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Psychiatric categories in general, and the personality disorders in particular, remain problematic and contested. This is no where more clearly evident than in the case of the 'antisocial' and 'histrionic' personality disorders. In part, the problem is related to the observation of differences in gender distribution. Men are more likely to be diagnosed 'antisocial' than women, and women are more likely to be diagnosed 'histrionic' than men. Confusion results partly from the suspicion that these categories may be culturally conditioned and therefore spurious as medical labels true in some 'absolute' sense. This paper argues that the antisocial and histrionic disorders have cultural histories, representing (in extreme form) values strongly congruent with familiar cultural stereotypes: the 'independent' male and the 'dependent' female. The process by which these values were delegated to men and women is examined, and then shown to be at least partly determinative of later developments in the formation of psychiatric categories.
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PMID:Toward a cultural history of the personality disorders. 149 11

This paper comments on the relevance to health visitors of research carried out to establish the number of children in England and Wales whose fathers' are imprisoned, the impact of this on the children concerned and the need for intervention by health and social welfare agencies. Men received into prison during two separate three month periods were surveyed, a sample of wives interviewed and health visitors and teachers questioned. The findings suggest that in one year more than one hundred thousand children have a father sent into custody. Because of the current concentration of crime in areas of high deprivation, imprisonment of a father is a relatively normal occurrence in some districts, frequently adding pain, confusion and worry to the child's social, economic and educational disadvantage. Health visitors and teachers reported disturbed behaviour, ill health and problems at school. The role of the health visitor can be crucial in some of these cases yet frequently she is unaware of the family's predicament.
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PMID:The health visitor and the prisoner's child. 276 83

A total of 74 manic or hypomanic episodes were scrutinized in 31 probands (18 women and 13 men), followed over the years by the author on an outpatient basis. These turned out to herald bipolar affective illness in some 70 percent of males and almost 40% of females. Unipolar mania occurred twice as often in men, as it did in women (38.4% vs. 22.2%). Men tended to be younger (only 30% aged 45 or older), than women (almost a half in the menopausal age bracket). One third of all female probands (and over 46% of those under age 45) manifested their manic episodes in connection with childbirth (gestational mania). As a paradoxical, acute grief reaction ("funeral mania"), the syndrome under scrutiny, occurred in about 1/7 of the men, and more than 1/4 of the women. Significant medico-surgical problems were found to accompany or precede female mania twice as often, compared to male cases (61.1% vs. 30.7%); and clinical confusion or other indices of "organicity" were present in 2/3 of the women, and less than a half (46.1%) of the men. Over half the male probands demonstrated either an inverted sexual attraction, or hypogonadism; and four out of 13 males were aged 45 or older. The above findings are tentatively related to gender differential in cerebral hemispheric specialization.
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PMID:Male and female mania. 394 10

Nursing homes have played a major role in deinstitutionalization, and their increased use for the mentally ill has been questioned. We performed a controlled study of nursing homes as an alternative to continued psychiatric hospitalization. Men (N = 403) referred for nursing home placement from eight Veterans Administration medical centers were randomly assigned to community nursing homes (CNHs), Veterans Administration nursing care units, continued care on the same ward, or transfer to another psychiatric ward. Patients met defined criteria for schizophrenia or organic brain disease. Data were collected before random assignment and six and 12 months later, covering physical and mental function, psychopathology, mood, social adjustment, satisfaction with care, as well as drug use, characteristics of settings, and movement in and out of settings. Significant differences between settings were found in self-care, behavioral deterioration, mental confusion, depression, and satisfaction with care. Results were strikingly consistent, showing the group transferred to another ward doing better and the CNH group doing worse. Drug use did not differ from six months before entering the study or later between the settings. Cost showed a marked advantage for the CNH group. Thus, the less costly community nursing home alternative must be viewed in the context of the nonmonetary costs of less favorable patient outcome.
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PMID:Nursing home care as an alternative to psychiatric hospitalization. A Veterans Administration cooperative study. 406 10

