In the last 10 years, organizations and researchers have recognized the importance of sustainable supply chain management (SSCM) because of the consumers, -profit and non-profit organizations, laws and regulations, and consumer social and corporate responsibilities. Supplier selection, environmental effects such as social cooperation, and other SSCM programmes, can all help to achieve the “triple bottom line (TBL)” of economic, environmental, and social advantages. Sustainable supplier selection (SSS) and firm performance are important factors in supply chain management (SCM). Organizations will traditionally consider a new framework when evaluating SSS performance to obtain all-encompassing criteria/sub-criteria of the sustainability index by encapsulating sustainability. This paper compiles 12 subcriteria for three sustainability pillars, namely economic, environmental, and social performance. Despite the fact that many articles on SSS and evaluation were published during COVID-19, there seems to be little research on sustainability issues to date. The goal of this study is to suggest a fuzzy multicriteria approach to SSCM planning. Additionally, using the TBL method, the problem of determining a current model for SSS in the supply chain was investigated. The linguistic value of the subjective preference of experts is represented by triangular fuzzy numbers. Fuzzy TOPSIS  is proposed to use standard weights to rank SSS for qualitative performance evaluation. COVID-19, on the other hand, has a detrimental impact on SSS and company results. The organization’s performance suffers as a result of the COVID-19 shutdown. The proposed method is demonstrated using an example. The supply chain cycle in detail. Over a period of time, significant changes have taken place in perceptions of enhancing the social and environmental performance of organizations. In the past few periods, due to the rapid natural resource consumption, concerns about the gap between the rich and the poor, and social responsibility, sustainability has become an important practice in professional research.This concern has been demonstrated in legislation to expand organizational responsibilities, while increasing emphasis on the training of sustainable managers and in theories development to support sustainable supply chain management (SSCM) decisions . In SCM,Usually, at the time of evaluating SSS the organizations consider cost, delivery, quality, price, technology, and flexibility criteria. Nowadays, logistics SCM solutions act as major factors in ensuring the competitiveness of the SCM, and the procurement actions have become more complicated due to three pillars of sustainability pressures. But now, thanks to many organizations to consider the adoption of a SSCM plan for economic, environmental, and social issues and to evaluate the sustainability performance of their SSS . HoweverA number of studies have been carried out on green SSS. In view of the past concerns and the multicriteria nature of SSCM issues, we have proposed a multicriteria framework to assess the sustainability performance of SSS. Multicriteria strategic methods in real-world systems usually deal with personal human preferences. Since human judgments and preferences are usually vague and complicated, experts cannot use accurate scale language assessments to estimate their preferences, but can only give accurate language valuations. However, the COVID-19 crisis has a negative impact on businesses. COVID-19 has a damaging effect on all organizations, demonstrating a negative impact on firm performance and SSS. Due to the lockdown, the supplier’s performance is rapidly deteriorating. As a result, the lockdown issue is causing the firms’ performance to deteriorate. There for firm’s performance increase, which aims to resolve such uncertainties . AccordiThe following is the structure of this paper: First, principles of SSS by reviewing GSCM, social duty, and determining sustainability standards that affect the company’s purchasing decisions are reviewed . Second,One of the most difficult aspects of sustainable development is to put the definition of the World Commission on Environment and Development into practice and guide decision-making with its terms of reference. Another method to describe sustainability is to assist in the design of human and industrial systems so that the use of natural resources and human recycling do not lead to a significant reduction in quality of life owing to bad conditions and the loss of future economic prospects, and the impact of social situations on human health and the atmospheree. So this definition clearly shows that concert indicators are required to judge the sustainability and success of any decision .The three pillars of sustainability and SSCM practice include a series of strategies. Although much work on green supply chain management (GSCM) has been done in the past, there is very little research on SSCM practices. To meet the needs of various stakeholder groups, increasing market pressure and stricter SSCM practices, organizations have begun to focus on their supply chains. Today, GSCM has become an important concern for companies that incorporate the three pillars of sustainability into their strategy . The orgSustainable supply chain management is defined as the management of materials and information flow, as well as the collaboration between companies in the supply chain. It also integrates the TBL selection issues including all three pillars of sustainable change . AccordiThere are many activities that can be incorporated into GSCM plans and SSCM practices . SSS andOrganizations are liable for social interests, and social interests can also be found in the company’s mission and value statement . AlthougSocial duty can be defined as the voluntary combination of environmental and social issues in the organization’s business operations and relationships with stakeholders . OrganizSocial duty has been the subject of many studies. The establishment of a standards system is one of the most significant operations in the process of making SSS judgments. Many scholars have been working on the development of these criteria since the 1960s. The development of social and green SSS is also essential for effective SSCM, and consideration of environmental and social factors must go beyond the forefront of the organization’s SSS agenda, but lockdown has a negative influence on the firm performance . The orgNatural language expressing awareness or judgment is always personal, unclear, or imprecise. The uncertainty and subjectivity of fuzzy numbers have been dealt with by probability and statistics for a long time. Since the accuracy of words is not as good as numbers, the concept of linguistic variables generally describes the definition of events . The defR with membership function fA(x), it is a constant mapping from x in X to the closed interval . If the membership level of an element is 1, it means that the element must be in the set. If the member level is 0, it means that the element is definitely not in the set. This article defines the perception of fuzzy numbers as follows  and B =  be two triangular fuzzy numbers. Then the operational laws of these two triangular fuzzy numbers are as follows:The distance between A, B fuzzy numbers is calculated as:Definition 3. Assume that an expert group has K expert, and the fuzzy rating of each expert  can be represented as a positive triangular fuzzy number kR with membership functionfRk(x). Then, the aggregated fuzzy number is defined as:a = mink{ak},b = 1/kbk,c = maxk{ck}where The multiattribute decision-making (MADM) technology functionally related to the problem of discrete alternatives is a practical tool for resolving real-world problems. Since many MADM technologies are involved, Meanwhile, this study proposes related technologies, such as ELECTRE and AHP, and the characteristics of the TOPSIS method make it a major MADM technology :•First and for most take unlimited range of all three pillars of sustainability performance attributes and criteria.•Then clear trade-offs and interactions between performance attributes. More precisely, the change of any one attribute can be compensated by other attributes in an opposite or direct way.•The MADM technology (such as ELECTRE) method only determines the level of each alternative, and the priority ranking of alternatives with numerical values can better understand the differences and similarities between alternatives .•AHP methods circumvents the pair-wise evaluation. This method is used when dealing with a large number of sustainability criteria/subcriteria.•This is systematic simple calculation process.•In general simulation comparison, when adding or deleting alternative methods in the MADM method, the rank inversion of TOPSIS is the smallest.