Cancer incidence patterns among adolescents and young adults in the United States

Objective The purpose of this study was to examine age-specific cancer incidence patterns among adolescents and young adults (ages 15–49).Method Cancer incidence data for 1995–1999 from 22 population-based central cancer registries, covering about 47% of the US population, were used. Relative frequencies and average annual age-specific incidence rates per 100,000 person-year were computed for the five-year age groups from age 15–19 years through 45–49 years. Tests of significance for comparison were at a level of p<0.05.Results The age at crossover from a predominance of non-epithelial cancers to a predominance of epithelial cancers during adolescence and young adulthood varied by gender and race. Epithelial cancer became the predominant type of tumor after age 40 years among males while it was the predominant type after age 25 years among females. There was also a shift in the top five cancer types with increasing age, which varied by race and gender. Epithelial cancers of the thyroid, breast, ovary, and cervix uteri started to increase sharply among young women in their 20s while among males epithelial cancers rarely occurred untill the early 30s (ages 30–34). Cancers of the female breast, colon and rectum, and lung began to occur at an earlier age and increased more sharply among blacks than among whites. However, the incidence rates of epithelial thyroid and ovarian cancers rose more quickly among whites than blacks. Non-Hodgkin lymphoma and soft tissue sarcoma (excluded Kaposis sarcoma) increased with age among both whites and blacks but the rates were significantly higher among blacks than among whites. Both Kaposis sarcoma and testicular cancer incidence increased with age and peaked in the early 30s (ages 30–34). The former was significantly higher among blacks than whites while the latter was significantly higher among whites than blacks. Cervical cancer incidence leveled offf when white women reached their 30s, but for black women the rate continued to rise with advancing age. Cutaneous melanoma rates were significantly higher among females than among males between the ages of 15 and 39.Conclusion Cancer incidence patterns among adolescents and young adults are distinctive. Specific cancer prevention and control strategies should be targeted accordingly and tailored to their specific needs.     

Portrayals of treatment decision-making on popular breast and prostate cancer web sites

The objective of this study was to describe the messages about treatment decision-making on popular cancer web sites, with particular reference to gender differences. The two most popular UK based web sites for breast and prostate cancer were chosen. Qualitative and quantitative comparative content analysis of the two case study web sites were performed. Web site portrayals of treatment decision-making by men with prostate cancer emphasize the obligation to be decisive, using information derived from medical sources, with minimal consultation with families and friends. Portrayals of treatment decision-making by women with breast cancer emphasize their family obligations, their need to make decisions about matters other than treatment, their right to opt out of decision-making, to take time, sometimes change their minds, consult with families and friends, and thereby take non-medical factors into account. This study will help health care practitioners understand the different factors that men and women feel obliged to consider when making decisions about their cancer treatments, and the role of the Internet in reinforcing gender differences.     

Errors in body temperature assessment related to individual variation, measuring technique and equipment

Errors in body temperature measurement might seriously influence the evaluation of an individual's health condition. We studied individual variation, measurement technique and the equipment used when assessing body temperature. In the first part of the study, three volunteers performed repeated measurements for five mornings. In the second part, the morning rectal, oral, ear and axillary temperatures were measured once in 84 men and women (19-59 years). The repeated measurements showed a daily temperature difference of 0.1-0.4 degrees C in rectal and oral temperatures, 0.2 degrees C-1.7 degrees C in the ear and 0.1-0.9 degrees C in the axillary temperatures. In the sample of 84 subjects, men and postmenopausal women had a lower mean body temperature compared to premenopausal women. The mean deviation between rectal temperature, and oral, ear and axillary temperatures, respectively, was > 0.5 degrees C, with a large individual variation. In conclusion, in order to improve the evaluation of body temperature, the assessment should be based on the individual variation, the same site of measurement and no adjustment of oral, ear or axillary temperatures to the rectal site.     

