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The World Federation of Ultrasound in Medicine and Biology (WFUMB) has started a series of position papers highlighting the role of ultrasound techniques for diagnosis, risk assessment and follow-up of incidental imaging findings. Gallbladder and biliary tree are among the most frequent anatomical localizations of incidental findings. A first part of the position paper on incidental findings of gallbladder and bile ducts was related to gallbladder polyps and other incidental findings of the gallbladder wall. Based on a description of normal findings, this second part addresses congenital anomalies and variations of the gallbladder and the biliary tree, asymptomatic bile duct dilatation and “silent” gallstones. Based on evidence on prevalence and outcome and with a special focus on ultrasound techniques, the position paper makes recommendations regarding diagnostic work-up, follow-up and treatment of these incidental findings.

The UK has the highest rate of cannabis use among young people worldwide. Dr. Alan Leshner, Director of the National Institute of Drug Abuse reports, "Every year more than 100,000 people, most of them adolescents, seek treatment for their inability to control their marijuana use." According to the Scottish Drug Misuse Statistics in Scotland 2002, 51% of individuals under 20 years have used cannabis. Cannabis use is not limited to youth; it is also the single-most used illicit drug among adults. Because of their widespread negative impact, illicit drugs have become a focus of the agenda of the English Parliament and there is ongoing debate on how to combat this problem. As the research assistant of Michael Matheson (MSP), the author compiled this report to gather information on cannabis and to assess approaches that would form the most effective cannabis policy. This research explores whether or not the recent change toward decriminalization is adequate, or if it needs further revising.

Derived from the myeloid lineage, granulocytes, including basophils, eosinophils, and neutrophils, along with mast cells, play important, often disparate, roles across the allergic disease spectrum. While these cells and their mediators are commonly associated with allergic inflammation, they also exhibit several functions either promoting or restricting tumor growth. In this Position Paper we discuss common granulocyte and mast cell features relating to immunomodulatory functions in allergy and in cancer. We highlight key mechanisms which may inform cancer treatment and propose pertinent areas for future research. We suggest areas where understanding the communication between granulocytes, mast cells, and the tumor microenvironment, will be crucial for identifying immune mechanisms that may be harnessed to counteract tumor development. For example, a comprehensive understanding of allergic and immune factors driving distinct neutrophil states and those mechanisms that link mast cells with immunotherapy resistance, might enable targeted manipulation of specific subpopulations, leading to precision immunotherapy in cancer. We recommend specific areas of investigation in AllergoOncology and knowledge exchange across disease contexts to uncover pertinent reciprocal functions in allergy and cancer and allow therapeutic manipulation of these powerful cell populations. These will help address the unmet needs in stratifying and managing patients with allergic diseases and cancer. [ABSTRACT FROM AUTHOR]

Background Physiotherapists have strong knowledge and skills to deal with many of the functional problems that result from cancer treatment. The role of physiotherapy spans from cancer prevention to palliative and end of life care. Physiotherapeutic interventions offer a solution for many of the impairments experienced by patients living with and beyond cancer such as declines in physical function and quality of life. Specialized physiotherapeutic interventions can manage complex cancer-related side effects. The aim of this position paper is to outline the role of physiotherapy in the cancer journey. Material and methods The research was performed by eleven physiotherapy experts in oncology between May and October 2021 by using PubMed, PeDro and clinical guidelines databases. The search was divided according to the phases of the cancer journey: primary and secondary prevention, prehabilitation, during cancer treatment, post-treatment cancer rehabilitation, long-term rehabilitation of people living after cancer and advanced cancer. The role of physiotherapy is described and statements for each phase are developed. The final text was reviewed by three external reviewers, who provided feedback to improve the final version. Results Ten statements were developed by the authors, including general statements and statements for the different phases of the cancer journey. An infographic compiles all the statements providing a general and graphic vision of the role of physiotherapy in cancer care, based on the evidence. Conclusions Physiotherapists play an increasingly important role in the multidisciplinary care of cancer survivors. Many oncology physiotherapists have skills that can help to manage cancer-related impairments such as lymphedema, functional decline and cancer-related fatigue. Physiotherapists have strong knowledge and skills to deal with many of the functional problems that result from cancer treatment. Rehabilitation services, including physiotherapy, should be integrated at the point of diagnosis to assess an individual's baseline functional performance status and inform about the cancer care plan.

