Parental cigarette smoking and childhood risks of hepatoblastoma: OSCC data

Reported cigarette smoking habits for the parents of 43 UK children who died with hepatoblastoma (1953-55 deaths, 1971-81 deaths) have been compared with corresponding information for the parents of 5777 healthy control children by means of unconditional logistic regression. Hepatoblastoma risks were doubled if both parents smoked relative to neither parent smoking (RR 2.28, 95% CI 1.02-5.09).     

Parental occupational exposure to engine exhausts and childhood brain tumors

Childhood brain tumors (CBT) are the leading cause of cancer death in children; their risk factors are still largely unknown. Since most CBTs are diagnosed before five years of age, prenatal exposure and early postnatal factors may be involved in their etiology. We investigated the association between CBT and parental occupational exposure to engine exhausts in an Australian population‐based case–control study. Parents of 306 cases and 950 controls completed detailed occupational histories. Odds ratios (OR) and 95% confidence intervals (CI) were estimated for both maternal and paternal exposure in key time periods. Increased risks were observed for maternal exposure to diesel exhaust any time before the child's birth (OR 2.03, 95% CI 1.09–3.81) and paternal exposure around the time of the child's conception (OR 1.62, 95% CI 1.12–2.34). No clear associations with other engine exhausts were found. Our results suggest that parental occupational exposure to diesel exhaust may increase the risk of CBT.     

The trajectory of religious coping across time in response to the diagnosis of breast cancer

Objectives: This study investigates the mobilization of religious coping in women's response to breast cancer. Methods: Ninety‐three breast cancer patients and 160 women with a benign diagnosis participated. Breast cancer patients were assessed on their use of religious coping strategies and their level of emotional distress and well‐being at pre‐diagnosis, 1 week pre‐surgery, and 1 month, 6 months, 1 year, and 2 years post‐surgery. Results: In general, breast cancer patients used religious strategies more frequently than women with a benign diagnosis; however, the patterns of use were similar across time for the majority of strategies. Results showed that religious coping strategies are mobilized early on in the process of adjustment to breast cancer. Breast cancer patients' use of support or comfort‐related strategies peaked around surgery and then declined, while the use of strategies that reflected more a process of meaning‐making remained elevated or increased into the long‐term. Positive and negative forms of religious coping were predictive of concurrent distress and emotional well‐being. As well, there was evidence that the mobilization of religious coping was predictive of changes in distress and well‐being across time. For example, women's increased use of active surrender coping from 1 to 6 months post‐surgery was related to a concomitant decrease in emotional distress and increase in emotional well‐being. Conclusions: Notably the nature of the relationship between religious coping and emotional adjustment depended on the type of religious coping strategy as well as the specific time of assessment. Specificity of information in the use of religious coping can allow health‐care professionals to better identify resources and address potential points of difficulty during the process of women's adjustment to breast cancer. Copyright © 2009 John Wiley & Sons, Ltd.     

Parental smoking and childhood cancer: results from the United Kingdom Childhood Cancer Study

There are strong a priori reasons for considering parental smoking behaviour as a risk factor for childhood cancer but case - control studies have found relative risks of mostly only just above one. To investigate this further, self-reported smoking habits in parents of 3838 children with cancer and 7629 control children included in the United Kingdom Childhood Cancer Study (UKCCS) were analysed. Separate analyses were performed for four major groups (leukaemia, lymphoma, central nervous system tumours and other solid tumours) and more detailed diagnostic subgroups by logistic regression. In the four major groups, after adjustment for parental age and deprivation there were nonsignificant trends of increasing risk with number of cigarettes smoked for paternal preconception smoking and nonsignificant trends of decreasing risk for maternal preconception smoking (all P-values for trend >0.05). Among the diagnostic subgroups, a statistically significant increased risk of developing hepatoblastoma was found in children whose mothers smoked preconceptionally (OR=2.68, P=0.02) and strongest (relative to neither parent smoking) for both parents smoking (OR=4.74, P=0.003). This could be a chance result arising from multiple subgroup analysis. Statistically significant negative trends were found for maternal smoking during pregnancy for all diagnoses together (P<0.001) and for most individual groups, but there was evidence of under-reporting of smoking by case mothers. In conclusion, the UKCCS does not provide significant evidence that parental smoking is a risk factor for any of the major groups of childhood cancers.     

In good times and in bad: what strengthens or challenges a parental relationship during a child’s cancer trajectory?

Abstract

Objectives: To identify events during a child’s cancer trajectory when parents perceived their marriage/partnership to be most strengthened and/or challenged.

Research approach: Using a cross-sectional qualitative design, participants completed a self-administered questionnaire addressing changes in their relationship during their child’s cancer trajectory, including events perceived to strengthen/challenge their relationship, and recommendations for other parents.

Participants: 192 parents of pediatric oncology patients across three institutions. Data were analyzed using qualitative content analysis.

