Feasibility of a multidisciplinary intervention to help cancer patients return to work.

This study evaluates feasibility of a multidisciplinary intervention combining occupational counselling with physical exercise to enhance cancer patients' return to work, assesses whether care providers and patients were satisfied with the intervention, and describes barriers to and facilitators of execution. Newly diagnosed cancer patients, treated with chemotherapy and on sick leave from (self-)employment participated. Patients received counselling from an oncological occupational physician (OOP), were assessed by a sports physician, and performed a 12-week training programme supervised by physiotherapists. Care providers completed registration forms to collect data on reach, dose delivered and received in executing the protocol and were interviewed about their satisfaction and barriers to and facilitators of execution. Patients completed three questionnaires on satisfaction and usefulness of the intervention. Fifty-six per cent of all patients were eligible (reach). In total, 123 patients participated. For all intervention components dose delivered exceeded 75%; dose received ranged from 49%-79%. Overall, patients and care providers were satisfied and perceived the intervention as useful. Care providers considered the intervention feasible, while execution was facilitated by highly motivated patients and impeded by physical limitations hindering exercise. It is feasible to conduct this multidisciplinary intervention in cancer patients during curative treatment. Patients and care providers were satisfied with the intervention.

Identification and functional characterization of rare SHANK2 variants in schizophrenia.

Recent genetic data on schizophrenia (SCZ) have suggested that proteins of the postsynaptic density of excitatory synapses have a role in its etiology. Mutations in the three SHANK genes encoding for postsynaptic scaffolding proteins have been shown to represent risk factors for autism spectrum disorders and other neurodevelopmental disorders. To address if SHANK2 variants are associated with SCZ, we sequenced SHANK2 in 481 patients and 659 unaffected individuals. We identified a significant increase in the number of rare (minor allele frequency<1%) SHANK2 missense variants in SCZ individuals (6.9%) compared with controls (3.9%, P=0.039). Four out of fifteen non-synonymous variants identified in the SCZ cohort (S610Y, R958S, P1119T and A1731S) were selected for functional analysis. Overexpression and knockdown-rescue experiments were carried out in cultured primary hippocampal neurons with a major focus on the analysis of morphological changes. Furthermore, the effect on actin polymerization in fibroblast cell lines was investigated. All four variants revealed functional impairment to various degrees, as a consequence of alterations in spine volume and clustering at synapses and an overall loss of presynaptic contacts. The A1731S variant was identified in four unrelated SCZ patients (0.83%) but not in any of the sequenced controls and public databases (P=4.6 × 10(-5)). Patients with the A1731S variant share an early prodromal phase with an insidious onset of psychiatric symptoms. A1731S overexpression strongly decreased the SHANK2-Bassoon-positive synapse number and diminished the F/G-actin ratio. Our results strongly suggest a causative role of rare SHANK2 variants in SCZ and underline the contribution of SHANK2 gene mutations in a variety of neuropsychiatric disorders.

Effect of patellar strap and sports tape on pain in patellar tendinopathy: A randomized controlled trial.

Numerous athletes with patellar tendinopathy (PT) use a patellar strap or sports tape during sports. This study's aim was to investigate the short-term effect of these orthoses on patellar tendon pain. Participants performed the single-leg decline squat, vertical jump test, and triple-hop test under four different conditions (patellar strap, sports tape, placebo, and control). Subsequently, participants practiced sports as usual for 2 weeks; during 1 week, they were assigned to one of the four conditions. Pain was measured with the visual analog scale (VAS). In total, 97 athletes with PT [61% male, age 27.0 (SD8.1), VISA-P 58.5 (SD12.7)] were analyzed. On the single-leg decline squat, the VAS pain score reduced significantly in the patellar strap (14 mm, P = 0.04) and the sports tape condition (13 mm, P = 0.04), compared with control, but not placebo. A significant decrease in VAS pain during sports was found in the sports tape (7 mm, P = 0.04) and placebo group (6 mm, P = 0.04). The VAS pain score two hours after sports decreased significantly in the patellar strap, sports tape and placebo group (8-mm, P < 0.001, 10 mm, P = 0.001 and 7 mm, P = 0.03, respectively). This study's findings indicate that an orthosis (including placebo tape) during sports can reduce pain in PT patients in the short term.