The presidential effect: the public health response to media coverage about Ronald Reagan's colon cancer episode

Little previous research has been done on the public health impact of mass media coverage of cancer episodes of public figures. This paper uses a variety of data sources to examine the impact of President Reagan's colon cancer episode of July, 1985. Records of phone calls to the Cancer Information Service of the National Cancer Institute are examined as a measure of public interest and concern about colorectal cancer; data on the use of two colorectal early detection tests--proctoscopy and fecal occult blood tests--are looked at as a measure of behavioral change; and data on the incidence of early and advanced colorectal cancer are used to estimate the potential public health impact of this behavioral change. We find that there was a sharp, albeit somewhat transitory, increase in public interest in colorectal cancer in the wake of President Reagan's colon cancer episode, with a corresponding increase in the use of early detection tests. The incidence data on early and advanced disease is indicative of a beneficial public health impact, but this can be confirmed only after additional data on mortality becomes available.     

病理类型特异的卵巢癌组织适配子的鉴定

目的鉴定经组织切片消减SELEX筛选获得的4条候选适配子对不同类型卵巢癌组织的识别特性。方法公司合成、荧光素修饰候选适配子,利用免疫荧光实验对筛选获得的适配子候选序列进行鉴定。结果免疫荧光实验证明,适配子OC-10．19和OC-10．36能够特异识别卵巢浆液性乳头状囊腺癌,且OC-10—36还能够对早期的不典型增生进行识别,另2条适配子OC-10—10和OC一10-37仅识别个别的卵巢浆液性囊腺癌。结论成功筛选获得识别不同类型卵巢癌组织的特异适配子,为适配子用于不同病理类型标志物的鉴定、临床辅助诊断等提供了理论基础．     

Testosterone,testosterone therapy and prostate cancer

Abstract

With prostate cancer not observed in eunuchs and total androgen suppression by castration an effective first-line treatment for advanced prostate cancer, the dramatic regression seen in tumour symptoms after castration, lead to the theory that high levels of circulating androgens were a risk factor for prostate cancer. This theory however, ignored the effects testosterone variations within a physiologic range could have on early tumour events and since the early 2000s, clinical evidence discounting testosterone as a linear mechanistic cause of prostate cancer growth mounted, with alternative mechanistic hypotheses such as the saturation model being proposed. Together with a growing understanding of the negative health effects and decreased quality of life in men with testosterone deficiency or hypogonadism, a paradigm shift away from testosterone as a prostate cancer inducer occurred allowing clinicians to use testosterone therapy as potential treatment for men with difficult and symptomatic hypogonadism that had been previously treated for prostate cancer. In this review we contextualise the idea of testosterone as a risk factor for prostate cancer inducement and compile the most current literature with regards to the influence of testosterone and testosterone therapy in prostate cancer.     

Obesity and gynaecological cancer

Obesity is now considered to be a global epidemic. The problem of obesity has significant implications for the diagnosis and treatment of gynaecological cancer. The cancer most frequently associated with obesity is that of the endometrium. The risk of endometrial cancer is 2-3 times higher in overweight and obese women. Obesity also adversely affects survival in most studies. With regard to ovarian cancer the evidence is inconsistent. Obesity in young adulthood may be more important than that in later life. With regard to survival obesity has an adverse effect but not in early stage disease. Few data are available regarding cervical cancer and obesity. There is evidence that obesity is associated with adenocarcinoma rather than squamous carcinoma. Data on vulval cancer and obesity are scant.     

Mutually Dependent Health Beliefs Associated With Breast Self-examination in British Female University Students

Abstract

Objective: Whereas research suggests young women's beliefs about breast cancer (susceptibility/severity) and its early detection (barriers/benefits) reliably distinguish breast self-examiners from nonexaminers, this study assessed whether these impressions are interreliant, especially in the context of familial risk. Participants: The sample comprised over 200 female undergraduates from a university in England, United Kingdom. Methods: Participants completed a self-administered survey on their attitudes concerning breast cancer and early detection. Data were analyzed using logistic regression analysis. Results: Nonexaminers were distinguished by a combination of greater perceived hindrances to self-examinations and stronger appraisals of breast cancer severity, and also by a permutation of fewer perceived benefits in self-examinations and lower perceived susceptibility to breast cancer. The latter interaction persisted after accounting for family history. Conclusions: Interwoven attitudes may depict sophisticated efforts on the part of nonexaminers to justify inaction. Clinical implications for college health providers are considered.     

