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News roundup
Update
NewsRound-up Specialists collaborate on landmark prostate cancer report Leading specialists in the management of prostate cancer have collaborated on a major new review of current knowledge and good practice. The first annual Report to the Nation on Prostate Cancer, published by the USA’s Prostate Cancer Foundation, is intended for all health professionals involved in the care of men with prostate cancer. According to the charity, the report represents ‘‘a comprehensive overview of the state-of-the-art in prostate cancer prevention, diagnosis, treatment, and research.’’ A total of 22 specialists from the USA and Canada contributed, with Professors Peter Carroll (University of California, San Francisco) and William Nelson (Johns Hopkins University, Baltimore, Maryland) serving as executive editors. It contains nine chapters, covering:
how PSA measurements such as PSA doubling time can best be used in different patient populations, how PSA subfractions such as free PSA might be more specific to prostate cancer, and how genetic biomarkers might be employed to even further increase the specificity without compromising the sensitivity, will each greatly enhance our ability to detect clinically meaningful tumors at a disease stage that is most likely to be curable.’’ The full 96-page report can be downloaded from the Prostate Cancer Foundation website (www.prostatecancerfoundation. org). A webcast recording of the launch event can also be viewed.
Detection, diagnosis, and prognosis. Management of localized prostate cancer. Androgen-deprivation therapy. Management of bone metastases. Chemotherapeutic options. Emerging therapies. Management of side effects of prostate cancer therapy. Nutrition and prevention strategies. Therapeutic strategies for patients with a rising PSA: a case-based approach.
The authors of each chapter present not only what is currently known, but also the questions that still need to be answered. Carroll and Nelson write in their introduction: ‘‘One of the underlying themes of the report is the need for multidisciplinary collaboration among urologists, radiation oncologists, and medical oncologists at all stages of the disease to optimise the deployment of currently available therapies as well as to efficiently advance new and emerging therapeutic strategies.’’ Introducing the subject of PSA testing, they write: ‘‘A better understanding of
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response to a general invitation from David Byrne, the EU’s Commissioner for Health and Consumer Protection, for suggestions on how to improve health policy. The paper, sent to Byrne in October, states that ‘‘biological as well as gender-based differences between women and men must be acknowledged and taken into consideration in all EU policies that affect health, either directly or indirectly.’’ It concludes with 8 recommendations, including making health targets more gender-specific, and ensuring that EU institutions and member states are adequately informed of the impact of sex and gender on health. See the EMHF’s website (www.emhf.org) for the full paper. At the end of October, representatives from EU institutions, including the European Parliament and European Commission, attended a roundtable meeting on gender and health, organised jointly by the EMHF, the European Institute of Women’s Health, and the Center for Health Ethics and Society. Speakers included Professor Alan White (see separate news story), and EMHF president Dr Ian Banks. The aim of the meeting, held in Brussels, was to raise awareness of gender issues among policy makers and stakeholders, and to identify ways of ensuring that gender is incorporated into all relevant EU policies, programmes and initiatives on health.
HIV survey deadline extended Gender is on the agenda in EU The European Union (EU) has been sent strong and consistent messages in recent months from men’s health and women’s health groups on the importance of gender equity in EU health policy. First, the European Men’s Health Forum (EMHF) produced a briefing paper in
Vol. 1, No. 4, pp. 374–376, December 2004
The European Men’s Health Forum has extended the deadline for its survey of HIV-positive adults to 31 March 2005. The ‘‘European HIV-Related Quality of Life Review’’ (see jmhg News Round-up, 2004;1:245) is a 51-item survey investigating the influence of various factors on physical and emotional well-being and quality of life. All HIV-positive men and women who are aged 18 and over, and who live in Europe, are
Update invited to take part. The questionnaire can be completed online at www.emhf.org, and is available in five languages: English, French, German, Italian, and Spanish.
