Study protocol for two pilot randomised controlled trials aimed at increasing physical activity using electrically assisted bicycles to enhance prostate or breast cancer survival

BACKGROUND: In 2020, 1.4 and 2.3 million new cases of prostate cancer and breast cancer respectively were diagnosed globally. In the UK, prostate cancer is the most common male cancer, while breast cancer is the most common female cancer. Engaging in physical activity (PA) is a key component of treatment. However, rates of PA are low in these clinical populations. This paper describes the protocol of CRANK-P and CRANK-B, two pilot randomised controlled trials, involving an e-cycling intervention aimed at increasing PA in individuals with prostate cancer or breast cancer respectively.METHODS: These two trials are single-centre, stratified, parallel-group, two-arm randomised waitlist-controlled pilot trials in which forty individuals with prostate cancer (CRANK-P) and forty individuals with breast cancer (CRANK-B) will be randomly assigned, in a 1:1 allocation ratio, to an e-cycling intervention or waitlist control. The intervention consists of e-bike training with a certified cycle instructor, followed by the provision of an e-bike for 12 weeks. Following the intervention period, participants in the e-bike condition will be directed to community-based initiatives through which they can access an e-bike. Data will be collected at baseline (T0), immediately post intervention (T1) and at 3-month follow-up (T2). In addition, in the intervention group, data will be collected during the intervention and follow-up periods. Quantitative and qualitative methods will be used. The primary objectives are to determine effective recruitment strategies, establish recruitment and consent rates, adherence and retention in the study, and determine the feasibility and acceptability of the study procedures and intervention. The potential impact of the intervention on clinical, physiological and behavioural outcomes will be assessed to examine intervention promise. Data analyses will be descriptive.DISCUSSION: The findings from these trials will provide information on trial feasibility and highlight the potential of e-cycling as a strategy to positively impact the health and behaviour of individuals with prostate cancer and breast cancer. If appropriate, this information can be used to design and deliver a fully powered definitive trial.TRIAL REGISTRATION: CRANK-B: [ISRCTN39112034]. CRANK-P [ISRCTN42852156]. Registered [08/04/2022] https://www.isrctn.com .</p

Physical activity in liver transplant recipients: a large multicenter study

Aim Healthy lifestyle and appropriate diet are of critical importance after liver transplant (LT). We provided an analysis of the main patterns of physical activity and found factors associated with physical activity itself.Methods Clinically stable LT recipients were enrolled between June and September 2021. Patients completed a composite questionnaire about physical activity, adherence to Mediterranean Diet (MD), quality of life (QoL), and employment. Correlations were analysed using the Pearson coefficients while different subgroups were compared by t-test for independent samples or ANOVAs. Multivariable logistic regression analysis was conducted to find predictors of inactivity.Results We enrolled 511 subjects (71% males, mean age 63 +/- 10.8 years). One hundred and ninety-three patients reported high level of physical activity, 197 a minimal activity and 121 declared insufficient activity. Among these latter, 29 subjects were totally inactive. Considering the 482 LT recipients performing some kind of physical activity, almost all reported a low-quality, non-structured activity. At multivariate analysis, time from LT (odds ratio 0.94, 95% CI 0.89-0.99, p = 0.017), sedentary lifestyle (odds ratio 0.99, 95% CI 0.19-0.81, p = 0.012), low adherence to MD (odds ratio 1.22, 95% CI 1.01-1.48, p = 0.049), and low level of QoL (physical dimension) (odds ratio 1.13, 95% CI 1.08-1.17, p &lt; 0.001), were independently associated with total inactivity.Conclusion A large portion of LT recipients report an insufficient level of physical activity or are wholly inactive. Inactivity increases with time from LT and was strongly associated with suboptimal diet and low QoL

Associations between screen-time behaviours, physical activity, and positive and negative mental health among Irish adolescents