Specialized cancer treatments have the potential to exploit glutamine dependence to increase patient survival rates. Glutamine diagnostics capable of tracking a patient’s response to treatment would enable a personalized treatment dosage to optimize the tradeoff between treatment success and dangerous side effects. Current clinical glutamine testing requires sophisticated and expensive lab-based tests, which are not broadly available on a frequent, individualized basis. To address the need for a low-cost, portable glutamine diagnostic, this work engineers a cell-free glutamine biosensor to overcome assay background and signal-to-noise limitations evident in previously reported studies. The findings from this work culminate in the development of a shelf-stable, paper-based, colorimetric glutamine test with a high signal strength and a high signal-to-background ratio for dramatically improved signal resolution. While the engineered glutamine test is important progress towards improving the management of cancer and other health conditions, this work also expands the assay development field of the promising cell-free biosensing platform, which can facilitate the low-cost detection of a broad variety of target molecules with high clinical value.

Summary: Transgender and gender-diverse individuals experience substantial health disparities across the cancer care continuum. Despite well recognized unique healthcare needs, there are barriers in accessing cancer prevention and treatment services, influenced by disadvantages in key social-economic determinants of health which result in worse clinical outcomes, as compared to the general population. The Italian Association of Medical Oncology (AIOM) acknowledges the critical relevance of this issue. The “Assisi Recommendations” here summarize the outcomes of the “AIOM Oncology Ethics Day” dedicated to gender differences in oncology and cancer care of transgender and gender-diverse people. The recommendations generated during a 2-day multidisciplinary discussion address the various aspects of cancer care experience of transgender and gender-diverse people. The promotion of research in this field, through the generation of new evidence and the collection of prospective data, has been identified as a priority action to mitigate these disparities. By acknowledging the challenges of cancer care in transgender and gender-diverse people and recognizing the need for dedicated policy and clinical recommendations, AIOM demonstrates its commitment to improving the health and well-being of all patients with cancer, regardless of their gender identity or any other personal or social circumstances, as part of health-for-all societal vision.

Specialized cancer treatments have the potential to exploit glutamine dependence to increase patient survival rates. Glutamine diagnostics capable of tracking a patient's response to treatment would enable a personalized treatment dosage to optimize the tradeoff between treatment success and dangerous side effects. Current clinical glutamine testing requires sophisticated and expensive lab-based tests, which are not broadly available on a frequent, individualized basis. To address the need for a low-cost, portable glutamine diagnostic, this work engineers a cell-free glutamine biosensor to overcome assay background and signal-to-noise limitations evident in previously reported studies. The findings from this work culminate in the development of a shelf-stable, paper-based, colorimetric glutamine test with a high signal strength and a high signal-to-background ratio for dramatically improved signal resolution. While the engineered glutamine test is important progress towards improving the management of cancer and other health conditions, this work also expands the assay development field of the promising cell-free biosensing platform, which can facilitate the low-cost detection of a broad variety of target molecules with high clinical value. [ABSTRACT FROM AUTHOR]

Historically it has been considered that preoperative patient optimisation is highly beneficial for patients undergoing anaesthesia and surgical intervention or treatment. Exploration of the concept and effect of prehabilitation interventions on the postoperative recovery of cancer patients will be explored and discussed through reviewing literature, with a focus on those undergoing colorectal cancer surgery. [ABSTRACT FROM AUTHOR]

Advances in scientific research and the launch of cancer prevention programs have changed the natural history of cancer. Especially, many types of cancer initially considered incurable has gradually transformed into a "chronic" disease. More recently, several epidemiological data have con rmed that some cancer patients can be considered "cured" after a certain period of time, a period that varies from tumour to tumour. Perhaps it has come the time to use this word when appropriate. Its use could have signi cant repercussions, not only from a psychological but also from a social point of view, with an extraordinary impact on the Quality of Life of each patient.

