Examining how early experiences in oncology settings influence nurses' career decisions.

The transition from nursing student to newly registered nurse is a complex process, and subsequent recruitment to cancer nursing posts can be challenging. This article details a service evaluation that aimed to describe the experiences of nursing students on placement and newly registered nurses or nursing associates working in a specialist cancer centre, and how these experiences might influence their future career aspirations. To gather data, the authors undertook a focus group with nursing students ( n= 8) and interviewed newly registered nurses or nursing associates ( n= 19). The data revealed four themes: navigating the nursing student experience; motivation to work in oncology; transition to staff nurse; and looking ahead. The service evaluation identified that education providers often lack awareness of cancer-specific content and career pathways. It also found that some aspects of cancer care, such as gaining specialist skills in systemic anticancer therapy, require particular attention since they were often anxiety-provoking for newly registered nurses.

Evolution of a video project to translate research findings about patient experiences into improved clinical care.

BACKGROUND: People living with HIV are at an increased risk of developing cancer. Cancer health professionals could benefit from improving and updating their knowledge of HIV and their understanding of patient experiences to deliver high-quality, patient-centred care. AIMS: Evidence-based educational resources to improve patient care were identified and developed using a co-production approach. METHODS: There were two stages: a workshop discussion by experts to reach consensus on a priority intervention; and co-production of video content Life with HIV and Cancer. FINDINGS: The consensus of the expert group was that video content featuring first-person accounts would be the most impactful intervention to address the gap in knowledge. Three co-produced and professionally made video resources were developed and disseminated. CONCLUSION: The videos provide insight into the impact of stigma as well as current information on HIV. Their use can improve oncology clinical staff knowledge and better equip them to provide patient-centred care.

How can we recruit more men of African or African-Caribbean ancestry into our research? Co-creating a video to raise awareness of prostate cancer risk and the PROFILE study.

BACKGROUND: Men of African ancestry are at increased risk of developing prostate cancer (PrCa) compared to men from other backgrounds. The PROFILE study aims to understand whether genetic information can better target who needs PrCa screening. PROFILE has so far had difficulty reaching men of African or African -Caribbean ancestry to take part. In this involvement project we worked in partnership with a group of such men to co-create a video to raise awareness of PrCa risk amongst this community and promote participation in the study. METHODS: We recruited seven men of African or African-Caribbean ancestry who completed an initial survey on the Cancer Patients' Voice platform. We then held an online discussion panel and maintained contact to encourage dialogue and planning of the video. Utilising a participatory approach, the ideas for the video were decided in collaboration with the panel who held expert knowledge of various communities and understood the messages that would best resonate and engage with other men of the same origins. Once the video had been edited and finalised, two members of the group expressed interest in writing up the project and are listed as co-authors. RESULTS: The video in its entirety was driven by the panel's ideas. The choice of a barber shop setting; leading with a positive case study and highlighting the importance of men's family members rather than a focus on scientific language, statistics or researchers were all features that were discussed and agreed upon by the panel. The men shared the video within their networks. It was placed on websites and promoted as part of a social media campaign during Black History Month. CONCLUSIONS: Groups with the greater healthcare needs and the most to gain from advances in care and treatment can often be the most excluded from research participation. This is pertinent in PrCa research where men of African or African-Caribbean ancestry are at greater risk. The project gave equal power and decision making to the men and provides an example of successful inclusive involvement. The result was a unique approach to making a study video.

METHODS: We engaged seven men of African or African-Caribbean ancestry: three PROFILE study participants and four from the Race, Ethnicity and Cultural Heritage (REACH) staff forums across the Royal Marsden Hospital and the Institute of Cancer Research. They completed a survey, joined an online discussion panel and we continued working together. The group decided on the structure and content of the video; to include a PrCa survivor who had been successfully screened and treated early for his disease, and a daughter of one of the panellists. The men were also involved in the dissemination plans of the finished video, and two agreed to be co-authors of this paper. FINDINGS: Features of the video led by the men included the choice of a barber shop setting; leading with a positive shared story and highlighting the importance of family rather than science, statistics or researchers. DISSEMINATION: The group shared the video within their networks. It was placed on websites and promoted as part of a social media campaign during Black History Month.

This project involved working in partnership with men of African or African-Caribbean ancestry to co-create a video intended to raise awareness of prostate cancer (PrCa) risk and promote participation in a genetic screening study called PROFILE. Men of African or African-Caribbean ancestry are at increased risk of developing PrCa compared to other men. The PROFILE study aims to understand whether genetic information can better target who needs PrCa screening. The study has had problems recruiting men from these communities.

HIV positive and treated for cancer: The convergence of pressures "invisible" in HIV and "visible" in cancer.

OBJECTIVE: An increasing number of people living with HIV are living longer and experiencing a dual diagnosis of HIV and cancer. Little is known of their experience and quality of care. This paper presents the findings of a study exploring experiences of cancer care, from the perspectives of both patients and healthcare professionals. METHODS: Thematic analysis of participant narratives provided in longitudinal, semi-structured interviews with 17 people, recruited from three London sites between 2015 and 2017. Focused ethnography comprising 27 hr of participant observation and seven semi-structured interviews with healthcare professionals. RESULTS: Both HIV and cancer have a powerful, combined impact; in cancer, the impact is visible; in HIV, it is generally hidden. Patients and staff experienced particular challenges in the cancer setting. Patients felt responsible for their HIV management and described being excluded from clinical trials. Both staff and patients encountered difficulties around the management of information relating to HIV. CONCLUSION: This dual diagnosis has a profound and negative effect on patients' experiences and potential outcomes. Improvement depends on interventions that acknowledge the shared social narrative and impact of HIV-related stigma so that this burden is not carried by the patient alone.

