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Qualitative Health Research Jan 2020Miscarriage is common, affecting one in five pregnancies, but the psychosocial effects often go unrecognized and unsupported. The effects on men may be subject to...
Miscarriage is common, affecting one in five pregnancies, but the psychosocial effects often go unrecognized and unsupported. The effects on men may be subject to unintentional neglect by health care practitioners, who typically focus on biological symptoms, confined to women. Therefore, we set out to systematically review the evidence of lived experiences of male partners in high-income countries. Our search and thematic synthesis of the relevant literature identified 27 manuscripts reporting 22 studies with qualitative methods. The studies collected data from 231 male participants, and revealed the powerful effect of identities assumed and performed by men or constructed for them in the context of miscarriage. We identified perceptions of female precedence, uncertain transition to parenthood, gendered coping responses, and ambiguous relations with health care practitioners. Men were often cast into roles that seemed secondary to others, with limited opportunities to articulate and address any emotions and uncertainties engendered by loss.
Topics: Abortion, Spontaneous; Adaptation, Psychological; Fathers; Female; Humans; Male; Pregnancy; Professional-Family Relations; Qualitative Research
PubMed: 31526062
DOI: 10.1177/1049732319870270 -
Psycho-oncology Sep 2022The purpose of this review was to synthesise the literature on the topic of masculinity and testicular cancer (TC) and investigate the relative impact of TC on men's... (Review)
Review
OBJECTIVE
The purpose of this review was to synthesise the literature on the topic of masculinity and testicular cancer (TC) and investigate the relative impact of TC on men's view of their masculinity.
METHODS
Searches were conducted across four databases (MEDline, PsycInfo, CINAHL Plus and Scopus) for articles published before April 2022 that included (1) TC and (2) masculinity. Two researchers independently rated studies for inclusion with a third resolving conflicts. Of the 6464 articles screened, 24 articles (10 quantitative and 14 qualitative) were included in the review. Articles were rated for quality and a narrative synthesis was performed.
RESULTS
Overall, results indicated some men experience a shift in the way they relate to their sense of masculinity following diagnosis and treatment for TC. Being single and without children was related to the experience of negative masculinity-related outcomes, possibly due to a compounding lack of relational support and being unable to conform to protector, provider traditions. Men who described testicle loss as symbolic of their diminished masculinity were also negatively impacted. However, recent, high-quality literature on the topic using standardised masculinity measures was limited.
CONCLUSION
Some men experience a reduced sense of masculinity after TC, however the impact of TC on masculinity remains person dependent. Further research using validated masculinity measures is required to uncover psycho-social variables that may account for whether and how meaning is made between TC and its treatment and any subsequent impact on perceived masculinity. Such factors may better support these men in life beyond cancer.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO. International Prospective Register of Systematic Reviews: CRD42020185649.
Topics: Child; Humans; Male; Masculinity; Neoplasms, Germ Cell and Embryonal; Testicular Neoplasms
PubMed: 35789023
DOI: 10.1002/pon.5994 -
Canadian Journal of Psychiatry. Revue... May 2021Suicide in Canadian men is high and rising. Research consistently indicates increased suicide risk in male subgroups including sexual minority, Indigenous, middle-aged,... (Review)
Review
OBJECTIVE
Suicide in Canadian men is high and rising. Research consistently indicates increased suicide risk in male subgroups including sexual minority, Indigenous, middle-aged, and military men. The current scoping review addresses the research question: Among male subgroups featured in Canadian suicide research, what are the key findings to inform suicide prevention efforts?.
METHOD
A scoping review was undertaken in accord with PRISMA-ScR guidelines. Structured searches were conducted in CIHAHL, Medline, PsychInfo, and Web of Science to identify studies reporting suicidality (suicidal ideation, plans and/or attempts) and suicide among men in Canada. Inclusion criteria comprised primary empirical studies featuring Canadian male subgroups published in English from 2009 to 2020 inclusive.