•The TOPSIS solution method includes the following steps :Step 1. To compute the normalized decision matrix. The normalized fuzzy-decision matrix can be expressed as:where B and C are the sets of product cost criteria and benefit correspondingly:rij  triangular fuzzy number.The above normalization method aims to retain the standardized attributes of the element Step 2. To estimate the weighted normalized decision matrix. The weighted normalized value vij is considered as:vij = rij.wij and wij are the weights of the jth attribute, or standard.where Step 3. To determine positive and negative ideal solutions: Fuzzy positive ideal solution  and fuzzy negative ideal of the solution  can be defined as:m;j = 1;2;nwhere Step 4. The distance of each alternative from the positive and the negative ideal solution A*,A− can be calculated as:j = 1,…2,, ndv is the distance measurement among two fuzzy numbers.and Step 5. To estimate the virtual proximity to the ideal resolution. One defines the tightness factor to determine all ranking orders possible SP after d_i and Ai has been calculated. For the closeness coefficient (CCl), the alternative calculation is:Step 6. To arrange the order of preferences. Alternative Ai is closer when criteria change index (cci) approaches 1, FPIS (A*) moves away from FNIS (A−). According to the descending order of cci, we can determine sort all alternatives and choose one of the best possible alternatives.To test the practicability of the proposed SSS and evaluation methods, a case of evaluation is illustrated. Thus the currently proposed method is used to solve this problem. The purpose of the sensitivity analysis is to deliberate the impact on SSS position when we select altered experts and criteria. This query is useful when there is uncertainty in the definition of the importance of different factors. Sustainable supply selection, the environment, and social cooperation are all supply chain management edges that can help achieve TBL benefits and promote long-term social development. Based on the TBL concept, this article focuses on the economic, environmental, and social criteria of SSS. All three sustainability features should be studied simultaneously in a comprehensive study of sustainable supply chain operations. In this paper, we present a fuzzy MCDM method for SSS decisions that is based on sustainability criteria. First, based on the literature, the SSS criteria was determined. Second, experts used fuzzy TOPSIS to aggregate scores and generate overall performance scores to assess SSCM practizes and business performance. Finally, we performed a sensitivity analysis to determine the decision-making process’ standard weights. The findings advised the company to choose the best SSS among the candidates in four ways to continue working with the SSS team, as well as suggesting that certain SSS improve certain defects or stop working with certain SSS. In general, one of the most important factors is the selection of SSS. This, too, is based on expert judgement. Opportunities for improving the company’s sustainability performance can be discovered and prioritized through its decision-making and implementation, reducing the activity’s negative impact on the environment and society.However, there are a few limitations to the above-mentioned article. There are over ten SSCM practizes that have been identified. Since no other SSCM practizes or issues have been discovered, actual concerns about the accuracy of these experts’ decision-making must be investigated to ensure the method’s viability. As this study was conducted during a lockdown, the companies were not fully operational, which may have led to data collection flaws. As a result, future research should focus on other countries to examine the impact of green supply chain management and SSCM practizes on firm performance. One of the limitations of this operation’s feasibility is the amount of information and data required to apply this method. Not only should supply chain managers adopt this strategy, but they should also keep such data for future organizational management. Experts are under time constraints and lack expertise on issues related to GSCM and SSCM practizes as a result of the SSS evaluation process. Despite the fact that the preferences are not exhaustive, we recommend that you consider SSS. Perhaps this will be the subject of future research. Various technologies and dynamic evaluation models can also be used to combine the SSS phase with continuous examination. Furthermore, after positioning all SSS, demand allocation is an important issue that may become a new trend in the future. However, COVID-19 has a negative effect on company performance. Due to the use of COVID-19, countries are under lockdown and business operations seem to be paralyzed. Therefore, the lock-in situation due to COVID-19 has a negative impact on the company’s performance.YH: conceptualization and data curation. MK: methodology, writing – original draft, data curation, visualization, and supervision. SZ: visualization and editing. AS: review and editing, review, editing, and software. All authors contributed to the article and approved the submitted version.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


The management of human resources is essential in a hospital, and its success can be seen based on the turnover rate of nursing personnel (nurses and midwives). In a hospital, the nursing personnel represents the largest number of professionals, and its performance greatly affects the effectiveness of services for patients. This study examined how organizations can predict turnover rates through intention to stay. Furthermore, this study aimed to explain the influence of cooperative behavior , which correlates with the intention to stay of nursing personnel. This quantitative research had a cross-sectional design, using a survey. The population involved non-permanent workers in five private and government hospitals. The sample consisted of 147 respondents. This study indicates that cooperative behavior showed positivity and significantly influenced the intention to stay, based on a 95% confidence degree. Perceived external prestige (p=0.009) and perceived internal respect (p=0.002) showed positivity and significantly influenced organizational identification. Perceived internal respect directly influenced the intention to stay (p=0.000), and organizational identification showed positivity and significantly influenced the intention to stay (p=0.000). Hospital management is more active in improving efforts and programs to improve the behavior of cooperatives, which is actually more dominant in non-financial aspects. The management of hospital human resources is essential, and its success can be seen in hospitals that experience a turnover rate in nursing personnel that increases every year. Nursing personnel is the most demanded profession in a hospital, being very important for service effectiveness. Previous research conducted by Sinding reported that since 2008, approximately 81% of companies had considered their employees a significant priority . Most nuThe current research aimed to explain the influence of cooperative behavior in the forms of perceived external prestige (PEP) and perceived internal respect (PIR) and how these were correlated with the intention to stay of nursing personnel. A high rate of turnover also causes uneven distribution of nursing personnel in every work unit. In certain work units, the shortage of nursing personnel is quite high compared to other work units. Besides the presence of several outgoing employees, the lack of workforce is also due to the insufficiency of the number of individuals recruited compared to the needs of the nursing personnel. According to Muchlis' research, organizational performance is a predictor of individuals and groups .Since nurse turnover has become an issue in the healthcare system , the preCarmeli defined organizational prestige as an organization's image . In thisAccording to previous research , cooperaRelated to this, an individual can be identified through two assessments, the assessment of the group status (pride) and the assessment of status in the group (respect) . This inIn previous research, job security was generally interpreted as the perception of financial guarantee in old age, whereas in this research, job security is interpreted as the perception of guarantee certainty regarding employee status in the hospital. The instrument was developed particularly on job security variables based on focus group discussions in the field. Some statements about why nursing personnel stays in the hospital were generally related to emotional factors (involving emotions) that refer to PEP and PIR and the job security of the hospital. The reasons for nursing personnel's preference to stay in the hospital were PIR, not yet passing the civil servant (job security), mutual respect for co-workers PIR, appreciation for each other's PIR, the fact that the hospital is one of the most well-known Islamic hospitals in Makassar PEP, working hard to pass the status of being a permanent employee (job security), be together with their colleagues PIR, financial problems (job satisfaction), and family atmosphere PIR like the nurses (job satisfaction). The management of nursing personnel was also adjusted to the needs and skill or skills of nurses (job satisfaction) and clarity of the recruitment system regarding the personnel in the hospital (job security). The organization's prestige in choosing the workplace and employee status becomes the basis of consideration to further examine PEP among nursing personnel, as well as PIR. Research studies are expected to address the high turnover rate in nursing personnel.This quantitative research had a cross-sectional design, using a survey to study the causal relationship between the variables involved, and develop a model on the intention to stay of nursing personnel in the hospital. The study was carried out in five private and one government hospital, which was determined by the turnover rate trend of the hospitals in the last three years. Data collection was carried out for two weeks, from June until July. The population involved 214 non-permanent nursing personnel  in five private hospitals. We conducted a survey (with a structured interview method) to patients/communities at each hospital to collect data on the level of PEP of the nursing personnel and people outside the hospital.The inclusion criteria were nursing personnel working in the hospital and who served in all nursing units with non-permanent employment status (except internship), individuals who have worked in the hospital for at least one year, under 36 years old, and with no leave status or studying out of town. The sample included 214 nursing personnel, out of which 184 met the inclusion criteria, and the final sample consisted of 147 people.To control the PEP of nursing personnel in the hospital, data were collected from the community/patient residing in the vicinity of the hospital location and from the patient at each study site. The inclusion criteria for the respondents of the survey were those who were at least 17 years old, with experience in visiting/using hospital services, with at least a junior high school/equivalent education (considered to have a fairly high education), and willing to participate in the survey. Meanwhile, the samples from the nursing personnel were collected based on proportionate random sampling, where the number of samples was collected based on the proportion of the number of nursing personnel in each hospital.Based on the predetermined inclusion criteria and the results obtained at each hospital, the sample size varied at each hospital. This occurred because several individuals did not meet the criteria, worked no more than a year, were over 36 years old, were on leave status, resigned from nursing personnel, or