RESUMEN
BACKGROUND: To the authors' knowledge, social network status in adolescent and young adult (AYA) cancer survivors has not been adequately studied to date. The authors developed and validated a functional social network index (FSNI) for AYA survivors, and compared its performance with that of 2 traditional indices (density and betweenness centrality). METHODS: A total of 102 AYA survivors and 102 noncancer controls who were matched for age, sex, and race were recruited from an Internet panel. Each participant reported relationships with up to 25 close friends and/or relatives. The authors developed a FSNI with reported marital status, contact frequency with friends/relatives, available resources for emotional and tangible support, and available resources for physical activity and weight management advice. Linear regression was used to analyze associations between the FSNI and cancer diagnoses, treatments, and coping skills. RESULTS: Based on the FSNI, survivors were found to have more available resources for emotional support (beta [b] = 3.02; P = .003), tangible support (b = 4.17; P<.001), physical activity advice (b = 3.94; P<.001), and weight management advice (b = 4.10; P<.001) compared with noncancer controls. Survivors of lymphoma had the largest FSNI, whereas survivors of central nervous system malignancies had the smallest (b = 2.77; P = .02). A higher FSNI was associated with better coping skills: less denial (b = 0.10; P = .01), using emotional support (b = 0.08; P = .04), using instrumental support (b = 0.12; P<.001), less behavioral disengagement (b = 0.08; P = .04), venting of emotions (b = 0.10; P = .004), positive reframing (b = 0.12; P = .003), planning for the future (b = 0.08; P = .03), and religious engagement (b = 0.16; P<.001). Density and betweenness centrality indices demonstrated neither significant differences in social networks between cancer survivors and controls (all P values >.05) nor significant associations with coping skills (all P values >.05). CONCLUSIONS: The FSNI appears to provide a better social network assessment for AYA cancer survivors than traditional indices. Cancer 2018;124:2220-7. © 2018 American Cancer Society.
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Supervivientes de Cáncer/psicología , Quimioradioterapia/efectos adversos , Neoplasias/psicología , Redes Sociales en Línea , Psicometría/métodos , Adaptación Psicológica/efectos de los fármacos , Adaptación Psicológica/efectos de la radiación , Adolescente , Adulto , Emociones , Femenino , Humanos , Masculino , Neoplasias/terapia , Calidad de Vida , Apoyo Social , Adulto JovenRESUMEN
BACKGROUND: Children are at risk for behavioral and adaptive difficulties following pediatric brain tumor. This study explored whether familial/demographic, developmental, diagnostic, or treatment-related variables best predict posttreatment behavioral and adaptive functioning. METHODS: Participants included 40 children (mean age = 12.76 years, SD = 4.01) posttreatment (mean time since diagnosis = 1.99 years, SD = 0.21) for pediatric brain tumor. Parents rated children's behavioral adjustment and adaptive functioning and provided demographic and developmental histories. Diagnostic and treatment-related information was abstracted from medical records. RESULTS: Ratings of adaptive and behavioral functioning approximately 2 years postdiagnosis were within the average range, although the percentage of children exceeding clinical cutoffs for impairment in adaptive skills exceeded expectation, particularly practical skills. Premorbid behavior problems and tumor size predicted posttreatment adaptive functioning. After accounting for adaptive functioning near diagnosis, premorbid behavior problems predicted declines in adaptive functioning 2 years postdiagnosis. After accounting for adjustment near diagnosis, no variables predicted declines in behavioral adjustment. CONCLUSIONS: Children may be vulnerable to reduced adaptive functioning following pediatric brain tumor treatment, especially in practical skills. Assessing prediagnosis functioning and diagnostic and treatment-related variables may improve our ability to predict those at greatest risk, although those factors may be less helpful in identifying children likely to develop behavioral difficulties. Screening of these factors in tertiary care and long-term follow-up settings may improve identification of those at greatest need for support services.
