An Interpretation of Four Men's Experiences of Suicidality

<p>Mental health nurses are frequently called upon to care and provide intervention for suicidal men. While there is substantial literature on male suicide, far less is known about the understandings men have of their suicidal experiences. This study draws upon Gadamer's philosophical hermeneutics to explore the understandings that four men have had of their past suicidal experiences. The interpretations developed in this study, as far as possible, make explicit use of my own particular horizon of meaning as researcher and mental health nurse, and as such, seeks to engage with a tradition of mental health nursing. In addition, by consciously bringing an anti-essentialist perspective of masculinity to this process, I explore the way in which gender impacts on men's suicidality. The primary source of information for this study is in-depth, open-ended conversations with four men of European descent in their middle adult years who were asked to talk about their past experiences of suicidality. The interpretations developed here show that for these men, the hermeneutic fusion of history, language, and sociocultural context, provided limited possibilities with which they were able to construe themselves as 'fitting in' with normative standards. These constraints, that are otherwise taken-for-granted and invisible, became explicit through their experience of ongoing victimisation. Furthermore, early understandings of these experiences became a potent horizon of meaning from which they then came to understand later difficult experiences. Victimisation became constitutive of an understanding of self as fundamentally different and (hierarchically)'less-than' other men. Ultimately, suicidality emerged out of a background of ever-present psychological pain accompanying a construction of self as being unable to see themselves as ever 'fitting in'. These men did not regard themselves as having recovered from suicidality, but remain in a process of recovering. This process did not mean figuring out how to 'fit in', or become 'normal' men, but rather, to live meaningfully as men in spite of not 'fitting in' with the sociocultural ideal. This involved a process of repeated cycles of revisiting and reflecting on their personal histories from vantage points permitting understandings that opened up opportunities for personal growth and learning. Relationships were significant for either enabling or disabling this process. Recovering was therefore a continual and idiosyncratic process, rather than an outcome of a specific technique or knowledge. The position taken in this study is that mental health nursing seeks to engage with people and work with them in collaborative, respectful, human relationships. It is argued that mental health nurses work with an individual's situated understandings rather than delivering prescribed treatment determined by diagnosis. Hence, viewing suicidality as socioculturally situated and historically emergent suggests mental health nurses must closely attend to the way in which we bring ourselves into relationships with our clients so that we are then able to create opportunities for change. The exploration of suicidality in this study also alerts us to the possibility that through fusion with clients' pre-understandings, mental health intervention can inadvertently further constrain choices to survive.</p>

An Interpretation of Four Men's Experiences of Suicidality

<p>Mental health nurses are frequently called upon to care and provide intervention for suicidal men. While there is substantial literature on male suicide, far less is known about the understandings men have of their suicidal experiences. This study draws upon Gadamer's philosophical hermeneutics to explore the understandings that four men have had of their past suicidal experiences. The interpretations developed in this study, as far as possible, make explicit use of my own particular horizon of meaning as researcher and mental health nurse, and as such, seeks to engage with a tradition of mental health nursing. In addition, by consciously bringing an anti-essentialist perspective of masculinity to this process, I explore the way in which gender impacts on men's suicidality. The primary source of information for this study is in-depth, open-ended conversations with four men of European descent in their middle adult years who were asked to talk about their past experiences of suicidality. The interpretations developed here show that for these men, the hermeneutic fusion of history, language, and sociocultural context, provided limited possibilities with which they were able to construe themselves as 'fitting in' with normative standards. These constraints, that are otherwise taken-for-granted and invisible, became explicit through their experience of ongoing victimisation. Furthermore, early understandings of these experiences became a potent horizon of meaning from which they then came to understand later difficult experiences. Victimisation became constitutive of an understanding of self as fundamentally different and (hierarchically)'less-than' other men. Ultimately, suicidality emerged out of a background of ever-present psychological pain accompanying a construction of self as being unable to see themselves as ever 'fitting in'. These men did not regard themselves as having recovered from suicidality, but remain in a process of recovering. This process did not mean figuring out how to 'fit in', or become 'normal' men, but rather, to live meaningfully as men in spite of not 'fitting in' with the sociocultural ideal. This involved a process of repeated cycles of revisiting and reflecting on their personal histories from vantage points permitting understandings that opened up opportunities for personal growth and learning. Relationships were significant for either enabling or disabling this process. Recovering was therefore a continual and idiosyncratic process, rather than an outcome of a specific technique or knowledge. The position taken in this study is that mental health nursing seeks to engage with people and work with them in collaborative, respectful, human relationships. It is argued that mental health nurses work with an individual's situated understandings rather than delivering prescribed treatment determined by diagnosis. Hence, viewing suicidality as socioculturally situated and historically emergent suggests mental health nurses must closely attend to the way in which we bring ourselves into relationships with our clients so that we are then able to create opportunities for change. The exploration of suicidality in this study also alerts us to the possibility that through fusion with clients' pre-understandings, mental health intervention can inadvertently further constrain choices to survive.</p>

