The PAPHIO study protocol : a randomised controlled trial with a 2 x 2 crossover design of physical activity adherence, psychological health and immunological outcomes in breast cancer survivors
Description:
BACKGROUND: The PAPHIO study; a randomized controlled trial with 2X2 crossover design will implement a self-directed physical activity program in which participants will engage in self-monitoring and receive motivational interviewing to enhance physical activity adherence. The study aims to determine the effects of 24 weeks self-directed activity combined with motivational interviewing (MI) on (i) psychological health, (ii) quality of life (QoL) and (iii) immune function in female breast cancer survivors. METHODS: The study will recruit 64 female breast cancer survivors within 3 years of diagnosis and at least 6 months post primary treatments at Western Health Sunshine Hospital, Melbourne, Australia. They will be randomly allocated to immediate intervention (IIG group) or delayed intervention groups (DIG group) in a 1:1 ratio. All participants will be given a wearable device (Fitbit Alta HR) and undertake self-directed physical activity for 24 weeks and will receive MI for 12 weeks (IIG; during week 0 to week 12 and DIG; during week 13 to week 24). Participants' daily step count and the changes of immune cell functionality will be assessed at the beginning (week 1: T1), week 12 (T2) and week 24 (T3) of the program. Physical activity adherence will be assessed at T2 and T3. Participants will also complete four questionnaires assessing exercise self-regulation (BREQ2), exercise barrier and task self-efficacy, mental health (DASS-21) and QoL (FACT-B) at three time points (T1 to T3). Linear-mixed models will be used to assess the relationship between physical activity volume by step counting and mental health (DASS-21), QoL (FACT-B), immune biomarkers, self-regulation (BREQ2) and self-efficacy at T1, T2 and T3;between 2 groups. DISCUSSION: We expect this physical activity intervention to be acceptable and beneficial to the participants in terms of psychological and immunological well-being with the potential outcomes to be implemented more widely at relatively low cost to these or other patient populations. TRIAL REGISTRATION: Australian New Zealand Clinical trials Registry- ACTRN12619001271190. Prospectively registered on 13 September 2019.
Description:
BACKGROUND: The PAPHIO study; a randomized controlled trial with 2X2 crossover design will implement a self-directed physical activity program in which participants will engage in self-monitoring and receive motivational interviewing to enhance physical activity adherence. The study aims to determine the effects of 24 weeks self-directed activity combined with motivational interviewing (MI) on (i) psychological health, (ii) quality of life (QoL) and (iii) immune function in female breast cancer survivors. METHODS: The study will recruit 64 female breast cancer survivors within 3 years of diagnosis and at least 6 months post primary treatments at Western Health Sunshine Hospital, Melbourne, Australia. They will be randomly allocated to immediate intervention (IIG group) or delayed intervention groups (DIG group) in a 1:1 ratio. All participants will be given a wearable device (Fitbit Alta HR) and undertake self-directed physical activity for 24 weeks and will receive MI for 12 weeks (IIG; during week 0 to week 12 and DIG; during week 13 to week 24). Participants' daily step count and the changes of immune cell functionality will be assessed at the beginning (week 1: T1), week 12 (T2) and week 24 (T3) of the program. Physical activity adherence will be assessed at T2 and T3. Participants will also complete four questionnaires assessing exercise self-regulation (BREQ2), exercise barrier and task self-efficacy, mental health (DASS-21) and QoL (FACT-B) at three time points (T1 to T3). Linear-mixed models will be used to assess the relationship between physical activity volume by step counting and mental health (DASS-21), QoL (FACT-B), immune biomarkers, self-regulation (BREQ2) and self-efficacy at T1, T2 and T3;between 2 groups. DISCUSSION: We expect this physical activity intervention to be acceptable and beneficial to the participants in terms of psychological and immunological well-being with the potential outcomes to be implemented more widely at relatively low cost to these or other patient populations. TRIAL REGISTRATION: Australian New Zealand Clinical trials Registry- ACTRN12619001271190. Prospectively registered on 13 September 2019.
Description:
A high sense of belonging to the community and physical activity are associated with improved mental health in older people. The present study tested a model incorporating physical activities performed alone and with others as predictors of sense of belonging, depression and suicide ideation. One hundred and ninety four retired adults (87 males, 107 females, mean age 68 years) completed the Yale Physical Activity Survey, the Sense of Belonging Instrument, the Suicide Subscale of the General Health Questionnaire and the Zung Depression Inventory. Within the context of the model, neither participating in physical activities alone, nor with at least one other person, predicted sense of belonging, depression or suicide ideation. Having the abilities and motivation to belong was a predictor of participating in physical activities with others and actual feelings of belonging and contributed to predicting mental health in retirees. It was concluded that simply performing activities with others was not associated with a sense of belonging or mental health. Rather, sense of belonging may need to be facilitated in order for mental health to be enhanced.