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Adaptación Psicológica/efectos de la radiación , Neoplasias Encefálicas/psicología , Neoplasias Encefálicas/radioterapia , Trastornos de la Conducta Infantil/etiología , Conducta Infantil/efectos de la radiación , Desempeño Psicomotor/efectos de la radiación , Adolescente , Neoplasias Encefálicas/diagnóstico , Niño , Trastornos de la Conducta Infantil/psicología , Femenino , Humanos , Masculino , Padres , Ajuste SocialRESUMEN
PURPOSE: Children treated for brain tumors with conformal radiation therapy experience preserved cognitive outcomes. Early evidence suggests that adaptive functions or independent-living skills may be spared. This longitudinal investigation prospectively examined intellectual and adaptive functioning during the first 5 years following irradiation for childhood craniopharyngioma and low-grade glioma (LGG). The effect of visual impairment on adaptive outcomes was investigated. METHODS AND MATERIALS: Children with craniopharyngioma (n=62) and LGG (n=77) were treated using conformal or intensity modulated radiation therapy. The median age was 8.05 years (3.21-17.64 years) and 8.09 years (2.20-19.27 years), respectively. Serial cognitive evaluations including measures of intelligence quotient (IQ) and the Vineland Adaptive Behavior Scales (VABS) were conducted at preirradiation baseline, 6 months after treatment, and annually through 5 years. Five hundred eighty-eight evaluations were completed during the follow-up period. RESULTS: Baseline assessment revealed no deficits in IQ and VABS indices for children with craniopharyngioma, with significant (P<.05) longitudinal decline in VABS Communication and Socialization indices. Clinical factors associated with more rapid decline included females and preirradiation chemotherapy (interferon). The only change in VABS Daily Living Skills correlated with IQ change (r=0.34; P=.01) in children with craniopharyngioma. Children with LGG performed below population norms (P<.05) at baseline on VABS Communication, Daily Living Indices, and the Adaptive Behavior Composite, with significant (P<.05) longitudinal decline limited to VABS Communication. Older age at irradiation was a protective factor against longitudinal decline. Severe visual impairment did not independently correlate with poorer adaptive outcomes for either tumor group. CONCLUSIONS: There was relative sparing of postirradiation functional outcomes over time in this sample. Baseline differences in functional abilities before the initiation of irradiation suggested that other factors influence functional outcomes above and beyond the effects of irradiation.
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Neoplasias Encefálicas/radioterapia , Trastornos del Conocimiento/prevención & control , Cognición/efectos de la radiación , Craneofaringioma/radioterapia , Glioma/radioterapia , Aprendizaje/efectos de la radiación , Radioterapia Conformacional/métodos , Actividades Cotidianas/psicología , Adaptación Psicológica/fisiología , Adaptación Psicológica/efectos de la radiación , Adolescente , Factores de Edad , Neoplasias Encefálicas/patología , Niño , Preescolar , Trastornos del Conocimiento/fisiopatología , Craneofaringioma/patología , Femenino , Glioma/patología , Humanos , Inteligencia/efectos de la radiación , Aprendizaje/fisiología , Estudios Longitudinales , Masculino , Radioterapia Conformacional/efectos adversos , Radioterapia de Intensidad Modulada/efectos adversos , Radioterapia de Intensidad Modulada/métodos , Trastornos de la Visión/etiología , Adulto JovenRESUMEN
PURPOSE: Conformal and intensity modulated radiation therapies have the potential to preserve cognitive outcomes in children with ependymoma; however, functional behavior remains uninvestigated. This longitudinal investigation prospectively examined intelligence quotient (IQ) and adaptive functioning during the first 5 years after irradiation in children diagnosed with ependymoma. METHODS AND MATERIALS: The study cohort consisted of 123 children with intracranial ependymoma. Mean age at irradiation was 4.60 years (95% confidence interval [CI], 3.85-5.35). Serial neurocognitive evaluations, including an age-appropriate IQ measure and the Vineland Adaptive Behavior Scales (VABS), were completed before irradiation, 6 months after treatment, and annually for 5 years. A total of 579 neurocognitive evaluations were included in these analyses. RESULTS: Baseline IQ and VABS were below normative means (P<.05), although within the average range. Linear mixed models revealed stable IQ and VABS across the follow-up period, except for the VABS Communication Index, which declined significantly (P=.015). Annual change in IQ (-.04 points) did not correlate with annual change in VABS (-.90 to +.44 points). Clinical factors associated with poorer baseline performance (P<.05) included preirradiation chemotherapy, cerebrospinal fluid shunt placement, number and extent of surgical resections, and younger age at treatment. No clinical factors significantly affected the rate of change in scores. CONCLUSIONS: Conformal and intensity modulated radiation therapies provided relative sparing of functional outcomes including IQ and adaptive behaviors, even in very young children. Communication skills remained vulnerable and should be the target of preventive and rehabilitative interventions.