RESULTS
Sixty-eight articles met the inclusion criteria, highlighting significant rates of male suicidality and/or suicide in 3 categories: (1) health inequities ( = 29); (2) age-specific ( = 30); and (3) occupation ( = 9). The health inequities category included sexual minority men, Indigenous, and other marginalized males (i.e., homeless, immigrant men, and men who use opiates). Age-specific men focused on adolescents and youth, and middle-aged and older males. Active military, veterans, and first responders featured in the occupation category. Studies compared at risk male subgroups to females, general male populations, and/or other marginalized groups in emphasizing mental health disparities and increased suicide risk. Some men's suboptimal connections to existing mental health care services were also highlighted.
CONCLUSION
While male subgroups who are vulnerable to suicidality and suicide were consistently described, these insights have not translated to tailored upstream suicide prevention services for Canadian boys and men. There may be some important gains through integrating social and mental health care services for marginalized men, implementing school-based masculinity programs for adolescent males, orientating clinicians to the potential for men's mid-life suicide risks (i.e., separation, bereavement, retirement) and lobbying employers to norm help-seeking among activate military, veterans, and first responder males.
Topics: Adolescent; Aged; Canada; Female; Humans; Male; Masculinity; Men's Health; Middle Aged; Suicidal Ideation; Suicide Prevention
PubMed: 33719600
DOI: 10.1177/07067437211000631 -
European Journal of Endocrinology Jan 2024Hypogonadotropic hypogonadism is characterized by inadequate secretion of pituitary gonadotropins, leading to absent, partial, or arrested puberty. In males, classical... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Hypogonadotropic hypogonadism is characterized by inadequate secretion of pituitary gonadotropins, leading to absent, partial, or arrested puberty. In males, classical treatment with testosterone promotes virilization but not testicular growth or spermatogenesis. To quantify treatment practices and efficacy, we systematically reviewed all studies investigating gonadotropins for the achievement of pubertal outcomes in males with hypogonadotropic hypogonadism.
DESIGN
Systematic review and meta-analysis.
METHODS
A systematic review of Medline, Embase, Global Health, and PsycINFO databases in December 2022. Risk of Bias 2.0/Risk Of Bias In Non-randomized Studies of Interventions/National Heart, Lung, and Blood Institute tools for quality appraisal. Protocol registered on PROSPERO (CRD42022381713).
RESULTS
After screening 3925 abstracts, 103 studies were identified including 5328 patients from 21 countries. The average age of participants was <25 years in 45.6% (n = 47) of studies. Studies utilized human chorionic gonadotropin (hCG) (n = 93, 90.3% of studies), human menopausal gonadotropin (n = 42, 40.8%), follicle-stimulating hormone (FSH) (n = 37, 35.9%), and gonadotropin-releasing hormone (28.2% n = 29). The median reported duration of treatment/follow-up was 18 months (interquartile range 10.5-24 months). Gonadotropins induced significant increases in testicular volume, penile size, and testosterone in over 98% of analyses. Spermatogenesis rates were higher with hCG + FSH (86%, 95% confidence interval [CI] 82%-91%) as compared with hCG alone (40%, 95% CI 25%-56%). However, study heterogeneity and treatment variability were high.
CONCLUSIONS
This systematic review provides convincing evidence of the efficacy of gonadotropins for pubertal induction. However, there remains substantial heterogeneity in treatment choice, dose, duration, and outcomes assessed. Formal guidelines and randomized studies are needed.
Topics: Humans; Male; Chorionic Gonadotropin; Follicle Stimulating Hormone; Gonadotropin-Releasing Hormone; Gonadotropins; Hypogonadism; Klinefelter Syndrome; Spermatogenesis; Testis; Testosterone; Young Adult
PubMed: 38128110
DOI: 10.1093/ejendo/lvad166 -
Frontiers in Endocrinology 2024To evaluate the effects of behavioral intervention for polycystic ovary syndrome (PCOS). (Meta-Analysis)
Meta-Analysis
The effects of behavioral intervention on anthropometric, clinical, and biochemical parameters in patients with polycystic ovary syndrome: a systematic review and meta-analysis.
OBJECTIVE
To evaluate the effects of behavioral intervention for polycystic ovary syndrome (PCOS).
