya, Yuji Sato, Yoshiki Uchida, Toshiharu Shichita, Noboru Kitagawa, and Tokiko Osawa. "Associations between Oral Hypofunction Tests, Age, and Sex." International Journal of Environmental Research and Public Health 18, no. 19 (September 29, 2021): 10256. http://dx.doi.org/10.3390/ijerph181910256.
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Oral function declines in older individuals due to disease and age-related changes, making them vulnerable to oral and physical frailty. Therefore, it is important to manage the decline in oral function in older outpatients. Oral hypofunction is diagnosed by seven tests related to oral function, oral hygiene, oral moisture, occlusal force, oral diadochokinesis, tongue pressure, masticatory function, and swallowing function. However, sex or age were not factored into the current reference values of these tests. We included subjects attending the dental hospital clinic for maintenance, and recorded and analyzed oral hypofunction and the factors associated with its diagnosis. Of the 134 outpatients (53 males and 81 females, mean age 75.2 ± 11.2 years), 63% were diagnosed with oral hypofunction. Oral hypofunction prevalence increased significantly with age, and significant variations were observed in all tests. Furthermore, oral hygiene and swallowing function were not associated with oral hypofunction diagnosis. All examined factors decreased with increasing age, even after adjusting sex, except for oral hygiene and moisture. Occlusal force and masticatory function were higher in men after adjusting age. This study suggested that older outpatients were likely to be diagnosed with oral hypofunction, and that the test reference value and their selection for oral hypofunction should be reconsidered.
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Khaw, Carole, Bin Li, and Russell Waddell. "Sexually transmissible infections and characteristics of men aged 60 years and over attending a public sexually transmitted diseases (STD) clinic in South Australia." Sexual Health 12, no. 5 (2015): 460. http://dx.doi.org/10.1071/sh15016.
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Background With society ageing, sexually transmissible infections (STIs) in the older population are of interest from an economic, health-related and social burden perspective. Few studies on STIs in men older than 60 years of age exist. Methods: A retrospective study was performed looking at characteristics of, and STIs in, 29 106 men (of which 689 were older than 60 years of age), at first presentation, visiting the only South Australian public sexually transmitted diseases (STD) clinic over a 13-year period. Results: Older men [men who have sex with men (MSM) and men who have sex with women (MSW)] were less likely than younger men to have been tested for HIV. Conclusion: There is a need for increased HIV testing in older men.
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Quine, S. "Health promotion for socially disadvantaged groups: the case of homeless older men in Australia." Health Promotion International 19, no. 2 (June 1, 2004): 157–65. http://dx.doi.org/10.1093/heapro/dah203.
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Raskiliene, Asta, Vilma Kriaucioniene, Jolanta Siudikiene, and Janina Petkeviciene. "Self-Reported Oral Health, Oral Hygiene and Associated Factors in Lithuanian Adult Population, 1994–2014." International Journal of Environmental Research and Public Health 17, no. 15 (July 24, 2020): 5331. http://dx.doi.org/10.3390/ijerph17155331.
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This study aimed to examine 20-year trends (1994–2014) in self-reported oral health and oral hygiene and to assess the associated factors in a Lithuanian population aged 20–64 years. Nationally representative cross-sectional data on 8612 men and 11,719 women were obtained from 11 biennial postal surveys of Lithuanian health behavior monitoring. Dentate status was assessed by asking about the number of missing teeth. Over the study period, the proportion of men with all teeth increased from 17.5% to 23.0% and the same proportion increased in women—from 12.5% to 19.6%. The prevalence of edentulousness was 2.8% in 2014. The proportion of individuals brushing teeth at least twice a day increased from 14.6% to 31.9% in men and from 33.0% to 58.8% in women. Multivariate logistic regression analysis revealed that older age, lower education, living in rural areas, daily smoking, confectionary consumption (only in women), obesity, no visits to a dentist during the past year, toothache and brushing teeth less than twice a day increased the odds of missing six or more teeth. Efforts should be made to promote good oral hygiene habits, prevent and control behavioral risk factors and increase access to dental care among risk groups.
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Oberoi, Devesh V., Moyez Jiwa, Alexandra McManus, and Richard Parsons. "Do Men Know Which Lower Bowel Symptoms Warrant Medical Attention? A Web-Based Video Vignette Survey of Men in Western Australia." American Journal of Men's Health 10, no. 6 (July 8, 2016): 474–86. http://dx.doi.org/10.1177/1557988315574739.
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The current study aims to explor how men would advise other men about seeking help for lower bowel symptoms and also to determine the factors that may influence help seeking. A purposive sample of Western Australian men aged 18 years and older was recruited for the study. Participants completed 8 of the 28 randomly assigned video vignettes (video clips) displaying men (older or younger) with various combinations of one or more lower bowel symptoms. Participants were asked if the person in the vignette should seek health advice. Subsequently, the participants answered a set of questions based on the Health Belief Model. A total of 408 participants (response rate = 51%) answered 3,264 vignettes. Participants younger than 50 years, participants who were not tertiary educated and those who had lower incomes, or those living in regional or remote areas were less likely to advise help seeking from general practitioner (GP). Participants who visited their general practitioner less frequently were also less likely to advisehelp seeking. There was a trend to consider unintentional weight loss and diarrhea as minor symptoms not necessitating medical attention compared with rectal bleeding. The findings suggest for a need to improve public awareness among men about the need to seek timely medical advice for lower bowel symptoms in primary care. The importance of early presentation of persistent lower bowel symptoms must be specifically targeted at men younger than 50 years, those with lower incomes, or residing in regional or remote areas.
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Yeap, Bu B., Helman Alfonso, S. A. Paul Chubb, David J. Handelsman, Graeme J. Hankey, Paul E. Norman, and Leon Flicker. "Reference Ranges and Determinants of Testosterone, Dihydrotestosterone, and Estradiol Levels Measured using Liquid Chromatography-Tandem Mass Spectrometry in a Population-Based Cohort of Older Men." Journal of Clinical Endocrinology & Metabolism 97, no. 11 (November 1, 2012): 4030–39. http://dx.doi.org/10.1210/jc.2012-2265.
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Context: Testosterone (T) levels decline with increasing age. Controversy exists over the threshold for classifying T as low vs. normal in older men. The relevance of assessing dihydrotestosterone (DHT) and estradiol (E2) remains unclear. Objective: We assessed the associations of T, DHT, and E2 in men aged 70 yr or older and established reference ranges for these in healthy older men. Participants: Community-dwelling men aged 70–89 yr residing in Perth, Western Australia, Australia, participated in the study. Main Outcome Measures: Plasma T, DHT, and E2 were assayed using liquid chromatography-tandem mass spectrometry in early morning samples from 3690 men. Results: Increasing age, higher body mass index and waist to hip ratio, dyslipidemia, diabetes, and higher LH were independently associated with lower levels of T and DHT. Increasing age, diabetes, and higher LH were associated with lower E2. In a reference group of 394 men aged 76.1 ± 3.2 yr reporting excellent or very good health with no history of smoking, diabetes, cardiovascular disease, cancer, depression, or dementia, the 2.5th percentile for T was 6.4 nmol/liter (184 ng/dl); DHT, 0.49 nmol/liter; and E2, 28 pmol/liter. Applying these cutoffs to all 3690 men, those with low T or DHT had an increased odds ratio for frailty, diabetes, and cardiovascular disease. Men with both low T and DHT had a higher odds ratio for these outcomes. Conclusions: The 2.5th percentile in a reference group of healthy older men provides age-appropriate thresholds for defining low T, DHT, and E2. Additional studies are needed to test their potential applicability and clinical utility in older men.
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Waern, Rosilene V. R., Robert G. Cumming, Fiona Blyth, Vasi Naganathan, Margaret Allman-Farinelli, David Le Couteur, Stephen J. Simpson, Hal Kendig, and Vasant Hirani. "Adequacy of nutritional intake among older men living in Sydney, Australia: findings from the Concord Health and Ageing in Men Project (CHAMP)." British Journal of Nutrition 114, no. 5 (August 12, 2015): 812–21. http://dx.doi.org/10.1017/s0007114515002421.
