Siblings In Family Research Articles

Serum levels of bone sialoprotein correlate with portal pressure in patients with liver cirrhosis.

Liver cirrhosis represents the common end-stage of chronic liver diseases regardless of its etiology. Patients with compensated disease are mostly asymptomatic, however, progression to a decompensated disease stage is common. The available stratification strategies are often unsuitable to identify patients with a higher risk for disease progression and a limited prognosis. SIBLINGs, soluble glycophosphoproteins, are secreted into the blood by immune-cells. While osteopontin, the most prominent member of the SIBLINGs family, has been repeatedly associated with liver cirrhosis, data on the diagnostic and/or prognostic value of bone sialoprotein (BSP) are scarce and partly inconclusive. In this study, we analyzed the diagnostic and prognostic potential of circulating BSP in comparison to other standard laboratory markers in a large cohort of patients with liver cirrhosis receiving transjugular intrahepatic portosystemic shunt (TIPS). Serum levels of BSP were similar in patients with different disease stages and were not indicative for prognosis. Interestingly, BSP serum levels did correlate inversely with portal pressure, as well as its surrogates such as platelet count, the portal vein cross-sectional area and correlated positively with the portal venous velocity. In summary, our data highlight that BSP might represent a previously unrecognized marker for portal hypertension in patients with liver cirrhosis.

The unequal distribution of sibling and parent deaths by race and its effect on attaining a college degree

PurposeExamine (1) the distribution of experiencing the death of a parent or sibling (family death) by race/ethnicity and (2) how a family death affects attaining a college degree. MethodsParticipants (n = 8984) were from National Longitudinal Survey of Youth 1997 aged 13–17 at baseline in 1997 and 29–32 in 2013. We examined the prevalence of family deaths by age group and race/ethnicity and used covariate-adjusted logistic regression to assess the relationship between a family death and college degree attainment. ResultsA total of 4.2% of white youth experienced a family death, as did 5.0% of Hispanics, 8.3% of Blacks, 9.1% of Asians, and 13.8% of American Indians (group test P < .001). A family death from ages 13–22 was associated with lower odds of obtaining a bachelor's degree by ages 29–32 (OR = 0.65, 95% CI = 0.50, 0.84), compared with no family death. The effect of a death was largest during college years (age 19–22) (OR = 0.57, 95% CI = 0.39, 0.82). ConclusionsYoung people of color are more likely to have a sibling or parent die; and family death during college years is associated with reduced odds of obtaining a college degree. Racial disparities in mortality might affect social determinants of health of surviving relatives, and college policies are a potential intervention point.

Safety and efficacy of patients with refractory B-lymphoblastic leukemia treated with anti-CD19 CAR-T cell bridging to allogeneic hematopoietic stem cell transplantation

目的探讨抗CD19 CAR-T细胞治疗达深度缓解后序贯异基因造血干细胞移植（allo-HSCT）治疗难治B淋巴细胞白血病的疗效及不良反应。方法回顾性分析2017年11月至2019年3月河南省肿瘤医院收治的10例抗CD19 CAR-T细胞治疗达深度缓解后序贯allo-HSCT难治B淋巴细胞白血病患者的临床资料。结果①10例患者中，男5例，女5例，中位年龄23.5（10～31）岁，其中难治急性B淋巴细胞白血病（B-ALL）9例，慢性淋巴细胞白血病（CLL）1例。10例患者抗CD19 CAR-T细胞治疗后第30天及移植前评估微小残留病（MRD）均为阴性。②亲缘全相合移植2例，亲缘单倍型移植8例，抗CD19 CAR-T细胞治疗获得深度缓解至allo-HSCT中位时间为32.5（20～60）d。③10例患者获得造血重建，中性粒细胞植入中位时间为15（15～21）d，血小板植入中位时间为19（17～30）d。④预处理过程中，10例患者均未出现肝静脉闭塞病及出血性膀胱炎。1例患者出现渗漏综合征，予以限制入量、补充白蛋白及利尿等治疗后好转。移植过程中8例（80％）出现发热，均经抗感染治疗后好转。发生Ⅱ度急性移植物抗宿主病（aGVHD）2例，Ⅲ度aGVHD 1例；至随访截止9例存活患者中8例出现局限性慢性移植物抗宿主病。⑤中位随访262（150～540）d，预期1年总生存率为（90.0±1.0）％，无病生存率为（85.7±1.3）％。结论抗CD19 CAR-T细胞治疗达深度缓解后序贯allo-HSCT可作为难治B淋巴细胞白血病患者的可选治疗方案。