METHODS
Electronic databases were searched, including Pubmed, Medline, EMBASE, and the Cochrane Central Register of Controlled Trials from inception to 1 April 2023. Inclusion criteria for this study required a diagnosis of PCOS. Interventions of interest included behavioral intervention and routine treatment compared with routine treatment. The studies included in the analysis were designed as randomized controlled trials (RCTs). We conducted meta-analyses following the recommended guidelines. The data was analyzed using either the random effects model or fixed effects model. The results of the studies were expressed as either mean differences (MD) or standardized mean differences (SMD) along with their corresponding 95% confidence intervals (CIs).
RESULTS
Eight RCTs were identified, including data from 744 patients (415 in the intervention group and 329 in the control group). The results indicate an improvement in the effectiveness of behavioral interventions for weight loss (MD: -1.07; 95% CI: -2.1 to 0.03; I = 0%; P=0.04), body mass index (BMI) (MD: -1.12; 95% CI: -1.92 to -0.33; I = 73%; P=0.006), waist circumference (MD: -3.97; 95% CI: -5.64 to -2.29; I = 0%; P<0.00001), quality of life about weight (MD: 0.58; 95% CI: 0.15 to 1.02; I = 0%; P=0.008), depression (SMD: -1.12; 95% CI: -2.35 to -0.07; I = 92%; P=0.04), and triglycerides (MD: -0.16; 95% CI: -0.27 to -0.05; I = 27%; P=0.004). However, there were no significant differences in menstrual cycles, hirsutism, emotions, and infertility. The study also found that behavioral interventions had no significant effect on systolic and diastolic blood pressure, high-density lipoprotein, low-density lipoprotein, homeostasis model assessment of insulin resistance, testosterone, total cholesterol, fasting glucose, fasting insulin, hemoglobin A1C, and sex hormone binding globulin.
CONCLUSION
Behavioral intervention supplementation contributes to weight loss, reduction in BMI and waist circumference, and improvement in depression among patients with PCOS. However, no significant improvement was observed in the biochemical index and quality of life. The long-term effects of behavioral intervention for PCOS remain unclear due to limitations in the quality of the studies involved and the short duration of treatment.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO, identifier CRD42023442875.
Topics: Female; Humans; Polycystic Ovary Syndrome; Hirsutism; Insulin Resistance; Quality of Life; Weight Loss
PubMed: 38481448
DOI: 10.3389/fendo.2024.1297841 -
Journal of Cancer Survivorship :... Feb 2021The purpose of this study is to systematically review the current literature on the post-treatment survivorship experiences of African-American men with prostate cancer... (Review)
Review
PURPOSE
The purpose of this study is to systematically review the current literature on the post-treatment survivorship experiences of African-American men with prostate cancer by exploring qualitative studies to gain a deep understanding of their survivorship experiences.
METHOD
We searched five databases for studies published from 2008 to 2018. We identified ten relevant qualitative studies, conducted a meta-synthesis using Noblit and Hare's meta-ethnography approach, and evaluated their quality appraisal using the validated Critical Appraisal Skills Program.
RESULTS
This review generated a total of four main themes and nine subthemes. The Four main themes included coping strategy, psychophysical impact, health system influence, and socioeconomic impact. Spirituality, healthy behaviors, supportive care of spouse/family/friends and non-communicating/reticent were subthemes identified in the coping strategy theme; physical well-being and sexuality and masculinity were subthemes in the psychophysical impact theme; healthcare provider interaction and treatment decision-making were subthemes identified in the health system influence theme, and health insurance status was the subtheme in the socioeconomic impact theme.
CONCLUSION
Our findings reveal that the experiences of African-American prostate cancer survivors are complex and multidimensional.
IMPLICATIONS FOR CANCER SURVIVORS
This review highlights the need for further studies with African-American prostate cancer survivors, precisely identify their needs and plan a culturally appropriate intervention to meet those needs.