Description:
A literature review was conducted to identify the experiences, challenges and acculturation of International Medical Graduates (IMGs) living and working throughout rural and remote Australia. As such recently published literature highlighted key factors impacting IMGs living and working in rural and remote areas which informed the acculturation process in western society. IMGs acculturation throughout Australian rural settings occurs rapidly among these higher educated migrants. Those IMGs with Australian spouses or who have practiced in rural settings prior to migration also experience a new phase of acculturation. However, maintaining cultural and religious connectivity continues to be challenging in these settings. Community awareness and an ability to embrace IMGs and cultural differences remain crucial for identity and cultural retention. Nevertheless, few studies recognised quality of life and social needs of IMGs and their family’s impact on the rural acculturation and settlement success. Previous research has focused primarily on employment integration, satisfaction and practice support. The identified literature is in no way extensive as it focuses on IMGs in the Australian context, which may impact on transferability. A gap exists where quality of life and social needs of IMGs and their families have been overlooked. These are crucial factors impacting rural acculturation, retention and IMGs health and wellbeing. The literature highlights insights into IMGs acculturation as they migrate and reside in Tasmania, a less culturally diverse population, remains absent with very little comparable research conducted.
Description:
A literature review was conducted to identify the experiences, challenges and acculturation of International Medical Graduates (IMGs) living and working throughout rural and remote Australia. As such recently published literature highlighted key factors impacting IMGs living and working in rural and remote areas which informed the acculturation process in western society. IMGs acculturation throughout Australian rural settings occurs rapidly among these higher educated migrants. Those IMGs with Australian spouses or who have practiced in rural settings prior to migration also experience a new phase of acculturation. However, maintaining cultural and religious connectivity continues to be challenging in these settings. Community awareness and an ability to embrace IMGs and cultural differences remain crucial for identity and cultural retention. Nevertheless, few studies recognised quality of life and social needs of IMGs and their family’s impact on the rural acculturation and settlement success. Previous research has focused primarily on employment integration, satisfaction and practice support. The identified literature is in no way extensive as it focuses on IMGs in the Australian context, which may impact on transferability. A gap exists where quality of life and social needs of IMGs and their families have been overlooked. These are crucial factors impacting rural acculturation, retention and IMGs health and wellbeing. The literature highlights insights into IMGs acculturation as they migrate and reside in Tasmania, a less culturally diverse population, remains absent with very little comparable research conducted.
Description:
Recently, there has been increasing scholarly interest in the relationship between tourism and quality of life (QOL). While the concept of QOL is contestable, a number of studies have revealed that travel can increase an individual’s perceived and actual QOL. To date, the focus has been on vacation travel, highlighting that travel primarily for the purpose of rest or recreation, whether to a holiday destination or touring, is a component of many people’s perceived QOL, and in some cases is a critical component. However, these more expensive forms of vacation travel are less accessible to those classified as socio-economically disadvantaged. Many such individuals can and do visit friends and relatives (VFR), suggesting that VFR may be a critical means by which socio-economically disadvantaged people can travel for pleasure and thereby maintain or improve their QOL. The article suggests a number of potential strategies based on the 8 Ps of the marketing mix, and these in turn inform avenues for future research.
Description:
Prostate cancer (PCa) is the second most frequent malignancy in men worldwide, accounting for 27% of new cancer cases in men and responsible for 3.8% of worldwide male cancer deaths (2018). This risk is projected to double before 204, so it is surprising that there are no well- established modifiable risk factors for PCa diagnosis orr progression. Considering this, the following thesis consists of three original research studies that examined; (1) the moderating effect of physical activity and muscular strength on prostate cancer mortality; (2) the magnitude of effect from pooled therapeutic exercise studies to impact quality of life and adverse events in PCa patients following surgery; (3) the head-to-head comparative efficacy of individual exercise therapies to impact quality of life and adverse events following surgery. The sum of works presented in this thesis lead to the conclusion that 1) when PCa is the only lifetime cancer diagnosis, life expectancy is similar to lifetime cancer free counterparts whereas diagnosis of PCa with any other lifetime cancer is associated with a 30.2% lower life expectancy during 10-year follow-up. Physical activity has negligible effect on life-expectancy whereas handgrip strength accounts for ~4% of the difference in life-expectancy between PCa with any other lifetime cancer compared with controls; 2) Pooled evidence from randomised controlled trials (n=999 participants) identifies that perioperative exercise therapy (aerobic, resistance, pelvic floor, mind-body exercise, or mixed exercise (combined aerobic and resistance) has a positive impact on patient quality of life and adverse events in PCa patients undergoing surgery which is predominant in perceptions of symptom related QoL (SMD: 0.56, 111 95% CI’s [0.22-0.89]) more so than health related quality of life (HRQoL) (SMD: 0.02, 95% 112 CI’s [-0.16-0.20]; 3) Comparison of head-to-head efficacy of different therapeutic exercise interventions [Aerobic, resistance, pelvic floor, mind-body exercise or mixed exercise (combined aerobic and resistance)] identified pelvic floor muscle exercise to be the most favorable exercise therapy to maintain QoL in PCa patients undergoing surgery, partly due to the current lack of evidence to support other exercise therapies. These findings provide new knowledge to support the effective treatment of PCa patients.