Introduction Every year there is an increase in the number of cases and deaths due to the majority of cancers. Currently, these diseases constitute the second cause of death in Poland and the USA. The number of cases of malignant neoplasms in Poland has more than doubled over the last three decades. According to the National Cancer Registry, in Poland about 95.5 people per thousand die every year from malignant neoplasms. Current epidemiological data on cancer is worrying because the World Health Organization predicts a significant increase in the incidence of cancer in the general population. This problem, which is significant on the global scale, demands the search for more effective prevention methods so that more and more attention is paid to both primary and secondary prevention. Prevention and early detection of cancer have become a priority for the national health policy of many European countries. Numerous studies around the world prove that reducing the risk of cancer is most effective through adopting a healthy lifestyle, avoiding exposure to carcinogens, combined with regular screening. Objective The aim of the study was to review knowledge on cancer prevention, including the latest research results. Conclusions Due to the systematic increase in the incidence of cancer, a strong emphasis should be placed on prevention. Preventive actions bring benefits not only to the individual, but are an important aspect of health policy. The importance of primary prevention in relation to healthy people has been demonstrated, including secondary prevention aimed at controlling risk factors in relation to persons exposed to them. The combination of these activities becomes an important element in maintaining the health of the individual, as well as society.

This article examines the influence that digital life stories (DLS) can have on cancer research, using the PARCA1 project as an example. After describing the theoretical framework of DLS, we present the PARCA1 project. The PARCA1 project was anchored in the French context (Grand Est region) and aimed at producing knowledge on patients' experience of the cancer pathway through DLS. It involved 10 patients chosen to favor heterogeneity in profiles and experiences of illness. The paper describes the digital tool and the life stories methodology used to accompany the DLS. Next, it presents the methods and strategies used by participants to complete their DLS and the relationship between people with cancer and the accompanying researcher. Following this, we present (1) the impact of DLS on people with cancer, i.e., their progressive engagement in research, and (2) the impact on research, i.e., the methodological impact of people with cancer on research. In the discussion and conclusion, we explore how DLS can impact individuals who engage in them and their role in research. [ABSTRACT FROM AUTHOR]

When students think of evolution, they might imagine T. rex, or perhaps an abiotic scene of sizzling electrical storms and harsh reducing atmospheres, an Earth that looks like a lunar landscape. Natural selection automatically elicits responses that include "survival of the fittest," and "descent with modification," and with these historical biological catch phrases, one conjures up images of large animals battling it out on the Mesozoic plane. Rarely do teachers or students apply these same ideas to cancer and the evolution of somatic cells, which have accrued mutations and epigenetic imprinting and relentlessly survive and proliferate. Our questions in this paper include the following: Can cancer become an important teaching model for students to explore fundamental hypotheses about evolutionary process? Can the multi-step somatic cancer model encourage visualizations that enable students to revisit and reenter previous primary concepts in general biology such as the cell, mitosis, chromosomes, genetic diversity, ecological diversity, immune function, and of course evolution, continually integrating their biology knowledge into process and pattern knowledge? Can the somatic cancer model expose similar patterns and protagonists, linking Darwinian observations of the natural world to our body? And, can the cancer clone model excite critical thinking and student hypotheses about what cancer is as a biological process? Does this visually simple model assist students in recognizing patterns, connecting their biological curriculum dots into a more coherent learning experience? These biological dynamics and intercepting aptitudes of cells are amplified through the cancer model and can help shape the way biology students begin to appreciate the interrelatedness of all biological systems while they continue to explore pivotal points of biological fuzziness, such as the microbiome, limitations of models, and the complex coordination of genomic networks required for the function of even a single cell and the realization of phenotypes. In this paper we use clonal evolution of cancer as a model experience for students to recreate how a single, non-germline cell appears to shadow the classic pattern of natural selection in body cells that have gone awry. With authentic STEAM activities students can easily crossover and revisit previous biological topics and the ubiquitous nature of natural selection as seen in the example of somatic cells that result in a metastasizing tumor, giving students insight into natural selection's accommodating and tractable patterns throughout the planet.

The World Federation of Ultrasound in Medicine and Biology (WFUMB) is addressing the issue of incidental findings with a series of position papers to give advice on characterization and management. The biliary system (gallbladder and biliary tree) is the third most frequent site for incidental findings. This first part of the position paper on incidental findings of the biliary system is related to general aspects, gallbladder polyps and other incidental findings of the gallbladder wall. Available evidence on prevalence, diagnostic work-up, malignancy risk, follow-up and treatment is summarized with a special focus on ultrasound techniques. Multiparametric ultrasound features of gallbladder polyps and other incidentally detected gallbladder wall pathologies are described, and their inclusion in assessment of malignancy risk and decision- making on further management is suggested. [ABSTRACT FROM AUTHOR]

Summary: During the early stages of the coronavirus disease 2019 (COVID-19) pandemic, EASL and ESCMID published a position paper to provide guidance for physicians involved in the care of patients with chronic liver disease. While some healthcare systems are returning to a more normal routine, many countries and healthcare systems have been, or still are, overwhelmed by the pandemic, which is significantly impacting on the care of these patients. In addition, many studies have been published focusing on how COVID-19 may affect the liver and how pre-existing liver diseases might influence the clinical course of COVID-19. While many aspects remain poorly understood, it has become increasingly evident that pre-existing liver diseases and liver injury during the disease course must be kept in mind when caring for patients with COVID-19. This review should serve as an update on the previous position paper, summarising the evidence for liver disease involvement during COVID-19 and providing recommendations on how to return to routine care wherever possible.