Topics: Black or African American; Cancer Survivors; Humans; Male; Prostatic Neoplasms; Qualitative Research; Survivors
PubMed: 32666419
DOI: 10.1007/s11764-020-00909-4 -
Psycho-oncology Nov 2023To evaluate the evidence base for patient, oncological, and treatment prognostic factors associated with multiple mental wellbeing outcomes in prostate cancer patients. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To evaluate the evidence base for patient, oncological, and treatment prognostic factors associated with multiple mental wellbeing outcomes in prostate cancer patients.
METHODS
We performed a literature search of MEDLINE, EMBASE, and CINAHL databases including studies evaluating patient, oncological, or treatment factors against one of five mental wellbeing outcomes; depression, anxiety, fear of cancer recurrence, masculinity, and body image perception. Data synthesis included a random effects meta-analysis for the prognostic effect of individual factors if sufficient homogenous data was available, with a structured narrative synthesis where this was not possible.
RESULTS
A final 62 articles were included. Older age was associated with a reducing odds of depression (OR 0.97, p = 0.04), with little evidence of effect for other outcomes. Additionally, baseline mental health status was related to depression and increasing time since diagnosis was associated with reducing fear of recurrence, albeith with low certainty of evidence. However, few other patient or oncological factors demonstrated any coherent relationship with any wellbeing outcome. Androgen deprivation therapy was associated with increased depression (HR 1.65, 95% CI 1.41-1.92, p < 0.01) and anxiety, however, little difference was seen between other treatment options. Overall, whilst numerous factors were identified, most were evaluated by single studies with few evaluating masculinity and body image outcomes.
CONCLUSION
We highlight the existing evidence for prognostic factors in mental wellbeing outcomes in prostate cancer, allowing us to consider high-risk groups of patients for preventative and treatment measures. However, the current evidence is heterogenous with further work required exploring less conclusive factors and outcomes.
Topics: Male; Humans; Prostatic Neoplasms; Depression; Prognosis; Androgen Antagonists; Neoplasm Recurrence, Local; Quality of Life
PubMed: 37789603
DOI: 10.1002/pon.6225 -
Annals of Translational Medicine Apr 2021Nipple-areola complex (NAC) reconstruction in transgender and gender non-binary (TGNB) individuals undergoing chest wall masculinization surgery is critical for adequate... (Review)
Review
Nipple-areola complex (NAC) reconstruction in transgender and gender non-binary (TGNB) individuals undergoing chest wall masculinization surgery is critical for adequate satisfaction and aesthetic results. Here, we conducted a systematic review to find the various techniques and outcomes of NAC reconstruction in double-incision mastectomy and free nipple grafts (DIM-FNG). A comprehensive search of several databases was conducted based on PRISMA guidelines. We included studies that described the NAC reconstruction technique after DIM-FNG, and evaluated the surgical outcomes, or satisfaction, or aesthetic results after a minimum duration of follow-up of 6 months. Studies were assessed for risk of bias. A qualitative synthesis was performed. A total of 19 studies, comprising 1,587 patients (3,174 breasts), were included. There was a total of 14 studies using the conventional FNG technique, 4 describing new approaches for NAC reconstruction in FNG and 1 study comparing the conventional FNG technique to another alternative technique. A total of 1,347 patients underwent DIM-FNG with conventional FNG and 240 underwent alternative techniques for NAC reconstruction after DIM-FNG. Postoperative complications were low, and satisfaction was high for conventional and alternative techniques. Newer techniques aim to reshape the new NACs in an oval shape, reduce nipple size and place the NACs using the pectoralis major lateral and inferior borders as reference. In addition, a horizontal oval incision at the recipient site may avoid an undesired vertical NAC.
PubMed: 33987310
DOI: 10.21037/atm-20-4522 -
Journal of Cancer Survivorship :... Feb 2022Body image, self-esteem, and masculinity are three interconnected constructs in men with prostate cancer, with profound effects on quality of life. This meta-synthesis... (Review)
Review
PURPOSE
Body image, self-esteem, and masculinity are three interconnected constructs in men with prostate cancer, with profound effects on quality of life. This meta-synthesis aimed to evaluate all known qualitative studies published studying the effect of prostate cancer on these constructs.
