Explore the vast range of titles available.

PurposeExercise training is an effective and safe way to counteract cancer-related fatigue (CRF) and to improve health-related quality of life (HRQoL). High-intensity interval training has proven beneficial for the health of clinical populations. The aim of this randomized controlled trial was to compare the effects of resistance and high-intensity interval training (RT–HIIT), and moderate-intensity aerobic and high-intensity interval training (AT–HIIT) to usual care (UC) in women with breast cancer undergoing chemotherapy. The primary endpoint was CRF and the secondary endpoints were HRQoL and cancer treatment-related symptoms.MethodsTwo hundred and forty women planned to undergo chemotherapy were randomized to supervised RT–HIIT, AT–HIIT, or UC. Measurements were performed at baseline and at 16 weeks. Questionnaires included Piper Fatigue Scale, EORTC-QLQ-C30, and Memorial Symptom Assessment Scale.ResultsThe RT–HIIT group was superior to UC for CRF: total CRF (p = 0.02), behavior/daily life (p = 0.01), and sensory/physical (p = 0.03) CRF. Role functioning significantly improved while cognitive functioning was unchanged for RT–HIIT compared to declines shown in the UC group (p = 0.04). AT–HIIT significantly improved emotional functioning versus UC (p = 0.01) and was superior to UC for pain symptoms (p = 0.03). RT–HIIT reported a reduced symptom burden, while AT–HIIT remained stable compared to deteriorations shown by UC (p < 0.01). Only RT–HIIT was superior to UC for total symptoms (p < 0.01).Conclusions16 weeks of resistance and HIIT was effective in preventing increases in CRF and in reducing symptom burden for patients during chemotherapy for breast cancer. These findings add to a growing body of evidence supporting the inclusion of structured exercise prescriptions, including HIIT, as a vital component of cancer rehabilitation.Trial registrationClinicaltrials.gov Registration Number: NCT02522260.

BackgroundAdvanced therapeutic strategies are often accompanied by significant adverse effects, which warrant equally progressive countermeasures. Physical exercise has proven an effective intervention to improve physical function and reduce fatigue in patients undergoing chemotherapy. Effects of high-intensity interval training (HIIT) in this population are not well established although HIIT has proven effective in other clinical populations. The aim of the OptiTrain trial was to examine the effects of concurrent resistance and high-intensity interval training (RT-HIIT) or concurrent moderate-intensity aerobic and high-intensity interval training (AT-HIIT), to usual care (UC) on pain sensitivity and physiological outcomes in patients with breast cancer during chemotherapy.MethodsTwo hundred and forty women were randomized to 16 weeks of RT-HIIT, AT-HIIT, or UC. Outcomes: cardiorespiratory fitness, muscle strength, body mass, hemoglobin levels, and pressure-pain threshold.ResultsPre- to post-intervention, RT-HIIT (ES = 0.41) and AT-HIIT (ES = 0.42) prevented the reduced cardiorespiratory fitness found with UC. Handgrip strength (surgery side: RT-HIIT vs. UC: ES = 0.41, RT-HIIT vs. AT-HIIT: ES = 0.28; non-surgery side: RT-HIIT vs. UC: ES = 0.35, RT-HIIT vs. AT-HIIT: ES = 0.22) and lower-limb muscle strength (RT-HIIT vs. UC: ES = 0.66, RT-HIIT vs. AT-HIIT: ES = 0.23) were significantly improved in the RT-HIIT. Increases in body mass were smaller in RT-HIIT (ES = − 0.16) and AT-HIIT (ES = − 0.16) versus UC. RT-HIIT reported higher pressure-pain thresholds than UC (trapezius: ES = 0.46, gluteus: ES = 0.53) and AT-HIIT (trapezius: ES = 0.30).ConclusionSixteen weeks of RT-HIIT significantly improved muscle strength and reduced pain sensitivity. Both exercise programs were well tolerated and were equally efficient in preventing increases in body mass and in preventing declines in cardiorespiratory fitness. These results highlight the importance of implementing a combination of resistance and high-intensity interval training during chemotherapy for women with breast cancer.

Purpose This paper aims to critically reflect the current specialist discourse on experiential approaches to higher education for sustainable development (HESD). Limitations to the current discourse are identified, and as a result, an alternative approach to the study of experiential education (EE) within HESD is suggested. Design/methodology/approach Three research questions are addressed by analysing the literature on EE and experiential learning (EL) within HESD in specialist academic journals. Findings There is a consensus among authors regarding the appropriateness of experiential approaches to HESD. However, limitations to the current discourse suggest the need for an alternative approach to studying EE within HESD. Therefore, this paper proposes the application of the learning landscape metaphor to take a more student-centred and holistic perspective. Originality/value The learning landscape metaphor has previously not been applied to EE within HESD. This alternative conceptualisation foregrounds student perspectives to experiential initiatives within HESD. The holistic approach aims to understand the myriad influences on students learning, while allowing examination of how experiential approaches relate to other educational approaches within HESD.