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Adaptación Psicológica/efectos de la radiación , Neoplasias Encefálicas/radioterapia , Ependimoma/radioterapia , Inteligencia/efectos de la radiación , Radioterapia Conformacional , Adolescente , Factores de Edad , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Encefálicas/tratamiento farmacológico , Neoplasias Encefálicas/patología , Neoplasias Encefálicas/psicología , Neoplasias Encefálicas/cirugía , Derivaciones del Líquido Cefalorraquídeo , Niño , Preescolar , Cognición/efectos de la radiación , Comunicación , Ependimoma/tratamiento farmacológico , Ependimoma/patología , Ependimoma/psicología , Ependimoma/cirugía , Femenino , Humanos , Hidrocefalia/etiología , Lactante , Modelos Lineales , Masculino , Estudios Prospectivos , Radioterapia de Intensidad Modulada , Factores de Tiempo , Adulto JovenRESUMEN
Melatonin levels, metabolic parameters, circadian rhythm activity patterns, and behavior were observed in rats subjected to a 12-h/12-h light/dark cycle (LD) compared to animals exposed to continuous dark (DD) or continuous light (LL). LD and DD animals were similar in melatonin levels, food intake, relative food intake, feed efficiency, water intake, circadian activity levels, and behavior. LL animals had lower melatonin levels in the subjective dark compared to LD and DD animals. Food intake, relative food intake, and water intake values were lower and feed efficiency was more positive in LL animals compared to LD and DD animals. In addition, LL animals exhibited greater visceral adiposity than the other two groups. The circadian rhythmicity of activity became free-running in LL animals and there was a decrease in overall activity. Notable behavioral changes in LL animals were an increase in irritability and excitability. Results indicate that a decrease in melatonin levels and concomitant changes in metabolism, circadian rhythms, and behavior are consequences of exposure to constant light.
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Adaptación Psicológica/efectos de la radiación , Adiposidad/efectos de la radiación , Ritmo Circadiano/efectos de la radiación , Ingestión de Alimentos/efectos de la radiación , Luz/efectos adversos , Melatonina/metabolismo , Actividad Motora/efectos de la radiación , Algoritmos , Animales , Peso Corporal/efectos de la radiación , Ingestión de Líquidos/efectos de la radiación , Grasa Intraabdominal/efectos de la radiación , Masculino , Melatonina/sangre , Ratas , Ratas Long-Evans , Privación de Sueño , Telemetría , Factores de TiempoRESUMEN
Solar radiation is one of the major factors responsible for the control of fungus populations in the environment. Inactivation by UVA and UVB radiation is especially important for the control of fungi that disperse infective units through the air, including fungi such as Cryptococcus spp. that infect their vertebrate hosts by inhalation. Cryptococcus neoformans produces melanin in the presence of certain exogenous substrates such as l-3,4 dihydroxyphenylalanine and melanization may protect the fungus against biotic and abiotic environmental factors. In the present study, we investigated the effect of exposure to an UVB irradiance of 1000 mW m(-2) (biologically effective weighted irradiance) on the survival of melanized and nonmelanized cells of four strains of C. neoformans and four strains of C. laurentii. The relative survival (survival of cells exposed to radiation in relation to cells not exposed) of cells grown 2, 4, 6 or 8 days on medium with or without L-dopa was determined after exposure to UVB doses of 1.8 and 3.6 kJ m(-2). Both the irradiance spectrum and the intensities of those doses are environmentally realistic, and, in fact, occur routinely during summer months in temperate regions. Differences in tolerance to UVB radiation were observed between the C. neoformans and C. laurentii strains. The C. neoformans strains were more susceptible to UVB radiation than the C. laurentii strains. In C. neoformans, differences in tolerance to radiation were observed during development of both melanized and nonmelanized cells. For most treatments (strain, time of growth and UVB dose), there were virtually no differences in tolerances between melanized and nonmelanized cells, but when differences occurred they were smaller than those previously observed with UVC. In tests with two strains of C. laurentii, there was no difference in tolerance to UVB radiation between melanized and nonmelanized cells during 8 days of culture; and in tests with four strains for less culture time (4 days) there were no significant differences in tolerance between melanized and nonmelanized cells of any strain of this species.