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AbstractPrevious research shows that older men tend to have lower nutritional intakes and higher risk of under-nutrition compared with younger men. The objectives of this study were to describe energy and nutrient intakes, assess nutritional risk and investigate factors associated with poor intake of energy and key nutrients in community-dwelling men aged ≥75 years participating in the Concord Health and Ageing in Men Project – a longitudinal cohort study on older men in Sydney, Australia. A total of 794 men (mean age 81·4 years) had a detailed diet history interview, which was carried out by a dietitian. Dietary adequacy was assessed by comparing median intakes with nutrient reference values (NRV): estimated average requirement, adequate intake or upper level of intake. Attainment of NRV of total energy and key nutrients in older age (protein, Fe, Zn, riboflavin, Ca and vitamin D) was incorporated into a ‘key nutrients’ variable dichotomised as ‘good’ (≥5) or ‘poor’ (≤4). Using logistic regression modelling, we examined associations between key nutrients with factors known to affect food intake. Median energy intake was 8728 kJ (P5=5762 kJ, P95=12 303 kJ), and mean BMI was 27·7 (sd 4·0) kg/m2. Men met their NRV for most nutrients. However, only 1 % of men met their NRV for vitamin D, only 19 % for Ca, only 30 % for K and only 33 % for dietary fibre. Multivariate logistic regression analysis showed that only country of birth was significantly associated with poor nutritional intake. Dietary intakes were adequate for most nutrients; however, only half of the participants met the NRV of ≥5 key nutrients.
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Bentley, Michael. "A Primary Health Care Approach to Men's Health in Community Health Settings: It's Just Better Practice." Australian Journal of Primary Health 12, no. 1 (2006): 21. http://dx.doi.org/10.1071/py06004.
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Promoting men's health in primary care settings such as general practice is now common, but what might primary health care for men's health look like in community health settings? This paper reports on case studies of diverse community-based health and wellbeing services for men in South Australia. The programs selected as case studies include Aboriginal men, gay men and homosexually active men, men from culturally and linguistically diverse backgrounds, older men, middle-aged men, fathers, young men, as well as services that focus on childhood sexual abuse and violence intervention. The case studies share the following main features - they have a social view of health, use a primary health care approach with an emphasis on prevention, address issues of access and equity, use social justice principles, and work across a number of sectors. These features were integrated into a socially just primary health care framework for men's health in community health settings. Socially just primary health care can address health inequities within men's health that are related to, among other things, class, race, ethnicity and sexuality. Socially just primary health care services can work collaboratively with women's health on common concerns such as violence intervention and childhood sexual abuse. Moreover, socially just primary health care services reflect local concerns, where health professionals work with men rather than acting as outside experts.
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Prina, A. Matthew, Martijn Huisman, Bu B. Yeap, Graeme J. Hankey, Leon Flicker, Carol Brayne, and Osvaldo P. Almeida. "Hospital costs associated with depression in a cohort of older men living in Western Australia." General Hospital Psychiatry 36, no. 1 (January 2014): 33–37. http://dx.doi.org/10.1016/j.genhosppsych.2013.08.009.
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Jackson, Caroline A., Cathie L. M. Sudlow, and Gita D. Mishra. "Education, sex and risk of stroke: a prospective cohort study in New South Wales, Australia." BMJ Open 8, no. 9 (September 2018): e024070. http://dx.doi.org/10.1136/bmjopen-2018-024070.
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ObjectiveTo determine whether the association between highest educational attainment and stroke differed by sex and age; and whether potential mediators of observed associations differ by sex.DesignProspective cohort study.SettingPopulation based, New South Wales, Australia.Participants253 657 stroke-free participants from the New South Wales 45 and Up Study.Outcome measuresFirst-ever stroke events, identified through linkage to hospital and mortality records.ResultsDuring mean follow-up of 4.7 years, 2031 and 1528 strokes occurred among men and women, respectively. Age-standardised stroke rate was inversely associated with education level, with the absolute risk difference between the lowest and highest education group greater among women than men. In relative terms, stroke risk was slightly more pronounced in women than men when comparing low versus high education (age-adjusted HRs: 1.41, 95% CI 1.16 to 1.71 and 1.25, 95% CI 1.07 to 1.46, respectively), but there was no clear evidence of statistical interaction. This association persisted into older age, but attenuated. Much of the increased stroke risk was explained by modifiable lifestyle factors, in both men and women.ConclusionLow education is associated with increased stroke risk in men and women, and may be marginally steeper in women than men. This disadvantage attenuates but persists into older age, particularly for women. Modifiable risk factors account for much of the excess risk from low education level. Public health policy and governmental decision-making should reflect the importance of education, for both men and women, for positive health throughout the life course.
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King, Kylie, Briony Dow, Louise Keogh, Peter Feldman, Allison Milner, David Pierce, Richard Chenhall, and Marisa Schlichthorst. "“Is Life Worth Living?”: The Role of Masculinity in the Way Men Aged Over 80 Talk About Living, Dying, and Suicide." American Journal of Men's Health 14, no. 5 (September 2020): 155798832096654. http://dx.doi.org/10.1177/1557988320966540.
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Men aged 85 years and over have the highest rate of suicide of any age or gender group in Australia. However, little is known about their trajectory toward suicide. The objective of this study was to understand the role of masculine norms and other life factors in the suicidality of older men. Thirty-three men aged 80 years or more took part in a semistructured focus group or interview, and/or completed a survey. Participants were asked about the issues facing older men, well-being and aging, physical health challenges, social support, mental health and help-seeking, and suicide and suicide prevention. Five themes emerged: “finding out we’re not invincible,” “active and tough,” “strong silent types,” “decision makers,” and “right to die.” Participants spoke about masculine norms that had influenced their lives as providers and decision makers, and now influenced how they coped with aging and their journey toward death. For some participants, suicide was seen to be a rational alternative to dependence in their final years. Suicide prevention should adopt a gendered approach and be cognizant of the influence of gender roles and masculinity in older men’s lives. Further research and prevention efforts should be mindful of the impact of masculine norms of self-reliance and control on an older man’s decision to end his life. Suicide prevention efforts should work to reduce stigma around the challenges of aging, maximize opportunities for control, facilitate social connection, and improve residential aged care.
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Charleson, Finley J., Christopher K. Fairley, Jane S. Hocking, Lenka A. Vodstrcil, Catriona S. Bradshaw, and Eric P. F. Chow. "Age, ethnic and travel-related disparities in kissing and sexual practices among heterosexual men in Melbourne, Australia." Sexual Health 17, no. 3 (2020): 279. http://dx.doi.org/10.1071/sh19230.
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Background The kissing practices of heterosexual men are not well understood, despite the potential of kissing to be a significant risk factor for gonorrhoea transmission. This study aimed to explore kissing and sex practices among heterosexual men. Methods: A cross-sectional survey among heterosexual men attending the Melbourne Sexual Health Centre in 2016–2017 was conducted. Men were asked to report their number of kissing-only (in the absence of sex), sex-only (in the absence of kissing) and kissing-with-sex partners in the last 3 months. The mean number of each partner type was calculated, and multivariable negative binomial regression was used to investigate associations between the number of different types of partners and demographic characteristics. Results: Of the 2351 heterosexual men, men reported a mean of 2.98 kissing-only, 0.54 sex-only and 2.64 kissing-with-sex partners in the last 3 months. Younger men had a mean higher number of kissing-only partners than older men (4.52 partners among men aged ≤24 years compared with 1.75 partners among men ≥35 years, P < 0.001). Men born in Europe had the most kissing-only partners (mean: 5.16 partners) and men born in Asia had the fewest kissing-only partners (mean: 1.61 partners). Men recently arrived in Australia, including travellers from overseas, had significantly more kissing-only partners (adjusted incidence rate ratio (aIRR): 1.53; 95% CI: 1.31–1.80) than local men. Conclusions: This study provides novel data about kissing practices of heterosexual men. Studies assessing oropharyngeal gonorrhoea should include measurements of kissing until studies can clarify its contribution to transmission risk.
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Lester, David, Priscilla Wood, Christopher Williams, and Janet Haines. "Motives for Suicide—A Study of Australian Suicide Notes." Crisis 25, no. 1 (January 2004): 33–34. http://dx.doi.org/10.1027/0227-5910.25.1.33.
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Summary: Analysis of a large sample of suicide notes from 262 suicides in Australia found that men less often had escape from pain as a motive for their suicides and more often had love/romantic problems. The suicides of older persons were more often motivated by escape from pain and less often had love/romantic problems.
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Moreira, Edson D., Dale B. Glasser, Rosie King, Fernanda Gross Duarte, Clive Gingell, and for the GSSAB Investigators' Group. "Sexual difficulties and help-seeking among mature adults in Australia: results from the Global Study of Sexual Attitudes and Behaviours." Sexual Health 5, no. 3 (2008): 227. http://dx.doi.org/10.1071/sh07055.
