Alan White

The main reason for the shift had been the decline in communicable diseases in the younger age groups, but this positive change has been accompanied by a growth in non-communicable diseases (NCDs). A key feature of the majority of the health challenges facing men is that they are mostly preventable, with lifestyles and risk-taking principal factors. The low growth in the younger population is more marked in some areas of the world than others, with Eastern European countries and others such as Japan seeing a drop in birth rates to below sustainable growth levels. Healthy life expectancy (HALE), gives the number of years the population is expected to live in good health as opposed to the total years lived. Male excess of premature mortality is seen from conception onwards, with most intrauterine fetal deaths occurring with a male embryo, as a result of genetic malformation.

The global pandemic as a result of the SARS-CoV2 virus has seen over 16 m people infected and over 650,000 deaths, with men at double the risk of both developing the severe form of the disease and mortality. There are both biological (sex) and socio-cultural (gender) factors, compounded by socio-economic factors and ethnicity, that impact on the aftermath of what has occurred over the short time that this novel coronavirus has been circulating the world. The potential life-long morbidity as a result of the infection and as a consequence of highly invasive critical care treatment needs to be factored into the rehabilitation of survivors. There are also many men whose lives will have been severely affected both physically and emotionally by the pandemic without ever contracting the disease, with the widespread disruption to normal existence and its impact on their social world and the economy. The implications of the closure of many healthcare services over the initial lockdown will also have both a shorter- and longer-term impact on other diseases due to missed early diagnosis and disrupted treatment regimes. Getting effective public health messages out to the population is critical and this current pandemic is demonstrating that there needs to be a more focused view on men’s health behavior. Without effective public support for preventative action, the more likely the disease will continue its path unabated. This review explores the wider ramifications of the disease both for those men who have survived the disease and those that have been affected by the wider social effects of the pandemic. The pandemic should be a wake-up call for all involved in the planning and delivery of health and social care for the greater attention to the central role of sex and gender.

Background: Globally, the uptake of health screening is suboptimal, especially in men and those of younger age. In view of the increasing internet access and mobile phone ownership, ScreenMen, a mobile Web app, was developed to improve health screening uptake in men. Objective: This study aimed to evaluate the utility and usability of ScreenMen. Methods: This study used both qualitative and quantitative methods. Healthy men working in a banking institution were recruited to participate in this study. They were purposively sampled according to job position, age, education level, and screening status. Men were asked to use ScreenMen independently while the screen activities were being recorded. Once completed, retrospective think aloud with playback was conducted with men to obtain their feedback. They were asked to answer the System Usability Scale (SUS). Intention to undergo screening pre- and postintervention was also measured. Qualitative data were analyzed using a framework approach followed by thematic analysis. For quantitative data, the mean SUS score was calculated and change in intention to screening was analyzed using McNemar test. Results: In total, 24 men participated in this study. On the basis of the qualitative data, men found ScreenMen useful as they could learn more about their health risks and screening. They found ScreenMen convenient to use, which might trigger men to undergo screening. In terms of usability, men thought that ScreenMen was user-friendly and easy to understand. The key revision done on utility was the addition of a reminder function, whereas for usability, the revisions done were in terms of attracting and gaining users’ trust, improving learnability, and making ScreenMen usable to all types of users. To attract men to use it, ScreenMen was introduced to users in terms of improving health instead of going for screening. Another important revision made was emphasizing the screening tests the users do not need, instead of just informing them about the screening tests they need. A Quick Assessment Mode was also added for users with limited attention span. The quantitative data showed that 8 out of 23 men (35%) planned to attend screening earlier than intended after using the ScreenMen. Furthermore, 4 out of 12 (33%) men who were in the precontemplation stage changed to either contemplation or preparation stage after using ScreenMen with P=.13. In terms of usability, the mean SUS score of 76.4 (SD 7.72) indicated that ScreenMen had good usability. Conclusions: This study showed that ScreenMen was acceptable to men in terms of its utility and usability. The preliminary data suggested that ScreenMen might increase men’s intention to undergo screening. This paper also presented key lessons learned from the beta testing, which is useful for public health experts and researchers when developing a user-centered mobile Web app.

