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Zordan R.D.,University of Sydney | Butow P.N.,University of Sydney | Kirsten L.,University of Sydney | Kirsten L.,Nepean Cancer Care Center | And 8 more authors.
Supportive Care in Cancer | Year: 2012

Purpose: The literature on cancer support groups supports the provision of ongoing education and training for cancer support group leaders, with evidence suggesting that more skilled and experienced leaders create better outcomes for group members. To address support and training needs reported by leaders, three novel interventions were developed and pilot-tested. These included a leaders' website and discussion forum, DVD and manual, and a 2-day training workshop. Methods: The interventions were developed using a combination of literature review, expert consensus, and consumer feedback. A convenience sample of ten leaders pilot-tested the Website and discussion forum. Using a mixed-method approach, evaluation of the workshop and the DVD and manual was conducted with 35 leaders. Results: Overall, satisfaction with all aspects of the Website and discussion forum was high. Analysis of the quantitative data revealed extremely high satisfaction with the workshop and DVD and manual. The qualitative responses of workshop participants further supported the quantitative findings with enhanced knowledge, understanding, and confidence reported by leaders. Conclusions: All three interventions exhibited a high degree of user acceptance, regardless of the skill or experience of the cancer support group leader. The overall positive findings from the evaluation of the leader Website and discussion forum, the DVD and manual, and the workshop for cancer support group leaders provides evidence to support more rigorous evaluation of these resources in a randomized controlled trial. © 2011 Springer-Verlag.

Casikar I.,Early Pregnancy and Advanced Endosurgery Unit | Casikar I.,University of Sydney | Lu C.,Aberystwyth University | Reid S.,Early Pregnancy and Advanced Endosurgery Unit | And 9 more authors.
Reviews on Recent Clinical Trials | Year: 2012

Background: In the 21st century, tubal ectopic pregnancies (EPs) are diagnosed earlier in their natural history due to transvaginal ultrasound technology. More women are haemodynamically stable and therefore can be offered non-invasive outpatient management with systemic Methotrexate (MTX). However there is no evidence that MTX is necessary in all these early EPs, as many may resolve spontaneously in the absence of any treatment. To date there are no published randomized trials comparing systemic MTX with a placebo. The aim of this study is to verify if MTX is more effective than the placebo in women with tubal EP and rising/plateauing serum human chorionic gonadotrophin (hCG) levels. Methods/Design: This is a multi-centre double-blind randomized controlled trial conducted in Australia. Haemodynamically stable women with a confirmed ultrasound diagnosis of tubal EP and a rising/plateauing serum hCG <1500 IU/L are eligible for the trial. Women with a declining serum hCG, hCG>1500 IU/L at 48hrs, viable tubal EP, severe abdominal pain, evidence of haemoperitoneum on ultrasound, diagnostic uncertainty, non-tubal ectopic pregnancy, or women with contraindications to MTX will be excluded. Systemic MTX in a single dose intramuscular regimen (50mg/m2) is compared to an identical placebo in an outpatient setting. All women will attend for a serum hCG measurement on day 4. Provided patients are haemodynamically stable, they will attend for another blood test on day 7. If a decline in serum hCG > 15% between days 4 - 7 is observed, weekly blood tests will be scheduled until undetectable hCG levels. If serum hCG levels increase or decrease < 15% between days 4 - 7, a second dose of MTX will be given and weekly blood tests will be scheduled until undetectable serum hCG. If any increase in serum hCG > 15% between days 4 - 7 or at any subsequent follow-up, women will be treated with MTX. Primary outcome measure is treatment success, defined as uneventful decline of serum hCG to an undetectable level (<5 IU/L) by the initial intervention. Secondary outcome measures are re-interventions (additional systemic MTX injections and/or surgery for haemodynamic instability/trophoblast persistence), treatment complications and length of follow-up. Discussion: This trial will clarify the actual effectiveness of MTX in haemodynamically stable women with an early tubal EPs and rising or plateauing hCG. © 2012 Bentham Science Publishers.

