Online, Group-Based Psychological Support for Adolescent and Young Adult Cancer Survivors: Results from the Recapture Life Randomized Trial.

Telehealth interventions offer a practical platform to support adolescent and young adult (AYA) cancer survivors' mental health needs after treatment, yet efficacy data are lacking. We evaluated an online, group-based, videoconferencing-delivered cognitive-behavioral therapy (CBT) intervention ('Recapture Life') in a 3-arm randomized-controlled trial comparing Recapture Life with an online peer-support group, and a waitlist control, with the aim of testing its impact on quality of life, emotional distress and healthcare service use. Forty AYAs (Mage = 20.6 years) within 24-months of completing treatment participated, together with 18 support persons. No groupwise impacts were measured immediately after the six-week intervention. However, Recapture Life participants reported using more CBT skills at the six-week follow-up (OR = 5.58, 95% CI = 2.00-15.56, p = 0.001) than peer-support controls. Recapture Life participants reported higher perceived negative impact of cancer, anxiety and depression at 12-month follow-up, compared to peer-support controls. Post-hoc analyses suggested that AYAs who were further from completing cancer treatment responded better to Recapture Life than those who had completed treatment more recently. While online telehealth interventions hold promise, recruitment to this trial was challenging. As the psychological challenges of cancer survivorship are likely to evolve with time, different support models may prove more or less helpful for different sub-groups of AYA survivors at different times.

"Just what the doctor ordered": Factors associated with oncology patients' decision to bank sperm.

INTRODUCTION: The purpose of this cross-sectional study was to explore factors associated with oncology patients' decision to bank sperm prior to cancer treatment. MATERIALS AND METHODS: Patients who were referred to the oncology sperm banking program between January 2009 and March 2010 were invited to complete an 18-item questionnaire during one of their sperm banking visits. RESULTS: Of the 157 cancer patients referred to the Mount Sinai Oncology Sperm and Tissue Bank for sperm banking during the 15-month period, 79 questionnaires were returned (50% response rate). Of the respondents, 89% were informed about sperm banking by their physician. Future family planning was cited as the main reason to bank. Cost was not a barrier for the vast majority of respondents. Forty percent of respondents banked sperm within 4 days prior to initiating cancer treatment. Most respondents relied on their physician for verbal information on sperm banking. Eighty-one percent were unaware of any patient organizations that have educational materials on oncology fertility preservation. CONCLUSION: Sperm banking prior to cancer treatment is the only proven method of preserving fertility for cancer patients. The two main determinants associated with deciding whether to bank sperm were: the physician's recommendation and the patient's desire for future fatherhood. Physicians play a key role in influencing patients' decisions. The recommendation to bank sperm is a persuasive message if patients are clearly informed about their potential risk of infertility post-cancer treatment, and that sperm banking is an effective way of preserving fertility. Providing patients with education materials might enhance compliance in sperm banking.

Ultrasonic analysis of rennet-induced pre-gelation and gelation processes in milk.

Dynamics of micro-structural changes in milk during the renneting process were analysed using high-resolution ultrasonic spectroscopy in combination with dynamic rheology and NIR transmission measurements. Two independent ultrasonic parameters, velocity and attenuation were measured in the frequency range 2 to 15 MHz, as a function of time after addition of rennet to milk. The results show an initial decrease of 20 nm for the average diameter of micelles caused by hydrolysis of the kappa-casein 'hairy' layer followed by an aggregation of the micelles into small clusters (effective aggregation number of 3) and then formation of the gel structure. It was found that evolution of ultrasonic attenuation in the renneting process could well be described by the scattering of the ultrasonic waves on aggregates. The evolution of ultrasonic velocity is well described by the scattering theory but deviates from the predicted curve at the gelation stage of the process, which shows the difference in propagation of ultrasonic waves in a gel structure compared with dispersions. Overall, we found high-resolution ultrasonic spectroscopy to be a powerful tool for analysis of microscopic processes in the formation of milk gel. It allows the characterisation of the pre-gelation processes, such as hydrolysis and aggregation, and the initial stages in the formation of the gel network as well as monitoring of the microscopic evolution in the gel at the post-gelation stage.

Dual diagnosis in an Australian forensic psychiatric hospital: prevalence and implications for services.

Despite a growing awareness of the unique needs of psychiatric patients with co-occurring substance abuse and dependence disorders (i.e. dual diagnosis), there is a dearth of research investigating the prevalence of dual diagnosis in forensic psychiatric populations. Similarly, little work has been done to determine the implications of dual diagnosis for forensic psychiatric patients. Patients at the Thomas Embling Hospital in Victoria, Australia, were assessed to determine the prevalence of substance abuse disorders and mental illnesses within this population. Results reveal that the majority of patients (approximately 74%) have a lifetime substance abuse or dependence disorder. Information was collected concerning patients' criminal histories and the Level of Service Inventory, Revised, was completed for each patient who participated. Results suggest that patients with both major mental illnesses and substance abuse disorders have more extensive criminal histories and demonstrate a higher level of risks and needs when compared with patients with major mental illness alone. The implications for the development and delivery of effective forensic mental health services that address both co-occurring disorders are also discussed.