Challenging gender stereotypes in the counselling of adult survivors of childhood sexual abuse

When working with adult survivors of childhood sexual abuse, the pairing of client with practitioner has implications for both parties. Many therapeutic pairings are ad hoc or based on stereotypical assumptions made by referrers or practitioners themselves. This paper reports on a small-scale study of practitioners working in the mental health directorate of an NHS Trust in Wales. One aim of the study was to explore practitioners' views on appropriate therapeutic pairings. Fifty-three respondents completed a postal questionnaire and six face-to-face interviews were also conducted. Key themes emerged from the study. These were social and cultural stereotyping, gender specific issues, the therapeutic relationship, service and professional issues and special opinions and unique angles. The terms 'therapist' and 'practitioner' will be used interchangeably in this paper.     

Immediate and delayed incorporations of events into dreams: further replication and implications for dream function

The incorporation of memories into dreams is characterized by two types of temporal effects: the day-residue effect, involving immediate incorporations of events from the preceding day, and the dream-lag effect, involving incorporations delayed by about a week. This study was designed to replicate these two effects while controlling several prior methodological problems and to provide preliminary information about potential functions of delayed event incorporations. Introductory Psychology students were asked to recall dreams at home for 1 week. Subsequently, they were instructed to select a single dream and to retrieve past events related to it that arose from one of seven randomly determined days prior to the dream (days 1-7). They then rated both their confidence in recall of events and the extent of correspondence between events and dreams. Judges evaluated qualities of the reported events using scales derived from theories about the function of delayed incorporations. Average ratings of correspondences between dreams and events were high for predream days 1 and 2, low for days 3 and 4 and high again for days 5-7, but only for participants who rated their confidence in recall of events as high and only for females. Delayed incorporations were more likely than immediate incorporations to refer to events characterized by interpersonal interactions, spatial locations, resolved problems and positive emotions. The findings are consistent with the possibility that processes with circaseptan (about 7 days) morphology underlie dream incorporation and that these processes subserve the functions of socio-emotional adaptation and memory consolidation.     

Gender,work-home conflict,and morbidity amongst white-collar bank employees in the United Kingdom

Most research on work-home conflict focuses solely on women. This study compares men and women’s perceptions of the extent to which paid work interferes with family life, and examines associations between work-home conflict and health. Data were collected from 2,176 full-time white-collar employees of a British bank. We did not find any significant gender differences in perceptions of work-home conflict. However, predictors of work-home conflict did vary by gender; having children and being in a senior position were more strongly related to work-home conflict for women than for men, while working unsociable hours was more important for men than for women. Work-home conflict was strongly associated with reporting fair or poor self-assessed health, a high number of reported physical symptoms and minor psychological morbidity (GHQ-12). These associations were equally strong for men and women. Our results suggest that work-home conflict is a problem for men as well as women.     

Gender differences in sympathetic nervous system regulation

1. Females are protected against the development of hypertension. The purpose of the current review is to present the evidence for gender differences in the regulation of the sympatho-adrenal nervous system and to determine if these differences support the hypothesis that, in females, the regulation of the sympathetic nervous system (SNS) is altered such that sympatho-adrenal activation is attenuated or sympatho-adrenal inhibition is augmented. 2. The central control of sympatho-adrenal function is different in females and responses vary during the oestral and menstrual cycles. Pathways regulating the SNS appear to be less sensitive to excitatory stimuli and more sensitive to inhibitory stimuli in females compared with males. 3. Gender differences in arterial baroreflex sensitivity suggest that females may have a greater baroreflex sensitivity, such that alterations in blood pressure are more efficiently controlled than in males. Cardiopulmonary reflex inhibition of sympathetic nerve activity is greater in females, possibly resulting in a greater renal excretory function. 4. An attenuated sensitivity to adrenergic nerve stimulation, but not to noradrenaline (NA), suggests that gender differences in noradrenergic neurotransmission may protect females against sympathetic hyperactivity. Gender differences in the regulation of NA release via presynaptic alpha 2-adrenoceptors, the vasoconstrictor response to the cotransmitter neuropeptide Y and the clearance of catecholamines are consistent with this hypothesis. 5. Similarly, attenuated stress-induced increases in plasma catecholamines in women suggest that females are less sensitive and/or less responsive to adrenal medullary activation. This is supported by findings of gender differences in adrenal medullary catecholamine content, release and degradation. 6. We conclude that there is strong evidence that supports the hypothesis that, in females, the regulation of the SNS is altered such that sympatho-adrenal activation is attenuated or sympatho-adrenal inhibition is augmented.     

