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- Adlard, Kirsten N, et al.
(författare)
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Peer support for the maintenance of physical activity and health in cancer survivors : the PEER trial - a study protocol of a randomised controlled trial.
- 2019
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Ingår i: BMC Cancer. - : Springer Science and Business Media LLC. - 1471-2407. ; 19:1, s. 656-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Despite an overwhelming body of evidence showing the benefits of physical activity (PA) and exercise for cancer survivors, few survivors meet the exercise oncology guidelines. Moreover, initiating, let alone maintaining exercise programs with cancer survivors continues to have limited success. The aim of this trial is to evaluate the influence of peer support on moderate-to-vigorous PA (MVPA) and various markers of health 12 months following a brief supervised exercise intervention in cancer survivors.METHODS: Men and women previously diagnosed with histologically-confirmed breast, colorectal or prostate cancer (n = 226), who are >1-month post-treatment, will be invited to participate in this trial. Once enrolled, participants will complete 4 weeks (12 sessions) of supervised high intensity interval training (HIIT). On completion of the supervised phase, both groups will be provided with written recommendations and verbally encouraged to achieve three HIIT sessions per week, or equivalent exercise that meets the exercise oncology guidelines. Participants will be randomly assigned to receive 12 months of peer support, or no peer support (control). Primary and secondary outcomes will be assessed at baseline, after the 4-week supervised HIIT phase and at 3-, 6- and 12-months. Primary outcomes will include accelerometry-derived MVPA and prescribed HIIT session adherence; whilst secondary outcomes will include cardiorespiratory fitness ([Formula: see text]), body composition, quality of life and select cytokines, myokines and inflammatory markers. Random effects mixed modelling will be used to compare mean changes in outcomes between groups at each time point. A group x time interaction will be used to formally test for differences between groups (alpha =0.05); utilising intention-to-treat analyses.DISCUSSION: If successful, peer support may be proposed, adopted and implemented as a strategy to encourage cancer survivors to maintain exercise beyond the duration of a short-term, supervised intervention. A peer support-exercise model has the long-term potential to reduce comorbidities, improve physical and mental wellbeing, and significantly reduce the burden of disease in cancer survivors.ETHICS: Human Research Ethics Committee of Bellberry Ltd. (#2015-12-840).TRIAL REGISTRATION: Australian New Zealand Clinical Trial Registry 12618001855213 . Retrospectively registered 14 November 2018. Trial registration includes all components of the WHO Trial Registration Data Set, as recommended by the ICMJE.
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| 4. |
- Brower Scribani, Melissa, 1979-
(författare)
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Insights on weight maintenance and impacts of obesity for two rural populations in the United States and Sweden
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Obesity is a serious public health concern worldwide, and nearly 40% of all adults in the United States and 21% in Sweden are now living with obesity. Efforts focusing mainly on weight loss have fallen short in reducing obesity prevalence. There is a great need for improved insight into what factors may promote a healthy weight, thereby avoiding the adverse health outcomes linked to obesity. Primary weight maintenance is a prevention strategy that emphasizes keeping a long-term stable weight in the non-obese range.Aim: The overall aims of this thesis were to improve understanding of the patterns of obesity and obesity-related mortality among rural adults in Central New York State (U.S.) and Västerbotten County (Sweden), and to explore factors that are related to primary weight maintenance.Material and methods: Data from U.S. health surveys and health examinations in Sweden were used to compare twenty-year (1989-2009) trends in body mass index (BMI) and obesity using multi-factor analysis of variance. The association between obesity and risk of 1) premature all-cause death, and 2) premature circulatory death, was compared between the U.S. and Sweden using proportional hazards regression. In 2009, a longitudinal questionnaire of attitudes, behaviors and perceptions regarding weight maintenance was administered to U.S. subjects. Associations between ten-year weight change and survey variables were tested using multiple linear regression, separately for sex and age strata. To gain a deeper understanding of influences, facilitators and barriers to healthy eating and physical activity, a qualitative interview study was conducted with U.S. women aged 26-35, with data analyzed by qualitative content analysis.Results: Over twenty years, BMI increased for both men and women in all age strata in both countries, and those with no university education consistently had higher BMI than their university-educated counterparts. BMI increased more for younger groups (ages 36-45) compared to those aged 46-55 and 56-62. U.S. females aged 36-45 showed the greatest increases in average BMI, particularly when comparing 1999 to 2009. Increases in the prevalence of obesity (BMI≥30) in Sweden were more modest than in the U.S. Severe obesity (BMI≥35) was associated with significantly increased risk of premature death from all causes and from circulatory causes for all subjects. Severe obesity was less common in Sweden (2% of men, 3% of women) than in the U.S. (8% of men, 9% of women). Nonetheless, severely obese Swedish men had 2.9 times the risk of premature death from all causes compared to those of normal weight, and 4.9 times the risk for circulatory causes. The gradient of risk among U.S. men was significantly lower than in Sweden; those with severe obesity had a 1.6 times increased risk for all-cause premature death and 3.2 times increased risk for premature circulatory death. The pattern of risk among women did not differ between countries. Longitudinal analysis of U.S. health survey participants showed that women aged 26-35 gained the most weight of any group (mean=10.3kg gained over ten years). The variables found to be associated with ten-year weight change were different across sex and age groups. Among women, all variables associated with weight change were exercise-related. Among men, three of the four predictors were focused on eating habits. Interviews with women aged 26-35 revealed the challenges of healthy eating and engaging in physical activity. Women often identified as caregivers for others, and those with more social support, who were financially stable and showed self-efficacy around healthy choices were able to more consistently engage in healthy habits.Conclusions: Obesity is an increasing problem for the rural adult population in both the U.S. and Sweden. When primary weight maintenance strategies are designed to support individuals towards healthy eating and increased physical activity, the complexity of the living environment must be considered. Individual conditions and personal relationships as well as the physical environment, home environment and work environment must be included in the assessment. Development of targeted programs for primary weight maintenance should be a focus of public health work for adults in rural areas in both Sweden and the U.S.
