***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: AIM To give a detailed description of the long-term outcome of a cohort of children with glioneuronal tumors regarding pre- and postsurgical factors , including " dual " and " double " pathology , seizure freedom , and psychosocial outcome . METHODS During a fifteen-year period ( 1995 - 2009 ) , all patients ( age 0 - 17.99years ) with a glioneuronal brain tumor diagnosed and treated at Uppsala University Children 's Hospital were identified from the National Brain Tumor Registry and the National Epilepsy Surgery Registry . Hospital medical records were review ed and neuroradiological and neuropathological findings were re-evaluated . A cross-sectional long-term follow-up prospect i ve evaluation , including an  interview , neurologic examination , and electroencephalogram  , was accomplished in patients accepting participants in the study . RESULTS A total of 25 out of 28 ( 89 % ) eligible patients were included . The M : F ratio was 1.5:1 . Mean follow-up time after surgery was 12.1years ( range 5.0 - 19.3 ) . Twenty patients were adults ( > 18years ) at follow-up .  Seizure freedom was achieved in 64 % . Gross total resection ( GTR ) was the only preoperative factor significantly correlating to seizure freedom ( p=0.027 ) . Thirty-eight percent were at some time postoperatively admitted for a psychiatric evaluation . There was a trend towards both higher educational level and employment status in adults who became seizure free . CONCLUSION Long-term outcome is good regarding seizure freedom if GTR can be achieved , but late seizure recurrence can occur . " Dual " and " double " pathology is uncommon and does not influence seizure outcome . Obtaining seizure freedom seems to be important for psychosocial outcome , but there is a risk for psychiatric comorbidities and long-term follow-up by a multi-professional team is advisable OBJECTIVE Self-reported data show differences in social outcomes ( not being married/having a registered partnership ; not living independently ; using social benefits ) for childhood cancer survivors compared with their peers . We aim ed to determine differences in these social outcomes between survivors and the general population using national register data and explored associated risk factors . METHODS We performed medical record linkage between a single-centre cohort of 1768 ≥ 5-year survivors of childhood cancer ( diagnosed 1966 - 2001 ) and two national registers ( 1999 - 2011 ) and obtained a r and om reference sample matched on gender and year of birth per survivor . We used multivariable logistic regression to calculate in adult survivors of childhood cancer ( born before 1990 ) the odds of the specified social outcomes at the end of follow-up in both groups . Within the survivors , we analysed risk factors for the social outcomes . RESULTS We retrieved data from 1283 adult childhood cancer survivors and 25 082 reference persons . Survivors had higher odds ( odds ratio ; 95 % confidence interval ) of not being married ( 1.2 ; 1.07 - 1.42 ) , not living independently ( 1.7 ; 1.41 - 2.00 ) and using social benefits ( 2.3 ; 1.98 - 2.69 ) compared with reference persons . Radiotherapy to head and /or neck , and an original central nervous system tumour diagnosis negatively influenced all social outcomes examined in childhood cancer survivors . CONCLUSIONS National register data show differences between social outcomes in childhood cancer survivors and the general population , especially for survivors treated with radiotherapy to head and /or neck and those originally diagnosed with central nervous system tumours . Development and implementation of effective targeted support strategies to improve social outcomes of childhood cancer survivors needs consideration . Copyright © 2015 John Wiley & Sons , BACKGROUND To determine if a group social skills intervention program improves social competence and quality of life ( QOL ) in pediatric brain tumor survivors ( PBTS ) . METHODS We conducted a r and omized control trial in which PBTS ( 8 - 16 years old , off therapy for over 3 months ) were allocated to receive social skills training ( eg , cooperation , assertion , using social cognitive problem solving strategies , role playing , games , and arts and crafts ) in 8 weekly 2-hour sessions , or an attention placebo control ( games and arts and crafts only ) . Outcomes were self-reported , proxy-reported ( caregiver ) , and teacher-reported using the Social Skills Rating System ( SSRS ) , to measure social competence , and the Pediatric Quality of Life ( PedsQL4.0 , generic ) to measure QOL at baseline , after intervention , and at 6 months follow-up . At baseline , SSRS were stratified into low and high scores and included as a covariate in the analysis . RESULTS Compared to controls ( n = 48 ) , PBTS in the intervention group ( n = 43 ) reported significantly better total and empathy SSRS scores , with improvements persisting at follow-up . The PBTS in the intervention group who had low scores at baseline reported the greatest improvements . Proxy and teacher reports showed no intervention effect . CONCLUSIONS Participating in group social skills intervention can improve self-reported social competence that persisted to follow up . The PBTS should be given the opportunity to participate in social skills groups to improve social competence OBJECTIVE The purpose of this study was to evaluate the feasibility and preliminary outcomes of a social skills group intervention program for child brain tumor survivors . METHODS Participants were 32 survivors ( 14 females ) aged 8 - 18 years . Medulloblastoma ( 28 % ) was the main diagnosis . The intervention consisted of eight 2-hr weekly sessions focused on social skills including friendship making and assertion . Survivors and parents completed measures of social skills , quality of life , behavior and depression , at