Cancer-related fatigue is defined as a distressing, persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning. It is one of the most common side effects in patients with cancer. Fatigue has been shown to be a consequence of active treatment, but it may also persist into posttreatment periods. Furthermore, difficulties in end-of-life care can be compounded by fatigue. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Cancer-Related Fatigue provide guidance on screening for fatigue and recommendations for interventions based on the stage of treatment. Interventions may include education and counseling, general strategies for the management of fatigue, and specific nonpharmacologic and pharmacologic interventions. Fatigue is a frequently underreported complication in patients with cancer and, when reported, is responsible for reduced quality of life. Therefore, routine screening to identify fatigue is an important component in improving the quality of life for patients living with cancer.

Background The incidence of and risk factors for falls in human immunodeficiency (HIV)-1-infected persons are unknown. Methods Fall history during the prior 12 months, medical diagnoses, and functional assessments were collected on HIV-infected persons 45 to 65 years of age receiving effective antiretroviral therapy. Fall risk was evaluated using univariate and multivariate regression analyses. Results Of 359 subjects, 250 persons (70%) reported no falls, 109 (30%) had ≥1 fall; 66 (18%) were recurrent fallers. Females, Caucasians, and smokers were more like to be recurrent fallers (p≤0.05). HIV-related characteristics including current and nadir CD4 T-cell count, estimated HIV duration, and Veterans Aging Cohort Study Index scores were not predictors of falls (all p≥0.09); didanosine recipients were more likely to be recurrent fallers (p=0.04). The odds of falling increased 1.7 for each comorbidity and 1.4 for each medication (p<0.001), and were higher in persons with cardiovascular disease, hypertension, dementia, neuropathy, arthritis, chronic pain, psychiatric disease, frailty or disability (all OR≥ 1.8; p≤0.05). Beta-blockers, antidepressants, anti-psychotics, sedatives, and opiates were independently associated with falling (all OR ≥2.7; p≤0.01). Female gender, diabetes, antidepressants, sedatives, opiates, didanosine, exhaustion, weight loss, and difficulty with balance were the most significant predictors of falls in logistic regression (all OR ≥2.5; p≤0.05). Conclusion Middle-aged HIV-infected adults have high fall risk. Multiple comorbidities, medications, and functional impairment were predictive of falls, but surrogate markers of HIV infection or an HIV-specific multimorbidity index were not. Fall risk should be assessed routinely as part the care of HIV-infected persons.

The purpose was to compare the effects of three physical education settings (structured contact, nonstructured contact, and no contact) on attitudes of children toward peers with severe mental retardation who used wheelchairs. Contact theory (Allport, 1954) guided the study. Participants were 131 Grade 4 students (62 females, 69 males) in three intact classes that were randomly assigned to treatments. During the experimental period (4 weeks, 20 sessions, each 25 min), two children in wheelchairs were integrated into each contact class, and a special helper model was implemented. The experimental design was pretest-posttest randomized groups. Attitudes were assessed by an adjective checklist and an intention survey. A three-way ANOVA (Gender X Group X Time) revealed that females had significantly better attitudes than males. Subsequent analysis revealed that males in the structured contact group improved significantly on the adjective checklist, whereas males in the nonstructured contact group improved significantly on the intention survey.

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Exercise provides a robust physiological stimulus that evokes cross-talk among multiple tissues that when repeated regularly (i.e., training) improves physiological capacity, benefits numerous organ systems, and decreases the risk for premature mortality. However, a gap remains in identifying the detailed molecular signals induced by exercise that benefits health and prevents disease. The Molecular Transducers of Physical Activity Consortium (MoTrPAC) was established to address this gap and generate a molecular map of exercise. Preclinical and clinical studies will examine the systemic effects of endurance and resistance exercise across a range of ages and fitness levels by molecular probing of multiple tissues before and after acute and chronic exercise. From this multi-omic and bioinformatic analysis, a molecular map of exercise will be established. Altogether, MoTrPAC will provide a public database that is expected to enhance our understanding of the health benefits of exercise and to provide insight into how physical activity mitigates disease.