Cancer Patients' Symptom Burden and Health-related Quality of Life (HRQoL) at Tertiary Cancer Center from 2006 to 2013 : A Cross-sectional Study

Background/Aim: To observe changes in symptoms and health-related quality of life (HRQoL) over 7 years among cancer patients at different stages of the disease. Patients and Methods: This prospective cross-sectional study at the Helsinki University Hospital Cancer Center, was carried out in 2006 and repeated in 2013. All participants filled in the EORTC-QLQ-C30 questionnaire. Results: Altogether, 581 patients responded (49% in 2006 and 54% in 2013). The disease was local in 51% and advanced in 49% of patients. The HRQoL was significantly lower, except for emotional and cognitive functions, and the symptom burden more severe in advanced cancer. The most prevalent symptoms were fatigue (93% and 85%; moderate/severe 22% and 9%), pain (65% and 47%; moderate/severe 16% and 5%), and insomnia (64% and 60%; moderate/severe 20 and 21%), respectively. No changes in HRQoL or symptoms were found at 7 years. Conclusion: There is a need for early integrated palliative care to improve HRQoL during cancer treatments.Peer reviewe

Length at maturity as a potential indicator of fishing pressure effects on coastal pikeperch (Sander lucioperca) stocks in the northern Baltic Sea

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Effects of top predator re-establishment and fishing on a simulated food web:Allometric Trophic Network model for Lake Oulujärvi

Fish communities face changes in environmental conditions and fishing that affects the abundances and structures of the populations. Before 1960s there were abundant stocks of both pikeperch (Stizostedion lucioperca) and whitefish (Coregonus lavaretus) in Lake Oulujärvi, but in 1960s–1970s the stock of pikeperch declined to very low levels while whitefish stock remained abundant. Due to massive re-introductions, pikeperch recovered since 1999 and is again common while whitefish stock has declined. To understand the ecosystem-level changes observed along the recovery of the pikeperch stock, we constructed a food web model capturing the two most recent states of pikeperch abundance in Lake Oulujärvi. We used Allometric Trophic Network (ATN) model to simulate the pelagic food web in the presence and absence of pikeperch and in the presence and absence of fishing. To parametrize ATN model based on body masses and food web interactions, we used data collections of fish cohort analyses, fish individuals, fish stomach contents, zooplankton, and phytoplankton in Lake Oulujärvi. Pikeperch decreased the biomasses of its planktivorous prey. Fishing truncated the age distribution of planktivorous fish. Pikeperch and fishing had synergistic negative effects on vendace (Coregonus albula) and smelt (Osmerus eperlanus) percentages of fish biomass, and antagonistic negative effect on whitefish and brown trout (Salmo trutta) percentages of fish biomass. Mysis relicta, Chaoborus flavicans, Leptodora and other predatory zooplankton, and Cyclopoida zooplankton guilds increased with fishing and pikeperch. Fishing, and pikeperch in the presence of fishing, increased biomass of Crustacean zooplankton guild. There were marked differences between the ATN model simulations and empirically observed time series of fish stock abundances suggesting that the observed changes are partially caused by environmental or fishing-related factors that were not included in the model.</p

Effects of top predator re-establishment and fishing on a simulated food web : Allometric Trophic Network model for Lake Oulujärvi

Fish communities face changes in environmental conditions and fishing that affects the abundances and structures of the populations. Before 1960s there were abundant stocks of both pikeperch (Stizostedion lucioperca) and whitefish (Coregonus lavaretus) in Lake Oulujärvi, but in 1960s–1970s the stock of pikeperch declined to very low levels while whitefish stock remained abundant. Due to massive re-introductions, pikeperch recovered since 1999 and is again common while whitefish stock has declined. To understand the ecosystem-level changes observed along the recovery of the pikeperch stock, we constructed a food web model capturing the two most recent states of pikeperch abundance in Lake Oulujärvi. We used Allometric Trophic Network (ATN) model to simulate the pelagic food web in the presence and absence of pikeperch and in the presence and absence of fishing. To parametrize ATN model based on body masses and food web interactions, we used data collections of fish cohort analyses, fish individuals, fish stomach contents, zooplankton, and phytoplankton in Lake Oulujärvi. Pikeperch decreased the biomasses of its planktivorous prey. Fishing truncated the age distribution of planktivorous fish. Pikeperch and fishing had synergistic negative effects on vendace (Coregonus albula) and smelt (Osmerus eperlanus) percentages of fish biomass, and antagonistic negative effect on whitefish and brown trout (Salmo trutta) percentages of fish biomass. Mysis relicta, Chaoborus flavicans, Leptodora and other predatory zooplankton, and Cyclopoida zooplankton guilds increased with fishing and pikeperch. Fishing, and pikeperch in the presence of fishing, increased biomass of Crustacean zooplankton guild. There were marked differences between the ATN model simulations and empirically observed time series of fish stock abundances suggesting that the observed changes are partially caused by environmental or fishing-related factors that were not included in the model.peerReviewe

Factors predicting long-term physical activity of breast cancer survivors. 5-year-follow-up of the BREX exercise intervention study

Background The benefits of exercise training are well documented among breast cancer (BC) survivors. Patients decrease their physical activity during treatment, and many fail to regain their previous exercise levels. There is therefore a need to define factors supporting long-term physical activity behavior in this patient group, to target supporting interventions aimed at preventing the decline in physical activity (PA). Aim The aim of this study was to determine physical and psychosocial factors explaining long-term physical activity after the adjuvant treatments in BC survivors. Methods Four-hundred forty-six BC survivors followed for 5-years within a randomized exercise trial participated. Factors explaining (1) physical activity after the adjuvant treatments and (2) changes in physical activity in long-term were analyzed using linear regression models and general estimating equation models. Pretreatment leisure-time physical activity (LTPA), demographic, and treatment factors, physical fitness, and quality of life (Qol) at baseline were independent factors. Results Exercise levels increased during the first year, and thereafter remained mostly stable. Higher LTPA, higher fitness level, better Qol and older age at baseline were associated with higher physical activity level after adjuvant treatments (p < .001) in multivariate analysis. Higher levels of fatigue (p < .008) and better emotional functioning (p = .017) at baseline were the main factors associated with increased physical activity during the follow-up. Conclusion Previous exercise habits and Qol after adjuvant chemo-, and radiotherapy were the strongest determinants of long-term physical activity levels in breast cancer survivors. Patients with better emotional functioning increased their exercise activity most as did those patients with higher fatigue levels at baseline. Patients suffering from fatigue after adjuvant treatment managed to increase their exercise levels, in contrast to patients with low emotional functioning, and may benefit from physical exercise interventions. Emotionally deprived patients may benefit from psychosocial support to regain their previous exercise levels.peerReviewe