Physical activity and quality of life in cancer 3 survivors: A meta-synthesis of qualitative research

Qualitative research on the impact of physical activity on quality of life (QoL) in adults diagnosed with cancer is accumulating. However, the fields of physical activity and cancer survivorship lack a synthesis of this research to reliably understand the implications for future research and practice. The aim of this meta-synthesis was to identify, appraise, and synthesize qualitative research on cancer survivors’ perspectives of the impact of physical activity on their QoL. Seven electronic databases were searched for original studies published in English, and reference lists of relevant studies were hand-searched to identify additional studies. Forty studies met eligibility criteria and were included in this meta-synthesis. Study characteristics and major findings were extracted, and findings were summarized, compared, and synthesized. Themes identified in this review revealed that physical activity positively impacted four dimensions of cancer survivors’ QoL: physical (e.g., managing the physical consequences of cancer and its treatment), psychological (e.g., evoking positive self-perceptions), social (e.g., feeling understood by others), and spiritual (e.g.,redefining life purpose). This meta-synthesis corroborates conclusions resulting from the synthesis of quantitative research and illustrates that physical activity can be used to improve QoL in adult cancer survivors, regardless of type of diagnosis (i.e., stage, cancer type) and treatment status. It also provides insight into which specific aspects within each dimension of QoL were impacted by physical activity from cancer survivors’ perspectives, which is important for understanding the meaning and utility of physical activity for them. However, more work remains to further develop the qualitative evidence base to better understand how physical activity impacts QoL in men, younger survivors, and those diagnosed with less common types of cancer at different points along cancer trajectory (i.e., diagnosis, treatment, post-treatment, palliation)

Modelling-based methodological approach to assess the effect of urbanization on hydrology and runoff water quality: a case of study for tropical and dry regions

ABSTRACT: It is necessary to have unified tools and methodologies for the correct understanding and quantification of urbanization effects on watershed hydrology. This study presents a modelling-based methodology developed on EPA SWMM to evaluate the effect of urbanization in conceptual watersheds using meteorological data from cities in Spain and Colombia. Results show that the effect of urbanization is significant in variables such as runoff volume, peak flow and pollutant loads, increasing these indicators in all cases. Furthermore, this effect has different dynamics for the regions evaluated. Overall, Colombian cities presented higher runoff volumes, peak flows and pollutant loads, while Spanish cities presented higher variability in these variables due to urbanization. The analysis allowed to cluster the cities within each country, using as criteria the modelled hydrological behaviour. A curve fitting procedure presented high performance rates for all the variables studied.This work was supported by the ‘Instituto Colombiano de Crédito Educativo y Estudios Técnicos en el Exterior’ (ICETEX) under the program ‘Pasaporte a la Ciencia’ granted to the first author under grant number 5334506

Changing cultural beliefs contributing to breast cancer deaths

Session presented on Sunday, July 27, 2014: Purpose: Chicago has one of the largest disparities in breast cancer mortality in the nation, with African American death rates twice that of Caucasians at its peak. Previous work of our team showed that the cultural beliefs we identified were associated with (1) longer delays after finding a suspicious breast symptom, (2) later stage of breast cancer at diagnosis, and (3) longer delays between diagnosis and the start of treatment for African American women. The purpose of this study was to determine whether cultural beliefs about breast cancer could be changed by viewing a short film on DVD followed by at question and answer session, which would provide a simple, cost-effective technique that could be widely disseminated. Methods: A 14-minute film on DVD was produced, in which five African American cancer survivors address the cultural beliefs identified in our earlier work, speaking compellingly in their own words. A pretest-posttest design was used to evaluate the DVD, with 260 African American women participating in community settings. Cultural beliefs were evaluated by questionnaire before and after watching the DVD, and again after a question and answer period led by an African American nurse, all in one continuous session lasting 90 minutes. Results: Changes in beliefs were found for the entire intervention (DVD plus Q&A), with the largest change occurring after watching the DVD, as shown by logistic regression (p \u3c.0001). Significant changes were found for total cultural belief scores, as well as specific beliefs. One of the most important beliefs that increased was endorsement of idea that breast cancer can be cured if treated correctly, even for poor women. There was a decrease in the belief that breast cancer would grow faster if it were cut open in surgery. Examples of faith-based beliefs that changed were faith in God can protect you from breast cancer and prayer can make breast lumps disappear. Ninety-nine percent considered the DVD to be worth watching, and 79% stated that it helped them decide to get screened for breast cancer (other women reported that they were already participating in screening). Conclusion: This is the first study we are aware of that demonstrated that cultural beliefs about breast cancer can be changed by viewing a short film on DVD. This DVD provides a simple, cost-effective technique that can be easily used for wide dissemination, with the goal of reducing disparities in breast cancer mortality. Our team is currently conducting a dissemination project focused on the south side of Chicago with the DVD. To date more than 8,500 women have participated in the project. The film has been endorsed by the American Cancer Society and was selected for a national Telly Award