Men use humour even when discussing serious illness Men are likely to make jokes even when discussing serious illness, a focus group study has shown. The finding has led to suggestions that public health messages aimed at men could potentially benefit from incorporating humour. Researchers from the Welsh School of Pharmacy, at Cardiff University, UK, conducted seven focus-group discussions on pharmacy, health, and illness, with a total of 37 relatively healthy and active men aged 18–65. They reported their findings at the British Pharmaceutical Conference, in September. At least two participants in each group used humour, in the form of sarcasm, teasing, or ‘one-liners’. Humour was used when talking about serious conditions, such as testicular cancer, as well as when discussing less serious illnesses such as headaches. Dr Dai John, co-researcher and senior lecturer, told the jmhg: ‘‘Many men use humour and banter simply as a way of communicating. It is part of their everyday life. This carried over into our focus groups, even when men were talking about potentially serious conditions.’’ He said the research suggests that humour could be a way of reaching some men who are otherwise uncomfortable dealing with health issues: ‘‘Public health messages aimed at men may be more successful if they use humour in some way – this is worth investigating.’’ The new findings support those of previous studies that have reported men using jokes and other types of humour in discussions about health issues that otherwise could be difficult to deal with. Other studies have reported the use of humour as a way of coping with ill health – this was not observed in the Cardiff study, probably because the focus group participants were in relatively good health. The researchers are currently looking to continue their work with other groups, possibly with older men, women, patients with limiting illnesses, and represen-
tatives from different religious, cultural, economic or geographical backgrounds. Dr John emphasised that the findings should not be interpreted as suggesting that health professionals should use humour in one-to-one contacts or consultations: ‘‘This will of course often be inappropriate. As a pharmacist who practises each week in the same pharmacy, there are a number of men I use humour with – but only if they use it first and if I know them.’’
World’s first professor of men’s health appointed Alan White, a member of the jmhg’s advisory board, has been appointed professor of men’s health – understood to be the first such title in the world – at Leeds Metropolitan University in the UK. White said the creation of the position reflects the acceptance of men’s health as an important and academically credible discipline in its own right. This has occurred due to the innovative and pioneering work of clinicians, researchers, and national and international men’s health organisations worldwide, he said. The two main tasks as professor, he said, will be to establish and run a Leeds Metropolitan University research unit dedicated to men’s health, and to help educate health professionals about men’s health and gender differences. He will deliver his inaugural lecture as professor, entitled "Being male in the 21st century – the emergence of men’s health as a major public health concern" on 27 April. To learn more about the appointment and plans for the future, see the interview with Alan White in the Resources section of the website of the European Men’s Health Forum (www.emhf.org) and Alan White’s editorial in this issue. Alan white is also highlighted in this issue in the occasional Curriculum Vitae series, which features members of jmhg’s editorial advisory board.
Action on osteoporosis in men ‘‘We have a long way to go before we reach the same level of understanding of osteo-
porosis in men as we have in women,’’ a report from the International Osteoporosis Foundation (IOF) has concluded. The report, Osteoporosis in Men, was launched in October 2004 to mark World Osteoporosis Day, and was written by Professor Ego Seeman, professor of medicine at the University of Melbourne, Australia. It points out that, worldwide, one in five men over 50 will suffer an osteoporotic fracture, and that the lifetime risk for men ‘‘is greater than the likelihood of developing prostate cancer.’’ Seeman writes that men who sustain osteoporotic fractures may suffer more severely in terms of the quality and quantity of their lives than when fractures occur in women: ‘‘Men and women lose about 7 years of life after a hip fracture, but this amount is a greater proportion of the number of years of life left in men than women.’’ The fully referenced report includes sections on the problems of fractures in men, how men’s bones differ from women’s bones, challenges in diagnosis and treatment, and prevention measures. It also contains seven detailed case histories of men with osteoporosis, some only in their 30s and 40s, and the IOF’s ‘‘One Minute Risk Test’’. ‘‘Today, the lack of awareness of osteoporosis and fractures as a disease in men is similar to the lack of awareness in women 50 years ago,’’ says Seeman. The full report can be downloaded from the IOF’s website (www.osteofound.org). See also the previous issue of the jmhg for a review article on the diagnosis and treatment of osteoporosis in men (2004;1:204-14).