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Background: The Global Study of Sexual Attitudes and Behaviours was a survey of 27 500 men and women in 29 countries. Here we report the sexual activity, the prevalence of sexual difficulties and related help-seeking behaviour among participants in Australia. Methods: A telephone survey was conducted in Australia in 2001–2002, with interviews based on a standardised questionnaire. A total of 1500 individuals (750 men and 750 women) aged 40 to 80 years completed the survey. The questionnaire covered demographic information, overall health, and sexual behaviours, attitudes and beliefs. Results: Overall, 83% of men and 74% of women had engaged in sexual intercourse during the 12 months preceding the interview, and 38% of all men and 29% of all women engaged in sexual intercourse more than once a week. Early ejaculation (23%), erectile difficulties (21%) and a lack of sexual interest (18%) were the most common male sexual difficulties. The most frequently reported female sexual difficulties were: lack of sexual interest (33%), lubrication difficulties (26%) and an inability to reach orgasm (25%). Older age was a significant predictor of male erectile difficulties and of lubrication difficulties in women. Only a minority of men and women had sought help for their sexual difficulty(ies) from a health professional. Conclusions: Many middle-aged and older adults in Australia report continued sexual interest and sexual activity. Several sexual difficulties are highly prevalent in this population, but those experiencing these difficulties rarely seek medical help. This may be because they do not perceive such difficulties as serious or sufficiently upsetting.
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Malakouti, S. K., M. Foroughan, M. Nojomi, and M. Ghalebandi. "Sleep Pattern, Sleep Disturbances and Sleepiness in the Retired Iranian Elderly." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)71461-0.
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Complaints of sleep disturbance increase with age and many studies have been reported on the relation of sleep problems with greater use of health services, physical and mental morbidity, functional decline and all cause mortality. This study aimed to examine the sleep patterns and sleep disturbances in Iranian older people and to see how their sleep quality relates to their health status. 400 men and women, 60 years or older, interviewed by trained psychiatrist regarding their physical and mental health status, then the Pittsburg Sleep Quality Index, the Epworth Sleepiness Scale, and General Health Questionnaire implemented on them. The gathered data analyzed by chi-square test, t-test, one-way analysis of variance and logistic regression. The results showed that the majority of participants (82.6%) suffered from poor sleep quality and approximately one third had sleepiness (29.2%) during daytime. Difficulty falling (p≤0.001) and maintaining (p≤0.01) sleep and feeling too hot at night sleep (p≤0.005) were significantly more prevalent in women, but men suffered more from leg twitching (p≤0.01). Being female (OR=2.52), and having GHQ scores more than 11 (OR=4.14) increased the risk of poor sleep quality considerably. Promoting sleep hygiene education and screening of mental health problems in primary health care services for older people are recommended.
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Stanaway, Fiona F., Robert G. Cumming, Vasi Naganathan, Fiona M. Blyth, Helen M. Creasey, Louise M. Waite, David J. Handelsman, and Markus J. Seibel. "Depressive symptoms in older male Italian immigrants in Australia: the Concord Health and Ageing in Men Project." Medical Journal of Australia 192, no. 3 (February 2010): 158–62. http://dx.doi.org/10.5694/j.1326-5377.2010.tb03456.x.
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Holden, Carol A., Robert I. McLachlan, Marian Pitts, Robert Cumming, Gary Wittert, Paul A. Agius, David J. Handelsman, and David M. de Kretser. "Men in Australia Telephone Survey (MATeS): a national survey of the reproductive health and concerns of middle-aged and older Australian men." Lancet 366, no. 9481 (July 2005): 218–24. http://dx.doi.org/10.1016/s0140-6736(05)66911-5.
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Ribeiro, Rosilene V., Vasant Hirani, Alistair M. Senior, Alison K. Gosby, Robert G. Cumming, Fiona M. Blyth, Vasi Naganathan, et al. "Diet quality and its implications on the cardio-metabolic, physical and general health of older men: the Concord Health and Ageing in Men Project (CHAMP)." British Journal of Nutrition 118, no. 2 (July 28, 2017): 130–43. http://dx.doi.org/10.1017/s0007114517001738.
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AbstractThe revised Dietary Guideline Index (DGI-2013) scores individuals’ diets according to their compliance with the Australian Dietary Guideline (ADG). This cross-sectional study assesses the diet quality of 794 community-dwelling men aged 74 years and older, living in Sydney, Australia participating in the Concord Health and Ageing in Men Project; it also examines sociodemographic and lifestyle factors associated with DGI-2013 scores; it studies associations between DGI-2103 scores and the following measures: homoeostasis model assessment – insulin resistance, LDL-cholesterol, HDL-cholesterol, TAG, blood pressure, waist:hip ratio, BMI, number of co-morbidities and medications and frailty status while also accounting for the effect of ethnicity in these relationships. Median DGI-2013 score was 93·7 (54·4, 121·2); most individuals failed to meet recommendations for vegetables, dairy products and alternatives, added sugar, unsaturated fat and SFA, fluid and discretionary foods. Lower education, income, physical activity levels and smoking were associated with low scores. After adjustments for confounders, high DGI-2013 scores were associated with lower HDL-cholesterol, lower waist:hip ratios and lower probability of being frail. Proxies of good health (fewer co-morbidities and medications) were not associated with better compliance to the ADG. However, in participants with a Mediterranean background, low DGI-2013 scores were not generally associated with poorer health. Older men demonstrated poor diet quality as assessed by the DGI-2013, and the association between dietary guidelines and health measures and indices may be influenced by ethnic background.
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Vodstrcil, Lenka A., Christopher K. Fairley, Deborah A. Williamson, Catriona S. Bradshaw, Marcus Y. Chen, and Eric P. F. Chow. "Immunity to hepatitis A among men who have sex with men attending a large sexual health clinic in Melbourne, Australia, 2012–2018." Sexually Transmitted Infections 96, no. 4 (March 13, 2020): 265–70. http://dx.doi.org/10.1136/sextrans-2019-054327.
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BackgroundOutbreaks of hepatitis A are being reported more commonly among men who have sex with men (MSM) globally. Australia has also reported a sharp increase in the number of cases of hepatitis A in 2017. This study aimed to determine the level of immunity to hepatitis A among MSM attending a large urban sexual health clinic in Victoria in the lead up to recent outbreak.MethodsThis was a retrospective audit of serological testing data from first-time MSM attendees at Melbourne Sexual Health Centre (MSHC) in Australia from 1 January 2012 to 31 December 2018. We determined the proportion of MSM who were tested and who had serological detection of hepatitis A IgG, stratified by age and calendar year. We used univariable and multivariable logistic regression to investigate factors associated with testing for and detection of hepatitis A IgG.ResultsThere were 16 609 first-time MSM attendees at MSHC over the 7-year period, of which 9718 (59%, 95% CI 58% to 60%) were tested for hepatitis A IgG. There was a 2% annual increase in the proportion of men tested (from 60% in 2012 to 69% in 2018; OR=1.02, 95% CI 1.00 to 1.03, p=0.025). Men born outside of Australia/New Zealand, and younger men <30 years had higher odds of being tested. Of those tested, 44% (n=4304, 95% CI 43% to 45%) had hepatitis A IgG detected at their first visit, with no change over time (OR=1.01, 95% CI 0.99 to 1.03, p=0.210). Detection of hepatitis A IgG was associated with being aged 30 years or older (adjusted OR=2.06, 95% CI 1.89 to 2.24, p<0.001) or being born overseas versus Australia/New Zealand (AOR=1.21, 95% CI 1.11 to 1.31, p<0.001).ConclusionHepatitis A immunity among MSM remains below the estimated 70% required to prevent outbreaks. Measures including increased testing and higher vaccination coverage are needed to prevent outbreaks and to limit the number of cases and deaths.
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Wong, Arthur, Garrett P. Prestage, I. Mary Poynten, Fengyi Jin, Richard J. Hillman, Carmella Law, Christopher K. Fairley, Suzanne M. Garland, Andrew E. Grulich, and David J. Templeton. "Effect of age on the association between recreational drug use and sexual risk behaviour: a cross-sectional observational analysis." Sexual Health 17, no. 6 (2020): 538. http://dx.doi.org/10.1071/sh20115.
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Recreational drug use (RDU) among gay and bisexual men (GBM) is associated with higher-risk sexual behaviours, however this has not been well defined among older GBM. We investigated the association between RDU and sexual behaviours among older GBM in Sydney, Australia. 617 GBM aged 35–79 years self-reported their RDU in the past 6 months and sexual behaviours. Age-stratified univariable associations between RDU and behaviour were examined. GBM aged 35–44 years were the most likely to report RDU, with rates decreasing with increasing age (Ptrend < 0.001). Associations between RDU and higher-risk sexual behaviours were most consistently found among GBM aged 35–54 years.
