Influence of Self-Efficacy on Cancer-Related Fatigue and Health-Related Quality of Life in Young Survivors of Childhood Cancer.

This study aims to elucidate how self-efficacy influences cancer-related fatigue and health-related quality of life (HRQoL) in young survivors of childhood cancer. Forty-six young survivors (age range, 8-18 years) of childhood cancer who were currently in complete remission completed measures for self-efficacy (Pediatric General Self-Efficacy Scale (PedsSE)), cancer-related fatigue (Cancer-related Fatigue Score (CRFS)), and HRQoL (Pediatric Quality of Life Inventory 4.0 Generic Core Scale, Pediatric Quality of Life Inventory (PedsQL)). Structural relationships between the PedsSE and CRFS or PedsQL, including the effects of potential demographic or clinical confounders, were examined by machine learning random forest algorithms and structural equation modeling. According to the distribution of the PedsQL, six survivors with PedsQL < 70 were determined to have compromised HRQoL (referred to as "low-PedsQL survivors"). The random forest model identified six variables for the prediction of the CRFS, with the PedsSE being the most important, and eight variables for the distinction of low-PedsQL survivors, with the CRFS being the most and the PedsSE the third most important variable. The structural equation model indicated that a direct influence of the PedsSE on the PedsQL was less detectable (ß = -0.049), whereas an indirect influence of the PedsSE on the PedsQL via the CRFS was evident (ß = 0.333). The model explained 51% of the variation of the CRFS and 28% of the variation of the PedsQL. The PedsSE was strongly correlated with "altered mood" in the subclass of the CRFS (r = -0.470), and "altered mood" was strongly correlated with the PedsQL (r = 0.737). In conclusion, self-efficacy is a major determinant of cancer-related fatigue and influences HRQoL via cancer-related fatigue in survivors of childhood cancer. The main pathway from self-efficacy to HRQoL is thought to be via the emotional aspect of cancer-related fatigue. However, unlike adult survivors of cancer, self-efficacy for young survivors may not contribute much to self-management behaviors that maintain HRQoL.

Screening of the Maturity Status of the Tibial Tuberosity by Ultrasonography in Higher Elementary School Grade Schoolchildren.

This study aimed to obtain screening data on the maturity status of the tibial tuberosity in schoolchildren of higher elementary school grades for risk management of Osgood-Schlatter disease (OSD). The maturity stages and cartilage thicknesses at the tibial tuberosity were determined by ultrasonography on the occasion of a school-based musculoskeletal examination for 124 grade 5-6 elementary schoolchildren, and their associations with the students' demographic characteristics and OSD were examined. The time-dependent changes of the maturity status of the tibial tuberosity were also examined in grade 5 students (n = 26) by a longitudinal survey. The cross-sectional survey showed that the epiphyseal stage was reached in 89% of girls and 35% of boys. The girls who had experienced menarche (n = 28) were all in the epiphyseal stage and had a decreased cartilage thickness (p = 0.004, after adjusting maturity stages). Students with OSD (n = 5) were all girls in the epiphyseal stage, and only two of them had an increased cartilage thickness. During the longitudinal survey, a marked increase in cartilage thickness from the previous measurement was observed in three boys (without clinical symptoms) and a girl who newly developed OSD. Two students with OSD without chronic pain had thin cartilage. In conclusion, for schoolchildren of higher elementary school grades, the risk of OSD is higher among girls with the epiphyseal stage. Cartilage thickness may not contribute to the diagnosis of OSD, since thick cartilage is not very common in OSD. However, cartilage thickness may reflect the status of OSD.

Factors affecting dance exercise performance in students at a special needs school.

BACKGROUND: In Japan, dance exercise has been introduced as a compulsory element of health and physical education, but there is a considerable discrepancy in the levels of performance among students with intellectual disability (ID) at special needs schools. The aim of this study was therefore to identify the factors affecting the performance of dance exercise in students with ID. METHODS: A 4 month dance exercise program was implemented for junior high school students at a special needs school, and the performance of 32 students at 22 sessions was assessed quantitatively according to calorie use during exercise and performance proficiency score. The measures were compared according to gender, age, body mass index, diagnosis, and development quotient (DQ) score. RESULTS: Performance in many students improved with repetition and reached the highest attainment level at around the third month. Male gender and older age had a significant positive impact on calorie use, whereas diagnosis of Down syndrome and higher DQ score had a significant positive impact on proficiency score. Four students with poor performance were all female students with autism. CONCLUSION: This study provides some possible explanations for differences in the levels of dance performance among students with ID.

Over-adaptation and heart rate variability in Japanese high school girls.

BACKGROUND: In the field of educational psychology in Japan, a model of "over-adaptation" has been applied to conceptualize the personality of students who are vulnerable to external stressors and prone to developing psychiatric problems. However, the influence of over-adaptation on physiological functions in adolescents is still largely unknown. Therefore, the present study aimed to investigate the association between an over-adapted tendency and autonomic nervous system activities in high school girls. METHODS: Circadian profiles of cardiac autonomic nervous system activities in 47 normal high school girls were evaluated using time-domain measures of heart rate variability (HRV) taken from 24-h ambulatory electrocardiogram recordings, and their relation to an over-adaptation scale composed of 5 subscales was evaluated. RESULTS: A significant increase in RMSSD (root mean square of successive difference of normal-to-normal beat intervals) during daytime (09:00-14:00) was observed in students who scored high on the sum of the over-adaptation subscales (n=6). Two of the over-adaptation subscales, namely, "self-restraint" and "self-insufficiency", were positively correlated with time-domain measures. CONCLUSIONS: Parasympathetic activity in over-adapted students was elevated during school, and this autonomic response was suggested to be linked to over-adaptation subscales related to repressed emotions in over-adapted students. Thus, in over-adapted students, repressing emotions appears to be a style of coping, and may lead to a quiet, emotionally stable life in school, which in turn may result in parasympathetic activation.

Population-based estimates of the cumulative risk of hospitalization potentially associated with rotavirus diarrhea among children living in two cities in Akita Prefecture, Japan.

A 4-year retrospective population-based survey was conducted in two cities in Akita Prefecture, Japan, to estimate the incidence rate and the cumulative risk of hospitalization potentially associated with rotavirus diarrhea. At monthly occasions of the 3-year-old checkup, we asked each parent if his or her child had ever been hospitalized because of rotavirus diarrhea. Based on 3-year follow-up of the four consecutive birth cohorts (1996-1999), we calculated the incidence rate and the cumulative risk of rotavirus-associated hospitalizations by the age of 3 years. The incidence rates of rotavirus-associated hospitalization in 1-year-old children in Akita city and Honjo city were 9.7 and 16 hospitalizations per 1,000 children per year, respectively, whereas 1.9% of children in Akita city and 3.3% of children in Honjo city were hospitalized by their third birthday because of rotavirus-associated diarrhea. The burden of rotavirus diarrhea in this region of Japan, and probably across the nation, appears substantially large.