Optimization of the sperm processing protocol for subsequent molecular cytogenetic studies

One of the causes of spontaneous pregnancy termination, infertility, and birth of children with development delay and malformations are chromosomal abnormalities (CA) as well as spontaneous aneuploidies in gametes of phenotypically normal parents. Often couples with reproductive problems, as well as spouses one of whom is a carrier of CA, turn to the programs of assisted reproductive technologies (ART) for preimplantation evaluation of the zygote chromosomal status. As part of ART programs, parental gametes are examined to assess the level of spontaneous aneuploidy. As a rule, the most accessible material for analysis is the ejaculate. Fluorescent in situ hybridization (FISH) is used to examine male gametes obtained from the ejaculate. However, this FISH-analysis has a number of limitations and difficulties because of the peculiarities of the sperm head structure, namely the supercondensed state of chromosome chromatin. In order to optimize the FISH protocol, five different protocols were used for pre-hybridization processing of ejaculate samples obtained from nine phenotypically normal men. A comparative analysis of hybridization efficiency showed that the protocol using tris(2-carboxyethyl)phosphine hydrochloride (TCEP) as a decondensation agent was the most effective for subsequent molecular cytogenetic studies. The developed hybrid protocol combining proteolytic pretreatment, TCEP and thermal decondensation can be used when other protocols for pre-hybridization treatment of ejaculate preparations are not effective.

Androgen Deprivation Therapy, Hypogonadism and Cardiovascular Toxicity in Men with Advanced Prostate Cancer

Androgen deprivation therapy (ADT) is successfully used in patients with advanced prostatic cancer, but there are many concerns about its systemic side effects, especially due to advanced age and frequent comorbidities in most patients. In patients treated with ADT there are metabolic changes involving the glycaemic control and lipid metabolism, increased thrombotic risk, an increased risk of myocardial infarction, severe arrhythmia and sudden cardiac death. Still, these adverse effects can be also due to the subsequent hypogonadism. Men with heart failure or coronary artery disease have a lower level of serum testosterone than normal men of the same age, and hypogonadism is related to higher cardiovascular mortality. Many clinical studies compared the cardiovascular effects of hypogonadism post orchiectomy or radiotherapy with those of ADT but their results are controversial. However, current data suggest that more intensive treatment of cardiovascular risk factors and closer cardiological follow-up of older patients under ADT might be beneficial. Our paper is a narrative review of the literature data in this field.

Semen biomarker TEX101 predicts sperm retrieval success for men with testicular failure

