count 298Key words: Exercise, prostate cancer, quality of life, fatigue, adverse effects AbstractContext: Exercise for prostate cancer survivors could be beneficial. However, no systematic review across cancer stages and treatment types addressing potential benefits and harms exists to date.Objectives: Primarily, to assess the effects of exercise on cancer specific quality of life and adverse events in prostate cancer trials. Evidence acquisition:We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, SPORTDiscus and PEDro. We also searched grey literature databases, including trials registers. Searches were from database inception to March 2015.Standardised mean differences (SMD) were calculated for meta-analysis. Evidence synthesis:We included 16 RCTs involving 1574 men with prostate cancer. Follow-up varied from just eight weeks to 12months. RCTs involved men with stages I-IV cancers. High risk of bias was frequently due to attrition and intervention adherence. Seven trials involving 912 men measured cancer specific quality of life. No significant effect on this outcome was found from pooling the data from these seven trials (SMD = 0.13, 95% CI = -0.08, 0.34, median follow-up 12 weeks). Sensitivity analysis of studies that were judged to be of high quality indicated a moderate positive effect estimate (SMD = 0.33, 95% CI = 0.08, 0.58, median follow-up 12 weeks). Similar beneficial effects were seen in cancer specific fatigue, submaximal fitness and lower body strength. We found no evidence of benefit for disease progression, cardiovascular health or sexual function. There were no deaths attributable to exercise interventions. Other serious adverse events (e.g. myocardial infarction) were equivalent to those seen in controls. Conclusions:These results support exercise interventions for improving cancer specific quality of life, cancer specific fatigue, submaximal fitness and lower body strength.Patient summary: This review shows that exercise or physical activity interventions can improve quality of life, fatigue, fitness and function for men with prostate cancer. BackgroundProstate cancer is the primary cause of years lived with cancer disability in the Americas, North- hypercalcaemia, spinal cord compression, pathological fractures) can also adversely affect health. [7,8] Several recent systematic reviews have examined the effects of exercise in cancer survivors, in terms of quality of life outcome [9,10], exercise behaviour [11] and effects on fatigue.[12] These reviews are an amalgamation of heterogeneous primary cancers. Indeed, most evidence comes from trials in breast cancer and as such cannot be generalised to men with prostate cancer. Further, exercise therapy appears beneficial in the short term, but little is known about dose, duration and longerterm effects of such therapy, including adverse effects over an extended follow-up. Finally, despite the potential health benefits for men with prostate cancer, few clinicians are aware of the role of...

Background: Exercise programmes that can demonstrate evidence of long-lasting

(2017) A qualitative investigation of exercise perceptions and experiences in people with multiple sclerosis before, during and after participation in a personally-tailored exercise program. Archives of Physical Medicine and Rehabilitation, 98 (12 Northumbria University has developed Northumbria Research Link (NRL) to enable users to access the University's research output. Copyright © and moral rights for items on NRL are retained by the individual author(s) and/or other copyright owners. Single copies of full items can be reproduced, displayed or performed, and given to third parties in any format or medium for personal research or study, educational, or not-for-profit purposes without prior permission or charge, provided the authors, title and full bibliographic details are given, as well as a hyperlink and/or URL to the original metadata page. The content must not be changed in any way. Full items must not be sold commercially in any format or medium without formal permission of the copyright holder. The full policy is available online: http://nrl.northumbria.ac.uk/policies.html This document may differ from the final, published version of the research and has been made available online in accordance with publisher policies. To read and/or cite from the published version of the research, please visit the publisher's website (a subscription may be required.)

BackgroundThe National Health Service (NHS) seems appropriately placed to be an exemplar employer in providing effective and proactive workplace health and wellbeing services for its staff. However, NHS staff sickness absence costs an estimated £2.4 billion. Evidence suggests staff health and wellbeing services delivered in the NHS can improve health, productivity and sickness absence and yet the adoption of these services remains a challenge, with few examples nationally. This research aimed to explore the perceptions of NHS senior leaders and health and wellbeing practitioners regarding barriers and facilitators to implementing workplace health and wellbeing services for staff in the NHS.MethodsSemi-structured interviews were conducted with NHS staff, consisting of four senior leaders, four heads of department and three health and wellbeing practitioners in one region of the UK. Interviews were transcribed verbatim and analysed using thematic analysis.ResultsThemes describe the experience of delivering workplace health and wellbeing services in the NHS, and barriers and facilitators to implementation from senior decision makers. Barriers to implementation of services include; a busy and pressurised environment, financial constraints and reluctance to invest in staff health and wellbeing. Barriers to staff engagement were also reported and include difficulty of access to health and wellbeing services and lack of time. Initiating services were facilitated by financial incentives, a supportive organisational structure and culture that takes a preventative, rather than reactive, approach to staff health and wellbeing. Facilitators to implementing health and wellbeing services include a coherent, strategic approach to implementation, effective communication and advertisement, being creative and innovative with resources and conducting a needs analysis and evaluation before, during and after implementation.ConclusionsBarriers to the successful initiation and implementation of health and wellbeing services in the NHS are numerous and range from front-line logistical issues with implementation to high-level strategic and financial constraints. Adopting a strategic and needs-led approach to implementation and ensuring thorough staff engagement are amongst a number of factors that facilitate implementation and help overcome barriers to initiation of wellbeing programmes in the NHS. There is a need for a culture that supports staff health and wellbeing in the NHS.

