Physical exercise and quality of life in patients with prostate cancer: systematic review and meta-analysis.

BACKGROUND: Prostate cancer leads to worse quality of life due to treatment and consequences of disease; benefits of physical exercise remain unclear on the improvement of quality of life in this population. The aim of this study is to evaluate the effectiveness of physical exercise in improving quality of life in patients with prostate cancer. METHODS: A systematic review and meta-analysis was carried out. For the search of studies, we used electronics databases such as Cochrane Library, MEDLINE via PUBMED, Regional Health Portal, and EMBASE, without language restrictions or year of publication. The descriptors used were as follows: "prostatic neoplasms," "exercise," and "quality of life." The risk analysis of bias in the meta-analysis was based on the Cochrane Collaboration Tool. For statistical analysis, the fixed effects model was used. Randomized controlled trials were included, which had a sample of patients with stage I-IV prostate cancer and that the intervention was aerobic physical exercise (AE) or resistance physical exercise (RE) or combined AE and RE. RESULTS: Five thousand six hundred nineteen studies were identified, but only 12 studies were selected. The quality of life of the patients was measured using instruments (SF 36, EORTC, AQoL-8D, IPSS and FACT-P), which served to divide the studies in groups where they presented the same instrument used. The analysis carried out shows that the quality of life of patients with prostate cancer submitted to aerobic training regimens had a protective effect in relation to the others. CONCLUSION: Most studies show an improvement in the quality of life of patients when they practice physical exercise, perceived by increasing the score of the instrument in question. However, methodological and heterogeneous differences between the studies increase the analysis bias.

Averting biodiversity collapse in tropical forest protected areas.

The rapid disruption of tropical forests probably imperils global biodiversity more than any other contemporary phenomenon. With deforestation advancing quickly, protected areas are increasingly becoming final refuges for threatened species and natural ecosystem processes. However, many protected areas in the tropics are themselves vulnerable to human encroachment and other environmental stresses. As pressures mount, it is vital to know whether existing reserves can sustain their biodiversity. A critical constraint in addressing this question has been that data describing a broad array of biodiversity groups have been unavailable for a sufficiently large and representative sample of reserves. Here we present a uniquely comprehensive data set on changes over the past 20 to 30 years in 31 functional groups of species and 21 potential drivers of environmental change, for 60 protected areas stratified across the world's major tropical regions. Our analysis reveals great variation in reserve 'health': about half of all reserves have been effective or performed passably, but the rest are experiencing an erosion of biodiversity that is often alarmingly widespread taxonomically and functionally. Habitat disruption, hunting and forest-product exploitation were the strongest predictors of declining reserve health. Crucially, environmental changes immediately outside reserves seemed nearly as important as those inside in determining their ecological fate, with changes inside reserves strongly mirroring those occurring around them. These findings suggest that tropical protected areas are often intimately linked ecologically to their surrounding habitats, and that a failure to stem broad-scale loss and degradation of such habitats could sharply increase the likelihood of serious biodiversity declines.