Heart risks fuel debate over COVID-19 boosters Couzin-Frankel, Jennifer
Science (American Association for the Advancement of Science),
10/2022, Volume:
378, Issue:
6617
Journal Article
Peer reviewed
With benefits unclear, some scientists question new round of shots for young people
With benefits unclear, some scientists question new round of shots for young people
Coronary artery disease (CAD) is a concerning late outcome for cancer survivors. However, uniform surveillance guidelines are lacking.
To harmonise international recommendations for CAD surveillance ...for survivors of childhood, adolescent and young adult (CAYA) cancers.
A systematic literature review was performed and evidence graded using the Grading of Recommendations, Assessment, Development and Evaluation criteria. Eligibility included English language studies, a minimum of 20 off-therapy cancer survivors assessed for CAD, and 75% diagnosed prior to age 35 years. All study designs were included, and a multidisciplinary guideline panel formulated and graded recommendations.
32 of 522 identified articles met eligibility criteria. The prevalence of CAD ranged from 0 to 72% and was significantly increased compared to control populations. The risk of CAD was increased among survivors who received radiotherapy exposing the heart, especially at doses ≥15 Gy (moderate-quality evidence). The guideline panel agreed that healthcare providers and CAYA cancer survivors treated with radiotherapy exposing the heart should be counselled about the increased risk for premature CAD. While the evidence is insufficient to support primary screening, monitoring and early management of modifiable cardiovascular risk factors are recommended. Initiation and frequency of surveillance should be based on the intensity of treatment exposures, family history, and presence of co-morbidities but at least by age 40 years and at a minimum of every 5 years. All were strong recommendations.
These systematically assessed and harmonised recommendations for CAD surveillance will inform care and guide research concerning this critical outcome for CAYA cancer survivors.
•Cancer survivors are at risk for premature coronary artery disease (CAD).•Especially survivors treated with radiotherapy exposing the heart.•This guideline provides recommendations for CAD surveillance.•Early monitoring and management of modifiable risk factors is recommended.•Key knowledge gaps regarding CAD in cancer survivors require further investigation.
Although ethnic and racial identity (ERI) are central to the normative development of youth of color, there have been few efforts to bring scholars together to discuss the theoretical complexities of ...these constructs and provide a synthesis of existing work. The Ethnic and Racial Identity in the 21st Century Study Group was assembled for this purpose. This article provides an overview of the interface of ERI with developmental and contextual issues across development, with an emphasis on adolescence and young adulthood. It proposes a metaconstruct to capture experiences that reflect both individuals' ethnic background and their racialized experiences in a specific sociohistorical context. Finally, it presents milestones in the development of ERI across developmental periods.
Purpose
To investigate the association between social isolation and loneliness, how they relate to depression, and whether these associations are explained by genetic influences.
Methods
We used data ...from the age-18 wave of the Environmental Risk Longitudinal Twin Study, a birth cohort of 1116 same-sex twin pairs born in England and Wales in 1994 and 1995. Participants reported on their levels of social isolation, loneliness and depressive symptoms. We conducted regression analyses to test the differential associations of isolation and loneliness with depression. Using the twin study design, we estimated the proportion of variance in each construct and their covariance that was accounted for by genetic and environmental factors.
Results
Social isolation and loneliness were moderately correlated (
r
= 0.39), reflecting the separateness of these constructs, and both were associated with depression. When entered simultaneously in a regression analysis, loneliness was more robustly associated with depression. We observed similar degrees of genetic influence on social isolation (40 %) and loneliness (38 %), and a smaller genetic influence on depressive symptoms (29 %), with the remaining variance accounted for by the non-shared environment. Genetic correlations of 0.65 between isolation and loneliness and 0.63 between loneliness and depression indicated a strong role of genetic influences in the co-occurrence of these phenotypes.
Conclusions
Socially isolated young adults do not necessarily experience loneliness. However, those who are lonely are often depressed, partly because the same genes influence loneliness and depression. Interventions should not only aim at increasing social connections but also focus on subjective feelings of loneliness.