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Liu, Xiaoying, Bu B. Yeap, Kaye E. Brock, Itamar Levinger, Jonathan Golledge, Leon Flicker, and Tara C. Brennan-Speranza. "Associations of Osteocalcin Forms With Metabolic Syndrome and Its Individual Components in Older Men: The Health In Men Study." Journal of Clinical Endocrinology & Metabolism 106, no. 9 (May 18, 2021): e3506-e3518. http://dx.doi.org/10.1210/clinem/dgab358.
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Abstract Context The osteoblast-derived polypeptide, osteocalcin (OC), has been associated with lower risk of type 2 diabetes and metabolic syndrome (MetS) in several epidemiological studies. Animal studies have indicated the undercarboxylated form of OC (ucOC) drives its association with metabolic outcomes. Objective We compared associations of ucOC and carboxylated OC (cOC) with MetS and its components in older men. Methods A cross-sectional analysis of 2575 men aged ≥70 years and older resident in Perth, Western Australia. ucOC was assayed using a hydroxyapatite-binding method, and cOC calculated by subtracting ucOC from total OC. Main outcome measures were MetS and its components. Results Both lower serum ucOC and cOC levels, and the proportion of cOC (%cOC) were associated with less favorable metabolic parameters (higher waist circumference, triglyceride, glucose, blood pressure, and lower high-density lipoprotein cholesterol), whereas inverse associations were found with %ucOC. Men in the lowest quintile of ucOC had higher risk of MetS compared to men in the highest quintile (Q1 ≤ 7.7 vs Q5 > 13.8 ng/mL; OR = 2.4; 95% CI, 1.8-3.2). Men in the lowest quintile of cOC had higher risk of MetS compared to those in the highest quintile (≤ 5.8 vs > 13.0 ng/mL; OR = 2.4; 95% CI, 1.8-3.2). Conclusion Lower concentrations of serum ucOC or cOC were associated with less favorable metabolic parameters and a higher risk of MetS. In contrast, a lower proportion of ucOC was associated with better metabolic parameters and lower MetS risk. Further research is warranted to determine whether ucOC and cOC are suitable biomarkers for cardiometabolic risk in men.
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Misan, Gary, Bronwyn Joan Ellis, Olivia M. Hutchings, Amy K. Beech, Courtney Moyle, and Nicola J. Thiele. "Teaching Old Dogs New Tricks: Health Promotion Through Intergenerational Learning in a Regional Men's Shed." Australian and International Journal of Rural Education 28, no. 1 (August 20, 2017): 3–16. http://dx.doi.org/10.47381/aijre.v28i1.110.
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Intergenerational learning activities benefit both older and younger participants. The Whyalla Men's Shed (WMS) not only meets many of the needs of its older participants but has recently become involved in several initiatives that foster intergenerational collaboration and learning. An agreement between the University of South Australia (UniSA) and the WMS has resulted in the WMS hosting several projects led by senior Occupational Therapy (OT) students aimed at improving health literacy and promoting healthy lifestyle choices in older men. WMS placements undertaken by the OT students have enabled the students to better understand the enablers and barriers to healthy lifestyle choices in this target group and how to adapt classroom-based knowledge to best engage a disparate group of older men. Initiatives have included informal 'teaching sessions' focusing on improving dietary knowledge and skills, and on physical activity and exercise, augmented by informal cooking and exercise sessions suited to the attitudes, skills and abilities of the shed members. Students reported changes in the men's knowledge, attitude, and behaviours and activities that demonstrated active engagement with the concepts promoted. The student experience was enhanced by working on small projects allowing them to develop basic woodworking and construction skills. Shed members reported enjoying the opportunity to share life stories, skills, and experience while 'learning by doing'. It is to be hoped that such intergenerational engagements will continue to provide enrichment for both younger and older learners, building mutual respect and enhancing the self-esteem of all concerned.
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FERSON, M. J., L. C. YOUNG, and M.-L. STOKES. "Changing epidemiology of hepatitis A in the 1990s in Sydney, Australia." Epidemiology and Infection 121, no. 3 (December 1998): 631–36. http://dx.doi.org/10.1017/s0950268898001563.
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Surveillance of hepatitis A in residents of Eastern Sydney Health Area identified substantial epidemics in homosexual males in 1991–2 with a peak rate of 520 per 100000 recorded in males aged 25–29 years, and again in 1995–6, with a peak rate of 405 per 100000 per year in males aged 30–34 years. During 1994–5 an epidemic was detected among disadvantaged youth associated with injecting drug use; peak rates of 200 per 100000 per year were reported in males aged 25–29 years and of 64 per 100000 per year among females aged 20–24 years. The epidemiology of hepatitis A in these inner suburbs of Sydney is characterized by very few childhood cases and recurrent epidemics among homosexual men. Identified risk groups need to be targeted with appropriate messages regarding the importance of hygiene and vaccination in preventing hepatitis A. However, poor access to health services among disadvantaged youth and a constant influx of young homosexual males into these inner suburbs present major challenges to hepatitis A control.
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Bassett, Kimberley, Judith Gullifer, and Ramon L. Varcoe. "Accepting, active and in control: older women's experiences of ageing with peripheral arterial disease." Ageing and Society 39, no. 12 (July 16, 2018): 2605–30. http://dx.doi.org/10.1017/s0144686x1800065x.
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AbstractThe population of Australia is ageing, with women being the primary beneficiaries of this increase in longevity. Increasingly older individuals are being diagnosed with different chronic illnesses such as peripheral arterial disease (PAD) which causes blockages of the blood vessels in the legs resulting in pain, non-healing ulcers, immobility and the potential amputation of the threatened limb. PAD has been traditionally thought to affect men more than women. Resultingly, women have been under-represented in clinical trials of PAD and under-diagnosed in the health-care setting. However, it has recently been acknowledged that women are indeedmorelikely to suffer from PAD than men due to increased presence of disease and survival advantage. As such, very little is known about women's understanding of and the meaning they create of their experiences of PAD. Therefore, how older women with PAD experience the ageing process is the focus of this qualitative research project. Interviews were conducted with 11 women from Sydney, Australia aged over 65 years who had been diagnosed with PAD. The interviews were analysed using an inductive thematic analysis. Three manifest themes were constructed: independence and control, active and involved, and the acceptance of ageing. These findings emphasised the idea that despite the presence of a chronic illness and increased age, remaining independent and engaged with life was vital to these women's wellbeing. Their subjective experiences of ageing reflect the fact that by adapting to the physical, mental and social changes that come with growing older, the focus does not need to be on loss and decline but rather can be about the continuation of life that can be both positive and meaningful.
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Laver, Kate, Emmanuel Gnanamanickam, Craig Whitehead, Susan Kurrle, Megan Corlis, Julie Ratcliffe, Wendy Shulver, and Maria Crotty. "Introducing consumer directed care in residential care settings for older people in Australia: views of a citizens’ jury." Journal of Health Services Research & Policy 23, no. 3 (March 9, 2018): 176–84. http://dx.doi.org/10.1177/1355819618764223.
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Objectives Health services worldwide are increasingly adopting consumer directed care approaches. Traditionally, consumer directed care models have been implemented in home care services and there is little guidance as to how to implement them in residential care. This study used a citizens’ jury to elicit views of members of the public regarding consumer directed care in residential care. Methods A citizens’ jury involving 12 members of the public was held over two days in July 2016, exploring the question: For people with dementia living in residential care facilities, how do we enable increased personal decision making to ensure that care is based on their needs and preferences? Jury members were recruited through a market research company and selected to be broadly representative of the general public. Results The jury believed that person-centred care should be the foundation of care for all older people. They recommended that each person’s funding be split between core services (to ensure basic health, nutrition and hygiene needs are met) and discretionary services. Systems needed to be put into place to enable the transition to consumer directed care including care coordinators to assist in eliciting resident preferences, supports for proxy decision makers, and accreditation processes and risk management strategies to ensure that residents with significant cognitive impairment are not taken advantage of by goods and service providers. Transparency should be increased (perhaps using technologies) so that both the resident and nominated family members can be sure that the person is receiving what they have paid for. Conclusions The views of the jury (as representatives of the public) were that people in residential care should have more say regarding the way in which their care is provided and that a model of consumer directed care should be introduced. Policy makers should consider implementation of consumer directed care models that are economically viable and are associated with high levels of satisfaction among users.
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Brener, Loren, Dean A. Murphy, Elena J. Cama, and Jeanne Ellard. "Hepatitis C risk factors, attitudes and knowledge among HIV-positive, HIV-negative and HIV-untested gay and bisexual men in Australia." Sexual Health 12, no. 5 (2015): 411. http://dx.doi.org/10.1071/sh14239.
