Health-Related Quality of Life of Adolescents with Cancer During the First Year of Treatment.

Purpose: Adolescents with cancer (aged 12-18 years) are at risk for impaired health-related quality of life (HRQoL). Little is known about this population during treatment. This study aimed to (1) determine the HRQoL of adolescents with cancer during the first year of treatment and compare them with age-matched peers and (2) obtain insight into cancer-specific HRQoL of adolescents during the first year of treatment. Methods: Participants were part of a larger study focused on routine monitoring of electronic reported outcomes in standard pediatric oncology care. Adolescents completed the pediatric quality of life inventory (PedsQL) 4.0 and the PedsQL Cancer Module 3.0. Mean generic HRQoL scale scores were compared between the groups using multivariate analysis of covariance. Cancer-specific item scores were dichotomized and percentages were calculated to determine the proportion of adolescents reporting presence or absence of problems. Results: A total of 73 (mean [M]age = 14.71, standard deviation [SD] = 1.85) adolescents with cancer (Mage = 14.71, SD = 1.85, Mtimesincediagnosis = 3.51 months, SD = 2.8) and 268 healthy peers (Mage = 14.23, SD = 1.51) participated. Adolescents with cancer reported significantly lower generic HRQoL scores on all domains than their peers (p's <0.05, η2 = 0.01-0.42). Most frequently reported cancer-specific HRQoL problems were pain (hurt joint/muscle, 42.9%), nausea (during medical treatments [47.1%]; food not tasting good [54.3%]; food and smells [61.4%]), worry (about relapse [45.7%]; about side effects [52.9%]), cognitive problems (paying attention [47.1%]), and physical appearance (not good looking [47.1%]). Conclusions: Adolescents with cancer showed impaired HRQoL during treatment on both physical and psychosocial domains. Close monitoring of physical and psychosocial symptoms during treatment is, therefore, important.

A cluster-randomized trial of screening for language delay in toddlers: effects on school performance and language development at age 8.

OBJECTIVE: The goal of this study was to assess the effects of screening and early treatment of preschool children for language delay on language development and school performance at age 8. METHODS: A cluster-randomized, controlled trial and follow-up study of 55 child health centers in 6 geographic regions were conducted from January 2002 to September 2005. A total of 9419 children who were from the general population and aged 15 months at entry were studied. School type end school progress was known for 5406 (57.4%) children. In the intervention group, a structured screening instrument was conducted twice (at ages 15/18 and 24 months), and usual care was applied in the control group. The screening instrument consisted of a uniform set of questions for the parents and test elements for the child. A positive screen result was followed by multidisciplinary assessments at speech and hearing centers and subsequent early treatment if needed. Percentages of children who attended a special school, repeated a class because of language problems, and scored low on standardized language tests, in intention-to-screen analyses, were measured. RESULTS: At age 8, 2.7% in the intervention group and 3.7% in the control group attended a special school, 6.1% vs 4.9% had repeated a grade, 8.8% vs 9.7% had deficient oral language performance, 4.7% vs 4.7% had deficient reading, and 2.8% vs 4.2% had deficient spelling. CONCLUSIONS: Screening toddlers for language delays reduces the number of children who require special education and leads to improved language performance at age 8. Nationwide implementation of the screening might be recommended.