Albert Botchway

Globalization, ideologies and well-being: a study of a West African and a North European society

Ideologies shape peoples belief systems about what constitutes a good life and well-being and how to navigate between considerations of own well-being versus the well-being of others. The present study investigates ideologies in West African Ghana and North European Norway. Comparative, longitudinal analyses of ideological shifts reflected in changes in language usage in public discourse (newspapers) in the two nations revealed how currently globalized ideology (consumerism, individualism and neo-liberalism) merges with local ideologies in unique ways with regard to the balance between individualist and communal values.

How is delayed ejaculation defined and treated in North America

Delayed ejaculation (DE) is an uncommon disorder that is difficult to treat because it is poorly understood. The aim was to evaluate the current opinion and clinical management of DE by practitioners in sexual medicine. Members of the Sexual Medicine Society of North America (SMSNA) were invited by email to participate in a web‐based survey. The questionnaire consisted of eight questions pertaining to DE. Questions addressed patient volume, qualification of patient bother, ranking of etiologies, perceived success, treatments used, quantification of symptom resolution, and broad characterization of practitioner type. A total of 94 respondents completed the survey with 73% of those being urologists. Fifty‐nine percent of the respondents saw ≤ 2 patients a month with DE and 89% of practitioners felt that DE was moderately or severely bothersome to the patients. Etiology was felt to be from medications and psychological factors primarily. Despite treatment modality, ‘seldom’ success was obtained for 49% of the time and ‘never’ for 11%. Carbergoline was the most common selected medication for DE. Academic and private urologists reported ‘never’ or ‘seldom’ success with sexual counseling compared to other practitioners, respectively (p = 0.008 and p = 0.001). Respondents who saw ≤ 2 patients per month often reported normalization of hypogonadism ‘never’ or ‘seldom’ corrected DE (p = 0.047). Delayed ejaculation is still a poorly understood disorder with inconsistent practice patterns seen among members of the SMSNA. A better understanding of this vexing disorder is needed with efforts placed on research and practitioner education.

Communal Values and Individualism in Our Era of Globalization: A Comparative Longitudinal Study of Three Different Societies

Ideologies shape people’s belief systems about what constitutes a good life and well-being and how to navigate between considerations of own well-being versus the well-being of others. In every culture, there is a powerful set of ideals about collectivism and individualism, and societies have to find a balance between individual independence and collective interdependence. Based on its own local historical and cultural traditions, every society has to negotiate its own balance between individual and communal values. Conceptions of what makes a good life have thus, in essential and fundamental ways, to consider both individual autonomy and personal growth and the individual’s partaking in developing, upholding, and maintaining his or her community. Conceiving globalization as an ideology or worldview, as a system of ideas and values circulating in the public realm influencing societies worldwide thereby defining and articulating local values and visions for social change, this study analyzes the influences of globalization on communal values and sense of community as reflected in language usage in public discourses (newspapers) in three different societies: a post-communist East European republic (the Czech Republic), a Nordic welfare state (Norway), and a modern West African society (Ghana).

Gender-specific relationships between socioeconomic disadvantage and obesity in elementary school students

OBJECTIVE To assess the gender-specific effect of socioeconomic disadvantage on obesity in elementary school students. METHODS We evaluated body mass index (BMI) data from 2,648 first- and fourth-grade students (1,377 male and 1,271 female students) in eight elementary schools in Springfield, Illinois, between 2012 and 2014. Other factors considered in analysis were grade level, year of data collection, school, race/ethnicity, gender, and socioeconomic disadvantage (SD). Students were considered SD if they were eligible for free/reduced price lunch, a school-based poverty measure. We performed Fishers exact test or chi-square analysis to assess differences in gender and obesity prevalence by the other factors and gender-stratified logistic regression analysis to determine if SD contributed to increased odds of obesity. RESULTS A higher proportion of SD female students (20.8%) were obese compared to their non-SD peers (15.2%) (p=0.01). Unadjusted and adjusted logistic regression analysis indicated no difference in obesity in SD and non-SD male students. However, in both unadjusted and adjusted analyses, SD female students had higher odds of obesity than their peers. Even after controlling for grade level, school, year of data collection, and race/ethnicity, SD female students had 49% higher odds of obesity than their non-SD classmates (odds ratio:1.49; 95% confidence interval: 1.09-2.04). CONCLUSIONS Obesity was elevated in SD female students, even after controlling for factors such as race/ethnicity, but such an association was not seen in male students. Further study is warranted to determine the cause of this disparity, and interventions should be developed to target SD female students.

