Exercise as a supportive care strategy in men with prostate cancer receiving androgen deprivation therapy at a regional cancer centre: a survey of patients and clinicians.

PURPOSE: To understand how frequently exercise is discussed and/or prescribed as a supportive care measure and the barriers and facilitators to exercise uptake for men with prostate cancer receiving androgen deprivation therapy (ADT) at a regional cancer centre. METHODS: An observational, cross-sectional study was conducted at a regional cancer centre in three stages: (1) Retrospective chart review of men with prostate cancer undergoing ADT to identify the frequency of discussion and/or prescription of supportive care measures; (2) prospective patient survey exploring barriers and facilitators to exercise; and (3) prospective clinician survey exploring barriers, facilitators and awareness of exercise guidelines in men with prostate cancer. RESULTS: Files of 100 men receiving ADT (mean age 73 years; mean ADT duration =12 months) in the medical oncology (n = 50) and radiation oncology (n = 50) clinics were reviewed. Exercise was discussed with 16% of patients and prescribed directly to 5%. Patient survey (n = 49). 44.2% of patients reported participating in exercise at a high level. Common barriers to exercise participation included fatigue (51.0%), cancer/treatment-related weakness (46.9%) and joint stiffness (44.9%). 36.7% of patients reported interest in a supervised exercise program. Clinician survey (n = 22). 36.4% identified one or more exercise guidelines, and 40.9% correctly identified national exercise guidelines. Clinicians reported low knowledge of referral pathways to a supervised exercise program (27.3%). Clinicians believe physiotherapists (95.5%) are most suited to exercise prescription and 72.7% stated that exercise counselling should be part of supportive care. Limited time (63.6%) and patient safety (59.1%) were the two most common barriers to discussing exercise with patients. Clinicians reported that only 21.9% of their patients asked about exercise. The most endorsed facilitators to increase exercise uptake were patient handouts (90.9%) and integration of exercise specialists into the clinical team (86.4%). CONCLUSION: Despite a third of patient respondents indicating an interest in a supervised exercise program, only 16% of patients with prostate cancer undergoing ADT at a regional cancer centre engaged in a discussion about exercise with their treating clinicians. Physical limitations and fatigue were the greatest barriers for patients. Clinicians indicated a need for more clinician education and better integration of exercise specialists into clinical care. A tailored, integrated approach is needed to improve the uptake of exercise in men with prostate cancer

Breast and Prostate Cancer Risks for Male BRCA1 and BRCA2 Pathogenic Variant Carriers Using Polygenic Risk Scores

BACKGROUND: Recent population-based female breast cancer and prostate cancer polygenic risk scores (PRS) have been developed. We assessed the associations of these PRS with breast and prostate cancer risks for male BRCA1 and BRCA2 pathogenic variant carriers. METHODS: 483 BRCA1 and 1318 BRCA2 European ancestry male carriers were available from the Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA). A 147-single nucleotide polymorphism (SNP) prostate cancer PRS (PRSPC) and a 313-SNP breast cancer PRS were evaluated. There were 3 versions of the breast cancer PRS, optimized to predict overall (PRSBC), estrogen receptor (ER)-negative (PRSER-), or ER-positive (PRSER+) breast cancer risk. RESULTS: PRSER+ yielded the strongest association with breast cancer risk. The odds ratios (ORs) per PRSER+ standard deviation estimates were 1.40 (95% confidence interval [CI] =1.07 to 1.83) for BRCA1 and 1.33 (95% CI = 1.16 to 1.52) for BRCA2 carriers. PRSPC was associated with prostate cancer risk for BRCA1 (OR = 1.73, 95% CI = 1.28 to 2.33) and BRCA2 (OR = 1.60, 95% CI = 1.34 to 1.91) carriers. The estimated breast cancer odds ratios were larger after adjusting for female relative breast cancer family history. By age 85 years, for BRCA2 carriers, the breast cancer risk varied from 7.7% to 18.4% and prostate cancer risk from 34.1% to 87.6% between the 5th and 95th percentiles of the PRS distributions. CONCLUSIONS: Population-based prostate and female breast cancer PRS are associated with a wide range of absolute breast and prostate cancer risks for male BRCA1 and BRCA2 carriers. These findings warrant further investigation aimed at providing personalized cancer risks for male carriers and informing clinical management

A large-scale investigation into drivers of effective retail strategies for wine

Purpose – Little is known about the relationship between distribution and market share in the wine category. Understanding the pattern of the relationship, and subsequently examining the market share variations of individual wine stock-keeping units (SKUs) from expected market share, has the potential to improve the market outcomes of wine brands. Understanding the influences of product and distribution characteristics at the SKU level and incorporating them into marketing strategy and planning has important managerial implications. Design/Methods/Approach – Sales of 3,524 wine SKUs across 4,218 stores and 4 states in the US for the year 2014 are analysed. We use the Reibstein-Farris equation (Reibstein & Farris 1995) to model the relationship between distribution and market share. We then use the market share deviations from the expected values and apply a secondary robust regression to investigate possible relationships between various product- and distribution characteristics and those market share deviations. Findings – The results show that the distribution and market share relationship in the wine category is convex and increasing, in line with previous findings for other consumer-packaged goods in the marketing literature. Beyond distribution breadth, we find that overall brand performance (above), unit price (above), packaging type (above), country-of-origin, grape variety, sales consistency (above) and store specialisation (below) are associated with above or below expected market performance of wine SKUs

