INTRODUCTION: After treatment with chemotherapy, many patients with breast cancer experience cognitive problems. While limited interventions are available to improve cognitive functioning, physical exercise showed positive effects in healthy older adults and people with mild cognitive impairment. The Physical Activity and Memory study aims to investigate the effect of physical exercise on cognitive functioning and brain measures in chemotherapy-exposed patients with breast cancer with cognitive problems.METHODS AND ANALYTICS: One hundred and eighty patients with breast cancer with cognitive problems 2-4 years after diagnosis are randomised (1:1) into an exercise intervention or a control group. The 6-month exercise intervention consists of twice a week 1-hour aerobic and strength exercises supervised by a physiotherapist and twice a week 1-hour Nordic or power walking. The control group is asked to maintain their habitual activity pattern during 6 months. The primary outcome (verbal learning) is measured at baseline and 6 months. Further measurements include online neuropsychological tests, self-reported cognitive complaints, a 3-tesla brain MRI, patient-reported outcomes (quality of life, fatigue, depression, anxiety, work performance), blood sampling and physical fitness. The MRI scans and blood sampling will be used to gain insight into underlying mechanisms. At 18 months online neuropsychological tests, self-reported cognitive complaints and patient-reported outcomes will be repeated.ETHICS AND DISSEMINATION: Study results may impact usual care if physical exercise improves cognitive functioning for breast cancer survivors.TRIAL REGISTRATION NUMBER: NTR6104.
Women want positive birth experiences with high quality maternity care that is neither too much, too soon, nor too little, too late. Research confirms the effectiveness of midwifery care, and the midwifery approach to birth as physiologic may counter the upward trend of the unnecessary medicalization of birth. The role of guardian of physiologic birth is seen as central to midwifery practice; however, medical hegemony has led to the subordination of midwives, which inhibits them in fulfilling the role as guardian of physiologic birth. Learning to become powerful advocates of physiologic birth creates midwives able to speak up for effective, evidence-based maternity care and challenge the unnecessary use of obstetric intervention. Midwifery education has a role to fulfil in molding midwives who are able to assume this role. This brief report describes the development of an educational prototype aimed at increasing student midwife agency as an advocate of physiologic birth. This was done using rapid prototyping (RP) methodology, in which important stakeholders gave input and feedback during the educational design and development process. Input from stakeholders led to the inclusion of persuasive communication strategies and discussion and debate as teaching methodologies in order to increase student midwife agency to argue for physiologic birth. Reflective evidence-based practice, using the Optimality Index-Netherlands, allowed students to reflect on their practice while providing a framework for discussion. Working with the RP methodology allowed for the development of a prototype that reflected the needs of midwifery stakeholders and was mindful of material and human resources.
Purpose: To examine the effects of different small-sided games (SSGs) on physical and technical aspects of performance in wheelchair basketball (WB) players. Design: Observational cohort study. Methods: Fifteen highly trained WB players participated in a single 5v5 (24-s shot clock) match and three 3v3 SSGs (18-s shot clock) on a (1) full court, (2) half-court, and (3) modified-length court. During all formats, players’ activity profiles were monitored using an indoor tracking system and inertial measurement units. Physiological responses were monitored via heart rate and rating of perceived exertion. Technical performance, that is, ball handling, was monitored using video analysis. Repeated-measures analysis of variance and effect sizes (ESs) were calculated to determine the statistical significance and magnitude of any differences between game formats. Results: Players covered less distance and reached lower peak speeds during half-court (P ≤ .0005; ES ≥ very large) compared with all other formats. Greater distances were covered, and more time was spent performing moderate- and high-speed activity (P ≤ .008; ES ≥ moderate) during full court compared with all other formats. Game format had little bearing on physiological responses, and the only differences in technical performance observed were in relation to 5v5. Players spent more time in possession, took more shots, and performed more rebounds in all 3v3 formats compared with 5v5 (P ≤ .028; ES ≥ moderate). Conclusions: Court dimensions affect the activity profiles of WB players during 3v3 SSGs yet had little bearing on technical performance when time pressures (shot clocks) were constant. These findings have important implications for coaches to understand which SSG format may be most suitable for physically and technically preparing WB players. DOI: https://doi.org/10.1123/ijspp.2017-0500 LinkedIn: https://www.linkedin.com/in/rienkvdslikke/ https://www.linkedin.com/in/moniqueberger/
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