Exploring the experiences of staff conducting psychology consultations via telehealth in an oncology hospital.

PURPOSE: During the COVID-19 pandemic, telehealth delivery of psychological care services expanded to meet the needs of people with cancer. This study examined psychologists' attitudes toward using telehealth during the pandemic peak in a tertiary oncology hospital. METHODS: Semi-structured interviews were conducted with ten psychologists who used telehealth to deliver psychological services. Thematic analysis was conducted to identify themes in the interview data. RESULTS: Themes identified: (1) increased uptake and attendance of psychology sessions was due to greater accessibility of services; (2) clinicians reported ease of communication and building of rapport when using telehealth; and (3) clinicians perceived differences in the psychotherapeutic process when sessions were delivered via telehealth compared to in-person. CONCLUSIONS: Clinicians expressed high satisfaction with delivering telehealth psychological support for oncology patients. Implications for Psychosocial Providers: Oncology services that are considering developing or expanding a telehealth psychology service can facilitate this by ensuring a reliable technological platform and providing training and/or support to staff and patients. Clinicians should also use their clinical judgment to decide if a patient is appropriate for telehealth-delivered psychological care or if a mix of modalities is more ideal.

Parathyroid carcinoma presenting as severe hypercalcaemia responding to steroids.

A man in his 50s was referred with profound, symptomatic hypercalcaemia. He was diagnosed with primary hyperparathyroidism, confirmed on 99mTc-sestamibi scan. He was treated for the hypercalcaemia and referred to ear, nose and throat (ENT) surgeons for parathyroidectomy, which was delayed due to the COVID-19 pandemic. In the ensuing 18 months, he had five hospital admissions with severe hypercalcaemia requiring intravenous fluids and bisphosphonate infusions. During the last admission, hypercalcaemia was resistant to maximal medical management. Emergency parathyroidectomy was planned, but delayed due to intervening COVID-19 infection. Due to persistent severe hypercalcaemia (serum calcium: 4.23 mmol/L), he was commenced on intravenous steroids, following which serum calcium normalised. Subsequently, he underwent emergency parathyroidectomy, which normalised his serum parathyroid and calcium levels. On histopathological examination, a diagnosis of parathyroid carcinoma was made. On follow-up, patient remained well and normocalcaemic. In patients with primary hyperparathyroidism unresponsive to standard therapy, but responsive to steroids, underlying parathyroid malignancy should be considered.

Addressing Gender Equity in Senior Leadership Roles in Translational Science.

Inequities for women exist across many leverage points of an academic career in science, technology, engineering, mathematics, and medicine (STEMM) disciplines, ranging from poorer success rates at promotion, reduced grant success, and a lower likelihood of invited conference presentations, to a propensity to undertake the lion's share of academic service roles. Moreover, an almost intractable salary gap exists, along with a stark under-representation of women in senior scientific leadership roles, widespread throughout the United States, United Kingdom, Europe, and Australia. Numerous factors have been put forward as contributors to this disparity, including the notions that these inequities are a result of a pipeline issue and that women are less qualified or have less experience than men, implicit bias, a lack of flexibility in the work place, a lack of role models, the use of biased measures of success for promotion, and the lack of equitable parental leave programs. In this viewpoint, we address factors shown to contribute to the lack of women in leadership roles. Specifically, we look at systemic barriers, parental and carer leave, and domestic barriers, and we present solutions to address these barriers across an individual's professional and personal life. For women to achieve equity in senior scientific leadership roles, we believe that barriers across all facets of life need to be addressed and that the important contributions that women make and have made to STEMM need to be recognized.

Comparing Clinical Outcomes for Radium-223: Do Older Patients Do Worse?

PURPOSE: To examine the clinical benefits and toxicities of 223Ra in 2 different age groups of patients with castrate-resistant prostate cancer. METHODS AND MATERIALS: This was a retrospective study of patients treated with 223Ra in 2 tertiary centers. Patients were divided into 2 different groups based on their age (≥72 years old and <72 years old). Treatment toxicities were graded according to Common Terminology Criteria for Adverse Events version 4.0. Comparison of characteristics and outcome was carried out with the Mann-Whitney test and analysis of overall survival with the log-rank test. RESULTS: In all, 129 patients were treated during the study period. Clinical benefit was similar in both groups. However, a statistically significant higher proportion of patients in the younger group had previously been treated with docetaxel. There was a higher rate of grade 3 anemia in younger patients. CONCLUSIONS: In line with other studies, 223Ra was well tolerated with minimum toxicities. The significantly higher rate of grade 3 anemia in younger patients may be due to more cautious patient selection in the elderly population.