Exploring the organisational structure of networks for exercise oncology provision: a social network analysis of OnkoAktiv

Background: Structured exercise programs provide considerable health benefits for cancer patients. Therefore, various OnkoAktiv (OA) networks were established in Germany with the aim to connect cancer patients with certified exercise programs. However, knowledge about the integration of exercise networks into cancer care systems and conditions of interorganisational collaboration is lacking. The aim of this work was to analyse the OA networks to guide further network development and implementation work. Methods: We used methods of social network analysis within a cross-sectional study design. Network characteristics were analysed such as node and tie attributes, cohesion and centrality. We classified all networks into their level of organisational form in integrated care. Results: We analysed 11 OA networks with 26 actors and 216 ties on average. The smallest network counted 12 actors/56 ties, the largest 52/530. 76% of all actors operated within the medical/exercise sector, serving 19 different medical professions. In smaller “linkage” networks, several individual professionals were linked “from service to service”, whereas the more integrated networks revealed a core-periphery-structure. Discussion: Collaborative networks enable the involvement of professional actors from different operational fields. This study provides an in-depth understanding of underlying organisational structures that provides information for further development of exercise oncology provision. Trial registration: Not applicable, as no health care intervention was performed

Structured physical activity interventions as a complementary therapy for patients with inflammatory bowel disease – a scoping review and practical implications

Background: Patients with Inflammatory Bowel Disease (IBD) also suffer from a wide range of additional disorders, which may be caused by the disease, the side effect of the medication, or a lack of physical activity (PA). This results in reduced physical and psychological wellbeing. However, as known from other chronic diseases exercise could be utilized as supportive therapy for IBD patients. Main goals of this article are (a) collecting data of the effects structured physical activity interventions have on validated clinical parameters of IBD and health related symptoms, (b) developing activity recommendations for this clientele. Methods: A scoping review was conducted, searching for relevant articles published until May 2018, which investigated the effects of structured exercise interventions in IBD patients. The heterogeneity of the outcomes and the interventions did not support a quantitative synthesis thus, a qualitative discussion of the studies is provided. Results: After reviewing 353 records, 13 eligible articles were identified. Five studies investigated aerobic exercise, three studies resistance exercise, three studies mind-body therapies and two studies yoga. The quality of the studies is mixed, and the duration is rather short for exercise interventions. Only few studies assessed validated IBD activity markers or inflammatory biomarkers. Nevertheless, the patients showed an increase in fitness, bone mineral density (BMD), quality of life and a decrease of IBD induced stress and anxiety. No severe adversial events were reported. Conclusion: Even though the evidence is limited the application of exercise interventions in IBD patients can be assumed to be safe and beneficial for the patients‘ overall-health, and IBD specific physical and psychosocial symptoms. But there is still a high demand for more thoroughly conducted studies, focussing on important clinical outcome parameters

Heidelberger Health Score HHS 3.0: Hinweise zur Validität des Fragebogens zu biopsychosozialen Gesundheitsdimensionen zum Erhalt der Arbeitsfähigkeit