Findings: Themes included relationship-specific, illness experience-related, and external supports/stressors that impacted the relationship. Dyadic strategies, empathic communication, and supportive behaviors strengthened the couple’s relationship, whereas physical and emotional distance most commonly challenged the relationship. Recommendations to other parents included open communication, couple’s connectedness, and use of external supports.

Interpretation: Offering psychosocial support and helping parents anticipate when their relationship can be strengthened/challenged can be an important part of ongoing care.

Implications for psychosocial providers: Teaching communication and dyadic coping strategies can help parents manage stress and build cohesion.     

A Mixed Methods Assessment of Coping with Pediatric Cancer

The purpose of this study was to describe child coping and parent coping assistance with cancer-related stressors during treatment. Fifteen children (age 6–12) with cancer and their parents (N = 17) completed semistructured interviews and self-report measures to assess coping and coping assistance. Results suggest families utilized a broad array of approach and avoidance strategies to manage cancer and its treatment. Quantitative and qualitative assessments provided complementary and unique contributions to understanding coping among children with cancer and their parents. Using a mixed methods approach to assess coping provides a richer understanding of families’ experiences, which can better inform clinical practice.     

Repressive coping style: Relationships with depression, pain, and pain coping strategies in lung cancer out patients

Researchers have shown that coping style is related to pain and adjustment in people with chronic illness. This study was the first to examine how coping style related to pain, pain coping strategies, and depression in lung cancer outpatients. We conducted a comparative, secondary data analysis of 107 lung cancer patients (73% male, mean age 61.4 ± 10.43 years, 88% Caucasian). As in prior studies, we classified patients into four coping style groups based on Marlowe-Crowne Social Desirability Scale and trait anxiety scores. The coping style groups were low-anxious (n = 25); high-anxious (n = 31); defensive high-anxious (n = 21); and repressive (n = 30). Compared to other coping style groups, the repressive group reported statistically significant lower mean scores for pain quality, pain catastrophizing, and depression. Assessing coping style by measuring personal characteristics such as social desirability and trait anxiety may help clinicians to identify vulnerable individuals with lung cancer who may be candidates for early and timely intervention efforts to enhance adjustment to pain.     

儿童白血病患者化疗过程中行为特征及应对方式

目的:了解学龄期白血病儿童行为特征及疾病的应对方式,为临床实施心理干预提供理论依据。方法:采用患病行为问卷（IBQ）调查患儿心理行为状况和医学应对方式问卷（MCMQ）调查患儿的应对方式。结果:白血病儿童组更多采用回避（P＜0.05）和放弃方式（P＜0.05）,白血病初使组儿童更不愿意面对疾病。结论:白血病初使组表现出更多的恶劣心境,采取有效的心理干预可帮助采用积极的应对方式面对疾病。     

Parental social contact in the work place and the risk of childhood acute lymphoblastic leukaemia

To study the possible relation between parental social contact through occupation, a marker for a child's risk of infection, and childhood acute lymphoblastic leukaemia (ALL), the parents of 294 children with ALL aged 0-14.9 years and 376 matched controls were interviewed about their jobs after their child's birth up to the age of 3 years. Job titles were assigned to a level of social contact, and an index of occupational social contact months was created using the level and the job duration. Positive interactions between this index and rural residence associated with an increased risk of childhood ALL and common ALL (c-ALL) were observed (interaction P-value=0.02 for both, using tertiles of contact months; interaction P-value=0.05 and 0.02 for ALL and c-ALL, respectively, using continuous contact months); such findings were not observed when job durations were ignored. Our data suggest that duration of parental occupation may be important when examining the association between parental social contact in the workplace and childhood leukaemia.     

Measurement of coping and stress responses in women with breast cancer

The development of the Responses to Stress Questionnaire-cancer version (RSQ-CV) to assess coping with and responses to the stress of breast cancer is described. The RSQ-CV was completed by 232 women with breast cancer near the time of their diagnosis. Confirmatory factor analyses verified a model that includes three voluntary coping factors (primary control engagement coping, secondary control engagement coping, disengagement coping) and two involuntary stress response factors (involuntary engagement, involuntary disengagement). Internal consistency reliability, and stability over 12 weeks for the five factors were adequate to excellent. Convergent and discriminant validity was examined through correlations with measures of intrusive thoughts, avoidance, and dimensions of perceived control. Significant correlations with symptoms of anxiety and depression are also reported. Applications of the RSQ-CV for research with breast cancer patients are discussed.     

Religious coping and problem-solving by couples faced with prostate cancer

Religion can be an important resource for people struggling with chronic illness. Problem-solving skills have also been shown to be helpful. This study examined whether turning to religion as a coping resource would be associated with better problem-solving in couples trying to manage challenges associated with prostate cancer. The sample was 101 patients with prostate cancer and their wives. Wives completed the Social Problem-Solving Inventory--Revised at baseline (T1) and 10 weeks later (T2). Patients and their wives also completed a measure that included items on religious coping. These items were used to classify couples into four groups based on whether one or both members engaged in religious coping: (1) husband only, (2) wife only, (3) both husband and wife, and (4) neither husband nor wife. From T1 to T2, wives who used religious coping along with their husbands (group 3) showed a significantly greater reduction in dysfunctional problem-solving (specifically, on impulsive/careless problem-solving) in comparison with wives who used religious coping while their husbands did not (group 2). Findings suggest that when couples share in turning to religion as a source of coping, this may be associated with improved problem-solving, but sole engagement in religious coping by wives may be associated with worse problem-solving.     