baseline , pre- and post-intervention , and 6 months later . RESULTS Feasibility analyses revealed promising acceptability , retention , recruitment , and treatment fidelity . Significant improvement was found after intervention based on parents ' reports of self-control [ F(1,27 ) = 5.97 , p < .05 ] , social skills [ F(1,28 ) = 5.70 , p < .05 ] , and quality of life [ F(1,15 ) = 17.98 , p < .01 ] . CONCLUSIONS The intervention is feasible and outcomes based on parental reports provide preliminary support for the efficacy of the program BACKGROUND Adult survivors of childhood cancer ( ASCC ) , especially those of the central nervous system ( CNS ) , have increased risks of educational and social difficulties . It is therefore hypothesized they are more likely to encounter legal difficulties ( LDs ) , such as workplace discrimination and disability insurance denials , which may negatively affect their quality of life ( QoL ) . PROCEDURE We developed a survey to collect information on patients ' legal needs .  QoL was assessed using the Functional Assessment of Cancer Therapy ( FACT ) . RESULTS We prospect ively approached 112 ASCC , 111 ( 99.1 % ) of whom completed the survey . The median age of respondents was 7 years at diagnosis and 31 years at survey completion . CNS tumors were the most common malignancy ( 32.4 % ) . LDs were common overall ( 40.7 % ) , though more prevalent in patients with CNS versus non-CNS tumors ( 58.6 % vs. 32.3 % ; P = 0.023 ) . The most prevalent LD was workplace discrimination ( 58.3 % ) . On multivariate analysis , CNS tumor was the only variable significantly associated with LDs ( OR = 4.49 , P = 0.041 ) . Individuals with LDs had lower QoL scores compared to those without LDs ( 79.96 versus 91.83 on the FACT ; P = 0.005 ) . On multivariate analysis , individuals with LDs had lower QoL scores ( 14.95 points lower on the FACT ) , which is both clinical ly and statistically significant ( P = 0.047 ) . CONCLUSIONS Legal difficulties are common in adult survivors of childhood cancer , especially those with brain tumors . Furthermore , individuals with legal difficulties have worse quality of life . Research is needed to develop effective and accessible legal re source programs Quality of life ( QOL ) is important for the survivors of malignancies . We investigated health-related QOL in 51 patients treated with iodine-125 ( ¹²⁵I ) brachytherapy for childhood low- grade gliomas . Instruments included a question naire on life situation , German versions of PEDQOL ( 8 - 18 years ) , EORTC QLQ-30 and head and neck module H&N-35 ( > 18 years ) , strength and difficulties question naire , " Fertigkeitsskala Münster Heidelberg " , and an adapted Rankin score . The time lapsed since ¹²⁵I-brachytherapy  was 134 months ( median , range : 29 - 293 months ) . 57 % of the patients were over 18 years of age , 34 % were 11 - 17 years old and 8 % were younger . 14 had undergone other treatments after ¹²⁵I brachytherapy .  Over half of the > 18 year olds  reported residual problems ; 68 % were disabled , 38 % to a severe degree . Many of the young adults still lived with their parents and 17 % were jobless . 43 % of the children/adolescents needed rehabilitative treatment , 20 % visited special schools and 71 % were disabled , 33 % severely . The patients and their caregivers rated their QOL as not different from that of the normal population . However , many QOL dimensions correlated to the severity of disability . Comparison of QOL outcomes between different treatment measures would require a prospect i ve study controlling for the most important factors of influence BACKGROUND Survivors of pediatric CNS tumors are at risk for persistent tumor/treatment-related morbidity , physical disability and social consequences that may alter self-perception , vital for self-identity , mental health and quality of survival . We studied the long-term impact of  childhood CNS tumors  and their treatment on the self-perception of adult survivors and compared outcomes with those of the general population . METHODS The cohort included 697 Swedish survivors diagnosed with a primary CNS tumor during 1982 - 2001 . Comparison data were r and omly collected from a stratified general population sample . Survivors and general population individuals were compared as regards self-perception in 5 domains : body image , sports/physical activities , peers , work , and family , and with a global self-esteem index . Within the survivor group , determinants of impact on self-perception were identified . RESULTS The final analyzed sample included 528 survivors , 75.8 % of the entire national cohort . The control sample consisted of 995 , 41 % of 2500 addressed . Survivors had significantly poorer self-perception outcomes in domains of peers , work , body image , and sports/physical activities , and in the global self-perception measure , compared with those of the general population ( all P < .001 ) . Within the survivor group , female gender and persistent visible physical sequelae predicted poorer outcomes in several of the studied domains . Tumor type and a history of cranial radiation therapy were associated with outcomes . CONCLUSION An altered self-perception is a potential late effect in adult survivors of pediatric CNS tumors .  Self-perception and self-esteem are significant elements of identity , mental health and quality of survival . Therefore , care and psychosocial follow-up of survivors should include measures for identifying disturbances and for assessing the need for psychosocial intervention 
    Output:
    
Cranial radiation therapy , neurocognitive deficits , and younger age at diagnosis were associated with poorer outcomes .
Hearing loss and bilateral blindness were also related to poorer outcomes .
Sex did not impact social attainment outcomes .
Survivors of pediatric CNS tumors are at elevated risk for poor attainment of key adult social outcomes .