Exercise for health: a randomized, controlled trial evaluating the impact of a pragmatic, translational exercise intervention on the quality of life, function and treatment-related side effects following breast cancer

Exercise for Health was a randomized, controlled trial designed to evaluate two modes of delivering (face-to-face [FtF] and over-the-telephone [Tel]) an 8-month translational exercise intervention, commencing 6-weeks post-breast cancer surgery (PS). Outcomes included quality of life (QoL), function (fitness and upper body) and treatment-related side effects (fatigue, lymphoedema, body mass index, menopausal symptoms, anxiety, depression and pain). Generalised estimating equation modelling determined time (baseline [5 weeks PS], mid-intervention [6 months PS], post-intervention [12 months PS]), group (FtF, Tel, Usual Care [UC]) and time-by-group effects. 194 women representative of the breast cancer population were randomised to the FtF (n = 67), Tel (n = 67) and UC (n = 60) groups. There were significant (p < 0.05) interaction effects on QoL, fitness and fatigue with differences being observed between the treatment groups and the UC group. Trends observed for the treatment groups were similar. The treatment groups reported improved QoL, fitness and fatigue over time and changes observed between baseline and post-intervention were clinically relevant. In contrast, the UC group experienced no change, or worsening QoL, fitness and fatigue, mid-intervention. Although improvements in the UC group occurred by 12-months post-surgery, the change did not meet the clinically relevant threshold. There were no differences in other treatment-related side effects between groups. This translational intervention trial, delivered either FtF or Tel, supports exercise as a form of adjuvant breast cancer therapy that can prevent declines in fitness and function during treatment and optimise recovery post-treatment

The Working After Cancer Study (WACS): a population-based study of middle-aged workers diagnosed with colorectal cancer and their return to work experiences

<p>Abstract</p> <p>Background</p> <p>The number of middle-aged working individuals being diagnosed with cancer is increasing and so too will disruptions to their employment. The aim of the Working After Cancer Study is to examine the changes to work participation in the 12 months following a diagnosis of primary colorectal cancer. The study will identify barriers to work resumption, describe limitations on workforce participation, and evaluate the influence of these factors on health-related quality of life.</p> <p>Methods/Design</p> <p>An observational population-based study has been designed involving 260 adults newly-diagnosed with colorectal cancer between January 2010 and September 2011 and who were in paid employment at the time they were diagnosed. These cancer cases will be compared to a nationally representative comparison group of 520 adults with no history of cancer from the general population. Eligible cases will have a histologically confirmed diagnosis of colorectal cancer and will be identified through the Queensland Cancer Registry. Data on the comparison group will be drawn from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. Data collection for the cancer group will occur at 6 and 12 months after diagnosis, with work questions also asked about the time of diagnosis, while retrospective data on the comparison group will be come from HILDA Waves 2009 and 2010. Using validated instruments administered via telephone and postal surveys, data will be collected on socio-demographic factors, work status and circumstances, and health-related quality of life (HRQoL) for both groups while the cases will have additional data collected on cancer treatment and symptoms, work productivity and cancer-related HRQoL. Primary outcomes include change in work participation at 12 months, time to work re-entry, work limitations and change in HRQoL status.</p> <p>Discussion</p> <p>This study will address the reasons for work cessation after cancer, the mechanisms people use to remain working and existing workplace support structures and the implications for individuals, families and workplaces. It may also provide key information for governments on productivity losses.</p> <p>Study Registration</p> <p>Australian and New Zealand Clinical Trial Registry No. <a href="http://www.anzctr.org.au/ACTRN12611000530921.aspx">ACTRN12611000530921</a></p

Jahn-Teller effect in the ground and excited states of MnO42- doped into Cs2SO4

The polarized low-temperature absorption spectra of the 3d(1) ion MnO42- in the Cs2SO4 host consist of a very weak, highly-structured band in the near-infrared (NIR) region corresponding to the (2)E-->T-2(2)(d-->d) transition and a series of intense ligand-to-metal charge transfer (LMCT) excitations above 16 000 cm(-1). As a result of the low-symmetry crystal-field (CF) potential in Cs2SO4 the T-2(2) ligand-field (LF) state of MnO42- is split into its three orbital components at 10 557, 10 848, and 10 858 cm(-1) above the ground state. The lowest-energy component serves as initial state for broadband luminescence to the (2)E ground state, exhibiting unusually well-resolved fine structure at 15 K. The orbital splitting of (2)E is 969 cm(-1) and thus larger by more than 1 order of magnitude and of opposite sign compared to the result of a ligand-field calculation within the angular-overlap model (AOM). This discrepancy is explained with the large contribution of the second-nearest neighbor Cs+ ions to the CF potential of MnO42- in the Cs2SO4 host lattice. The vibrational progressions in the (2)EtT-2(2) absorption and luminescence spectra are dominated by O-Mn-O bending modes. This is the result of a weak Exe and a stronger T(2)xe Jahn-Teller (JT) effect in the ground and excited LF states, respectively. The observed vibronic levels in the luminescence spectrum are fitted with a single-mode Exe JT Hamiltonian with an additional term representing the noncubic CF potential, in Cs2SO4. The JT effect in the T-2(2) LF state causes a large displacement of the emitting level along the two coordinates of the e mode and thus substantially. affects the intensity distribution in the luminescence spectrum. The fitted linear and quadratic vibronic constants for the (2)E ground state are 91 and 12 cm(-1), respectively, and for the T-2(2) excited state the Linear coupling constant is -790 cm(-1). The corresponding JT stabilization energies are 14 and 925 cm(-1) for (2)E and T-2(2), respectively. (C) 1996 American Institute of Physics

Quality of life detriments through self-reported swelling associated with gynaecological cancer

Background and aims: \ud Lower-limb lymphoedema is a serious and feared sequela after treatment for gynaecological cancer. Given the limited prospective data on incidence of and risk factors for lymphoedema after treatment for gynaecological cancer we initiated a prospective cohort study in 2008.\ud \ud Methods: \ud Data were available for 353 women with malignant disease. Participants were assessed before treatment and at regular intervals after treatment for two years. Follow-up visits were grouped into time-periods of six weeks to six months (time 1), nine months to 15 months (time 2), and 18 months to 24 months (time 3). Preliminary data analyses were undertaken up to time 2 using generalised estimating equations to model the repeated measures data of Functional Assessment of Cancer Therapy-General (FACT-G) quality of life (QoL) scores and self-reported swelling at each follow-up period (best-fitting covariance structure).\ud \ud Results: \ud Depending on the time-period, between 30% and 40% of patients self-reported swelling of the lower limb. The QoL of those with self-reported swelling was lower at all time-periods compared with those who did not have swelling. Mean (95% CI) FACT-G scores at time 0, 1 and 2 were 80.7 (78.2, 83.2), 83.0 (81.0, 85.0) and 86.3 (84.2, 88.4), respectively for those with swelling and 85.0 (83.0, 86.9), 86.0 (84.1, 88.0) and 88.9 (87.0, 90.7), respectively for those without swelling.\ud \ud Conclusions: \ud Lower-limb swelling adversely influences QoL and change in QoL over time in patients with gynaecological cancer