74 research outputs found

    Physical and Psychological Aggression in At-Risk Young Couples: Stability and Change in Young Adulthood

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    Physical and psychological aggression was examined over a 2 1/2-year period for at-risk young couples. It was predicted, first, that there would be persistence in any physical aggression across time in the group of couples who stayed together; second, that stability in levels of aggression toward a partner would be higher for men who remained with the same partner compared to men who repartnered; third, that increases in levels of aggression would occur over time for couples with the same partners; and fourth, that changes in aggression over time would be concordant for couples. Measures of aggression included reports of aggression and observed aggression. Findings indicated considerable stability in aggression for the same-, but not for the different-, partner group

    Studying Adolescent Male Sexuality: Where Are We?

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    This article critically reviews the literature about adolescent males’ sexuality in order to describe the state of the science and to identify promising concepts and research designs that have the potential to guide the next generation of research. A critique was conducted on 94 peer-reviewed studies of sexual behaviors that included a sample of adolescent males; 11 scholarly texts and 2 dissertations. Most studies lacked a theoretical foundation and had cross-sectional designs. For those studies with a theoretical base, 3 perspectives were most often used to guide research: cognitive, biological, or social-environmental. Studies frequently relied on older adolescents or young adult males to report behaviors during early adolescence. Male-only samples were infrequent. Findings include (a) the measurement of sexual activity is frequently limited to coitus and does not explore other forms of “sex”; (b) cognitive factors have been limited to knowledge, attitudes, and intent; (c) little is known about younger males based on their own self-reports; (d) little is known about the normative sexuality development of gay adolescent males; and (e) longitudinal studies did not take into account the complexities of biological, social, and emotional development in interaction with other influences. Research on adolescent sexuality generally is about sexual activity, with little research that includes cognitive competency or young males’ sense of self as a sexual being. The purpose of the paper is to critically review the literature about male sexuality in order to describe the state of the science as well as to identify potential directions to guide the next generation of adolescent male sexual being research.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45299/1/10964_2005_Article_5762.pd

    Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

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    Background Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear. Methods RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047. Findings Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths. Interpretation Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population

    Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

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    Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society

    Adolescent/Young Adult Romantic Relationships and Psychopathology

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    Navigating romantic relationships in adolescence/young adulthood is a normative developmental task that can be both pleasurable and challenging for youth. The success with which one does so is both predicted by and subsequently affects psychological well‐being. This chapter reviews the literature on the associations between psychopathology and youth romantic relationships and experiences. We focus particularly on internalizing and externalizing disorders, for which the bulk of the literature exists. We also cover eating disorders and attention‐deficit/hyperactivity disorder (ADHD) as well as other disorders and issues of comorbidity. Following the reviews of specific disorders and symptoms, we review the emerging literature on psychopathology and same‐sex relationships among youth. We then address key peer and family contexts in which psychopathology and skills for romantic relationships are developing, and we discuss the intergenerational transmission of psychopathology and romantic dysfunction. The chapter closes with discussions of methodological issues and implications for prevention and intervention, emphasizing the need for ongoing basic research that can translate into novel approaches that can treat or prevent youth romantic dysfunction and psychopathology
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