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Objective: Chronic disease is common in people with cancer. However, the utilisation of Medicare chronic disease management (CDM) items for cancer patients in Australia remains unexplored. This study investigates Medicare CDM item numbers relating to people with cancer, including general practitioner (GP) and allied health CDM item numbers, and any associated sociodemographic factors. Methods: Data from 86,571 people with cancer registered in the Queensland Cancer Registry between July 2011 and June 2015 and the CDM items codes from Medical Benefits Scheme records until 2018 were analysed. This includes utilisation of General Practitioner Management Plans (GPMP) and Team Care Arrangements (TCAs), reviews of GPMPs and TCAs, and engagement with allied health services until June 2018 following a cancer diagnosis. Results: In total 47,615 (55%) and 43,286 (50%) people with cancer initiated at least one GPMP and TCA, respectively, with 31,165 (36%) receiving at least one review, and 36,359 (42%) utilising at least one allied health service (e.g. physiotherapists (41%), podiatrists (27%), exercise physiologists (19%)) with variations by cancer type. While people with cancer from disadvantaged socioeconomic groups had a higher likelihood of receiving GPMP (odds ratio, OR: 1.16, 95% confidence interval, CI: 1.11–1.21) and TCA (OR: 1.12, 95% CI: 1.07–1.16), they were less likely to utilise allied health services (OR: 0.89, 95% CI: 0.85–0.93). People with cancer living in remote areas were less likely to receive TCA (OR: 0.84, 95% CI: 0.80–0.88) or utilise allied health services (OR: 0.63, 95% CI: 0.60–0.67) than those in metropolitan areas. Conclusion: Our findings underscore the need to examine uptake and implementation patterns of CDM items, especially in relation to clinical, social, and service provider-level factors and related potential barriers. Further exploration is warranted to understand whether people with cancer's care needs are being met and ways to optimise the supportive care of these people. What is known about the topic? Comorbid chronic conditions are common in people with cancer, but the uitlisation of Medicare chronic disease management (CDM) item numbers for them remained unexplored. What does this paper add? Approximately half of the cancer survivors had General Practitioner Management Plan and Team Care Arrangements, and just over two-fifths utilised subsidised allied health services, with notable variations by people with cancers' characteristics. What are the implications for practitioners? The findings underscore the need for further investigation to examine the contributing factors for the variation in CDM plans and the low utilisation of allied health services, particularly those living in the outer regional or remote areas. [ABSTRACT FROM AUTHOR]

Background: This study compared the physical activity level of men with metastatic prostate cancer at baseline of the multicentre INTERVAL‐GAP4 trial to the American Cancer Society guidelines and examined associations with physical fitness. Methods: A total of 140 men on androgen deprivation therapy (ADT) were included in this cross‐sectional analysis of baseline data from the INTERVAL‐GAP4 trial. Exclusion criteria included a maximum of 1 h of vigorous aerobic exercise or one structured resistance exercise session per week but no restrictions on habitual physical activity. Moderate‐to‐vigorous physical activity (MVPA) was assessed using a modified Godin–Shephard Leisure‐Time Physical Activity Questionnaire. Physical fitness measurements included peak oxygen consumption (VO2peak), maximal power output (Wmax), 400 m walk time, one‐repetition maximum (1RM) of leg extension, leg press, chest press and seated row, and handgrip strength. Quantile regression was used to analyse associations of MVPA with physical fitness outcomes at the 25th, 50th and 75th percentiles of the physical fitness distributions. Results: Total self‐reported MVPA was 60 (IQR: 0, 180) min per week, with 29% meeting the aerobic physical activity guidelines. There was a statistically significant association of higher MVPA with higher relative VO2peak at the 25th (β = 0.53, p = 0.020) and 75th percentiles (β = 0.66, p = 0.001), relative Wmax at the 25th (β = 0.05, p = 0.003), 50th (β = 0.05, p = 0.009) and 75th percentiles (β = 0.07, p = 0.004) and reduced 400 m walk time at the 75th percentile (β = −4.26, p = 0.023), with β corresponding to the change in the dependent variable for each one‐hour increase in weekly MVPA. Conclusion: Few men recruited to the INTERVAL‐GAP4 trial were meeting aerobic physical activity guidelines at baseline. Higher MVPA was associated with better aerobic capacity and walking performance but not maximal strength in men with metastatic prostate cancer on ADT. Trial Registration: ClinicalTrials.gov: NCT02730338; German Clinical Trials Register: DRKS00010310 [ABSTRACT FROM AUTHOR]

Purpose: To understand the consequences of diseases and treatment such as cancer and thus the needs of patients for surveillance and care and to improve quality of life, patients should be assessed using a holistic approach. However, instruments to create such a holistic view do not exist and the development presents unique challenges. Therefore, this study presents a method for the development of a holistic assessment questionnaire using cancer‐related fatigue (CRF) as a case. Method: We started with (1) the definition of our construct of interest (CRF) on the theme level followed by (2) item selection, an iterative process of searching for validated questionnaires that together cover the full holistic construct. The construct definition on theme level (1) was too broad and was, therefore, redefined on the element level (construct > theme > element) based on interviews with relevant stakeholders. Hereafter, item selection (2) was performed on the element level based on a priority list, psychometric properties (e.g., discriminative parameter value) and consultation of experts and future users. Lastly, (3) items were reformulated. Results: Initial CRF construct definition (1) resulted in 110 relevant validated questionnaires with over three thousand items, requiring a construct redefinition on element level. Seventy‐two items from 21 validated questionnaires were included (2) in the preliminary holistic assessment questionnaire. For item reformulation (3), easy language was used to better suit the target population. Conclusion: Tailoring care to the individual requires a holistic view. This article presents a novel method to develop a holistic assessment questionnaire, including an example for CRF, with several recommendations for cancer‐specific instrument development. Although the development process of a holistic assessment questionnaire is time‐consuming, more late and long‐term effects of cancer are multidimensional and could benefit from a holistic approach in their assessment to enable personalised care, thereby improving quality of life and reducing societal impact. [ABSTRACT FROM AUTHOR]