The seventeenth-century philosopher Leibniz is famous, as the author of a system of metaphysics so grand and abstract that Kant called it ‘a kind of enchanted world’, Hegel ‘a metaphysical romance’ and Bertrand Russell ‘a fantastic fairy tale’. As a mathematician, Leibniz held that a formula could always be found to describe, explain and give a pattern for any set of points, however randomly they had been set down. Leibniz argues that ‘always, in every true proposition, necessary or contingent, universal or particular, the concept of the predicate is in a sense included in that of the subject; the predicate’ ‘is present in the subject’. Leibniz applies his doctrine of the predicate being in the subject to individual substances. A connection between Leibniz’s mathematical idea of substance as a point and his psychological idea of substance as a mind is made in his view that a mind is itself a point.

Plato enters the second stage of the metaphysical method, namely his assumption of several principles which guide and colour his answer and lead him on to a metaphysical system. Plato is led to posit the existence of Forms, goodness, justice, beauty, courage, the archetypal bed. because his attempt to solve the conceptual problem led him to suppose that as well as the examples of goodness. Plato thinks that the kind of thing which something is a kind of thing. Plato held that knowledge must be of what is ignorance of what is not, and belief of a mixture of the two. This supposition about the unchanging and unchangeable nature of any object of knowledge has also proved popular in much subsequent philosophy. Plato believed that to be unchanging was a mark not only of that which alone could be discernible by thought and be known, as contrasted with being believed, but of that which was divine and existed elsewhere.

R. G. Collingwood, like Kant, considered attempts by metaphysical arguments to reach what lies beyond experience as doomed to futility. R. G. Collingwood does frequently call an absolute presupposition itself, such as ‘Every event has a cause’, ‘there is motion in nature’, ‘God exists’, a metaphysical proposition. Collingwood is, in fact, quite ambivalent about how much a description of actual metaphysical practice his definition of ‘metaphysics’ is. He often claims that it is true of, and indeed derived from, the work of Aristotle, after which the subject was called. His commentators and supporters clearly speak and think of his metaphysics as a ‘reformed metaphysics’. Collingwood’s ‘reformed metaphysics’ as a history of ideas, namely those ideas and principles which either actually has been or logically ought to have been presupposed in the thought of any given period or thinker is a perfectly legitimate study.

Colorectal cancer (CRC) is an illness strongly influenced by sex and gender, with mortality rates in males significantly higher than females. There is still a dearth of understanding on where sex differences exist along the pathway from presentation to survival. The aim of this review is to identify where actions are needed to improve outcomes for both sexes, and to narrow the gap for CRC. A cross-sectional review of national data was undertaken to identify sex differences in incidence, screening uptake, route to diagnosis, cancer stage at diagnosis and survival, and their influence in the sex differences in mortality. Overall incidence is higher in men, with an earlier age distribution, however, important sex differences exist in anatomical site. There were relatively small differences in screening uptake, route to diagnosis, cancer staging at diagnosis and survival. Screening uptake is higher in women under 69 years. Women are more likely to present as emergency cases, with more men diagnosed through screening and two-week-wait. No sex differences are seen in diagnosis for more advanced disease. Overall, age-standardised 5-year survival is similar between the sexes. As there are minimal sex differences in the data from routes to diagnosis to survival, the higher mortality of colorectal cancer in men appears to be a result of exogenous and/or endogenous factors pre-diagnosis that lead to higher incidence rates. There are however, sex and gender differences that suggest more targeted interventions may facilitate prevention and earlier diagnosis in both men and women.

This book includes a foreword by Peter Baker, Chief Executive, The Men's Health Forum. Male weight problems are a serious public health issue and can lead to hypertension, hyperlipidaemia, diabetes and cancer. If current trends continue, the prospect of the majority of men becoming overweight is a very real one, and urgent action is imperative. The middle-aged spread that most men 'expect' to develop as they enter into their thirties and forties is now occurring much earlier with boys and young men developing life limiting weight problems. This multidisciplinary guide provides a gender sensitive approach to weight issues. Men need to be targeted specifically and in a male-focused manner, in order to overcome the multitude of contributing factors in their weight gain; social influences, dietary restrictions, education, cultural expectations, psychological considerations and exercise regime. This book takes a balanced approach, offering practical guidance as well as evidence-based research, academic perspectives and personal experiences. The advice is easy to implement and has been proven in real-life settings. All healthcare professionals, nutritionists and dieticians will find the assistance invaluable. It is also highly recommended for psychologists, counsellors and therapists, particularly those working with men. Healthcare policy makers and shapers too, will find much of interest. 'A definitive and seminal book that will change the way male weight problems are tackled in the UK and beyond.' - Peter Baker, in the Foreword.