Family Violence, Sibling, and Peer Aggression During Adolescence: Associations With Behavioral Health Outcomes

Bullying and sibling aggression can appear as similar behavior, though the latter is comparatively understudied. Aligned with the Theory of Intergenerational Transmission of Violence, research suggests that exposure to family violence increases an individual's risk for perpetrating violence in their own future relationships. Additionally, Problem Behavior Theory suggests that engaging in one problem behavior (e.g., bullying) increases the likelihood of engaging in other problem behavior (e.g., substance use). In Phase 1, this study of middle school students from the U.S. examined how exposure to family violence predicted membership in latent classes of bullying and sibling aggression perpetration (N = 894, sampled from four middle schools). In Phase 2, we used mixture modeling to understand how latent classes of family violence, sibling aggression, and bullying predict future substance use, mental health outcomes, and deviance behavior later in high school. Results yielded four profiles of peer and sibling aggression: high all, high sibling aggression, high peer aggression, and low all aggression. Youth who reported witnessing more family violence at home were significantly more likely to fall into the sibling aggression only and high all classes, compared to the low all class. Phase 2 results also yielded four classes: a high all class, a sibling aggression and family violence class, a peer aggression class, and a low all class. Individuals in the high all class were more likely to experience several unfavorable outcomes (substance use, depression, delinquency) compared to other classes. This study provides evidence for pathways from witnessing violence, to perpetrating aggression across multiple contexts, to developing other deleterious mental and behavioral health outcomes. These findings highlight the negative impact family violence can have on child development, providing support for a cross-contextual approach for programming aimed at developing relationships skills.

The Effects of Aerial Spraying of Coca Crops on Child Labor, School Attendance, and Educational Lag in Colombia, 2008-2012

Since 1999, one of the main strategies the Colombian government has used to mitigate coca cultivation is to spray the crops with herbicide, which is carried out from airplanes. This paper evaluates the consequences of this strategy for rural households in areas where coca is cultivated, specifically the effects of aerial spraying on child labor and education. Since the areas where spraying takes place are fundamentally different from those where it does not, I use a two-stage least squares model, instrumenting for aerial eradication with the number of days high-speed winds in the municipality made spraying difficult. These were days in which the wind was one standard deviation above the municipality's monthly average. This corrects for possible sources of endogeneity due to selection bias. The results of this study show that aerial spraying was associated with a one percentage point increase in the likelihood that children ages 12-17 would work instead of going to school. Crop spraying was further associated with a 0.15 percentage point increase in the probability that older siblings in families living in a coca-growing area would fall behind in school, and a five percentage point increase in the probability that younger siblings would drop out of school. Thus, the findings of this research, based on data that cover the period from 2008 to 2012, suggest that the war on drugs has the potential to generate new barriers to educational access for children who live in areas where aerial spraying occurs.

The prevalence of childhood bereavement in Scotland and its relationship with disadvantage: the significance of a public health approach to death, dying and bereavement.

Background and Method:There is an absence of research on the prevalence of bereavement during early childhood and the relationship between childhood bereavement and socioeconomic status (SES) and this poses a challenge in both understanding and supporting children’s bereavement experiences. Using longitudinal data from the Growing Up in Scotland study, which tracks the lives of three nationally representative cohorts of children, this paper aimed to address these gaps in research. It specifically drew on data from Birth Cohort 1 to document the recorded bereavements of 2,815 children who completed all 8 sweeps of data collection, from age 10 months to 10 years.Findings:The study found that 50.8% of all children are bereaved of a parent, sibling, grandparent or other close family member by age 8 and this rises to 62% by age 10. The most common death experienced was that of a grandparent or other close relative. The study also found that children born into the lowest income households are at greater risk of being bereaved of a parent or sibling than those born into the highest income households.Discussion and Conclusion:Given the prevalence of childhood bereavement and its relationship with disadvantage, this paper argues that there is an important need to understand bereavement as a universal issue that is affected by the social conditions in which a child becomes bereaved, as well as an individual experience potentially requiring specialist support. This paper thus seeks to position childhood bereavement more firmly within the public health approach to palliative and bereavement care discourse and contends that doing so provides a unique and comprehensive opportunity to better understand and holistically respond to the experience of bereavement during childhood.

