For whom and what outcomes does cognitive-behavioral-therapy work among cancer survivors: a systematic review and meta-analysis.

OBJECTIVE: To perform a systematic review and meta-analysis of CBT for individuals diagnosed with cancer across a broad range of outcome domains, i.e., functional health, psychological health, health behaviors, social relational, and general wellness. METHODS: A comprehensive search of 7 databases, 91 published reviews, and 4 professional websites was performed on August 30th, 2021. English-language clinical trials of CBT for cancer patients/survivors were included. Studies were independently screened, and data were extracted by 2 reviewers, and discrepancies were resolved by consensus among the investigative team. A total of 151 clinical trials (154 articles) published between 1986 and 2021 were included in the analysis. RESULTS: CBT was overall effective for cancer patients/survivors in the domains of functional health, g = 0.931, p < 0.001, psychological health, g = 0.379, p < 0.001, and general wellness, g = 0.257, p < 0.001, but ineffective in domains of health behaviors, g = 0.792, p > 0.05, and social relational outcomes, g = 0.319, p > 0.05. Additional subgroup and moderator analyses further revealed CBT's differential treatment effect for different within domain outcomes, across different cancer disease stages, and CBT delivery format. CONCLUSIONS: Findings of the study showed that CBT is an effective treatment for individuals diagnosed with cancer. However, treatment effects differ by important disease- and intervention-related factors, which should be considered when recommending CBT for cancer patients/survivors.

Scale-dependence in elk habitat selection for a reintroduced population in Wisconsin, USA.

Habitat selection is a critical aspect of a species' ecology, requiring complex decision-making that is both hierarchical and scale-dependent, since factors that influence selection may be nested or unequal across scales. Elk (Cervus canadensis) ranged widely across diverse ecoregions in North America prior to European settlement and subsequent eastern extirpation. Most habitat selection studies have occurred within their contemporary western range, even after eastern reintroductions began. As habitat selection can vary by geographic location, available cover, season, and diel period, it is important to understand how a non-migratory, reintroduced population in northern Wisconsin, USA, is limited by the lack of variation in topography, elevation, and vegetation. We tested scale-dependent habitat selection on 79 adult elk from 2017 to 2020 using resource selection functions across temporal (i.e., seasonal) and spatial scales (i.e., landscape and home range). We found that selection varied both spatially and temporally, and elk selected areas with the greatest potential to influence fitness at larger scales, meaning elk selected areas closer to escape cover and further from "risky" features (e.g., annual wolf territory centers, county roads, and highways). We found stronger avoidance of annual wolf territory centers during spring, suggesting elk were selecting safer habitats during calving season. Elk selected habitats with less canopy cover across both spatial scales and all seasons, suggesting that elk selected areas with better access to forage as early seral stage stands have greater forage biomass than closed-canopy forests and direct solar radiation to provide warmth in the cooler seasons. This study provides insight into the complexity of hierarchical decision-making, such as how risky habitat features and land cover type influence habitat selection differently across seasons and spatial scales, influencing the decision-making of elk. Scale-dependent behavior is crucial to understand within specific geographic regions, as these decisions scale up to influence population dynamics.

Effectiveness of cognitive behavioral therapy in improving functional health in cancer survivors: A systematic review and meta-analysis.

BACKGROUND: Cancer survivors suffer from health deficits caused by their disease and treatment. This study conducted a systematic review and meta-analysis on how, and to what extent, cognitive-behavioral therapy (CBT) impacts functional health outcomes in cancer survivors. METHODS: We searched 7 electronic databases, 91 published review articles, and 4 professional websites for eligible randomized and non-randomized controlled trials focusing on cancer survivors. RESULTS: We included 95 studies published between 1986 and 2021. Risk of bias across studies was low overall. We identified an overall statistically significant treatment effect size across functional health categories, d = 0.391, p < 0.001, and significant moderators associated with CBT's treatment effect, i.e., treatment phase and type of comparison. CONCLUSIONS: CBT was effective at improving functional health outcomes of cancer survivors, regardless of therapy delivery modality or number of cancer diagnoses patients had, but not for newly diagnosed patients or those currently benefiting from an active comparator intervention.