Pre‐clinical murine and in vitro models have demonstrated that exercise suppresses tumour and cancer cell growth. These anti‐oncogenic effects of exercise were associated with the exercise‐mediated release of myokines such as interleukin (IL)‐15. However, no study has quantified the acute IL‐15 response in human cancer survivors, and whether physiological adaptations to exercise training (i.e. body composition and cardiorespiratory fitness) influence this response. In the present study breast, prostate and colorectal cancer survivors (n = 14) completed a single bout of high‐intensity interval exercise (HIIE) [4×4 min at 85–95% heart rate (HR) peak, 3 min at 50–70% HR peak] before and after 7 months of three times weekly high‐intensity interval training (HIIT) on a cycle ergometer. At each time point venous blood was sampled before and immediately after HIIE to assess the acute myokine (IL‐15, IL‐6, IL‐10, IL‐1ra) responses. Markers of inflammation, cardiorespiratory fitness and measures of body composition were obtained at baseline and 7 months. An acute bout of HIIE resulted in a significant increase in IL‐15 concentrations (pre‐intervention: 113%; P = 0.013, post‐intervention: 102%; P = 0.005). Post‐exercise IL‐15 concentrations were associated with all other post‐exercise myokine concentrations, lean mass (P = 0.031), visceral adipose tissue (P = 0.039) and absolute V̇O2${{\dot{V}}_{{{{\mathrm{O}}}_{\mathrm{2}}}}}$ peak (P = 0.032). There was no significant effect of 7 months of HIIT on pre‐ or post‐HIIE IL‐15 concentrations (P > 0.05). This study demonstrates HIIE is a sufficient stimulus to increase circulating IL‐15 and other myokines including IL‐6, IL‐10 and IL‐1ra which may be clinically relevant in the anti‐oncogenic effect of exercise and repetitive exposure to these effects may contribute to the positive relationship between exercise and cancer recurrence. Key points: Exercise has been demonstrated to reduce the risk of cancer recurrence.Pre‐clinical murine and in vitro models have demonstrated that exercise suppresses tumour and cancer cell growth, mediated by exercise‐induced myokines (IL‐6 and IL‐15).High‐intensity interval exercise significantly increased myokines associated with the anti‐oncogenic effect of exercise and the magnitude of response was associated with lean mass, but training did not appear to influence this response.Given IL‐15 has been implicated in the anti‐oncogenic effect of exercise and is being explored as an immunotherapy agent, high‐intensity interval exercise may improve outcomes for people living beyond cancer through IL‐15‐mediated pathways.Interventions that increase lean mass may also enhance this response. [ABSTRACT FROM AUTHOR]

We aimed to report the epidemiology of lower-limb and lumbosacral injuries in Police Force recruits. We performed a cohort study of Police Force recruits undergoing a six-month training program with prospective injury data collected between 2018 and 2021. Cardiorespiratory fitness was quantified by the beep-test and police-specific-functional-capacity was quantified using a specifically designed physical performance evaluation (PPE) tool. Injury frequency and prevalence were reported. Fifteen percent (n = 180) of study Police Force recruits (n = 1,181) sustained a lower-limb or lumbosacral injury. The six-month training program significantly improved cardiorespiratory fitness (p < 0.001) and functional capacity (p < 0.001). Increased cardiorespiratory fitness at baseline decreased injury risk (OR = 0.8, 95%CI: 0.66–0.97, p = 0.019). Injury rates decreased over time and females were injured significantly earlier than males (HR = 0.70, 95%CI: 0.52 to 0.95, p = 0.021). Interventions that can pre-condition Police Force recruits prior to the commencement of their basic physical training may reduce the number of lower-limb and lumbosacral injuries. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the acute effect of repeated-sprint activity (RSA) on change-of-direction economy (assessed using shuttle running economy [SRE]) in soccer players and explore neuromuscular and cardiorespiratory characteristics that may modulate this effect. Methods: Eleven young elite male soccer players (18.5 [1.4] y old) were tested on 2 different days during a 2-week period in their preseason. On day 1, lower-body stiffness, power and force were assessed via countermovement jumps, followed by an incremental treadmill test to exhaustion to measure maximal aerobic capacity. On day 2, 2 SRE tests were performed before and after a repeated-sprint protocol with heart rate, minute ventilation, and blood lactate measured. Results: Pooled group analysis indicated no significant changes for SRE following RSA due to variability in individual responses, with a potentiation or impairment effect of up to 4.5% evident across soccer players. The SRE responses to RSA were significantly and largely correlated to players' lower-body stiffness (r =.670; P =.024), and moderately (but not significantly) correlated to players' force production (r = −.455; P =.237) and blood lactate after RSA (r =.327; P =.326). Conclusions: In summary, SRE response to RSA in elite male soccer players appears to be highly individual. Higher lower-body stiffness appears as a relevant physical contributor to preserve or improve SRE following RSA. [ABSTRACT FROM AUTHOR]