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The aim of this research is to examine the experience and impact of radiotherapy related fatigue in children diagnosed with solid tumours. Children (n = 25) and parents (n = 19) participated in a semi-structured interview on the last week of radiotherapy treatment. The study sample included children who were 6 to 14 years of age, diagnosed with brain or solid tumour, and received radiotherapy as part of their treatment protocol over the period of 6 weeks. Interpretation of data was undertaken through the adoption of thematic analysis approach. Data revealed children's experience and response to fatigue while undergoing radiotherapy. Several recurring themes arose about their experience of fatigue/tiredness while undergoing radiotherapy. Two themes and eight sub themes, namely 'Experience of Fatigue' ("You feel Different in your body", Mood and Feeling, Activity and Occurrence) and 'Response to Fatigue' (Rest and Sleep, Activity, Mood and Concentration and Eating Habit) were identified. The findings illustrated significant fatigue on activity sleep, rest and mood of children undergoing radiotherapy. Monitoring and addressing fatigue and its consequences during radiotherapy treatment are essential to improve well-being of children with cancer. • Some children described fatigue as physical, mental or a combination of both. • Fatigue impacted on many aspects of their lives such as daily activities, mood and social interaction. • Assessment of fatigue during radiotherapy treatment is key to improve well-being of children with cancer. [ABSTRACT FROM AUTHOR]

Summary: Background: Ewing''s sarcoma family of tumours has been associated with a history of hernia and with a parental occupation of farming. However, the causes of these tumours remain unknown. We therefore aimed to investigate the association between hernia and Ewing''s sarcoma family of tumours. Methods: We did a pooled analysis of two case-control studies and a meta-analysis of three case-control studies of Ewing''s sarcoma family of tumours that had adequate information on history of hernia. The primary endpoint was development of a tumour from the Ewing''s sarcoma family. 138 patients with such a tumour and 574 controls were included in the pooled analysis, and 357 patients with these tumours and 745 controls were included in the meta-analysis. Risk was assessed by an odds ratio (OR) and 95% CI by use of multivariate analysis with unconditional logistic regression for the pooled analysis and random effects model for the meta-analysis. Findings: Pooled analysis showed that children with Ewing''s sarcoma family of tumours were more likely to have had an umbilical hernia than were controls (odds ratio [OR] 3·3 [95% CI 1·3–8·0]). Meta-analysis showed that children with Ewing''s sarcoma family of tumours were more likely to have had a hernia (3·2 [1·9–5·7]). Interpretation: Ewing''s sarcoma family of tumours and hernias (particularly inguinal hernias) have common embryological pathways of neuroectodermal origin, and environmental factors, such as farming, might link the two entities. [Copyright &y& Elsevier]

Background and Objective: Although the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire has been used in many countries and has been validated previously, it has not been used in Australian Indigenous communities. We endeavoured to assess its performance when administered in Aboriginal and Torres Strait Islander communities.Methods: In a cross-sectional study, we assessed the ISAAC''s questionnaire when administered face-to-face in Indigenous communities in the Torres Strait region, Australia.Results: Comparing responses to the questionnaire with clinical assessment of 260 Indigenous children by a pediatric respiratory physician, sensitivity (87%) was high, but specificity (51%) and positive predictive value (33%) were low. Using a logistic regression model, we determined which questions were most useful in predicting a clinical diagnosis of asthma. Using a predictive equation, asthma was detected with 79% sensitivity and 77% specificity, and the calculated weighted estimate of asthma prevalence in the region was 16.3%.Conclusion: Our findings reveal that although the ISAAC questionnaire is a reasonably sensitive tool for both epidemiologic and clinical studies of asthma in Indigenous communities, its value is enhanced when used in conjunction with a predictive model. We have also shown that asthma is prevalent in the Torres Strait region. [Copyright &y& Elsevier]

Summary: Although the cancer burden in indigenous children has been reported in some countries, up to now, no international comparison has been made. We therefore aimed to assess the available evidence of the burden of childhood cancer in indigenous populations. We did a systematic review of reports on cancer incidence, mortality, and survival in indigenous children worldwide. Our findings highlight the paucity of accessible information and advocate the pressing need for data by indigenous status in countries where population-based cancer registries are established. The true extent of disparities between the burden in the indigenous community needs to be measured so that targeted programmes for cancer control can be planned and implemented. [Copyright &y& Elsevier]