Insights into the social context of living with a dual diagnosis of HIV and cancer: a qualitative, thematic analysis of popular discourse in London newspapers.

As growing numbers of people living with HIV also develop cancer, a holistic understanding of their experiences is essential to the provision of patient centred care. Both conditions are linked to powerful beliefs in our society that may affect experiences. This study explored how HIV and cancer were represented in UK newspapers to gain insight into the social context of living with a dual diagnosis. We performed an initial content analysis of HIV articles and of cancer articles published in the free London newspapers, The Metro and The Evening Standard between 2012 and 2017, followed by qualitative thematic analysis and in-depth analysis of selected articles of exemplar cases. Both conditions were presented very differently. The underlying subtext was that cancer could happen to any of us. HIV was framed as a potentially dangerous, stigmatising phenomenon affecting "others". Popular discourse about HIV within news media remains largely negative and stigmatising. People living with a dual diagnosis of HIV and cancer may choose to prioritise the sharing of the more socially acceptable condition, cancer, in order to access support. The negotiation of cancer healthcare services is likely to be adversely influenced by the social burden of HIV related stigma.

Exploring the views and experiences of HIV positive patients treated for cancer: a systematic review of the literature.

A systematic review of the literature was conducted to find out what is known about patients' experiences of a dual diagnosis of HIV and cancer. We systematically searched the following databases; MEDLINE (Ovid Version); CINAHL Plus; PsycINFO and EMBASE from inception to June 2016 for studies that included patients with a dual diagnosis of cancer and HIV and focused on patient experiences. Studies with a focus on one illness rather than a dual diagnosis, those that focused on treatment strategies and medical management, epidemiology and pathology studies and comparison studies were all excluded. The full text of the included studies were reviewed. Information on location, sample size, study design and a narrative summary of findings were extracted using a standardised format. Studies were combined thematically. 1777 records were screened by title and abstract using the selection criteria described in the methods. Eight records were reviewed in depth in full text and seven selected as eligible. The selected studies suggest that a dual diagnosis of HIV and cancer has a powerful impact on individuals' behaviour. The experience of stigma was a consistent factor in all patient accounts and the strategy of selective disclosure to access support reveals how patient agency can interplay with stigma. This is an area largely unexplored in the published literature; further research into patients' experiences of a dual diagnosis of HIV and cancer will provide relevant knowledge in order to tailor and improve services.

Reconstitution of herpes simplex virus-specific T cell immunity in HIV-infected patients receiving highly active antiretroviral therapy.

Production of herpes simplex virus (HSV)-specific interferon- gamma by peripheral-blood mononuclear cells (PBMCs) of HSV-seropositive healthy donors and human immunodeficiency virus-infected persons was determined by use of ELISPOT. The mean +/- SD number of spot-forming cells/10(6) PBMCs was 314 +/- 74 in 11 healthy donors, 360 +/- 69 in 3 long-term nonprogressors (LTNPs), 186 +/- 52 in 9 newly diagnosed patients, and 181 +/- 59 in 33 patients who were receiving highly active antiretroviral therapy (HAART) for a median period of 30 months (range, 1-109 months). In 9 patients monitored prospectively while receiving virologically and immunologically successful first-line HAART, the number of spot-forming cells increased by 5.6/month (95% confidence interval, 1.2-9.9 [P=.01]) and 21.3/100 CD4 cells/mm(3) gained (95% confidence interval, 13.8-28.7 [P<.0001]). Responses were correlated with LTNP status and CD4 cell count.

A randomized, controlled trial comparing ganciclovir to ganciclovir plus foscarnet (each at half dose) for preemptive therapy of cytomegalovirus infection in transplant recipients.

Forty-eight patients who provided 2 consecutive blood samples that tested positive for cytomegalovirus DNA by polymerase chain reaction (PCR) were randomized to receive either full-dose ganciclovir (5 mg/kg intravenously [iv] twice daily) or half-dose ganciclovir (5 mg/kg iv once daily) plus half-dose foscarnet (90 mg/kg iv once daily) for 14 days. In the ganciclovir arm, 17 (71%) of 24 patients reached the primary end point of being CMV negative by PCR within 14 days of initiation of therapy, compared with 12 (50%) of 24 patients in the ganciclovir-plus-foscarnet arm (P = .12). Toxicity was greater in the combination-therapy arm. In patients who failed to reach the primary end point, baseline virus load was 0.77 log10 higher, the replication rate before therapy was faster (1.5 vs. 2.7 days), and the viral decay rate was slower (2.9 vs. 1.1 days) after therapy. Bivariable logistic regression models identified baseline virus load, bone-marrow transplantation, and doubling time and half-life of decay as the major factors affecting response to therapy within 14 days. This study did not support a synergistic effect of ganciclovir plus foscarnet in vivo.