Importance In the United States, the lifetime risk of being diagnosed with prostate cancer is approximately 13%, and the lifetime risk of dying of prostate cancer is 2.5%. The median age of death from prostate cancer is 80 years. Many men with prostate cancer never experience symptoms and, without screening, would never know they have the disease. African American men and men with a family history of prostate cancer have an increased risk of prostate cancer compared with other men. Objective To update the 2012 US Preventive Services Task Force (USPSTF) recommendation on prostate-specific antigen (PSA)–based screening for prostate cancer. Evidence Review The USPSTF reviewed the evidence on the benefits and harms of PSA-based screening for prostate cancer and subsequent treatment of screen-detected prostate cancer. The USPSTF also commissioned a review of existing decision analysis models and the overdiagnosis rate of PSA-based screening. The reviews also examined the benefits and harms of PSA-based screening in patient subpopulations at higher risk of prostate cancer, including older men, African American men, and men with a family history of prostate cancer. Findings Adequate evidence from randomized clinical trials shows that PSA-based screening programs in men aged 55 to 69 years may prevent approximately 1.3 deaths from prostate cancer over approximately 13 years per 1000 men screened. Screening programs may also prevent approximately 3 cases of metastatic prostate cancer per 1000 men screened. Potential harms of screening include frequent false-positive results and psychological harms. Harms of prostate cancer treatment include erectile dysfunction, urinary incontinence, and bowel symptoms. About 1 in 5 men who undergo radical prostatectomy develop long-term urinary incontinence, and 2 in 3 men will experience long-term erectile dysfunction. Adequate evidence shows that the harms of screening in men older than 70 years are at least moderate and greater than in younger men because of increased risk of false-positive results, diagnostic harms from biopsies, and harms from treatment. The USPSTF concludes with moderate certainty that the net benefit of PSA-based screening for prostate cancer in men aged 55 to 69 years is small for some men. How each man weighs specific benefits and harms will determine whether the overall net benefit is small. The USPSTF concludes with moderate certainty that the potential benefits of PSA-based screening for prostate cancer in men 70 years and older do not outweigh the expected harms. Conclusions and Recommendation For men aged 55 to 69 years, the decision to undergo periodic PSA-based screening for prostate cancer should be an individual one and should include discussion of the potential benefits and harms of screening with their clinician. Screening offers a small potential benefit of reducing the chance of death from prostate cancer in some men. However, many men will experience potential harms of screening, including false-positive results that require additional testing and possible prostate biopsy; overdiagnosis and overtreatment; and treatment complications, such as incontinence and erectile dysfunction. In determining whether this service is appropriate in individual cases, patients and clinicians should consider the balance of benefits and harms on the basis of family history, race/ethnicity, comorbid medical conditions, patient values about the benefits and harms of screening and treatment-specific outcomes, and other health needs. Clinicians should not screen men who do not express a preference for screening. (C recommendation) The USPSTF recommends against PSA-based screening for prostate cancer in men 70 years and older. (D recommendation)
Hilla Nordquist, Tea Lallukka, Jatta Valkonen
et al.
Abstract Introduction This salutogenic-oriented study focuses on weight management among retired individuals living with obesity. We also consider individuals’ educational level, as higher education has been linked to enhanced health and well-being, and improved access to and utilization of various resources. Our research question was: How do retired individuals with low or high levels of education living with obesity implement weight management in their daily lives, from the salutogenic approach? Methods Twenty retired individuals with a body mass index (BMI) of at least 30 kg/m2 participated in individual qualitative interviews in 2023. The participants were selected from a Helsinki Health Study cohort of retired former employees of the City of Helsinki, Finland. Half of the interviewees had a low level of education, and the other half had a high level of education. Women and men were equally represented. We analyzed the data using a deductive-inductive content analysis. Results Four main categories were formed: 1) visionary life management; 2) daily life supporting well-being, 3) enjoying food as an essential part of life; and 4) feeling supported. The main categories had altogether eleven generic categories, and they further had eleven sub-categories. The main categories and most of the generic categories and sub-categories were similar across the low and high levels of education groups, but both groups still had specific characteristics. Conclusion A salutogenic orientation, which focuses on health and well-being rather than illness, was evident in many ways in how participants approached their weight management. Educational differences were moderate overall and hinted at specific characteristics of how the resources were utilized. Comprehensibility, manageability, and meaningfulness were evident in the results for both educational groups. According to the results of this study, retired individuals living with obesity implement weight management strategies in their daily lives in ways that are suitable and meaningful for their individual circumstances. They make thoughtful yet enjoyable food choices, select forms of physical activity that motivate them, and spend active quality time with the important people in their lives.