were unwilling to participate in the research.Concerning the characteristics of the respondents, all respondents worked for 1 to 5 years in the hospital. This was also certainly related to the age of the respondents, who were relatively young. Most respondents worked in the nursing unit, and only a few of them worked in the intensive care unit (ICU), emergency room (ER), and operation room (OK) . This isThe ethnicity distribution included Bugis, Makassar, Java, Mandar, Toraja, and Manado. Among these 6 ethnicities, Bugis ethnicity was mostly found in all hospitals, followed by Makassar.As a control, surveys were conducted to patients and communities who used health services at the respective sites to determine their perceptions on the prestige of each hospital.These are based on the final model results obtained from direct or indirect influence, presented in Based on the second model regarding the intention to stay of nursing personnel, perceived external prestige had a positive and significant effect on organization identification, with a path coefficient of 0.358 and probability significance (p) of <0.001. Perceived internal respect positively and significantly influenced organization identification, with a path coefficient of 0.527 and probability significance (p) of <0.001. The identification of the organization had a positive and significant impact on the intention to stay, with a path coefficient of 0.313 and probability significance (p) of 0.002. Perceived internal respect had a significant effect on the intention to stay, with a path coefficient of 0.319 and probability significance (p) of 0.261 .Increased perceived external presence (PEP) and perceived internal respect (PIR) could improve the organization identification (IO) of nursing personnel. The increased integration of perceived external prestige and perceived internal respect will improve the intention to stay nursing personnel. Increased job security will improve the intention to stay of nursing personnel. The developed model consisted of PEP, organizational identification, and PIR used to assess the intention to stay of nursing personnel which was fit as a model.The cooperative behavior theory of a group in another study  explainsSome of the results of this study are different compared to previous studies and differ from the hierarchical theory of needs . In MaslFurthermore, based on the Job Demands-Resources model, the mediator between social support (job resource) and job satisfaction  is work engagement. Meanwhile, recent studies assumed that social support is the moderator between work engagement and job satisfaction in nursing staff. This indicates that job satisfaction results from work engagement and social support from the supervisor and co-workers. Social support given by co-workers can improve work engagement, thus increasing the job satisfaction of nursing employees .In addition to social support from the co-worker, emotional support from the supervisor also determines the employees' job satisfaction. However, no study has been conducted on assessing the effect of supervisor emotional support on job satisfaction. In this case, multilevel statistical techniques can help disentangle the effects of subjective assessments from those of group factors. Hence, nurses with high work engagement levels tend to have high job satisfaction levels, which strongly correlates with the supervisor's emotional support at the group level .Furthermore, Terje Slåtten examined the role of organizational attractiveness (OA) from the perspective of hospital organizations. The examination revealed that the hospital manager's skill in developing an internal market-oriented culture was directly correlated to the hospital frontline employees since both have a direct effect on OA and an indirect effect on frontline employees' engagement, turnover intentions, and service-quality provision. Consequently, OA has a main role in affecting the frontline employees' perception regarding their opinion of whether their workplace is a great place to work. Therefore, it is important for the hospital manager to consider, focus, maintain, and cultivate OA as the hospital's main asset to make the hospital an attractive workplace in a very competitive market .Additionally, the balance between personal life and professional life has become a discussion topic. This is due to the involvement of new technologies in personal life, the overlap between work time and family time, new organizational systems, and changes in the nature of work. This issue is further exacerbated by the intense working hours or schedules that are undoubtedly experienced by nursing professionals. Nurses are expected to work quickly and effectively so that they can meet the demand of public health needs. In addition, they also work in an industry with an intensive work environment, which operates nonstop for a whole day and a whole year and sometimes requires exceeding the standard 40 h a week of full-time employment .The nursing profession in Europe will benefit significantly from this study's theoretical and practical outcomes. Theoretically, knowing how the Job Demands-Control-Support Model functions in a field like nursing, where complicated and dynamic activities are carried out, might significantly improve the work-life balance of professionals with demanding work schedules. The results of this study support the premise that work demands are not the only factors that affect work-life balance, particularly when employees feel that their employers are giving them job control and/or social support. As a result, the sector must examine the workplace elements that influence work-life balance. Human resource managers should look into new equipment to give employees control over their daily tasks, particularly in a profession like nursing where direct patient contact occurs and where the workers' ability to make decisions and exercise their freedom of action determines the quality of services provided. Greater autonomy will result from any advancement in this area , which should improve the work-life balance (WLB). Managers should also encourage cooperation and foster a collaborative work environment built on a supportive company culture. By investing in the training of work teams, the organizational environment and social support will improve, leading to organizational changes (such as in the scheduling of work shifts) and employees' attitudes toward patient care. These techniques should lessen work-related stress and raise workers' WLB .Downsizing would also affect middle managers, but they are required to demonstrate professionalism by performing their roles during the period of change. This research was conducted on companies experiencing downsizing in Indonesia. After downsizing, middle managers were satisfied with the process but did not show the expected work performance. This condition was different from a study by Bergström, who found that the survivors' organizational commitment increased after the downsizing process because the workers' program was well communicated .The study by Purwaningrum showed the importance of developing a positive atmosphere during times of change. The positive atmosphere developed by the organization at the beginning of change did not affect the effective commitment to change sufficiently; therefore, a positive atmosphere must be sustainably grown. The organization had a major role in building a positive atmosphere by showing its commitment to change, and top management could be role models in change .While there was a negative association between consensual organizational culture, sacrifice, appropriateness, and connection of job inclination, there was a positive correlation between turnover intention, resignation, and protective silence. The explanatory power of turnover intention was 47%, and the variables influencing it were current job experience, protective quiet, and sacrifice. Therefore, it will be required to create various programs to improve the communication pattern in the nursing organization and to give a diversified welfare system to reduce the intention of turnover .Nurses' intention to remain in their current job can be influenced by authentic leadership and nursing organizational culture, particularly relation-focused culture. It is advised to employ a genuine leadership training program for nursing leaders and to make efforts to create a relation-focused culture at the hospital to retain nurses .The long-term care of hospital nurses' level of happiness was not very high. Regarding the variables influencing their happiness, people reported feeling happier when their subjective health status was judged to be better, when they worked for an organization with a hierarchy-oriented culture, when they expressed a higher level of job satisfaction concerning autonomy, and when there were fewer task requests. Among these, autonomy-based work satisfaction had the most impact .The findings of multiple studies revealed that the intention to stay is influenced by various circumstances (ITS). The most accurate indicators of an intention to quit (ITL) or stay were affective and normative commitment (ITS). ITS may be impacted by the interaction between emotive and cognitive ideas . There aThe importance of growing cooperative behavior through perceived internal respect and perceived external prestige can increase nurses' intention to stay. There is a need to develop a more in-depth study and a model regarding the intention to stay of nursing personnel in the ministry of health. The development of an intention-to-stay model is not limited to hospitals but to other types of health services, including different types of professions.Furthermore, the hospital's management is expected to be more proactive in preventing a high turnover rate by adopting the intention to stay model, not only reactive and continuously recruiting, because it can lead to the inefficiency of human resource management and financial power in hospitals. In the formal form, the intention to stay model can be implemented and continued as part of the human resources management system in the hospital by involving the head of the team leader room and the nursing personnel themselves. In an informal manner, it can be done through daily interaction by discussing as an attempt to improve the intention to stay of nursing personnel.


