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.
Als gevolg van nieuwe wetgeving zoals Sarbanes-Oxley en gedragscodes als die van de commissie Tabaksblat is het de expliciete verantwoordelijkheid van de directie om te zorgen voor een adequaat en effectief risicomanagement en intern beheersingssysteem. Het is opvallend dat deze nieuwe interne-controlevereisten de kredietcrisis niet hebben kunnen voorkomen in een zo streng gereguleerde bedrijfstak als die van de financiële dienstverlening. De grote vraag is dan ook hoe dit allemaal heeft kunnen gebeuren en welke mogelijke lessen er te trekken zijn.