Irene López-Ferreruela, Irene López-Ferreruela, Antonio Gimeno-Miguel
et al.
IntroductionSecondary prevention after an acute myocardial infarction (AMI) has the objective of improving quality of life, minimizing recurrence, and reducing morbidity and mortality. Despite European guidelines highlighting the importance of cardiovascular risk factor (CVRF) management and optimal healthcare utilization, inequalities persist, particularly between genders. This study aims to identify and analyze gender inequalities in healthcare utilization and CVRF monitoring during the first year after AMI using real-world data (RWD).MethodsAn analytical study was conducted within the CARhES (CArdiovascular Risk factors for Health Services research) cohort in Aragon, Spain. The study population included 3,464 subjects who survived a first AMI and were followed for one full year after the event. Sociodemographic, anthropometric, clinical data, healthcare utilization, CVRF monitoring and pharmacological prescriptions, were extracted from the Aragon Health Service. Statistical analyses included chi-squared tests, Student's t-tests, and logistic regression, with Blinder-Oaxaca decomposition applied to explore possible explanatory factors for gender differences.ResultsWomen represented 28.3% of the study population. Compared with men, they were older and had a higher morbidity burden. Primary care utilization was similar between genders; however, women had fewer cardiology visits (p < 0.001) and were less likely to achieve risk factor monitoring goals. Differences were also observed in pharmacological treatment, with women being less likely to receive beta-blockers, lipid modifying agents, and antiplatelet agents (p < 0.001). Several of these inequalities persisted after controlling for age. The Oaxaca decomposition showed that age and morbidity burden were the main contributors to gender disparities. In addition, socioeconomic status and place of residence played a role in health services utilization differences.ConclusionsGender inequalities are still present in post-AMI care and CVRF management, with women being more likely to receive less adequate treatment and management. Addressing these inequalities is crucial to ensuring equitable care and improving health outcomes for women.
James Edward Mensah, Evans Akpakli, Mathew Kyei
et al.
Purpose of the study: This study aims to determine the role of serum prostate-specific antigen (PSA) levels and digital rectal examination (DRE) in predicting the histological outcomes of prostate biopsies by analyzing a database of over 7000 patients who underwent transrectal ultrasound (TRUS)-guided prostate biopsies. Methods: We conducted a retrospective analysis of men who underwent TRUS-guided prostate biopsies at Korle Bu Teaching Hospital, a tertiary referral center in Accra, Ghana, from July 2005 to December 2022. The biopsies, which included 10 to 12 core samples, were prompted by PSA levels greater than 4.0 ng/mL, abnormal DRE findings, or both. We then correlated histopathology results with PSA and DRE findings. Results: Out of 7,338 patients who presented for biopsy, 76.3% were between the ages of 60 and 79. Histology reports were available for 5,289 patients, of whom 2,564 (48.5%) were diagnosed with prostate cancer. Cancer detection rates based on PSA levels were as follows: 21.6% for PSA <4 ng/mL, 21.7% for PSA 4-10 ng/mL, 32.7% for PSA 10-20 ng/mL, 53.0% for PSA 20-50 ng/mL, 71.5% for PSA 50-100 ng/mL, and 92.0% for PSA >100 ng/mL. When DRE findings were classified according to the 2016 TNM System (AJCC 8th Edition) as T1, T2, T3, and T4, cancer detection rates were 26.8%, 51.8%, 87.6%, and 95.7%, respectively. The overall cancer detection rate was significantly higher with abnormal DRE findings (64.6% vs. 26.7%, p < 0.001). Additionally, 78.2% of the detected cancers were high-grade (Gleason score of 7 or more). Conclusion: This extensive study of Ghanaian men undergoing TRUS biopsies reveals a high prostate cancer detection rate, with nearly 80% of the detected cancers being high-grade. These findings underscore the importance of PSA and DRE in the early detection of prostate cancer and should be considered in patient counseling and discussions regarding the implementation of prostate cancer screening programs in this population.