Acute tropical pulmonary eosinophilia: characterization of the lower respiratory tract inflammation and its response to therapy

Although acute tropical pulmonary eosinophilia (TPE) is well recognized as a manifestation of filarial infection, the processes that mediate the abnormalities of the lung in TPE are unknown. To evaluate the hypothesis that the derangements of the lower respiratory tract in this disorder are mediated by inflammatory cells in the local milieu we utilized bronchoalveolar lavage to evaluate affected individuals before and after therapy. Inflaminatory cells recovered from the lower respiratory tract of individuals with acute, untreated TPE (a = 8) revealed a striking eosinophilic alveolitis, with marked elevations in both the proportion of eosinophils (TPE 54±5%; normal 2±5%; P < 0.001) and the concentration of eosinophils in the recovered epithelial lining fluid (ELF) (TPE 63±20 X 103/Al; normal 03±0.1 X 103/jl; P < 0.01). Importantly, when individuals (a = 5) with acute TPE were treated with diethylcarbamazine (DEC), there was a marked decrease of the lung eosinophils and concomitant increase in lung function. These observations are consistent with the concept that at least some of the abnormalities found in the lung in acute TPE are mediated by an eosinophil-dominated inflammatory process in the lower respiratory tract

Health, Health-Related Quality of Life, and Quality of Life: What is the Difference?

The terms health, health-related quality of life (HRQoL), and quality of life (QoL) are used interchangeably. Given that these are three key terms in the literature, their appropriate and clear use is important. This paper reviews the history and definitions of the terms and considers how they have been used. It is argued that the definitions of HRQoL in the literature are problematic because some definitions fail to distinguish between HRQoL and health or between HRQoL and QoL. Many so-called HRQoL questionnaires actually measure self-perceived health status and the use of the phrase QoL is unjustified. It is concluded that the concept of HRQoL as used now is confusing. A potential solution is to define HRQoL as the way health is empirically estimated to affect QoL or use the term to only signify the utility associated with a health state

Exposing quality of life and deadly health disparities: Using research to change health care policy

Session presented on Friday, July 25, 2014: At this meeting in Hong Kong, Dr. Carol Ferrans will be inducted into the International Nurse Researcher Hall of Fame of Sigma Theta Tau International. The purpose of this presentation is to trace her research trajectory from its earliest beginnings in quality of life and health disparities, over 30 years, including how she used research findings as a tool to strategically to shape and create changes in healthcare policy and legislation. Since the early 1980s when quality of life was a new concept, she has been an advocate for the voice of the patient in QOL assessment, developing a conceptual framework for QOL and instrument to capture the patient\u27s viewpoint. The Ferrans and Powers Quality of Life Index (QLI) was introduced in 1985 and since then has been translated into 21 languages and used in 30+ countries, in every continent except Antarctica. To date, 48 published studies provide support for the instrument\u27s reliability and validity, and 27 intervention studies have demonstrated its sensitivity in detecting change in QOL. More than 250 studies using the QLI have been published to date by nurses, physicians, psychologists, physical therapists, and other health care professionals. It is one of the most popular instruments for cardiac rehabilitation and pulmonary rehabilitation programs across the USA. Dr. Ferrans\u27 program of research also has focused on understanding and reducing disparities in cancer. In 1987 Dr. Ferrans conducted one of the earliest comparisons of QOL of African American and white breast cancer survivors, and reported various psychological sequelae of surgery, including significant depression persisting years after treatment. Building on this work, Dr. Ferrans conducted a study with 16 participating institutions across the country, examining the barriers to participation in cancer screening, long-term effects of cancer, and QOL of African American survivors of breast, colon, and prostate cancer. In her next study, Dr. Ferrans examined the factors contributing to late-stage diagnosis of breast cancer in economically disadvantaged African American and Hispanic women. She found that delay in seeking diagnosis of a suspicious breast symptom was twice that previously reported in the literature, and that cultural beliefs and fear were major contributing factors. Next, she developed an instrument that correctly identified cultural beliefs contributing to later stage of breast cancer at diagnosis for African American and Hispanic women. Her team\u27s published findings were cited by the American Cancer Society in their 2011 guidelines for breast cancer screening. Dr. Ferrans then developed a short film on DVD to address these beliefs, which was endorsed by the American Cancer Society. Evaluation of the DVD demonstrated that cultural beliefs could be changed in a single viewing. Dr. Ferrans currently has reached more than 8,500 women with the DVD. Her research and advocacy work culminated in the creation of the Illinois Reducing Breast Cancer Disparities Act, designed to improve access to screening and the quality of mammography throughout Illinois. This work provides a model for the effective dissemination of research findings to create wide-ranging changes in health care and policy

