Although women diagnosed with cancer during their childbearing years are at significant risk for infertility, we know little about the relationship between infertility and long-term quality of life (QOL). To examine these relationships, we assessed psychosocial and reproductive concerns and QOL in 231 female cancer survivors. Greater reproductive concerns were significantly associated with lower QOL on numerous dimensions (P<.001). In a multiple regression model, social support, gynecologic problems, and reproductive concerns accounted for 63% of the variance in QOL scores. Women who reported wanting to conceive after cancer, but were not able to, reported significantly more reproductive concerns than those who were able to reproduce after cancer (P<.001). These preliminary data suggest that at least for vulnerable subgroups, the issue of reproductive concerns is worthy of additional investigation to assist cancer survivors living with the threat or reality of infertility.

Purpose: Cancer diagnosis and treatment imparts chronic stressors affecting quality of life (QOL) and basic physiology. However, the capacity to increase survival by improving QOL is controversial. Patients with cervical cancer, in particular, have severely compromised QOL, providing a population well-suited for the evaluation of novel psychosocial interventions and the exploration of mechanisms by which modulation of the psychoneuroimmune axis might result in improved clinical outcomes. Experimental Design: A randomized clinical trial was conducted in cervical cancer survivors that were enrolled at z13 and <22 months after diagnosis (n = 50), comparing a unique psychosocial telephone counseling (PTC) intervention to usual care. QOL and biological specimens (saliva and blood) were collected at baseline and 4 months post-enrollment. Results: The PTC intervention yielded significantly improved QOL (P = 0.011). Changes in QOL were significantly associated with a shift of immune systemT helper type 1and 2 (Th1/Th2) bias, as measured by IFN-g/interleukin-5 ELISpot T lymphocyte precursor frequency; improved QOL being associated with increasedTh1bias (P = 0.012). Serum interleukin-10 and the neuroendocrine variables of cortisol and dehydroepiandrosterone revealed trends supporting this shift in immunologic stance and suggested a PTC-mediated decrease of the subject's chronic stress response. Conclusions: This study documents the utility of a unique PTC intervention and an association between changes in QOL and adaptive immunity (T helper class).These data support the integration of the chronic stress response into biobehavioral models of cancer survivorship and suggests a novel mechanistic hypotheses by which interventions leading to enhanced QOL could result in improved clinical outcome including survival.The association between cancer patient survival and performance status at diagnosis, i.e., baseline quality of life (QOL), is well documented. Patient-reported outcomes, broadly addressed as QOL variables, are now integral components of cancer clinical trials (1) and highlight opportunities for psychosocial interventions to improve these outcomes for patients with cancer. Whether effective psychosocial interventions improve both patient QOL and survival remains controversial (2 -10). Nevertheless, any potential cancerspecific survival benefit implies improved control of occult micrometastatic disease (11) and the immune system is a prime candidate effector for this biological antitumor activity. The recognition of cross-talk between neurologic, neuroendocrine, and immune systems has given rise to the concept of psychoneuroimmunology, the psychoneuroimmune axis, and the so-called ''mind-body '' connection (5, 12 -15). This conceptual framework provides a foundation for biobehavioral paradigms (16 -18) and for the postulation of potential mechanisms by which a psychosocial intervention might influence cancer patient survival (2,5,11,17,18).Various studies evaluating if psychosocial interventions could affect ...

Best friendship, Close friendships, Friendship quality, Happiness, Perceived mattering, Structural equation modeling,

Cyberbullying is a ubiquitous topic when considering young people and internet and communication technologies (ICTs). For interventional purposes, it is essential to take into account the perspective of adolescents. This is the reason why our main focus is (1) investigating the role of different criteria in the perceived severity of cyberbullying incidents, and (2) examining the differences between countries in the perceived severity of cyberbullying. The sample consisted of 1,964 adolescents (48.2% girls) from middle and high schools of four different countries, i.e., Estonia, Italy, Germany, and Turkey. The participants' age ranged from 12 to 20 years old with a mean age of 14.49 (SD = 1.66) years. To assess perceived severity, participants rated a set of 128 scenarios, which systematically included one or more of five criteria (intentionality, repetition, imbalance of power, public vs. private, and anonymity) and represented four types of cyberbullying behaviors (Written—Verbal, Visual, Exclusion, Impersonation). The role of different criteria was analyzed using the Exploratory Structural Equation Modeling (ESEM). Results showed a similar structure across the four countries (invariant except for the latent factors' means). Further, criteria of imbalance of power and, to a lesser extent, intentionality, anonymity, and repetition always in combination, were found to be the most important criteria to define the severity of cyberbullying. Differences between countries highlighted specific features of Turkish students, who perceived all scenarios as more severe than adolescents from other countries and were more sensitive to imbalance of power. German and Italian students showed an opposite perception of anonymity combined with intentionality. For Italian participants, an anonymous attack was less threatening than for participants of other countries, whereas for German students anonymity caused more insecurity and fear. In addition, Italian adolescents were more perceptive of the criterion of intentionality. Finally, Estonian adolescents did not show strong differences in their factor scores compared to adolescents from the other countries.