This study investigated the association of fatigue and cognitive complaints among employees post-cancer diagnosis, with work-related outcomes, and moderation by cancer-related anxiety. A survey was carried out among workers 2–10 years after cancer diagnosis. Employees without cancer recurrence or metastases were selected (N = 566). Self-reported fatigue and cognitive complaints were classified into three groups. ANOVA’s and regression analyses were used, controlling for age. Group 1 (cognitive complaints, n = 25, 4.4%), group 2 (fatigue, n = 205, 36.2%), and group 3 (cognitive complaints and fatigue, n = 211, 37.3%) were associated with higher burnout complaints and lower work engagement, and group 2 and 3 with lower work ability. Cancer-related anxiety positively moderated the association of group 3 with higher burnout complaints. Employees with both fatigue and cognitive complaints report less favorable work functioning. Cancer-related anxiety needs attention in the context of burnout complaints.
BACKGROUND: Patients with glioma often suffer from cognitive deficits. Physical exercise has been effective in ameliorating cognitive deficits in older adults and neurological patients. This pilot randomized controlled trial (RCT) explored the possible impact of an exercise intervention, designed to improve cognitive functioning in glioma patients, regarding cognitive test performance and patient-reported outcomes (PROs).METHODS: Thirty-four clinically stable patients with World Health Organization grades II/III glioma were randomized to a home-based remotely coached exercise group or an active control group. Patients exercised 3 times per week for 20-45 minutes, with moderate to vigorous intensity, during 6 months. At baseline and immediate follow-up, cognitive performance and PROs were assessed with neuropsychological tests and questionnaires, respectively. Linear regression analyses were used to estimate effect sizes of potential between-group differences in cognitive performance and PROs at 6 months.RESULTS: The exercise group (n = 21) had small- to medium-sized better follow-up scores than the control group (n = 11) on several measures of attention and information processing speed, verbal memory, and executive function, whereas the control group showed a slightly better score on a measure of sustained selective attention. The exercise group also demonstrated small- to medium-sized better outcomes on measures of self-reported cognitive symptoms, fatigue, sleep, mood, and mental health-related quality of life.CONCLUSIONS: This small exploratory RCT in glioma patients provides a proof of concept with respect to improvement of cognitive functioning and PROs after aerobic exercise, and warrants larger exercise trials in brain tumor patients.
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.
Goed slapen is van belang voor de gezondheid, de alertheid en stressreductie van mensen. Echter kampen veel mensen met slaapproblemen, waarbij chronisch slecht slapen kan leiden tot o.a. cognitieve problemen (depressie en dementie) en het heeft een negatief effect op de kwaliteit van leven. Kwaliteit van slapen hangt samen met hoe de slaap wordt ervaren en of iemand voldoende uitrust en tevreden is over de slaap, echter is 63% van de Nederlanders ontevreden over de eigen slaapkwaliteit. Dit project richt zich op volwassenen met slaapproblemen. Door middel van co-creatie wordt er gewerkt aan een digitale slaapcoach, als verlengstuk van een slaapexpert. Uitgangspunt van de coach is de eerder ontwikkelde voedingscoach Halloliz. De nieuwe slaapcoach helpt bij het in kaart brengen van individuele factoren die de slaapkwaliteit verminderen, bij het verbeteren van slaapgedrag en bij het bestendigen hiervan. Er wordt gebruik gemaakt van Cognitive Behavior Therapy for Insomnia, waarbij het effect van interventies op slaapgedrag direct wordt verwerkt in een aangepast slaapplan. Het project richt zich op het ontwikkelen van een slaapcoach rekening houdend met adoptie en motivatie van de doelgroep om de coach te gebruiken. Adoptie hangt onder andere samen met de vorm en uitstraling van de slaapcoach, maar ook met de bereidheid van de gebruiker om het gedrag te veranderen. Daarnaast speelt motivatie een belangrijke rol bij het bestendigen van gedragsverandering. In het project wordt de patient journey in kaart gebracht en wordt uitgezocht hoe het ontwerp van de coach kan worden geoptimaliseerd richting adoptie, motivatie en uiteindelijk de gewenste gedragsverandering. Een consortium van experts in het ontwerpen (co-creatie) van eHealth oplossingen en gebruikersonderzoek zal het project uitvoeren. Deze worden bijgestaan door een klankbordgroep bestaande uit onder andere slaapexperts.
More and more aged people are joining the traffic, either using a passenger car or through a special low speed two-seater for in-city use. For elderly people, self-management in staying mobile is an essential part of their quality of life. However, with increased involvement of elderly in traffic, the risk of serious accidents increases, especially in cities. Fortunately, a rapid development of innovative technology is shown in vehicle design, with focus on advanced driver support, herewith referred to as ‘ambient intelligence’. This holds a promise to improve the safety situation, under the condition that adaption to the elderly driver’s need is accounted for. And that is not a straightforward issue, since ‘no size fits all’. With increasing age, we see an increased variety in driving skills with emphasis on cognitive, perceptual and physical limitations. In addition, people may suffer from diseases with a neurological background or other (cardiopulmonary disease, obesity or diabetes). The partners in this project have expressed the need to survey the feasibility of ‘ambient intelligence’ technology for low-speed vehicles also addressing E-Health functions to bring people safely home or involve medical help in case of health-critical situations. The MAX Mobiel make their vehicle available for that, and will help to guard the elder customer demand. The HAN Automotive Research team carries out the research, in cooperation with the HAN professorship on E-Health. Hence, both the automotive technology part of the HAN University of Applied Sciences as well as expertise from the Health oriented part of the HAN are included, being essential to successfully extend the relevant technologies to a fully integrated elderly driver support system, in the future. Noldus Information Technology is involved on the basis of their knowledge in human monitoring (drive lab) and data synchronization. The St. Maartenskliniek (Nijmegen) brings in their experience with people being restricted in physical or neurological sense.