Flood Management with SUDS: A Simulation-Optimization Framework

ABSTRACT: Urbanization and climate change are the main driving force in the development of sustainable strategies for managing water in cities, such as sustainable urban drainage systems (SUDS). Previous studies have identified the necessity to develop decision-making tools for SUDS in order to adequately implement these structures. This study proposes a simulation?optimization methodology that aims to ease the decision-making process when selecting and placing SUDS, with the specific goal of managing urban flooding. The methodology was applied to a real case study in Dresden, Germany. The most relevant variables when selecting SUDS were the spatial distribution of floods and the land uses in the catchment. Furthermore, the rainfall characteristics played an important role when selecting the different SUDS configurations. After the optimal SUDS configurations were determined, flood maps were developed, identifying the high potential that SUDS have for reducing flood volumes and depth, but showing them to be quite limited in reducing the flooded areas. The final section of the study proposes a combined frequency map of SUDS implementation, which is suggested for use as a final guide for the present study. The study successfully implemented a novel methodology that included land-use patterns and flood indicators to select SUDS in a real case study.This research was funded by ICETEX, grant number 5334506, granted to the first author. This research was funded by the German Federal Ministry of Education and Research, grant number 01LR2005A

Selective expression of RT6 superfamily in human bronchial epithelial cells.

RT6 proteins are glycosylphosphatidylinositol (GPI)-linked alloantigens that are localized to cytotoxic T lymphocytes and that have nicotinamide adenine dinucleotide glycohydrolase and adenosine diphosphate (ADP)-ribosyltransferase activities. In view of the importance of GPI-linked surface proteins in mediating interactions of cells with their milieu, and the varied functions of airway cells in inflammation, we undertook the present study to determine whether human homologues of the RT6 superfamily of ADP-ribosyltransferases (ART) are expressed in pulmonary epithelial cells. We hypothesized that these surface proteins or related family members may be present in cells that interact with inflammatory cells, and that they may thereby be involved in intercellular signaling. Using in situ analysis and Northern blot analysis, we identified ART1 messenger RNA (mRNA) in airway epithelial cells. As expected for GPI-anchored proteins, the localization of ART1 at the apical surface of ciliated epithelial cells was demonstrated by staining with polyclonal anti-ART1 antibody, and was confirmed by loss of this immunoreactivity after treatment with phosphatidylinositol-specific phospholipase C (PI-PLC), which selectively cleaves GPI anchors and releases proteins from the plasma membrane. Using in situ hybridization with specific ART3 and ART4 oligonucleotides, we also identified two additional members of the RT6 superfamily in epithelial cells. In accord with these findings, we identified ART3 and ART4 mRNAs through reverse transcription- polymerase chain reaction of polyadenine-positive RNA from human trachea. Interestingly, these proteins appeared to be preferentially localized to the airway epithelium. The localized expression of these members of the RT6 superfamily in human pulmonary epithelial cells may reflect a role for them in cell-cell signaling during immune responses within the airwa

A systematic review of the use of quality-of-life instruments in randomized controlled trials for psoriasis

This is the peer reviewed version of the following article: F. M. Ali, A. C. Cueva, J. Vyas, A. A. Atwan, M. S. Salek, A. Y. Finlay, and V. Piguet, ‘A systematic review of the use of quality-of-life instruments in randomized controlled trials for psoriasis’, British Journal of Dermatology, Vol. 176 (3): 577-593, March 2017, which has been published in final form at https://doi.org/10.1111/bjd.14788. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.Planners of interventional studies in psoriasis face the dilemma of selecting suitable quality-of-life (QoL) measures. Systematic reviews have the potential of identifying psychometrically sound measures in a given therapeutic area, while guiding the development of practice guidelines. The aim of this systematic review was to generate evidence of the use of QoL instruments in randomized controlled trials (RCTs) for interventions in psoriasis. The methodology followed the PRISMA guidelines. Six databases were searched with 388 search terms. Abstracts of articles were reviewed independently by two assessors, and a third adjudicator resolved any opinion differences. Risk of bias was assessed using the Jadad scale. Of 3646 screened publications, 99 articles (100 trials) met the eligibility criteria for inclusion, describing research on 33 215 patients. Thirty-three trials tested topical therapy, 18 systemic, 39 biologics, nine phototherapy and 10 other interventions. The Dermatology Life Quality Index (DLQI) was the most commonly used QoL instrument (83 studies, 83%), followed by the 36-Item Short Form Survey (SF-36) (31, 31%), EuroQoL-5D (EQ-5D) (15, 15%), Psoriasis Disability Index (14, 14%) and Skindex (five, 5%). There was widespread inconsistency in the way that QoL data were reported. Of the 100 trials identified, 37 reported minimal clinically important difference (MCID): 32 for DLQI, 10 for SF-36 and six for EQ-5D. QoL measurement is increasingly being reported in RCTs of psoriasis. Formal guidelines are needed for assessment and publishing of QoL data. Researchers should consider whether MCID information is available, and development of MCID data should be encouraged.Peer reviewedFinal Accepted Versio