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Celine Haaland-Johansen,1 Ingebjørg Haugen,2 Anne Marie Mork Rokstad1,3 1Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; 2Faculty of Health Studies, VID Specialized University, Oslo, Norway; 3Faculty of Health Sciences and Social Care, Molde University College, Molde, NorwayCorrespondence: Anne Marie Mork Rokstad, Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Postboks 2136, Tønsberg, 3103, Norway, Email anne.m.m.rokstad@himolde.noPurpose: Being a young carer of a parent with dementia can be challenging, with many carers undertaking various practical and caring tasks. The weekend course Time to be young? gathers young carers, aiming to support them to cope with their challenges in everyday life. The aim of this study was to explore their role as a caregiver and the experienced impact of the course on their strategies of coping in their everyday life.Participants and Methods: The study had a qualitative descriptive design inspired by Lindseth and Norberg’s phenomenological hermeneutical method, using individual semi-structured interviews for data collection. The participants were recruited from former participants of the course Time to be young?, and the final sample included eight participants.Results: Through the analysis, four main themes were identified: 1) Help to accept the situation, 2) A sense of community, 3) The need for information and 4) The need to live one’s own life. The study found that attendance at Time to be young? for young adults having a parent with dementia affected their coping strategies in their situation as a young care.Conclusion: The study demonstrated the importance of courses like Time to be young?, and need for a meeting place, tailored information about dementia, and an opportunity to share and reflect upon their experiences as a young carer.Keywords: dementia, young carers, young adults, course, information

Background and Purpose: MyHealth is a new follow-up program including individual nurse-led sessions based on Guided Self-Determination (GSD), which has been shown to improve health and psychological outcomes in patients after treatment for breast cancer. Fidelity assessment is important to support the implementation of GSD in clinical practice. The purpose of this study was thus to investigate fidelity and acceptance of the GSD program in the MyHealth study and whether sociodemographic and psychological factors were associated with patients' completion of the GSD program and completion of reflection sheets., Material and Methods: We assessed fidelity quantitatively by examining patients' completion of the GSD program (i.e. ≥3 sessions), completion of the reflection sheets and their associations with sociodemographic and psychological factors among 239 patients, and nurse-reported acceptance qualitatively through a focus group interview with all five nurses providing the GSD program., Results: A total of 81% of patients completed the GSD program, while 71% of the reflection sheets were completed. Including a relative in a GSD session and lower education were significantly associated with completion of the program. Younger age and including a relative in a GSD session were significantly associated with completion of reflection sheets. Nurses found GSD highly applicable and especially appreciated a values-clarifying GSD reflection sheet and the inclusion of a relative., Interpretation: The GSD program was applied with moderate-to-high fidelity, and the inclusion of relatives is potentially valuable. The GSD program indicates high usability and potential for being translated into clinical practice.

Background and Purpose: Melanoma is one of the deadliest skin cancers and challenges clinicians worldwide due to rising incidence, potential aggressiveness, and propensity for metastasis, necessitating comprehensive follow-up programs after primary treatment. Circulating tumor DNA (ctDNA) is a promising biomarker that may indicate disease progression earlier than traditional surveillance methods, including 18F-FDG PET-CT, ultrasound, and clinical examination. This study examines ctDNA detection in blood as a minimally invasive method for early identification of progression following primary treatment of melanoma. The aim is to overcome the limitations of current methods, potentially improving prognosis and survival., Patients/material and Methods: Patients with high risk of recurrence following primary treatment of melanoma are offered inclusion. Blood sampling is performed at each follow-up visit. In case of recurrence, patient-specific mutations are identified through next-generation sequencing (NGS) of formalin and paraffin embedded tissue from diagnostic routine. Detection of mutation-specific ctDNA is performed on blood using digital droplet polymerase chain reaction (ddPCR) or NGS. This allows determination of the value and sensitivity of ctDNA for early detection of recurrence., Results and Interpretation: For validation purposes, we conducted a small pilot study using blood samples from 10 patients who had experienced recurrence and had a clinically confirmed BRAF V600E mutation. Detection of BRAF V600E ctDNA using ddPCR varied from 0/5 (0%) in DNA harvested from 4 mL plasma, to 3/5 (60%) in DNA from 8 mL of plasma. These results show promise and highlight the importance of high sensitivity and sampling volumes to ensure accurate detection of low levels of ctDNA.