Emerging evidence suggests the association between screen-time and mental health is complex as findings thus far are mixed. This programme of research elucidated the individual and joint associations between screen-based behaviours, physical activity and negative (depressive and anxiety symptoms) and positive mental health among representative population samples of adolescents in Ireland. The systematic review established a dearth of evidence on the joint associations between screen-time, sedentary behaviour, and physical activity with positive and negative mental health. An initial exploratory, secondary analysis of data from 422 adolescents from the Children’s Sports Participation and Physical Activity Study (CSPPA) revealed positive associations between total screen-based sedentary behaviours and depressive symptoms (β=0.27, p=0.002). When screen-time type and mentally-active or mentally-passive context were examined in the same model, only mentally-active screen-time (e.g., computer use for fun) was positively associated with depressive symptoms (β=0.39, p=0.007). Informed by initial findings, two novel cross-sectional studies of 1,756 adolescents’ expanded previous work by investigating associations between three types of screen-time (TV, computer, and phone use) and physical activity with depressive and anxiety symptoms. Results showed greater computer (depression: β=0.11, p=0.00, anxiety: β=0.09 p≤0.00) and phone use (depression: β=0.14, p=0.00, anxiety: β=0.08, p≤0.00) showed the strongest associations with depressive and anxiety symptoms. These studies also showed a moderating influence of physical activity level on the screen-time mental health relationship.A final study among 879 adolescents advanced previous findings both replicating initial findings and expanding to quantify associations with positive mental health and potential dose-response relationships. Results replicated findings for depressive symptoms and the protective, moderating influence of physical activity. However, findings showed that TV viewing was inversely associated with anxiety symptoms (β=- 0.11 p≤0.00), and, conversely, higher phone use (β=0.11 p≤0.00) and physical activity (β=0.12 p≤0.00) were associated with better positive mental health. Dose-response relationships revealed a non-linear curve for depressive symptoms, indicating the optimal dose of TV watching may be between low and moderate hours of use (Overall, the findings of this research programme demonstrate differential associations between screen-time, physical activity, and mental health outcomes. These associations differ based on type of screen-time mode, gender, level of physical activity, and mental health outcome. Additionally, not all screen-time appears to be detrimental, and moderation may be key for some screen-time modes. A protective, moderating influence of physical activity was observed for some types of screen-time behaviours. Regardless, this research highlights the need for further, rigorous investigations into the screen-time-physical activity and mental health relationship that focuses more on type of activity and considers that not all screen-time is detrimental.</p

Associations between screen-time media use, physical activity, and positive and negative mental health outcomes among adolescents in Ireland : a cross-sectional study

Purpose Understanding the individual and joint associations of positive and negative mental health with screen-time and physical activity (PA) among adolescents is essential to develop enhanced guidance for prevention strategies and appropriate interventions. Methods Participants (n=879, n = 463 female, mean age 14.71 (SD = 1.51) years) from second-level schools in Ireland completed a battery of well-validated questionnaires assessing hours of daily screen-time use (TV, computer, and phone), PA levels (PACE+) (low (0–2 day/week), moderate (3–4 day/week), or high (5+day/week), and mental health outcomes (anxiety (STAI-Y2) and depressive symptoms (QIDS) and positive mental health (MHC-SF)). Multiple linear regressions examined associations between screen-time, PA and mental health and one-way ANOVA’s examined differences in mental health outcomes between screen-time mode and use categories (none (0 hours), low (0.5-1.5 hours), moderate (2-4.5 hours), and high (5+ hours)). Cohen’s d effect size and 95% confidence intervals quantified the magnitude of the difference. Results Higher computer (β=0.112, p≤0.001) and phone use (β=0.138, p≤0.001) were associated with higher depressive symptoms. Higher TV use (β=-0.111, p≤0.002) and PA levels (β=-0.123, p≤0.001) were associated with lower anxiety symptoms. Higher phone use (β=0.113, p≤0.002) and PA levels (β=0.116, p≤0.001) were associated with higher positive mental health. The magnitude of differences in depressive and anxiety symptoms across screen-time use categories were largely small-to-moderate (d = 0.02 to 0.67) and in positive mental health, ranged from small to large (d = 0.03 to 0.88). The sample was then stratified by PA level to assess the potential moderating influence of PA on the screen-time-mental health association, with mixed results. Conclusions Results are among the first findings regarding the relationship between screen-time mode and PA levels with mental health, particularly positive mental health among adolescents in Ireland. Associations of screen-time and PA with mental health outcomes varied according to PA level and screen-time mode. The variation in these findings suggest the need to investigate the context of screen-time use and the screen-time activity engaged with. These results suggest that not all screen-time is detrimental and some, in moderation, may be beneficial for mental health. Future research should investigate longitudinal associations between screen-time, PA, and mental health. Support/Funding Source N/AnonPeerReviewe