METHODS
A systematic review utilising PubMed, Embase, MEDLINE, and PsycINFO databases up to May 2020 was conducted in line with PRISMA and ENTREQ guidelines. All qualitative studies of men's experiences with body image, self-esteem, and masculinity whilst living with prostate cancer were included. A thematic meta-synthesis was conducted to identify emergent descriptive and analytical themes under the main study constructs.
RESULTS
Of 2188 articles identified, 68 were included. Eight descriptive themes were identified under two analytical themes: 'Becoming a Prostate Cancer Patient' and 'Becoming a Prostate Cancer Survivor'. These described the distress caused by changes to body image, sexual functioning, sense of masculinity, and self-esteem, and the subsequent discourses men engaged with to cope with and manage their disease. A key element was increased flexibility in masculinity definitions, and finding other ways to re-affirm masculinity.
CONCLUSIONS
Prostate cancer has an important effect on men's health post-diagnosis, and we identified strong relationships between each construct evaluated. The role of hegemonic masculinity is important when considering men's coping mechanisms and is also a key factor when addressing these constructs in counselling post-treatment.
IMPLICATIONS FOR CANCER SURVIVORS
This meta-synthesis provides key topics that uniquely affect prostate cancer survivors, enabling these patients to be effectively counselled, and have their concerns recognised by clinicians.
Topics: Body Image; Humans; Male; Masculinity; Prostatic Neoplasms; Qualitative Research; Quality of Life; Self Concept
PubMed: 33963973
DOI: 10.1007/s11764-021-01007-9 -
Scientific Reports Nov 2022Vitamin E supplementation might have favorable effects on risk factors of polycystic ovary syndrome (PCOS). This systematic review and meta-analysis aimed to summarize... (Meta-Analysis)
Meta-Analysis
Vitamin E supplementation might have favorable effects on risk factors of polycystic ovary syndrome (PCOS). This systematic review and meta-analysis aimed to summarize the effects of vitamin E supplementation or vitamin E in combination with omega-3 or magnesium on PCOS. PubMed, Scopus, ISI Web of Science, Cochrane, Embase electronic databases, and Google scholar were searched for all available articles up to September 2022. Randomized controlled trials (RCTs) that examined the effect of vitamin E supplementation or vitamin E in combination with omega-3 or magnesium on lipid and glycemic profiles, anthropometric measurements, biomarkers of inflammation and oxidative stress, hormonal profile, and hirsutism score in patients with PCOS were included. Ten RCTs (with 504 participants) fulfilled the eligible criteria. Vitamin E supplementation or vitamin E in combination with omega-3 or magnesium in comparison to placebo could significantly reduce serum levels of TG (weighted mean difference: - 18.27 mg/dL, 95% CI - 34.68 to - 1.87), VLDL (- 5.88 mg/dL, 95% CI - 8.08 to - 3.68), LDL-c (- 12.84 mg/dL, 95% CI - 22.15 to - 3.52), TC (- 16.30 mg/dL, 95% CI - 29.74 to - 2.86), TC/HDL-c ratio (- 0.52, 95% CI - 0.87 to - 0.18), hs-CRP (- 0.60 ng/mL, 95% CI - 0.77 to - 0.44), hirsutism score (- 0.33, 95% CI - 0.65 to - 0.02) and significantly increase nitric oxide levels (2.79 µmol/L, 95% CI 0.79-4.79). No significant effect was found on HDL-c, glycemic indices, hormonal profile, anthropometric measurements, and other biomarkers of inflammation or oxidative stress. This meta-analysis highlights the potential anti-hyperlipidemic, anti-oxidant, and anti-inflammatory properties of vitamin E supplementation alone or in combination with omega-3 or magnesium on PCOS patients.
Topics: Humans; Female; Magnesium; Polycystic Ovary Syndrome; Hirsutism; Dietary Supplements; Fatty Acids, Omega-3; Vitamin E; Biomarkers; Inflammation; Antioxidants
PubMed: 36402830
DOI: 10.1038/s41598-022-24467-0