74 research outputs found
Physical and Psychological Aggression in At-Risk Young Couples: Stability and Change in Young Adulthood
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
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Parental Monitoring of Childrenâs Media Consumption: The Long-term Influences on Body Mass Index in Children
IMPORTANCE: Although childrenâs media consumption has been one of the most robust risk factors for childhood obesity, effects of specific parenting influences, such as parental media monitoring, have not been effectively investigated.
OBJECTIVES: This study examined the potential influences of maternal and paternal monitoring of child media exposure and childrenâs general activities on childrenâs BMI in middle childhood.
DESIGN: A longitudinal study, taken from a subsample of the Three Generational Study, with assessments at childrenâs ages of 5, 7, and/or 9 years collected from 1998-2012.
SETTING: The Three Generational Study, a predominantly Caucasian, Pacific-Northwest U.S. community sample (overall participation rate 90%).
PARTICIPANTS: Analyses included 112 mothers, 103 fathers and their 213 children (55% girls) at ages 5, 7, and/or 9 years. Participation rates ranged from 67% to 72% of all eligible Three Generational Study children across the three assessments.
MAIN EXPOSURES: Parents reported on their general monitoring of their children (whereabouts and activities), specific monitoring of child media exposure, childrenâs participation in sports and recreational activities, childrenâs media time (hours/week), annual income, and education level. Parental BMI was recorded.
MAIN OUTCOME MEASURE: Predictions to level and change in child BMI z scores were tested.
RESULTS: Linear mixed-effects modeling indicated that more maternal, but not paternal, monitoring of child media exposure predicted lower child BMI z scores at age 7 years (95% CI, -.39 â -.07) and less steeply increasing child BMI z scores from ages 5-9 years (95% CI, -.11 â -.01). These effects held when controlling for more general parental monitoring, and parent BMI, income and education. Results supported that the significant negative effect of maternal media monitoring on childrenâs BMI z scores at age 7 years was marginally accounted for by the effect of child media time. The maternal media monitoring effect on childrenâs BMI z score slopes remained significant once adjusting for childrenâs media time, and sports and recreational activity.
CONCLUSIONS: This study suggests that parental behaviors related to childrenâs media consumption may have long-term impacts on childrenâs BMI in middle childhood. The results underscore the importance of targeting parental media monitoring in efforts to prevent childhood obesity
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Two Longterm Studies of Seasonal Variation in Depressive Symptoms among Community Participants
Background: There is evidence that seasonal variation in depressive symptoms is common in the population. However, research is limited by a reliance on longterm retrospective methods. Methods: Seasonal patterns were tested in two samples of community participants recruited in separate prospective studies in the Midwestern (n = 556 males/females) and Pacific Northwestern (n = 206 males) United States. Participants completed self-report measures of depressive symptoms 10-19 times from ages 14-36 years (n = 8,316 person observations). These data were compared with local meteorological conditions (e.g., solar radiation) recorded across the 2 weeks prior to each self-report.
Results: In within-subjects analyses, participantsâ depressive symptoms and the probability of clinically significant symptoms varied with the time of year, as hypothesized (highest in the weeks of early Winter; lowest in early Fall). However, effects sizes were modest and were not explained by recent sunlight or other meteorological conditions.
Limitations: Samples were not nationally representative. Participants did not complete retrospective reports of seasonal depression or measures of current vegetative symptoms.
Conclusions: Neither time of the year or recent seasonally linked meteorological conditions were powerful influences on depressive symptoms experienced by community populations in relevant geographic regions. Prior studies may have overestimated the prevalence and significance of seasonal variation in depressive symptoms for the general population.This is an author's peer-reviewed manuscript, as accepted by the publisher. The published article is copyrighted by Elsevier and can be found at: http://www.journals.elsevier.com/journal-of-affective-disorders/.Keywords: Seasonal depression, Adolescence, Community, Longitudina
Studying Adolescent Male Sexuality: Where Are We?
This article critically reviews the literature about adolescent malesâ 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 âsexâ; (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 malesâ 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
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 61â69]) 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 7·1â10·1), 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 0·688â1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4â82·5) in the no ADT group and 80·4% (76·6â83·6) 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
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 60â69) 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 (7·0â10·0), 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 0·612â0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6â75·7) in the short-course ADT group and 78·1% (74·2â81·5) 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
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 wellâbeing. 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 attentionâdeficit/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 sameâsex 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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