Return-to-work intervention during cancer treatment - The providers' experiences.

To explore in-depth understanding of providers' experiences when involved in a return-to-work (RTW) intervention offered during cancer treatment. Semi-structured individual interviews and participant observations at a hospital department and two municipal job centers were carried out, including ten providers (physicians, nurses and social workers). A phenomenological-hermeneutic approach was applied, involving coding, identification of themes and interpretation of findings. Three major themes were identified: Treatment first, Work as an integrated component in cancer rehabilitation, and Challenges in bringing up work issues. Differences in providers' experiences of the RTW intervention offered to cancer patients were found: in the hospital setting RTW was a second priority, whereas in the municipality job centers it was an integrated component. Further studies are needed to investigate how and when occupational rehabilitation services can be implemented across sectors to support cancer patients' RTW. In the future, work issues ought to be systematically presented by providers across sectors as early as possible to support cancer patients' RTW. Cancer patients' individual needs and thoughts about RTW are to be identified by both health care providers during treatment and social workers at the municipality level and shared across sectors.

Evaluation of three-dimensional SonoAVC ultrasound for antral follicle count in infertile women: its agreement with conventional two-dimensional ultrasound and serum levels of anti-Müllerian hormone.

BACKGROUND: Several studies have reported a correlation between antral follicle count by conventional 2D transvaginal sonography and serum anti-Müllerian hormone levels. However, few studies have investigated the effectiveness of 3D SonoAVC transvaginal ultrasound technology, particularly in infertile women. Therefore, this study aims to evaluate the usefulness of three-dimensional (3D) SonoAVC transvaginal ultrasound technology for antral follicle count and its correlation to conventional two-dimensional (2D) transvaginal ultrasound and serum levels of anti-Müllerian hormone in infertile women. METHODS: This cross-sectional study included 42 infertile women with age lower than 40 years that underwent treatment at a private fertility clinic between June and December 2015. Patient data included age, body mass index and cause of infertility. On cycle day 3 the following hormone levels were measured: serum levels of anti-Müllerian hormone, follicle-stimulating hormone, cancer antigen 125, prolactin, thyroid-stimulating hormone and oestradiol; the number of antral follicles was counted as well. The scanning were performed through 2D and 3D technology transvaginal ultrasound. RESULTS: Using a Bland-Altman test we demonstrated that both technologies are quite equivalent. However, antral follicle count is higher using 3D ultrasound technology compared to 2D technology (p < 0.001; Wilcoxon test), this finding is mainly remarkable in ovaries with more than 20 antral follicles. Moreover, the mean time required for manual 2D ultrasound and 3D SonoAVC measurements were 275 ± 109 and 103 ± 57 s, respectively (p < 0.001). Serum AMH concentration correlated to the total number of early antral follicles (correlation coefficients = 0.678 and 0.612; p < 0.001 by 2D ultrasound and 3D SonoAVC, respectively; Spearman's correlation test). CONCLUSIONS: Antral follicle count is better estimated using 3D ultrasound compared to 2D technology. A great advantage of 3D SonoAVC was less time required for an examination and the visual advantage when it need to count more than 20 follicles. TRIAL REGISTRATION: CAAE: 35141114.4.0000.5327 . Registered 10 June 2015.

Teenagers and young adults with cancer in Europe: from national programmes to a European integrated coordinated project.

Over 14 000 patients aged 15-24 are estimated to be diagnosed with cancer in the European Union (EU) each year. Teenagers and young adults (TYA) often fall down gaps between children's and adults cancer services. The specific challenges of providing optimal care to them are described, but we present a summary of recent progress. Progress to overcome these challenges is happening at different rates across Europe. We summarise the European national projects in this field but more recently we have seen the beginnings of European coordination. Within the EU 7th Funding Programme (FP7) European Network for Cancer Research in Children and Adolescents programme (ENCCA), a specific European Network for Teenagers and Young Adults with Cancer has held a series of scientific meetings, including professionals, patients and caregivers. This group has proposed unanswered research questions and agreed key features of a high-quality service that can improve outcomes for TYA with cancer, including the primacy of collaboration between adult and paediatric services to eliminate the gap in the management of TYA with cancer.

