Personal and Social Resources Are Linked to Cognition and Health-Related Quality of Life in Childhood Cancer Survivors

Personal and social resources may buffer the adverse effects of childhood cancer and its impact on cognition and quality of life. While childhood cancer survivors show domain-specific cognitive difficulties, little is known about their personal and social resources. We therefore investi- gated personal and social resources and their association with cognitive and quality-of-life outcomes in childhood cancer survivors. Seventy-eight survivors of childhood cancer of different etiologies (aged 7–16 years; ≥one year since treatment) and fifty-six healthy controls were included. Cognitive outcome was assessed by neuropsychological tests; personal and social resources, as well as health-related quality of life, were assessed by standardized questionnaires. In the social resource domain, peer integration was worse in survivors than in controls (puncorr < 0.04, d = 0.33). Personal resources and all other subscales of social resources did not significantly differ between survivors and controls. In survivors, the global resource score was significantly correlated with processing speed (r = 0.39, pcorr < 0.001) and quality of life (parent: r = 0.44; self-report: r = 0.46; pscorr < 0.001). In controls, no association occurred between resources and cognitive outcome, and the correlation between the global resource score and quality of life did not withstand correction for multiple comparison (parent: r = 0.28; self-report: r = 0.40, psuncorr < 0.001). After an adverse event such as childhood cancer, resources might play a particularly buffering role on cognitive performance and quality of life (when compared to the everyday life of healthy controls). This highlights the importance of interventions that strengthen the resources of children and their families, even years after cancer. Such resource-focused intervention could help to counteract long-term sequelae in cognitive outcomes and health-related quality of lif

Cognition, psychosocial functioning, and health-related quality of life among childhood cancer survivors

Long-term sequelae of cancer and its treatment render childhood cancer (CC) survivors vulnerable to cognitive and behavioural difficulties and likely affect their quality of life (QoL). Our aim was to compare levels of cognition, psychosocial functioning, and health-related QoL of CC survivors to healthy controls and examine the associations between these three domains. Seventy-eight CC survivors (age range = 7-16 years, ≥ one year since cancer treatment) and 56 healthy controls were included. Cognition (i.e., fluid intelligence, executive functions, memory, processing speed, and selective attention), psychosocial functioning, and health-related QoL were assessed using standardized tests and questionnaires. The cognitive performance, parent-reported psychosocial behaviour, and health-related QoL of the CC survivors were within the normative range. However, working memory was significantly poorer in survivors than controls, and visuospatial working memory below the normative range was more commonly observed among survivors than among controls. Processing speed significantly predicted survivors' performance in executive functions. Among survivors, greater peer problems were significantly associated with poorer cognitive functions and health-related QoL. Despite the evidence for good intellectual functioning, which might point towards adequate reserves, in some survivors, domain-specific difficulties may emerge years after cancer relating to psychosocial development and QoL. Keywords: Cognitive late effects; Cognitive reserve; Executive functions; Pediatric cancer survivors; Psychosocial functioning

Cognition, psychosocial functioning, and health-related quality of life among childhood cancer survivors

Long-term sequelae of cancer and its treatment render childhood cancer (CC) survivors vulnerable to cognitive and behavioural difficulties and likely affect their quality of life (QoL). Our aim was to compare levels of cognition, psychosocial functioning, and health-related QoL of CC survivors to healthy controls and examine the associations between these three domains. Seventy-eight CC survivors (age range = 7–16 years, ≥ one year since cancer treatment) and 56 healthy controls were included. Cognition (i.e., fluid intelligence, executive functions, memory, processing speed, and selective attention), psychosocial functioning, and health-related QoL were assessed using standardized tests and questionnaires. The cognitive performance, parent-reported psychosocial behaviour, and health-related QoL of the CC survivors were within the normative range. However, working memory was significantly poorer in survivors than controls, and visuospatial working memory below the normative range was more commonly observed among survivors than among controls. Processing speed significantly predicted survivors’ performance in executive functions. Among survivors, greater peer problems were significantly associated with poorer cognitive functions and health-related QoL. Despite the evidence for good intellectual functioning, which might point towards adequate reserves, in some survivors, domain-specific difficulties may emerge years after cancer relating to psychosocial development and QoL

Impact of non‐CNS childhood cancer on resting‐state connectivity and its association with cognition