Daily assessment of stressful events and coping among post-menopausal women with breast cancer treated with adjuvant chemotherapy

The purpose of the study was twofold: to examine what type of daily stressful events post-menopausal woman with breast cancer experience during adjuvant chemotherapy and how bothersome these are and to identify coping strategies used by these women used to manage such stressful events. The patient group comprised 75 consecutively invited women (≥55 years of age) at two university hospitals and one county hospital in Sweden. The Daily Coping Assessment was used to collect data over time. Data were analysed both qualitatively and quantitatively. Six categories of stressful events were identified: 'nausea and vomiting', 'fatigue', 'other symptoms', 'isolation and alienation', 'fear of the unknown' and 'being controlled by the treatment'. The first three categories were subsumed under the domain physical problems and the latter three under psychosocial problems. Almost 30% of the diary entries recorded no stressful event. Physical problems were three times as frequent as psychosocial problems. 'Nausea/vomiting' was the most frequently observed stressful event (21.6%). 'Isolation and alienation' and 'fear of the unknown' were less frequent, but when they occurred they were rated as the most distressing. Several coping strategies were used to manage each stressful event. The most common strategies were acceptance, relaxation and distraction. Religion was rarely used as a coping strategy.     

Parental occupational exposure to pesticides,animals and organic dust and risk of childhood leukemia and central nervous system tumors: Findings from the International Childhood Cancer Cohort Consortium (I4C)

Parental occupational exposures to pesticides, animals and organic dust have been associated with an increased risk of childhood cancer based mostly on case–control studies. We prospectively evaluated parental occupational exposures and risk of childhood leukemia and central nervous system (CNS) tumors in the International Childhood Cancer Cohort Consortium. We pooled data on 329,658 participants from birth cohorts in five countries (Australia, Denmark, Israel, Norway and United Kingdom). Parental occupational exposures during pregnancy were estimated by linking International Standard Classification of Occupations-1988 job codes to the ALOHA+ job exposure matrix. Risk of childhood (<15 years) acute lymphoblastic leukemia (ALL; n = 129), acute myeloid leukemia (AML; n = 31) and CNS tumors (n = 158) was estimated using Cox proportional hazards models to generate hazard ratios (HR) and 95% confidence intervals (CI). Paternal exposures to pesticides and animals were associated with increased risk of childhood AML (herbicides HR = 3.22, 95% CI = 0.97–10.68; insecticides HR = 2.86, 95% CI = 0.99–8.23; animals HR = 3.89, 95% CI = 1.18–12.90), but not ALL or CNS tumors. Paternal exposure to organic dust was positively associated with AML (HR = 2.38 95% CI = 1.12–5.07), inversely associated with ALL (HR = 0.55, 95% CI = 0.31–0.99) and not associated with CNS tumors. Low exposure prevalence precluded evaluation of maternal pesticide and animal exposures; we observed no significant associations with organic dust exposure. This first prospective analysis of pooled birth cohorts and parental occupational exposures provides evidence for paternal agricultural exposures as childhood AML risk factors. The different risks for childhood ALL associated with maternal and paternal organic dust exposures should be investigated further.     

视网膜母细胞瘤发病年龄与分化程度

目的　探讨视网膜母细胞瘤 (Retinoblastoma ,RB)发病年龄与肿瘤细胞分化程度及其与预后的关系。方法　光镜下观察2 91名RB患儿的 2 97只眼球的病理切片 ,并追踪观察患儿的预后。将肿瘤细胞的分化程度分为四级 ,即肿瘤细胞完全未分化(D0 ) ;分化的肿瘤细胞所占的范围 <1/ 3肿瘤面积 (D1) ;1/ 3～ 2 / 3肿瘤面积 (D2 ) ;>2 / 3肿瘤面积 (D3)。结果　年龄 <6个月 ,肿瘤细胞分化最好 (D3) ,年龄在 6～ 12个月者 ,肿瘤细胞分化较好 (D2 ) ,年龄 >36个月 ,肿瘤细胞分化不良 (D1) ,年龄在 2 4～30个月者 ,肿瘤细胞未分化 (D0 )。 4例 15～ 2 4个月的患儿死于肿瘤细胞转移 ,肿瘤细胞分化程度在D0 -D1。结论　 2岁以前患儿肿瘤细胞的分化程度较高。若在此年龄段患儿的肿瘤细胞分化不良 ,又同时伴有脉络膜浸润和 /或视神经浸润 ,应视为预后不好的指征。