Essay I: I study how digital skill requirements affect the gender composition of new hires in female-dominated administrative occupations in Sweden from 2006 to 2016. I track the prevalence of digital skill requirements in Swedish vacancy ads and analyze the gender composition of new hires through a matching process using Swedish register data. I also examine changes in age composition and its interaction with gender. Although men are overrepresented among computer-related educational fields and occupations, I find that the share of women has not decreased, despite a significant increase in digital skill requirements. Using employer fixed effects, I observe an increase in female hires ages 36-50 for ads that specify digital skill requirements. This may be due to the fact that increased exposure to technology increases the complexity of tasks, resulting in a higher demand for skilled workers, which are predominantly women in female-dominated occupations. Essay II: I study the effects of robot and software technology exposure on the evolution of the gender wage gap in cities across the US from 1980 to 2010. Technology exposure, measured via task-replacing patents, has reduced labor demand in primarily male-dominated occupations. Consequently, the gender wage gap declined more in cities with high employment shares of exposed occupations. Moving from the 25th to the 75th percentile of city-level software exposure explains approximately 15% of the average decline in the gender wage gap in the sampled cities. The city-level association between robot patent exposure and changes in the gender wage gap is lower and less robust, possibly due to lower average wages for robot-exposed occupations. I perform a tentative analysis of AI-exposed occupations and show that AI patents are mostly related to tasks performed in male-dominated occupations high up in the wage distribution. Essay III: (with Ola Andersson, Niklas Bengtsson, and Per Engström) Previous research suggests that student evaluations of teacher performance are biased against women. We test this hypothesis on economics students in a randomized, double-blind experiment, set up in a natural educational setting. During the Covid-19 pandemic, teaching assistants moved online and answered questions through email instead of on campus. We randomly assigned a male or female name to the instructions given by the online teachers. Importantly, the teachers actually responding to the questions did not know if they interacted with the students as male or female, which is a novel contribution to the literature. The course evaluation asked students to rate the mentors' helpfulness, knowledge, and response time. The results show no bias against the female mentor in any dimension. Our confidence interval around the zero effect does not overlap the effect sizes reported in highly influential previous studies.

The lack of effective, scalable solutions for lifestyle treatment is a global clinical problem, causing severe morbidity and mortality. We developed a method for lifestyle treatment that promotes self-reflection and iterative behavioral change, provided as a digital tool, and evaluated its effect in 370 patients with type 2 diabetes (ClinicalTrials.gov identifier: NCT04691973). Users of the tool had reduced blood glucose, both compared with randomized and matched controls (involving 158 and 204 users, respectively), as well as improved systolic blood pressure, body weight and insulin resistance. The improvement was sustained during the entire follow-up (average 730 days). A pathophysiological subgroup of obese insulin-resistant individuals had a pronounced glycemic response, enabling identification of those who would benefit in particular from lifestyle treatment. Natural language processing showed that the metabolic improvement was coupled with the self-reflective element of the tool. The treatment is cost-saving because of improved risk factor control for cardiovascular complications. The findings open an avenue for self-managed lifestyle treatment with long-term metabolic efficacy that is cost-saving and can reach large numbers of people.

Purpose Supervised exercise is a potentially promising supportive care intervention for people with metastatic breast cancer (MBC), but research on the patients’ perspective is limited. The aim of the current focus group study was to gain an in-depth understanding of MBC patients’ perceived barriers, facilitators, and preferences for supervised exercise programs. Methods Eleven online focus groups with, in total, 44 MBC patients were conducted in four European countries (Germany, Poland, Spain, Sweden). Main topics of the semi-structured discussions covered attitudes towards participation in supervised exercise programs, perceived facilitators, experienced barriers, and exercise preferences. Interviews were transcribed verbatim, translated into English, and coded based on a preliminary coding framework, supplemented by themes emerging during the sessions. The codes were subsequently examined for interrelations and re-organized into overarching clusters. Results Participants had positive attitudes towards exercise, but experienced physical limitations and insecurities that inhibited their participation. They expressed a strong desire for exercise tailored to their needs, and supervision by an exercise professional. Participants also highlighted the social nature of group training as an important facilitator. They had no clear preference for exercise type, but rather favored a mixture of different activities. Flexible training modules were considered helpful to increase exercise program adherence. Conclusions MBC patients were generally interested in supervised exercise programs. They preferred group exercise that facilitates social interaction, but also expressed a need for individualized exercise programs. This suggests the relevance to develop flexible exercise programs that are adjusted to the individual’s needs, abilities, and preferences.

