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Study objectivesThe primary objective of this study was to compare circadian activity rhythms (CARs) of adolescents within 5 years of completing cancer treatment (survivors) with that of healthy adolescent controls. Secondary objectives were to explore differences in the relationship of CARs and fatigue between survivors and controls and between early survivors (

PURPOSE:Robust circadian rhythms are increasingly recognized as essential to good health. Adult cancer patients with dysregulated circadian activity rhythms (CAR) experience greater fatigue, lower responsiveness to chemotherapy, and shorter time to relapse. There is scant research describing circadian rhythms and associated outcomes in children with cancer. As part of a larger study examining whether a cognitive-behavioral intervention could preserve sleep in children and adolescents with central nervous system cancers hospitalized for high-dose chemotherapy (HDCT), this study aimed to compare CAR of these children to published values and to investigate the relationship between CAR and fatigue. METHODS:Participants aged 4-19 years wore an actigraph throughout their hospitalization (5 days). From activity counts recorded by actigraphy, six CAR variables were calculated: amplitude, 24-h autocorrelation (r24), dichotomy index (I < O), interdaily stability (IS), intradaily variability (IV), and acrophase. Parent-reported child fatigue and child/adolescent self-reported fatigue measures were collected daily. RESULTS:Thirty-three participants were included. Three CAR variables (amplitude, r24, and I < O) showed dysregulation compared to published values. Older age was significantly associated with later acrophase and greater dysregulation of all other CAR variables. Controlling for age, more dysregulated amplitude (p = 0.001), r24 (p = 0.003), IS (p = 0.017), and IV (p = 0.001) were associated with higher parent-reported fatigue; more dysregulated IV (p = 0.003) was associated with higher child-reported fatigue. CONCLUSIONS:Participants demonstrated dysregulated CAR during hospitalization for HDCT. Greater dysregulation was associated with greater fatigue. Research on circadian dysregulation and its relationship to health-related outcomes in children with cancer, and interventions to support circadian rhythmicity, is urgently needed.

ObjectivesTo determine whether a sleep intervention compared with standard of care (SOC) was successful in preserving nighttime sleep in children with central nervous system cancers hospitalized for high-dose chemotherapy (HDCT) and autologous stem cell rescue, and to explore associations between sleep and fatigue during treatment.MethodsAn unblinded, randomized, controlled, multicomponent intervention (NCT00666614) including evidence-based cognitive and behavioral strategies to improve sleep was implemented in 33 children (age 4-12 years) and adolescents (age 13-19 years) during hospitalization. Children wore an actigraph to measure sleep and wake, and reported fatigue scores daily. Parents concurrently kept a sleep diary and reported fatigue scores for their children.ResultsThe mean age was 9.5 ± 3.9 years, 81.8% were white, and 60.6% were male. Sleep in all children was seriously disturbed throughout the study. Children in the intervention group maintained their longest nighttime sleep across the study, while it declined in children receiving SOC (P = 0.009 for interaction). There were few other differences in sleep between groups. Controlling for age and baseline fatigue, higher nighttime activity score, and lower percent sleep were significantly associated with higher next-day adolescent-reported fatigue (P < 0.05); longest sleep was significantly positively associated with next-day child-reported fatigue (P = 0.018).ConclusionIn this sample of children undergoing HDCT, a multicomponent sleep intervention modestly preserved nighttime sleep duration, although overall sleep was poor in both groups. Sleep is an integral component of health, and may influence outcomes of children receiving HDCT. Further investigation into methods of preserving sleep in children undergoing intensive cancer therapy is warranted.