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Adaptación Psicológica/efectos de la radiación , Cryptococcus/metabolismo , Cryptococcus/efectos de la radiación , Melaninas/metabolismo , Pigmentos Biológicos/metabolismo , Pigmentos Biológicos/efectos de la radiación , Rayos Ultravioleta , Levodopa/metabolismo , Factores de TiempoRESUMEN
The fact of modulating influence of low-intensity electromagnetic field on the behavioral acts in mice was established. The dependence of mice behavior on the modulating frequency, electromagnetic field parameters (intermittent or continuous) and on the time of adaplive reaction was found.
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Adaptación Psicológica/efectos de la radiación , Conducta Animal/efectos de la radiación , Campos Electromagnéticos , Reacción de Fuga/efectos de la radiación , Animales , Reacción de Fuga/fisiología , RatonesRESUMEN
Electroretinograms were recorded from the horseshoe crab compound eye using a high-intensity light-emitting diode and a whole-eye seawater electrode. Recordings were made from both lateral eyes in natural daylight or in continuous darkness with the optic nerve intact or cut. Recordings from two eyes of the same animal in different conditions facilitated direct comparisons of the effects of diurnal lighting and circadian efferent activity on the daily patterns of sensitivity of the eye. Structural changes appear to account for about half of the total electroretinogram excursion. Circadian input begins about 45 min in advance of sunset and the nighttime sensitivity returns to the daytime values 20 min after sunrise. When the optic nerve is cut, the nighttime sensitivity shows exponential decay over the next 5 or 6 days, consistent with a light-triggered structural light adaptation process unopposed by efferent input. Our results suggest that two mechanisms mediate the increase in lateral eye sensitivity at night-physiological dark adaptation and circadian efferent input. Three mechanisms appear to be involved in mediating the decrease in lateral eye sensitivity during daylight-physiological light adaptation, a continuous structural light adaptation process, and a separate light-triggered, efferent-primed structural light adaptation process.
