Gravity, Calcium, and Bone: Update, 1989

Some of the results of recent short-term flights and ground-based experiments that have contributed new insights into skeletal adaptation, calcium metabolism, and growth processes in 0 g, are highlighted. After 6 months in space, bone demineralization, invariably involving the os calcis, was found not to extend to the lumbar spine in 4 exercising cosmonauts. A flight experiment in the Space Shuttle crew has documented the early events in the calcium endocrine system during spaceflight. On the ground, brief and long-term bed rest studies of healthy volunteers in the head-down tile (HDT) model of weightlessness were completed. The skeleton of the adult male responds more rapidly to unloading than previously recognized. Regional changes in bone density can be quantified in only 30 days, are highly individual, and follow the direction of gravitational forces in the HDT model during inactivity. Bone biopsy results in healthy volunteers after bed rest differ from results in paraplegics from the same sampling site. Flight experiments in growing rats reveal changes in the composition of bone mineral and matrix in the femur postflight that were found to be highly regional and suggestive of an effect of gravity on mineral distribution. These observations may be relevant to the results from an earlier Cosmos flight where artificial gravity in space was found to maintain bone strength, but not to correct the radial growth deficit

Skeletal responses to spaceflight

The role of gravity in the determination of bone structure is elucidated by observations in adult humans and juvenile animals during spaceflight. The primary response of bone tissue to microgravity is at the interface of the mineral and matrix in the process of biomineralization. This response is manifested by demineralization or retarded growth in some regions of the skeleton and hypermineralization in others. The most pronounced effects are seen in the heelbone and skull, the most distally located bones relative to the heart. Ground based flight simulation models that focus on changes in bone structure at the molecular, organ, and whole body levels are described and compared to flight results. On Earth, the morphologic and compositional changes in the unloaded bones are very similar to changes during flight; however, the ground based changes appear to be more transient. In addition, a redistribution of bone mineral in gravity-dependent bones occurs both in space and during head down positioning on Earth. Longitudinal data provided considerable information on the influence of endocrine and muscular changes on bone structure after unloading

Citizens Apart? Representing post-Brexit youth politics in the UK media

In 2016, the UK voted to leave the European Union (EU). This outcome was not only unexpected but also had clear geographical and age-bound divisions. While people over the age of 65 tended to vote to leave, younger voters were more likely to vote to remain a part of the EU. Reflecting on 7 years of journalism, this paper explores the ways in which young people have been represented by the news media with regards to the issue of Brexit. It analyses a database of 700 news media articles published from 2016 to 2022 across the UK, equating to 100 articles per calendar year and ranging from regional sources to those with an international reach. The paper showcases how young people occupy liminal spaces within the news media through an analysis of the language used to describe their political participation, and a focus on their role within political activism. As it is this media that dominates hegemonic narratives within traditional political spheres, the retelling and representation of young people's engagement serves, we argue, to reinforce their liminality as citizens apart.</p

GPs’ Insights into Prostate Cancer Diagnosis and Care in Regional Victoria, Australia

The aim of this research was to ascertain General Practitioners’ (GPs) perceptions and experiences of prostate cancer (PCa) diagnosis, treatment, and care in metropolitan Melbourne and in a regional area of Victoria, Australia, associated with poorer PCa outcomes. Semi-structured qualitative interviews were conducted with GPs (N= 10) practising in the selected region and in metropolitan Melbourne, Australia. GPs thought that most men wanted PSA testing and were willing to undergo rectal examination. Some GPs were troubled by inconsistent screening guidelines from different professional bodies. They identified a need for resources to support them in educating patients about PCa. GPs thought it might be more difficult for young female GPs to care for patients in relation to PCa screening; differences were evident between younger female GPs and older male GPs in the approach they adopted in interviews. Regional GPs often referred patients to services in larger centres because no local specialists were available. GPs also found it hard to explain differences in PCa outcomes in regional and metropolitan areas. Potential age and gender differences in GPs in relation to prostate care warrant further examination. Although GPs were able to offer only limited insights into the poorer outcomes in regional areas, they identified ways in which they could be assisted to provide best-practice care. Multidisciplinary care, resources for patients, and consistent guidelines for the detection and treatment of PCa should contribute to better care in all areas

Poly-victimisation and health risk behaviours, symptoms of mental health problems and suicidal thoughts and plans among adolescents in Vietnam

