The wide range of values reflects the paucity of information on the subject and demographic factors such as age; it is known that teenagers are more prone to having their adoptions disrupted than young children. Adoption by same-sex couples
Joint adoption by same-sex couples is legal in 34 countries as of March 2022, and additionally in various sub-national territories. Adoption may also be in the form of step-child adoption (6 additional countries), wherein one partner in a same-sex couple adopts the child of the other. Most countries that have same-sex marriage allow joint adoption by those couples, the exceptions being Ecuador (no adoption by same-sex couples), Taiwan (step-child adoption only) and Mexico (in one third of states with same-sex marriage). A few countries with civil unions or lesser marriage rights nonetheless allow step- or joint adoption. Parenting of adoptees
Parenting
The biological relationship between a parent and child is important, and the separation of the two has led to concerns about adoption. The traditional view of adoptive parenting received empirical support from a Princeton University study of 6,000 adoptive, step, and foster families in the United States and South Africa from 1968 to 1985; the study indicated that food expenditures in households with mothers of non-biological children (when controlled for income, household size, hours worked, age, etc.) were significantly less for adoptees, step-children, and foster children, causing the researchers to speculate that people are less interested in sustaining the genetic lines of others.
It is difficult to notice anything suspicious on examination of the tonsil other than slight enlargement or the development of firmness around the area. The carcinoma may occur in one or more sites deep within the tonsillar crypts. It may be accompanied by the enlargement of the tonsil. The affected tonsil grows into the oropharyngeal space making it noticeable by the patient in the form of a neck mass mostly in the jugulodigastric region. As the tonsils consist of a rich network of lymphatics, the carcinoma may metastasize to the neck lymph nodes which many are cystic. Extension of tumor to skull or mediastinum can occur. The additional symptoms include a painful throat, dysphagia, otalgia (due to cranial nerve involvement), foreign body sensation, bleeding, fixation of tongue (infiltration of deep muscles) and trismus (if the pterygoid muscle is involved in the parapharyngeal space).On the other hand, the tumor may also present as a deep red or white fungating wound growing outwards, breaking the skin surface with a central ulceration. This wound-like ulcer fails to heal (non-healing) leading to bleeding and throat pain and other associated symptoms.During biopsy, the lesion may show three signs: gritty texture, firmness and cystification owing to keratinization, fibrosis and necrosis respectively.Cervical lymphydenopathy may be present. Cause
Smoking and alcohol abuse are the major risk factors. Viral causes have recently been taken under consideration as one of the risk factors. Viruses such as Epstein-Barr virus (EBV) (majorly involved in causing nasopharyngeal carcinoma) and human papilloma virus are included in this category.