Obesity prevalence doubles in China? The prevalence of obesity in China almost doubled between 1992 and 2002, according to new national survey figures. The rise has been attributed to a decline in poverty and fattier diets. China’s Ministry of Health conducted the survey of 272,023 people in the second half of 2002. Newswire reports of the release of the survey findings in late 2004 show that, overall, 7.1 percent of Chinese adults were found to be obese and 22.8 percent were
Vol. 1, No. 4, pp. 374–376, December 2004
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Update overweight (although the precise definitions of obesity and overweight used in the survey are not known). These figures were higher in cities, and lower in rural areas. The overall prevalence of obesity in children was 8.1 percent. No breakdown by sex is available. Comparisons with a similar survey conducted in 1992 suggest that the proportion of adults who were obese had increased by 97 percent, while the proportion of adults who were overweight had increased by 39 percent. Kong Lingzhi, director of the Ministry of Health, is quoted as saying: ‘‘We will consolidate our work to improve people’s nutrition status and the control and prevention of chronic diseases through policy support, market guidance, and public education.’’
Football clubs target men’s health The UK’s Department of Health is talking with the English Premier League on the potential for football clubs nationwide to help improve the health of local supporters by offering screening, advice, and other healthcare services. The discussions surround whether some of the health initiatives already underway at some clubs should be extended and adopted by all. The Premier League comprises and represents the 20 top clubs in English football. A number of clubs have recently run projects, often in partnership with local health authorities, intended to encourage men in particular to take their health more seriously. Liverpool and Manchester United, for example, have hosted ‘‘healthy walks’’
376
around their grounds, while Manchester City and Newcastle United have offered blood pressure testing. Other clubs have run occasional match-day drop-in clinics and printed health messages on tickets. Manchester City are already planning to go further in their efforts to improve the health of their supporters. It is planning to open a ‘‘wellness centre’’ in its stadium in the spring of 2005, staffed on weekdays by nurses, nutritionists, and health educators.
Progress is ‘‘uneven’’ 10 years after Cairo, says UNFPA Uneven progress has been made in improving women’s rights and access to reproductive healthcare in the past 10 years, according to a new report from the United Nations Population Fund (UNFPA). In the report, The State of World Population 2004, the UNFPA evaluates the impact of the International Conference on Population And Development held in Cairo in 1994. In Cairo, the leaders of 179 countries agreed on a 20-year Programme of Action, a main part of which was to link the alleviation of poverty to the empowerment of women and universal access to reproductive healthcare. Halfway through this programme, the UNFPA says some ‘‘impressive’’ progress has been achieved. It says 99 percent of 151 developing countries surveyed have adopted measures to protect the rights of girls and women, including passing national legislation and laws on women’s rights. In addition, 131 countries have changed national policies, laws, or institutions, to recognise reproductive rights. The use of
Vol. 1, No. 4, pp. 374–376, December 2004
contraception has increased from 55 percent of couples in 1994 to 61 percent in 2004, and three-quarters of the countries surveyed have adopted national strategies on HIV/ AIDS. However, major problems remain, says the UNFPA. A total of 200 million women in developing countries continue to have an unmet need for effective contraception. Maternal mortality rates are still high: the report states that the lifetime risk of a woman dying in pregnancy or childbirth in West Africa is 1 in 12, compared with 1 in 4,000 in developed regions. Fewer than 20 percent of people at high risk of HIV infection have access to proven prevention measures, and poverty will be exacerbated by an estimated tripling of the populations of the world’s 50 poorest countries by 2050. Lack of resources is currently the main barrier to further progress, according to Thoraya Ahmed Obaid, executive director of the UNFPA. She said donor countries have given only half the amount that they agreed would be needed to implement the Programme of Action – US$ 3.1 billion per year rather than the US$ 6.1 billion pledged by 2005. ‘‘Unless international assistance rises to the levels agreed to at the Cairo Conference, the numbers of people who need family planning, maternal healthcare, and HIV/AIDS prevention, testing, and treatment, will continue to grow. Lack of reproductive health care will continue to be the leading cause of death for women in the developing world, and the AIDS pandemic will continue to expand and wreak havoc.’’ The full report, and extensive information about the Cairo goals and implementation of the Programme of Action, is available from www.unfpa.org.
