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2.
Support Care Cancer ; 28(12): 5803-5812, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32221668

RESUMO

PURPOSE: To evaluate the uptake and effect of RENEW, a 12-week exercise referral programme for young adult cancer survivors delivered by Trekstock, a UK-based cancer charity. METHODS: The RENEW programme provides one-to-one individually tailored support from a level-4 cancer-rehabilitation-qualified gym instructor, free gym membership and access to information resources online. Objective and self-report data on cardiorespiratory function, strength, body composition, fatigue, sleep quality and general health-related quality of life (HRQoL) was collected from participants before the programme (week 0), immediately after (week 12) and 1 month later (week 16). RESULTS: Forty-eight young adults (83% female; mean age, 29 years) with a history of cancer took part within the 12-week programme and completed the evaluation measures. Physical activity (PA) levels significantly increased following the programme and remained raised at follow-up. Improvements in physical function were significant: peak expiratory flow (mean change, 30.96, p = 0.003), sit-and-reach test (mean change, 6.55 ± 4.54, p < 0.0001), and 6-mine-walk test (mean change, 0.12 ± 0.04, p < 0.0001). No significant changes in BMI, weight or muscle mass were observed. Improvements in fatigue, sleep and HRQoL were observed across the programme and at follow-up (mean change, weeks 0-16; 8.04 ± 1.49 p < 0.01; 1.05 ± 0.49 p < 0.05; and - 0.9 ± 0.46 p = 0.051, respectively). Changes in self-efficacy to exercise and motivations to exercise were not observed at 12 weeks or at follow-up. CONCLUSIONS: Results suggest that the RENEW exercise referral programme has a positive impact upon some domains of physical function and well-being among young adult cancer survivors. IMPLICATION FOR CANCER SURVIVORS: Exercise referral programmes delivered by charity organisations are one means by which PA behaviour change support may be widely disseminated to young adult cancer survivors. Health professionals and charitable bodies specialising in the care of young adults with cancer should look to address factors which prevent engagement and uptake of 'real-world' PA interventions such as the RENEW programme.


Assuntos
Sobreviventes de Câncer/psicologia , Instituições de Caridade/normas , Terapia por Exercício/métodos , Neoplasias/reabilitação , Qualidade de Vida/psicologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Encaminhamento e Consulta , Adulto Jovem
3.
World J Surg ; 37(7): 1562-70, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23232819

RESUMO

BACKGROUND: The study measured the success of SmileTrain, the largest cleft charity globally, in alleviating the global burden of disease (GBD). It was done by estimating averted disability-adjusted life years (DALYs) and delayed averted DALYs because of the global backlog in cleft procedures. METHODS: Anonymized data for all procedures in the SmileTrain global database were analyzed by age, sex, country, region, and surgery type. DALYs averted were calculated using life expectancy tables and established and estimated disability weights. The cost-effectiveness analysis used mean SmileTrain procedural disbursement figures. Sensitivity analysis was performed using various cleft incidence rates, life expectancy tables, and disability weights. RESULTS: During 2003-2010 a total of 536,846 operations were performed on 364,467 patients-86 % in Southeast Asia and the western Pacific region. Procedure numbers increased yearly. Mean age at primary surgery-6.2 years (9.8 years in Africa)-remained fairly constant over time in each region. Globally, 2.1-4.7 million DALYs were averted through the operations at a total estimated cost of US$196 M. Mean DALYs per patient were 3.8-9.0, and mean cost per DALY was $72-$134. Total delayed GBD due to advanced age at surgery was 191,000-457,000 DALYs. CONCLUSIONS: Despite an unparalleled number of surgeries performed and yearly increase by one charity, the unmet and delayed averted cleft GBD remains significant in all regions. Large geographic disparities reflect varied challenges regarding access to surgery. Cleft surgeries are cost-effective interventions to reduce the global burden of disease (GBD). Future challenges include increased collaboration among cleft care providers and a focus on remote global areas by building infrastructure and local training.


Assuntos
Instituições de Caridade , Fissura Palatina/cirurgia , Efeitos Psicossociais da Doença , Saúde Global , Cooperação Internacional , Procedimentos de Cirurgia Plástica/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Instituições de Caridade/economia , Instituições de Caridade/normas , Instituições de Caridade/estatística & dados numéricos , Criança , Pré-Escolar , Fissura Palatina/economia , Análise Custo-Benefício , Feminino , Acessibilidade aos Serviços de Saúde/organização & administração , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Lactente , Expectativa de Vida , Tábuas de Vida , Masculino , Avaliação de Programas e Projetos de Saúde/métodos , Procedimentos de Cirurgia Plástica/economia
7.
Nature ; 379(6561): 99, 1996 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-8538773
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