Dietary habits and family correlates whether family has any role in shaping the dietary habits of adolescents? A school based cross-sectional study from Mangaluru, Karnataka State, India

Background: Adolescence is widely defined as the time in life when the developing individual attains the skills and attributes necessary to become a productive and reproductive adult. Objective: to study the dietary habits of school going adolescents and role of family in shaping the habits. Material and methods: This Cross-sectional study was conducted in Mangalore city of Dakshina Kannada also known as South Canara a coastal district situated in the southern part of Karnataka state for a period of two years from November 2014 to September 2016. Adolescents aged 10 to 19 years studying in grade VII to grade X of two selected schools and their parents/guardians. Results: Majority of the adolescents viz., 63.9%, 90.0%, and 68.7% had inadequate intake of proportion of fruits, green leafy vegetables and junk foods per day during the past 7 days respectively. As seen in table 2, gender, number of siblings in family, father literacy and religion were the socio-demographic variables found to have statistically significant association with fruit intake with p<0.05. Conclusions: This study throws light on the existence of various health needs of the adolescents and should be addressed by their parents and they should be offered counseling services. Keywords: Dietary habits, adolescents, fruits, green leafy vegetables, junk foods

Expression of BSP-GFPtpz Transgene during Osteogenesis and Reparative Dentinogenesis

Bone sialoprotein (BSP) is a member of the SIBLING family with essential roles in skeletogenesis. In the developing teeth, although the expression and function of BSP in the formation of acellular cementum and periodontal attachment are well documented, there are uncertainties regarding the expression and function of BSP by odontoblasts and dentin. Reporter mice are valuable animal models for biological research, providing a gene expression readout that can contribute to cellular characterization within the context of a developmental process. In the present study, we examined the expression of a BSP-GFPtpz reporter mouse line during odontoblast differentiation, reparative dentinogenesis, and bone. In the developing teeth, BSP-GFPtpz was expressed at high levels in cementoblasts but not in odontoblasts or dentin. In bones, the transgene was highly expressed in osteoblasts at an early stage of differentiation. Interestingly, despite its lack of expression in odontoblasts and dental pulp during tooth development, the BSP-GFPtpz transgene was detected during in vitro mineralization of primary pulp cultures and during reparative dentinogenesis following pulp exposures. Importantly, under these experimental contexts, the expression of BSP-GFPtpz was still exclusive to DSPP-Cerulean, an odontoblast-specific reporter gene. This suggests that the combinatorial use of BSP-GFPtpz and DSPP-Cerulean can be a valuable experimental tool to distinguish osteogenic from dentinogenic cells, thereby providing an avenue to investigate mechanisms that distinctly regulate the lineage progression of progenitors into odontoblasts versus osteoblasts.

Mother-child and siblings' mediated learning strategies in families with and without children with intellectual disability

The objectives of the research were to study differences in Mediated Learning Experience (MLE) strategies between mothers and their children in families with intellectually disabled and typically developing children and the cross-generation transmission of MLE strategies. Dyads of mother-child and siblings were observed interacting in free-play and teaching situations and their mediation strategies were analyzed by the Observation of Mediation Interaction scale. The child in the mother-child interaction was the older sibling in the siblings’ interaction. Siblings samples were composed of two main groups: where the younger sibling (a) had an intellectual disability (ID, n = 25), or typically developing sibling dyads matched on (b) difference in mental age (TDM, n = 25) and (c) difference in chronological age (TDC, n = 25). The mediation strategies of older-younger siblings were compared to that of mother-child (with older sibling). The findings showed that siblings demonstrated higher level of MLE strategies than mothers in the ID group as compared with the two TD groups and that there is a cross-generation transmission of MLE strategies after controlling variables of group, mothers’ years of education, level of occupation, and level of religiosity. The findings implications are related to the central role of siblings in families with a child with ID and working with families to enhance children’s cognitive development.

