Effects of exercise dose and type during breast cancer chemotherapy on longer-term patient-reported outcomes and health-related fitness: A randomized controlled trial

The Combined Aerobic and Resistance Exercise (CARE) Trial compared different types and doses of exercise performed during breast cancer chemotherapy. Here, we report the longer-term follow-up of patient-reported outcomes, health-related fitness and exercise behavior at 6, 12 and 24 months postintervention. A multicenter trial in Canada randomized 301 breast cancer patients initiating chemotherapy to thrice weekly, supervised exercise consisting of a standard dose of 25–30 min of aerobic exercise (STAN; n = 96), a higher dose of 50–60 min of aerobic exercise (HIGH; n = 101) or a combined dose of 50–60 min of aerobic and resistance exercise (COMB; n = 104) performed for the duration of chemotherapy (median of 17 weeks). Primary outcomes were patient-reported outcomes including quality of life, cancer-related symptoms and psychosocial outcomes. Secondary outcomes were objective health-related fitness (assessed at 12 months only) and self-reported exercise behavior. A total of 269 (89.4%) participants completed patient-reported outcomes at all three follow-up time points and 263 (87.4%) completed the health-related fitness assessment at 12-month follow-up. COMB was significantly superior to (i) STAN for sleep quality at 6-month follow-up (p = 0.027); (ii) HIGH for upper body muscular endurance at 12-month follow-up (p = 0.020); and (iii) HIGH for meeting the resistance exercise guideline at 6-month follow-up (p = 0.006). Moreover, self-reported meeting of the combined exercise guideline during follow-up was significantly associated with better patient-reported outcomes and health-related fitness. Performing combined exercise during and after breast cancer chemotherapy may result in better longer-term patient-reported outcomes and health-related fitness compared to performing aerobic exercise alone.     

The search for the “next” euphoric non-fentanil novel synthetic opioids on the illicit drugs market: current status and horizon scanning

Forensic Toxicology - A detailed review on the chemistry and pharmacology of non-fentanil novel synthetic opioid receptor agonists, particularly N-substituted benzamides and acetamides (known...     

Development of a valid and reliable scale to assess parents’ beliefs and attitudes about childhood vaccines and their association with vaccination uptake and delay in Ghana

Background

Parents’ attitudes and beliefs in vaccination are important to understand for shaping vaccine acceptance and demand interventions. Little research has focused on developing a validated scale to measure parents’ attitudes towards vaccinations in low and middle-income countries; Ghana provided an opportunity develop a caregiver vaccination attitudes scale (CVAS) validated against childhood vaccine compliance.

Developing collaborative approaches to international research: Perspectives of new global health researchers

Within a global context of growing health inequities, the fostering of partnerships and collaborative research have been promoted as playing a critical role in tackling health inequities and health system problems worldwide. Since 2004, the Canadian Coalition for Global Health Research (CCGHR) has facilitated annual Summer Institutes for new global health researchers aimed at strengthening global health research competencies and partnerships among participants. We sought to explore CCGHR Summer Institute alumni perspectives on the Summer Institute experience, particularly on the individual research pairings of Canadian and low- and middle-income countries researchers that have characterised the program. The results reveal that the Summer Institute offered an enriching learning opportunity for participants and worked to further their collaborative projects through providing dedicated one-on-one time with their international research partner, feedback from colleagues from around the world and mentorship by more senior researchers. Positive individual relationships among researchers, as well as the existence of institutional collaborations, employer and funding support, and agendas of local and national politicians were factors that have influenced the ongoing collaboration of partners. There is a need to more fully examine the interplay between individual and institutional-level collaborations, as well as their social and political contexts.     

Social capital and psychosis: a scoping review

Social Psychiatry and Psychiatric Epidemiology - Social capital has been studied as a risk factor for psychotic disorders. The purpose of this scoping review was to scope the literature and...     

Pulse modulated radiofrequency exposure influences cognitive performance

Purpose: To investigate whether exposure to pulse modulated radiofrequency (PM RF) influences human cognitive performance, and whether it does so in a dose-dependent manner.

Materials and methods: Thirty-six healthy adults participated in a randomized, double-blind, counterbalanced provocation study. Cognitive performance was assessed using a visual discrimination task and a modified Sternberg working memory task, which were calibrated to individual performance levels in a preliminary testing session. An sXh920 planar exposure system was used to generate a 920?MHz GSM-like signal, providing three conditions (peak-spatial SAR averaged over 10?g) of 0?W/kg (sham), 1 W/kg (low RF) and 2 W/kg (high RF).

Results: A significant decrease in reaction time (RT) in the Sternberg working memory task was found during exposure compared to sham. This effect was not dose-dependent.

Conclusions: Cognitive performance was shown to be faster under PM RF conditions, relative to sham, in a working memory task. While the majority of the literature has not found effects of PM RF exposure on cognitive performance, it is possible that the methodological improvements employed in the present study increased sensitivity, and thus the ability to detect potential effects.     

The messenger between worlds: the regulation of innate and adaptive type‐2 immunity by innate lymphoid cells

Although type‐2 immune responses evolved primarily to defend against extracellular helminths, in part through the co‐opting of tissue repair and remodeling mechanisms, they are often inappropriately directed towards relatively innocuous allergens resulting in conditions including asthma, allergic rhinitis, food allergy, and atopic dermatitis. The recent discovery of group 2 innate lymphoid cells (ILC2) has increased our understanding of the initiation of these responses and the roles played by CD4⁺ T helper (Th) 2 cells in their modulation. This review focuses on the important messenger role of ILC2 in translating epithelial‐derived alarmins into downstream adaptive type‐2 responses via dendritic cells and T cells, with special emphasis on their roles in allergic disease.     

What we (Should) Talk about when we Talk about Deep Brain Stimulation and Personal Identity

Neuroethics - A number of reports have suggested that patients who undergo deep brain stimulation (DBS) may experience changes to their personality or sense of self. These reports have attracted...     

Relationship between chronic diseases and sleep duration among older adults in Ghana

Quality of Life Research - Aging increases the prevalence of health problems that are often chronic, resulting in more sleep problems for people with poor health or chronic conditions. Relatively...