Background: Azoospermia could be due to either obstruction (obstructive azoospermia: OA) or spermatogenic failure (non-obstructive azoospermia: NOA). Close to 50% of men with NOA have small pockets of sperm in the testis which could be retrieved surgically and then injected into oocytes in a program of intra-cytoplasmic sperm insertion. Presently, there are no accepted non-invasive tests allowing clinicians to predict the success rates of sperm retrieval. Previously, we have identified a germ cell-specific protein TEX101 in semen found in the primary spermatocytes and more mature sperm forms, but not in spermatogonia, Sertoli or Leydig cells. We hypothesized that the semen concentration of TEX101 could be used to predict sperm production in men with NOA. Methods: This was a prospective cohort study on men with NOA being treated at a male infertility centre. Men with NOA planning sperm retrieval provided 1–3 semen samples prior to surgery. Semen TEX101 concentrations were measured by an in-house-developed ELISA assay and compared with the results of the surgery to retrieve sperm. Results: 20/60 karyotypically normal men with NOA had semen TEX101 < LOD (<0.2ng/mL). Of these, 0% had successful sperm retrieval(0-17%: 95% CI) . In contrast, of the 40 men with TEX101> LOD, sperm was found in 50% (34-66%: 95% CI, sig diff. Fisher’s exact test, p<0.05). Conclusions: Undetectable (<0.2 ng/mL) semen TEX101 is highly predictive of sperm retrieval failure for karyotypically normal men with NOA and is the single strongest non-invasive predictor of sperm retrieval failure reported so far. Semen TEX101 concentration will help couples decide their individual chances of successful sperm retrieval.

Association of sexual behaviours and premature ejaculation

Premature ejaculation (PE) is the most common reported sexual complaint in men. It is believed that PE is associated with sexual behavior such as early sexual experience, novelty of partners or frequencies of intercourse. Therefore, to examine the association of PE and sexual behaviors in men, a case-control study was conducted with a total of 418 clients Subjects were interviewed for general health status, sexual behaviors, IELT and requested to complete the premature ejaculation diagnostic tool (PEDT). DSM-IV-TR criteria were applied for the diagnosis of PE. Those who diagnosed with PE(+) and PEDT score ≥ 11 belonged to the PE group; those diagnosed with PE(-) and PEDT < 11 belonged to the non-PE group. The results indicated that no significant difference was noted regarding demographic features in the 2 groups. Normal men had a more frequent sexual life compared with PE patients (9.71 ± 6.09 and 6.62 ± 5.44 episodes of sexual intercourses per month, respectively with p < 0.001. Subjects who were single or circumcised had higher prevalence of PE than married or uncircumcised men. Multivariable logistic analysis elucidated that circumcision, number of lifetime sexual partners and sexual frequencies were associated factors of PE. In conclusion, PE is a common sexual dysfunction in men. It was found to be significantly associated with circumcision and frequencies of sexual intercourse. Medical history taking of PE patients should include these sexual behavior factors.

Helicobacter Pylori Infection Is Associated with Neurodegeneration in Cognitively Normal Men

Background: An association between Helicobacter pylori (H. pylori) infection and dementia was reported in previous studies; however, the evidence is inconsistent. Objective: In the present study, the association between H. pylori infection and brain cortical thickness as a biomarker of neurodegeneration was investigated. Methods: A cross-sectional study of 822 men who underwent a medical health check-up, including an esophagogastroduodenoscopy and 3.0 T magnetic resonance imaging, was performed. H. pylori infection status was assessed based on histology. Multiple linear regression analyses were conducted to evaluate the relationship between H. pylori infection and brain cortical thickness. Results: Men with H. pylori infection exhibited overall brain cortical thinning (p = 0.022), especially in the parietal (p = 0.008) and occipital lobes (p = 0.050) compared with non-infected men after adjusting for age, educational level, alcohol intake, smoking status, and intracranial volume. 3-dimentional topographical analysis showed that H. pylori infected men had cortical thinning in the bilateral lateral temporal, lateral frontal, and right occipital areas compared with non-infected men with the same adjustments (false discovery rate corrected, Q < 0.050). The association remained significant after further adjusting for inflammatory marker (C-reactive protein) and metabolic factors (obesity, dyslipidemia, fasting glucose, and blood pressure). Conclusion: Our results indicate H. pylori infection is associated with neurodegenerative changes in cognitive normal men. H. pylori infection may play a pathophysiologic role in the neurodegeneration and further studies are needed to validate this association.

