Background: There is a growing population of survivors of colorectal cancer (CRC). Fatigue and insomnia are common symptoms after CRC, negatively influencing health-related quality of life (HRQoL). Besides increasing physical activity and decreasing sedentary behavior, the timing and patterns of physical activity and rest over the 24-h day (i.e. diurnal rest-activity rhythms) could also play a role in alleviating these symptoms and improving HRQoL. We investigated longitudinal associations of the diurnal rest-activity rhythm (RAR) with fatigue, insomnia, and HRQoL in survivors of CRC.
Methods: In a prospective cohort study among survivors of stage I-III CRC, 5 repeated measurements were performed from 6 weeks up to 5 years post-treatment. Parameters of RAR, including mesor, amplitude, acrophase, circadian quotient, dichotomy index, and 24-h autocorrelation coefficient, were assessed by a custom MATLAB program using data from tri-axial accelerometers worn on the upper thigh for 7 consecutive days. Fatigue, insomnia, and HRQoL were measured by validated questionnaires. Confounder-adjusted linear mixed models were applied to analyze longitudinal associations of RAR with fatigue, insomnia, and HRQoL from 6 weeks until 5 years post-treatment. Additionally, intra-individual and inter-individual associations over time were separated.
Results: Data were available from 289 survivors of CRC. All RAR parameters except for 24-h autocorrelation increased from 6 weeks to 6 months post-treatment, after which they remained relatively stable. A higher mesor, amplitude, circadian quotient, dichotomy index, and 24-h autocorrelation were statistically significantly associated with less fatigue and better HRQoL over time. A higher amplitude and circadian quotient were associated with lower insomnia. Most of these associations appeared driven by both within-person changes over time and between-person differences in RAR parameters. No significant associations were observed for acrophase.
Conclusions: In the first five years after CRC treatment, adhering to a generally more active (mesor) and consistent (24-h autocorrelation) RAR, with a pronounced peak activity (amplitude) and a marked difference between daytime and nighttime activity (dichotomy index) was found to be associated with lower fatigue, lower insomnia, and a better HRQoL. Future intervention studies are needed to investigate if restoring RAR among survivors of CRC could help to alleviate symptoms of fatigue and insomnia while enhancing their HRQoL.
Trial Registration: EnCoRe study NL6904 ( https://www.onderzoekmetmensen.nl/ ).
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http://dx.doi.org/10.1186/s12966-024-01601-x | DOI Listing |
Int J Nurs Stud
December 2024
School of Nursing, Inha University, Incheon, South Korea. Electronic address:
Background: Cancer survivors may have a variety of survivorship concerns despite their cancer treatment having ended, with some negatively affecting their health-related quality of life. An in-depth understanding of survivorship concerns is essential for the development of survivorship care programs. However, previous findings have been limited to Western countries, and evidence from Asian countries is lacking.
View Article and Find Full Text PDFBMC Infect Dis
December 2024
Department of Infectious Diseases, Peking University Third Hospital, Beijing, China.
Objective: We aim to investigate whether Coronavirus disease 2019 (COVID-19) worsens chronic hepatitis B virus(HBV)infection and explore the incidence of long COVID symptoms in patients with chronic hepatitis B virus infection.
Methods: Patients with chronic HBV infection and COVID-19 patients attending the hepatitis clinic or fever clinic were included in the study. Clinical manifestations of COVID-19 and information about long COVID were collected for all patients.
Support Care Cancer
December 2024
School of Nursing, Hunan Normal University, Changsha, China.
Purpose: To clarify the implementation steps, characteristics, effects, acceptability, and feasibility of the stepped care model (SCM) while also offering a resource for pertinent interventions in cancer care.
Methods: We searched the PubMed, Embase, CINAHL, Web of Science, the Cochrane Library, and PsycINFO databases from inception to October 22, 2023. Two key concepts were used: cancer and stepped care model.
J Neurotrauma
December 2024
Center for Neurologic Studies, Boca Raton, Florida, USA.
Traumatic brain injury (TBI) is frequently associated with hypopituitarism. The hypothalamic-pituitary axis appears to be susceptible to the same forces that cause injury to the parenchyma of the brain. Following even a mild TBI (mTBI), patients may suffer transient or permanent decreases in anterior pituitary hormones, including somatotropin (growth hormone [GH]), gonadotropins (luteinizing hormone and follicle-stimulating hormone), thyrotropin, and adrenocorticotropic hormone, with the most frequent long-term deficiency being GH deficiency (GHD).
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