Pathology of Sibling Sub System: Phenomenal World of Sibling in Families with Children with ADHD Disorder; a Qualitative Study

مقدمه: باتوجهبهمشکلات فراوان خانواده های دارای فرزند مبتلا به اختلال ADHD و عدم شناسایی آسیب های زیرمنظومه همشیرها در پیشینه پژوهشی ،هدف این پژوهششناساییآسیب هایزیر منظومه همشیرها درخانواده های دارای فرزند مبتلا به اختلال ADHD است.روش: این پژوهش یک مطالعه کیفی است که با روش پدیدارشناسی[1] انجام شده است. جامعه آماری شامل کلیه خانواده های دارای فرزند مبتلا به اختلال ADHD بود که به مراکز مشاوره یا روانپزشکی شهر سنندج رجوع کرده بودند.نمونه گیری با روش هدفمند و شامل 27 نفربوده است.ابزار پژوهش مصاحبه نیمه ساختار یافته و تحلیل داده ها با روش هفت مرحله ای کلایزی(1987) انجام شده است.یافته ها: در این پژوهش اطلاعات به دست آمده ی حاصل از کدگذاری در سه دسته کدگذاری توصیفی[2]، تفسیری[3] و تبیینی[4] قرار گرفته اند که شامل 3 کد تبیینی، 9 کد تفسیری و 44 کد توصیفی است.نتیجه گیری: نتایج نشان داد که زیرمنظومه همشیرها تحت تأثیر مشکلات فرزند ADHD خانواده قرار دارد و آسیب های خاص و تأثیرات منفی بر این زیرمنظومه وارد می کند. بنابراین این زیرمنظومه نیازمند نظارت،حمایت و آموزش های خاصی است تا از میزان آسیب های آن کاسته شود.[1] Phenomenological[2] .Descreptive[3] . Interpretative[4] .Explanatory

Role of Family in Entrepreneurial Endeavour and Business in Hong Kong: Implications of Declining Fertility

ABSTRACT Through the theoretical lens of the family as a breeding ground for new business, this article argues that the drastic and prolonged decline in fertility affects business creation. Since entrepreneurship is a high-risk endeavour, and during the start-up or expansion period, various kinds of resource support from family are badly needed, the small family is in an unfavourable position. By using qualitative research data obtained in Hong Kong, this article unravels the possible interplay among the factors of continuous fertility decline, shrinking family human resource support and sibling network, and ultimately diminishing entrepreneurship. It argues that if fertility keeps declining, not only could entrepreneurial activity remain low, but momentum for sustaining economic development might also become weak and feeble.

Clinical observation of 12 patients with refractory/relapsed acute myeloid leukemia treated with allogeneic hematopoietic stem cell transplantation containing cladribine regimen

目的评估含克拉屈滨序预处理异基因造血干细胞移植（allo-HSCT）治疗难治/复发急性髓系白血病（AML）的疗效。方法回顾性分析12例接受含克拉屈滨预处理allo-HSCT难治/复发AML患者的临床资料。结果①12例患者中，男9例，女3例，中位年龄36（27~50）岁。亲缘全相合供者移植3例，无关供者移植1例，单倍型移植8例。移植前部分缓解9例，未缓解3例，移植前化疗中位疗程6（2~13）个。②预处理：司莫司汀250 mg·m−2·d−1，−7 d；克拉屈滨5 mg·m−2·d−1，−6 d~−2 d；阿糖胞苷2 g·m−2·d−1，−6 d~−2 d；白消安3.2 mg·m−2·d−1，−6 d~−3 d；兔抗人胸腺细胞免疫球蛋白（ATG）1.5 mg·m−2·d−1（无关供者移植）或2.0~2.5 mg·m−2·d−1（单倍型移植），−4 d~−1 d。③11例患者获得造血重建，1例发生原发植入失败。可评估患者中，中性粒细胞植入时间为15（15~21）d，中位血小板植入时间为19（17~30）d。④预处理过程中，12例患者均未发生肝静脉闭塞病，2例患者发生出血性膀胱炎。移植过程中8例出现发热，均经抗感染治疗后好转。3例患者发生Ⅱ度急性GVHD。至随访截止9例存活患者中8例发生慢性局限型GVHD。⑤中位随访时间为8（4~12）个月，2例患者分别在移植后6、12个月复发。预期1年总生存率为（71.1±1.8）%，无病生存率为（62.2±1.8）%。结论含克拉屈滨预处理allo-HSCT可作为难治/复发AML患者的可选治疗方案。