Objective: To investigate the existence and distribution of 2 typologies (termed “factors”) of men with rheumatoid arthritis (RA) identified through our previous Q‐methodology study (n = 30) in a larger sample of men with RA, and whether differences in psychosocial impact or support preferences exist between the 2 factors, and between men and women with RA.Methods: A postal survey was sent to 620 men with RA from 6 rheumatology units across England, and the support preferences section of the survey was given to 232 women with RA.Results: A total of 295 male patients (47.6%) and 103 female patients (44.4%) responded; 15 male participants had missing data, and thus 280 were included in the analysis. Of these, 61 (22%) were assigned to factor A (“accept and adapt”), 120 (35%) were assigned to factor B (“struggling to match up”), and 99 (35%) were unassigned. The two factors differed significantly, with factor B reporting more severe disease, less effective coping strategies, and poorer psychological status. For support, men favored a question and answer session with a consultant (54%) or specialist nurse (50%), a website for information (69%), a talk by researchers (54%), or a symptom management session (54%). Overall, women reported more interest in support sessions than men, with ≥50% of women reporting interest in nearly every option provided.Conclusion: Some men accept and adapt to their RA, but others (43%) report severe disease, less effective coping, and poor psychological status. Men's preferences for support are practical, with a focus on expanding their knowledge.

BACKGROUND Globally, the uptake of health screening is suboptimal, especially in men and those of younger age. In view of the increasing internet access and mobile phone ownership, ScreenMen, a mobile Web app, was developed to improve health screening uptake in men. OBJECTIVE This study aimed to evaluate the utility and usability of ScreenMen. METHODS This study used both qualitative and quantitative methods. Healthy men working in a banking institution were recruited to participate in this study. They were purposively sampled according to job position, age, education level, and screening status. Men were asked to use ScreenMen independently while the screen activities were being recorded. Once completed, retrospective think aloud with playback was conducted with men to obtain their feedback. They were asked to answer the System Usability Scale (SUS). Intention to undergo screening pre- and postintervention was also measured. Qualitative data were analyzed using a framework approach followed by thematic analysis. For quantitative data, the mean SUS score was calculated and change in intention to screening was analyzed using McNemar test. RESULTS In total, 24 men participated in this study. On the basis of the qualitative data, men found ScreenMen useful as they could learn more about their health risks and screening. They found ScreenMen convenient to use, which might trigger men to undergo screening. In terms of usability, men thought that ScreenMen was user-friendly and easy to understand. The key revision done on utility was the addition of a reminder function, whereas for usability, the revisions done were in terms of attracting and gaining users’ trust, improving learnability, and making ScreenMen usable to all types of users. To attract men to use it, ScreenMen was introduced to users in terms of improving health instead of going for screening. Another important revision made was emphasizing the screening tests the users do not need, instead of just informing them about the screening tests they need. A Quick Assessment Mode was also added for users with limited attention span. The quantitative data showed that 8 out of 23 men (35%) planned to attend screening earlier than intended after using the ScreenMen. Furthermore, 4 out of 12 (33%) men who were in the precontemplation stage changed to either contemplation or preparation stage after using ScreenMen with P=.13. In terms of usability, the mean SUS score of 76.4 (SD 7.72) indicated that ScreenMen had good usability. CONCLUSIONS This study showed that ScreenMen was acceptable to men in terms of its utility and usability. The preliminary data suggested that ScreenMen might increase men’s intention to undergo screening. This paper also presented key lessons learned from the beta testing, which is useful for public health experts and researchers when developing a user-centered mobile Web app.