The aim of this paper is to outline the role and potential benefits of physical activity for cancer patients. We present a review of publications on the subject in order to compare the findings reported in the literature and draw general conclusions that could help clinicians who provide cancer care to develop a more comprehensive treatment approach. This review may also help patients overcome barriers and become more motivated to take up physical activity, which would improve their quality of life. We wish to demonstrate to patients that physical activity should not be regarded as a burdensome medical recommendation but rather as a factor that can reduce the risk of cancer mortality and recurrence.In 2020, 19.3 million new cancer cases were diagnosed, and almost 10 million deaths from cancer were recorded. Cancer patients may experience fatigue, depression, anxiety, reduced quality of life and sleep problems. Cancer treatments cause numerous side effects and have a negative impact on all body systems. Physical activity is important for cancer patients. The aim of this review is to analyse recent studies on the role of physical activity in cancer patients and emphasize its importance. The review included 36 papers published in English between 2017 and 2021. The findings from these studies show that physical activity decreases the severity of side effects of cancer treatment, reduces fatigue, improves quality of life, has a positive impact on mental health and improves aerobic fitness in cancer patients. Moreover, it reduces the risk of cancer recurrence and death. Physical activity is recommended for patients with any type of cancer and at all stages of treatment. The type of physical activity should depend on the condition of the individual patient. It is extremely difficult to determine what type, intensity and duration of physical activity is likely to have the greatest effect. In 2020, 19.3 million new cancer cases were diagnosed, and almost 10 million deaths from cancer were recorded .Cancer treatments have many side effects. They exert a negative impact on: the cardiovascular system, the endocrine system, the digestive system, the immune system, the nervous system, the respiratory system, systemic symptoms such as fatigue, which can persist for many years after treatment, and lymphedema .Physical activity (PA) is important for cancer patients. The World Health Organization distinguishes between two types of physical activity: aerobic physical activity and anaerobic physical activity. Physical activity can be classified according to intensity as: light-intensity physical activity, 1.5–3 metabolic equivalents of task (METs), which does not result in a significant increase in heart rate or respiratory rate ; moderate-intensity physical activity, 3–6 METs; and vigorous-intensity physical activity, more than 6 METs [PA improves QoL, increases aerobic fitness, has a positive influence on mental health and reduces the side effects of cancer treatment, fatigue and mortality in cancer patients ,3,7,8,9.With patients facing a life-threatening illness, recommending additional physical activity may seem to be unnecessarily burdensome or too simplistic, as it would require an investment of time and energy from the patient .Although there are many research papers about the benefits of physical activity in cancer patients, in practice combining PA with treatment is rare. In 2020, as many as 35.5% of the cancer survivors aged 18 years and older reported physical inactivity . Only 7%The aim of the study is to present the impact of physical activity on cancer patients and cancer survivors in order to reach the largest possible group of readers, both among healthcare professionals and oncological patients.n = 326). During the eligibility assessment, we also excluded articles concerning cancer prevention, since the aim of this review was to evaluate the role of physical activity in patients already diagnosed with cancer, as well as articles with insufficient data (n = 228). Thirty-six articles were ultimately identified as eligible for inclusion. These publications were meta-analyses, systematic reviews and randomised controlled trials. The identification process of eligible studies is shown in We conducted a search of articles in the PubMed, Web of Science and EBSCO Information Services using the following keywords: cancer care, physical activity, survivors, quality of life, QoL. The inclusion criteria were as follows: articles in English, publication between 2017 and 2022. A total of 971 records were initially identified. We removed 381 duplicates and excluded articles to which we had no access, articles in a language other than English and articles not directly related to the subject of the review  reduced the fatigue resulting from intensive cancer treatment. The QoL was improved as well as lower limb muscle mass and endurance in breast cancer patients undergoing chemotherapy or radiotherapy. An important finding from the study was that the beneficial effect on QoL and fatigue persisted one year after the intervention , analysiPhysical activity improves physical and social QoL and reduces anxiety and depression in cancer patients ,3. UnlikPhysical activity has a positive impact on the mental health of cancer patients and adds positivity to their daily life . One stuStudies have shown that exercise improves aerobic fitness and upper-body strength and reduces BMI and body fat in colorectal cancer patients. The results of a meta-analysis conducted by Singh et al. showed a greater effect for exercise interventions lasting over 12 weeks and interventions conducted during chemotherapy in patients with colorectal cancer . Combinep = 0.006), with no differences between the TNM stage of a tumour.There is an association between greater physical activity and reduced mortality in colorectal, breast and prostate cancer patients, with 40–50% risk reductions observed among individuals undertaking physical activity . A studyCombined aerobic and resistance exercise reduces the incidence of metabolic syndrome in cancer survivors, particularly breast cancer survivors. Metabolic syndrome is a risk factor for breast cancer recurrence ,40. A raA diagnosis of cancer has a profound impact on the life of the patient. The fear of cancer progression, metastases and side effects of systemic treatment affects the quality of life as well as the mental and physical health of cancer patients. The anxiety, depression and bothersome somatic symptoms, such as fatigue, nausea, vomiting and hair loss, experienced by cancer patients significantly inhibit their physical activity. The barriers to undertaking physical activity faced by cancer patients are a very complex issue. They are associated with a number of factors. The nature, type and extent of cancer; the presence of metastases; cancer treatment and its side effects; the patient’s attitude to their illness and their coping strategy, as well as social and family support, have an enormous impact on the patient’s motivation and quality of life and thus their attempt to undertake regular physical activity. Moreover, cancer patients are often concerned that physical activity could have a negative impact on their illness, especially patients with diagnosed multiple myeloma, whom have the highest physical and mental impairments and a low QoL ,45. FurtCancer-related fatigue is a serious and complex problem that affects the quality of life and daily activities of cancer patients. Although, based on the results in the studies ,3,4, it According to the National Comprehensive Cancer Network (NCCN) and the American College of Sports Medicine (ACSM) (2018), physical activity improves QoL and physiological and psychological fitness in cancer patients .Chemotherapy and radiotherapy have a negative impact on many aspects of the lives of cancer patients, reducing their interest in physical activity and decreasing the effectiveness of exercise. The side effects of treatment are bothersome, especially for patients with MM, and their intensity is much higher than people with other haematological cancers ,47. One The results from a study by Cannioto et al.  showed tPhysical activity can improve immune system function by mobilizing leukocytes with increased functional capacities into the circulation. It helps with the elimination of dysfunctional T cells and improves the abundance of some T cell populations. PA may have an impact on CTLA-4 (inhibitory immune checkpoint) and provide to better response to immunotherapy in cancer patients ,52.As for incorporating exercise into cancer care and improving treatment outcomes, it is crucial to understand the role of the intensity, dose and mode of exercise in cancer patients. It is necessary to consider the individual needs of patients, the type of cancer they have as well as their treatment and health history. It has been found that the sooner physical activity is incorporated into a patient’s treatment plan after diagnosis, the more effective it is . High-inA major challenge for cancer patients is the very initiation of regular physical activity. This, in turn, is influenced by their strategy for coping with the illness. Strategies for coping with cancer can be constructive  or destructive . Choosing a constructive strategy will help initiate and maintain physical activity, whereas destructive strategies are a major barrier to the initiation of physical activity. The helplessness and anxiety associated with a diagnosis of cancer result in the patient giving in to the illness. This reduces the patient’s QoL, making it more difficult for them to maintain motivation for engaging in physical activity . Other bIt is very difficult for patients to maintain the appropriate intensity of exercise, especially if they suffer from chronic comorbidities or experience bothersome side effects of cancer treatment. The occurrence of comorbidities such as hypertension, kidney disease, diabetes, liver disease or obesity is increasing in cancer survivors . ObesityThe study has potential limitations. The first limitation is the selection of articles only in English, which introduces a language bias. The reason for this limitation is the insufficient knowledge of other languages to discuss the results in the study with appropriate precision. The second limitation is exclusion of the papers which the authors had no access to, which may potentially have impact on the results. The third limitation is the lack of an unequivocal way to encourage patients to start and maintain PA. Our purpose is to motivate the authors of future studies to search for an effective method encouraging patients to exercise.Physical activity improves quality of life, increases survival and reduces mortality, fatigue, side effects of treatment and the risk of recurrence.Physical activity should be selected individually, depending on the type of cancer, treatment and comorbidities.It is extremely difficult to determine what type, intensity and duration of physical activity is likely to have the greatest effect.


