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Morris BJ, Katelaris A, Blumenthal NJ, Hajoona M, Sheen AC, Schrieber L, Lumbers ER, Wodak AD, Katelaris P. Evidence-based circumcision policy for Australia. J Mens Health 2022; 18:132. [PMID: 36034719 PMCID: PMC9409339 DOI: 10.31083/j.jomh1806132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The aim was (1) to perform an up-to-date systematic review of the male circumcision (MC) literature and (2) to determine the number of adverse medical conditions prevented by early MC in Australia. Searches of PubMed using "circumcision" with 39 keywords and bibliography searches yielded 278 publications meeting our inclusion criteria. Early MC provides immediate and lifetime benefits, including protection against: urinary tract infections, phimosis, inflammatory skin conditions, inferior penile hygiene, candidiasis, various STIs, and penile and prostate cancer. In female partners MC reduces risk of STIs and cervical cancer. A risk-benefit analysis found benefits exceeded procedural risks, which are predominantly minor, by approximately 200 to 1. It was estimated that more than 1 in 2 uncircumcised males will experience an adverse foreskin-related medical condition over their lifetime. An increase in early MC in Australia to mid-1950s prevalence of 85% from the current level of 18.75% would avoid 77,000 cases of infections and other adverse medical conditions over the lifetime for each annual birth cohort. Survey data, physiological measurements, and the anatomical location of penile sensory receptors responsible for sexual sensation indicate that MC has no detrimental effect on sexual function, sensitivity or pleasure. US studies found that early infant MC is cost saving. Evidence-based reviews by the AAP and CDC support early MC as a desirable public health measure. Although MC can be performed at any age, early MC maximizes benefits and minimises procedural risks. Parents should routinely be provided with accurate, up-to-date evidence-based information in an unbiased manner early in a pregnancy so that they have time to weigh benefits and risks of early MC and make an informed decision should they have a son. Parental choice should be respected. A well-trained competent practitioner is essential and local anaesthesia should be routinely used. Third party coverage of costs is advocated.
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Affiliation(s)
- Brian J. Morris
- School of Medical Sciences, University of Sydney, Sydney, NSW 2006, Australia
| | - Athos Katelaris
- Department of Urology, St George Hospital, Sydney, NSW 2217, Australia
| | - Norman J. Blumenthal
- Department of Obstetrics and Gynaecology, SAN Clinic, Wahroonga, NSW 2076, Australia
| | - Mohamed Hajoona
- Victoria Circumcision Clinic, The Regent Medical Group, Preston, VIC 3072, Australia
| | | | - Leslie Schrieber
- Department of Medicine, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
| | - Eugenie R. Lumbers
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Pregnancy and Reproduction Program, Hunter Medical Research Institute, New Lambton Heights; Priority Research Centre for Reproductive Sciences, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Alex D. Wodak
- St Vincent’s Hospital, Australian Tobacco Harm Reduction Association and Australia21, Darlinghurst, NSW 2010, Australia
| | - Phillip Katelaris
- Katelaris Urology, North Shore Private Hospital, St Leonards, NSW 2065, Australia
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Branciari R, Franceschini R, Roila R, Valiani A, Pecorelli I, Piersanti A, Haouet N, Framboas M, Ranucci D. Nutritional Value and Contaminant Risk Assessment of Some Commercially Important Fishes and Crawfish of Lake Trasimeno, Italy. Int J Environ Res Public Health 2020; 17:ijerph17072545. [PMID: 32276363 PMCID: PMC7177714 DOI: 10.3390/ijerph17072545] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 03/29/2020] [Accepted: 04/03/2020] [Indexed: 12/31/2022]
Abstract
The aim of our study was to describe the balance between health benefits and risks associated with the consumption of crawfish and nine fish species from lake Trasimeno. We thus determined both fatty acid profiles (particularly, eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids) and chemical pollutants (some polychlorinated biphenyls, pesticides, and heavy metals) in fish muscle tissues. The contents of all fatty acids varied significantly among species. Sand smelt, carp, and tench, which have a high fat content, contained considerable amounts of EPA and DHA; lean fish, like perch, pike, and largemouth bass, which have relatively high percentages of the predominant n-3 fatty acids EPA and DHA, showed lower amounts of these fatty acids because of their low lipid contents. Some species contributed strongly to the Dietary Reference Intake (RDI) of EPA and DHA. The contribution of lean fish to the RDI of EPA and DHA was more limited. The concentrations of all contaminants in fish muscle tissues were lower than the regulatory limits, demonstrating the safety of the environmental conditions of the lake. The contribution to health-based reference values and benefit–risk quotients indicated that the health benefits of consumption of fish from lake Trasimeno outweigh the potential risks.