Skin to Intramuscular Compartment Thigh Measurement by Ultrasound in Pediatric Population

Introduction Pediatric obesity threatens the efficacy of medications given intramuscularly. In anaphylactic patients, epinephrine auto-injector needle lengths are potentially too short to reach the muscle compartment in patients with elevated body habitus. The objective of the study was to determine needle-length requirements for intramuscular injections in pediatric patients. Methods We used ultrasound to measure the distance from skin to muscle compartment of the thigh in 200 pediatric patients of various weight and body mass index who presented to the emergency department. Results Patients with higher body mass index had an increased distance to muscle and bone. If current recommendations were followed, 5% of patients within the EpiPen adult weight category and 11% of patients within the Centers for Disease Control and Prevention weight category would have potentially used a needle inadequate in length for intramuscular injections. Conclusion With the increase in childhood obesity, needle lengths may be too short to effectively deliver medications to the intramuscular compartment. Needle length should be evaluated to accommodate pediatric patients with increased skin to muscle distance.

Assessing outcomes of educational videos in group visits for patients with chronic pain at an academic primary care clinic

ABSTRACT Objectives: This study evaluates the impact of pain education group visits on patients with chronic non-cancer pain (CNCP). The primary outcome of the study was to evaluate patients’ functional status and secondary outcomes included knowledge, behavior, and satisfaction, before and after participation in the pain education group visits. Methods: Locally produced patient educational videos on chronic non-cancer pain were delivered during patient group visits led by a healthcare provider. Study participants included patients with CNCP pain in an academic general medicine practice. The primary outcome was functional status, measured by the Pain Intensity, Enjoyment of life, and General Activity (PEG) score and the Oswestry Disability Index. Secondary outcomes were evaluated through a pre- and post-intervention knowledge assessment and chart review of opioid use and utilization of emergency and urgent care services. A satisfaction survey was administered after each group visit. Results: Thirty-five patient-group visits were analyzed and 14 patient charts reviewed. A moderately positive correlation was observed between PEG and Oswestry Disability Index (r = 0.47, p < 0.05). Patient knowledge improved after watching the videos and participating in group discussion. The median amount of daily morphine equivalents for patients (n = 14) was 17.5mg (range 0-120mg) at the first study, and decreased to 12.5mg (range 0-110mg) at the last study visit (p = 0.39). None of the 14 patients utilized emergency or urgent care services for pain during the study. Overall, patient satisfaction scores with the intervention were high. Conclusion: Group visits providing patient education about CNCP may benefit patients’ knowledge about this clinical condition, and was received with high patient satisfaction. Further investigation is needed to evaluate longer-term knowledge retention, sustainability of improvements resulting from the intervention, and longer-term effects of the intervention on functional status.

Young adults with depression are at increased risk of sexually transmitted disease

Sexually transmitted diseases (STDs) and depression impact millions of individuals each year in the United States, with direct medical costs exceeding

A Meta-Analysis Comparing All-Polyethylene Tibial Component to Metal-Backed Tibial Component in Total Knee Arthroplasty: Assessing Survivorship and Functional Outcomes

41 billion. While the interactions of these conditions are poorly understood, they are increasingly addressed in primary care whereas historically they have been addressed separately. We analyzed data associated with the 18-25year age group from the 2014 National Survey of Drug Use and Health, a cross-sectional survey of the civilian, non-institutionalized US population aged ≥12years for factors associated with past year diagnosis of STD (STDy). Independent variables included participant demographics; lifetime diagnosis of major depressive episode (MDE); participant behaviors associated with STD risk (patient-provided); and medical record data associated with mental illness treatment (clinically-observed). Of 18,142 participants, the prevalence of MDE and STD was 15.3% and 2.4%, respectively, with significant differences by gender and race. MDE was associated with increased risk of STDy among females (odds ratio [OR]=1.61; 95% confidence interval [CI]=1.18-2.20), males (OR=2.32; CI=1.15-4.70), those of white race (OR=3.02; CI=2.02-4.53), and lower income levels and insurance status. Univariate modeling found that receiving mental health treatment, and use of marijuana, alcohol, and illegal drugs were each associated with significantly increased STDy. In a multivariate logistic regression, receiving mental health treatment became protective for STDy (AOR=0.55; CI=0.32-0.95]). Individuals with a history of depression are at increased risk of STDy, with this risk modified by factors readily ascertained within primary care. As depression treatment is increasingly incorporated into primary care there are means to more effectively target intervention resources.