Description:
Prostate cancer (PCa) is the second most frequent malignancy in men worldwide, accounting for 27% of new cancer cases in men and responsible for 3.8% of worldwide male cancer deaths (2018). This risk is projected to double before 204, so it is surprising that there are no well- established modifiable risk factors for PCa diagnosis orr progression. Considering this, the following thesis consists of three original research studies that examined; (1) the moderating effect of physical activity and muscular strength on prostate cancer mortality; (2) the magnitude of effect from pooled therapeutic exercise studies to impact quality of life and adverse events in PCa patients following surgery; (3) the head-to-head comparative efficacy of individual exercise therapies to impact quality of life and adverse events following surgery. The sum of works presented in this thesis lead to the conclusion that 1) when PCa is the only lifetime cancer diagnosis, life expectancy is similar to lifetime cancer free counterparts whereas diagnosis of PCa with any other lifetime cancer is associated with a 30.2% lower life expectancy during 10-year follow-up. Physical activity has negligible effect on life-expectancy whereas handgrip strength accounts for ~4% of the difference in life-expectancy between PCa with any other lifetime cancer compared with controls; 2) Pooled evidence from randomised controlled trials (n=999 participants) identifies that perioperative exercise therapy (aerobic, resistance, pelvic floor, mind-body exercise, or mixed exercise (combined aerobic and resistance) has a positive impact on patient quality of life and adverse events in PCa patients undergoing surgery which is predominant in perceptions of symptom related QoL (SMD: 0.56, 111 95% CI’s [0.22-0.89]) more so than health related quality of life (HRQoL) (SMD: 0.02, 95% 112 CI’s [-0.16-0.20]; 3) Comparison of head-to-head efficacy of different therapeutic exercise interventions [Aerobic, resistance, pelvic floor, mind-body exercise or mixed exercise (combined aerobic and resistance)] identified pelvic floor muscle exercise to be the most favorable exercise therapy to maintain QoL in PCa patients undergoing surgery, partly due to the current lack of evidence to support other exercise therapies. These findings provide new knowledge to support the effective treatment of PCa patients.
Description:
This stimulating volume examines the many faces of Australias ageing population, the social and health issues they contend with, and the steps being takenand many that should be takento help ensure a more positive and productive later life. Individual and societal ageing are conceptualized as developmental in nature, socially diverse, and marked by daily life challenges stemming from the countrys economic structures, attitudes, geography, political landscape, and infrastructure. Wide-ranging coverage (e.g., health, inequalities, employment, transportation) assesses options available to older people, and the role of families, employers, service providers, government agencies, and others in promoting or expanding those choices. The books double emphasis on challenges in older peoples lives and opportunities for enhancing their quality of life is on clear display as case studies examine policy issuesand propose solutionsin a societal and individual context. Included in the coverage: · Australian developments in ageing: issues and history · Cultural diversity, health, and ageing · Indigenous Australians and ageing: responding to diversity in policy and practice · Enhancing the health and employment participation of older workers · Housing and the environments of ageing · Health services and care for older people The rich examples in Ageing in Australia contain a depth of understanding and evidence for sociologists, gerontologists and psychologists studying ageing, health care professionals providing care to older people, and policy analysts assessing areas for improvement.