Role of androgens in mediating hypertension and renal injury

1. Men are generally at greater risk for cardiovascular disease than are women, particularly with regard to enhanced progression of hypertension and loss of renal function. Despite these gender differences in the progression of hypertension and renal disease in humans and animals, the mechanisms responsible are unknown. 2. Castration in males has been shown to slow the progression of hypertension and ameliorate the loss in renal function. When serum testosterone was measured in the developing male spontaneously hypertensive rat (SHR), the peak serum testosterone level at 12 weeks coincided with the time when differences in systolic blood pressure could be measured between intact male SHR and females or castrated male SHR. Ovariectomy does not affect blood pressure in female SHR but testosterone treatment of ovariectomized females for 5 weeks results in exacerbation of hypertension almost to the level found in intact male SHR. These data strongly suggest a role for androgens in mediating the gender differences in hypertension. 3. The mechanisms by which androgens could increase blood pressure are not known. We have recently shown that, at comparable renal perfusion pressures, there is a hypertensive shift in the pressure-natriuresis relationship in male SHR compared with females or castrated male SHR. Testosterone treatment of ovariectomized female SHR also causes a rightward shift in the pressure-natriuresis relationship. 4. We hypothesize that androgens increase arterial pressure by causing a hypertensive shift in the pressure-natriuresis relationship, either by having a direct effect to increase proximal tubular reabsorption or by activation of the renin-angiotensin system. We also hypothesize that the enhanced proximal tubular reabsorption leads to a tubuloglomerular feedback-mediated afferent vasodilation, which, in combination with the increase in arterial pressure, results in glomerular hypertension and renal injury.     

Sleep, age, and shiftwork experience

The effects of age and shiftwork experience (never, past, present) on sleep were studied in a sample of 3236 wage earners and retired workers by means of a questionnaire. The sample was composed of 32-, 42-, 52-, and 62-year-old subjects, and included both sexes and various occupational statuses. Age resulted in a continuously increasing frequency of sleep disturbances and hypnotic use, except for difficulty getting back to sleep and early awakening, which peaked at 52 years and then decreased at 62 years, thus suggesting a 'retirement effect'. Current and past shiftworkers reported more problems with falling asleep and early awakening than subjects who had never worked on shifts. This is a likely explanation of why the effect of age was massive in the latter group and much less pronounced in the former groups. There were no clear effects of the length or recency of shiftwork experience. This finding does not support the hypothesized permanent effect of shiftwork experience on subsequent sleep. Females had higher complaint rates at every age. There was little interaction between age and sex, but women were affected more by shiftwork as they got older, particularly as to hypnotic consumption. Some of the results support the hypothesis that a selection process excludes workers who are no longer able to cope with the demands of shiftwork.     

Gender differences in testing for syphilis in emergency department patients diagnosed with sexually transmitted diseases

The purpose of this study was to investigate the effect of gender on the likelihood of syphilis screening in Emergency Department (ED) patients with suspected sexually transmitted diseases (STDs). We reviewed charts of patients diagnosed with STDs in an urban university hospital ED from January 1995 through June 1996. Exclusion criteria included documented history of syphilis, syphilitic lesions, return visit within 30 days of the original ED care, and hospital admission. Records for 208 eligible patients were included in the study. Twenty-two of 45 male patients were screened for syphilis as opposed to 12 of 163 female patients (48.9% vs. 7.4%, respectively). This study demonstrates that male patients diagnosed and treated for STDs are more likely to be screened for syphilis than female patients.