Do no harm: no psychological harm from colorectal cancer screening

Background:

Participation in cancer screening programmes might cause worries in the population outweighting the benefits of reduced mortality. The present study aimed to investigate possible psychological harm of participation in a colorectal cancer (CRC) screening pilot in Norway.

Methods:

In a prospective, randomised trial participants (aged 50–74 years) were invited to either flexible sigmoidoscopy (FS) screening, faecal immunochemical test (FIT), or no screening (the control group; 1 : 1: 1). Three thousand two hundred and thirteen screening participants (42% of screened individuals) completed the Hospital Anxiety and Depression Scale questionnaire as well as the SF-12—a health-related quality of life (HRQOL) questionnaire when invited to screening and when receiving the screening result. A control group was invited to complete the questionnaires only. Two thousand six hundred and eighteen control participants (35% of invited individuals) completed the questionnaire.

Results:

A positive screening result did not increase participants'' level of anxiety or depression, or decrease participants'' level of HRQOL. Participants who received a negative result reported decreased anxiety and improvement on some HRQOL dimensions. However, no change was considered to be of clinical relevance.

Conclusion:

The current study showed no clinically relevant psychological harm of receiving a positive CRC screening result or of participating in FS or FIT screening, in a Norwegian population.     

Neighborhood SES and walkability are related to physical activity behavior in Belgian adults

ObjectiveTo investigate whether neighborhood walkability (higher residential density, land use mix, street connectivity) is positively associated with physical activity in Belgian adults and whether this association is moderated by neighborhood SES.MethodsThe Belgian Environmental Physical Activity Study (BEPAS) was conducted in Ghent, Belgium. Data were collected between May 2007 and September 2008. Twenty-four neighborhoods were selected, stratified on GIS-based walkability and neighborhood SES. In total, 1200 adults (aged 20–65 years; 50 per neighborhood) completed the International Physical Activity Questionnaire and wore an accelerometer for seven days. After omitting participants with missing accelerometer data, the final sample consisted of 1166 adults.ResultsLiving in a high-walkable neighborhood was associated with more accelerometer-based minutes of moderate-to-vigorous physical activity (38.6 vs. 31.8 min/day, p < 0.001), transportational walking and cycling, recreational walking, and less motorized transport (all p < 0.05). Low neighborhood SES was related to more cycling for transport and less motorized transport (all p < 0.05). No interactions between walkability and neighborhood SES were found.ConclusionsThe BEPAS results generally confirmed the findings from Australia and the US showing that, in Europe, walkability is also positively related to physical activity. As neighborhood SES was not a significant moderator, walkability appears beneficial for all economic strata.     

Progressive resistance training and dynamic alignment in osteoarthritis: A single-blind randomised controlled trial

Background

We hypothesised that high intensity progressive resistance training would improve lower limb dynamic alignment and function (lower knee adduction moment, increased muscle strength, and fewer knee osteoarthritis symptoms).

Methods

Women (n = 54) with osteoarthritis in at least one knee were randomised into a 6-month resistance training or a sham-exercise program. The primary outcomes were dynamic shank and knee adduction angles and knee adduction moment of the most symptomatic knee measured with quantitative gait analysis. Secondary outcomes were muscle strength, gait speed, and osteoarthritis symptoms.

Findings

Dynamic alignment and knee adduction moment did not change over time or between groups. Muscle strength improved in both groups over time, but significantly more in the resistance training group (P = 0.002). By contrast, gait velocity and pain improved over time (P ≤ 0.009) in both groups. Improvements in shank adduction angle were related to improvements in self-reported disability (r = 0.381, P = 0.015), but not to changes in muscle strength, gait velocity, or pain (all P > 0.05).

Interpretations

Although muscle strength improved significantly more in the PRT group, the hypothesised reduction in knee adduction moment, shank and knee adduction angles were not evident after either exercise modality. However, improvements in disability and shank adduction angle were significantly directly related. Initial alignment should be used to stratify this population into separate groups when designing future trials and alternative modes of training investigated to potentially enhance beneficial alterations in knee alignment.     

Polymorphisms of the lamina maturation pathway and their association with the metabolic syndrome: the DESIR prospective study

Laminopathies are rare monogenic diseases, some of them exhibiting features of the metabolic syndrome. These diseases are mainly due to mutations in LMNA, encoding A-type lamins. One LMNA polymorphism, rs4641, has been associated with the metabolic syndrome, but results have been controversial. We therefore investigated the effect of single nucleotide polymorphisms (SNPs) in the LMNA gene in combination with four other genes encoding enzymes influencing lamin post-translational maturation on risk of metabolic syndrome (MS). Twenty-three tagging SNPs characterising the haplotypic variability of five genes (LMNA, ICMT, ZMPSTE24, FNTA and FNTB) were genotyped in 3,916 French men and women who took part in the prospective DESIR study. Single locus and haplotype analyses were performed but did not detect any significant association with the risk of MS. No robust interaction between SNPs located in different genes on the risk of MS was identified. In conclusion, we did not observe any convincing evidence that common polymorphisms of the lamina pathway could modulate the risk of MS.