Hintergrund: Der Heidelberger Health Score (HHS 3.0) ist ein ökonomisches Messinstrument mit 14 Indikatoren zur systematischen Identifikation von Bedarfen zum Erhalt der Arbeitsfähigkeit. Die 6 im Fragebogen erhobenen Gesundheitsdimensionen umfassen persönliche Gesundheitseinschätzung (PGE), gesundheitliche Ressourcensituation (GRS), mentale Widerstandsfähigkeit (MWF), Work Ability Index (WAI), allgemeines Aktivitätsprofil (AAP) und arbeitsplatzbezogenes Beanspruchungsprofil (ABP). Die Ergebnisse können in einem Gesamtscore abgebildet werden. Ziel der Arbeit (Fragestellung): Wir untersuchten Hinweise auf Validität der Revision 3.0 des HHS anhand von fünf Stichproben. Material und Methoden: Bezüge des HHS zu Standardmessinstrumenten wie SF-36, WAI und SCL wurden in korrelativen Querschnittsdesigns analysiert. Angaben zu Sitzzeiten wurden mit objektiver einwöchiger Akzelerometrie überprüft. Ein prospektives Längsschnittdesign analysierte prädiktive Validität, Sensitivität und Spezifität des HHS für AU-Tage. Ergebnisse: Der HHS wies die erwarteten Korrelationen zu Standardmessinstrumenten wie SF-36 (r = 0,30-0,55), WAI (r = 0,49) und SCL (r = -0,53) auf. Probanden verschätzten sich zwar bei absoluten Sitzzeiten, jedoch wurden Probandenunterschiede laut Akzelerometrie vom HHS recht gut abgebildet (r = 0,57). Mit dem HHS konnten AU-Tage prognostiziert werden (r = -0,43). Diskussion: Der HHS-Gesamtscore und die HHS-Dimensionen erlauben ein spezifisches Screening der arbeitsrelevanten Gesundheitsressourcen. Vor dem Hintergrund der festgestellten Ressourcenlage können gesundheitliche Risikofaktoren für AU-Tage adressiert und bedarfsgerechte Interventionen geplant werden. Der HHS erlaubt es damit, Maßnahmen bedarfsgerecht, zielgenau und effizient im betrieblichen Gesundheitsmanagement zu verankern.Background: The Heidelberg Health Score (HHS 3.0) is an economical 14-item measurement instrument for systematically identifying crucial risk factors and general resistance resources related to preserving employee work ability. The six health-related dimensions reflect Subjective Health Assessment (PGE), General Health Resources (GRS), Mental Resilience (MWF), Work Ability Index (WAI), General Activity Profile (AAP), and Workplace-related Stress Profile (ABP). Results can be formed into a total score. Objectives: The results on the validity of the revised HHS 3.0 as established with five samples are reported. Materials and methods: The relationships between HHS and standard assessment tools such as the SF-36, WAI, and SCL were investigated by means of cross-sectional designs. Subjectively reported sitting times were evaluated against an objective accelerometer worn for a week. A prospective longitudinal study analyzed the HHS’s predictive validity, sensitivity, and specificity for days of incapacity to work. Results: HHS was statistically associated with standard assessment tools as hypothesized: SF-36 (r = 0.30-0.55), WAI (r = 0.49), and SCL (r = -0.53).Though participants misestimated their absolute sitting times, individual differences between them were captured quite well according to the accelerometer (r = 0.57). Days of incapacity to work could be predicted with the help of HHS (r = -0.43). Conclusions: The HHS total score and HHS dimensions provide tools for screening staff’s work-related health resources. Corporate health management may accurately identify areas of staff health in need of attention that - in light of individuals' resources - may affect their days of incapacity to work. Thus HHS enables corporate health management to plan tailored interventions more efficiently

A life span perspective on competencies for a healthy, physically active lifestyle: Findings of a data pooling initiative with over 7000 individuals.

Individuals are recommended to lead active lifestyles throughout the life course. The model of physical activity-related health competence (PAHCO) adopts a competence approach by integrating physical, cognitive, and motivational determinants for health-enhancing PA (movement competence, control competence, self-regulation competence). Drawing on a comprehensive dataset pooling, the goal of the present study was to model the idiosyncratic courses of 10 PAHCO indicators over the life span. We identified studies that empirically operationalized PAHCO, combining data of 7134 individuals (age range: 15-97 years; 61% female) from 18 different populations (prevention and rehabilitation sectors). We applied a stepwise multilevel analysis approach with disjunct sub-samples (n = 48) to examine linear and quadratic associations between age and PAHCO. Indicators of movement competence (i.e., manageability of endurance, strength, and balance demands; task-specific self-efficacy) congruently showed negative associations with age (0.054 ≤   ≤ 0.211). However, parameters of control competence remained stable across the life span (-0.066 ≤ β ≤ 0.028). The three indicators of self-regulation competence revealed an inconsistent relationship with age, though uncovering positive associations for self-control (β = 0.106) and emotional attitude toward PA (β = 0.088). The associations of some indicators varied significantly across sub-samples. The results suggest differential analyses for associations between PAHCO and age. While the physically determined PAHCO indicators (movement competence) probably decline across the life span, the ability to ensure regularity of PA (self-regulation competence) or align PAs with an individual's health (control competence) appear to remain constant or improve with increasing age. The findings reinforce a de-stigmatizing approach for PA promotion practices with considerable space for aligning activities with health also in the elderly

Aktuelle Fragestellungen beim leitungsgebundenen Transport von Wasserstoff

Als speicherbarer chemischer Energieträger wird Wasserstoff eine wichtige Rolle bei der Energiewende spielen. Um die erwarteten Bedarfe in Europa und Deutschland bereitstellen zu können, wird eine leistungsstarke europaweite Transportinfrastruktur benötigt. Existierende Erdgastransportnetze können auf den Betrieb mit Wasserstoff umgestellt werden. Die notwendigen technischen und betrieblichen Anpassungen sind Gegenstand von umfangreichen Forschungs-, Entwicklungs- und Demonstrationsvorhaben. Bis 2030 soll in Europa ein Netz mit einer Gesamtlänge von 33 000 km entstehen. In Deutschland sind 9700 km Wasserstofftransportleitungen bis 2032 vorgesehen