The international political economy of educational policy development in Nepal: 1950 – 2020

The modern history of Nepal started after the Kingdom of Nepal was formed during the 1760s through a series of military battles, which is now known as a national unification campaign, led by Prithvi Narayan Shah. The history of mass education, however, started during the 1950s when a political uprising overthrew autocratic Rana regime that had ruled the country for more than a century. This paper aims to explore Nepal’s educational history by analysing key educational policy documents produced by the Government of Nepal as well as its major donor the World Bank from 1950 to 2020. The paper uses international political economy as a theoretical framework and critical policy sociology as a methodological approach. The key argument of the paper is that, since some of the problematic assumptions of modernism, nationalism, and globalism have guided Nepal’s policy agendas, its education system has not addressed multifarious challenges faced by its citizens. The theoretical and methodological approaches taken for exploring the interconnections between education, economy, and politics will be helpful for future researchers to understand the significance of education not only for economic development but also for the institutionalisation of democracy in both developed and developing countries

Awareness, trial and use of heated tobacco products among adult cigarette smokers and e-cigarette users: findings from the 2018 ITC Four Country Smoking and Vaping Survey

OBJECTIVE: To evaluate heated tobacco product (HTP) awareness, trial and current use among adult cigarette smokers and vaping product users in four countries with varying regulations governing HTP sales. DESIGN: Data came from Wave 2 of the ITC Four Country Smoking and Vaping Survey, collected from February to July 2018. Respondents were current and former smokers and/or users of vaping products (18 years or older) from Canada (CA; n=3778), England (EN; n=4848), the USA (US; n=2846) and Australia (AU; n=1515). At the time of the survey, only Canada and England permitted the sale of contemporary HTPs (eg, IQOS). RESULTS: Overall, 30.2% of respondents reported being aware of HTPs (CA=30.4%; EN=31.0%; US=30.2%; AU=27.4%; p=0.346), 2.4% had ever tried HTPs (CA=3.3%; EN=2.4%; US=2.0%; AU=0.9%; p=0.001) and 0.9% currently used HTPs at least monthly (CA=0.8%; EN=1.2%; US=0.7%; AU=0.2%; p<0.001). Trial and current use were higher among those who concurrently smoked and vaped (at least monthly) versus other nicotine use categories (trial: 10.9% v. 1.2%-2.0%, p<0.001; current use: 8.4% v. 0.1%-1.0%, p<0.001). In multivariable analyses, HTP awareness did not differ across countries, whereas odds of trial and current use were lower where HTPs were unavailable. Odds of HTP trial did not differ by regulatory environment when restricting analysis to HTP-aware concurrent smokers-vapers. CONCLUSION: Approximately one third of respondents were aware of HTPs, even in the USA and Australia, where contemporary HTPs were not yet on the market. Trial and use were uncommon, except among concurrent smokers-vapers. Restrictions on availability may have limited HTP use generally, but less so for concurrent smokers-vapers

When Positive Psychology and CSR Collide: Emerging and Prospective Research in Positive CSR

Positive psychology (PP) is concerned with understanding positive human qualities and experiences, optimal functioning, and well-being, with broad applications across the behavioral and social sciences. Past applications of PP in corporate social responsibility (CSR) have been limited. This chapter highlights opportunities that the integration of PP and CSR bring for research and practice. The chapter first introduces the field of PP, acquainting readers with the historical background, aims, and assumptions of the field. Applied to CSR, PP offers organizational scholars an affirmative perspective of the role of business in society, with particular emphasis given to individual and collective human strengths, capabilities, and virtues. We propose Positive CSR, which refers to cross-disciplinary CSR research that integrates PP perspectives, concepts, and theories. To identify emerging trends in Positive CSR, we review prior CSR research that has integrated PP. We conclude by discussing three potential research directions for Positive CSR

Listening to Country: A prison pilot project that connects Aboriginal and Torres Strait Islander women on remand to Country

Research shows that prison programs addressing intergenerational trauma and grief, loss of culture and spiritual healing are necessary for incarcerated Aboriginal and Torres Strait Islander peoples. Indigenous-led or culturally focused programs receive little attention and limited resourcing in Australia’s prison system compared with mainstream rehabilitation programs. Depending on the jurisdiction and prison, such programs can be even less accessible for Aboriginal and Torres Strait Islander women. Listening to Country was an arts-based prison pilot project that was developed by and delivered to Aboriginal and Torres Strait Islander women in the Brisbane Women’s Correctional Centre. It aimed to explore the role of acoustic ecology, soundscape and deep listening in connection to culture and Country. This article presents findings from a process evaluation of that pilot project in order to illustrate the potential for Indigenous-led, culturally focused and culturally safe prison programs to improve wellbeing for incarcerated Indigenous peoples