ABSTRACT
The purpose of this study was to characterize reproductive concerns among female cancer survivors and determine the role of targeted counseling in improving overall reproductive quality of life (QOL). A survey was administered to women from the California Cancer Registry, ages 18-40, with nongynecologic cancers diagnosed from 1993 to 2007, who received fertility-compromising treatments. In total, 356 women completed the survey, which included questions regarding their reproductive health counseling history and the reproductive concerns scale (RCS), a validated reproductive QOL tool. Factors independently associated with higher RCS scores included a desire for children at the time of diagnosis, posttreatment infertility, treatment with chemoradiation or bone marrow transplant, and income less than $100,000 per year at diagnosis. Among the highest reported reproductive concerns were those related to loss of control over one's reproductive future and concerns about the effect of illness on one's future fertility. Across our population and independent of age, in-depth reproductive health counseling prior to cancer treatment was associated with significantly lower RCS scores. Our findings highlight the importance of early counseling and targeting high-risk groups for additional counseling after completion of cancer treatment. This approach may be an effective strategy for optimizing long-term reproductive QOL in this vulnerable population.
Subject(s)
Attitude to Health , Counseling , Neoplasms/therapy , Reproductive Health , Survivors/psychology , Adolescent , Adult , Female , Fertility , Humans , Neoplasms/psychology , Quality of Life , Retrospective Studies , Surveys and Questionnaires , Survivors/statistics & numerical data , Young AdultABSTRACT
Using the AGP*, PGI-1*, PGI-2*, LDH*, IDH*, and PGM* allozyme markers, the differentiation of cod groups during the spawning period in Baltic Sea was evaluated. It was shown that cod samples from the eastern and western parts of Baltic Sea (being statistically significantly different from the cod samples from the Norwegian Sea, Barents Sea, and the Skagerrak Strait) demonstrated a high degree of identity (I = 0.99-1.0), which could be associated with the observed from the beginning of the present millennium increased migration of cod from eastern Baltic regions to the waters of Bornholm basin, and the distribution of the part of migrants from Bornholm basin to Arkona basin.
Subject(s)
Gadus morhua/genetics , Genetic Markers , Genetics, Population , Animal Migration , Animals , Atlantic Ocean , Gene Frequency , Isoenzymes/genetics , Oceans and SeasABSTRACT
BACKGROUND: Life history models suggest that biological preparation for current versus longer term reproduction is favored in environments of adversity. In this context, we present a model of reproductive aging in which environmental adversity is proposed to increase the number of growing follicles at the cost of hastening the depletion of the ovarian reserve over time. We evaluated this model by examining psychological stress in relation to reproductive aging indexed by antral follicle count (AFC), a marker of total ovarian reserve. We hypothesized that stress would be related to (i) higher AFC in younger women, reflecting greater reproductive readiness as well as (ii) greater AFC loss across women, reflecting more accelerated reproductive aging. METHODS: In a multi-ethnic, community sample of 979 participants [ages 25-45 (mean (standard deviation) = 35.2 (5.5)); 27.5% Caucasian] in the Ovarian Aging study, an investigation of the correlates of reproductive aging, the interaction of age-x-stress was assessed in relation to AFC to determine whether AFC and AFC loss varied across women experiencing differing levels of stress. Stress was assessed by the perceived stress scale and AFC was assessed by summing the total number of antral follicles visible by transvaginal ultrasound. RESULTS: In linear regression examining AFC as the dependent variable, covariates (race/ethnicity, socio-economic status, menarcheal age, hormone-containing medication for birth control, parity, cigarette smoking, bodymass index, waist-to-hip ratio) and age were entered on step 1, stress on step 2 and the interaction term (age-x-stress) on step 3. On step 3, significant main effects showed that older age was related to lower AFC (b = -0.882, P = 0.000) and greater stress was related to higher AFC (b = 0.545, P = 0.005). Follow-up analyses showed that the main effect of stress on AFC was present in the younger women only. A significant interaction term (b = -0.036, P = 0.031) showed the relationship between age and AFC varied as function of stress. When the sample was divided into tertiles of stress, the average follicle loss was -0.781, -0.842 and -0.994 follicles/year in the low-, mid- and high-stress groups, respectively. CONCLUSIONS: Psychological stress was related to higher AFC among younger women and greater AFC decline across women, suggesting that greater stress may enhance reproductive readiness in the short term at the cost of accelerating reproductive aging in the long term. Findings are preliminary, however, due to the cross-sectional nature of the current study.
Subject(s)
Aging , Fertility , Reproduction , Adult , Aging/psychology , Cross-Sectional Studies , Female , Follow-Up Studies , Humans , Middle Aged , Ovarian Follicle/pathology , Ovarian Follicle/physiopathology , Premenopause , Regression Analysis , Stress, Psychological , Ultrasonography/methodsABSTRACT
OBJECTIVE: To examine the influence of parent-child relationship quality on the association between illness-related functional status and depressive symptoms in children with asthma. METHODS: Questionnaire data were collected from the child, caregiver, and physician. Fifty-five children with asthma (8-17 years of age), their caregivers, and physicians participated. RESULTS: Regression analyses suggest that patterns of mother-child relatedness (secure vs. insecure) mediate the relationship between functional status and depressive symptoms. CONCLUSIONS: The parent-child relationship may be an important pathway by which illness influences symptoms of depression in children with asthma. This study suggests that impaired functional status does not directly contribute to symptoms of depression, but rather influences the parent-child relationship in ways that may promote the development of depressive symptoms in the child.