Sprint interval training in young adult males with & without elevated worry

Using a pre-post design, we investigated state anxiety and worry responses to a single Wingate, three weeks of sprint interval training (SIT), and, change in response to a single Wingate. Differences between males with and without elevated worry were explored. Thirty-eight young adult males, 18 with elevated worry (Penn State Worry Questionnaire [PSWQ] ≥45), completed a single 30s Wingate at 7.5% body mass before and after three weeks of SIT (nine sessions of 4–6 sprints). The state subscale of the State-Trait Anxiety Inventory assessed state anxiety; the PSWQ measured worry and worry engagement. A single Wingate increased state anxiety (d =-0.37, [-0.82, 0.09]) and decreased worry engagement (d = 0.16, [-0.29, 0.61]). SIT resulted in non-significant reductions in state anxiety (d = 0.20, [-0.25, 0.65]) and worry (d = 0.09, [-0.36, 0.54]). SIT non-significantly attenuated state anxiety response to a single Wingate (d = 0.23, [-0.22, 0.68]), approximating a 2.5-fold reduction from pre- (d = -0.37, [-0.82, 0.09]) to post-SIT (d = -0.16, [-0.61, 0.29]). Improvements in worry (d = 0.61, [-0.04, 1.26]) and worry engagement (d = 0.60, [-0.05, 1.25]) were moderately larger among males with elevated worry. Findings indicated that a single Wingate may acutely perturb state anxiety and improve worry. Three weeks of SIT may improve anxiety and worry and response to a single Wingate. Responses were moderately larger among males with elevated worr

Quality of life in liver transplant recipients during the Corona virus disease 19 pandemic: A multicentre study

Background Liver transplant recipients require specific clinical and psychosocial attention given their frailty. Main aim of the study was to assess the quality of life after liver transplant during the current pandemic. Methods This multicentre study was conducted in clinically stable, liver transplanted patients. Enrollment opened in June and finished in September 2021. Patients completed a survey including lifestyle data, quality of life (Short Form health survey), sport, employment, diet. To examine the correlations, we calculated Pearson coefficients while to compare subgroups, independent samples t-tests and ANOVAs. To detect the predictors of impaired quality of life, we used multivariable logistic regression analysis. Results We analysed data from 511 patients observing significant associations between quality of life's physical score and both age and adherence to Mediterranean diet (p &lt; .01). A significant negative correlation was observed between mental score and the sedentary activity (p &lt; .05). Female patients scored significantly lower than males in physical and mental score. At multivariate analysis, females were 1.65 times more likely to report impaired physical score than males. Occupation and physical activity presented significant positive relation with quality of life. Adherence to Mediterranean diet was another relevant predictor. Regarding mental score, female patients were 1.78 times more likely to show impaired mental score in comparison with males. Sedentary activity and adherence to Mediterranean diet were further noteworthy predictors. Conclusions Females and subjects with sedentary lifestyle or work inactive seem to show the worst quality of life and both physical activity and Mediterranean diet might be helpful to improve it

Adherence to Mediterranean diet in liver transplant recipients: a cross-sectional multicenter study

Background: Seeing the importance of healthy diet after liver transplant (LT), our study aimed to evaluate the adherence to Mediterranean diet (MD) in a large population of LT recipients. Methods: The present multicenter study was developed in clinically stable, liver transplanted patients, from June to September 2021. Patients completed a survey about adherence to MD, Quality of Life (QoL), sport, and employment. To analyze the correlations, we computed Pearson's coefficients; while to compare subgroups, independent samples t-tests and ANOVAs. We used a multivariable logistic regression analysis to find the predictors of impaired adherence to MD. Results: The questionnaire was administered to 511 patients. They were males in 71% of cases with a mean age of 63.1 years (SD±10.8). LT recipients coming from central Italy displayed higher adherence to the MD (M=11.10±1.91) than patients from northern (M=9.94±2.28, P&lt;0.001) or southern Italy (M=10.04±2.16, P&lt;0.001). Patients from central Italy showed a significantly higher consumption of fruit, vegetables, legumes, cereals, olive oil, fish and a significantly lower intake of dairy products than patients resident in the other Italian areas. At multivariate analysis, recipients from central Italy were 3.8 times more likely to report adherence to the MD. Patients with a high physical health score were more adherent to MD, as well as patients transplanted at an earlier time. Conclusions: We demonstrated that place of stay, time from transplant and physical dimension of QoL significantly influences the adherence to MD. Continuous information campaigns about a correct diet and lifestyle would be necessary

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Letter to the editor