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| 5. |
- Kirsten, Franz, 1983, et al.
(författare)
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Detection of two bright radio bursts from magnetar SGR 1935 + 2154
- 2021
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Ingår i: Nature Astronomy. - : Springer Science and Business Media LLC. - 2397-3366. ; 5:4, s. 414-422
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Tidskriftsartikel (refereegranskat)abstract
- Fast radio bursts are millisecond-duration, bright radio signals (fluence 0.1-100 Jy ms) emitted from extragalactic sources of unknown physical origin. The recent CHIME/FRB and STARE2 detection of an extremely bright (fluence similar to MJy ms) radio burst from the Galactic magnetar SGR 1935+2154 supports the hypothesis that (at least some) fast radio bursts are emitted by magnetars at cosmological distances. In follow-up observations totalling 522.7 h on source, we detect two bright radio bursts with fluences of 112 +/- 22 Jy ms and 24 +/- 5 Jy ms, respectively. Both bursts appear to be affected by interstellar scattering and we measure significant linear and circular polarization for the fainter burst. The bursts are separated in time by similar to 1.4 s, suggesting a non-Poissonian, clustered emission process-similar to those seen in some repeating fast radio bursts. Together with the burst reported by CHIME/FRB and STARE2, as well as a much fainter burst seen by FAST (fluence 60 mJy ms), our observations demonstrate that SGR 1935+2154 can produce bursts with apparent energies spanning roughly seven orders of magnitude, and that the burst rate is comparable across this range. This raises the question of whether these four bursts arise from similar physical processes, and whether the fast radio burst population distribution extends to very low energies (similar to 10(30) erg, isotropic equivalent).
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- Koehler, Jonathan, et al.
(författare)
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An agenda for sustainability transitions research: State of the art and future directions
- 2019
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Ingår i: Environmental Innovation and Societal Transitions. - : Elsevier BV. - 2210-4224 .- 2210-4232. ; 31, s. 1-32
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Tidskriftsartikel (refereegranskat)abstract
- Research on sustainability transitions has expanded rapidly in the last ten years, diversified in terms of topics and geographical applications, and deepened with respect to theories and methods. This article provides an extensive review and an updated research agenda for the field, classified into nine main themes: understanding transitions; power, agency and politics; governing transitions; civil society, culture and social movements; businesses and industries; transitions in practice and everyday life; geography of transitions; ethical aspects; and methodologies. The review shows that the scope of sustainability transitions research has broadened and connections to established disciplines have grown stronger. At the same time, we see that the grand challenges related to sustainability remain unsolved, calling for continued efforts and an acceleration of ongoing transitions. Transition studies can play a key role in this regard by creating new perspectives, approaches and understanding and helping to move society in the direction of sustainability.
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- Owolabi, Mayowa O., et al.
(författare)
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Gaps in Guidelines for the Management of Diabetes in Low- and Middle-Income Versus High-Income Countries : A Systematic Review
- 2018
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Ingår i: Diabetes Care. - : AMER DIABETES ASSOC. - 0149-5992 .- 1935-5548. ; 41:5, s. 1097-1105
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Forskningsöversikt (refereegranskat)abstract
- OBJECTIVE The extent to which diabetes (DM) practice guidelines, often based on evidence from high-income countries (HIC), can be implemented to improve outcomes in low-and middle-income countries (LMIC) is a critical challenge. We carried out a systematic review to compare type 2 DM guidelines in individual LMIC versus HIC over the past decade to identify aspects that could be improved to facilitate implementation. RESEARCH DESIGN AND METHODS Eligible guidelines were sought from online databases and websites of diabetes associations and ministries of health. Type 2 DM guidelines published between 2006 and 2016 with accessible full publications were included. Each of the 54 eligible guidelines was assessed for compliance with the Institute of Medicine (IOM) standards, coverage of the cardiovascular quadrangle (epidemiologic surveillance, prevention, acute care, and rehabilitation), translatability, and its target audiences. RESULTS Most LMIC guidelines were inadequate in terms of applicability, clarity, and dissemination plan as well as socioeconomic and ethical-legal contextualization. LMIC guidelines targeted mainly health care providers, with only a few including patients (7%), payers (11%), and policy makers (18%) as their target audiences. Compared with HIC guidelines, the spectrum of DM clinical care addressed by LMIC guidelines was narrow. Most guidelines from the LMIC complied with less than half of the IOM standards, with 12% of the LMIC guidelines satisfying at least four IOM criteria as opposed to 60% of the HIC guidelines (P < 0.001). CONCLUSIONS A new approach to the contextualization, content development, and delivery of LMIC guidelines is needed to improve outcomes.
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