Arm Function in Women Treated for Breast Cancer

Background/Purpose: Women with breast cancer (WBC) report decreased function following cancer treatment, yet objective measures of function typically return within the first year after surgery. Kinesiophobia, or fear of physical activity (PA), has been documented following other musculoskeletal pathologies. This study explored the relationships between fear of PA and self-reported arm function, QOL, perceived stress, and objective measures of range of motion (ROM), strength, and muscular endurance in WBC. Methods: Women (n=30) diagnosed with stage 0-3 breast cancer 6-60 months prior to enrollment participated; WBC were excluded with metastatic disease, shoulder pathology, or history of shoulder/neck surgery. Self-reported function was measured with the Penn Shoulder Score; FACT-B QOL, Perceived Stress Scale (PSS), Canadian Occupational Performance Measure (COPM), bilateral flexion, external and internal rotation ROM and strength, and muscular endurance measures were also collected. Relationships between fear of PA and all variables were explored using Pearson’s correlations. Significance was set ≤0.05 a priori. Results:Mean age and BMI were 57 (SD 13.65) and 28.86 (SD 5.17). Mean scores (SD) were: PENN 84.15 points (4.8), FACT-B 110.89 (16.13), FPAX-B 39.22 (11.73), COPM satisfaction 6.34 (1.71) and COPM performance (7.42 (1.19). Fear of PA was significantly correlated to PENN pain and satisfaction subscales (p Conclusion: Fear of PA was associated with self-reported function, QOL, and perceived stress in this population of WBC, while objective measures were not. These findings suggest that personal factors play a significant role in functional recovery. Clinical Relevance: Rehabilitation professionals must address personal factors to ensure complete and successful functional recovery among WBC.https://ecommons.udayton.edu/dpt_symposium/1004/thumbnail.jp

Creating an Interprofessional Collaborative Research Opportunity for Physical and Occupational Therapy Students

Physical therapy (PT) and occupational therapy (OT) professional associations assert the importance that entry-level therapists learn and apply the knowledge and skills necessary for interprofessional collaborative practice; however, the majority of PT and OT programs do not have the other discipline at their university. A challenge exists for the creation of a transparent active learning opportunity promoting interprofessional student engagement when the two professions do not reside in the same university. This case study provides a model for how to feasibly create an interprofessional experience for students in universities that do not include a complementary or collaborative allied health professional program, using various technologies. While creating this collaborative project, we provided opportunities to meet the Interprofessional Education Collaborative’s (IPEC) competencies: a) value/ethics for interprofessional practice, b) roles and responsibilities, c) interprofessional communication, and d) teams and teamwork through participation in a breast cancer survivorship research study. Within this demonstration project, the faculty were able to make “micro level” changes to foster interprofessional collaboration among universities with other allied health profession programs, which may lead to improved health outcomes for our clients

Extending Literacy Work Beyond Our Buildings: The Collaborative Work of Creating a Community Writing Center

YpsiWrites, a community writing center that supports youth and adults, is a collaborative effort among 826michigan, Eastern Michigan University’s Office of Campus and Community Writing, and the Ypsilanti District Library. The authors share the background for this work, the partnerships that sustain it, and the day-to-day realities of operating it. They conclude with ideas for how others might create similar collaborations to extend literacy beyond the walls of schools

Systematics of Desmognathus monticola

Undergraduate Basi

Self-Reported Arm Function Is Associated with Stress and Fear of Physical Activity among Women Treated for Breast Cancer

Background: Self-reported upper extremity function and objective measures are not strongly associated with each other in women treated for breast cancer (BC). It is not known if the lack of relationship between self-reported upper extremity function and objective measurements may be influenced by perceived levels of stress and fear of physical activity. The purpose of this study was to investigate the relationships between self-reported upper extremity function and the following: perceived stress levels (PS), fear of physical activity (FPA), health-related quality of life (HRQOL), and objective measures of upper extremity function among women treated for BC. Methods: This cross-sectional observational study included 23 women diagnosed with breast cancer 12-60 months prior to data collection. Self-reported upper extremity function, PS, HRQOL and FPA were assessed using the Disabilities of the Arm, Shoulder and Hand (DASH), Perceived Stress Scale (PSS), Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B), and Fear of Physical Activity and Exercise for Breast Cancer (FPAX-B), respectively. Objective shoulder measures included range of motion (ROM), strength, and muscular endurance. Results: The DASH was significantly correlated (p\u3c0.001) with the FACT-B, PSS, and FPAX-B (r=-0.863; r= -0.733; r= -0.709 respectively). No significant correlation was found between the DASH and objective measures except non-dominant shoulder endurance (p\u3c0.05, r=-0.432). Conclusions: There is a significant relationship between the self-reported arm function, PS, HRQOL and FPA among women treated for BC. Further research should be done to understand the role that PS and FPA have on the perceived level of upper extremity function that women treated for BC report

Perceived Stress Levels May Impact Upper Extremity Function Among Women Treated for Breast Cancer