Men, masculinity, and cancer: risk-factor behaviors, early detection, and psychosocial adaptation

Men and women experience cancer differently. More men than women get cancer, more men than women die from cancer, and men usually adapt less well than women after a cancer diagnosis. In this article, the author suggests that the consequences of male gender-role socialization may explain some of these differences. The focus of the article is on (a) cancer risk-factor behaviors; (b) screening, early detection, symptom recognition, and help seeking; and (c) psychosocial adaptation. Research that has identified gender differences is reviewed and the impact of male gender-role socialization is offered as a potential explanation for these differences. In addition, practice implications for college health professionals are offered.     

The role of physical activity in primary cancer prevention

Few modifiable lifestyle factors have been shown to be associated with reduced cancer risk. For physical activity, more than 200 epidemiologic studies have provided evidence that its association with cancer risk is convincing for colon and breast cancers; probable for endometrial cancer; possible for prostate, gastric, and ovarian cancers; and insufficient for all other cancer sites. Relative risk reductions are in the range of 10–30 %. On the absolute scale, about 9–19 % of the most frequent cancers can be attributed to a lack of sufficient physical activity. As modifiable health behavior, exercise thus has a strong potential for primary cancer prevention and the evidence is sufficiently established to recommend physical activity as a means for the primary prevention of cancer. Current recommendations call for at least 30–60 min of moderate to vigorous activity daily. However, further research is needed to provide a stronger evidence base specifically for these recommendations. The exact type, dose, and timing of physical activity remain unclear but ongoing and planned research will elucidate these associations. In addition, possible biologic mechanisms whereby physical activity may influence carcinogenesis, independently and/or jointly with other factors of the energy balance equation, need further attention in future research.     

Leaving Home Early: Passing from Girlhood to Womanhood

This paper presents a case study of a young woman’s narrative of leaving home and her transition to adulthood. The case study is part of a larger research project about young women with an experience of an early break-up from home, through running away or being thrown out. Empirical material underlying this paper consists of a qualitative study of 12 young women that have been interviewed. The aim of the study is to understand how events like running away/being thrown out of home influences their transition to adulthood. The particular narrative demonstrates how a young woman presents and accounts for such a dramatic event as running away or being thrown out from home, and how that is understood in relation to her adulthood. A further aim is to illustrate how social services efforts are reflected in her narrative.     

Men,Masculinity, and Cancer: Risk-factor Behaviors,Early Detection,and Psychosocial Adaptation

Abstract

Men and women experience cancer differently. More men than women get cancer, more men than women die from cancer, and men usually adapt less well than women after a cancer diagnosis. In this article, the author suggests that the consequences of male gender-role socialization may explain some of these differences. The focus of the article is on (a) cancer risk-factor behaviors; (b) screening, early detection, symptom recognition, and help seeking; and (c) psychosocial adaptation. Research that has identified gender differences is reviewed and the impact of male gender-role socialization is offered as a potential explanation for these differences. In addition, practice implications for college health professionals are offered.     

WHAT'S HAPPENED TO FAMILY INTERACTION RESEARCH? AN HISTORICAL ACCOUNT AND A FAMILY SYSTEMS VIEWPOINT

The origins and evolution of family interaction research are outlined in order to examine the apparent lag in the field after the initial hopes and enthusiasms of the 1960s. It is argued that family interaction research naturally drew upon the methodology of social psychology and that there was an insufficient integration of the implications of the clinical viewpoint of family systems theory into research procedure. A discussion is presented of some central concepts in scientific psychology, drawing conclusions as to how they can be broadened for the special field of family research. An experimental method for evaluating the public verifiability of complex clinical notions is described, and a number of recent investigations are scrutinized in the light of our critique. It is concluded that there are grounds for being optimistic that the gap between clinical and research thinking can be bridged, making the assessment and refinement of abstract and intricate concepts discovered in clinical procedures accessible to scientific experimentation.     

Motivational Factors Affecting Patient Attrition in a Weight Reduction Program

Abstract

The study hypothesizes that the greater the satisfaction of a patient's basic motivational needs, the greater the likelihood that the patient will complete the program. Patients were given a self-report questionnaire to assess the strength of their basic motivational needs as they entered the program; and a Likert-type questionnaire concerning satisfaction of needs as they left the program. The results show that those who completed the program experienced greater satisfaction of needs than those who did not complete the program. Analysis of covariance of completion of the program and need satisfaction was significant (p < .01) thus supporting the hypothesis.