Previous studies showed a higher incidence of lung cancer among young women than among young men in the United States. Whether this pattern has continued in contemporary birth cohorts and, if so, ...whether it can be fully explained by sex differences in smoking behaviors are unknown.
We examined the nationwide population-based incidence of lung cancer according to sex, race or ethnic group, age group (30 to 34, 35 to 39, 40 to 44, 45 to 49, and 50 to 54 years), year of birth (1945 to 1980), and calendar period of diagnosis (1995-1999, 2000-2004, 2005-2009, and 2010-2014), and we calculated female-to-male incidence rate ratios. We also examined the prevalence of cigarette smoking, using data from the National Health Interview Survey from 1970 to 2016.
Over the past two decades, the age-specific incidence of lung cancer has generally decreased among both men and women 30 to 54 years of age in all races and ethnic groups, but the declines among men have been steeper. Consequently, among non-Hispanic whites, the female-to-male incidence rate ratios increased, exceeding 1.0 in the age groups of 30 to 34, 35 to 39, 40 to 44, and 45 to 49 years. For example, the female-to-male incidence rate ratio among whites 40 to 44 years of age increased from 0.88 (95% confidence interval CI, 0.84 to 0.92) during the 1995-1999 period to 1.17 (95% CI, 1.11 to 1.23) during the 2010-2014 period. The crossover in sex-specific rates occurred among non-Hispanic whites born since 1965. Sex-specific incidence rates converged among non-Hispanic blacks, Hispanics, and non-Hispanic Asians and Pacific Islanders but crossed over from a higher incidence among men to a higher incidence among women only among Hispanics. The prevalence of cigarette smoking among women born since 1965 has approached, but generally not exceeded, the prevalence among men.
The patterns of historically higher incidence rates of lung cancer among men than among women have reversed among non-Hispanic whites and Hispanics born since the mid-1960s, and they are not fully explained by sex differences in smoking behaviors. Future studies are needed to identify reasons for the higher incidence of lung cancer among young women. (Funded by the American Cancer Society.).
A sociologist and former fashion model takes readers inside the elite global party circuit of "models and bottles" to reveal how beautiful young women are used to boost the status of men ...Million-dollar birthday parties, megayachts on the French Riviera, and $40, 000 bottles of champagne. In today's New Gilded Age, the world's moneyed classes have taken conspicuous consumption to new extremes. In Very Important People, sociologist, author, and former fashion model Ashley Mears takes readers inside the exclusive global nightclub and party circuit—from New York City and the Hamptons to Miami and Saint-Tropez—to reveal the intricate economy of beauty, status, and money that lies behind these spectacular displays of wealth and leisure.Mears spent eighteen months in this world of "models and bottles" to write this captivating, sometimes funny, sometimes heartbreaking narrative. She describes how clubs and restaurants pay promoters to recruit beautiful young women to their venues in order to attract men and get them to spend huge sums in the ritual of bottle service. These "girls" enhance the status of the men and enrich club owners, exchanging their bodily capital for as little as free drinks and a chance to party with men who are rich or aspire to be. Though they are priceless assets in the party circuit, these women are regarded as worthless as long-term relationship prospects, and their bodies are constantly assessed against men's money.A story of extreme gender inequality in a seductive world, Very Important People unveils troubling realities behind moneyed leisure in an age of record economic disparity.
A good stair‐climbing (SC) ability is crucial for independent living in older adults. A simple formula that estimates the mean power needed to ascend a flight of stairs in a predetermined time (i.e., ...total ascent duration) is easy to implement in practice, but lacks information on actual power values generated per step. The latter is possible with body‐fixed sensors. This study aimed at comparing both methodologies and investigating their sensitivity to detect age‐related differences. 318 participants (162 ♀; age 19–85 years) were tested on a 6‐step staircase and two methodologies were used to estimate mean SC power: (1) a body‐fixed sensor with automated detection of power production per step, and (2) a mathematic equation based on timed ascent duration, body mass and stair height. SC power was 210.4 W lower with formula compared to sensor, lower in women versus men and in older versus young adults (p < 0.001). The difference in SC power between sensor and formula was greater in individuals with better performance (i.e., men and young adults) (p < 0.001), indicating a ceiling effect of the formula in well‐functioning and younger individuals. Likewise, ICC's between both methodologies showed poor reliability in people aged <65 years (0.087–0.363) and moderate to good reliability in people aged ≥65 years (0.453–0.780). To conclude, participants with better SC performance are able to largely overshoot the minimal power required to ascend the stairs in a certain duration. This makes the sensor more sensitive to identify early age‐related differences compared to the formula.