Tourism destinations constitute a conglomerate of attractions, service providers, and retailers that make up the overall offerings and experiences that attract visitors. However, given the severe consequences that the COVID-19 pandemic has had on the tourism industry, it is crucial to appraise consumer loyalty towards destinations in the context of the coronavirus disruptions. An increasing number of academic works examining the factors that influence destination loyalty have been carried out since the pandemic breakout, but no evaluation of their cumulative results and findings has been offered in the literature. Therefore, this research conducts a review of studies that have empirically investigated the drivers of destination loyalty during the pandemic in diverse geographical settings. By analyzing 24 journal articles selected from the Web of Science (WoS) database, this work adds to the literature by providing an assessment of the state-of-the-art body of knowledge about the explanation and prediction of loyalty for tourism destinations in the context of COVID-19. Building consumer loyalty is an essential objective for managers and is among the core relational constructs that have drawn greater attention in marketing and consumer behavior . For insDestination loyalty can be defined as the “behavioral consistency of repeated visits to a destination fueled by a psychological desire to visit the destination “, p. 870.By conducting a review of empirical results from studies elaborated during the pandemic, this work contributes to identify the drivers of destination loyalty as the focal construct, supporting the advancement of marketing theory based on inductive-statistical explanations . UnderstThe review of the literature was conducted through the Web of Science (WoS) platform , as in r2) ranging from 0.234 to 0.942. The outcome variables employed scale items corresponding to conative, affective, and/or cognitive loyalty to elicit revisit intentions or likelihood to return to the same destination. The operationalization of destination loyalty typically included scale items referring to recommendation or positive word-of-mouth (WOM) about the destinations, combined with other revisit intentions items within the same loyalty construct. However, some investigations specified and operationalized tourists’ recommendations or endorsements as additional, separate constructs in their models , with samples ranging from 123 to 774 (average sample size = 382). As indicated in Journal of Travel Research), rated “A” , or rated “B” . Three journals published more than one of the works reviewed: Sustainability (five articles), Journal of Destination Marketing & Management (three articles), and Current Issues in Tourism (two articles). The fact that two studies were published in Spanish language journals by Revista Universidad & Empresa, and by El Periplo Sustentable reflects the growing interest of academics based in Latin America to disseminate their research to broader audiences through journals indexed in international databases  tourist’s destination loyalty in the research of Three of the reviewed works addressed technological innovations used by consumers and also as part of the destination’s offerings. Due to the lack of a synthesis about research on tourism destination loyalty in COVID-19 settings, a literature review was conducted by examining 24 journal articles published in 2021 and 2022. Although the search for studies encompassed the time period since the coronavirus appeared, none of the 24 studies was published with an assigned volume/issue during 2020. It seems logical that when the pandemic crisis first broke out early in 2020 (first epidemic wave), many authors devoted their work to design, execute, write, and submit their research for peer-review, which ultimately led to final journal publication in the following years. In this respect, it should be noted that the effects of the constructs in the estimated loyalty models could have been influenced by the distinct time periods in which survey-data was obtained for each study. The perceived threat of infection according to fluctuations in coronavirus waves (upward or downward trends) has an impact on tourists’ risk assessments and intentions to travel . ConsideWhile some of the articles studied destination loyalty drawing from existing models in the marketing and tourism literature framed within the context of COVID-19 impacts, others works hypothesized moderation and/or mediation effects with new constructs specifically relevant to the pandemic disruptions e.g., . The oveNonetheless, it appears that loyalty towards destinations in some parts of the world could have been additionally influenced by the restrictions imposed on overseas travel to certain regions during the pandemic. This is suggested by the large variance explained in the loyalty outcomes reported for highly populated countries with significant domestic markets such as China , India , or someThe literature review was performed based on the records provided by the Web of Science (WoS) database derived from key term queries in English. Therefore, studies that could have been obtained by searching key terms in other languages were not included in the review. Further, the 24 works analyzed correspond to studies published in the form of journal articles, so other types of research in books, chapters, conference proceedings, or dissertations/theses were out of the scope of the review. The findings of the studies were based on convenience samples, which calls for caution in inferring generalizations given the limitations of non-probabilistic sampling . In termThe review of journal articles found that only one of the examined models specified cognitive and affective dimensions as drivers of destination loyalty . Hence, OC-M conceived, designed the concept, collected the data, wrote the manuscript, and read and agreed to the published version of the manuscript.This publication was supported by the TAMU-CC Open Access Publication Fund.The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


Since the mid-twentieth century, the proportion of elderly adults in the world’s population has steadily increased. Consequently, life events typically associated with youth, for example, pregnancy and childbirth, have become more common in older individuals. Efforts to gain a better understanding of how factors such as pregnancy, altered endocrine profiles and sleep patterns, as well as changes in metabolic function, are influenced by age have become increasingly important, especially with regard to healthspan, an indicator of the quality-of-life at an advanced age. Interventional strategies aimed at extending healthspan, even in the absence of a marked increase in longevity, are needed. In this Research Topic, the interplay of aging, reproductive hormones, and physiological function in humans is examined in addition to a critical review of the putative role of the widely prescribed antidiabetic drug metformin in regulating human longevity and healthspan.Yu et al. collected maternal and fetal cord blood samples, as well as placental tissue from females aged 35 and above (AMA) experiencing pregnancy and from those aged 34 and below. These samples were used to profile the levels of select estrogens, androgens, glucocorticoids, and the mineralocorticoid deoxycorticosterone. Not surprisingly, marked variation in the levels of individual steroids existed among sources , but only androgens in maternal blood varied significantly among women of AMA relative to young controls. Moreover, within AMA women the level of these same androgens differed significantly among individuals that experienced pregnancy complications versus those that did not. Although the mechanistic basis for these differences  is unknown, this study has provided significant insight into endocrine mechanisms underlying increased risk of abnormal pregnancy with advancing age.The age at first pregnancy for women has risen largely due to new societal norms that delay childbirth among reproductively competent women. Hence, pregnancies at an advanced maternal age (AMA) have become increasingly common. To address how age affects the steroidomics of pregnancy, Tehrani et al. provide convincing evidence that long-term monitoring of anti-Mullerian hormone (AMH) is a reliable predictor of the age at menopause in this population. Continued improvement in predicting the time of menopause, as well as the onset of other age-related states, has important implications for improving the healthspan of our increasingly aged population.The cessation of menses  is inevitable for women and typically occurs around the fifth decade of life. Due to the dramatic change in circulating hormone levels, especially the loss of estrogen-dependent signaling, multiple health risks have been linked to the onset and progression of menopause. Using a longitudinal dataset collected from 18 – 50 year-old women over almost two decades, Geraci et al. focus on the role of estradiol in the development of sarcopenia and the potential benefits of nutritional and physical interventions coupled with estradiol replacement therapy to counter the negative effects of menopause on muscle function to increase the healthspan of postmenopausal women.Meanwhile, a significant long-term risk of menopause is sarcopenia, the loss of muscle mass and the accompanying decline in muscle quality and function. Individuals suffering from sarcopenia demonstrate increased frailty and a reduction in healthspan, regardless of the cause. In the case of menopause, sarcopenia is thought to be largely due to the loss of estrogen-dependent signaling. This has led to hormone replacement therapy (HRT) being advocated to counter the effects of menopause on sarcopenia and other conditions common in postmenopausal women. In their mini-review, Yu et al. demonstrating an association between maternal androgen level and the risk of complications during pregnancy in women of advanced maternal age, Zhao et al. report that the risk of experiencing one or more morbidities allied with a decline in healthspan