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Background There are increasing reports of sexual transmission of hepatitis C virus (HCV) among HIV-positive men who have sex with men (MSM). Still unclear is the level of HCV knowledge and the risk factors specific to HCV transmission among this population. This study compared HCV knowledge and risk practices among HIV-positive, HIV-negative and HIV-untested gay and bisexual men in Australia. Methods: Participants (n = 534) completed an online survey assessing sexual risk practices, HCV knowledge, perceived risk of acquiring HCV and perceptions of people with HCV and who inject drugs. Results: HIV-positive participants were older, reported greater engagement in sexual risk and injecting drug practices, felt they were at greater risk of acquiring HCV, were less likely to socially and sexually exclude people with HCV and had more positive attitudes towards people who inject drugs and people with HCV compared with HIV-negative and HIV-untested participants. HIV-untested participants were younger, reported fewer HCV-related serosorting practices and were more likely to socially and sexually exclude people with HCV than the other groups. Conclusions: Findings suggest that HCV education and prevention for gay men may be most effective if tailored according to HIV status. For HIV-positive men, health promotion could focus on specific sexual practices and biological factors linked to HCV transmission, regular HCV testing and better strategies for disclosure of HCV serostatus. For HIV-negative and HIV-untested men, there should be a more general focus on awareness, changing attitudes towards HCV testing and increasing general knowledge around HCV, including evidence of sexual transmission.
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Selvey, Linda A., Claudia Slimings, Emma Adams, and Justin Manuel. "Incidence and predictors of HIV, chlamydia and gonorrhoea among men who have sex with men attending a peer-based clinic." Sexual Health 15, no. 5 (2018): 451. http://dx.doi.org/10.1071/sh17181.
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Introduction Despite a range of interventions, annual numbers of new diagnoses of HIV infection among men who have sex with men (MSM) in Australia have not declined in recent years. Peer-based sexual health clinics targeting MSM, such as the M Clinic in Perth (WA, Australia), have been put in place to provide safe sex counselling and to increase testing rates among MSM and who are at high risk of HIV infection. The aim of this study was to assess the incidence of HIV, chlamydia and gonorrhoea among men attending the M Clinic. Methods: This was a historical cohort study of repeated M Clinic clients from January 2011 to June 2015 inclusive. Testing and risk factor data from M Clinic client software were used to estimate the incidence of HIV, chlamydia and gonorrhoea and associated factors. Results: The incidence of HIV, chlamydia and gonorrhoea was 1.87, 13.58 and 6.48 per 100 person-years respectively. Older men had a higher incidence of HIV infection but a lower incidence of chlamydia and gonorrhoea than younger men. Conclusions: The HIV incidence was higher than found in similar studies in other Australian sexual health clinics, but the incidence of chlamydia and gonorrhoea was similar. The high HIV incidence among clients of the M Clinic points to the importance of making pre-exposure HIV prophylaxis available to clients of the M Clinic and similar services.
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NURMI, MARY ANNE, COREY S. MACKENZIE, KERSTIN ROGER, KRISTIN REYNOLDS, and JAMES URQUHART. "Older men's perceptions of the need for and access to male-focused community programmes such as Men's Sheds." Ageing and Society 38, no. 4 (December 21, 2016): 794–816. http://dx.doi.org/10.1017/s0144686x16001331.
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ABSTRACTAlthough participating in community social programming is associated with positive physical and mental health outcomes for older adults, older men participate less often than women. Men's Sheds is a community programme used primarily by older men that originated in Australia and is well established there. The goal of the current study was to explore men's perceptions of the need for Men's Sheds and issues concerning access to them in Canada, a country with a small but growing Men's Sheds movement. We conducted focus groups with 64 men aged 55 years and older, including Men's Sheds members and men from the community who were unfamiliar with this programme, and analysed the data using the framework analytic approach. The data revealed two primary themes concerning: (a) the need for male-focused community programmes, including the sub-themes reducing isolation, forming friendships and engaging in continued learning; and (b) access to programmes, including the sub-themes points of contact, sustaining attendance and barriers. Findings suggest that in order to reduce the likelihood of isolation and increase opportunities for social engagement, exposure to the concept of male-focused programming should begin before retirement age. In addition, such programmes should be mindful of how they are branded and marketed in order to create spaces that are welcoming to new and diverse members.
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Read, Phillip J., Vickie Knight, Christopher Bourne, Rebecca Guy, Basil Donovan, Warwick Allan, and Anna M. McNulty. "Community event-based outreach screening for syphilis and other sexually transmissible infections among gay men in Sydney, Australia." Sexual Health 10, no. 4 (2013): 357. http://dx.doi.org/10.1071/sh13012.
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Objectives Increased testing frequency is a key strategy in syphilis control, but achieving regular testing is difficult. The objective of this study is to describe a sexually transmissible infection (STI) testing outreach program (the Testing Tent) at a gay community event. Methods: Gay men attending the testing tent in 2010–11 completed a computer-assisted self-interview and were screened for STIs. Clinical, demographic, behavioural and diagnostic data were compared with gay men attending a clinic-based service during 2009. The Testing Tent was marketed on social media sites and data were extracted on the number of times the advertisements were viewed. Staffing, laboratory, marketing and venue hire expenses were calculated to estimate the cost of delivering the service. Results: Ninety-eight men attended the Testing Tent. They were older (median age: 42 years v. 30 years; P < 0.001), had more sex partners (median: five in 3 months v. two; P < 0.001) and more likely to inject drugs (9% v. 4%; P = 0.034) than the 1006 clinic attendees, but were more likely to have previously tested for STIs (81% v. 69%; P = 0.028) and to always use condoms for anal sex (59% v. 43%; P = 0.005). Five cases of STIs were detected; the diagnostic yield was not significantly different from that of the clinic. The cost of the Testing Tent was A$28 440. Conclusion: Nonclinical testing facilities are an acceptable option and are accessed by gay men requiring regular testing, and may be an important addition to traditional testing environments.
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Edmiston, Natalie, Erin Passmore, David J. Smith, and Kathy Petoumenos. "Multimorbidity among people with HIV in regional New South Wales, Australia." Sexual Health 12, no. 5 (2015): 425. http://dx.doi.org/10.1071/sh14070.
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Background Multimorbidity is the co-occurrence of more than one chronic health condition in addition to HIV. Higher multimorbidity increases mortality, complexity of care and healthcare costs while decreasing quality of life. The prevalence of and factors associated with multimorbidity among HIV positive patients attending a regional sexual health service are described. Methods: A record review of all HIV positive patients attending the service between 1 July 2011 and 30 June 2012 was conducted. Two medical officers reviewed records for chronic health conditions and to rate multimorbidity using the Cumulative Illness Rating Scale (CIRS). Univariate and multivariate linear regression analyses were used to determine factors associated with a higher CIRS score. Results: One hundred and eighty-nine individuals were included in the study; the mean age was 51.8 years and 92.6% were men. One-quarter (25.4%) had ever been diagnosed with AIDS. Multimorbidity was extremely common, with 54.5% of individuals having two or more chronic health conditions in addition to HIV; the most common being a mental health diagnosis, followed by vascular disease. In multivariate analysis, older age, having ever been diagnosed with AIDS and being on an antiretroviral regimen other than two nucleosides and a non-nucleoside reverse transcriptase inhibitor or protease inhibitor were associated with a higher CIRS score. Conclusion: To the best of our knowledge, this is the first study looking at associations with multimorbidity in the Australian setting. Care models for HIV positive patients should include assessing and managing multimorbidity, particularly in older people and those that have ever been diagnosed with AIDS.
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Hollingworth, Samantha A., Dan J. Siskind, Lisa M. Nissen, Maxine Robinson, and Wayne D. Hall. "Patterns of Antipsychotic Medication Use in Australia 2002–2007." Australian & New Zealand Journal of Psychiatry 44, no. 4 (April 2010): 372–77. http://dx.doi.org/10.3109/00048670903489890.