P.21Genetic analysis of first-degree relatives with inclusion body myositis

Inclusion body myositis (IBM) is a sporadic clinicopathologically defined myopathy characterised by finger flexor and quadriceps weakness, along with the histological triad of endomysial autoaggressive inflammation, rimmed vacuoles and protein aggregates. Rare familial occurrences of IBM have however been reported. We have identified 3 such families. Families 1 and 2 consisted of pairs of affected siblings, while family 3 consisted of a mother and her two children. The onset of symptoms was between 55 and 73 years. Patients displayed finger flexion greater than shoulder abduction and/or quadriceps greater than iliopsoas weakness. One individual in family 3 developed amyotrophic lateral sclerosis (ALS) 5 years after the diagnosis of IBM. An autoaggressive endomysial inflammatory infiltrate was present in all patients, while congophilic inclusions and rimmed vacuoles were observed in 6 and 5 patients, respectively. Anti-cytosolic 5′-nucleotidase 1A (cN1A) antibodies were present in the only 2 patients tested. Whole genome sequencing was performed in all patients and failed to identify causative variants in well-characterised Mendelian myopathy genes, including myopathies with rimmed vacuoles. The two siblings of family 1 both carried a heterozygous frameshift variant in TANK binding kinase 1 (TBK1). In the other 2 families, no candidate variant has so far been identified. Loss-of-function variants in TBK1 have recently been reported to cause ALS. TBK1 is a ubiquitously-expressed protein kinase known to regulate autophagy, mitophagy, neuroinflammation and adipose tissue energy metabolism. Several of these pathways have been hypothesised to play a role in the development of IBM. Further research is therefore warranted to explore the role of TBK1 in the pathogenesis of both familial and sporadic IBM.

INHERITED AND DE NOVO GENETIC RISK FOR AUTISM IMPACTS SHARED BIOLOGICAL NETWORKS

Well-functioning error monitoring of the inner and outer environments is essential for adaptively altering behavior, while malfunction characterizes conditions such as obsessive–compulsive disorder (OCD). The underlying brain processing is manifested as Error-Related Negativity (ERN) signal elicited following error comission, and Perceived Error Related Theta Activity (PERTA) signal elicited following detection of discrepancy in the environment. Yet, while enhanced ERN was repeatedly demonstrated in OCD patients and was found to be potentiated among their unaffected first degree relatives, no comparable observations were reported with regard to PERTA. We recorded EEG activity while OCD patients, OCD patients’ siblings (Family), and healthy controls (HC) performed computerized tasks. For the examination of ERN we used the Stroop task and for the examination of PERTA we presented correct and incorrect mathematical equations. Increased ERN (0–120 ms post response) was observed in both the OCD and Family groups, but only the OCD patients’ signal significantly differed from that of HC's. Similarly, modified PERTA activity was observed in both the OCD and Family groups in the N1 peak (65–125 ms post perceived error), but only for the OCD group this activity significantly differed from that of HC. Both ERN and PERTA's N1 are fast occurring peaks, which suggests that OCD is associate with a constantly over-activated detection system that monitors the inner and outer environment and reacts promptly following detection of a mistake. Furthermore, the modified but non-significantly different activity of the Family group suggests that the pathological condition evolves in vulnerable individuals with neuronal predisposition.