The pragmatic exercise intervention is highly likely to be cost effective at current established thresholds, and there is scope for it to be tailored to particular sub-groups of patients or services to reduce its cost impact.

These results indicate that EBV lytic activity in a subject cannot be inferred from a single measure of EBV in saliva. Also, subjects do not appear to be behave constantly as "EBV shedders" or "non-shedders". The assay is useful in giving a clear indication of salivary gland EBV lytic activity across a patient cohort - for example, in testing anti-viral drugs in MS.

BackgroundThe success of a clinical trial is often dependant on whether recruitment targets can be met in the required time frame. Despite an increase in research into the benefits of exercise in people with multiple sclerosis (PwMS), no trial has reported detailed data on effective recruitment strategies for large-scale randomised controlled trials. The main purpose of this report is to provide a detailed outline of recruitment strategies, rates and estimated costs in the Exercise Intervention for Multiple Sclerosis (ExIMS) trial to identify best practices for future trials involving multiple sclerosis (MS) patient recruitment.MethodsThe ExIMS researchers recruited 120 PwMS to participate in a 12-week exercise intervention. Participants were randomly allocated to either exercise or usual-care control groups. Participants were sedentary, aged 18–65 years and had Expanded Disability Status Scale scores of 1.0–6.5. Recruitment strategies included attendance at MS outpatient clinics, consultant mail-out and trial awareness-raising activities.ResultsA total of 120 participants were recruited over the course of 34 months. To achieve this target, 369 potentially eligible and interested participants were identified. A total of 60 % of participants were recruited via MS clinics, 29.2 % from consultant mail-outs and 10.8 % through trial awareness. The randomisation yields were 33.2 %, 31.0 % and 68.4 % for MS clinic, consultant mail-outs and trial awareness strategies, respectively. The main reason for ineligibility was being too active (69.2 %), whilst for eligible participants the most common reason for non-participation was the need to travel to the study site (15.8 %). Recruitment via consultant mail-out was the most cost-effective strategy, with MS clinics being the most time-consuming and most costly.ConclusionsTo reach recruitment targets in a timely fashion, a variety of methods were employed. Although consultant mail-outs were the most cost-effective recruitment strategy, use of this method alone would not have allowed us to obtain the predetermined number of participants in the required time period, thus leading to costly extensions of the project or failure to reach the number of participants required for sufficient statistical power. Thus, a multifaceted approach to recruitment is recommended for future trials.Trial registrationInternational Standard Randomised Controlled Trial Registry number: ISRCTN41541516; date registered: 5 February 2009.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-015-0996-3) contains supplementary material, which is available to authorized users.

Purpose Women with polycystic ovary syndrome (PCOS) exhibit many metabolic abnormalities that are associated with an increased cardiovascular disease risk. Exercise may promote improvements in lipid profile and insulin sensitivity in women with PCOS. There is however, a knowledge gap on the optimal dose of exercise, regarding duration, intensity, type, and frequency of exercise. The aim of this systematic review and meta-analysis was to define effective types of exercise to improve cardiometabolic profile in PCOS. Methods We included randomised controlled trials (RCT), quasi-RCT, and controlled clinical trials focusing on reproductiveaged women diagnosed with PCOS. Eligible interventions included those with at least two weeks of supervised exercise sessions. Primary outcomes were blood lipids, blood glucose, blood pressure, measures of abdominal adiposity, and inflammation markers. Secondary outcomes were total and free testosterone, sex hormone binding globulin, and measures of insulin resistance. Nine electronic databases were searched from inception to present for English language publications. The Cochrane Risk Assessment tool was used to assess bias in the included studies. Outcomes were quantitatively synthesised and a meta-analysis was performed. Pooled effect estimates and 95% confidence intervals were presented. Results This systematic review identified three trials, including 231 participants with PCOS, that examined the effect of structured, supervised exercise on cardiometabolic outcomes. Analysis of pooled data indicated statistical favourable effects of exercise on total cholesterol, fasting glucose, waist circumference and waist-to-hip ratio, systolic blood pressure, C-reactive protein, total testosterone, and sex hormone binding globulin using post-intervention scores. Conclusions Moderate aerobic exercise interventions ≥3 months in duration, with a frequency of 3/week for at least 30-min, may have favourable effects on various cardiometabolic risk factors in women with PCOS. However, results should be interpreted with caution. Many of the outcomes were based on studies with serious methodological limitations, and only one "gold-standard" RCT was identified. PROSPERO ID: CRD42018086117.