Background To successfully implement exercise programs for patients with metastatic breast cancer (MBC), services and patient education should consider patients’ knowledge, preferences, values, and goals. Hence, gaining insight into their perspectives on exercise and exercise programming is important. Method In this cross-sectional survey, we recruited patients with MBC from the Netherlands, Germany, Poland, Spain, and Sweden. We collected data on patients’ knowledge and skills about exercise and outcome expectations. We identified barriers to and facilitators of participation in exercise programs, and patients’ preferences for program content and modes of exercise delivery. Results A total of 420 patients participated in the survey. Respondents were, on average, 56.5 years old (SD 10.8) and 70% had bone metastases. Sixty-eight percent reported sufficient skills to engage in aerobic exercise, but only 35% did so for resistance exercise. Respondents expected exercise to have multiple physical benefits, but a few patients expected exercise to worsen their pain (5%). Not having access to an exercise program for cancer patients (27%), feeling too tired (23%), and/or weak (23%) were the most often reported barriers. Facilitators for exercising regularly were previous positive physical (72%) and emotional (68%) experiences with exercising, and receiving personalized advice from a physiotherapist or sport/fitness instructor (62%). Patients were most interested in walking and preferred exercising at a public gym, although there were differences by country. Fifty-seven percent did not know whether their insurance company reimburses exercise programs and only 9% would be willing to pay more than €50 per month to participate. Conclusion A large percentage of patients with MBC lack the skills to engage in regular exercise as recommended by exercise guidelines for people with cancer. Patients may benefit from personalized advice and appropriate training facilities to overcome barriers. When implementing exercise interventions, attention should be given to reimbursement and the relatively low willingness-to-pay.

Purpose We aimed to identify metastatic breast cancer (MBC) patients’ preferences for exercise programs and identify patients’ characteristics associated with these preferences, to facilitate implementation of exercise programs for MBC patients. Methods We used data from a multinational cross-sectional survey conducted among MBC patients. Patients reported their preferred exercise frequency, intensity, type, session duration, and supervision mode. We used latent class analysis to identify subgroups with similar preferences and descriptive statistics to compare demographic and clinical characteristics of patients within subgroups. Results Four distinct classes were identified based on data from 409 participants. Class 1 (47% of participants) is characterized by a preference for moderate exercise with supervision within the health care setting. Most participants in this class had bone metastases. Class 2 (30%) is characterized by a preference for vigorous exercise with supervision. This class included participants who were, on average, younger, and had a higher education level. Class 3 (13%) is characterized by a preference for active walking. These participants were less likely to have bone metastases or comorbidities. Class 4 (10%) is characterized by a preference for recreational walking and included participants who were, on average, older, and less likely to be employed. Conclusion We identified four classes of patients with different preferences for exercise programs. Many patients with MBC express exercise preferences that meet the current guideline recommendations. Some patients with MBC may benefit from targeted education to align their preferences and behavior with the amount of exercise that is necessary to gain health benefits.

This paper studies the effect of same-sex teachers on students attending Economics A at Uppsala University from 2013 to 2018. Having a female teacher has no significant effect on female students’ exam performance but a significant and positive effect on the likelihood of attending the subsequent course in Economics. Certain types of female teachers have negative effects on male students’ exam performance in certain specifications and no effect on the likelihood of them attending the subsequent course. It was not possible to identify the underlying mechanism behind these results.

To design, apply, evaluate, and analyse a pedagogical model to enhance nurses' ability to create pedagogical encounters to support patients' learning. The study relies on an educational design research approach. A pedagogical model based on learning theories was designed, applied, evaluated, and analysed in a specialist nursing programme in cancer care. All students (n=28) who attended the programme accepted to participate in the evaluation of the model. Their perception of the learning activities was evaluated in a questionnaire, and 16 (57%) students responded. The students' learning was assessed in written assignments, including all students. Descriptive statistics, content analysis and theoretical reasoning, were used to analyse data and interpret the usefulness and shortcomings of the model. The most appreciated learning activities were to study learning theories, observe pedagogical encounters, act as a critical friend, and document one's own pedagogical encounters. The written assignments about observing and performing their own pedagogical encounters with patients showed students' increased awareness of how to support patients' learning. The clinical supervisors' lack of pedagogical knowledge inhibited the feedback on students' performances. The theoretical analysis of the evaluation identified strengths and needs for further development. The strengths tend to be the ongoing learning process created by learning activities supporting students to continuously study, experience, and apply their knowledge. Nurse supervisors and other stakeholders at the clinics are suggested to be involved in improving the design and require pedagogical competence. Further research should include observational and interview studies related to students' performance in pedagogical encounters.