Activities of contemporary Mayan elders.

Social gerontology researchers have investigated various aspects of elder activities in diverse culture contexts. This project assessed the knowledge that Mayan people have about the activities of their elders. Data were collected through two interview procedures. The first procedure, free-listing, was conducted with an initial sample of Mayan subjects (n=31), who provided terms representing their cultural knowledge of elder Mayan activities. A second sample (n=56) performed a pile sort task using 18 of those activities. The pile sort findings were subjected to multidimensional scaling, and that technique produced a two-dimensional visual representation of three distinct clusters of activities: productive work, serious socio-religious undertakings and frivolous ventures. Besides the coherent multidimensional scaling representation for that total sample of 56 subjects, scalings for subsamples based on generational affiliation were run. Two-dimensional pictures or visual maps for the aged, middle-aged and young adult subjects are remarkably similar to each other and to the picture for the total sample. From a methodological perspective the research findings demonstrate that elder Mayan activities, and presumably those of elders in other societies, are amenable to interview procedures that have high validity and high reliability.

Primary mucosal and glans penis melanomas: the Sydney Melanoma Unit experience.

BACKGROUND: Melanomas that arise on mucosal surfaces and the glans penis are rare. METHODS: A retrospective study of the Sydney Melanoma Unit experience with 69 patients treated since 1956 for these types of melanomas was undertaken to determine primary lesion site, sex, age at diagnosis, symptoms, clinical stage at first presentation. histopathology, treatment and outcome. RESULTS: Primary lesion sites were: nasal cavity (n = 9), oral cavity (n = 16), vulva/vagina (n = 25), anus/rectum (n = 13) and glans penis (n = 6). At diagnosis, 55 patients had local disease only, eight had regional lymph node metastases and six had widespread disease. Local recurrence as the first sign of relapse developed in 15 of the 55 stage I patients (three-stage system). Prognosis for the entire group was poor, only 10% being disease free 3 years after diagnosis and overall 3- and 5-year actuarial survival being 40% and 23%. respectively. The only statistically significant factor influencing survival was stage of disease at diagnosis (P = 0.002). CONCLUSIONS: Possible reasons for poor survival include: (i) non-specific symptoms resulting in late presentation; (ii) locally advanced disease not being recognized by a clinician as a rare form of melanoma, resulting in a delay in treatment; (iii) anatomical constraints precluding surgery with generous margins and consequently resulting in a high incidence of local recurrence. Also, rich vascularity and multiple lymphatic drainage pathways may mean a predisposition to early dissemination. Prompt diagnosis and referral to a specialist unit for treatment and follow up are essential. Adequate surgery remains the cornerstone of treatment for these types of melanoma until more effective systemic therapies become available.