Impairments, activity limitations and participation restrictions 6 and 12 months after breast cancer operation

OBJECTIVE: To describe the impairments of upper body and limbs, activity limitations and participation restrictions 6 and 12 months after operation for breast cancer and to examine the impact of impairments on activity limitations. DESIGN: A prospective survey 6 and 12 months after operation. PATIENTS: Ninety-six breast cancer patients. METHODS: A questionnaire for assessing the impairments, activity limitations and participation restrictions was developed. RESULTS: The most common impairments 6 months after operation were breast and axilla scar tightness, axilla oedema and neck-shoulder pain. At 12-month follow-up the breast scar tightness (p=0.008) and axilla oedema (p=0.023) decreased, and limb ache (p=0.005) increased significantly. The most limiting impairments were axilla oedema and limb numbness 6 months after operation, and at 12-month follow-up axilla oedema. Lifting, carrying and reaching out caused worsening of impairments to more than half of the respondents at 6-month follow-up. Regression analysis showed that many impairments together were determinants of activity limitations and sleep impairment. Participation restrictions were constant. Respondents had not given up participation in activities in the home, but some had abandoned leisure activities and felt that their work ability had decreased. CONCLUSION: Impairments and their impact on activities were frequent and constant. There is an urgent need for developing rehabilitation protocols for breast cancer patients

Effects of the viability of Lactobacillus rhamnosus GG on rotavirus infection in neonatal rats

Peer reviewe

Determinants of adult psychomotor speed : a study of monozygotic twins

The determinants of hand and foot psychomotor speed were investigated in monozygotic twins 35 to 69 years of age. First, the reliability study was conducted to investigate the consistency of the reaction time measurements using the method selected. Second, the effects of exercise, smoking and driving were examined by contrasting co-twins discordant for the factor studied. Finally, the contribution of these factors and others suspected of influencing psychomotor speed were studied using a multivariate model. Recruited from the population-based Finnish Twin Cohort, including 2,050 male monozygotic twin pairs, were 61 relatively healthy twin pairs. Psychomotor speed was determined by simple and choice visual signal tests using the hand and foot, yielding measurement of decision time, movement time, and their sum, reaction time. The consistency of the within-test and between-test sessions was acceptable (r=.49-.99) for both hand and foot measurements. Twins with a history of strenuous and frequent exercise had faster psychomotor speed than their co-twins with histories of moderate, occasional lifetime exercise. Twins with a history of smoking, as well as twins with histories of excessive vehicular driving tended to have slower psychomotor speed than their less exposed co-twins. The major determinant of psychomotor speed, however, was familial aggregation, a combination of genetic and shared early environmental influences, which explained 18-52% of the variation in psychomotor speed, depending on the extremity and psychomotor speed outcome measured. Other determinants accounted for 0- 17% of the variation, with age alone explaining up to 13% of the variation in psychomotor speed. Other factors which had more minor effects were cardiovascular morbidity, associated with impaired psychomotor speed, and strenuous exercise and sedentary work which were associated with slightly faster speeds. These results suggest that promoting a healthy lifestyle that includes vigorous exercise and minimal cardiovascular disease may have a modest effect on reducing the age-related decline in psychomotor speed. A combination of genetics and family environment influences appear to have considerable effect on psychomotor speed in later adulthood, yet much of the variability in psychomotor speed remains unexplained

Pohjois-Karjalan moottorikelkkaurien käyttäjäkysely 2012

Käyttäjäkyselyn avulla kerättiin tietoa ja käyttäjäkokemuksia Pohjois-Karjalan moottorikelkkaurien ja niitä ylläpitävän Pohjois-Karjalan virkistysreitistöyhdistyksen toiminnan kehittämiseksi. Kysymyslomakkeita lähetettiin uraluvan lunastaneille moottorikelkkailijoille syksyllä 2012. Kyselyyn pystyi osallistumaan sähköisen Typala -ohjelmalla toteutetun kyselyn kautta tai paperisella kyselylomakkeella. Vastaajista 77,1 % oli Pohjois-Karjalasta ja 22,9 % Pohjois-Karjalan ulkopuolelta. Käyttäjäkysely osoitti, että tammi- maaliskuu ovat suosituimpia moottorikelkkailu kuukausia Pohjois-Karjalassa. Moottorikelkkailu suuntautuu eniten Joensuun seudulle. Uralupien hinnat jakavat mielipiteitä vahvasti. Pääasiassa lupia pidetään kuitenkin joko edullisina tai kalliina. Suurin osa ostaa koko kauden käsittävän uraluvan. Pohjois-Karjalan moottorikelkkaurien kuntoa pidetään kohtalaisena. Moottorikelkkailijoiden mielestä uria voisivat käyttää myös mönkijät, maastopyöräilijät ja ratsastajat kesäaikaan. Maksullisista palveluista moottorikelkkailijat käyttävät huoltamoja ravitsemuspalveluita. Pohjois-Karjalaan kaivataan uusia moottorikelkkauria, mutta kokonaisuudessa Pohjois-Karjalan moottorikelkkauriin ollaan melko tyytyväisiä.Using the survey , information and user experiences were collected to improve the North Karelian snowmobile tracks and the operation of their maintainer, North Karelian Association for Recreational Trails. Questionnaires were sent to those who had collected their track permits on the fall of 2012. The questionnaire could be answered using the electronic Typala -program or a paper form. 77,1% of the respondents were from North Karelia and 22,9 % outside of North Karelia. Based on the survay , it can be noted that the most popular snowmobiling months in North Karelia are from January to March. Snowmobiling is mostly headed for the Joensuu region. The prices of the track permits strongly divide opinions. The permits are mainly considered to be either inexpensive or expensive. The majority collects a permit that covers the whole season. The condition of the North Karelian snowmobile tracks is considered reasonable. In the opinion of the snowmobilers the tracks could also be used in the summertime by all terrain vehicles, mountain bikers, and horsebackriders. Out of the chargeable services the snowmobilers use service stations and restaurants. North Karelia still needs new snowmobile tracks but as a whole people are fairly pleased with the snowmobile tracks in North Karelia

Postoperative education concerning the use of the upper limb, and exercise and treatment of the upper limb: cross-sectional survey of 105 breast cancer patients

In this retrospective survey we investigated the recall of breast cancer patients (n=105) 6 months after the operation concerning postoperative instructions on exercises for shoulder mobility, and instructions for oedema prevention and treatment, upper limb strength training and the use of the upper limb in daily activities. Patients also described the content in their own words and ranked the instructors who had mostly given this education. Operation type and length of hospital stay did not have any effect on the education recalled, but the age of the respondent had some effect (r=−0.23, p<0.05). The Wilcoxon signed ranks test showed that the most commonly reported item was instructions on shoulder movements (P<0.001). Patients reported that they had more instructions for using the upper limb in daily activities than instructions for strength training (P=0.002) and oedema prevention and treatment (P=0.001). Patients own comments were sometimes conflicting: “Use the upper limb as before and you can even lift weights” and “You cannot drive a car or lift a weight over 3 kg for 6 weeks”. Over half of the respondents named the physiotherapist or physiotherapy assistant as the person who had given them most of the instructions. A medical doctor was ranked in first place by 19% of the patients. Only half of the patients reported that they had some education after hospitalization. This study suggests that postoperative education of breast cancer patients is inconsistent and insufficient to provide knowledge for independent rehabilitation for future