Cancer survivors’ experiences of a community-based cancer-specific exercise programme: results of an exploratory survey

Purpose Exercise levels often decline following cancer diagnosis despite growing evidence of its benefits. Treatment side-effects, older age, lack of confidence and opportunity to exercise with others in similar circumstances influence this. Our study explored the experiences of people attending a cancer-specific community-based exercise programme (CU Fitter™). Methods A survey distributed to those attending the programme gathered demographic/clinical information, self-reported exercise levels, information provision and barriers to/benefits of exercise. Results Sixty surveys were evaluable from 65/100 returned (62% female, 68% >60yrs, 66% breast/prostate cancer). Most (68%) were receiving treatment. 68% attended classes once or twice weekly. 55% received exercise advice after diagnosis, usually from their hospital doctor/nurse. More (73%) had read about exercising, but less used the internet to source information (32%). Self-reported exercise levels were higher currently than before diagnosis (p=0.05). 48% said their primary barrier to exercising was the physical impact of cancer/treatment. Improving fitness/health (40%) and social support (16%) were the most important gains from the programme. Many (67%) had made other lifestyle changes and intented to keep (50%), or increase (30%) exercising. Conclusions This community-based cancer-specific exercise approach engaged people with cancer and showed physical, psychological, and social benefits. Implications for cancer survivors Community grown exercise initiatives bring cancer survivors together creating their own supportive environment. Combining this with instructors familiar with the population and providing an open-ended service may prove particularly motivating and beneficial. Further work is required to provide evidence for this

Digital health behaviour change interventions targeting physical activity and diet in cancer survivors: a systematic review and meta-analysis

Purpose: The number of cancer survivors has risen substantially due to improvements in early diagnosis and treatment. Health behaviours such as physical activity (PA) and diet can reduce recurrence and mortality, and alleviate negative consequences of cancer and treatments. Digital behaviour change interventions (DBCIs) have the potential to reach large numbers of cancer survivors. Methods: We conducted a systematic review and meta-analyses of relevant studies identified by a search of Medline, EMBASE, PubMed and CINAHL. Studies which assessed a DBCI with measures of PA, diet and/or sedentary behaviour were included. Results: 15 studies were identified. Random effects meta-analyses showed significant improvements in moderate-vigorous PA (7 studies; mean difference (MD) = 41 minutes per week; 95% CI: 12, 71) and body mass index (BMI)/weight (standardised mean difference (SMD) = -0.23; 95% CI: -0.41, -0.05). There was a trend toward significance for reduced fatigue and no significant change in cancer-specific quality of life (QoL). Narrative synthesis revealed mixed evidence for effects on diet, generic QoL and self-efficacy and no evidence of an effect on mental health. Two studies suggested improved sleep quality. Conclusions: DBCIs may improve PA and BMI among cancer survivors and there is mixed evidence for diet. The number of included studies is small and risk of bias and heterogeneity was high. Future research should address these limitations with large, high-quality RCTs, with objective measures of PA and sedentary time. Implications for cancer survivors: Digital technologies offer a promising approach to encourage health behaviour change among cancer survivors

Electric vehicles: problems or solutions

This paper discusses the current directions of vehicle developments, as well as the barriers and opportunities for using electric vehicles instead of conventional vehicles. There is also mentioned a problem of the battery charging system. Compared to refueling gasoline powered vehicles, charging of battery electric vehicles takes considerably more time, which renders a single-purpose charging infrastructure inconvenient. However, an objective of this article is also to investigate the future market prospects of various types of EVs, with the economics of EVs in comparison to conventional cars. Only if the final driving costs can be considerably reduced will EVs gain significant market shares

Wojskowy i cywilny transport drogowy towarów niebezpiecznych oraz ładunków ponadgabarytowych

W artykule omówiono najważniejsze aspekty wojskowego i cywilnego transportu drogowego towarów niebezpiecznych i ładunków ponadgabarytowych. Przedstawione zostały podstawowe zasady przewozu ładunków ponadgabarytowych i towarów niebezpiecznych. Scharakteryzowano parametry ładunków ponadgabarytowych oraz czynności przygotowawcze do przewozu takich ładunków. Omówione zostało oznakowanie sztuk przesyłek oraz jednostki transportowej przewożącej towary niebezpieczne. Opisano obowiązkowe wyposażenie jednostki transportowej przewożącej po drogach publicznych towary niebezpieczne

Podstawowe zasady transportu i ruchu wojsk własnych i sojuszniczych

W artykule omówiony został wojskowy transport sił sojuszniczych i sił własnych. Przedstawione zostały podstawowe zasady i reguły planowania przemieszczenia sił wojskowych. Scharakteryzowane zostało wsparcie sojusznicze Host Nation Support. Przybliżono czytelnikowi oznakowanie kolumn wojskowych, pojazdów regulacji ruchu oraz oznakowanie infrastruktury transportowej. Omówiono bezpieczeństwo ruchu wojskowych pojazdów

Podstawowe zasady transportu i ruchu wojsk własnych i sojuszniczych

W artykule omówiony został wojskowy transport sił sojuszniczych i sił własnych. Przedstawione zostały podstawowe zasady i reguły planowania przemieszczenia sił wojskowych. Scharakteryzowane zostało wsparcie sojusznicze Host Nation Support. Przybliżono czytelnikowi oznakowanie kolumn wojskowych, pojazdów regulacji ruchu oraz oznakowanie infrastruktury transportowej. Omówiono bezpieczeństwo ruchu wojskowych pojazdów

Mentally Ill Caregivers And Differential Patterns of Substance Abuse in a Sample of University Students