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
<p>Evidence suggests that gay, bisexual and other men who have sex with men (MSM) score higher than heterosexual-identifying men on disordered eating symptomology (DES). This exploratory study examined if the following psychosocial factors were associated with DES among a diverse sample of MSM: race, age, sexual identity, sexual risk, substance use, depression, history of childhood sexual abuse (CSA) and internalized homophobia. Using cross sectional data collected at "Pride Toronto 2008" (N = 383), multivariate analysis revealed the following factors to be associated with DES: CSA, depression, being White (vs. Black or Asian), being younger, and engaging in behaviours to increase muscle mass. These results may inform the development of useful and efficacious interventions to reduce the risks associated with body dissatisfaction and DES among MSM.</p>
Samart Karuchit, Panupit Thiengtham, Suvimon Tanpradech
et al.
BackgroundThailand’s HIV epidemic is heavily concentrated among men who have sex with men (MSM), and surveillance efforts are mostly based on case surveillance and local biobehavioral surveys.
ObjectiveWe piloted Kai Noi, a web-based respondent-driven sampling (RDS) survey among MSM.
MethodsWe developed an application coded in PHP that facilitated all procedures and events typically used in an RDS office for use on the web, including e-coupon validation, eligibility screening, consent, interview, peer recruitment, e-coupon issuance, and compensation. All procedures were automated and e-coupon ID numbers were randomly generated. Participants’ phone numbers were the principal means to detect and prevent duplicate enrollment. Sampling took place across Thailand; residents of Bangkok were also invited to attend 1 of 10 clinics for an HIV-related blood draw with additional compensation.
ResultsSampling took place from February to June 2022; seeds (21 at the start, 14 added later) were identified through banner ads, micromessaging, and in online chat rooms. Sampling reached all 6 regions and almost all provinces. Fraudulent (duplicate) enrollment using “borrowed” phone numbers was identified and led to the detection and invalidation of 318 survey records. A further 106 participants did not pass an attention filter question (asking recruits to select a specific categorical response) and were excluded from data analysis, leading to a final data set of 1643 valid participants. Only one record showed signs of straightlining (identical adjacent responses). None of the Bangkok respondents presented for a blood draw.
ConclusionsWe successfully developed an application to implement web-based RDS among MSM across Thailand. Measures to minimize, detect, and eliminate fraudulent survey enrollment are imperative in web-based surveys offering compensation. Efforts to improve biomarker uptake are needed to fully tap the potential of web-based sampling and data collection.
Manuel Mendizabal, Marcos Thompson, Esteban Gonzalez-Ballerga
et al.
Introduction and Objectives: To achieve WHO's goal of eliminating HCV, innovative strategies must be designed to diagnose and treat more patients. This study aimed to describe an implementation strategy to identify patients with HCV who were lost to follow-up (LTFU) and offer them re-linkage to Figure 1. Analysis of global DNA methylation. A) Representative dot blot using anti-5mC which recognizes global methylated DNA, anti-IgG as negative control and methylene blue staining as total DNA loading control. B) Graphs shows mean ± standard deviation of 5mC densitometry brand intensity of study groups. C) Graph that represents the percentage of global methylation of the DNA analyzed with ELISA.A one-way ANOVA statistical test and a Tukey post hoc test were performed. Group NT: only received vehicle; Group HCC: damage group induced by weekly administration of DEN and 2-AAF for 12 weeks; and Group HCC/PFD: which received the same treatment as Group HCC, plus PFD (300 mg/kg) (**p<0.005)Figure 1. Analysis of global DNA methylation. A) Representative dot blot using anti-5mC which recognizes global methylated DNA, anti-IgG as negative control and methylene blue staining as total DNA loading control. B) Graphs shows mean ± standard deviation of 5mC densitometry brand intensity of study groups. C) Graph that represents the percentage of global methylation of the DNA analyzed with ELISA.A one-way ANOVA statistical test and a Tukey post hoc test were performed. Group NT: only received vehicle; Group HCC: damage group induced by weekly administration of DEN and 2-AAF for 12 weeks; and Group HCC/PFD: which received the same treatment as Group HCC, plus PFD (300 mg/kg) (**p<0.005)Figure 1. Analysis of global DNA methylation. A) Representative dot blot using anti-5mC which recognizes global methylated DNA, anti-IgG as negative control and methylene blue staining as total DNA loading control. B) Graphs shows mean ± standard deviation of 5mC densitometry brand intensity of study groups. C) Graph that represents the percentage of global methylation of the DNA analyzed with ELISA.A one-way ANOVA statistical test and a Tukey post hoc test were performed. Group NT: only received