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Additional file 1. Supplementary material-CONSORT diagram.

Additional file 2 : Table 2. Variables included in multiple imputation analyses as predictors of missingness or auxiliary variables.

Additional file 7 : Table 7. Baseline (pre) to post-program changes in patient reported outcomes in Healthy Living after Cancer participants (sensitivity analyses).

Additional file 3 : Table 3. Comparison of eligible participants versus eligible non-participants.

Additional file 6 : Table 6. Patient-reported outcomes in Healthy Living after Cancer participants by Cancer Council (evaluable case analysis).

Additional file 5 : Table 5. Comparison of those who met Healthy Living after Cancer program completion criteria (n = 476) with those who withdrew (n = 310).

Additional file 4 : Table 4. Percentage of participants meeting recommendations before and after Healthy Living after Cancer.

Additional file 8 : Table 8. Patient-reported outcomes in Healthy Living after Cancer program completers by Cancer Council (per-protocol analysis, evaluable cases).

Background Upper-limb dysfunction is a commonly reported side effect of treatment for breast cancer and may include decreased shoulder range of motion (the range through which a joint can be moved) (ROM) and strength, pain and lymphedema. Objectives To review randomized controlled trials (RCTs) evaluating the effectiveness of exercise interventions in preventing, minimi sing, or improving upper-limb dysfunction due to breast cancer treatment.Search methods We searched the Specialised Register of the Cochrane Breast Cancer Group, MEDLINE, EMBASE, CINAHL, and LILACS (to August 2008); contacted experts, handsearched reference lists, conference proceedings, clinical practice guidelines and other unpublished iterature sources. Selection criteria RCTs evaluating the effectiveness and safety of exercise for upper-limb dysfunction. Data collection and analysis Two authors independently performed the data abstraction. Investigators were contacted for missing data. Main results We included 24 studies involving 2132 participants. Ten of the 24 were considered of adequate methodological quality. Ten studies examined the effect of early versus delayed implementation of post-operative exercise. Implementing early exercise was more effective than delayed exercise in the short term recovery of shoulder flexion ROM (Weighted Mean Difference (WMD): 10.6 degrees; 95% Confidence Interval (CI): 4.51 to 16.6); however, early exercise also resulted in a statistically significant increase in wound drainage volume (Standardized Mean Difference (SMD) 0.31; 95% CI: 0.13 to 0.49) and duration (WMD: 1.15 days; 95% CI: 0.65 to 1.65). Fourteen studies examined the effect of structured exercise compared to usual care/comparison. Of these, six were post-operative, three during adjuvant treatment and five following cancer treatment. Structured exercise programs in the post-operative period significantly improved shoulder flexion ROM in the short-term (WMD: 12.92 degrees; 95% CI: 0.69 to 25.16). Physical therapy treatment yielded additional benefit for shoulder function post-intervention (SMD: 0.77; 95% CI: 0.33 to 1.21) and at six-month follow-up (SMD: 0.75; 95% CI: 0.32 to 1.19). There was no evidence of increased risk of lymphedema from exercise at any time point. Authors' conclusions Exercise can result in a significant and clinically meaningful improvement in shoulder ROM in women with breast cancer. In the post-operative period, consideration should be given to early implementation of exercises, although this approach may need to be carefully weighed against the potential for increases in wound drainage volume and duration. High quality research studies that closely monitor exercise prescription factors (e.g. intensity), and address persistent upper-limb dysfunction are needed.

Supplemental material, Supplementary_file_SMO for Automatic associations of breast cancer and heart disease with fruit and vegetables and physical activity by Tanya R Berry, Kerry S Courneya, Colleen M Norris, Wendy M Rodgers and John C Spence in SAGE Open Medicine

Supplemental material, Supplementary_file_SMO for Automatic associations of breast cancer and heart disease with fruit and vegetables and physical activity by Tanya R Berry, Kerry S Courneya, Colleen M Norris, Wendy M Rodgers and John C Spence in SAGE Open Medicine

Purpose: The purpose of this study was to determine associations of objectively assessed moderate-to-vigorous intensity physical activity (MVPA) and sedentary time with psychological health outcomes including depression symptoms, anxiety symptoms, and overall satisfaction with life in colon cancer survivors. Methods: Colon cancer survivors (N = 180) from Alberta, Canada (n = 91), and Western Australia (n = 89) completed a mailed survey that assessed depression symptom severity, state anxiety, and satisfaction with life (SWL). Sedentary time and MVPA were assessed using the Actigraph ® GT3X+ accelerometer (60-s epochs) via a 7-day monitoring protocol. MVPA and sedentary time were corrected for wear time and then examined as quartiles (Q). Multivariate analysis of variance was used to examine associations of MVPA and sedentary time with psychological health. Results: There was a significant association between psychological health outcomes and objectively assessed MVPA [Wilks’ λ = 0.886, F(3382.2) = 2.156, p = 0.024] that suggested a small and significant association between MVPA and SWL (p = 0.032). A significant multivariate analysis of variance (MANOVA) [Wilks’ λ = 0.945, F(3159) = 3.1, p = 0.028] suggested participants meeting guidelines reported significantly fewer anxiety symptoms (M < inf > diff < /inf > = −1.23, p = 0.027) and higher perceptions of SWL (M < inf > diff < /inf > = 3.0, p = 0.008). No significant associations emerged for sedentary time [Wilks’ λ = 0.956, F(9382.3) = 0.788, p = 0.628]. Conclusions: Contrary to previously published research using self-reports, objectively assessed MVPA and sedentary time were not associated with depression symptoms. Objectively assessed MVPA was associated with SWL and anxiety outcomes in colon cancer survivors. Implications for Cancer Survivors: Colon cancer survivors should continue to engage in regular and sustained MVPA for the accrual of psychological health benefits. Refereed/Peer-reviewed