Zordan R.D.,University of Sydney | Juraskova I.,University of Sydney | Butow P.N.,University of Sydney | Jolan A.,University of Sydney | And 5 more authors.
Health Expectations | Year: 2010

Existing literature suggests that the effectiveness of a support group is linked to the qualifications, skills and experience of the group leader. Yet, little research has been conducted into the experiences of trained vs. untrained support group leaders of chronic-illness support groups. The current study aimed to compare the experience of leaders, trained vs. untrained in group facilitation, in terms of challenges, rewards and psychological wellbeing.Methods A total of 358 Australian leaders of cancer and multiple sclerosis (MS) support groups, recruited through State Cancer Councils and the MS society (response rate of 66%), completed a mailed survey.Results Compared with untrained leaders, those with training were significantly younger, leading smaller groups and facilitating more groups, more frequently (all P < 0.05). Trained leaders were more likely to be female, educated beyond high school, paid to facilitate, a recipient of formal supervision and more experienced (in years) (all P < 0.01). Untrained leaders reported more challenges than trained leaders (P < 0.03), particularly struggling with being contacted outside of group meetings (52%) and a lack of leadership training (47%). Regardless of level of training, leaders identified a number of unmet support and training needs. Overwhelmingly, leaders found their facilitation role rewarding and the majority reported a high level of psychological wellbeing.Conclusions Group facilitator training has the potential to reduce the burden of support group leadership. Developing interventions to assist support group leaders will be particularly beneficial for leaders with minimal or no training group facilitation training. © 2010 The Authors. Health Expectations © 2010 Blackwell Publishing Ltd.

Latty D.,Crown Princess Mary Cancer Center | Stuart K.E.,Crown Princess Mary Cancer Center | Stuart K.E.,Westmead Breast Cancer Institute | Wang W.,Crown Princess Mary Cancer Center | And 3 more authors.
Journal of Medical Radiation Sciences | Year: 2015

Radiation treatment to the left breast is associated with increased cardiac morbidity and mortality. The deep inspiration breath-hold technique (DIBH) can decrease radiation dose delivered to the heart and this may facilitate the treatment of the internal mammary chain nodes. The aim of this review is to critically analyse the literature available in relation to breath-hold methods, implementation, utilisation, patient compliance, planning methods and treatment verification of the DIBH technique. Despite variation in the literature regarding the DIBH delivery method, patient coaching, visual feedback mechanisms and treatment verification, all methods of DIBH delivery reduce radiation dose to the heart. Further research is required to determine optimum protocols for patient training and treatment verification to ensure the technique is delivered successfully. Despite variation in the literature regarding the deep inspiration breath-hold (DIBH) delivery method, patient coaching, visual feedback mechanisms and treatment verification, all methods of DIBH delivery reduce radiation dose to the heart. Further research is required to determine optimum protocols for patient training and treatment verification to ensure that the technique is delivered successfully. © 2015 The Authors.

Luo J.,Nepean Cancer Care Center | Yau S.,Nepean Cancer Care Center | White S.,Nepean Cancer Care Center | Wilfert L.,Calvary Materials Newcastle Hospital | Wilfert L.,University of Newcastle
Australasian Physical and Engineering Sciences in Medicine | Year: 2012

Physics quality assurance (QA) is an integral part of a medical physicist's role in the radiotherapy centre. Management of physics QA documents is an issue with a long-term accumulation. Storage space, archive administration and paper consumption are just some of the difficulties faced by physicists. Plotting trends and drawing meaningful conclusions from these results can be challenging using traditional QA methods. Remote checking of QA within a hospital network can also be problematic. The aim of this project is introduce a paperless QA system that will provide solutions to many of these issues. © Australasian College of Physical Scientists and Engineers in Medicine 2012.

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