vehicle; Group HCC: damage group induced by weekly administration of DEN and 2-AAF for 12 weeks; and Group HCC/PFD: which received the same treatment as Group HCC, plus PFD (300 mg/kg) (**p<0.005) Materials and Methods: We conducted an implementation study utilizing a strategy to contact patients with HCV who were not under regular follow-up in 45 centers from 13 Latin American countries. Patients with HCV were identified by the international classification of diseases (ICD-9/10) or equivalent. Medical records were then reviewed to confirm the diagnosis of chronic HCV infection defined by anti-HCV+ and detectable HCV-RNA. Identified patients who were not under follow-up by a liver specialist were contacted by telephone or email and offered a medical reevaluation. Results: A total of 10364 patients were classified to have HCV. After reviewing their medical charts, 1349 (13%) had undetectable HCV-RNA or were wrongly coded (figure). Overall, 9015 (86.9%) individuals were identified with chronic HCV infection. A total of 5096 (56.5%) patients were under routine HCV care and 3919 (43.5%) had been LTFU. We were able to contact 1617 (41.3%) of the 3919 patients who were LTFU at the primary medical institution, of which 427 (26.4%) were cured at different institutions or were dead. Of the remaining patients, 906 (76.1%) were candidates for retrieval. Overall, patients who were LTFU were younger (58.7 vs. 61.1 years; p<0.001), were more likely to be men (57.4% vs. 49.5%; p<0.001), and to have a concomitant infection of HIV (13.8% vs. 7.3%; p<0.001) and HBV (3.1% vs. 1.7%; p<0.001). Conclusions: In our cohort, about 1 out of 4 patients with chronic HCV who were LTFU were candidates to receive treatment. This strategy has the potential to be effective and accessible and significantly impacts the HCV care cascade. (NCT04470271)
Syftet med denna studie är att bidra med kunskap om läsförståelseundervisning i svenskämnet i mellanstadiet. Material från en observationsstudie i två klasser i årskurs 6 analyseras för att förstå och beskriva hur lärare undervisar i läsförståelse utifrån skönlitterära böcker som eleverna valt själva, så kallade tystläsningsböcker, respektive ett läromedel i svenskämnet. Genom innehållsanalys synliggörs vad som kan vara undervisning för att förstå ett specifikt textinnehåll respektive förståelsestrategier. Trots olika utgångspunkter vad gäller texter och läsaktiviteter ställer båda lärarna frågor och genererar diskussioner på hög nivå. De utmanar även eleverna att tänka om textens innehåll, form och budskap, men undervisar i låg grad om strategier för att förstå och komma ihåg textinnehåll. Ingen av lärarna påpekar explicit för eleverna att det sätt som de tar sig an läsaktiviteterna hjälper dem att förstå textinnehåll och att liknande strategier kan användas vid all läsning. En slutsats är att lärare behöver bli medvetna om att det inte räcker med att låta elever träna på att synliggöra textinnehåll eller att knyta textinnehåll till sig själva, utan det behövs också direkt undervisning om det. Potential att undervisa explicit om när och hur olika strategier kan användas för att stötta elever att bli självständiga läsare diskuteras.
English abstract
Teaching Reading Comprehension in Grade 6 Using Fiction and a Textbook in Swedish
This article aims to contribute to knowledge about the teaching of reading comprehension in the subject Swedish in middle school. Material from an observational study in two grade six classes is analysed to learn about and describe how teachers teach reading comprehension using fiction books chosen by students (so-called silent reading books) and a Swedish textbook, respectively. A content analysis makes visible teaching that supports students in understanding the content of a text, as well as teaching that provides students with reading strategies. Despite differences in their use of texts and reading activities, the teachers in both classrooms ask questions and initiate high-level discussions. They also challenge students to think about the content, form, and message of texts. However, strategies for understanding and remembering text content are taught to a low degree. None of the teachers explicitly point out to students that the way they approach reading activities can help them understand text content and that similar strategies can be used for all reading. One conclusion is that teachers need to become aware that it is not enough to let students practice making text content visible or to connect text content to themselves; explicit teaching about comprehension strategies is also needed. The article also discusses when and how different strategies can be used to support students to become independent readers.
Education (General), Language. Linguistic theory. Comparative grammar
Objective: suicide attempts and suicide death fall within a category of psychological disorders that is under the influence of economic, social, and cultural factors. Awareness of the prevalence of this phenomenon is essential for the adoption of preventive policies. Accordingly, the current study was carried out in order to determine the prevalence of suicide attempts and suicide deaths via Meta-analysis in Iran.