“Long-term Oral Contraceptive Use and the Risk of Breast Cancer,” THE CENTERS FOR DISEASE CONTROL CANCER AND STEROID HORMONE STUDY. Using oral contraceptives for long periods or using them when one has other risk factors has been hypothesized to increase the risk of breast cancer. To study these issues, we analyzed data from a multicenter, case-control investigation—the Centers for Disease Control's Cancer and Steroid Hormone Study. All women 20 to 54 years old with a first diagnosis of breast cancer ascertained by eight population-based cancer registries are study subjects; controls are selected at random from the general population of these eight areas. Analysis of the first 689 cases and 1,077 controls studied showed that women who had used oral contraceptives at some time in their lives had a relative risk of 0.9 compared with never-users (95% confidence interval, 0.8 to 1.2). Neither duration of oral contraceptive use nor time since first use altered a user's risk of breast cancer; women whose first use was more than 15 years ago and who used oral contraceptives for 11 years or more had a relative risk of 0.8 (0.5 to 1.4). Oral contraceptive use did not increase the risk of breast cancer among women with benign breast disease or a family history of breast cancer. Oral contraceptive use before a woman's first pregnancy did not increase her risk of breast cancer significantly more than other methods of delaying first pregnancy. This study provides no support to the hypothesis that oral contraceptive use increases a woman's risk of breast cancer. (Journal of the American Medical Association 1983;249:1591–1595.)

“Oral Contraceptive Use and the Risk of Ovarian Cancer,” THE CENTERS FOR DISEASE CONTROL CANCER AND STEROID HORMONE STUDY. Since oral contraceptives have been used by more than 40 million American women, an association between oral contraceptives and ovarian cancer could have a substantial public health impact. The Centers for Disease Control, Atlanta, is studying this relationship as part of a multicenter, case-control study—the Cancer and Steroid Hormone Study. During the first ten months of the study, we enrolled 179 women aged 20 to 54 years who had been ascertained to have newly diagnosed ovarian cancer by eight population-based cancer registries. From the general population of those eight areas, we selected as controls 1,642 women with intact ovaries. Users of oral contraceptives had an age-adjusted risk of ovarian cancer developing of 0.6 relative to those who had never used them (95% confidence interval, 0.4 to 0.9). The risk of ovarian cancer decreased with increasing duration of oral contraceptive use and remained low long after cessation of use. These results were not accounted for by parity, infertility, or other potentially confounding factors. We estimate that more than 1,700 cases of ovarian cancer are averted each year by past and current oral contraceptive use among women in the United States. (Journal of the American Medical Association 1983;249:1596–1599.)     

Institutional factors,government policies and appropriate technologies

Traditionally the use of inappropriate technologies in the developing countries has been explained by the existence of factor price distortions, e.g. the price of labor being artificially raised by labor legislation, and the price of capital being reduced by subsidies and unrealistic exchange rates. In reality the technological choice is often determined by economic conditions and the local sociocultural/political conditions. The institutional framework of the country may discourage the appropriate technology. The obstacles can be overcome when the following conditions are met: 1) a national consensus about the need for development efforts and importance of policy goals; 2) promising market prospects and/or an effective marketing system; and, 3) sufficient industrial competition in both home and international markets. Institutional problems come from the generation and diffusion of technologies from the supply side which are introduced to people who do not see the need for them. More emphasis on the marketing side ususally results in application of correct technology, especially where governments fund research and development projects and formulate their plans on the basis of a concrete investment or production plan and a clear idea about the target market. Land reforms and agricultural price policies are needed as well as the establishment of an efficient national administrative network.     

Cancer Knowledge and Examination Frequency in College Students

Abstract

College students are now being considered an appropriate target for cancer education programs. However, research has demonstrated that only a fraction of those individuals knowledgeable about the importance of cancer examinations actually practice these examinations. This study investigated whether the personality construct of repression-sensitization could identify which individuals would or would not practice regular examinations for breast, cervical, and testicular cancer. College students were identified as repressors, neutral, or sensitizers and tested as to their knowledge and examination frequency for breast, cervical, and testicular cancer. After a cancer lecture, this information was reasessed. No differences were found among repressors, neutrals, or sensitizers in cancer knowledge or examination frequency, either prelecture or postlecture. Cancer knowledge significantly increased after the lecture for both males and females. No change was found in the frequency of breast self-examination, while frequency of pap smears declined after the lecture. In contrast, testicular self-examination frequency increased. The implications of these results for future research are discussed.     

Follow the money: using payment behaviour as predictor for future self-exclusion

Behavioural tracking is an increasingly discussed method of early detection of potential gambling-related problems. Recent research has focused predominantly on information derived from gambling transactions and communication logs. Even though payment behaviour establishes a direct link to the financial consequences of gambling, it had thus far not become subject to this field of research. This article uses transactional data generated by 2696 customers from the online gambling label bwin.com to investigate how far specific payment behaviours and specific payment methods enable a prospective differentiation between self-excluders and controls. The number and amount of deposits, the variance of withdrawals, the amount of funds subject to reversed withdrawals and the usage of mobile phone billing were found to be positively associated with self-exclusion; the number of active gambling months and the usage of electronic wallets and prepaid cards negatively. Customer age displayed a U-shaped relation, with customers of below and above average being stronger associated with self-exclusion. However, it must be noted that the validity of the resulting predictive model derived from payment data is lower than comparable models derived from gambling data. The results are discussed in the light of implementing early-detection and intervention algorithms based on customer behaviour.     