NewsRound-up Specialists collaborate on landmark prostate cancer report Leading specialists in the management of prostate cancer have collaborated on a major new review of current knowledge and good practice. The first annual Report to the Nation on Prostate Cancer, published by the USA’s Prostate Cancer Foundation, is intended for all health professionals involved in the care of men with prostate cancer. According to the charity, the report represents ‘‘a comprehensive overview of the state-of-the-art in prostate cancer prevention, diagnosis, treatment, and research.’’ A total of 22 specialists from the USA and Canada contributed, with Professors Peter Carroll (University of California, San Francisco) and William Nelson (Johns Hopkins University, Baltimore, Maryland) serving as executive editors. It contains nine chapters, covering:
how PSA measurements such as PSA doubling time can best be used in different patient populations, how PSA subfractions such as free PSA might be more specific to prostate cancer, and how genetic biomarkers might be employed to even further increase the specificity without compromising the sensitivity, will each greatly enhance our ability to detect clinically meaningful tumors at a disease stage that is most likely to be curable.’’ The full 96-page report can be downloaded from the Prostate Cancer Foundation website (www.prostatecancerfoundation. org). A webcast recording of the launch event can also be viewed.
Detection, diagnosis, and prognosis. Management of localized prostate cancer. Androgen-deprivation therapy. Management of bone metastases. Chemotherapeutic options. Emerging therapies. Management of side effects of prostate cancer therapy. Nutrition and prevention strategies. Therapeutic strategies for patients with a rising PSA: a case-based approach.
The authors of each chapter present not only what is currently known, but also the questions that still need to be answered. Carroll and Nelson write in their introduction: ‘‘One of the underlying themes of the report is the need for multidisciplinary collaboration among urologists, radiation oncologists, and medical oncologists at all stages of the disease to optimise the deployment of currently available therapies as well as to efficiently advance new and emerging therapeutic strategies.’’ Introducing the subject of PSA testing, they write: ‘‘A better understanding of
374
response to a general invitation from David Byrne, the EU’s Commissioner for Health and Consumer Protection, for suggestions on how to improve health policy. The paper, sent to Byrne in October, states that ‘‘biological as well as gender-based differences between women and men must be acknowledged and taken into consideration in all EU policies that affect health, either directly or indirectly.’’ It concludes with 8 recommendations, including making health targets more gender-specific, and ensuring that EU institutions and member states are adequately informed of the impact of sex and gender on health. See the EMHF’s website (www.emhf.org) for the full paper. At the end of October, representatives from EU institutions, including the European Parliament and European Commission, attended a roundtable meeting on gender and health, organised jointly by the EMHF, the European Institute of Women’s Health, and the Center for Health Ethics and Society. Speakers included Professor Alan White (see separate news story), and EMHF president Dr Ian Banks. The aim of the meeting, held in Brussels, was to raise awareness of gender issues among policy makers and stakeholders, and to identify ways of ensuring that gender is incorporated into all relevant EU policies, programmes and initiatives on health.
HIV survey deadline extended Gender is on the agenda in EU The European Union (EU) has been sent strong and consistent messages in recent months from men’s health and women’s health groups on the importance of gender equity in EU health policy. First, the European Men’s Health Forum (EMHF) produced a briefing paper in
Vol. 1, No. 4, pp. 374–376, December 2004
The European Men’s Health Forum has extended the deadline for its survey of HIV-positive adults to 31 March 2005. The ‘‘European HIV-Related Quality of Life Review’’ (see jmhg News Round-up, 2004;1:245) is a 51-item survey investigating the influence of various factors on physical and emotional well-being and quality of life. All HIV-positive men and women who are aged 18 and over, and who live in Europe, are
Update invited to take part. The questionnaire can be completed online at www.emhf.org, and is available in five languages: English, French, German, Italian, and Spanish.
