Patient navigation is a strategy for overcoming barriers to reduce disparities and to improve access and outcomes. The aim of this umbrella review was to identify, critically appraise, synthesize, and present the best available evidence to inform policy and planning regarding patient navigation across the cancer continuum. Systematic reviews examining navigation in cancer care were identified in the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Cumulative Index of Nursing and Allied Health (CINAHL), Epistemonikos, and Prospective Register of Systematic Reviews (PROSPERO) databases and in the gray literature from January 1, 2012, to April 19, 2022. Data were screened, extracted, and appraised independently by two authors. The JBI Critical Appraisal Checklist for Systematic Review and Research Syntheses was used for quality appraisal. Emerging literature up to May 25, 2022, was also explored to capture primary research published beyond the coverage of included systematic reviews. Of the 2062 unique records identified, 61 systematic reviews were included. Fifty‐four reviews were quantitative or mixed‐methods reviews, reporting on the effectiveness of cancer patient navigation, including 12 reviews reporting costs or cost‐effectiveness outcomes. Seven qualitative reviews explored navigation needs, barriers, and experiences. In addition, 53 primary studies published since 2021 were included. Patient navigation is effective in improving participation in cancer screening and reducing the time from screening to diagnosis and from diagnosis to treatment initiation. Emerging evidence suggests that patient navigation improves quality of life and patient satisfaction with care in the survivorship phase and reduces hospital readmission in the active treatment and survivorship care phases. Palliative care data were extremely limited. Economic evaluations from the United States suggest the potential cost‐effectiveness of navigation in screening programs.

Measures of strength and change of direction (COD) ability reporting inconsistent relationships to performance. These inconsistencies may be the result of the strength assessment used and the assumption that 1 measure of strength can represent all “types” of strength required during a COD task. Therefore the purpose of this study was to determine the relationship between several lower-body strength and power measures, COD, and agility performance. Twelve (n = 12) elite female basketball athletes completed a maximal dynamic back squat, isometric midthigh pull, eccentric and concentric only back squat, and a countermovement jump, followed by 2 COD tests (505 and T-test) and a reactive agility test. Pearson product-moment correlation and stepwise regression analysis were performed on all variables. The percentage contribution of each strength measure to an athletes total strength score was also determined. Our results demonstrated that both COD tests were significantly correlated to maximal dynamic, isometric, concentric, and eccentric strength (r = −0.79 to −0.89), with eccentric strength identified as the sole predictor of COD performance. Agility performance did not correlate with any measure of strength (r = −0.08 to −0.36), whereas lower-body power demonstrated no correlation to either agility or COD performance (r = −0.19 to −0.46). These findings demonstrate the importance of multiple strength components for COD ability, highlighting eccentric strength as a deterministic factor of COD performance. Coaches should aim to develop a well-rounded strength base in athletes; ensuring eccentric strength is developed as effectively as the often-emphasized concentric or overall dynamic strength capacity....

Tiple components to produce a faster performance. However, the mechanisms contributing to a faster performance without the confounding factor of athlete expertise or gender is currently unknown. Therefore, the purpose of this study was to assess body composition, strength, and kinetic profile required for a faster COD and agility performance across multiple directional changes. Six faster and 6 slower (n = 12) elite female basketball athletes completed a maximal dynamic back squat; eccentric and concentric only back squat; isometric midthigh pull; whole-body scan to determine lean, fat, and total mass; 505 COD test; T-test; and a multidirectional agility test over in-ground force plates to obtain relevant kinetic measures. Group (faster and slower) by test (2 × 3) multivariate analyses of variance with follow-up analyses of variance were conducted to examine differences between faster and slower groups and each COD and agility test (p ≤ 0.05). Faster athletes during the 505 COD test produced significantly greater vertical force (p = 0.002) and eccentric and isometric strength capacity (p = 0.001). Faster agility and T-test athletes demonstrated significantly shorter contact times (p = 0.001), greater propulsive impulse (p = 0.02), isometric strength, and relative lean mass compared with slower athletes. Differences between faster athletes across each test seem to be attributed to the mechanical demands of the directional change, increasing force and impulse application as the degree of directional change increased. These findings indicate that different mechanical properties are required to produce a faster COD and agility performances, and the importance of a greater strength capacity to enable greater mechanical adjustment through force production and body control, during different directional changes....

This review summarises current understanding of how bone is sculpted through adaptive processes, designed to meet the mechanical challenges it faces in everyday life and athletic pursuits, serving as an update for clinicians, researchers and physical therapists. Bone’s ability to resist fracture under the large muscle and locomotory forces it experiences during movement and in falls or collisions is dependent on its established mechanical properties, determined by bone’s complex and multidimensional material and structural organisation. At all levels, bone is highly adaptive to habitual loading, regulating its structure according to components of its loading regime and mechanical environment, inclusive of strain magnitude, rate, frequency, distribution and deformation mode. Indeed, the greatest forces habitually applied to bone arise from muscular contractions, and the past two decades have seen substantial advances in our understanding of how these forces shape bone throughout life. Herein, we also highlight the limitations of in vivo methods to assess and understand bone collagen, and bone mineral at the material or tissue level. The inability to easily measure or closely regulate applied strain in humans is identified, limiting the translation of animal studies to human populations, and our exploration of how components of mechanical loading regimes influence mechanoadaptation.

Understanding the magnitude of forces and lower body kinematics that occur during a change of direction (COD) task can provide information about the biomechanical demands required to improve performance. To compare the magnitude of force, impulse, lower body kinematics and post-COD stride velocity produced between athletes of different strength levels during a COD task, 12 stronger (8 males, 4 females) and 12 weaker (4 males, 8 females) recreational team sport athletes were recruited. Strength levels were determined by relative peak isometric force of the dominant and non-dominant leg. All athletes performed 10 pre-planned 45° changes of direction (5 left, 5 right) while three-dimensional motion and ground reaction force (GRF) data were collected. Differences in all variables for the dominant leg were examined using a one-way analysis of variance (ANOVA) with a level of significance set at p ≤0.05. The stronger group displayed significantly faster post-COD stride velocity and greater vertical and horizontal braking forces, vertical propulsive force, vertical braking impulse, horizontal propulsive impulse, angle of peak braking force application, hip abduction and knee flexion angle compared to the weaker group. The results suggest that individuals with greater relative lower body strength produced higher magnitude plant foot kinetics and modified lower body positioning while producing faster COD performances. Future investigations should determine if strength training to enable athletes to increase plant foot kinetics while maintaining or adopting a lower body position results in a concomitant increases in post-COD stride velocity.