There is considerable confusion about the effects of prostatitis syndromes on male reproductive physiology. Therefore, we correlated findings on seminal fluid and expressed prostatic secretions from 100 men attending a special prostatitis clinic. These men had symptoms of prostatitis but no evidence of urethritis, acute or chronic bacterial prostatitis, or significant urological abnormalities. All subjects were evaluated following a standardized protocol, including lower urinary tract localization studies, expressed prostatic secretion analyses, and seminal fluid analyses with Bryan-Leishman staining. Seminal fluid findings were compared in men with inflammation (> or = 10(6) leukocytes/ml) in their expressed prostatic secretions, i.e., nonbacterial prostatitis, and men without inflammation in prostatic secretions, i.e., prostatodynia. Of 23 men with inflammation (> or = 10(6) leukocytes/ml) in their seminal fluid, 6 (26%) had nonbacterial prostatitis (mean leukocyte concentration 8.6 +/- 9.4 x 10(6)/ml of semen) and 17 (74%) had prostatodynia (mean leukocyte concentration 6.2 +/- 7.0 x 10(6)/ml, not significant). Of 77 men who did not have seminal inflammation, 15 (19%) had nonbacterial prostatitis (mean leukocyte concentration 0.1 +/- 0.2 x 10(6)/ml) and 62 (81%) had prostatodynia (mean leukocyte concentration 0.1 +/- 0.2 x 10(6)/ml, not significant). Men with nonbacterial prostatitis had lower values for several parameters associated with sperm motility, especially the proportion of motile sperm (45% compared with 60% for men with prostatodynia, P = 0.08) and sperm subjective speed score (median 3 compared to 4 for men with prostatodynia, P = 0.03). In summary, a minority of men had seminal inflammation, even among men with nonbacterial prostatitis. There was poor correlation between inflammation in the prostatic secretions and in the semen. Nonbacterial prostatitis, but not seminal inflammation, was associated with reduced sperm motility. Our findings highlight technical issues and the importance of investigating different sites and samples, including the urethra, expressed prostatic secretions, and seminal fluid.
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PMID:Seminal fluid findings in men with nonbacterial prostatitis and prostatodynia. 879 22

Men's health has emerged as an important public concern that may require new kinds of healthcare interventions and increased resources. Considerable uncertainty and confusion surround prevailing understandings of men's health, particularly those generated by media debate and public policy, and health research has often operated on oversimplified assumptions about men and masculinity. A more useful way of understanding men's health is to adopt a gender-relations approach. This means examining health concerns in the context of men's and women's interactions with each other, and their positions in the larger, multidimensional structure of gender relations. Such an approach raises the issue of differences among men, which is a key issue in recent research on masculinity and an important health issue. The gender-relations approach offers new ways of addressing practical issues of healthcare for men in college environments.
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PMID:Understanding men's health and illness: a gender-relations approach to policy, research, and practice. 1086 68

Six regions for prostate cancer genes have been identified, and it is anticipated that prostate cancer susceptibility testing will be available in the future. This correlational study identified predictors for interest in prostate cancer susceptibility testing among African American men. Participants were 320 African American men from the African American Hereditary Prostate Cancer Study and the South Carolina Prostate Cancer Education and Screening Study participated. Two questions measured interest in genetic prostate cancer susceptibility testing and family history of prostate cancer. Chi-square analyses by family history as well as demographics (age, education, marital status) were performed. Most of the men (277 [87%]) indicated an interest in genetic prostate cancer susceptibility testing. Interest in undergoing testing did not vary by family history, age, or education. Marital status was the only significant demographic predictor. Men who were married were significantly more likely to respond with a "yes" to interest in prostate cancer susceptibility testing than were men who were not married. The high "yes" response rate and the men's confusion between the genetic prostate cancer susceptibility testing and prostate cancer screening highlight the need for public education once prostate cancer genes are identified and available for public testing.
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PMID:Interest in genetic prostate cancer susceptibility testing among african American men. 1183 17