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Objective: Atypical antipsychotic medications that are primarily used to treat schizophrenia and bipolar disorder cost the Pharmaceutical Benefits Scheme (PBS) AUD$334.4m in 2007. There are indications that they have also been used outside the approved indications to treat behavioural disturbances in the elderly. The aim of the present study was therefore to examine (i) trends in prescribing of subsidized atypical antipsychotic drugs in the Australian population from 2002 to 2007; and (ii) gender and age differences in the utilization of these drugs. Methods: Government (Medicare Australia) data on numbers of prescriptions, quantity and doses for atypical and typical antipsychotics from 2002 to 2007 were analysed. Defined daily dose per 1000 population per day were estimated for age and sex groups using Australian Bureau of Statistics population data. Results: The proportion of prescribed antipsychotics that were atypical increased from 61% in 2002 to 77% in 2007. In male subjects, olanzapine was most often prescribed between the ages of 25 and 55 years. In female subjects, in contrast, the highest rates of prescribing were in those ≥75 years. Lower doses of these drugs were prescribed in older adults. Conclusions: Atypical antipsychotic drugs were most commonly used to treat schizophrenia in younger men and behavioural disturbances in older women with dementia. They appear to have been used outside of the approved indication for schizophrenia and bipolar disorder with significant financial costs to the PBS. Research into the reasons for their extensive use in elderly women is needed to inform more rational prescribing of these medicines.
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Chow, Eric P. F., Rebecca Wigan, Anna McNulty, Charlotte Bell, Mandy Johnson, Lewis Marshall, David G. Regan, et al. "Early sexual experiences of teenage heterosexual males in Australia: a cross-sectional survey." BMJ Open 7, no. 10 (October 2017): e016779. http://dx.doi.org/10.1136/bmjopen-2017-016779.
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ObjectiveThere are limited data on the patterns of early sexual behaviours among Australian teenage heterosexual boys. This study describes the nature and onset of early sexual experiences in this population through a cross-sectional survey.DesignA cross-sectional survey between 2014 and 2015SettingMajor sexual health clinics and community sources across AustraliaParticipantsHeterosexual men aged 17–19 yearsResultsThere were 191 men in the study with a median age of 19.1 years. Median age at first oral sex was 16.4 years (IQR: 15.5–17.7) and 16.9 years (IQR: 16.0–18.0) for first vaginal sex. Most men had engaged in oral sex (89.5%) and vaginal sex (91.6%) in the previous 12 months with 32.6% reporting condom use at last vaginal sex. Of the total lifetime female partners for vaginal sex reported by men as a group (n=1187): 54.3% (n=645) were the same age as the man, 28.3% (n=336) were a year or more younger and 17.4% (n=206) were a year or more older. Prior anal sex with females was reported by 22% with 47% reporting condom use at last anal sex. Median age at first anal sex was 18.2 years (IQR: 17.3–18.8). Anal sex with a female was associated with having five or more lifetime female sexual partners for oral and vaginal sex.ConclusionsThese data provide insights into the trajectory of sexual behaviours experienced by teenage heterosexual boys following sexual debut, findings which can inform programme promoting sexual health among teenage boys.
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Wasonga, Job, Mark Okowa, and Felix Kioli. "Sociocultural Determinants to Adoption of Safe Water, Sanitation, and Hygiene Practices in Nyakach, Kisumu County, Kenya: A Descriptive Qualitative Study." Journal of Anthropology 2016 (December 8, 2016): 1–5. http://dx.doi.org/10.1155/2016/7434328.
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Provision of safe water, adequate sanitation, and hygiene has been lauded as one way of preventing diarrheal infections and improving health especially in developing countries. However, lack of safe water, inadequate sanitation, and poor hygiene practices in most parts of rural Kenya have posed a challenge that exposes the populace to diarrhea cases and possible deaths. In this regard, many nongovernmental organizations and governmental agencies have tried to provide water, sanitation, and hygiene services with poor results. This study was conducted using qualitative research methods in Central Nyakach in Kisumu County, Kenya. The methods were focus group discussions (FGD), key informant interviews (KII), and observation of homesteads. The data were then analyzed thematically. Findings revealed that water issues are gendered and its use is socially and culturally categorized. Water storage is affected by traditions such as use of a clay pot, while sanitation and hygiene issues are ritualized and bound by taboos. Latrines are majorly constructed by men and sharing the same with in-laws and older children is prohibited. Children faeces are thrown out in the open fields as a means of disposal and hand washing with soap is nonexistent, since it is believed that doing so would make a person lose the ability to rear livestock. The implications of these findings are that some of these sociocultural practices have a profound effect on health of the population. This affects health care delivery through high incidence rates of disease, encourages “unhealthy” environments through open defecation and pollution, and negates the government’s commitment to national and international policies on universal health care provision.
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Naraghi, Reza, Alan Bryant, and Linda Slack-Smith. "Description of Total Population Hospital Admissions for Morton's Metatarsalgia in Australia." Journal of the American Podiatric Medical Association 104, no. 5 (September 1, 2014): 451–54. http://dx.doi.org/10.7547/0003-0538-104.5.451.
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Background Morton's metatarsalgia is a painful perineural fibroma of a plantar nerve, most commonly of the second or third intermetatarsal spaces of the forefoot. The aim of this study was to investigate hospital admissions with a diagnosis of Morton's metatarsalgia in the Australian population from 1998 to 2008. Methods Data regarding admissions with a diagnosis code of ICD-10 G57.6 were extracted from the Australian Institute of Health and Welfare databases of hospital morbidity from 1998 to 2008. The event of interest was an admission with ICD-10 G57.6 (Morton's metatarsalgia). The explanatory variables included sex and age group. Rates were calculated using the estimated resident population counts to determine denominators. Results Morton's metatarsalgia admissions were almost three-fold higher for women in the population compared to men. The rate of admissions for Morton's metatarsalgia was the highest for the total population in the 55- to 59-year-old age group. Among women admitted for Morton's metatarsalgia, the highest rate was in the 50- to 54-year-old age group; among men, the highest rate was in the slightly older 55- to 59-year-old age category. Conclusions Population-level information on admissions for Morton's metatarsalgia show that admissions were three times higher among women compared to men. The highest admission rate was in the 50- to 55-year-old age group.
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Phillips, Tiffany R., Heidi Constantinou, Christopher K. Fairley, Catriona S. Bradshaw, Kate Maddaford, Marcus Y. Chen, Jane S. Hocking, and Eric P. F. Chow. "Oral, Vaginal and Anal Sexual Practices among Heterosexual Males and Females Attending a Sexual Health Clinic: A Cross-Sectional Survey in Melbourne, Australia." International Journal of Environmental Research and Public Health 18, no. 23 (December 1, 2021): 12668. http://dx.doi.org/10.3390/ijerph182312668.
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Sex practices among heterosexuals are not well studied. We aimed to explore sexual practices among heterosexuals attending a sexual health clinic. This cross-sectional survey was conducted at Melbourne Sexual Health Centre between March and April 2019. Data were collected on kissing, oral sex (fellatio or cunnilingus), vaginal sex, anal sex and rimming in the previous 3 months. Univariable and multivariable logistic regression analyses were performed to examine the associations between engaging in anal sex and other sex practices. There were 709 participants (333 men; 376 women) who were eligible and completed the survey (response rate was 24.6%). In the past 3 months, most participants had had vaginal sex (n = 677; 95.5%), with a mean of 3.0 (standard deviation (SD): 3.9) vaginal sex partners, and half reported engaging in condomless vaginal sex in the past 3 months (n = 358; 50.1%). A total of 135 (19.0%) participants had had anal sex, with a mean of 1.3 (SD: 1.0) anal sex partners, with 63.5% (n = 94) engaging in any condomless anal sex in the past 3 months. Most participants (n = 637, 89.8%) had received oral sex in the past 3 months; this proportion did not differ by age group or gender. Women (n = 351, 93.4%) were more likely to perform oral sex than men (n = 275; 82.6% men) (p < 0.001) and to have received rimming (26.6% women vs. 12.6% men; p < 0.001). Men were more likely to have performed rimming (25.5% men vs. 9.3% women; p < 0.001). After adjusting for age, number of partners and sexual practice, anal sex was associated with being ≥35 years (adjusted odds ratio (aOR): 2.3; 95% CI: 1.2–4.2), receiving rimming (aOR: 3.8; 95% CI: 2.4–6.0) and performing rimming (aOR: 2.8; 95% CI: 1.8–4.6). Rimming and anal sex are practiced by one-fifth or more of heterosexuals. Older heterosexuals were more likely to engage in anal sex and to perform rimming. Future research should consider the benefits of testing extragenital sites where appropriate.
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Khalatbari-Soltani, Saman, Fiona Stanaway, Cathie Sherrington, Fiona M. Blyth, Vasi Naganathan, David J. Handelsman, Markus J. Seibel, Louise M. Waite, David G. Le Couteur, and Robert G. Cumming. "The Prospective Association Between Socioeconomic Status and Falls Among Community-Dwelling Older Men." Journals of Gerontology: Series A 76, no. 10 (February 4, 2021): 1821–28. http://dx.doi.org/10.1093/gerona/glab038.