Abstract: Aim: To determine current rates of childhood cancer mortality at a national level for Australia and to evaluate recent trends. Methods: Using population-based data from the Australian Paediatric Cancer Registry, we calculated cancer-related mortality counts and rates for the 3-year period 2006–2008 and trends between 1998 and 2008 by sex, age group, and cause of death (defined according to the International Classification of Childhood Cancers, third edition). Rates were directly age-standardised to the 2000 World Standard Population, and linear regression was used to determine the magnitude and significance of trends. The standardised mortality ratio for non-cancer deaths among children with cancer was also estimated. Results: A total of 282 children (23 per million per year) died from cancer in Australia between 2006 and 2008. Large decreases were observed in cancer mortality rates over the study period, particularly for boys (−5.5% per year; p <0.001), children aged 10–14 years old (−5.5% per year; p =0.001), and leukaemia patients (−9.4% per year; p <0.001). However, there was no significant change in mortality due to tumours of the central nervous system. Children with cancer were twice as likely to die from non-cancer causes compared to other children (SMR=2.06; p =0.001). Conclusions: While ongoing improvements in childhood cancer mortality in Australia are generally encouraging, of concern is the lack of a corresponding decrease in mortality among children with certain types of tumours of the central nervous system during the past decade. The results also highlight the need for intensive monitoring of childhood cancer patients for other serious diseases that may subsequently arise. [Copyright &y& Elsevier]

Background: Conditional survival estimates take into account the time that a patient has remained alive following diagnosis to provide a realistic perspective on the probability of longer term survival. Such estimates are scarce for childhood cancer, particularly by age at diagnosis or stage of cancer. Methods: De-identified population-based data were obtained from the Australian Paediatric Cancer Registry for children aged 0-14 years diagnosed with cancer between 1983 and 2010. Mortality status was followed up to the end of 2011. The hybrid period method was used to calculate relative survival estimates for those who were at risk during the period 2002-2011. Conditional survival stratified by diagnostic group or subgroup, age and stage at diagnosis was then obtained from the ratio of the relative survival estimates at different time points. Results: A total of 13,537 children were eligible for inclusion. Five-year survival for all childhood cancers combined improved from 82% at diagnosis (95% confidence interval = 81-83%) to 89% (88-90%) conditional on surviving one year, and 97% (97-98%) conditional on surviving five years after diagnosis. Conditional survival reached 95% within five years of diagnosis for nearly all types of cancer, regardless of a child's age or stage at diagnosis. Conclusion: Most children diagnosed with cancer who are alive five years after diagnosis can anticipate similar survival to children in the general population. This information may help alleviate some of the distress associated with childhood cancer, particularly for those with an initially poor prognosis. [ABSTRACT FROM AUTHOR]

Vitamin D deficiency is common and implicated in risk of several human diseases. Evidence on the relative quantitative contribution of environmental, genetic and phenotypic factors to vitamin D status (assessed by the serum concentration of 25-hydroxyvitamin D, 25(OH)D) in free-living populations is sparse. We conducted a cross-sectional study of 494 Caucasian adults aged 18–61years, randomly selected from the Australian Electoral Roll according to groups defined by age, sex and region (spanning 27°–43°South). Data collected included personal characteristics, sun exposure behaviour, biomarkers of skin type and past sun exposure, serum 25(OH)D concentration and candidate single nucleotide polymorphisms. Ambient ultraviolet radiation (UVR) levels in the month six weeks before blood sampling best predicted vitamin D status. Serum 25(OH)D concentration increased by 10nmol/L as reported time in the sun doubled. Overall, 54% of the variation in serum 25(OH)D concentration could be accounted for: 36% of the variation was explained by sun exposure-related factors; 14% by genetic factors (including epistasis) and 3.5% by direct measures of skin phenotype. Novel findings from this study are demonstration of gene epistasis, and quantification of the relative contribution of a wide range of environmental, constitutional and genetic factors to vitamin D status. Ambient UVR levels and time in the sun were of prime importance but it is nonetheless important to include the contribution of genetic factors when considering sun exposure effects. This article is part of a Special Issue entitled ‘Vitamin D Workshop’. [ABSTRACT FROM AUTHOR]