Exploring the organisational structure of networks for exercise oncology provision: a social network analysis of OnkoAktiv

Abstract Background Structured exercise programs provide considerable health benefits for cancer patients. Therefore, various OnkoAktiv (OA) networks were established in Germany with the aim to connect cancer patients with certified exercise programs. However, knowledge about the integration of exercise networks into cancer care systems and conditions of interorganisational collaboration is lacking. The aim of this work was to analyse the OA networks to guide further network development and implementation work. Methods We used methods of social network analysis within a cross-sectional study design. Network characteristics were analysed such as node and tie attributes, cohesion and centrality. We classified all networks into their level of organisational form in integrated care. Results We analysed 11 OA networks with 26 actors and 216 ties on average. The smallest network counted 12 actors/56 ties, the largest 52/530. 76% of all actors operated within the medical/exercise sector, serving 19 different medical professions. In smaller “linkage” networks, several individual professionals were linked “from service to service”, whereas the more integrated networks revealed a core-periphery-structure. Discussion Collaborative networks enable the involvement of professional actors from different operational fields. This study provides an in-depth understanding of underlying organisational structures that provides information for further development of exercise oncology provision. Trial registration Not applicable, as no health care intervention was performed

Exercise Preferences in Young Adults with Cancer—The YOUEX Study

(1) Background: Strong evidence supports the persuasive positive effects of exercise for cancer patients and survivors. Different approaches of exercise programs have been established; however, the special interests of young adults (YAs) with cancer have rarely been considered in exercise interventions. Therefore, the study YOUng EXercisers (YOUEX) aimed to investigate exercise preferences in YAs. (2) Methods: YOUEX was a three-arm, patient preference-based non-randomized, longitudinal, pre–post exercise intervention, offering three different exercise modules to YAs during or after acute therapy (Module 1: online supervised group-based (M1); Module 2: online unsupervised (M2); Module 3: in-person supervised (M3)). The intervention period was 12 weeks with another 12-week follow-up period, the modules could be changed or amended after 6 and 12 weeks. (3) Results: 92 YAs were allocated to the study. At baseline, 50 YAs (54%) chose M2, 32 YAs (35%) M1 and 10 YAs (11%) M3. The analysis revealed high acceptability and feasibility of the online exercise programs (M1, M2). There was a high impact of the COVID-19 pandemic on the execution of M3. YAs showed diverse preferences in module selection due to differences in, e.g., cancer therapy status or favored level of supervision. (4) Conclusions: YAs need personalized exercise programs that consider their individual interests and needs. Online exercise programs can be a promising addition to existing exercise opportunities. They are an effective way to increase physical activity levels in YAs

Exercise Preferences in Young Adults with Cancer—The YOUEX Study

(1) Background: Strong evidence supports the persuasive positive effects of exercise for cancer patients and survivors. Different approaches of exercise programs have been established; however, the special interests of young adults (YAs) with cancer have rarely been considered in exercise interventions. Therefore, the study YOUng EXercisers (YOUEX) aimed to investigate exercise preferences in YAs. (2) Methods: YOUEX was a three-arm, patient preference-based non-randomized, longitudinal, pre–post exercise intervention, offering three different exercise modules to YAs during or after acute therapy (Module 1: online supervised group-based (M1); Module 2: online unsupervised (M2); Module 3: in-person supervised (M3)). The intervention period was 12 weeks with another 12-week follow-up period, the modules could be changed or amended after 6 and 12 weeks. (3) Results: 92 YAs were allocated to the study. At baseline, 50 YAs (54%) chose M2, 32 YAs (35%) M1 and 10 YAs (11%) M3. The analysis revealed high acceptability and feasibility of the online exercise programs (M1, M2). There was a high impact of the COVID-19 pandemic on the execution of M3. YAs showed diverse preferences in module selection due to differences in, e.g., cancer therapy status or favored level of supervision. (4) Conclusions: YAs need personalized exercise programs that consider their individual interests and needs. Online exercise programs can be a promising addition to existing exercise opportunities. They are an effective way to increase physical activity levels in YAs.German Foundation of Young Adults with CancerPeer Reviewe