Men use humour even when discussing serious illness Men are likely to make jokes even when discussing serious illness, a focus group study has shown. The finding has led to suggestions that public health messages aimed at men could potentially benefit from incorporating humour. Researchers from the Welsh School of Pharmacy, at Cardiff University, UK, conducted seven focus-group discussions on pharmacy, health, and illness, with a total of 37 relatively healthy and active men aged 18–65. They reported their findings at the British Pharmaceutical Conference, in September. At least two participants in each group used humour, in the form of sarcasm, teasing, or ‘one-liners’. Humour was used when talking about serious conditions, such as testicular cancer, as well as when discussing less serious illnesses such as headaches. Dr Dai John, co-researcher and senior lecturer, told the jmhg: ‘‘Many men use humour and banter simply as a way of communicating. It is part of their everyday life. This carried over into our focus groups, even when men were talking about potentially serious conditions.’’ He said the research suggests that humour could be a way of reaching some men who are otherwise uncomfortable dealing with health issues: ‘‘Public health messages aimed at men may be more successful if they use humour in some way – this is worth investigating.’’ The new findings support those of previous studies that have reported men using jokes and other types of humour in discussions about health issues that otherwise could be difficult to deal with. Other studies have reported the use of humour as a way of coping with ill health – this was not observed in the Cardiff study, probably because the focus group participants were in relatively good health. The researchers are currently looking to continue their work with other groups, possibly with older men, women, patients with limiting illnesses, and represen-
tatives from different religious, cultural, economic or geographical backgrounds. Dr John emphasised that the findings should not be interpreted as suggesting that health professionals should use humour in one-to-one contacts or consultations: ‘‘This will of course often be inappropriate. As a pharmacist who practises each week in the same pharmacy, there are a number of men I use humour with – but only if they use it first and if I know them.’’
World’s first professor of men’s health appointed Alan White, a member of the jmhg’s advisory board, has been appointed professor of men’s health – understood to be the first such title in the world – at Leeds Metropolitan University in the UK. White said the creation of the position reflects the acceptance of men’s health as an important and academically credible discipline in its own right. This has occurred due to the innovative and pioneering work of clinicians, researchers, and national and international men’s health organisations worldwide, he said. The two main tasks as professor, he said, will be to establish and run a Leeds Metropolitan University research unit dedicated to men’s health, and to help educate health professionals about men’s health and gender differences. He will deliver his inaugural lecture as professor, entitled "Being male in the 21st century – the emergence of men’s health as a major public health concern" on 27 April. To learn more about the appointment and plans for the future, see the interview with Alan White in the Resources section of the website of the European Men’s Health Forum (www.emhf.org) and Alan White’s editorial in this issue. Alan white is also highlighted in this issue in the occasional Curriculum Vitae series, which features members of jmhg’s editorial advisory board.
Action on osteoporosis in men ‘‘We have a long way to go before we reach the same level of understanding of osteo-
porosis in men as we have in women,’’ a report from the International Osteoporosis Foundation (IOF) has concluded. The report, Osteoporosis in Men, was launched in October 2004 to mark World Osteoporosis Day, and was written by Professor Ego Seeman, professor of medicine at the University of Melbourne, Australia. It points out that, worldwide, one in five men over 50 will suffer an osteoporotic fracture, and that the lifetime risk for men ‘‘is greater than the likelihood of developing prostate cancer.’’ Seeman writes that men who sustain osteoporotic fractures may suffer more severely in terms of the quality and quantity of their lives than when fractures occur in women: ‘‘Men and women lose about 7 years of life after a hip fracture, but this amount is a greater proportion of the number of years of life left in men than women.’’ The fully referenced report includes sections on the problems of fractures in men, how men’s bones differ from women’s bones, challenges in diagnosis and treatment, and prevention measures. It also contains seven detailed case histories of men with osteoporosis, some only in their 30s and 40s, and the IOF’s ‘‘One Minute Risk Test’’. ‘‘Today, the lack of awareness of osteoporosis and fractures as a disease in men is similar to the lack of awareness in women 50 years ago,’’ says Seeman. The full report can be downloaded from the IOF’s website (www.osteofound.org). See also the previous issue of the jmhg for a review article on the diagnosis and treatment of osteoporosis in men (2004;1:204-14).
