Adolescent attachment to parents and peers in singletons and twins born with assisted and natural conception.

STUDY QUESTION: Does adolescent attachment to parents and peers differ between singletons and twins born with ART or natural conception (NC)? SUMMARY ANSWER: Adolescent attachment anxiety with the father was higher among NC singletons than among ART and NC twins, whereas attachment avoidance with the father was higher in ART singletons than in NC singletons and NC twins. No differences were found in attachment to the mother, best friend or romantic partner. WHAT IS KNOWN ALREADY: Most studies have not found differences between ART and NC singletons in parent-adolescent relationships, but twin relationships may be more at risk. No previous study has examined all four groups in the same study, or specifically looked at attachment relationships. STUDY DESIGN SIZE DURATION: This was an 18-year, prospective and controlled longitudinal study with families of 496 ART singletons, 101 ART twin pairs, 476 NC singletons and 22 NC twin pairs. Families were recruited during the second trimester of pregnancy; the ART group was recruited from five infertility clinics in Finland and the control group was recruited from a hospital outpatient clinic during a routine visit. PARTICIPANTS/MATERIALS SETTING METHODS: Mothers and fathers gave background information for this study during pregnancy, and during the child's first year and early school age (7-8 years). For the ART group, infertility characteristics and prenatal medical information was also obtained from the patient registry of the infertility clinics. Children (originally 50% girls) filled in electronic questionnaires related to their attachment to mother, father, best friend and romantic partner (Experiences in Close Relationships-Relationship Structures) at 17-19 years of age. MAIN RESULTS AND THE ROLE OF CHANCE: Adolescent attachment anxiety to father was higher in NC singletons than in ART twins, P = 0.004 and marginally higher than in NC twins, P = 0.06. Adolescent attachment avoidance to father was higher in ART singletons than in NC singletons, P = 0.006 and marginally higher than in NC twins, P = 0.055. LIMITATIONS REASONS FOR CAUTION: The sample size was small especially in the NC twin group and there was drop-out over the 18-year time period, especially among boys and families with lower parental education level. The study only included native Finnish-speaking families. The results could differ in a more diverse population. ART singletons were younger and had fewer siblings than ART twins and NC children, and ART and NC twins had more newborn health risks than ART and NC singletons. WIDER IMPLICATIONS OF THE FINDINGS: The study adds to a growing body of evidence that neither ART treatments nor being a twin places mother-child relationships or peer relationships at long-term risk. However, in our study, which was the first to examine both ART and twinhood simultaneously, we found that there may be more problems in father-adolescent relationships, but only in ART singletons and only related to attachment avoidance. Our findings suggest that men, as well as women, should receive enough support in pre- and peri-natal health care during and after infertility treatments. STUDY FUNDING/COMPETING INTERESTS: This study was funded by Academy of Finland (grant number 2501308988), the Juho Vainio Foundation and the Finnish Cultural Foundation. The authors report no conflict of interest. TRIAL REGISTRATION NUMBER: N/A.

Do maternal knowledge and paternal knowledge of children's whereabouts buffer differently against alcohol use? A longitudinal study among Finnish boys and girls.

BACKGROUND: Previous research suggests that parental knowledge of the child's activities and whereabouts prevents adolescents' alcohol use. However, evidence on whether the positive effects of maternal and paternal knowledge are distinctive for boys' and girls' alcohol use is inconclusive. We examined whether perceived parental knowledge at age 13 prevents alcohol use at age 16, whether the effect of maternal and paternal knowledge was the same for both genders, and whether paternal knowledge had as strong an effect as maternal knowledge. METHOD: Adolescents answered a school survey in 2011 (age 13) and 2014 (age 16) in Finland (N = 5742). Perceived maternal and paternal knowledge was measured separately using a Parents' Monitoring Scale. The data were analysed via moderation regression modelling using Bayesian estimation. RESULTS: Perceived maternal and paternal knowledge at age 13 predicted boys' and girls' lower alcohol use at age 16. For those who had not used alcohol at age 13, parental knowledge protected against an increase of alcohol use at age 16. Both maternal and paternal knowledge had a shielding effect against the increase of boys' and girls' alcohol use, but maternal knowledge had a stronger shielding effect than paternal knowledge. CONCLUSIONS: Both maternal and paternal perceived knowledge at age 13 buffers against the adverse development of alcohol use at age 16 for both genders. Underlining the importance of parent-child communication and knowledge about the child's activities should be a part of family health counselling and school health services.

Preservation of intestinal integrity during radiotherapy using live Lactobacillus acidophilus cultures.

Twenty-four female patients suffering from gynaecological malignancies and scheduled for internal and external irradiation of the pelvic area (pelvic dose 5000 cGy) were selected for a study on prevention of intestinal side-effects by live Lactobacillus acidophilus cultures. The patients were randomised into two groups. Both groups received dietary counselling recommending a low-fat and low-residue diet during radiotherapy. The control group received dietary counselling only. The test group received 150 ml of a fermented milk test product supplying them with at least 2 X 10(9) live Lactobacillus acidophilus bacteria daily and 6.5% lactulose as substrate for the bacteria. The results indicated that the test product appeared to prevent radiotherapy-associated diarrhoea. However, flatulence was increased probably due to lactulose ingestion in the test group.

Operative finding, treatment, and prognosis of carcinoma of the pancreas: an analysis of 267 cases.

Two hundred sixty-seven laparotomized patients with pancreatic cancer during the period 1947 to 1980 were retrospectively analyzed. In 199 histologically confirmed cases of pancreatic carcinoma the tumor was only local with no invasion to neighboring tissues or distant metastases in 15% of the cases at the primary laparotomy and diagnosis stages, and the survival rates after 1, 3, and 5 years were 22%, 3% and 1%, respectively. The prognosis was a little better if a patient was over 70 years old, duration of symptoms was more than one year, the reason for laparotomy was cholecystopathy, the tumor was stage I, the treatment was a combination therapy of pancreatic resection and postoperative irradiation (with a depth dose of greater than or equal to 4,000 rad). We concluded that, excluding the extremely rare cases of pancreatic carcinoma which are cured with pancreatic resection, the survival of patients after primary operation is correlated nearly in the same way with the given treatment and the stage of the disease. It seems that at present the only possibility of improving the results of treatment in pancreatic carcinoma is to develop the combined treatment of surgery, irradiation, and chemotherapy.

Postoperative radiotherapy of renal adenocarcinoma.

125 patients with renal adenocarcinoma treated at two departments of radiotherapy in Finland are presented. 82 (66%) of the patients had localized disease and 43 (34%) had distant metastases. The five year survival for all stages was 38% and for cases with local disease 56%. There were no essential differences among Stage I, II and III patients treated with surgery alone or treated with combined operation and postoperative radiotherapy. For tumours with infiltration to adjacent organs or metastases in the lymph nodes the survival was slightly higher after combined surgery and radiotherapy than after surgery alone. For patients with P4 tumours or regional lymph node dissemination postoperative radiotherapy is recommended.