Introduction
At the epicentre of the HIV epidemic in southern Africa, adolescent girls and young women aged 15–24 contribute a disproportionate ~30% of all new infections and seroconvert 5–7 years ...earlier than their male peers. This age–sex disparity in HIV acquisition continues to sustain unprecedentedly high incidence rates, and preventing HIV infection in this age group is a pre‐requisite for achieving an AIDS‐free generation and attaining epidemic control.
Discussion
Adolescent girls and young women in southern Africa are uniquely vulnerable to HIV and have up to eight times more infection than their male peers. While the cause of this vulnerability has not been fully elucidated, it is compounded by structural, social and biological factors. These factors include but are not limited to: engagement in age‐disparate and/or transactional relationships, few years of schooling, experience of food insecurity, experience of gender‐based violence, increased genital inflammation, and amplification of effects of transmission co‐factors. Despite the large and immediate HIV prevention need of adolescent girls and young women, there is a dearth of evidence‐based interventions to reduce their risk. The exclusion of adolescents in biomedical research is a huge barrier. School and community‐based education programmes are commonplace in many settings, yet few have been evaluated and none have demonstrated efficacy in preventing HIV infection. Promising data are emerging on prophylactic use of anti‐retrovirals and conditional cash transfers for HIV prevention in these populations.
Conclusions
There is an urgent need to meet the HIV prevention needs of adolescent girls and young women, particularly those who are unable to negotiate monogamy, condom use and/or male circumcision. Concerted efforts to expand the prevention options available to these young women in terms of the development of novel HIV‐specific biomedical, structural and behavioural interventions are urgently needed for epidemic control. In the interim, a pragmatic approach of integrating existing HIV prevention efforts into broader sexual reproductive health services is a public health imperative.
Amidst population ageing trends and epidemiological transitions, there has been a growing emergence of young family caregivers, about whom most studies have been conducted in Western countries. Their ...subjective experiences and perceptions toward caregiving remain underexplored in Asia. This qualitative study explored the lived experiences of caregiving for older family members by young caregivers in Singapore. Interpretative phenomenological analysis was employed to collect and analyse data from semi-structured, in-depth interviews with six young adult caregivers aged between 23 and 29. Interviews were supplemented with photo-elicitation techniques to deepen interview discussions and uncover experiential significance. Findings illustrated transitions into caregiving, challenges across role conflicts and expectations amidst developmental tasks and transitions, and navigation of intergenerational conflicts and ambivalence. Although no definitive conclusions can be reached from this small-scale study, the findings offer important insights into the convergence and intensity of young caregivers' experiences. Given that caregiving challenges are likely to continue amidst Singapore's rapidly ageing population, these necessitate further in-depth research efforts. Implications for policy and practice across multiple stakeholders interfacing with youth and older adults are presented. A whole-of-society approach is called for to enable young caregivers to realise their full potential while contributing to their ageing families and nation.
Investigating social participation of young adults with an autism spectrum disorder (ASD) is important given the increasing number of youth aging into young adulthood. Social participation is an ...indicator of life quality and overall functioning. Using data from the National Longitudinal Transition Study 2, we examined rates of participation in social activities among young adults who received special education services for autism (ASD group), compared to young adults who received special education for intellectual disability, emotional/behavioral disability, or a learning disability. Young adults with an ASD were significantly more likely to never see friends, never get called by friends, never be invited to activities, and be socially isolated. Among those with an ASD, lower conversation ability, lower functional skills, and living with a parent were predictors of less social participation.
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