Description:
Background Many tools are used to examine the Quality of Life (QOL) of patients with kidney disease, but little is known about how culturally relevant they are and why one should utilise one tool over another. As part of a larger study on the QOL of dialysis patients in United Arab Emirates, the cultural relevance of two tools (SF-36 and the QOL Index) was examined. This paper suggests a model to establish cultural relevance of QOL tools. Method A descriptive comparative survey design using a mixed method design was used in 2007 to study the QOL of 161 patients on dialysis and 350 people from the community. The cultural relevance of each tool was assessed by (i) examining missed questions, (ii) asking respondents about the cultural relevance of each tool, (iii) asking respondents what questions could be added or deleted to make the tools more culturally relevant and (iv) asking respondents to identify the factors that might contribute to their QOL. Results Of respondents, 94.7% from the dialysis sample and 90.4% from the community sample considered both tools culturally relevant. The QOL Index tool had more missing data. Many of the themes generated from the analysis of the qualitative data were addressed by the subscales of both tools. Themes not addressed by either tool were concerned with values, safety and country. Conclusion Cultural adaptation of QOL tools needs to follow well-established guidelines. The target population should be involved in establishing the cultural relevance of QOL tools.
The psychological aftermath of prostate cancer treatment choices : A comparison of depression, anxiety and quality of life outcomes over the 12 months following diagnosis
Description:
Objective: To assess the psychological impact of the different treatments for localised prostate cancer (PCA). Design, participants and setting: Observational, prospective study of consecutive patients with PCA attending clinics in public hospitals and private practices in metropolitan Melbourne between 1 April 2001 and 30 December 2005. Data were collected at initial diagnosis of histologically confirmed localised PCA, and close to the commencement of definitive treatment (Time 1), and 12 months later (Time 2). Patients were stratified according to treatment type (radical prostatectomy [RP], hormone therapy [HT] or other early treatment including radiation therapies [OET]). Patients who elected to undergo active surveillance/ watchful waiting (WW) rather than active treatment were treated as a naturalistic control group. Main outcome measures: Levels of depression and anxiety were assessed by the Brief Symptom Inventory, and physical and psychosocial aspects of health-related quality of life (HRQOL) were assessed by the 36-item Short-Form Health Survey. Results: 211 patients with PCA were recruited; 193 completed the Time 1 questionnaires (38 RP, 56 HT, 38 OET and 61 WW); and 172 completed the Time 2 questionnaires (33 RP, 51 HT, 33 OET and 55 WW). At Time 1, the three active treatment groups all reported greater dysfunction in work role and daily activities compared with the WW group. The RP group also reported worse social and emotional role functioning, while the HT and OET groups reported poorer vitality levels. The HT group reported significantly higher depression scores. At Time 2, the RP and OET groups did not differ from the WW group on either HRQOL or psychological status. By contrast, the HT group reported significantly worse HRQOL (physical functioning, role-physical and vitality domains) and greater psychological distress compared with the WW group. Conclusions: Compared with the other active treatments for localised PCA, HT appears to be associated with poorer HRQOL and greater psychological distress 12 months after commencing treatment.
Description:
Objective: To assess the psychological impact of the different treatments for localised prostate cancer (PCA). Design, participants and setting: Observational, prospective study of consecutive patients with PCA attending clinics in public hospitals and private practices in metropolitan Melbourne between 1 April 2001 and 30 December 2005. Data were collected at initial diagnosis of histologically confirmed localised PCA, and close to the commencement of definitive treatment (Time 1), and 12 months later (Time 2). Patients were stratified according to treatment type (radical prostatectomy [RP], hormone therapy [HT] or other early treatment including radiation therapies [OET]). Patients who elected to undergo active surveillance/ watchful waiting (WW) rather than active treatment were treated as a naturalistic control group. Main outcome measures: Levels of depression and anxiety were assessed by the Brief Symptom Inventory, and physical and psychosocial aspects of health-related quality of life (HRQOL) were assessed by the 36-item Short-Form Health Survey. Results: 211 patients with PCA were recruited; 193 completed the Time 1 questionnaires (38 RP, 56 HT, 38 OET and 61 WW); and 172 completed the Time 2 questionnaires (33 RP, 51 HT, 33 OET and 55 WW). At Time 1, the three active treatment groups all reported greater dysfunction in work role and daily activities compared with the WW group. The RP group also reported worse social and emotional role functioning, while the HT and OET groups reported poorer vitality levels. The HT group reported significantly higher depression scores. At Time 2, the RP and OET groups did not differ from the WW group on either HRQOL or psychological status. By contrast, the HT group reported significantly worse HRQOL (physical functioning, role-physical and vitality domains) and greater psychological distress compared with the WW group. Conclusions: Compared with the other active treatments for localised PCA, HT appears to be associated with poorer HRQOL and greater psychological distress 12 months after commencing treatment.