Lung cancer remains the leading cause of cancer‐related death worldwide. Affected patients frequently experience debilitating disease‐related symptoms, including dyspnea, cough, fatigue, anxiety, ...depression, insomnia, and pain, despite the progresses achieved in term of treatment efficacy.
Physical activity and exercise are nonpharmacological interventions that have been shown to improve fatigue, quality of life, cardiorespiratory fitness, pulmonary function, muscle mass and strength, and psychological status in patients with lung cancer. Moreover, physical fitness levels, especially cardiorespiratory endurance and muscular strength, are demonstrated to be independent predictors of survival. Nevertheless, patients with lung cancer frequently present insufficient levels of physical activity and exercise, and these may contribute to quality of life impairment, reduction in functional capacity with skeletal muscle atrophy or weakness, and worsening of symptoms, particularly dyspnea.
The molecular bases underlying the potential impact of exercise on the fitness and treatment outcome of patients with lung cancer are still elusive. Counteracting specific cancer cells’ acquired capabilities (hallmarks of cancer), together with preventing treatment‐induced adverse events, represent main candidate mechanisms.
To date, the potential impact of physical activity and exercise in lung cancer remains to be fully appreciated, and no specific exercise guidelines for patients with lung cancer are available. In this article, we perform an in‐depth review of the evidence supporting physical activity and exercise in lung cancer and suggest that integrating this kind of intervention within the framework of a global, multidimensional approach, taking into account also nutritional and psychological aspects, might be the most effective strategy.
Implications for Practice
Although growing evidence supports the safety and efficacy of exercise in lung cancer, both after surgery and during and after medical treatments, most patients are insufficiently active or sedentary. Engaging in exercise programs is particularly arduous for patients with lung cancer, mainly because of a series of physical and psychosocial disease‐related barriers (including the smoking stigma). A continuous collaboration among oncologists and cancer exercise specialists is urgently needed in order to develop tailored programs based on patients’ needs, preferences, and physical and psychological status. In this regard, benefit of exercise appears to be potentially enhanced when administered as a multidimensional, comprehensive approach to patients’ well‐being.
The potential effect of physical activity in lung cancer is not fully understood, and no specific exercise guidelines for lung cancer patients are available. This article reviews the evidence supporting physical activity and exercise in lung cancer and suggests that this type of intervention, along with considerations for the nutritional and psychological aspects of such an intervention, might be the most effective strategy.
Material selection problem can be interpreted as an intricate MCDM problem. The aim of this work is to provide a simple and comprehensive MCDM-based framework for solving this problem. First, we ...review basic characteristics of general material selection problem under MCDM paradigm. For doing so, we have studied over 60 papers11This study demonstrates that a very important number of articles in this field have been published in “Materials and Design” (published by Elsevier). published between 2010 and 2016 as a brief continuation of previous review 42 in this field. On the other hand, many researchers have emphasized in complicated decision problems more than one MCDM methods should be applied to obtain a more trustworthy and safer decision. Under the scrutiny of over 100 scientific articles, COPRAS and TOPSIS are chosen for tackling material selection problem in general. It is observed that the suggested approach by integrating these MCDM techniques is simple and effective. Also we examine the use of DEA as an MCDM tool in material selection problem. It is found that DEA can be employed to handle this problem by considering a classical remark, but MCDM cannot be generally replaced by DEA in this area.
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•TOPSIS and COPRAS are chosen as the best multi-criteria decision making (MCDM) techniques for ranking the alternative materials in general practice.•An excellent agreement between COPRAS and TOPSIS is observed.•DEA can be used in material selection problem as an auxiliary tool by considering a classic rough rule of thumb, which represents the relation between the number of alternatives and the number variables.
Excess mortality in persons with severe mental disorders (SMD) is a major public health challenge that warrants action. The number and scope of truly tested interventions in this area remain limited, ...and strategies for implementation and scaling up of programmes with a strong evidence base are scarce. Furthermore, the majority of available interventions focus on a single or an otherwise limited number of risk factors. Here we present a multilevel model highlighting risk factors for excess mortality in persons with SMD at the individual, health system and socio‐environmental levels. Informed by that model, we describe a comprehensive framework that may be useful for designing, implementing and evaluating interventions and programmes to reduce excess mortality in persons with SMD. This framework includes individual‐focused, health system‐focused, and community level and policy‐focused interventions. Incorporating lessons learned from the multilevel model of risk and the comprehensive intervention framework, we identify priorities for clinical practice, policy and research agendas.
