Gender, the gender gap, and their interaction; analysis of relationships with children's mental health problems.

PURPOSE: The present study seeks to examine gender differences in internalizing and externalizing problems either parent/teacher or self-reported and to investigate the influence of country-level gender gap on children's mental health problems across countries with high and low gender gap across Europe. METHODS: The School Children's Mental Health in Europe (SCMHE) survey collected data on primary school children living in six European countries, using self-reports (SR) from children (Dominic Interactive), as well as combination of parent- and teacherreports (P/T C) (Strengths and Difficulties Questionnaire) to assess internalizing and externalizing mental health problems. The World Economic Forum's (WEF's) Global Gender Gap report's Gender Gap Index (GGI) was used to categorize countries with high and low gender gap. RESULTS: Boys had greater odds of externalizing problems (OR = 2.6 P/T C, 1.95 SR), and lower odds of internalizing problems (OR = 0.85 P/T C, 0.63 SR). The gender gap's association with mental health problems was different depending on the informant used to identify these problems. A small gap was a risk factor based on reports from adults for externalizing (OR = 1.53) and internalizing problems (OR = 1.42) while it was a protective factor for SR internalizing problems (OR = 0.72). For these problems the gender gap impacted boys and girls differently: a small gender gap was protective for boys but not for girls, including when controlling for key confounding variables. CONCLUSIONS: The differential impact of country-level gender gap observed between self-reported and parent- or teacher-reported mental health is complex but nevertheless present trough mechanisms that are worthwhile to study in depth, with a special attention to the informants and the type of problems examined.

Phthalates and Sex Steroid Hormones Among Men From NHANES, 2013-2016.

CONTEXT: Phthalates are commonly found in commercial packaging, solvents, vinyl, and personal care products, and there is concern for potential endocrine-disrupting effects in males. The commonly used di-2-ethylhexyl phthalate (DEHP) has progressively been replaced by seldom studied compounds, such as bis-2-ethylhexyl terephthalate and 1,2-cyclohexane dicarboxylic acid di-isononyl ester (DINCH). OBJECTIVE: To investigate the associations between the urinary phthalate metabolites and serum sex steroid hormone concentrations in a nationally representative sample of adult males. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTION: This was a cross-sectional analysis of data from the 2013-2016 National Health and Nutrition Examination Survey among 1420 male participants aged ≥20 years. MAIN OUTCOME MEASURES: Serum levels of total testosterone, estradiol, SHBG, and derived sex hormone measurements of free testosterone, bioavailable testosterone, and free androgen index were examined as log-transformed continuous variables. RESULTS: Phthalate metabolites were not statistically significantly associated with sex hormone concentrations among all men. However, associations varied by age. High molecular weight phthalates were associated with lower total, free, and bioavailable testosterone among men age ≥60. Specifically, each doubling of ΣDEHP was associated with 7.72% lower total testosterone among older men (95% confidence interval, -12.76% to -2.39%). Low molecular phthalates were associated with lower total, free, and bioavailable testosterone among men age 20 to 39 and ∑DINCH was associated with lower total testosterone among men age ≥40. CONCLUSIONS: Our results indicate that males may be vulnerable to different phthalate metabolites in age-specific ways. These results support further investigation into the endocrine-disrupting effects of phthalates.

The exercise prescription for enhancing overall health of midlife and older women.

BACKGROUND: For midlife and older women, this period of their life is associated with an increase in risk factors for the development of chronic medical conditions. Data confirms the importance of regular exercise for both prevention and management of cardiovascular and other non-communicable diseases, unwanted weight gain, worsening metabolic profile and osteoporosis. However, in most clinical practices, midlife and older women patients are not offered specific exercise guidance. OBJECTIVES: This review assessed the current environment of what exercise advice is being offered to women at clinical encounters and suggests ways of incorporating an exercise prescription into clinical practice. MATERIALS AND METHODS: A PubMed review of the literature from the past 20 years was conducted. RESULTS: A universal template for an exercise prescription for aging women does not exist. Globally, there are scant programs that offer exercise advice and interventions to patients at the end of clinical encounters. CONCLUSIONS: Although most aging women know the benefits of engaging in a regular exercise program, many do not establish a regular routine. By the clinician offering an exercise prescription, this not only reinforces the importance of exercise but also provides simple guidelines on how women can commence an exercise routine in their life.