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Introduction: Men referred for borderline testosterone levels represent an increasingly common clinical scenario, yet there is little literature on this population., Aim: We hypothesized that men referred for borderline testosterone levels would have higher rates of depression and depressive symptoms than the general population., Methods: Subjects included 200 adult men (mean age of 48 years old) referred for borderline total testosterone levels between 200 and 350 ng/dL (6.9-12 nmol/L). Collected data included demographic information, medical histories, medication use, signs and symptoms of hypogonadism, and assessments of depressive symptoms and/or a known diagnosis of depression or use of an antidepressant., Main Outcome Measures: The main outcome measure was a combination of known depression, current use of an antidepressant, and/or depressive symptoms according to the Patient Health Questionnaire 9 (PHQ-9) with scores ≥10 considered positive., Results: Depression and/or depressive symptoms were present in 56% of the subjects. This rate was significantly higher than rates of 6-23% (PHQ-9 scores ≥10) seen in general populations. Antidepressant use was 25%. The population was notable for high rates of overweight/obesity and physical inactivity. Common symptoms were erectile dysfunction, decreased libido, fewer AM erections, low energy, and sleep disturbances., Conclusions: While sexual and nonspecific symptoms (i.e., fatigue) likely prompted measurements of testosterone in this selected population, clinicians should recognize the high rates of depression and depressive symptoms in men referred for borderline testosterone levels. Clinicians should consider screening for depression/depressive symptoms and overweight and unhealthy lifestyle risk factors in men referred for tertiary care for potential hypogonadism., (© 2015 International Society for Sexual Medicine.)

There is an increasing interest in the variety of healers and treatments considered as complementary and alternative medicine (CAM). Care managers often encourage patients to take an active role in their self-care. The approach to self-care may include CAM. Care managers need to understand CAM and help patients become educated consumers in order to enhance their health and quality of life.

In this article we describe how providing regular foot care for the residents of public housing at an on-site nursing clinic has become a vital part of the clinic's services for the elderly and disabled residents. Good foot care contributes significantly to the health and well-being of elderly and at-risk groups of clients. With relatively little extra education for the nursing staff and for minimal cost, foot care can become an integral part of nursing services provided in many different types of community health settings. A framework for initiating and implementing a foot care program is highlighted.