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Abstract Background Socioeconomic status (SES) has been suggested as a risk factor for falls but the few prospective studies to test this have had mixed results. We evaluated the prospective association between SES and falls in the Concord Health and Ageing in Men Project (CHAMP). Methods CHAMP is a population-based prospective cohort study of men aged ≥70 years in Sydney, Australia. Incident falls were ascertained by triannual telephone calls for up to 4 years. SES was assessed with 4 indicators (education, occupation, source of income, home ownership) and cumulative SES score. We tested for interaction between SES indicators and country of birth and conducted stratified analyses. Results We evaluated 1624 men (mean age: 77.3 ± 5.4 years). During a mean ± SD follow-up of 42.6 ± 8.7 months, 766 (47%) participants reported ≥1 incident falls. In nonstratified analyses, there were no associations between SES indicators and falls. In stratified analyses, falls rates were higher among Australian-born men with less formal education (incidence rate ratio [IRR] 1.66, 95% confidence interval [CI] 1.16–2.37, compared with those with more education) and those with low occupational position (1.45; 1.09–1.93). However, among men born in non-main English-speaking countries the rate of falls was lower among those with low educational level and no associations were evident for occupational position. Conclusions Lower educational level and occupational position predicted a higher falls rate in Australian-born men; the opposite relationship was evident for educational level among migrants born in non-main English-speaking countries. Further studies should test these relationships in different populations and settings and evaluate targeted interventions.
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Battersby, Malcolm W., John J. O'mahoney, Andrew R. Beckwith, and Justin L. Hunt. "Antidepressant Deaths by Overdose." Australian & New Zealand Journal of Psychiatry 30, no. 2 (April 1996): 223–28. http://dx.doi.org/10.3109/00048679609076098.
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Objective: To determine the prevalence of antidepressant deaths in South Australia, the relative frequency of each antidepressant used and demographic data of those who died. Method: This was a retrospective, case note study of all cases where death was caused by lethal levels of antidepressants in South Australia for the period from 1986 to 1990. The study occurred at the South Australian coroner's office. Subjects were selected from toxicology data, where serum or liver levels of one or more antidepressant were in the lethal range. Results: Seventy-one cases were identified and information was obtained on 68 of these cases from the coroner's files. Amitriptyline, Doxepin and Dothiepin accounted for the majority of antidepressant deaths. Women were 2.5 times more likely to use antidepressants to suicide than men. At least 63% had a known psychiatric illness and 45% had previously attempted suicide. Conclusions: The older tricyclic antidepressants are a significant cause of suicide. It is recommended that the newer antidepressants, which are as efficacious yet safer in overdose, be prescribed in preference to the older tricyclic antidepressants, as the first line of treatment in newly diagnosed depressed outpatients.
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Ball, Kylie, David Crawford, Paul Ireland, and Allison Hodge. "Patterns and demographic predictors of 5-year weight change in a multi-ethnic cohort of men and women in Australia." Public Health Nutrition 6, no. 3 (June 2003): 269–80. http://dx.doi.org/10.1079/phn2002431.
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AbstractObjective:This study investigated 5-year trends in body weight, overweight and obesity and their association with sociodemographic variables in a large, multi-ethnic community sample of Australian adults.Design:This prospective population study used baseline and 5-year follow-up data from participants in the Melbourne Collaborative Cohort Study (MCCS).Setting:Population study in Melbourne, Australia.Subjects:In total, 12 125 men and 17 674 women aged 35–69 years at baseline.Results:Mean 5-year weight change in this sample was +1.58 (standard deviation (SD) 4.82) kg for men and +2.42 (SD 5.17) kg for women. Younger (35–44 years) men and, in particular, women gained more weight than older adults and were at highest risk of major weight gain (≥5 kg) and becoming overweight. Risk of major weight gain and associations between demographic variables and weight change did not vary greatly by ethnicity. Education level showed complex associations with weight outcomes that differed by sex and ethnicity. Multivariate analyses showed that, among men, higher initial body weight was associated with decreased likelihood of major weight gain, whereas among women, those initially overweight or obese were about 20% more likely to experience major weight gain than underweight or healthy weight women.Conclusions:Findings of widespread weight gain across this entire population sample, and particularly among younger women and women who were already overweight, are a cause for alarm. The prevention of weight gain and obesity across the entire population should be an urgent public health priority. Young-to-mid adulthood appears to be a critical time to intervene to prevent future weight gain.
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Hanna, Shaddy, Chun Wah Michael Tam, Andrew Knight, Linheng Zhao, Lucille Ban, Belinda Pellizzon, and James Parks. "The ED2GP (emergency department to general practice) for Women study: understanding lower follow-up rates among older women." Australian Journal of Primary Health 26, no. 5 (2020): 396. http://dx.doi.org/10.1071/py19221.
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Older women seem to have lower GP follow-up rates after an emergency department (ED) discharge than men. This qualitative study investigated how older women seek GP follow up after an ED visit. In 2018, women aged ≥65 years were recruited from an ED in a suburban hospital in south-western Sydney, Australia, and then contacted 1 week later for a telephone interview exploring factors associated with their follow-up behaviour. Grounded theory was used to construct a potential explanatory model of follow-up behaviours. Of the 100 women recruited, 64% had attended a GP follow up by Day 7, as instructed. The balance of perceived cost and benefit of GP follow up emerged as a useful model to understand the factors affecting follow-up behaviour. Perceived costs included inconvenience caused to self and others, access to transport options and the availability of a patient’s GP. Perceived benefits included previous experiences with the healthcare system, pre-existing health-seeking behaviours and ED messaging. Our findings suggest that follow-up rates could be improved by strengthening the perceived benefit of GP follow up at the point of ED discharge, in addition to addressing perceived costs. Approaches may include ensuring discharge instructions are purposeful and given in the company of an older woman’s social supports.
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Hanrahan, P. F., C. A. D’Este, S. W. Menzies, T. Plummer, and P. Hersey. "A randomised trial of skin photography as an aid to screening skin lesions in older males." Journal of Medical Screening 9, no. 3 (September 1, 2002): 128–32. http://dx.doi.org/10.1136/jms.9.3.128.
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OBJECTIVES: We have previously shown that photographs assist in detection of change in skin lesions and designed the present randomised population based trial to assess the feasibility of photographs as an aid to management of skin cancers in older men. SETTING: 1899 men over fifty, identified from the electoral roll in two regions in New South Wales (NSW), Australia, were invited by mail to participate. METHODS: A total of 973 of 1037 respondents were photographed and randomised into intervention (participants given their photographs) or control groups (photographs withheld by investigators). At one and two years from the time of photography, all participants were advised to see their primary care practitioner for a skin examination. Those in the intervention group were examined with their photographs and those in the control group without their photographs. RESULTS: The results indicated that the practitioners were more likely to leave suspicious lesions in place for follow up observation (37% v 29%) (p=0.006) and less likely to excise benign non pigmented lesions (20 v 32%). There was little difference in excision rates for benign pigmented lesions (21% v 23%). Lesions excised were more likely to be non-melanoma skin cancer (58% v 42%) from patients who had photographs compared to those without photographs (p=0.005). The use of skin photography resulted in a substantial savings due to the reduced excision of benign lesions. CONCLUSIONS: These results suggest that it would be feasible to conduct a large scale randomised trial to evaluate the value of photography in early detection of melanoma and that such a trial could be cost effective due to the reduced excision of benign skin lesions.
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Huebner, Marianne, and Wenjuan Ma. "Health challenges and acute sports injuries restrict weightlifting training of older athletes." BMJ Open Sport & Exercise Medicine 8, no. 2 (June 2022): e001372. http://dx.doi.org/10.1136/bmjsem-2022-001372.
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ObjectivesTo quantify acute injuries sustained during weightlifting that result in training restrictions and identify potential risk factors or preventative factors in Master athletes and to evaluate potentially complex interactions of age, sex, health-related and training-related predictors of injuries with machine learning (ML) algorithms.MethodsA total of 976 Masters weightlifters from Australia, Canada, Europe and the USA, ages 35–88 (51.1% women), completed an online survey that included questions on weightlifting injuries, chronic diseases, sport history and training practices. Ensembles of ML algorithms were used to identify factors associated with acute weightlifting injuries and performance of the prediction models was evaluated. In addition, a subgroup of variables selected by six experts were entered into a logistic regression model to estimate the likelihood of an injury.ResultsThe accuracy of ML models predicting injuries ranged from 0.727 to 0.876 for back, hips, knees and wrists, but were less accurate (0.644) for shoulder injuries. Male Master athletes had a higher prevalence of weightlifting injuries than female Master athletes, ranging from 12% to 42%. Chronic inflammation or osteoarthritis were common among both men and women. This was associated with an increase in acute injuries.ConclusionsTraining-specific variables, such as choices of training programmes or nutrition programmes, may aid in preventing acute injuries. ML models can identify potential risk factors or preventative measures for sport injuries.
