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This 1-year, longitudinal comparative study of Chinese and Caucasian family caregiving for a child with cancer is reported in two parts. Part I describes data obtained from the initial interviews at diagnosis with Chinese and Caucasian families. Interviews revealed that Chinese families use supplemental care methods, Chinese families have fewer resources and are more isolated; Caucasian families emphasize emotional care; and family emotional coping patterns differed between the two groups. Measures of functional status of the child, the impact of the child's illness on the family, the symptomatic responses of the parents to the child's illness, and patterns of caregiving were also analyzed over the first year after diagnosis. There were no statistical differences between ethnic groups. General health was lower for the children with cancer than for chronically ill children. Part II reports on the results from the two following interviews during the first year after diagnosis.

The increasing prevalence of the nuclear family in China challenges the cultural ideal and tradition of the extended family caring for children with chronic illness at home. This study examined and documented the caregiving experiences in a sample of this population of children and their families. A descriptive survey with both quantitative and qualitative questions was developed and used to interview a total of 75 families in three urban areas of China. Factors such as the severity of illness, physical symptoms, the amount of assistance the child needed for daily living, and the emotional and social impact on the child were identified. Descriptions of the family's living circumstances, caregiving situations, and the child's experiences are illustrated through the use of three case studies.

Apolipoprotein[a] polymorphism has been investigated by sodium dodecyl sulfate polyacrylamide (5.37%) gel electrophoresis and immunoblotting using a standardized sample load in four ethnic groups: German, Ghanaian, Chinese, and San (Kalahari Bushmen). A total of 10 different apparent molecular weight (Mr) polymorphs, designated 1 to 10 with increasing Mr, were detected in greater than 99% of all individuals tested (German, 99%; Ghanaian, 99%; Chinese, 100%; San 100%). A null allele is therefore at most an infrequent variant in all populations. Polymorphs 6-10 were common to all four populations, while polymorphs 1-5 appeared to be relatively rare variants not universally detected in each group in the present study. The Chinese had the highest proportion of double-band phenotypes and the observed frequencies were not significantly different from those expected according to simple Mendelian inheritance, whereas the observed apo[a] phenotype distributions of the other three groups did not concur with those expected for Hardy Weinberg equilibrium. The German and Ghanaian groups displayed similar distributions of apo[a] phenotypes while the Chinese and San had significantly higher frequencies of polymorphs 9 and 10. Mean plasma Lp[a] concentrations in Ghanaians (36.2 +/- 31.5 mg/dl) were almost 2-fold greater than in Germans (18.7 +/- 23.1 mg/dl) and ca 1.65-fold greater than in either Chinese (22.9 +/- 18.3 mg/dl) or San (21.1 +/- 19.3 mg/dl). A strong inverse correlation was observed between apo[a] Mr and plasma Lp[a] concentration in Germans but this was much less pronounced in Ghanaians. While the mean plasma Lp[a] levels associated with polymorphs 1-6 were similar in both Germans (43.4 +/- 30.0 mg/dl) and Ghanaians (49.2 +/- 37.6 mg/dl), those Ghanaians with any combination of the polymorphs 9 and 10 had an almost 3-fold greater mean plasma Lp[a] level (20.6 +/- 11.3 mg/dl) than their German counterparts (7.8 +/- 5.7 mg/dl). It is therefore apparent that: 1) differences in apo[a] allele frequencies are not primarily responsible for differences in Lp[a] levels between populations; and 2) the greatest ethnic variation is observed in plasma Lp[a] concentrations associated with the high molecular weight apo[a] polymorphs.