Siblings of children with Williams syndrome: Correlates of psychosocial adjustment and sibling relationship quality

BackgroundPrevious research has examined adjustment in parents of children with Williams syndrome (WS), but little is known about sibling outcomes. AimsTo explore sibling adjustment and relationship quality, and their demographic, psychological and behavioural phenotypic correlates from the perspective of caregivers and siblings in families of children with WS. Methods and proceduresForty-one caregivers of children with WS participated in this questionnaire study on the adjustment and relationship quality of the siblings. In 31 of these families, self-report data were also provided by the siblings themselves. Data were also gathered on potential correlates, including anxiety and social functioning in the child with WS, caregiver mental health, and sibling social support. Outcomes and resultsSibling adjustment was similar to population norms, though significantly increased caregiver-reported emotional difficulties were found. Siblings reported greater behavioural, emotional and relationship difficulties than caregivers perceived them to have. Some significant associations were found between the behaviour of the child with WS, sibling behaviour problems and sibling relationship quality. Conclusions and implicationsA picture of relatively positive sibling adjustment and relationships emerged, but findings of individual differences and some emotional difficulties emphasise the need for an individualised approach to support in families of children with WS.

Higher risk of intracranial aneurysms and subarachnoid haemorrhage in siblings of families with intracranial aneurysms.

IntroductionFirst-degree relatives of patients with familial aneurysmal subarachnoid hemorrhage have an increased risk of unruptured intracranial aneurysms and aneurysmal subarachnoid hemorrhage. We assessed whether the type of kinship of first-degree relatives of aneurysmal subarachnoid hemorrhage patients influences this risk.Patients and methodsWe used all available data from the prospectively collected database of families consulting our outpatient clinic between 1994-2016. We constructed pedigrees for all families with ≥2 first-degree relatives with aneurysmal subarachnoid hemorrhage or unruptured intracranial aneurysms. The proband was defined as the first family member with aneurysmal subarachnoid hemorrhage who sought medical attention. We compared both the proportion of aneurysmal subarachnoid hemorrhage and unruptured intracranial aneurysms in proband's first-degree relatives by calculating relative risks (RR) with children as the reference.ResultsWe studied 154 families with 1,105 first-degree relatives of whom 146 had aneurysmalsubarachnoid hemorrhage. Unruptured intracranial aneurysms were identified in 63 (19%) of the 326 screened relatives. Siblings had a higher risk of aneurysmal subarachnoid hemorrhage (RR:1.62, 95% CI:1.12–2.38) and parents a lower risk (RR:0.44, 95% CI:0.24–0.81) than children. Siblings also had a higher risk of unruptured intracranial aneurysms (RR:2.28, 95% CI:1.23–4.07, age-adjusted RR:2.04, 95% CI:1.07–3.92) than children.Conclusion: Siblings of patients with aneurysmal subarachnoid hemorrhage have a significanthigher risk of both unruptured intracranial aneurysms and aneurysmal subarachnoid hemorrhage and parents have a lower risk of aneurysmal subarachnoid hemorrhage than children. Discussion: Type of kinship is a relevant factor to consider in risk prediction and screening advice in families with familial aneurysmal subarachnoid hemorrhage.

From self-induced to perceived errors – A generalized over-monitoring activity in obsessive–compulsive disorder

Well-functioning error monitoring of the inner and outer environments is essential for adaptively altering behavior, while malfunction characterizes conditions such as obsessive–compulsive disorder (OCD). The underlying brain processing is manifested as Error-Related Negativity (ERN) signal elicited following error comission, and Perceived Error Related Theta Activity (PERTA) signal elicited following detection of discrepancy in the environment. Yet, while enhanced ERN was repeatedly demonstrated in OCD patients and was found to be potentiated among their unaffected first degree relatives, no comparable observations were reported with regard to PERTA. We recorded EEG activity while OCD patients, OCD patients’ siblings (Family), and healthy controls (HC) performed computerized tasks. For the examination of ERN we used the Stroop task and for the examination of PERTA we presented correct and incorrect mathematical equations. Increased ERN (0–120 ms post response) was observed in both the OCD and Family groups, but only the OCD patients’ signal significantly differed from that of HC's. Similarly, modified PERTA activity was observed in both the OCD and Family groups in the N1 peak (65–125 ms post perceived error), but only for the OCD group this activity significantly differed from that of HC. Both ERN and PERTA's N1 are fast occurring peaks, which suggests that OCD is associate with a constantly over-activated detection system that monitors the inner and outer environment and reacts promptly following detection of a mistake. Furthermore, the modified but non-significantly different activity of the Family group suggests that the pathological condition evolves in vulnerable individuals with neuronal predisposition.