can be ascertained using serum testosterone level alone or in conjunction with specific genetic factors. Interestingly, these associations were found in both men and women; however, they were sex-specific, and in opposition to serum testosterone levels. Akin to prescribing estradiol replacement therapy for menopausal women, testosterone replacement therapy has widespread clinical use to counter the presumed effects of reduced testosterone in older men, as well as being used in postmenopausal women to counter reductions in sex drive. Given its robust sample size  the results of this study will aid in refining the guidelines currently used for the application of HRT in both men and women.As a complement to the work of Mohammed et al. posit that evidence for a direct life-extending effect of metformin remains ambiguous but there is strong evidence that metformin can extend healthspan consequent to a reduced rate of early mortality for individuals suffering from various disease states.Pharmaceutical interventions to stave off the effects of aging on functional outcomes , or to simply increase longevity, are desirable due to ease of use and widespread availability. Hormone replacement therapies, as mentioned previously, are excellent examples. The insulin sensitizer metformin has been used to treat individuals with type 2 diabetes mellitus for over 6 decades and has more recently garnered attention as a putative anti-aging drug. In a critical review of the literature, Che et al. has added improper sleep to the list of causal factors involved in the development of metabolic syndrome using data from more than 300,000 individuals. In short, either too little sleep or too much sleep was equally likely to contribute to the development of metabolic syndrome. Fortunately, sleep behavior is amendable, and the promotion of healthy sleep habits would significantly improve human healthspan.Metabolic syndrome is the consequence of altered endocrine function, most notably insulin resistance, and not surprisingly, those suffering from metabolic syndrome also suffer from increased mortality. While inactivity and obesity are established causes of metabolic syndrome, the study by These studies serve to highlight the myriad factors that can contribute to reduced healthspan. Continued study of these factors, and others, will serve us well in developing strategies to mitigate their effects and improve the quality of life in the increasingly elderly population.The author confirms being the sole contributor of this work and has approved it for publication.The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


Over recent years, online shopping has grown at a tremendous rate, reaching a worldwide online retail sales of 4.9 trillion USD in 2021. Moreover, forecasts predict a growth by 50% over the following four years, reaching ~7.4 trillion USD in 2025 , and this with or without sensory-enabling technologies that can deliver sensory input and enriched experiences . From the between-participants study with different combinations of these three features, it can be concluded that changes in the visual appearance of packaging can modulate the expectations consumers have concerning product quality, healthiness, price, and product properties such as sweetness, tastiness, and crumbliness. The presence of labeling and transparent (vs. opaque) packaging yielded higher expectations concerning the quality of the product. The latter, on the other hand, had an opposite effect on the expected healthiness of such cookies. The authors conclude that the visual appearance of packaging can nudge consumers toward healthier purchase habits.The first empirical paper assesses the role of different configurations of visual cues commonly present in a product's packaging  in the expectations associated with dietary cookies when presented in e-commerce platforms Iseki et al. it is studied whether gender-specific information associated with an otherwise neutral scent may influence congruent olfactory and tactile perception. For example, feminine labeling of a scent could induce a more positive rating of the tactile quality of smooth papers soaked with a neutral scent than when the smell is labeled masculine. From their congruency experiments, they could decide that a feminine-labeled scent was perceived as more feminine than a masculine-labeled scent. However, the feminine and masculine labeling did not influence the haptic perceptions and hedonic evaluations of paper imbued with a neutral scent.In the second empirical paper the focus is drawn to the inclusion of the olfactory sense since odor perception can be cognitively modulated. In Brengman et al. analyze the effects of scent in multisensory VR ads on consumer experience, depending on whether the scent is coherent or not with the product category. In a 2 ×3 between-subjects study, the researchers manipulate the presence of sound (on vs. off) and scent (congruent vs. incongruent vs. no). They found that whether sound is enabled or not, adding a congruent scent results in a more compelling sensory experience, than without enriching the VR ad with any scent. It should also be noted that adding an incongruent scent (as opposed to no scent) does not result in lower sensory experiences. The authors conclude on the interest of creating multisensory advertising in VR including scents to improve the consumer experience. They also stress the importance of not considering ambient stimuli in isolation, since it is the total configuration of cues that influence consumer responses.Doucé et al., who examine multisensory congruency via crossmodal correspondences and the moderating role of shopping goals  on this crossmodal congruency effect. Results show that when the online shop and music played on this webshop are crossmodally congruent  more positive consumer reactions are present when compared to the crossmodal incongruent situation, irrespective of the shopping goal. When compared to a no music situation, however, the crossmodal congruent situation only has a positive effect for experiential browsers and no adverse effect on goal-directed searchers.This multisensory perspective is further analyzed by the fourth empirical paper of Spence et al. offers insights into the combined inclusion of the sense of taste and audition. In particular, it investigates the technique of pairing sounds (music) with tastes (flavor), referred to as sonic seasoning. The paper offers insights into the creation of this multisensory tasting experience by reviewing a number of brands and case studies and exploring the added value of this type of sensorial stimulation in the phygital and online environment. In conclusion, the authors make a case for the creation of sonic seasoning whilst taking into account the scientific underlying principles, such as the crossmodal correspondences that may exists between basic tastes and the auditory sense.The literature review paper by  discuss the importance of consciousness in the digital consumer experience and how the introduction of multisensory technologies in this environment can challenge this consciousness. How can living experiences through augmented reality, virtual reality, or even in the metaverse represented by an avatar modify the perception of oneself and one's body? How does this affect consumers' consciousness of their experiences, their desires, and choices? Are all questions that are discussed in this paper. The authors conclude on the need for further research to understand how best to stimulate the consumer's senses in digital environments to improve the wellbeing of consumers. They also alert on the ethical issues that the loss of consciousness can generate in these environments.In their perspective paper Reinoso-Carvalho et al.) as well as product perceptions  in other senses, (2) offering a rich online customer experience leading to positive consumer reactions involves a multisensory perspective , and (3) multisensory technologies in a digital customer experience can affect consumers' consciousness .To conclude, the articles in this Research Topic show that (1) visual and auditory information can influence product expectations (i.e., taste and quality expectations; All authors listed have made a substantial, direct, and intellectual contribution to the work and approved it for publication.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


Cancer diagnosis and treatment represent a real upheaval both for the patient and for his or her life partner. Adjustment to cancer has been widely studied at the individual level, however, there is little in the literature about the experiences of the couple as an entity. This is especially true with regard to a population facing advanced cancer. This systematic review aimed to make an inventory of 1) the current knowledge relating to the experience of the patient-partner dyad when confronted with advanced cancer, and 2) the psychosocial interventions specifically centered on this dyad.This review was conducted using the Cochrane methodology. The eligibility criteria for the literature review were: one of the members of the dyad being treated for advanced cancer, dyad composed of the patient and his/her life partner. Databases from PubMed, PsycArticle, PsycInfo, Psychology and Behavioral Sciences Collection and Scopus were investigated. A thematic content analysis on the basis of admitted articles made it possible to respond to each of our research objectives.Three hundred eighty-nine citations were found. Twenty were admitted to the systematic review of the literature. It highlighted the following experiences of the advanced cancer patient-life partner dyad: uncertainty about the future, disjointed time, intrusion into the couple's intimacy, attachment style and caregiving within the couple, couple's adjustment to cancer symptomatology, the couple's supportive care needs, role changes, nature of communication within the couple, anticipation of the coming death, and the meanings and beliefs around death. This review also describes the range of couple therapies used in the context of advanced cancer: emotionally focused-couple therapy, existential therapy, art therapy, support therapy and couple communication and intimacy promotion. These therapies seem to have individual beneficial effects for both the patient and his or her life partner as well as improving marital functioning.These results clearly highlight that consideration of the couple and communication within the couple during care are fundamental to dyadic adjustment to advanced cancer. Further studies  are needed to better understand the couple's experience in order to adapt the management of the couple facing advanced cancer. Cancer diagnosis and treatment represent a real upheaval, both for the patient and for those around him or her  to break down the evaluation question into different concepts that we used to build the research strategy:- Population: All studies on adult patients (>18 years old) with a diagnosis of advanced cancer  and their life partner , with no limitations regarding time since diagnosis or cancer location were included. Couples could be either homosexual or heterosexual.