Purpose/Hypothesis: Women treated for breast cancer report ongoing upper extremity disability with functional limitations; however, objective measures do not appear to explain the extent of perceived dysfunction. The purpose of this study was to investigate the relationship between perceived stress level, fear of physical activity, self-reported upper extremity function, and objective measures of upper extremity function including range of motion (ROM), strength, and muscular endurance, among women treated for breast cancer. Number of Subjects: 25 Materials/Methods: Women diagnosed with stage I-III breast cancer in the past 12-60 months were evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH), Perceived Stress Scale (PSS), Fear of Physical Activity/Exercise Scale - Breast Cancer (FPAX-B), and the Functional Assessment of Cancer Therapy for Breast Cancer (FACT-B). Bilateral arm flexion, external rotation, and internal rotation ROM and strength were measured with a digital inclinometer and a hand held dynamometer fixed to a stationary device. Bilateral arm muscle endurance was measured using the Upper Limb Lift Test. Descriptive statistics were calculated for all variables and relationships between the PSS, FPAX-B, FACT-B and the DASH and objective measures were analyzed with Pearson’s r. Results: The mean age of participants was 52 (range 31-68), with a mean BMI of 28.07 (SD= 6.6). The mean ROM of shoulder flexion was ≥147°, ER ≥85°, and IR ≥70°. The PSS, FPAX-B, and FACT-B were significantly correlated (p=0.000) with the DASH (r= -.739; r= -.717 and r= .779 respectively). No significant correlation was found between any of the self-reported measures and the objective ROM, strength, or muscular endurance measures. Conclusions: The experience of stress and fear of physical activity appear to result in lower levels of self-reported upper extremity function despite adequate motion, strength, and muscular endurance. Perceived stress and other cognitive constructs may explain the apparent difference between objective and perceived measures of function currently observed in this population. Further exploration into the cognitive and psychological effect of a breast cancer diagnosis and the associated impact on self-perceived function is warranted. Clinical Relevance: Investigating the impact of stress and fear of physical activity on self-perceived upper extremity function in women treated for breast cancer may help clinicians identify and address barriers to recovery for this population

Perceived Stress Levels May Impact Upper Extremity Function Among Women Treated for Breast Cancer. American Congress of Rehabilitation Medicine

Women treated for breast cancer report ongoing disability in their involved upper extremity, however, often objective measures do not appear to explain the level of perceived dysfunction. The purpose of this study was to investigate the relationship between perceived stress level, fear of physical activity and self-reported upper extremity function among women treated for breast cancer

Building spaces for controversial public engagement – Exploring and challenging democratic deficits in NHS marketization

The Brighton Citizen's Health Services Survey (BCHSS) was developed to explore and potentially challenge how knowledge is used and by whom in the production of local health commissioning institutions and relations. Through the creation of an ‘animating set of questions’, it sought to open up spaces through which to make visible some of the ways of knowing and valuing the NHS and health services that had been minimised through the commensuration practices of post-2012 public engagement. In this way there was a clear agenda to facilitate a form of knowledge democratisation which opened up and validated different 'health publics’, in order to explore and broaden participative engagement opportunities. The paper provides an account of the project. It considers the theoretical and methodological underpinnings of this example of ‘evidence-based activism’, reflects on the impact of the project on local commissioning and considers the range of controversies that arose as a result of the work. It explores the way that research straddling the boundary between academic inquiry and political activism speaks to the many issues that are prevalent in the changing HE sector as well as NHS privatisation, health commissioning and public sector cuts

Growth, development, and phenotypic spectrum of individuals with deletions of 2q33.1 involving SATB2

SATB2-Associated syndrome (SAS) is an autosomal dominant, multisystemic, neurodevelopmental disorder due to alterations in SATB2 at 2q33.1. A limited number of individuals with 2q33.1 contiguous deletions encompassing SATB2 (ΔSAS) have been described in the literature. We describe 17 additional individuals with ΔSAS, review the phenotype of 33 previously published individuals with 2q33.1 deletions (n = 50, mean age = 8.5 ± 7.8 years), and provide a comprehensive comparison to individuals with other molecular mechanisms that result in SAS (non-ΔSAS). Individuals in the ΔSAS group were often underweight for age (20/41 = 49%) with a progressive decline in weight (95% CI = −2.3 to −1.1, p \u3c 0.0001) and height (95% CI = −2.3 to −1.0, p \u3c 0.0001) Z-score means from birth to last available measurement. ΔSAS individuals were often noted to have a broad spectrum of facial dysmorphism. A composite image of ΔSAS individuals generated by automated image analysis was distinct as compared to matched controls and non-ΔSAS individuals. We also present additional genotype–phenotype correlations for individuals in the ΔSAS group such as an increased risk for aortic root/ascending aorta dilation and primary pulmonary hypertension for those individuals with contiguous gene deletions that include COL3A1/COL5A2 and BMPR2, respectively. Based on these findings, we provide additional care recommendations for individuals with ΔSAS variants

EAACI guidelines on the diagnosis of IgE‐mediated food allergy

This European Academy of Allergy and Clinical Immunology guideline provides recommendations for diagnosing IgE‐mediated food allergy and was developed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Food allergy diagnosis starts with an allergy‐focused clinical history followed by tests to determine IgE sensitization, such as serum allergen‐specific IgE (sIgE) and skin prick test (SPT), and the basophil activation test (BAT), if available. Evidence for IgE sensitization should be sought for any suspected foods. The diagnosis of allergy to some foods, such as peanut and cashew nut, is well supported by SPT and serum sIgE, whereas there are less data and the performance of these tests is poorer for other foods, such as wheat and soya. The measurement of sIgE to allergen components such as Ara h 2 from peanut, Cor a 14 from hazelnut and Ana o 3 from cashew can be useful to further support the diagnosis, especially in pollen‐sensitized individuals. BAT to peanut and sesame can be used additionally. The reference standard for food allergy diagnosis is the oral food challenge (OFC). OFC should be performed in equivocal cases. For practical reasons, open challenges are suitable in most cases. Reassessment of food allergic children with allergy tests and/or OFCs periodically over time will enable reintroduction of food into the diet in the case of spontaneous acquisition of oral tolerance