BACKGROUND: Limited evidence is available about poly-victimisation (exposure to multiple forms of victimisation) and mental health among adolescents in low and lower-middle-income countries. The aim of this study was to examine the associations between lifetime exposure to poly-victimisation, health risk behaviours, symptoms of common mental health problems and suicidal ideas in the previous year among high school students in Vietnam. METHODS: Participants were high school students in rural and urban districts of Hanoi, Vietnam. The data source was an anonymously-completed structured self-report survey. Lifetime exposure to poly-victimisation was assessed using the juvenile victimisation questionnaire revised 2 (JVQ R-2); mental health symptoms by the depression, anxiety and stress scale-21 (DASS-21); involvement in health risk behaviours and previous year suicidal thoughts and plans by questions adapted from the 2013 youth risk behaviour survey. Data were collected between October, 2013 and January, 2014 and were analysed using generalised structural equation modelling. RESULTS: In total 1616/1745 (92.6 %) eligible students provided complete data. Prior year suicidal thoughts were reported by 21.4 % (95 % CI 18.5–24.5 %) of the female respondents and 7.9 % (95 % CI 6.2–9.8 %) of the male respondents. Prior year suicidal plans were reported by 7.8 % (95 % CI 5.9–9.8 %) of the girls and 4.0 % (95 % CI 2.7–5.3 %) of the boys. Poly-victimisation was associated with increased likelihood of involvement in health risk behaviours and symptoms of common mental health problems among both sexes, which increased adolescents’ risk of having suicidal ideas in the previous year. Compared to non-victims or victims of fewer forms, poly-victims were also more likely to report suicidal thoughts and plans among both girls and boys (p < 0.05). CONCLUSIONS: Overall, the results revealed that poly-victimisation was associated with increased involvement in health risk behaviours, poorer mental health and increased risks of suicidal ideas among Vietnamese adolescents. Suicidal ideas were prevalent among the students. Interventions to assist victims of violence and prevention of violence, especially poly-victimisation, among adolescents in Vietnam is therefore important

Victimisation, poly-victimisation and health-related quality of life among high school students in Vietnam: a cross-sectional survey

BACKGROUND: In high and upper-middle income countries poly-victimisation (exposure to multiple forms of victimisation) is associated with worse health-related quality of life (HRQoL) among adolescents. There is a lack of empirical evidence about these associations from low- and lower-middle income countries. The aims of this study were to examine the associations between exposure to 1) individual forms of victimisation and 2) poly-victimisation and the HRQoL of adolescents in Vietnam. METHOD: A cross-sectional, anonymously-completed survey of high school students in Hanoi, Vietnam. Lifetime exposure to eight individual forms of victimisation and poly-victimisation were assessed using the Juvenile Victimisation Questionnaire Revised-2 (JVQ R2). Health-related quality of life was assessed using the Duke Health Profile Adolescent Version (DHP-A). Bi-variate analyses and multiple linear regressions were conducted to assess the associations between individual forms of victimisation, poly-victimisation and HRQoL among girls and boys. RESULTS: In total 1616/1745 students (92.6&nbsp;%) completed the questionnaire. Adolescent girls had significantly worse HRQoL than boys in all domains, except disability. Different forms of victimisation were associated with different HRQoL domains among girls and boys. Cyber victimisation was the most detrimental to girls\u27 HRQoL while for boys maltreatment was the most detrimental. Experiences of poly-victimisation were associated with worse HRQoL in physical, mental, social and general health, lower levels of self-esteem and increased levels of anxiety, depression and pain domains among both sexes. CONCLUSIONS: Among Vietnamese adolescents, experiences of individual forms of victimisation were associated with poorer HRQoL in specific domains; the most detrimental forms of victimisation varied for girls and boys. However, it was experiences of poly-victimisation that had the most detrimental impacts on the HRQoL of both sexes. Recognition of violence, including poly-victimisation, is still low in Vietnam. These data indicate that community education, prevention and early intervention programs to reduce violent victimisation and assist adolescents who have experienced it, with attention to gender differences, are needed in Vietnam

Impact of the COVID-19 pandemic on breast, colorectal, lung, and prostate cancer stage at diagnosis according to race

