Limited research exists regarding healthcare professionals' knowledge and practice of physical activity promotion for cancer survivors in Ireland. There is also a lack of research identifying the barriers experienced by oncology professionals when promoting physical activity, or referring patients to community-based exercise programmes. This study aims to identify healthcare professionals' knowledge, barriers and practices in relation to physical activity promotion for cancer survivors, and to generate guidance regarding the optimisation of the referral process to community-based exercise programmes. Oncology healthcare professionals (n = 114) were invited to participate in two rounds of an online Delphi study. The response rates in rounds one and two were 38% (43/114) and 70% (30/43). Most respondents acknowledged the value of physical activity for cancer survivors (≥86%) and agreed that discussing physical activity with cancer patients was part of their role (88%). However, the majority of recommendations provided to patients did not align with the current physical activity guidelines. Strategies related to four themes that could optimise the referral process to community-based exercise programmes achieved consensus, including providing education to healthcare professionals and patients regarding the benefits of physical activity and the logistics and quality of programmes, and optimising the logistics of the referral process.

BackgroundVirtual reality (VR) computer technology creates a simulated environment, perceived as comparable to the real world, with which users can actively interact. The e ectiveness of VR distraction on acute pain intensity in children is uncertain. ObjectivesTo assess the e ectiveness and adverse e ects of virtual reality (VR) distraction interventions for children (0 to 18 years) with acute pain in any healthcare setting. Search methodsWe searched CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO and four trial registries to October 2019. We also searched reference lists of eligible studies, handsearched relevant journals and contacted study authors. Selection criteriaRandomised controlled trials (RCTs), including cross-over and cluster-RCTs, comparing VR distraction to no distraction, non-VR distraction or other VR distraction. Data collection and analysisWe used standard Cochrane methodological processes. Two reviewers assessed risk of bias and extracted data independently. The primary outcome was acute pain intensity (during procedure, and up to one hour post-procedure). Secondary outcomes were adverse e ects, child satisfaction with VR, pain-related distress, parent anxiety, rescue analgesia and cost. We used GRADE and created 'Summary of findings' tables. Main resultsWe included 17 RCTs (1008 participants aged four to 18 years) undergoing various procedures in healthcare settings. We did not pool data because the heterogeneity in population (i.e. diverse ages and developmental stages of children and their di erent perceptions and reactions to pain) and variations in procedural conditions (e.g. phlebotomy, burn wound dressings, physical therapy sessions), and consequent level of pain experienced, made statistical pooling of data impossible. We narratively describe results.We judged most studies to be at unclear risk of selection bias, high risk of performance and detection bias, and high risk of bias for small sample sizes. Across all comparisons and outcomes, we downgraded the certainty of evidence to low or very low due to serious study limitations and serious or very serious indirectness. We also downgraded some of the evidence for very serious imprecision. Virtual reality distraction for acute pain in children (Review)

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The Implicit Association Test (IAT) is a reaction time based categorization task that measures the differential associative strength between bipolar targets and evaluative attribute concepts as an approach to indexing implicit beliefs or biases. An open question exists as to what exactly the IAT measures, and here EEG (Electroencephalography) has been used to investigate the time course of ERPs (Event-related Potential) indices and implicated brain regions in the IAT. IAT-EEG research identifies a number of early (250–450 ms) negative ERPs indexing early-(pre-response) processing stages of the IAT. ERP activity in this time range is known to index processes related to cognitive control and semantic processing. A central focus of these efforts has been to use IAT-ERPs to delineate the implicit and explicit factors contributing to measured IAT effects. Increasing evidence indicates that cognitive control (and related top-down modulation of attention/perceptual processing) may be components in the effective measurement of IAT effects, as factors such as physical setting or task instruction can change an IAT measurement. In this study we further implicate the role of proactive cognitive control and top-down modulation of attention/perceptual processing in the IAT-EEG. We find statistically significant relationships between D-score (a reaction-time based measure of the IAT-effect) and early ERP-time windows, indicating where more rapid word categorizations driving the IAT effect are present, they are at least partly explainable by neural activity not significantly correlated with the IAT measurement itself. Using LORETA, we identify a number of brain regions driving these ERP-IAT relationships notably involving left-temporal, insular, cingulate, medial frontal and parietal cortex in time regions corresponding to the N2- and P3-related activity. The identified brain regions involved with reduced reaction times on congruent blocks coincide with those of previous studies.