Using a knowledge utilization framework to explore how findings from one study can be applied to other nursing contexts.

AIM: To discuss the complexities of moving research into practice and through a case example, explore how empirical findings from one specific study could be applied to nursing in other contexts. BACKGROUND: The processes of moving research findings into practice are complex and multidimensional. In this paper, an innovative approach to social support, network-focused nursing (NFN), is used as a case example to illustrate these complexities. Social support is associated with better recovery and survival after illness and based on this, a NFN programme was developed in a Danish oncology youth unit. Subsequently, a research study was undertaken to investigate the programme and based on the findings, the concept NFN was developed. METHODS: A knowledge utilization framework is used to explore how empirical findings from the NFN study could be applied to nursing more generally. Aligned with this, the specific considerations for implementing NFN are explicated. DISCUSSION: Strong leadership, education, management support and effective communication are critical factors for research utilization. Moving research into practice requires openness to new ideas. Nursing and healthcare policies therefore need to support environments in which creativity and innovation can flourish. NFN was developed in teenager and young adult cancer care, but its principles may be transferable to other clinical environments. CONCLUSIONS: It is important that nurse managers and policy makers ensure that support and education are available to nurses to facilitate moving research into practice. Moreover, resources need to be considered, particularly in countries where financial and organizational infrastructures may be weak.

[Impotence and corpus cavernosum leakage. Results after surgical treatment]. / Impotens og corpus cavernosum laekage. Resultater efter kirurgisk behandling.

A consecutive series of 15 impotent men (mean age: 53 (range 18-65 years)) underwent venous surgery for abnormal drainage of the cavernous bodies. During the follow-up period (mean 19 months (range 10-34)), 11 patients became potent and sexually active. Three of the impotent men had had a primary venous leakage of the corpora cavernosum, and all these three had to be re-operated. Two achieved full potency. The three postoperative failures in the 12 patients with the secondary type of venous impotence occurred in one heavy smoker, one patient with severe arterial hypertension and one continued to be impotent until his death eight months postoperatively. It is concluded that erectile impotence due to pronounced leakage of the cavernous bodies should be treated surgically, and that the longterm effect is acceptable.

[Laser treatment of penile cancer]. / Laserbehandling af cancer penis.

The treatment of localized penile cancer has hitherto been surgical amputation of the penis. In our 12 cases, tumorectomy was performed by CO2 or ND:YAG-laser radiation with minimal tissue ablation. Local recurrences occurred and the patients must be followed regularly in the outpatient clinic. The recurrences were treated by repeated laser radiation. No patients died of penile cancer during a mean observation of 16 months (range 3-50). Laser tumorectomy has definitive therapeutic advantages compared with penile amputation, because the result is acceptable for the patient and his micturition and sexual life are not altered.

[The open, interdisciplinary incontinence clinic at Hvidovre Hospital. Preliminary experiences from the first 16 months]. / Den åbne, tvaerfaglige inkontinensklinik på Hvidovre Hospital. Praeliminaere erfaringer fra de første 16 måneder.

A "minimal care" program for examination and treatment of urinary incontinence in an open access incontinence clinic was assessed. The first 300 women and 27 men consecutively investigated in the clinic are described. A reference program based on minimal relevant work-up and non-operative treatment as first line with use of minimal resources was followed. Of 171 evaluated women, 100 received non-operative treatment besides general advice on voiding/toilet pattern and appropriate incontinence appliances. Subjectively 69% felt cured or very much improved, 25% experienced improvement while 6% did not report benefit of the treatment. Objectively, diminished leakage was demonstrated by pad-weighing test. Similar results were found in the treated men. Our preliminary results demonstrate, that an open access, interdisciplinary clinic is patient-accepted and effective for the evaluation and treatment of urinary incontinence.