Analysis and Comparison of Human Prostasomes Amino Acid Content Variation in Normal Men and Infertile Men-A Clinical Relevance Study for Effective Diagnosis Method for Human Male Infertility

Aim: The main objective of this study is to compare and analyse human prostasomes amino acid content variation in normal men semen samples and infertile men semen samples for identification of clinical relevance. Materials and methods: Semen samples were collected from normal men (N=32) and from infertile men (N=32) and by following the standard world health organisation protocol semen analysis was done. Amino acid quantification was done by using amino acid analyzer. Prostasomes were separated from spermatozoa and seminal plasma by using centrifugation technique at 95000 RPM for 90 mins. Results: Independent sample T-test was carried out and shows that proline and alanine amino acids concentration (p<0.01) statistically significant compared with fertile men and infertile men. High concentration of amino acids in prostasomes were found in fertile men samples (18.09 ± 0.20 μmoles/L) when compared with infertile men samples (15.12± 0.37 μmoles/L). Conclusion: Amino acid in prostasomes plays an important role in the fertilization; the change in the concentration of amino acid in prostasomes leads to infertility of men. Here we found that the concentration of amino acids is high in fertile men when compared to infertile men which could act as an innovative diagnosis method for infertility.

Composition of Urine Collected from Non-Stone-Forming Chinese Persons during Different Short-Term Periods of the Day

The purpose of this study in a small group of non-stone-forming Chinese persons was to measure the levels of supersaturation with calcium oxalate and calcium phosphate and pH with the aim of confirming if any of the different short-term urine samples were better for risk evaluation than a 24-h sample. Nine normal men and 1 woman collected urine during 4 periods of the day. Period 1 between 08 and 12 h, Period 2 between 12 and 18 h, Period 3 between 18 and 22 h, and Period 4 between 22 and 08 h. Each sample was analysed for calcium, oxalate, citrate, magnesium and phosphate, and estimates of supersaturation with calcium oxalate (CaOx) and calcium phosphate (CaP) were expressed in terms of AP(CaOx) and AP(CaP) index. An estimate of the solute load of CaOx was also calculated. Urine composition for 24-h urine (Period 24) was obtained mathematically from the analysed variables. Urine composition corresponding to 14-h urine portions 22–12 h (Period 14N) and 08–22 h (Period 14 D) were calculated. The lowest pH levels were recorded in Period 1 urine. The highest level of AP(CaOx) index was recorded during Period 1, and the product AP(CaOx) index × 107 × hydrogen ion concentration was significantly higher in Period 1 urine than in 24-h urine (p = 0.02). Also, the product SL(CaOx) × 107 × hydrogen ion concentration was significantly higher in Period 1 urine (p = 0.02). Low AP (CaP) index levels were recorded in Period 4, but also in all periods following dietary loads of calcium and phosphate. With the important reservation that the analytical results were obtained from non-stone-forming persons, the conclusion is that analysis of urine samples collected between 08 and 12 h might be an alternative to 24-h urine. The risk evaluation might advantageously be expressed either in terms of the product AP(CaOx) index × 107 × hydrogen ion concentration or the product SL(CaOx) × 107 × hydrogen ion concentration.

The relation between the menopause transition with higher rates of Alzheimer in the female gender: a literature review

Introduction: The reproductive senescence and the complete exhaustion of the germ cells result in processes capable of provoking changes in the hormone profile of women. The decrease in the bioenergetic metabolism during the menopause transition (MT), due to modifications in the estrogen levels, can be substrate for neurological dysfunctions. The physiopathological mechanisms of the Alzheimer’s Disease (AD) are activated years before the symptoms and coincide with MT, making the female gender a risk factor. The review aims on analyzing the higher rates of AD in the female gender, based on physiological changes that occur in the MT. Methods: Literature review based on articles from the PubMed database. Results: Were compared results from cerebral images of women in MT with cognitively normal men with the same age. In the women were found alterations such as abnormalities in the biomarkers of AD and reduction of the cerebral metabolic rate. It was noticed that women in the post menopause presented hypometabolism in the same cerebral regions as patients with AD and a reduction of the mitochondrial cytochrome oxidase of the platelets. Conclusion: The study presented evident bioenergetic factors that corroborate to the relation of MT and higher incidence of AD in the female gender. This way, such transition represents a window of opportunity for possible therapeutic interventions.