To elucidate the core executive function profile (strengths and weaknesses in inhibition, updating, and switching) associated with dyslexia, this study explored executive function in 27 children with dyslexia and 29 age matched controls using sensitive z-mean measures of each ability and controlled for individual differences in processing speed. This study found that developmental dyslexia is associated with inhibition and updating, but not switching impairments, at the error z-mean composite level, whilst controlling for processing speed. Inhibition and updating (but not switching) error composites predicted both dyslexia likelihood and reading ability across the full range of variation from typical to atypical. The predictive relationships were such that those with poorer performance on inhibition and updating measures were significantly more likely to have a diagnosis of developmental dyslexia and also demonstrate poorer reading ability. These findings suggest that inhibition and updating abilities are associated with developmental dyslexia and predict reading ability. Future studies should explore executive function training as an intervention for children with dyslexia as core executive functions appear to be modifiable with training and may transfer to improved reading ability.

The structural networks in the human brain are consistent across subjects, and this is reflected also in that functional networks across subjects are relatively consistent. These findings are not only present during performance of a goal oriented task but there are also consistent functional networks during resting state. It suggests that goal oriented activation patterns may be a function of component networks identified using resting state. The current study examines the relationship between resting state networks measured and patterns of neural activation elicited during a Stroop task. The association between the Stroop-activated networks and the resting state networks was quantified using spatial linear regression. In addition, we investigated if the degree of spatial association of resting state networks with the Stroop task may predict performance on the Stroop task. The results of this investigation demonstrated that the Stroop activated network can be decomposed into a number of resting state networks, which were primarily associated with attention, executive function, visual perception, and the default mode network. The close spatial correspondence between the functional organization of the resting brain and task-evoked patterns supports the relevance of resting state networks in cognitive function.

Background Community-based exercise rehabilitation programmes for chronic disease are an effective alternative to traditional hospital-based programmes. MedEx Wellness is a novel community-based exercise rehabilitation programme that integrates a range of chronic diseases. The aim of this trial was to investigate the effect of participating in MedEx Wellness on physical, clinical and psychological health. Methods A prospective cohort study was conducted. Participants were recruited at induction to the MedEx Wellness programme following referral from healthcare professionals. Participants underwent a baseline assessment before commencing the exercise programme and repeat assessments at 3, 6 and 12 months. The primary outcome was cardiorespiratory fitness (6 minute- time trial) at 12 months. Secondary outcomes included health-related quality of life (EuroQoL-5D, Satisfaction with Life Scale, Warwick Edinburgh Mental Wellbeing Scale, Patient Health Questionnaire8, Functional Assessment of Cancer Therapy Questionnaire), free living activity behavior (accelerometer) and healthcare utilization (recall questionnaire). Tertiary outcomes included blood pressure (24 h), biomarkers (lipids, glucose and C-reactive protein), other components of physical fitness, including strength (handgrip test, sit-to-stand test), flexibility (sit-and-reach test), body composition (body mass index and waist-to-hip ratio), and falls risk (timed up and go test), and claudication time (incremental treadmill walking test), cognitive function, including attention (Attention Network Task), memory (Luck & Vogel Visual Working Memory Task) and cognitive reserve. Exploratory outcomes included psychosocial determinants of physical activity (self-efficacy, social support, intentions). Discussion This trial will evaluate whether participation in the MedEx Wellness programme has positive effects on physical, clinical and psychological health in individuals with a range of chronic diseases. Trial registration ISRCTN Registry ISRCTN10351412.

Objective: Cancer remains one of the most enduring health crises of the modern world. Prehabilitation is a relatively new intervention aimed at preparing individuals for the stresses associated with treatment from diagnosis. Prehabilitation can include exercise, psychological and nutrition-based interventions. The present systematic review aimed to assess the efficacy of prehabilitation on affective and functional outcomes for young to midlife adult cancer patients (18-55 years). Outcomes of interest included prehabilitation programme composition, duration, mode of delivery and measures used to determine impact on affective and functional outcomes. Methods: The following databases were searched with controlled and free text vocabulary; Psychological Information database (PsychINFO), Culmunated Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica Database (EMBASE) andPublic MEDLINE (PubMed). Abstract and full-text screening was conducted with a secondary reviewer and final texts were subject to risk of bias analysis.Results: Thirteen texts were included at full-text. These included data of 797 prehabilitation participants (mean age 53 years) and a large representation of female participants (71% average). Evidence was found for the efficacy of psychological prehabilitation for anxiety reduction. Prehabilitation did not significantly affect health related quality of life. Findings moderately supported the therapeutic validity of exercise prehabilitation for functional outcomes, both in terms of clinical and experimental improvement with respect to the quality of evidence. Variation between all prehabilitation types was observed. There was insufficient evidence to support the efficacy of psychological prehabilitation on stress, distress or depression. Conclusion:Implications for future research are highlighted and then discussed with respect to this young to midlife age group.