JOINING FOR CHANGE: AN INTERVENTION OF STATE CHANGE OR AN INTERACTION OF UNFORESEEN CONSEQUENCES?

This article is in response to Laurie Charlés' (this issue) research article on hostage negotiation. It is suggested that her article provides an opportunity for family therapists to reexamine our own taken-for-granted clinical practices, particularly the practice of joining to achieve rapport. Rapport is considered from the two perspectives of either being an experience of the individual (state trait) or as a dynamic process that is relationally accomplished with unpredictable consequences for both participants. Implications for practice and training are presented.     

Clinical Results Using Virtual Reality

Abstract

Virtual Reality (VR) technology offers new opportunities for the development of innovative clinical research, assessment, and intervention tools. VR-based testing, training, teaching, and treatment approaches that would be difficult, if not impossible to deliver using traditional methods are now being developed that take advantage of the assets that are available with VR technology. As research evidence continues to indicate clinical efficacy, VR applications are being increasingly regarded as providing innovative options for targeting the cognitive, psychological, motor, and functional impairments that result from various clinical health conditions. VR allows for the precise presentation and control of stimuli within dynamic multisensory 3-D computer generated simulations as well as providing advanced methods for capturing and quantifying behavioral responses. These characteristics support the rationale for the use of VR applications in clinical assessment, intervention, and training. This article begins with a brief review of the history and rationale for the use of VR with clinical populations. We then detail one use-case for the clinical application of VR—the exposure therapy treatment of anxiety disorders and post-traumatic stress disorder. While significant work is cited in other areas of Clinical VR (e.g., pain management, cognitive/physical assessment/rehabilitation, eating disorders, social skills/clinical training, etc.), a full overview of such a broad literature is beyond the scope of this article. Thus, we have opted to provide more in-depth analysis of one specific clinical area that clearly illustrates how VR has been successfully applied and is supported by an encouraging and evolving scientific literature.     

Methods of Self-Confrontation in Family Therapy

The research, clinical applications, and effects of audiotape and videotape self-confrontation techniques to family therapy are reviewed. A variety of new applications, such as cross-confrontation and interpersonal process recall, are integrated into the practice of family therapy. Thirteen specific audiovisual self-confrontation methods are reviewed along with reported positive and negative effects of their use. As most novel additions to a therapists "bag of tricks", self-confrontation methods are being abused, applied randomly and unsystematically. There is an urgent need for well-designed and relevant research in the area.     

Understanding and Reducing Sexual Prejudice in Jamaica: Theoretical and Practical Insights From a Severely Anti-Gay Society

Jamaica has earned an international reputation for severe sexual prejudice—perhaps disproportionately so compared to other severely anti-LGBT (lesbian, gay, bisexual, and transgender) societies. Until recently, however, no quantitative empirical research had investigated Jamaica’s sexual prejudice, leaving the prejudice poorly understood and methods of reducing it unclear. This article reviews empirical research on Jamaican anti-LGBT prejudice from the past 15 years. It situates Jamaica within the global context, explains the current understanding of the severity and nature of the problem, evaluates solutions currently being explored, and suggests promising strategies based on available evidence. Importantly, this article also reflects on lessons learned from Jamaica that are relevant for other severely anti-LGBT societies.     

When should there be which kind of technology assessment? A plea for a strictly problem-oriented approach from the very outset

Technology assessment (TA) is generally classified as problem-oriented and thus transdisciplinary research. This is due to the fact that the aim of TA is to work out solutions for problems outside science in order to offer advice to its addressees, namely those working in politics and science and members of society in general. In this paper, we propose that the problem-oriented approach also be used as the basis for the decision regarding when a TA should be conducted in a particular situation, and which TA should be used. As a first step to this end, a broad range—almost like a kind of coarse radar—and large number of topics or problem sketches are created, which then serve as a basis for a discursive process of negotiation, during which topics are to be carried over into a detailed problem analysis (“fine radar”). These detailed problem analyses, which are important for transdisciplinary research, represent in themselves small research projects (pre-projects). They provide, in addition, some initial indications for a methodologically promising project design. The methodological approach described here is currently being tested in a procedure in which TA topics are being monitored for the German Federal Ministry of Education and Research (Bundesministerium für Bildung und Forschung, BMBF).