Psychosocial Impacts of Cancer on Siblings: Qualitative Evidence From Indonesia

&lt;div class="WordSection1"&gt;&lt;div class="WordSection1"&gt;&lt;div class="WordSection1"&gt;&lt;p&gt;Living with brothers and/or sisters who have been diagnosed with cancer can cause psychological problems on the part of siblings. This paper aimed to explore the psychosocial impacts of cancer on siblings. This research is a qualitative study using a descriptive phenomenology approach. There were eight siblings who were key informants aged between 8-18 years old, selected through a purposive sampling technique. In-depth interviews were the techniques used to collect data, followed by conducting verbatim transcripts. For data analysis, the Colaizzi’s analysis model was applied. The qualitative thematic analyses identified that the psychosocial impact experienced by siblings included the following: (1) grieving process (2) psychological responses; and (3) changes in the sibling's life. This paper suggests that all relevant parties, with particular reference to health care institutions and nurses, should pay attention to information and communication given to the siblings and family so that the effect of children with cancer and the psychosocial impact on siblings in families can be reduced.&lt;/p&gt;&lt;/div&gt;&lt;/div&gt;&lt;/div&gt;

A Child With Autism Spectrum Disorder Teaches Siblings to Skateboard: Effects on Sibling Skills and Family Social Behavior

Children with autism spectrum disorder (ASD) may have few common activities with their siblings who do not have ASD, and this can limit their opportunities for social play. In this study, we used a multiple-baseline across skills design to assess the effects of a boy with ASD following an activity schedule to teach his favorite activity of skateboarding to his two siblings who do not have ASD. Family social behavior was also measured before and after sibling training. After training by the boy with ASD, both of the siblings’ skateboarding skills improved, and measures of family social behavior also increased. Results suggest that sibling relationships may benefit when a child with ASD teaches siblings to play.

Familial aggregation of early-onset cancers.

This registry‐linkage study evaluates familial aggregation of cancer among relatives of a population‐based series of early‐onset (≤40 years) cancer patients in Finland. A cohort of 376,762 relatives of early‐onset cancer patients diagnosed between 1970 and 2012 in 40,538 families was identified. Familial aggregation of early‐onset breast, colorectal, brain and other central nervous system (CNS) cancer and melanoma was explored by standardized incidence ratios (SIR), stratified by relatedness. Gender‐, age‐ and period‐specific population cancer incidences were used as reference. Cumulative risks for siblings and offspring of the proband up to age ≤40 years were also estimated. Almost all early‐onset cancers were sporadic (98% or more). Among first‐degree relatives, SIR was largest in colorectal cancer (14, 95% confidence interval 9.72–18), and lowest in melanoma (1.93, 1.05–3.23). Highest relative‐specific SIRs were observed for siblings in families, where also parent had concordant cancer, 90 (43–165) for colorectal cancer and 29 (11–64) for CNS cancer. In spouses, all SIRs were at population level. Cumulative risk of colorectal cancer by age 41 was 0.98% in siblings and 0.10% in population, while in breast cancer the corresponding risks were 2.05% and 0.56%. In conclusion, early‐onset cancers are mainly sporadic. Findings support high familial aggregation in early‐onset colorectal and CNS cancers. Familial aggregation in multiplex families with CNS cancers was mainly attributed to neurofibromatosis and in colorectal cancer to FAP‐ and HNPCC‐syndromes. The pattern of familial aggregation of early‐onset breast cancer could be seen to support very early exposure to environmental factors and/or rare genetic factors.