The cancerous process is result of disturbed cell function. This is due to the accumulation of many genetic and epigenetic changes within the cell, expressed in the accumulation of chromosomal or molecular aberrations, which leads to genetic instability. It is difficult to assess the validity of individual aetiological factors, but it can be concluded that interaction of various risk factors has the largest contribution to the cancer development. Environmental, exogenous and endogenous factors as well as individual factors, including genetic predisposition contribute to the development of cancer. Epidemiological research on the development of malignant tumors has focused over the years on the determinants of environmental and genetic factors of cancer incidence and mortality rate. According to current state of knowledge, 80–90% of malignant tumors are caused by external environmental factors (carcinogens). Epidemiological studies have proved that the main factors responsible for the development of malignant neoplasia among humans are environmental factors arising from human behaviour. It has been confirmed that smoking, excessive alcohol consumption, diet, and reproductive behaviour are important for the development of malignant neoplasia in the human population. According to the World Health Organization, in 2020 we may expect about 10 million deaths, including 7–8 million in the developing countries, while this number in the developed countries will not change and will be 2–3 million. The aim this study was systematization of knowledge concerning the risk factors of malignant tumours and supplementing them with the latest research results.

Introduction: Every year there is an increase in the number of cases and deaths due to the majority of cancers. Currently, these diseases constitute the second cause of death in Poland and the USA. The number of cases of malignant neoplasms in Poland has more than doubled over the last three decades. According to the National Cancer Registry, in Poland about 95.5 people per thousand die every year from malignant neoplasms. Current epidemiological data on cancer is worrying because the World Health Organization predicts a significant increase in the incidence of cancer in the general population. This problem, which is significant on the global scale, demands the search for more effective prevention methods so that more and more attention is paid to both primary and secondary prevention. Prevention and early detection of cancer have become a priority for the national health policy of many European countries. Numerous studies around the world prove that reducing the risk of cancer is most effective through adopting a healthy lifestyle, avoiding exposure to carcinogens, combined with regular screening. Objective: The aim of the study was to review knowledge on cancer prevention, including the latest research results. Conclusions: Due to the systematic increase in the incidence of cancer, a strong emphasis should be placed on prevention. Preventive actions bring benefits not only to the individual, but are an important aspect of health policy. The importance of primary prevention in relation to healthy people has been demonstrated, including secondary prevention aimed at controlling risk factors in relation to persons exposed to them. The combination of these activities becomes an important element in maintaining the health of the individual, as well as society. [ABSTRACT FROM AUTHOR]

Multikinase inhibitors (MKIs), and particularly tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (CPIs), are currently some of the major breakthroughs in cancer treatment. Proton pump inhibitors (PPIs) revolutionised the treatment of acid-related diseases, but are frequently overused for epigastric pain or heartburn. However, long-term acid suppression from using PPIs may lead to safety concerns, and could have a greater impact in cancer patients undergoing therapy, like bone fractures, renal toxicities, enteric infections, and micronutrient deficiencies (iron and magnesium). Moreover, acid suppression may also affect the pharmacokinetics of drugs (at least during acid suppression) and decrease the absorption of many molecularly-targeted anticancer therapies, which are mostly weak bases with pH-dependent absorption. This type of drug-drug interaction may have detrimental effects on efficacy, with major clinical impacts described for some orally administrated targeted therapies (erlotinib, gefitinib, pazopanib, palbociclib), and conflicting results with many others, including capecitabine. Furthermore, the long-term use of PPIs results in severe alterations to the gut microbiome and recent retrospective analyses have shown that the benefit of using CPIs was suppressed in patients treated with PPIs. These very expensive drugs are of great importance because of their efficacy. As the use of PPIs is not essential, we must apply the precautionary principle. All these data should encourage medical oncologists to refrain from prescribing PPIs, explaining to patients the risks of interaction in order to prevent inappropriate prescription by another physician.