- Intervention: Studies relating both to (1) the couple's experience and (2) psychosocial interventions intended for the couple, in the context of advanced cancer, were included.- Comparison: In view of the difficulty accessing the population studied, the absence of a control group was not an exclusion criterion.- Outcomes: Studies relating to the quality of life, psychosocial aspects and symptoms were included and any studies reporting results which related to the structural, functional, behavioral, emotional and social balance of the dyadic system.- Temporality: We did not place any time restrictions.- Setting: The study population is accompanied by care services (ambulatory or complete) or an oncologist.We are aware that with such broad search criteria many documents could be found . We wanted to make our own selection of the types of documents to integrate according to the number of results found. We made this choice with regard to the research context (end of life) in which we operate. We know that this is a context where it is difficult to conduct analytical studies.We queried the following electronic databases: PubMed, PsycArticle, PsycInfo, Psychology and Behavioral Sciences Collection and Scopus, with no limitation for publication date or language. The search was last updated on 31 October 2021. While the search strategies were the same for each database, they were adapted to the way the database works. The search strategy with thesaurus was as follows: “Couple” AND “palliative care” . AccordiAll search results were merged into an Excel spreadsheet. Duplicates were excluded. The title and abstract of each of the articles were reviewed and those who did not meet the eligibility criteria were excluded. The process of excluding articles on the basis of title and abstract was carried out in an independent double rating, by MH and BQ on 10 references, in order to reinforce the interrater validity of this review. In case of doubt, the full texts were read. Full texts were studied for all remaining studies. Those who did not meet the eligibility criteria were excluded. The process of excluding articles on the basis of reading the full texts, was carried out in independent double rating, by MH and BQ on 10 references in order to reinforce the interrater validity of this review. For accepted articles, a characteristic table of studies was completed. We completed our search strategy by studying the bibliographies of the included studies.Then, for each study, a distinction was made as to whether it met objective 1 (dyadic experience of the patient and his/her life partner when confronted with advanced cancer) or objective 2 . Finally, a thematic content analysis of each study was conducted separately by two psychology researchers (BQ and MH) who then compared their results in order to identify the main themes mentioned in the literature, related to each of the two research objectives. This thematic content analysis was conducted according to the methodology proposed by Paill and Mucchielli . We chosThe Critical Appraisal Toolkit was developed by a team from the Public Health Agency of Canada and a Cochrane reviewer with methodological expertise to appraise analytical studies, descriptive studies and reviews of literature . When discrepancies appeared, oral discussion of the manuscripts was performed for consensus.n = 40), 349 records were screened (titles and abstracts), which led to the exclusion of 293 studies . Thus, 56 full-text articles were assessed, of which 38 were excluded, leaving 18 studies. Two additional references, found in the bibliography of the articles, were included, which finally corresponded to 20 studies admitted to the review. Ten studies met our first objective and 10 studies met our second objective.A total of 389 citations were found through this search strategy, including 301 through PsycINFO, PsycArticle, Psychology and Behavioral Sciences Collection, 71 through PubMed and 17 through Scopus . After eN = 1), the United Kingdom (N = 1), France (N = 1), Belgium (N = 1) and Germany (N = 1). At least 779 couples were studied. Patients had an average age of 63.08 years. Caregivers had an average age of 60.27 years. The results of these studies are summarized in Of the 20 studies admitted in our review, 10 met our first objective (to describe the adjustment of the patient-life partner dyad for advanced cancer):we identified 1 book chapter, 1 clinical correspondence, 1 case study, 1 review of the literature (2007), 3 qualitative studies and 3 quantitative studies . Most of the studies were conducted in North America . The other studies were conducted in Switzerland  and shared (dyadic) experiences Gardner, . While mOne of the most common concerns described by patients and spouses was the struggle to deal with the uncertainty and ambiguity surrounding the patient's health status and future (and thus the partner's own future) Gardner, . This coFaced with serious illness, time-sharing no longer took the same signification Reny, . The patChanges in relationships were related, among other things, to treatment  healthy Reny, . Faced wCommunication is central to the intimate relationships. Following the diagnosis of advanced cancer, communicational patterns within the couple change  , Switzerland (N = 1) and France (N = 1). At least 69 couples were studied. Patients had an average age of 61.28 years. Caregivers had an average age of 55.59 years. We detailed the methodology and results of each of the included studies in a comparative table : 5 case studies, 2 qualitative studies, 3 quantitative studies . Most studies were conducted in America . The other studies were conducted in the United Kingdom   as a mediator was identified  without being linked to a particular current   to explore scientific actual knowledge about the dyadic experience of the patient and his/her life partner when they are confronted with advanced cancer; (2)to highlight the impact of psychosocial interventions that are offered to the couples in the context of an advanced cancer.Faced with often uncertain and ambiguous circumstances, cancer patients and their partners describe the individual and dyadic processes in which they have engaged as they approach the end of life Gardner, . ChangesThese results, particularly those related to communication, are consistent with the results found among the cancer population . Our results (and our avenues for reflection) should therefore be taken into consideration (as there are no others), but with a critical eye. They allow us to think about the relationship between the couple and advanced cancer, without asserting that a conclusion proposed in a study is a general truth. This is all the more true since there is a great diversity in the ways of apprehending the experience of the couple facing advanced cancer . This diversity, although very enriching, is confronted with the lack of existing studies, which means that there is little or no possibility of comparing the results of our studies (except for communication).The interventions identified in our review focus on certain areas of interest identified above . All interventions identified have common general objectives: the promotion of communication and intimacy within the couple. Couple therapy, as a complement to end-of-life care, generates a relationship of trust between the couple and the therapist , gives couples the opportunity to express their concerns together, to identify differences in understanding, and to learn to find new strategies to manage daily life . Our results must therefore be interpreted with caution. Normally, it cannot be used as the basis for a practical recommendation unless no other source of evidence is available; which is the case here. Consequently, we could develop clinical recommendations, but we will not do so and will only propose avenues for reflection. There is an obvious observation: using a robust methodology (and therefore obtaining evidence) in the context of the end of life is a real challenge. This raises the following question: should we focus on the level of evidence and exclude from review certain leads proposed by poor quality studies or should we lower our requirements regarding the level of evidence and adopt an inclusive approach? (We made the choice to reduce our level of requirements with regard to the field of study in which we are enrolled: that of the end of life).Through these results, one can see that communication is an axis that has been widely studied by descriptive and interventional research. This is consistent with all models of dyadic adjustment that consider communication as a fundamental element  that guided this systematic exploration of the literature, some limitations should be highlighted. While we followed the recommendations of Cochrane, the selected studies include various risks of bias due to their design: selection bias, response bias, social desirability bias, absence of psychometric data on certain questionnaires used, small sample size, non-generalizable results, variables not