PURPOSE: To determine if the COVID-19 pandemic has further exacerbated racial disparities in late-stage presentation of breast, colorectal, lung, and prostate cancers. METHODS: We conducted a registry-based retrospective study of patients with newly reported diagnoses of breast, colorectal, lung, and prostate cancers between March 2019-June 2019 (pre-COVID-19) and March 2020-June 2020 (early-COVID-19). We compared the volume of new diagnoses and stage at presentation according to race between both periods. RESULTS: During the study period, a total of 3528 patients had newly diagnosed cancer; 3304 of which had known disease stages and were included in the formal analyses. 467 (14.1%) were Blacks, and 2743 were (83%) Whites. 1216 (36.8%) had breast, 415 (12.6%) had colorectal, 827 (25%) had lung, and 846 (25.6%) had prostate cancers, respectively. The pre-COVID-19 period included 2120 (64.2%), and the early-COVID-19 period included 1184 (35.8%), representing a proportional 44.2% decline in the volume of new cases of breast, colorectal, lung, and prostate cancers, p \u3c 0.0001. Pre-COVID-19, 16.8% were diagnosed with metastatic disease, versus 20.4% early-COVID-19, representing a proportional increase of 21.4% in the numbers of new cases with metastatic disease, p = 0.01. There was a non-significant proportional decline of 1.9% in Black patients diagnosed with non-metastatic breast, colorectal, lung, and prostate cancers early-COVID-19 (p = 0.71) and a non-significant proportional increase of 7% in Black patients diagnosed with metastatic disease (p = 0.71). Difference-in-difference analyses showed no statistically significant differences in metastatic presentation comparing Black to White patients. CONCLUSION: While we identified substantial reductions in the volume of new cancer diagnoses and increases in metastatic presentations due to the COVID-19 pandemic, the impact was similar for White and Black patients

Letter to editor

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To have or not to have?: Australian women's childbearing desires, outcomes and expectations

© 2010 Dr. Sara HoltonAlthough Australia’s fertility rate has recently increased it has been below replacement level since the mid 1970s. There are widespread perceptions that Australia’s fertility rate is too low mainly due to concerns regarding the social and economic implications of low fertility for Australia’s future prosperity. Yet the factors which contribute to Australian women’s childbearing outcomes are not fully understood, and it is not well known whether the low fertility rate is a deliberate or unintended consequence of women’s childbearing behaviour. There have been several investigations into the factors which are salient in Australian women’s childbearing outcomes. A limited number of individual explanatory factors have been identified including women’s level of education, labour force participation, marital status and age. Existing theoretical explanations of fertility decision-making tend to view childbearing as a rational, voluntary process and focus on the ‘costs’ to women of having children. Although this may help explain why women do not have children, it contributes very little to understanding why women do have children. The aims of this study were: to explore the relative importance of a range of psychosocial factors (including attitudes toward women and motherhood, the influence of women’s partners’ fertility preferences and behaviours, women’s education debts, and housing conditions) and women’s health status to women’s childbearing outcomes; to determine any differences in the contributory factors and their relative importance by parity; and to identify women’s childbearing desires and expectations. The study used a cross-sectional survey design in a population based sample of Australian women currently of childbearing age. The sample was drawn from women aged 30-34 years living in Victoria, one Australian state, in 2005 randomly selected from the Australian Electoral Roll by the Australian Electoral Commission. Participation involved the completion of a study specific anonymous self administered postal questionnaire. The questionnaire assessed participants’ sociodemographic characteristics; attitudes toward women and motherhood; previous childbearing experiences, current and future childbearing desires, and future childbearing expectations; the importance of a variety of psychosocial and health factors in childbearing outcomes; and past and present health status. 569 women (47%) completed and returned questionnaires, which is high for an unsolicited postal survey. The participants were broadly representative of women of the same age in the general population. Most participants wanted children and were mothers, and voluntary childlessness was very uncommon. Multiple, complex and interrelated biological, psychological and social factors such as adverse health conditions, attitudes toward women and motherhood, an interest in being a mother, lack of a partner, education debts and housing affordability were associated with women’s childbearing outcomes. The factors and their relative importance varied by parity. Many of the reasons participants identified as salient to their childbearing outcomes were actually obstacles or constraints which prevented them from achieving their childbearing desires. The results indicate that women often have fewer children than they actually desire and many would have (more) children if their circumstances were different. It appears that it is not the ‘costs’ of children that are important in women’s childbearing outcomes but the necessity for women’s circumstances to be optimal before they will consider having (more) children. An innovative conceptual framework highlighting the importance of women’s circumstances in their childbearing behaviour was developed as a result of the findings. The results challenge prevailing views that women’s childbearing outcomes are mostly voluntary, and based mainly on financial or career considerations. The findings have implications for theoretical explanations of fertility decision-making, and policies which aim to address the fertility rate and women’s childbearing behaviour suggesting that such policies need to address the barriers women face in family formation