The immune system interacts with many nominal 'danger' signals, endogenous danger‐associated (DAMP), exogenous pathogen (PAMP) and allergen (AAMP)‐associated molecular patterns. The immune context under which these are received can promote or prevent immune activating or inflammatory mechanisms and may orchestrate diverse immune responses in allergy and cancer. Each can act either by favouring a respective pathology or by supporting the immune response to confer protective effects, depending on acuity or chronicity. In this Position Paper under the collective term danger signals or DAMPs, PAMPs and AAMPs, we consider their diverse roles in allergy and cancer and the connection between these in AllergoOncology. We focus on their interactions with different immune cells of the innate and adaptive immune system and how these promote immune responses with juxtaposing clinical outcomes in allergy and cancer. While danger signals present potential targets to overcome inflammatory responses in allergy, these may be reconsidered in relation to a history of allergy, chronic inflammation and autoimmunity linked to the risk of developing cancer, and with regard to clinical responses to anti‐cancer immune and targeted therapies. Cross‐disciplinary insights in AllergoOncology derived from dissecting clinical phenotypes of common danger signal pathways may improve allergy and cancer clinical outcomes. [ABSTRACT FROM AUTHOR]

Byline: Georgiaria. Fernandes, Sanjay. Pai Background: The editors of the Indian Journal of Cancer (IJC) have not, so far, objectively analyzed the editorial processes involving author, referee, and editor data [...]

Research with nonhuman primates (NHPs) – monkeys for the most part – has led to critical health advances that have saved or improved millions of human lives. While NHPs account for just one-half of one percent of animals in current medical research, it is no exaggeration to say they are essential to our ability to find cures for cancer, AIDS, Alzheimer’s, Parkinson’s, obesity/diabetes, and dozens of other diseases that cause human suffering and death.

Experiencing cancer impinges life in several ways. Research on the biographical implications of cancer has focused on its disruptive nature. Biographical renewal is not given full attention despite existing literature on positive transformations after cancer. This conceptual paper presents an account of biographical renewal in the milieu of cancer survivorship. Further, we discussed some crucial facilitators that promote the biographical renewal. Caregivers may consider biographical renewal as a substantially new goal in the survivorship care plan to improve patients' quality of life. The discussion is designed to foster an understanding of biographical renewal for the psychosocial practice by professionals with cancer patients, survivors, and their caregivers – formal and informal, to provide comprehensive care during cancer survivorship. Implications for palliative care are also discussed. [ABSTRACT FROM AUTHOR]

The cancerous process is result of disturbed cell function. This is due to the accumulation of many genetic and epigenetic changes within the cell, expressed in the accumulation of chromosomal or molecular aberrations, which leads to genetic instability. It is difficult to assess the validity of individual aetiological factors, but it can be concluded that interaction of various risk factors has the largest contribution to the cancer development. Environmental, exogenous and endogenous factors as well as individual factors, including genetic predisposition contribute to the development of cancer. Epidemiological research on the development of malignant tumors has focused over the years on the determinants of environmental and genetic factors of cancer incidence and mortality rate. According to current state of knowledge, 80-90% of malignant tumors are caused by external environmental factors (carcinogens). Epidemiological studies have proved that the main factors responsible for the development of malignant neoplasia among humans are environmental factors arising from human behaviour. It has been confirmed that smoking, excessive alcohol consumption, diet, and reproductive behaviour are important for the development of malignant neoplasia in the human population. According to the World Health Organization, in 2020 we may expect about 10 million deaths, including 7-8 million in the developing countries, while this number in the developed countries will not change and will be 2-3 million. The aim this study was systematization of knowledge concerning the risk factors of malignant tumours and supplementing them with the latest research results. [ABSTRACT FROM AUTHOR]