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Sui, Sophia X., Kara L. Holloway-Kew, Natalie K. Hyde, Lana J. Williams, Monica C. Tembo, Sarah Leach, and Julie A. Pasco. "Prevalence of Sarcopenia Employing Population-Specific Cut-Points: Cross-Sectional Data from the Geelong Osteoporosis Study, Australia." Journal of Clinical Medicine 10, no. 2 (January 18, 2021): 343. http://dx.doi.org/10.3390/jcm10020343.
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Background: Prevalence estimates for sarcopenia vary depending on the ascertainment criteria and thresholds applied. We aimed to estimate the prevalence of sarcopenia using two international definitions but employing Australian population-specific cut-points. Methods: Participants (n = 665; 323 women) aged 60–96 years old were from the Geelong Osteoporosis Study. Handgrip strength (HGS) was measured by dynamometers and appendicular lean mass (ALM) by whole-body dual-energy X-ray absorptiometry. Physical performance was assessed using gait speed (GS, men only) and/or the timed up-and-go (TUG) test. Using cut-points equivalent to two standard deviations (SDs) below the mean young reference range from the same population and recommendations from the European Working Group on Sarcopenia in Older People (EWGSOP), sarcopenia was identified by low ALM/height2 (<5.30 kg for women; <6.94 kg for men) + low HGS (<16 kg women; <31 kg men); low ALM/height2 + slow TUG (>9.3 s); low ALM/height2 + slow GS (<0.8 m/s). For the Foundation for the National Institutes of Health (FNIH) equivalent, sarcopenia was identified as low ALM/BMI (<0.512 m2 women, <0.827 m2 men) + low HGS (<16 kg women, <31 kg men). Receiver Operating Characteristic curves were also applied to determine optimal cut-points for ALM/BMI (<0.579 m2 women, <0.913 m2 men) that discriminated poor physical performance. Prevalence estimates were standardized to the Australian population and compared to estimates using international thresholds. Results: Using population-specific cut-points and low ALM/height2 + HGS, point-estimates for sarcopenia prevalence were 0.9% for women and 2.9% for men. Using ALM/height2 + TUG, prevalence was 2.5% for women and 4.1% for men, and using ALM/height2 + GS, sarcopenia was identified for 1.6% of men. Using ALM/BMI + HGS, prevalence estimates were 5.5–10.4% for women and 11.6–18.4% for men. Conclusions: This study highlights the range of prevalence estimates that result from employing different criteria for sarcopenia. While population-specific criteria could be pertinent for some populations, a consensus is needed to identify which deficits in skeletal muscle health are important for establishing an operational definition for sarcopenia.
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Cervo, Mavil May, David Scott, Markus Seibel, Robert Cumming, Vasi Naganathan, Fiona Blyth, David Le Couteur, et al. "Adherence to Mediterranean Diet and Its Associations With Circulating Cytokines, Musculoskeletal Health and Incident Falls in Community-Dwelling Older Men." Current Developments in Nutrition 5, Supplement_2 (June 2021): 6. http://dx.doi.org/10.1093/cdn/nzab033_006.
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Abstract Objectives Mediterranean dietary patterns may exert favorable effects on various health conditions. This study aimed to determine associations of adherence to Mediterranean diet with circulating cytokine levels, musculoskeletal health and incident falls in community-dwelling older men. Methods Seven hundred ninety-four (794) community-dwelling men with mean age 81.1 ± 4.5 years, who participated in the five-year follow-up of the Concord Health and Ageing in Men Project (CHAMP) were included in the cross-sectional analysis, and 616 attended follow-up three years later. Adherence to Mediterranean diet was assessed using MEDI-LITE (literature-derived Mediterranean diet) score which was derived using a validated diet history questionnaire. Twenty-four evaluable circulating cytokines were analyzed using Bio-Plex Pro Human Cytokine 27-plex Assay kit. Appendicular lean mass (ALM) and bone mineral density (BMD) were measured using dual-energy x-ray absorptiometry (DXA). Three-year changes in gait speed and hand grip strength were assessed by walking a 6-meter course and using a dynamometer respectively. Incident falls over three years were determined through telephone interviews every four months. Results A higher MEDI-LITE score, indicating greater adherence to Mediterranean diet, was associated with higher appendicular lean mass adjusted for body mass index (ALMBMI) (β: 0.004 kg/kg/m2; 95% CI: 0.000, 0.008), and lower serum interleukin-7 (IL-7) (β: −0.017 pg/mL; 95% CI: −0.031, −0.003), and incident falls rates (IRR: 0.94; 95% CI: 0.89, 0.99). Higher consumption of monounsaturated fatty acids (IRR: 0.76; 95% CI: 0.59, 0.98) and monounsaturated fatty acids to saturated fatty acids ratio (IRR: 0.72; 95% CI: 0.57, 0.90) were associated with 24%, and 28% lower falls risk in older men respectively. MEDI-LITE scores were not associated with bone mineral density or physical function parameters. Conclusions Adherence to a Mediterranean diet is associated with higher ALMBMI, lower levels of serum IL-7, and fewer falls in community-dwelling older men. Monounsaturated and saturated fatty acids were the most important contributors to the association between Mediterranean diet and falls risk. Funding Sources The CHAMP study is funded by the National Health and Medical Research Council of Australia, and the Ageing and Alzheimer's Institute.
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Pitts, Marian K., Wendy Heywood, Richard Ryall, Anthony M. Smith, Julia M. Shelley, Juliet Richters, and Judy M. Simpson. "Knowledge of human papillomavirus (HPV) and the HPV vaccine in a national sample of Australian men and women." Sexual Health 7, no. 3 (2010): 299. http://dx.doi.org/10.1071/sh09150.
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Background: Human papillomavirus (HPV) knowledge has rarely been investigated in the context of a national vaccination program. The present study investigated HPV knowledge after the introduction of a national HPV vaccination program in Australia using a national sample of men and women. Methods: Questions assessing HPV knowledge were part of a broader national study of health and relationships administered via a computer-assisted telephone interview. These findings are from wave four of the study, conducted between 2007 and 2008. Knowledge questions about HPV included its association with cervical cancer, genital warts and abnormal Pap tests. Results: A total of 2634 women and 2556 men between the ages of 18 and 70 were interviewed. Overall, 62.8% (95% confidence interval (CI): 60.8–64.7%) of women and 38.3% (95% CI: 36.3–40.4%) of men had heard of HPV. Of these, 66.0% (95% CI: 64.1–67.9%) correctly answered that HPV is associated with cervical cancer, 50.2% (95% CI: 48.2–52.1%) answered that HPV is associated with abnormal Pap tests and 44.5% (95% CI: 42.5–46.5%) answered that HPV causes warts. Predictors of good knowledge included being female, aged between 26 and 45, holding higher education levels and older age at first sex. Ever having a Pap test was also associated with awareness about HPV. Conclusion: One of the highest levels of knowledge about HPV in Australia to date is reported in the present study. Knowledge about the association between HPV and cervical cancer was particularly high, especially when compared with knowledge of the association with genital warts. This appears to be a consequence of the marketing of the HPV vaccine as a vaccination against cervical cancer.
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GILLEARD, CHRIS. "Renaissance treatises on ‘successful ageing’." Ageing and Society 33, no. 2 (December 19, 2011): 189–215. http://dx.doi.org/10.1017/s0144686x11001127.
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ABSTRACTNumerous treatises on ‘successful ageing’ were published during the late Renaissance. Zerbi'sGerontocomiaand Cornaro'sTrattato della Vita Sobria, in particular, have been considered as early precursors of modern gerontology. In this paper I revisit these two treatises, outline their content and common themes, and set them in the context of other literature written about ageing in this period. The rise of civic humanism, increased access to classical texts on health and hygiene, and the emergence of environmental and public health concerns, particularly in the Italian city states, are some of the factors that influenced this writing. The powerful yet insecure position of older men in the upper ranks of Italian society gave the topic of ‘seniority’ added relevance. While their roots in the scholastic tradition prevent them from serving as forerunners of scientific gerontology, their humanist concern with ‘lifestyle’ succeeds in making them the prototypes of the ‘do-it-yourself’ manuals for successful ageing that now proliferate in our late modernity.