Introduction Non‐central nervous system cancer in childhood (non‐CNS CC) and its treatments pose a major threat to brain development, with implications for functional networks. Structural and functional alterations might underlie the cognitive late‐effects identified in survivors of non‐CNS CC. The present study evaluated resting‐state functional networks and their associations with cognition in a mixed sample of non‐CNS CC survivors (i.e., leukemia, lymphoma, and other non‐CNS solid tumors). Methods Forty‐three patients (off‐therapy for at least 1 year and aged 7–16 years) were compared with 43 healthy controls matched for age and sex. High‐resolution T1‐weighted structural magnetic resonance and resting‐state functional magnetic resonance imaging were acquired. Executive functions, attention, processing speed, and memory were assessed outside the scanner. Results Cognitive performance was within the normal range for both groups; however, patients after CNS‐directed therapy showed lower executive functions than controls. Seed‐based connectivity analyses revealed that patients exhibited stronger functional connectivity between fronto‐ and temporo‐parietal pathways and weaker connectivity between parietal‐cerebellar and temporal‐occipital pathways in the right hemisphere than controls. Functional hyperconnectivity was related to weaker memory performance in the patients' group. Conclusion These data suggest that even in the absence of brain tumors, non‐CNS CC and its treatment can lead to persistent cerebral alterations in resting‐state network connectivity

Gender-Specific Effects of Unemployment on Family Formation: A Cross-National Perspective

This paper investigates the impact of unemployment on the propensity to start a family. Unemployment is accompanied by bad occupational prospects and impending economic deprivation, placing the well-being of a future family at risk. I analyze unemployment at the intersection of state-dependence and the reduced opportunity costs of parenthood, distinguishing between men and women across a set of welfare states. Using micro-data from the European Community Household Panel (ECHP), I apply event history methods to analyze longitudinal samples of first-birth transitions in France, Finland, Germany, and the UK (1994-2001). The results highlight spurious negative effects of unemployment on family formation among men, which can be attributed to the lack of breadwinner capabilities in the inability to financially support a family. Women, in contrast, show positive effects of unemployment on the propensity to have a first child in all countries except France. These effects prevail even after ontrolling for labour market and income-related factors. The findings are pronounced in Germany and the UK where work-family conflicts are the cause of high opportunity costs of motherhood, and the gender-specific division of labour is still highly traditional. Particularly among women with a moderate and low level of education, unemployment clearly increases the likelihood to have a first child

Cerebral blood flow and structural connectivity after working memory or physical training in paediatric cancer survivors - Exploratory findings.

Paediatric cancer survivors often suffer from cognitive long-term difficulties. Consequently, strengthening cognition is of major clinical relevance. This study investigated cerebral changes in relation to cognition in non-brain tumour paediatric cancer survivors after working memory or physical training compared to a control group. Thirty-four children (≥one-year post-treatment) either underwent eight weeks of working memory training (n = 10), physical training (n = 11), or a waiting period (n = 13). Cognition and MRI, including arterial spin labelling and diffusion tensor imaging, were assessed at three time points (baseline, post-training, and three-month follow-up). Results show lower cerebral blood flow immediately after working memory training (z = -2.073, p = .038) and higher structural connectivity at the three-month follow-up (z = -2.240, p = .025). No cerebral changes occurred after physical training. Short-term changes in cerebral blood flow correlated with short-term changes in cognitive flexibility (r = -.667, p = .049), while long-term changes in structural connectivity correlated with long-term changes in working memory (r = .786, p = .021). Despite the caution given when interpreting data from small samples, this study suggests a link between working memory training and neurophysiological changes. Further research is needed to validate these findings

Motor ability, physical self-concept and health-related quality of life in pediatric cancer survivors

Background: Cancer survivorship is frequently associated with severe late effects. However, research into pediatric cancer survivors on late effects in motor ability, physical self-concept and their relationship to quality of life is limited. Methods: Using multiple regression analyses, 78 pediatric cancer survivors and 56 typically developing children were compared in motor ability, physical self-concept and health-related quality of life. In addition, mediational multi-group analyses between motor ability (independent variable), physical self-concept (mediator) and quality of life (dependent variable) were calculated. Results: Pediatric cancer survivors had a lower motor ability (gHedges = 0.863), a lower physical self-concept with regard to several scales of the PSDQ-S (gHedges = 0.318-0.764) and a higher relative risk for a below average quality of life than controls (RR = 1.44). Children with a history of cancer involving the central nervous system showed poorer motor ability compared to those without central nervous system involvement (gHedges = 0.591). Furthermore, the physical self-concept significantly mediated the relationship between motor ability and quality of life in pediatric cancer survivors but not in typically developing children. Conclusions: Results show the importance of monitoring and supporting the development of motor ability in the aftercare of pediatric cancer survivors. Physical activity interventions may be advisable to prevent physical activity-related late effects and potentially improve related psychosocial variables such as quality of life