Method: This study is a systematic review and meta-analysis of articles published between 2010 and 2021 to estimate the prevalence of suicide attempts and suicide deaths in Iran. Accordingly, databases including Web of Science, PubMed, Scopus, Cochrane Library, Science Direct, Google Scholar, SID, and Magiran were searched and all related articles were extracted by the statistical tests of random and fixed effects model, meta-regression, and funnel plot using the STATA software. These articles were then analyzed.
Results: A total of 20 studies were entered into the systematic review, with a total of 271,212 attempted suicides and 22,780 suicide deaths. Accordingly, the prevalence of suicide attempts in the whole population was 131.0 (CI 95%: 124.0 – 137.0) per 100,000 people (152 per 100,000 women and 128 per 100,000 men). Moreover, the prevalence of suicide death was 8.14 (CI 95% 7.8 – 8.5) per 100,000 people in the general population (5.0 per 100,000 women and 9.1 per 100,000 men).
Conclusion: According to these findings, Iran can be ranked among the countries with a low prevalence of suicide attempts and completed suicides (compared to the global average). Although the trend of completed suicides is declining, the trend of suicide attempts is increasing and has often affected young people.
Erika M Nadile, Emilie Alfonso, Briana Michelle Barreiros
et al.
Allowing students to voluntarily ask and answer questions in front of the whole class are common teaching practices used in college science courses. However, few studies have examined college science students' perceptions of these practices, the extent to which students choose to engage in these practices, and what discourages students from participating. In this study, we surveyed 417 undergraduates at a research-intensive institution about their experiences asking and answering questions in large-enrollment college science courses. Specifically, students answered questions about to what extent they perceive voluntarily asking and answering questions in large-enrollment science courses is helpful to them and why. They also answered questions about to what extent they engage in asking and answering questions in large-enrollment college science courses and what factors could discourage them from participating. Using binary logistic regression, we examined whether there were differences among students of different demographic groups regarding their opinions about asking and answering questions. We found that overwhelmingly students reported that other students voluntarily asking and answering instructor questions is helpful to them. Notably, compared to continuing generation students, first-generation students were more likely to perceive other students asking questions to be helpful. Despite perceiving asking and answering questions to be helpful, over half of students reported that they never ask or answer questions in large-enrollment college science courses during a semester, and women were more likely than men to report never asking questions. We identified fear of negative evaluation, or students' sense of dread associated with being unfavorably evaluated, as a primary factor influencing their decision to answer instructor questions. This work adds to a growing body of literature on student participation in large-enrollment college science courses and begins to uncover underlying factors influencing student participation.
During the last decade numerous review articles have been published on how concurrent strength and endurance training affect cycling performance. However, none of these have reviewed if there are any sex differences in the effects of concurrent training on cycling performance, and most research in this area has been performed with male cyclists. Thus, the aim of the current paper is to review the scientific literature on the effect of concurrent training on cycling performance in male and female cyclists with a special emphasis on potential sex differences. The results indicate that both male and female cyclists experience a similar beneficial effect from concurrent training on cycling performance and its physiological determinants compared to normal endurance training only. Some data indicate that women have a larger effect on cycling economy, but more studies are needed to explore this further. Furthermore, the adaptations to strength training thought to be responsible for the beneficial effects on cycling performance seem to be very similar between men and women. Interestingly, increased muscle cross-sectional area in the main locomotor muscles seems to be an important adaptation for improved performance, and, contrary to popular belief, cyclists should aim for increased muscle cross-sectional area when adding strength training to their normal training. We conclude that both male and female cyclists can improve their cycling performance by adding strength training to their normal training.
The mining of manganese ore in India started in the year 1899, in Nagpur district of the Central Provinces. Almost six decades later, in 1957, Dr. T. P. Niyogi examined several young men involved in dry drilling of Manganese ore, who had symptoms of muscular pain, weakness, clumsy movements, asthenia, anorexia, insomnia, and gait difficulties. These patients were also emotionally disturbed and prone to falls and accidents. He concluded that these symptoms were due to chronic manganese toxicity with parkinsonian features and psychiatric manifestations which he published in 1958.[1] This lead to the formation of an Enquiry Committee by the Ministry of Labour and Employment, Government of India which instituted corrective measures in mining of manganese in India. Very few reports of chronic toxicity due to inhalation of manganese have been reported subsequently. This paper highlights the contributions of Dr. T.P. Niyogi who was the Civil Surgeon in Chhindwara, MP during that period.