This work asserts that men as a gender are being physically and psychically devastated by the prevailing socioeconomic system. American society empowers a small percentage of men, but it causes confusion and anxiety for the majority. Men are beginning to realize that they cannot properly relate to each other or understand exploitation until they understand the extent and nature of their dispossession by economic and political institutions. The oppression of men is mirrored in the growing incidence of male self-destruction, addiction, homelessness, and hopelessness. With the advent of industrialization, millions of men who had found fulfillment in husbandry of family, community, and land were forced into an industrial system whose ultimate goal was to turn man against man in the competitive system of modern society. The traditional male role was replaced with a new image of men as autonomous, efficient, self-interested, and disconnected from nature and community. As men become more and more powerless in their own lives, they are fed more and more media images of excessive, caricatured masculinity with which to identify. It is imperative that the increasing sense of personal liberation fostered by the men's movement be channeled into political action. A brief political platform for men would include actions centered on the family and children, protection of the environment, increasing male presence in classrooms and community activities involving children, health prevention, and dismantling the military-industrial establishment. A network of activists should be established to support the men's political agenda.
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PMID:A time for men to pull together. A manifesto for the new politics of masculinity. 1229 66

Intensive market research, completed in El Salvador for the contraceptive social marketing project of the Asociacion Demografica Salvadorena (ADS), was designed to obtain a better understanding of Salvadoran usage of and attitudes toward contraceptives in general and ADS products in particular. The research results are being used to develop a new marketing plan for the Contraceptive Social Marketing (CSM) program as it works to increase the program's effectiveness in reaching consumers. Points-of-purchase (retail outlets) were surveyed in November 1982 to study brand presence and vendor perceptions of consumer behavior in order to define the market in terms of products, prices, and distribution. Focus groups were conducted during November and December 1982 to probe consumer awareness and attitudes regarding methods, brands, and purchasing behavior. The results of the focus groups helped guide the development of a door-to-door consumer survey conducted from December 1982 through February 1983 to further define the market in terms of consumer size and characteristics. Personal interviews were conducted with the owner or manager of each of 247 pharmacies selected at random but in proportion to their distributional weight as to location. Aragon and Associates found that standard-dose orals and condoms were sold in 86% of the outlets surveyed and foaming tablets and low-dose pills in 37%. In terms of brand presence in outlets, the CSM products Perla (orals) and Condor (condom) both led their respective categories. In the foaming tablet category Suave had the lowest presence and Neo Sampoon the highest. The difference between reported and actual presence of contraceptives in the outlets was significant: 32% of the sellers of Perla, 18% of the sellers of Condor, and 26% of the sellers of Suave were out of stock at the time of the survey. The difference in average CSM product prices and the next lowest priced brands is very large. Dealers reported that their contraceptive consumers are fairly evenly divided between men and women. Results of the 8 focus groups suggested that there is a high awareness of and positive attitude toward family planning, although there was some confusion between family planning and birth control. Most respondents regarded control. Most respondents regarded 2-4 children as ideal. Men were much less concerned about using contraceptives than were women. Focus group participants had a high level of knowledge about contraceptives and were interested in learning more. Most thought mass media was an appropriate source for this type of information.
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PMID:Market research completed in El Salvador. 1231 65

Suggestions are offered for community workers on how to discuss acquired immunodeficiency syndrome (AIDS) in a stimulating way, answering questions and enabling communities to understand the many problems created by AIDS. A story or play is useful to start discussion of AIDS, for instance one opening with the funeral of a young village man who had been working in the city. Men are talking about his life and death with the following highlights: social lifestyle in the village and city; features of the sickness and death; the fact that a neighbor's daughter has similar symptoms; effects on the dead man's wife and infant; and the confusion and anxiety of the whole community. Discussion of the play should focus on what is seen, what is happening, how the play relates to the community, why the events happened, and the possible solutions. The community worker will need different approaches to different groups, based upon particular interests and motivations.
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PMID:The disease of AIDS is a critical community problem. 1231 39


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