considered, correlational effects and not causality, little diversity, high attrition rate, use of established tools and criteria that are not necessarily those recognized at the present time current. In addition, from one study to another, we observe significant differences  which leads to difficulties in comparing our results.A relatively small number of articles were eligible for inclusion in this review, demonstrating the lack of evidence on the experiences of patients and life partners facing advanced cancer, but also the lack of evidence on the effectiveness of couple interventions. This observation limits the current clinical perspectives in terms of solid management of these dyads and conversely, it offers a multitude of research perspectives.This literature review reveals that consideration  of the couple within the care appears fundamental. What is more, communication within the patient-life partner dyad is an essential axis of work. While many other variables appear important in the couple's dyadic adjustment to advanced cancer, there is very little evidence on the couple facing advanced cancer, though we know how severely the couple unit is impacted by cancer . It could also provide elements of response relating to the apprehension of the trajectory of the disease by each partner of the dyad and from an interactional point of view. Also, qualitative protocols would allow a better understanding of the phenomena studied, in particular the representations that each partner has of the illness, the end of life, the post- death, etc. and the possible conflicts or difficulties resulting from a representational incongruence between them both. That is why, an openness to the concepts of ”reciprocal influence“ and ”congruence“ seems fundamental in order to open up our research perspectives in this field. Finally, experimental studies are needed  to scientifically test the impact of specific dyadic therapies for couples facing advanced cancer and at the end of life. These research approaches would enable greater understanding of the complexity of the issues surrounding the dyadic experience of couples facing advanced cancer and allow effective psychosocial interventions to be proposed that are as close as possible to the realities of individual and dyadic experiences.The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author/s.MH and BQ participated in the overall research and writing of the article. Both authors contributed to the article and approved the submitted version.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


The outbreak response was complicated due to insecurity and armed conflict in the region, and over the next 19 months, thousands of cases and deaths would occur, making this the world´s second-largest outbreak of EVD to date. On 4 August 2018, the Uganda Ministry of Health (MoH) activated the national coordination mechanisms for public health emergencies. The National Rapid Response Team (NRRT) immediately mobilized and embarked on a preparedness assessment and risk mapping to inform the country´s EVD response plan. This case study describes the events that transpired from declaration, activation of the coordination mechanisms, preparedness and response to EVD. The case study is meant to teach rapid responders, Incident Management Team members and the National and District Task Forces on how to prepare and respond to such outbreaks.On August 1 How to use this case study: case studies in applied epidemiology allow students to practice applying epidemiologic skills in the classroom to address real-world public health problems. The case studies are used as a vital component of an applied epidemiology curriculum, rather than as stand-alone tools. They are ideally suited to reinforce principles and skills already covered in a lecture or in background reading. This case study has a facilitator guide and a participant guide. Each facilitator should review the Facilitator Guide, gain familiarity with the outbreak and investigation on which the case study is based, review the epidemiologic principles being taught, and think of examples in the facilitator´s own experience to further illustrate the points. Ideally, participants receive the case study one part at a time during the case study session. However, if the case study is distributed in whole, participants should be asked not to look ahead.During the case study session, one or two instructors facilitate the case study for 8 to 20 students in a classroom or conference room. The facilitator should hand out Part I and direct a participant to read one paragraph out loud, then progressing around the room and giving each participant a chance to read. Reading out loud and in turns has two advantages. First, all participants engage in the process and overcome any inhibitions by having her/his voice heard. Second, it keeps all the participants progressing through the case study at the same speed.After a participant reads a question, the facilitator will direct participants to answer the question and perform calculations, construct graphs, or engage in a discussion of the answer. Sometimes, the facilitator can split the class to play different roles or take different sides in answering the question. As a result, participants learn from each other, not just from the facilitator.After the questions have been answered, the facilitator hands out the next part. At the end of the case study, the facilitator should direct a participant to once again read the objectives on page 1 to review and ensure that the objectives have been met.Prerequisites: for this case study, participants should have received instruction or conducted readings in: National Multi-Hazard Preparedness and Response Plan for Public Health Threats and Emergencies in Uganda; WHO Framework for a Public Health Emergency Operations Centre.Target audience: trainees in the Field Epidemiology Training Program / Public Health Fellowship Program, other Field Epidemiology and Laboratory Training Programs (FELTPs), public health students, public health workers who may participate in rapid needs assessments, and others who are interested in this topic.Level of case study: advancedTime required: provide expected duration Language: EnglishDownload the case study student guide (PDF - 910 KB)Request the case study facilitator guide


This special issue of Bioinformatics serves as the proceedings of the 30th annual conference on Intelligent Systems for Molecular Biology (ISMB), which took place on July 10–14, 2022, in Madison, WI, USA. ISMB is the leading international forum for presenting new research results, disseminating methods and techniques and facilitating discussions among leading researchers, practitioners and students in the field. In addition, ISMB is the flagship conference of the International Society for Computational Biology. Due to the worldwide COVID-19 pandemic, the ISMB 2022 meeting was run as a hybrid conference, with online participants from all around the world complementing the on-site participants.The papers published in this volume were selected from 243 submitted full-length papers featuring original research. The submitted papers were thoroughly reviewed with each paper receiving 4.08 reviews on average. For the review purpose, the submitted manuscripts were assigned to one of the 11 scientific areas according to the authors’ preference and research topic, allowing for minor adjustments to avoid conflicts of interest. In addition to selecting one of the 11 areas, the authors could also designate a particular Community of Special Interest COSI;  that wouThe reviewing of the submissions was overseen by the Senior Program Committee (SPC), which included the Proceedings Chairs  and Area Chairs . The definition of conflict was defined as broadly as possible—including collaborators (present and past few years), same institution , family relations, advisees/advisors, as well as any personal conflicts that could cause the appearance of a conflict of interest, or that could genuinely interfere with objective reviewing. Finally, as Proceedings Chairs, we refrained from submitting papers to the conference.Among the 243 submissions, 48 were accepted for presentation at ISMB 2022 and publication in the proceedings, conditioned on revisions properly addressing the comments of the reviewers. In a few cases, the authors had to be reminded to release their source code alongside their manuscript. This year, all 48 conditionally accepted papers were revised and subsequently judged to have properly addressed the concerns of the reviewers and were accepted for the conference proceedings, resulting in a 19.8% acceptance rate overall. The acceptance rates for individual areas are shown in We are deeply grateful to the Area Chairs, the 304 members of the Program Committee and the 270 sub-reviewers for their outstanding efforts in conducting thorough and timely reviews. Their contribution is at the core of the scientific quality of the conference. We also thank Steven Leard, Diane Kovats and Seth Munholland for their support, guidance and handling logistical questions and all the other members of the ISMB Steering Committee for their expert advice and supervision. We also thank the team at Oxford University Press for producing this special proceedings volume.We also thank all the authors for submitting their work. These proceedings would not be possible without the scientific ingenuity of the contributors of all the papers. We recognize that, despite our best efforts, the selection process is necessarily imperfect, and some outstanding work will have been missed. Nonetheless, we hope that all authors received helpful feedback on their work. Finally, we want to thank all the keynote speakers, presenters, and all conference participants.Thank you all for making this meeting possible and the entire ISMB community to continue to thrive.No new data were generated or analysed in support of this research.This work was supported by the James McDonnell Foundation to S.R.; Swiss National Science Foundation grants (205085 and 186397 to C.D.).Conflict of Interest: none declared.