Obesity prevalence doubles in China? The prevalence of obesity in China almost doubled between 1992 and 2002, according to new national survey figures. The rise has been attributed to a decline in poverty and fattier diets. China’s Ministry of Health conducted the survey of 272,023 people in the second half of 2002. Newswire reports of the release of the survey findings in late 2004 show that, overall, 7.1 percent of Chinese adults were found to be obese and 22.8 percent were
Vol. 1, No. 4, pp. 374–376, December 2004
375
Update overweight (although the precise definitions of obesity and overweight used in the survey are not known). These figures were higher in cities, and lower in rural areas. The overall prevalence of obesity in children was 8.1 percent. No breakdown by sex is available. Comparisons with a similar survey conducted in 1992 suggest that the proportion of adults who were obese had increased by 97 percent, while the proportion of adults who were overweight had increased by 39 percent. Kong Lingzhi, director of the Ministry of Health, is quoted as saying: ‘‘We will consolidate our work to improve people’s nutrition status and the control and prevention of chronic diseases through policy support, market guidance, and public education.’’
Football clubs target men’s health The UK’s Department of Health is talking with the English Premier League on the potential for football clubs nationwide to help improve the health of local supporters by offering screening, advice, and other healthcare services. The discussions surround whether some of the health initiatives already underway at some clubs should be extended and adopted by all. The Premier League comprises and represents the 20 top clubs in English football. A number of clubs have recently run projects, often in partnership with local health authorities, intended to encourage men in particular to take their health more seriously. Liverpool and Manchester United, for example, have hosted ‘‘healthy walks’’
376
around their grounds, while Manchester City and Newcastle United have offered blood pressure testing. Other clubs have run occasional match-day drop-in clinics and printed health messages on tickets. Manchester City are already planning to go further in their efforts to improve the health of their supporters. It is planning to open a ‘‘wellness centre’’ in its stadium in the spring of 2005, staffed on weekdays by nurses, nutritionists, and health educators.
Progress is ‘‘uneven’’ 10 years after Cairo, says UNFPA Uneven progress has been made in improving women’s rights and access to reproductive healthcare in the past 10 years, according to a new report from the United Nations Population Fund (UNFPA). In the report, The State of World Population 2004, the UNFPA evaluates the impact of the International Conference on Population And Development held in Cairo in 1994. In Cairo, the leaders of 179 countries agreed on a 20-year Programme of Action, a main part of which was to link the alleviation of poverty to the empowerment of women and universal access to reproductive healthcare. Halfway through this programme, the UNFPA says some ‘‘impressive’’ progress has been achieved. It says 99 percent of 151 developing countries surveyed have adopted measures to protect the rights of girls and women, including passing national legislation and laws on women’s rights. In addition, 131 countries have changed national policies, laws, or institutions, to recognise reproductive rights. The use of
Vol. 1, No. 4, pp. 374–376, December 2004
contraception has increased from 55 percent of couples in 1994 to 61 percent in 2004, and three-quarters of the countries surveyed have adopted national strategies on HIV/ AIDS. However, major problems remain, says the UNFPA. A total of 200 million women in developing countries continue to have an unmet need for effective contraception. Maternal mortality rates are still high: the report states that the lifetime risk of a woman dying in pregnancy or childbirth in West Africa is 1 in 12, compared with 1 in 4,000 in developed regions. Fewer than 20 percent of people at high risk of HIV infection have access to proven prevention measures, and poverty will be exacerbated by an estimated tripling of the populations of the world’s 50 poorest countries by 2050. Lack of resources is currently the main barrier to further progress, according to Thoraya Ahmed Obaid, executive director of the UNFPA. She said donor countries have given only half the amount that they agreed would be needed to implement the Programme of Action – US$ 3.1 billion per year rather than the US$ 6.1 billion pledged by 2005. ‘‘Unless international assistance rises to the levels agreed to at the Cairo Conference, the numbers of people who need family planning, maternal healthcare, and HIV/AIDS prevention, testing, and treatment, will continue to grow. Lack of reproductive health care will continue to be the leading cause of death for women in the developing world, and the AIDS pandemic will continue to expand and wreak havoc.’’ The full report, and extensive information about the Cairo goals and implementation of the Programme of Action, is available from www.unfpa.org.