Child obesity is a major public health issue. Alarming obesity projections have sparked widespread concern, albeit not much consensus on how to address the problem. Obesity has been often viewed as a ...matter of personal responsibility, and especially of parental responsibility when it concerns children. Elsewhere, I discussed the importance of adopting instead a children’s rights approach to hold governments accountable for preventing and combating child obesity. This article focuses instead on the right of children to participate in decision-making processes affecting their lives recognized under Article 12 of the Convention on the Rights of the Child. The article argues that its implementation through experiential food learning opportunities integrated into early childhood school curricula deserves much attention and holds some promise for effective solutions.
Geriatric syndromes: A therapeutic challenge Vandna Pandey; Nancy Kurien; Remiya Mohan
Journal of the Indian academy of geriatrics,
01/2022, Letnik:
18, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Aging is a natural phenomenon that is irrevocable. The older adult population is increasing rapidly in India, projected to increase from 6% to nearly 20% in 2050. Clinical conditions found among the ...elderly that do not fit into discrete disease categories and result from accumulated impairments in multiple systems are called geriatric syndromes. The authors have done a literature search of research papers from indexed and nonindexed journals e databases, Google Scholar, PubMed, and Scopus, Science Direct, Research Gate, and Cochrane. The search terms included were geriatric population, geriatric syndrome, geriatric care, elderly health problem, and comprehensive approach. The management of geriatric syndromes is a challenge to modern geriatric clinical practice. The comprehensive assessment of older adults using standardized tools must be carried out in any healthcare facility to ensure that their needs are met through care and treatment. Evidence-based standards of practice need to be implemented to provide nursing care for dealing with the therapeutic challenges of various geriatric syndromes.
•Sustainability challenges require both specialized and integrative approaches.•Domination of specialism and reductionism calls for emphasis on comprehensiveness.•The GHH framework can be used as a ...tool to add comprehensiveness in education.•The framework consists of three dimensions: generalism, holism, and holarchism.•The dialectical approach combines comprehensive and differentiative approaches.
Sustainability challenges such as climate change, biodiversity loss, poverty and rapid urbanization are complex and strongly interrelated. In order to successfully deal with these challenges, we need comprehensive approaches that integrate knowledge from multiple disciplines and perspectives and emphasize interconnections. In short, they aid in observing matters in a wider perspective without losing an understanding of the details. In order to teach and learn a comprehensive approach, we need to better understand what comprehensive thinking actually is. In this paper, we present a conceptual framework for a comprehensive approach, termed the GHH framework. The framework comprises three dimensions: generalism, holism, and holarchism. It contributes to the academic community’s understanding of comprehensive thinking and it can be used for integrating comprehensive thinking into education. Also, practical examples of the application of the framework in university teaching are presented. We argue that an ideal approach to sustainability challenges and complexity in general is a balanced, dialectical combination of comprehensive and differentiative approaches. The current dominance of specialization, or the differentiative approach, in university education calls for a stronger emphasis on comprehensive thinking skills. Comprehensiveness should not be considered as a flawed approach, but should instead be considered as important an aspect in education as specialized and differentiative skills.
Urban laws define power relations to change and reproduce urban spaces. The present article aimed to evaluate the effectiveness of "the law of the endorsement of revitalization, improvement and ...regeneration of decayed and inefficient urban neighborhoods on the process of urban regeneration in the decayed districts of Hamidia city, Yazd province, Iran, by using statistical methods including the Chi-square test, one-sample T-test and path analysis. The results showed all indicators related to urban regeneration are lower than the expected situation because regenerating drivers, including public-private participation, the socio-economic empowerment of residents, the provision of financial resources, tax incentives, building incentives, the allocation of urban infrastructure, urban land supply, the reduction of organizational bureaucracy and the improvement of inter-organizational coordination, do not work efficiently in the study area. The results of the one-sample T-test indicated that the above drivers have a significant distance from the expected conditions. According to the path analysis, the variables of socio-economic empowerment of residents, the allocation of urban infrastructure and the provision of financial resources have the most positive and overall effect on the urban regeneration of the decayed districts, respectively. Variables of the organizational bureaucracy, inter-organizational coordination and urban land supply have the most negative and overall effects, respectively. The ineffectiveness of urban regeneration law in Hamida city may result from its holistic and comprehensive approach. In urban environments like Hamida city with low diversity and low desirability of socio-economic-physical potentials, this approach can reduce the capacity of urban planners and managers to mobilize socio-economic and spatial resources to revitalize decayed districts.
The presented text reports on the offer of selected courses for Speech Therapists in the Czech Republic. These courses are able to assist Clinical Speech Therapists to support the direction of ...therapy and the therapy itself. All courses are based on the need for comprehensive Speech Therapy and human approach. The article also emphasizes the need for permanent lifelong learning, in view of the changing conditions regarding the development of modern Science and Technology.
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