Can physical activity help to maintain cognitive functioning and psychosocial well-being among breast cancer patients treated with chemotherapy? A randomised controlled trial: study protocol

Background: Evidence suggests chemotherapy treatment for breast cancer is associated with side effects such as cognitive impairment in domains of memory, attention, concentration and executive function. Cognitive impairments reported by patients have been associated with higher levels of emotional distress. To date, intervention studies to alleviate cognitive impairment associated with chemotherapy have focused on psycho-educational techniques or cognitive training. Studies have not yet considered physical activity as a potential for alleviating cognitive problems. Physical activity interventions are reported to be effective in alleviating emotional distress and fatigue in those with breast cancer. They have also been reported to improve cognitive functioning in the elderly, in those suffering with dementia and in children. We propose that physical activity could also help to alleviate cognitive impairments in women diagnosed with breast cancer. The study has been designed using a recently developed taxonomy of behaviour change techniques to reliably report the content of the intervention to allow future replication. Method: This study will deliver a home-based moderate intensity walking intervention to women diagnosed with breast cancer mid-way through their chemotherapy treatment and will compare them to patients receiving usual care alone. The primary outcome measure for this intervention is changes in an objective measure of memory assessed using the Digit Span. Secondary outcome measures include: objective measures of executive function; attention; visual spatial skills; self report cognitive function; self-report fatigue; anxiety; depression; mood and self-esteem. As emotional distress has been associated with self-reporting of cognitive problems, this intervention will further test whether emotional distress mediates between the amount of walking undertaken during the intervention period and levels of self-reported cognitive functioning. Discussion: The development of an effective intervention for preventing difficulties in emotional and cognitive functioning of cancer patients’ post-treatment will help to guide health care professionals to improve patients’ overall quality of life. It will also provide direction for future research, ultimately to improve the day to day functioning of breast cancer survivors. Trial Registration: Current Controlled Trials ISRCTN50709297. Keywords: Intervention, Breast cancer, Chemotherapy, Physical activity, Exercise, Walking, Cognitive function, Emotional distress, Psychosocial well-bein

Control of style-of-faulting on spatial pattern of earthquake-triggered landslides

Predictive mapping of susceptibility to earthquake-triggered landslides (ETLs) commonly uses distance to fault as spatial predictor, regardless of style-of-faulting. Here, we examined the hypothesis that the spatial pattern of ETLs is influenced by style-of-faulting based on distance distribution analysis and Fry analysis. The Yingxiu–Beichuan fault (YBF) in China and a huge number of landslides that ruptured and occurred, respectively, during the 2008 Wenchuan earthquake permitted this study because the style-of-faulting along the YBF varied from its southern to northern parts (i.e. mainly thrust-slip in the southern part, oblique-slip in the central part and mainly strike-slip in the northern part). On the YBF hanging-wall, ETLs at 4.4–4.7 and 10.3–11.5 km from the YBF are likely associated with strike- and thrust-slips, respectively. On the southern and central parts of the hanging-wall, ETLs at 7.5–8 km from the YBF are likely associated with oblique-slips. These findings indicate that the spatial pattern of ETLs is influenced by style-of-faulting. Based on knowledge about the style-of-faulting and by using evidential belief functions to create a predictor map based on proximity to faults, we obtained higher landslide prediction accuracy than by using unclassified faults. When distance from unclassified parts of the YBF is used as predictor, the prediction accuracy is 80%; when distance from parts of the YBF, classified according to style-of-faulting, is used as predictor, the prediction accuracy is 93%. Therefore, mapping and classification of faults and proper spatial representation of fault control on occurrence of ETLs are important in predictive mapping of susceptibility to ETLs