Hydrological changes in groundwater coupled with earthquakes had been documented in previous studies by global researchers. Although few reports investigate multiple geochemical parameters that respond to earthquakes, trace elements received less attention, whereas they were suggested to be more sensitive to small earthquakes than the commonly used geochemical parameters. Beijing is located in the Zhangjiakou-Bohai(Zhang-Bo) seismic belt of North China, and although the occurrence of small earthquakes is frequent, the great historic earthquake in the Sanhe-Pinggu area M8 in 1679 in the adjoining southeast of Beijing gained widespread public attention. To find effective precursors that are significant for operational earthquake forecasting of the Beijing area, we carried out a one year test research project through weekly collection of groundwater samples during June 2021 to June 2022 from the seismic monitoring well of Wuliying in northwest Beijing. The 41 trace elements chemical compositions were analyzed for each sample. During the project ongoing period, the biggest earthquake with a magnitude of ML3.3 occurred in the Chaoyang District of Beijing on 3 February 2022. The content changes in these trace elements were systematically monitored before and after the earthquake. Through retrospective research, it was found that a few sensitive trace elements were anomalous to be coupled to the earthquake, including Li,Sc, Rb, Mo, Cs, Ba, W, U, Sr, Mn, Ni,andZn. In addition to trace elements, we examined stable isotopes of hydrogen and oxygen and the existing hydrological data on groundwater level, temperature, major ions, and gases to assess the validity of geochemistry as a monitoring and predictive tool. We only found that F(fluorine) ions and He (helium) gas had apparent shifts related to the earthquakes, while no shifts in the groundwater level were observed. Such characteristics of multiple geochemical parameters indicate that trace elements are likely to be more sensitive to crustalstrain than the groundwater level and major ions. We assumed a most likely mechanism of the combination of mixing and water-rock interactions to explain the phenomenon. The probable scenario was that minor stresses caused by the earthquakes might create microcracks in bedrocks, thereby leading to a small volume of chemically distinct water mixing with the original water of the aquifer, and finally, the earthquakeinduced rock fractures enhance the water-rock interactions, resulting in the post-seismic recovery of trace elements and δ180 value migration to the GWML. More testing works to find other sensitive sites to investigate multiple geochemical characteristics aiming at long-term to short-term earthquake prediction in the Beijing area and Zhang-Bo seismic belt are in progress. [ABSTRACT FROM AUTHOR]

The purpose of this manuscript is to describe the protocol for an Alzheimer's Association‐funded cluster randomized trial that focuses on engaging assisted living residents with dementia in meaningful activity to help address their behavioral symptoms of distress using a theoretically based approach, Meaningful Activity for Managing Behavioral Symptoms of Distress (MAC‐4‐BSD). The development of MAC‐4‐BSD was based on the Social Ecological Model and Social Cognitive Theory. The MAC‐4‐BSD intervention includes the following four steps: (1) Assessment of the assisted living physical environment and policies to facilitate meaningful activity; (2) Education of staff about implementation of meaningful activity; (3) Assessment of resident preferences and goals for meaningful activity; (4) Mentoring and motivating staff and residents to facilitate engagement in meaningful activity. The overall aim of this study will be to determine the feasibility and preliminary efficacy of implementing the MAC‐4‐BSD intervention and test whether it will improve residents' engagement in meaningful activity, behavioral symptoms of distress, and quality of life as well as the environment and policies to promote meaningful activity in assisted living. [ABSTRACT FROM AUTHOR]

This study aimed to test a model of factors associated with resilience and physical activity post-hip fracture and compare model fit between men and women. We used data from the seventh Baltimore Hip Study that included 339 participants. Model testing indicated that health status (men: β =.237, p =.002; women: β =.265, p = <.001), depression (men: β = −.245, p =.001; women: β = −.241, p = <.001), and optimism (men: β =.320, p = <.001; women: β =.282, p = <.001) were associated with resilience in men and women, but resilience was only associated with physical activity in men (β =.203, p =.038) and not in women. Social interaction was related to physical activity only among women (β =.206, p =.044). This study provides support for the relationship between resilience and physical activity at least among men. [ABSTRACT FROM AUTHOR]

Objectives: Cancer has become a chronic disease that requires a considerable amount of informal caregiving, often quite burdensome to family caregivers. However, the influence of spirituality on the caregivers' burden and mental health outcomes has been understudied. This study was to examine how caregiver burden, spirituality, and depression change during cancer treatment and investigate the moderating role of spirituality in the relationship between caregiver burden and depression for a sample of caregivers of persons with cancer. Methods: This secondary analysis used a longitudinal design employing 3 waves of data collection (at baseline, 3 months, and 6 months). Family caregivers completed the Caregiver Reaction Assessment, Spiritual Perspective Scale, and the PROMIS® depression measure. Linear mixed model analyses were used, controlling for pertinent covariates. Results: Spirituality, total caregiver burden, and depression remained stable over 6 months. More than 30% of the caregivers had mild to severe depressive symptoms at 3 time points. There was evidence of overall burden influencing depression. Of note was a protective effect of caregivers' spirituality on the relationship between depression and caregiver burden over time (b = −1.35, p =.015). The lower the spirituality, the stronger the relationship between depression and burden, especially regarding subscales of schedule burden, financial burden, and lack of family support. Significance of results: Spirituality was a significant resource for coping with caregiving challenges. This study suggests that comprehensive screening and spiritual care for cancer caregivers may improve their cancer caregiving experience and possibly influence the care recipients' health. [ABSTRACT FROM AUTHOR]