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Affiliation(s)
- Raffaella Branciari
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy;
- Correspondence: (R.B.); (R.R.)
| | - Raffaella Franceschini
- Department of Sustainability Engineering, Guglielmo Marconi University, 00193 Rome, Italy;
| | - Rossana Roila
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy;
- Correspondence: (R.B.); (R.R.)
| | - Andrea Valiani
- Istituto Zooprofilattico Sperimentale dell’Umbria e delle Marche “Togo Rosati”, Via G. Salvemini 1, 06126 Perugia, Italy; (A.V.); (I.P.); (A.P.); (N.H.); (M.F.)
| | - Ivan Pecorelli
- Istituto Zooprofilattico Sperimentale dell’Umbria e delle Marche “Togo Rosati”, Via G. Salvemini 1, 06126 Perugia, Italy; (A.V.); (I.P.); (A.P.); (N.H.); (M.F.)
| | - Arianna Piersanti
- Istituto Zooprofilattico Sperimentale dell’Umbria e delle Marche “Togo Rosati”, Via G. Salvemini 1, 06126 Perugia, Italy; (A.V.); (I.P.); (A.P.); (N.H.); (M.F.)
| | - Naceur Haouet
- Istituto Zooprofilattico Sperimentale dell’Umbria e delle Marche “Togo Rosati”, Via G. Salvemini 1, 06126 Perugia, Italy; (A.V.); (I.P.); (A.P.); (N.H.); (M.F.)
| | - Marisa Framboas
- Istituto Zooprofilattico Sperimentale dell’Umbria e delle Marche “Togo Rosati”, Via G. Salvemini 1, 06126 Perugia, Italy; (A.V.); (I.P.); (A.P.); (N.H.); (M.F.)
| | - David Ranucci
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy;
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Abstract
UNLABELLED Sodium valproate and related preparations have recently undergone regulatory review following concern about effects on the unborn child and doctors' failure to communicate risk. The issues are wider. Valproate is overused in psychiatry based on the false perception that 'ease' of use equates to better safety than alternatives. Valproic acid can disrupt fundamental physiological processes, the consequences of which are poorly understood and little discussed in the psychiatric literature. Valproate may be useful in a small number of patients with bipolar disorder but current prescribing patterns are unjustified. Perception needs to change. DECLARATION OF INTEREST D.C.O. is psychiatric commissioner on the Commission on Human Medicines and a member of the European Medicines Agency's Scientific Advisory Group on Psychiatry. He chaired the European Medicines Agency's review of the psychiatric use of valproate in pregnancy and women of childbearing potential.
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Affiliation(s)
- David Cunningham Owens
- Professor of Clinical Psychiatry and Honorary Consultant Psychiatrist, Centre for Clinical Brain Sciences, Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, UK.
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Salameh P, Salamé J, Waked M, Barbour B, Zeidan N, Baldi I. Risk perception, motives and behaviours in university students. Int J Adolesc Youth 2014; 19:279-292. [PMID: 25431509 PMCID: PMC4235506 DOI: 10.1080/02673843.2014.919599] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Accepted: 04/27/2014] [Indexed: 11/12/2022] Open
Abstract
Risky behaviours among young people are relatively frequent, with several motives and attitudes lying behind. Our objective was to evaluate the role of risk perception, attractiveness and motives for risk behaviour taking among university students in Lebanon. A cross-sectional study was carried out using a proportionate cluster sample of Lebanese students in public and private universities. Items of risk intake and perception scale, attractiveness of risky behaviours, and motives for risky behaviours were assessed, in addition to cigarette and waterpipe smoking and dependence, alcohol problematic consumption and mental distress scale. After verifying the validity of scales and reliability in the university students' population, we found that risk perception was associated with lower risk intake, while risk attractiveness was a driver for it. Moreover, motives differed in their driving of risky behaviour, a particular point was that women indicated more goal achievement objectives, the latter concept was associated with lower risk taking. University students in Lebanon, women in particular, demonstrated wiser behaviour and may benefit from heath education programme to increase their awareness about risky behaviours. Identifying other personal, environmental, social and psychological predictors may also be important to improve effectiveness of these programmes.
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Affiliation(s)
- P Salameh
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University , Hadath , Lebanon
| | - J Salamé
- Charité, Universitätsmedizin University Hospital , Berlin , Germany
| | - M Waked
- Pulmonology Department, Faculty of Medicine, Saint Georges Hospital, Balamand University , Beirut , Lebanon
| | - B Barbour
- Faculty of Public Health, Lebanese University , Fanar , Lebanon
| | - N Zeidan
- Faculty of Public Health, Lebanese University , Fanar , Lebanon
| | - I Baldi
- Laboratoire Santé Travail Environnement, Université Bordeaux Segalen , Bordeaux , France
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