MENTALLY ILL CAREGIVERS AND DIFFERENTIAL PATTERNS OF SUBSTANCE ABUSE IN A SAMPLE OF UNIVERSITY STUDENTS Teliyah A. Cobb1, Alyssa P. Gretak1, MA, Kelcey L. Puszkiewicz1, MA, Jill D. Stinson1, PhD, and Megan Quinn2, DrPH, MSc, East Tennessee State University, Johnson City, TN 1Dept. of Psychology, College of Arts and Sciences 2Dept. of Biostatistics and Epidemiology, College of Public Health Existing literature demonstrates a dose-responsive relationship between adverse childhood experiences (i.e., abuse, neglect, and household dysfunction) and the risk of problematic substance use later in life. While controlling for the effects of early adversity, a recent study found that childhood household dysfunction independently increased the risk of excessive alcohol use in adulthood. However, there are few studies focusing specifically on differences in substance use behaviors in individuals who had a caregiver with a mental health diagnosis. This study aims to fill this gap by examining whether having a caregiver with mental illness during one’s childhood increases the risk of abusing alcohol and illegal or prescription drugs in adulthood in a college sample. Our sample includes University students in the Southeastern U.S. (N = 995) who are mostly Caucasian (84%) and female (63%). Participants completed an online, anonymous survey for course credit. Approximately 23% (n = 227) reported having a caregiver with mental illness or who attempted or died by suicide. Regarding substance abuse, nearly 11% of the sample (n = 106) reported abuse of alcohol, 13% (n = 126) indicated abuse of illegal drugs, and almost 5% (n = 47) reported abuse of prescription medication. Pearson Chi-square tests were conducted to analyze the relationship between caregiver mental illness, including a caregiver who attempted or died by suicide, and abuse of alcohol, illegal, and prescription drugs in adulthood. Interestingly, individuals with a mentally ill caregiver were less likely to abuse alcohol, c2 (1, N = 983) = 12.56, p = .000, and illegal drugs, c2 (1, N = 984) = 22.68, p = .000, as an adult, compared to those without a mentally ill caregiver. In contrast, students with a mentally ill caregiver were more likely to abuse prescription drugs as adults, c2 (1, N = 979) = 32.54, p = .000, compared to those without a caregiver suffering from a mental illness. Thus, findings suggest that having a mentally ill caregiver differentially impacted the risk of abusing varying types of substances. Additional analyses examining the influence of mental illness in biological versus non-biological caregivers (e.g., stepparent, foster parent) and further discussion of implications will be included

Patients’ and healthcare professionals’ views on a pre- and post-operative rehabilitation programme (SOLACE) for lung cancer: A qualitative study

Aims and objectives: To explore patients’ and healthcare professionals’ views and experiences of a pre- and post-operative rehabilitation intervention (SOLACE) for patients undergoing surgery for early stage lung cancer. Background: Considerable post-operative complications can occur after surgery. A specialist lung cancer service (SOLACE) was developed to optimise health and fitness levels prior to and following lung cancer resections, as well as reducing morbidity and mortality, and improving the physical and psychological wellbeing of patients. Design: The design was an exploratory, descriptive qualitative interview study. Methods: Seventeen lung cancer patients and eight healthcare professionals were recruited from a large teaching hospital in South England. Data was collected through semi-structured telephone and face to face interviews. Transcribed interview data was analysed thematically. The COREQ checklist was used to report on the study process. Results: The SOLACE service was positively perceived by patients and healthcare professionals. Patients valued the provision of tailored support/advice and peer support and reported benefits to their health and wellbeing. Barriers to patient uptake of the classes included time constraints, motivation and access for patients who lived at a distance. Conclusions: There is benefit in providing a personalised approach through a pre and post-operative rehabilitation service for lung cancer patients. Virtual support may address equality of access to service for those who live at a distance from the hospital. Relevance to clinical practice: Introduction of a pre and post-operative rehabilitation service provided by specialist peri-operative rehabilitation nurses and practitioners can yield positive outcomes for patients undergoing surgical treatment of early stage lung cancer. Engagement of key healthcare professionals, consideration of virtual follow up services and making patients aware of services could maximise patient uptake. Further consideration is needed of the best way to promote patient self-management and long-term continuation of patient rehabilitation in the community

Designing more engaging computer-tailored physical activity behaviour change interventions for breast cancer survivors: lessons from the iMove More for Life study

© 2017, Springer-Verlag GmbH Germany. Background: Participating in regular physical activity is a recommended cancer recovery strategy for breast cancer survivors. However, tailored support services are not widely available and most survivors are insufficiently active to obtain health benefits. Delivering tailored programs via the Internet offers one promising approach. However, recent evaluations of such programs suggest that major improvements are needed to ensure programs meet the needs of users and are delivered in an engaging way. Understanding participants’ experiences with current programs can help to inform the next generation of systems. Purpose: The purposes of this study are to explore breast cancer survivor’s perspectives of and experiences using a novel computer-tailored intervention and to describe recommendations for future iterations. Methods: Qualitative data from a sub-sample of iMove More for Life study participants were analysed thematically to identify key themes. Participants long-term goals for participating in the program were explored by analysing open-ended data extracted from action plans completed during the intervention (n = 370). Participants negative and positive perceptions of the website and recommendations for improvement were explored using data extracted from open-ended survey items collected at the immediate intervention follow-up (n = 156). Results: The majority of participants reported multi-faceted goals, consisting of two or more outcomes they hoped to achieve within a year. While clear themes were identified (e.g. ‘being satisfied with body weight’), there was considerable variability in the scope of the goal (e.g. desired weight loss ranged from 2 to 30 kg). Participants’ perceptions of the website were mixed, but clear indications were provided of how intervention content and structure could be improved. Conclusions: This study provides insight into how to better accommodate breast cancer survivors in the future and ultimately design more engaging computer-tailored interventions