Background and objectives With an increasing number of racial/ethnic minorities in the U.S., nursing research frequently involves the use of multiple languages, especially to promote the understanding of educational materials related to nursing care. Furthermore, with a recent emphasis on innovation in health-related research, the use of technology is prominent in nursing research. However, practical issues in the use of multiple languages, especially in technology-based intervention studies, have rarely been reported and/or discussed in nursing literature. The purpose of this paper is to identify practical issues in conducting a technology-based intervention study using multiple languages among Asian American breast cancer survivors. Methods In a large-scale technology-based breast cancer intervention study, research team members wrote memos on issues in translation process and plausible reasons for the issues. Then, the memos and written records were analyzed using a content analysis. By using individual words as the unit of analysis, line-by-line coding was done, and idea categories representing practical issues were extracted from the codes. Results Six themes representing the practical issues were extracted. Issues were found in recruiting and retaining bilingual research team members; maintaining consistency in translation process; keeping cultural and conceptual equivalence; repeating IRB protocol modifications; finding and using existing translated versions; and arranging technological aspects related to electronic multiple-language versions. Conclusion The use of multiple languages in a technology-based intervention study is feasible. However, it is necessary to effectively manage unforeseen challenges through various strategies. [ABSTRACT FROM AUTHOR]

In their senior year, biochemistry majors at the University of Detroit Mercy take a senior seminar course entitled "Recent Advances in Biochemistry Related to Societal Issues." Students read papers selected from the current literature and take turns presenting these papers to the class. Papers are grouped into units dealing with molecular biology, protein structure/function, apoptosis/cancer/AIDS, and neurochemistry. The ethical/societal implications of the research are also discussed. In addition, a term paper dealing with societal issues and written in dialogue format by teams of students is required. The students present their dialogue papers as skits to an audience composed of faculty as well as junior biochemistry, chemistry, and biology majors. Based upon a survey taken at the beginning, at midterm, and at the end of the semester, the familiarity of the students with the ethical/societal issues related to the subjects covered increased significantly. Also, in course evaluations administered at the end of the semester, students expressed a high degree of satisfaction with this course. (Contains 6 tables and 2 footnotes.)

Simple Summary: Canine lymphoma is a common cancer of one of the white blood cells that is commonly treated with chemotherapy. Many papers have been published about this disease and treatment, but few comprehensive reviews of the outcomes reported after chemotherapy, and the prognostic factors that influence the outcomes, have been published. Knowledge of the potential outcomes for this disease is important for veterinarians as they guide dog owners in the decision making about treatment options. This review evaluated the papers published on this topic and found that there is a wide variation in outcomes reported, as well as the factors that influence the outlook. Additionally, while individual papers have shown a much better survival, over the last 40 years, the overall improvement in outcome has been modest at best. The use of uniform reporting in the studies is needed, and novel approaches are likely needed to significantly improve the outlook for dogs with this disease. While canine lymphoma is a relatively common and important disease seen by veterinarians, there are limited comprehensive reviews of the literature regarding the remission and survival times following chemotherapy, and the associated prognostic factors. This comprehensive thematic review covers the available veterinary literature covering treatment outcomes and identified prognostic factors. A lack of standardised approaches to evaluate and report the outcomes was identified, including factors that would alter the duration of responses by weeks, or occasionally months. After publication of the suggested reporting criteria, this has improved but is still not uniformly applied. The prognostic factors included for evaluation varied from as few as three to seventeen, with over 50 studies using only univariate analysis. Individual papers reported much longer outcomes than others, but assessing the outcomes overall, there has been minimal change over the last 40 years. This supports the belief that novel approaches for lymphoma therapy will be required to substantively improve outcomes. [ABSTRACT FROM AUTHOR]

Physical activity (PA) is an important facet in survivorship care. Standardized curriculum which teaches undergraduate student exercise leaders how to implement PA programs for childhood cancer survivors have not been developed. Delivery of PA programs are limited by resources, so utilizing students to lead PA sessions is a potentially cost-effective approach. The purpose of this study was to learn how to optimize mentorship of student PA leaders in pediatric oncology. The aims were to report on the level of guidance provided to the student PA leaders, share student PA leaders' reflection of their mentorship and the challenges they faced. Student PA leaders designed and delivered a 31-week, virtual PA program to pediatric cancer survivors (5-18-year-olds). Mentors provided feedback on the recorded sessions. PA leaders were interviewed about their perceptions, their experiences and the type of feedback they valued the most. Student PA leaders received the most feedback during the first 2 weeks of the program, suggesting close oversight is needed during this time. Students valued the feedback on improving PA delivery/instruction the most. Students reported feeling anxious prior to sessions, especially when new content would be introduced because they were unsure how the patients would respond to the new activities. Reinforcing that the leaders have the ability to minimize PA barriers and provide support may help to resolve their anxiety of working with this population. Using a similar approach as presented in this paper may be advantageous in the development of high-performing PA leaders.