Purpose: Physical activity (PA) has been suggested to help increase the survival of individuals with cancer. The objective of this review was to systematically evaluate and summarize the available evidence investigating the effect of PA on the survival of individuals with cancer. Methods: Electronic databases (CINAHL, EMBASE, and MEDLINE) were systematically searched for randomized controlled trials and cohort studies. Selected studies were assessed by two independent investigators for methodological quality, using the PEDro scale. Results: Ten prospective cohort studies met the inclusion criteria. Quality-assessment scores averaged 5/10 on the PEDro scale, with two articles obtaining a score of 6/10. The majority of studies found that individuals participating in higher levels of physical activity had a reduced risk of cancer-related mortality. This trend was observed specifically for breast, colon, and colorectal cancers. On average, it appears that engaging in higher levels of metabolic equivalent hours per week may help to improve survival rates among individuals diagnosed with cancer. Conclusion:Patients diagnosed with cancer demonstrated a trend toward increased survival with greater levels of PA. However, because only prospective cohort studies were included in the study, the conclusions drawn should be regarded with caution.Key Words: cancer, exercise, physical activity, survival, systematic review RÉ SUMÉObjectif : L'activité physique (AP) a é té suggé ré e comme moyen d'aider à la survie des individus atteints de cancer. L'objectif de cette analyse consistait à é valuer systé matiquement et à ré sumer l'ensemble des preuves disponibles relativement aux effets de l'activité physique sur la survie des personnes atteintes de cancer. Mé thode : Une recherche systé matique a é té ré alisé e dans les bases de donné es é lectroniques (CINAHL, EMBASE et MEDLINE), afin de ré pertorier les essais cliniques comparatifs randomisé s et les é tudes par cohortes. La qualité mé thodologique des é tudes sé lectionné es a é té é valué e par deux chercheurs indé pendants à l'aide de l'é chelle PEDro. Ré sultats : Dix é tudes prospectives par cohortes satisfaisaient les critè res d'inclusion. Les ré sultats de l'é valuation de la qualité se chiffraient en moyenne à 5/10 sur l'é chelle de PEDro ; deux articles ont obtenu une note de 6/10. La majorité des é tudes ont permis de constater que les individus prenant part à de l'activité physique plus soutenue couraient moins de risque de mourir du cancer. Cette tendance a é té particuliè rement observé e pour le cancer du sein, du cô lon et pour le cancer colorectal. En moyenne, il semble que le fait de participer à des niveaux plus é levé s d'é quivalents mé taboliques par semaine peut aider à amé liorer les taux de survie chez les individus ayant reç u un diagnostic de cancer. Conclusion : Les patients ayant reç u un diagnostic de cancer ont dé montré un plus grand taux de survie avec un niveau plus é levé d'AP. Toutefois, en raison de l'inclusion d'é tudes sur cohor...

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Innovation in the development of new drugs has to balance the needs of health actors and administrators, the pharmaceutical industry and patients. Differing perspectives on what constitutes an innovation, where research and development should be directed and how new drugs should be evaluated and priced cause ongoing tensions within the regulatory framework. In the current climate, where Europe's health systems face rising demand for health services and increasingly restricted resources, the efficiency of pharmaceutical regulation and drug development is under even greater scrutiny. How can regulation foster innovation and industry growth while also serving the public health needs of society, and what is the EU's role in pursuing this objective? Drawing on a provision which formerly existed in Norwegian pharmaceutical legislation, this article explores the potential of a medical need clause (MNC) in addressing these issues. In restricting market authorisations to those drugs that offer an added therapeutic value, might a MNC foster innovation and spending efficiency in Europe's health systems?

Until 1994, pharmaceutical products seeking market authorisation in Norway were required to demonstrate a fulfilment of unmet medical need. This clause enabled the national regulator to dramatically limit the number of products on the market whilst encouraging price competition to keep drug expenditure low and was credited with encouraging the development of drugs with genuine added therapeutic value and reducing the incidence of antimicrobial resistance. Norway was forced to abandon its Medical Need Clause (MNC) when it joined the European Economic Area as it was incompatible with the acquis communautaire of the European Union. This article reviews Norway's experience with its MNC in light of contemporary debates in European health policy. It discusses the potential contribution of an MNC-style regulation to improving health, reducing illness, ensuring sustainable health systems and fostering pharmaceutical innovation. It concludes by asking how these findings can inform current European Union debates over the growing cost of prescription drugs and direction of pharmaceutical development.

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Models of interest group politics can help public health professionals (PHPs) to identify potential allies and establish mechanisms of sustainable political influence. This article focusses on a particular model, known as the Advocacy Coalition Framework (ACF), and its explanations of coalition behaviour, the role of scientific information and the ways in which coalitions can bring about policy change. The analysis illustrates the relevance of the ACF for public health by drawing on examples from the recent policy debate on direct-to-consumer advertising of prescription drugs (DTCA-PD) in the European Union (EU). It explores the strengths and weaknesses of the ACF in explaining why ‘control’ of particular governmental units was key to the anti-DTCA coalition success, how the evidence base was used strategically and why the pro-DTCA coalition ultimately failed in bringing about major policy change. The article aims to equip PHPs with a tool which can be used to understand and engage with the policy process. Moreover, in offering a more nuanced view of this process, a case is made for moving beyond traditional, linear conceptions of the policy process and engaging in further research which uses political science concepts to inform the study and practice of public health. The article concludes with a set of recommendations for practitioners and researchers, emphasizing the value of political science for the former and the need for the latter to reflect on the accessibility of policy studies for PHPs.

Rationale, aims and objectives Between 2001 and 2011 the pharmaceutical industry, supported by DG Enterprise, was engaged in an ongoing campaign to repeal/amend the European Union (EU) ban on direct‐to‐consumer advertising of prescription drugs (DTCA‐PD). As it became increasingly clear that the ban would not be repealed, DTCA‐PD supporters tried to shift the debate away from advertising and towards the provision of ‘patient information’ and the rights of patients to access such information. Meanwhile, a variety of national and European health organizations, supported by DG SANCO, sought to maintain the ban and oppose the industry‐supported ‘patient information’ campaign. Instead, they promoted a concept of ‘health information’ that included all aspects of citizens' health, not just pharmaceuticals. This article aims to analyse the transition from DTCA‐PD to patient information to health information and examine its implications for EU health policy as a complex policy space. Methods The article examines the emergence and development of EU health policy and the evolution of the DTCA‐PD debate through the lens of complexity theory. It analyses the nature of the semantic, political and policy transition and asks why it occurred, what it tells us about EU health policy and future EU health legislation and how it may be understood from a complexity perspective. Results and conclusions The article concludes that the complexity framework is ideally suited for the field of public health and, in particular, the DTCA‐PD debate. Having successfully shifted the policy‐focus of the debate to patients’ rights and health information, opponents of the legislation are likely to face their next battle in the realm of cyberspace, where regulatory issues change the nature of advertising.

Although most governments were heavily scrutinized and looked bad early in the COVID-19 pandemic, the EU was most noticeable for its absence. As spring 2020 turned to summer it has become clear that most European citizens, and most European governments, expected their local, regional, and especially member state governments to protect them, not the EU. They are not wrong; the role of the EU in responding to a ramifying crisis such as COVID-19, with components ranging from public health to liquidity to trade to demand crises, is far from obvious. The law and politics are clear: the EU can only help save Europeans from a human public health crisis if member states instruct it to (Anderson et al. 2020).