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IntroductionPhysical activity can attenuate cancer-related declines in physical functioning, improve emotional well-being, and prolong survival among older (≥65 years) breast cancer survivors. However, factors associated with physical activity among older breast cancer survivors are not well-understood.Materials and methodsParticipants were enrolled in the Women's Health Initiative (WHI) Life and Longevity After Cancer (LILAC) study. Descriptive statistics, multiple linear regression, and relative risk [RR] regression were used to assess the association of demographic, clinical, physical and psychosocial variables with the total duration of and participation in physical activity among postmenopausal breast cancer survivors. Age-specific correlates (65-74 years vs. 75-84 years vs. ≥85 years) of physical activity were also examined.ResultsThe majority of participants (n = 3710, mean age = 78.8 ± 5.9) were white (90.7%) and had in situ/localized breast cancer (78.9%). Women who had higher education (RR = 1.47 for graduate/professional school versus high school or less, 95% CI: 1.32, 1.63), higher self-rated health (RR = 1.04 for 10 point increase, 95% CI:1.02, 1.07), higher physical functioning (RR = 1.03 for 5 point increase, 95% CI: 1.02, 1.04), and higher social support (RR = 1.41 for social support all of the time versus none of the time, 95% CI: 1.01, 1.96), were more likely to engage in any physical activity. Similar results were observed for duration of physical activity. Among women aged

With the advent of new alternative methods for rapid toxicity screening of chemicals comes the need for new statistical methodologies which appropriately synthesize the large amount of data collected. For example, transcriptomic assays can be used to assess the impact of a chemical on thousands of genes, but current approaches to analyzing the data treat each gene separately and do not allow sharing of information among genes within pathways. Furthermore, the methods employed are fully parametric and do not account for changes in distribution shape that may occur at high exposure levels. To address the limitations of these methods, we propose Constrained Logistic Density Regression (COLDER) to model expression data from different genes simultaneously. Under COLDER, the dose‐response function for each gene is assigned a prior via a discrete logistic stick‐breaking process (LSBP) whose weights depend on gene‐level characteristics (e.g., pathway membership) and atoms consist of different dose‐response functions subject to a shape constraint that ensures biological plausibility. The posterior distribution for the benchmark dose among genes within the same pathways can be estimated directly from the model, which is another advantage over current methods. The ability of COLDER to predict gene‐level dose‐response is evaluated in a simulation study and the method is illustrated with data from a National Toxicology Program study of Aflatoxin B1. [ABSTRACT FROM AUTHOR]

Self-efficacy (SE) has been found to be a robust predictor of success in achieving physical activity (PA) goals. While much of the current research has focused on SE as a trait, SE as a state has received less attention. Using day-to-day measurements obtained over 84 days, we examined the relationship between state SE and PA. Postmenopausal women (n = 71) participated in a 12-week PA intervention administered via cell phone and monitored their daily PA using a pedometer. At the end of each day, they reported their state SE and number of steps. Using a longitudinal model, state SE was found to be a robust predictor of PA even after accounting for trait SE and other covariates. The findings offer insights about the temporal relationship between SE and PA over the course of an intervention, which can be of interest to researchers and intervention designers.

Purpose: Due to cancer survivors living longer and morbidity associated with cancer treatments, it is necessary to understand symptoms experienced by cancer survivors. This study will analyze the symptom burden among a large cohort of survivors across multiple cancer sites. Methods: Data from the Women's Health Initiative (WHI) Life and Longevity After Cancer (LILAC) study were used to examine the symptom burden of older cancer survivors. Poisson regression with robust standard errors was utilized to determine differences in symptoms by cancer site, treatment, and other covariates. Results: The most frequently reported symptoms among cancer survivors were fatigue (15.8%) and feeling sad or depressed (14.1%). Multivariable analyses indicated that more symptoms were reported among survivors who were younger (p = 0.002), divorced or separated (p = 0.03), and had a combination of public and private insurance (p = 0.01). Survivors who received chemotherapy (p < 0.001), radiation (p = 0.01), or hormone therapy (p = 0.02) reported more symptoms than survivors who did not receive these treatments. Survivors diagnosed with cancer < 5 years ago reported fewer symptoms than longer-term survivors, particularly those diagnosed > 10 years ago (p = 0.02). Conclusions: Results indicate that common physical and psychological symptoms are reported across cancer types. Cancer survivors diagnosed with cancer 10 or more years ago reported more symptoms than those recently diagnosed. This suggests that symptoms may remain a problem for some survivors decades after their diagnosis. Implications for Cancer Survivors: Future research should focus on implementing active surveillance of cancer survivors. Healthcare providers and those who care for cancer survivors should understand that the symptom burden associated with cancer may persist even decades following diagnosis. [ABSTRACT FROM AUTHOR]

Simple Summary: Approximately 30% of breast cancer survivors experience cancer-related cognitive impairment (CRCI) after cancer treatments. Given that CRCI adversely affects quality of life and increases the risk of stroke and dementia, there is an urgent need to identify who might be more vulnerable to CRCI, and how to improve outcomes. Several studies have suggested the possibility that individuals who are sensitive to uncertainty (i.e., intolerance of uncertainty (IU)) are more likely to experience cognitive problems. Consistent with these studies, our findings also showed that greater IU is associated with higher anxiety, and such higher anxiety lowers perceived cognitive function. While much is still to be learned about this association, this study suggests that identifying those with IU and anxiety could assist with identifying those at higher risk for CRCI and that IU and anxiety may be potential targets for future intervention studies. Cancer-related cognitive impairment (CRCI) is one of the most prevalent symptoms that breast cancer survivors experience. While cancer treatments are established contributors to CRCI, inter-individual differences in CRCI are not well understood. Individual differences in sensitivity to uncertainty are potential contributors to CRCI; however, no prior studies have attempted to examine this link in the context of breast cancer. To address the gap, we used preliminary findings from an ongoing cross-sectional study. A total of 38 women with stage I–III breast cancer (1–4 years post-treatment) were included in this study. Intolerance of uncertainty (IU) was assessed using the Intolerance of Uncertainty Scale. Self-reported cognitive function was assessed with the Neuro-QoL questionnaire. Anxiety was assessed using the Patient-Reported Outcomes Measurement System Bank. From this study, we found that anxiety mediates the association between IU and cognitive function of survivors. In other words, among post-menopausal breast cancer survivors, those with higher IU showed higher anxiety and consequently had lower cognitive function. This finding suggests that assessing IU may help predict the risk of CRCI. This study expands the current knowledge that addresses the importance of IU as a factor associated with cognitive health. [ABSTRACT FROM AUTHOR]