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Ritmo Circadiano/fisiología , Electrorretinografía/métodos , Ojo/efectos de la radiación , Cangrejos Herradura/fisiología , Fenómenos Fisiológicos Oculares/efectos de la radiación , Umbral Sensorial/fisiología , Adaptación Psicológica/fisiología , Adaptación Psicológica/efectos de la radiación , Animales , Luz , Sensibilidad y EspecificidadRESUMEN
Propósito: dar respuesta a tres cuestiones que se plantean en el Servicio de Oncología Radioterápica (OR) del Hospital Militar Central de La Defensa: ¿qué necesidades presenta un paciente que se somete a tratamiento de radioterapia (RT)?, ¿cómo pueden afrontar esas necesidades los pacientes y el personal sanitario de esta unidad?, y ¿existe un modelo que cubra esas necesidades? Material y métodos: se han realizado dos estudios, el primero dirigido a detectar los factores que generan burnout en el personal sanitario, y el segundo al estudio de la evolución del dolor de cada paciente en el tratamiento de RT. Resultados: las necesidades que presenta el paciente son de dos tipos: médicas y emocionales. Las primeras son cubiertas por los oncólogos radioterapeutas, y para las segundas el equipo de psicólogos elaboró un programa de asistencia psicológica para pacientes y otro para personal sanitario de esta unidad. Conclusiones: es necesario ofertar un soporte especializado de Psicología Clínica a pacientes para facilitar su adherencia al tratamiento, y al personal sanitario para mejorar la relación terapéutica equipo sanitario-paciente (AU)
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Humanos , Radioterapia/psicología , Adaptación Psicológica/efectos de la radiación , Personal de Salud/psicología , Dolor/psicología , Psicoterapia/métodos , Neoplasias/psicologíaRESUMEN
The neuroendocrine and behavioral effects of repetitive transcranial magnetic stimulation (rTMS) were investigated in two rat lines selectively bred for high and low anxiety-related behavior. The stimulation parameters were adjusted according to the results of accurate computer-assisted and magnetic resonance imaging-based reconstructions of the current density distributions induced by rTMS in the rat and human brain, ensuring comparable stimulation patterns in both cases. Adult male rats were treated in two 3-day series under halothane anesthesia. In the forced swim test, rTMS-treatment induced a more active coping strategy in the high anxiety-related behavior rats only (time spent struggling; 332% vs. controls), allowing these animals to reach the performance of low anxiety-related behavior rats. In contrast, rTMS-treated low anxiety-related behavior rats did not change their swimming behavior. The development of active coping strategies in high anxiety-related behavior rats was accompanied by a significantly attenuated stress-induced elevation of plasma corticotropin and corticosterone concentrations. In summary, the behavioral and neuroendocrine effects of rTMS of frontal brain regions in high anxiety-related behavior rats are comparable to the effects of antidepressant drug treatment. Interestingly, in the psychopathological animal model repetitive transcranial magnetic stimulation induced changes in stress coping abilities in the high-anxiety line only.
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Ansiedad/terapia , Conducta Animal/efectos de la radiación , Depresión/terapia , Campos Electromagnéticos , Sistemas Neurosecretores/efectos de la radiación , Adaptación Psicológica/efectos de la radiación , Hormona Adrenocorticotrópica/sangre , Animales , Ansiedad/sangre , Ansiedad/complicaciones , Simulación por Computador , Corticosterona/sangre , Depresión/sangre , Depresión/complicaciones , Modelos Animales de Enfermedad , Estimulación Eléctrica/instrumentación , Lóbulo Frontal/efectos de la radiación , Humanos , Sistema Hipotálamo-Hipofisario/metabolismo , Sistema Hipotálamo-Hipofisario/efectos de la radiación , Masculino , Aprendizaje por Laberinto/efectos de la radiación , Sistemas Neurosecretores/metabolismo , Sistema Hipófiso-Suprarrenal/metabolismo , Sistema Hipófiso-Suprarrenal/efectos de la radiación , Ratas , Ratas Endogámicas , Ratas Wistar , Tiempo de Reacción/efectos de la radiación , Estrés Fisiológico , Factores de Tiempo , Estimulación Magnética TranscranealRESUMEN
Modern treatment has increased the survival rate for children with brain tumour, but treatment with radiation may lead to late adverse neuropsychologic effects. Also, peer problems may follow long periods away from school, and painful treatment and anxiety about the disease may mobilize emotional stress reactions. 16 brain tumour children with a mean age of 11 years (range 6-16 years), all of them treated with radiation, were tested with WISC-R. The mean time between diagnosis and study was five years (range 2-11 years). Parents and teachers completed the Achenbach check lists CBCL and TRF. Children below age four years at diagnosis achieved the lowest WISC-R IQs, the highest problem scores and the lowest social adaptive scores on CBCL and TRF. More problems were reported among the youth group aged 12-16 years than among the child group aged 6-11 years. Hypoactivity and low psychomotor speed seemed to have an adverse effect on both intellectual and psychosocial functioning. An almost normal communicative and reasoning ability was a resource for most of the children.