Background and Purpose: Many men with cancer experience that changes created by cancer and its treatment may impair sexual function. However, many studies investigating sexual impairments fail to consider whether such impairments are perceived as distressing, i.e. create sexual distress. We investigated the prevalence of sexual distress, overlap with sexual impairment, and sociodemographic and clinical characteristics and other symptoms associated with sexual distress in a heterogeneous male cancer population., Patients and Methods: Across cancer diagnoses, 2792 men in treatment or follow up at the Department of Oncology, Rigshospitalet, were invited. The Sexual Complaint Screener (SCS) assessed sexual impairments and sexual distress. Regression analyses estimated the association of sexual distress with sociodemographic and tumor-related factors, other symptoms (pain, depression, fatigue, insomnia, fear of recurrence), and health-related quality of life. The number of patients who received help for or were interested in a consultation for sexual problems was calculated., Results: Six hundred and ninety-six patients, most frequently diagnosed with testicular (26%) or multiple (16%) cancers, completed the SCS. Forty-one per cent experienced sexual distress, 60% sexual impairment, and 34% overlapping sexual distress and impairment. Sexual distress was significantly associated with clinically relevant insomnia (OR:2.15; 95% CI:1.5-3.1) and pain (OR:1.90; 95% CI:1.3-2.9). Two thirds of all patients wished for help, but only one third of these were receiving help., Interpretation: Sexual distress was widespread in men across different cancer diagnoses and sometimes presented without impairment, demonstrating that assessment of sexual problems must include the personal experience of distress and extend to men across cancer diagnoses.

focused on patients living with metastatic cancer. We examined the feasibility of the SleepNow intervention combining cognitive behavioral therapy for insomnia (CBT-I) with physical exercise in men with metastatic prostate cancer (mPCa)., Patients/material and Methods: We conducted a feasibility randomized trial in patients under treatment for castration resistant mPCa with insomnia (Insomnia Severity Index [ISI] score ≥ 8). Patients were randomized 1:1 to either SleepNow or usual care. SleepNow is a manualized 12-week program consisting of bi-weekly sessions of physical exercise and four nurse-led sessions of CBT-I. Patients in usual care received no insomnia treatment. We assessed feasibility and measured objective and patient-reported outcomes at baseline and 3-months follow-up. Changes in both groups were compared using the Wilcoxon test., Results: We randomized 12 patients (5 intervention and 7 control; age range = 59-81 years, mean Gleason score = 7.75, mean time since diagnosis ≈ 7 years). Intervention patients reported high satisfaction, all attended at least three CBT-I sessions (75%) and four completed at least 20 of the 24 training sessions. The intervention group showed improvements in insomnia, sleep quality, fatigue, anxiety, depression and health-related quality-of-life but between-group differences were not statistically significant., Interpretation: The SleepNow intervention is the first to combine nurse-delivered CBT-I and physical exercise and was acceptable and potentially efficacious. Our results are important for targeting sleep interventions to the growing population of patients living long term with metastatic cancer.

Recombinant proteins are critical tools in research; however, their purity is often assumed rather than verified, leading to potential experimental errors. This study aimed to investigate the inflammatory role of recombinant human IL-17F in dermal fibroblasts. Unexpectedly, we discovered with Western blot that recombinant IL-17F from the supplier was contaminated with IL-4, leading to unintended stimulatory effects such as STAT6 phosphorylation and gene induction of CCL26 and IL4R. This contamination led to misinterpretation of data, loss of research time, and erroneous conclusions about IL-17F activity. These findings underscore the critical need for stringent quality control in recombinant protein production and highlight the risks of relying on single-source suppliers. Researchers should remain cautious about potential contamination, ideally validating proteins from multiple suppliers. Our experience illustrates a broader requirement for suppliers to strengthen quality assurance measures, as contaminants can propagate misleading data in the literature and undermine research reproducibility., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: Early childhood obesity (ECO) significantly increased in the United States. ECO interventions lack focus on the prevention of ECO for infants under two. Caregiver's feeding styles (CFS) has shown to affect ECO development, but studies on CFS are limited. This study examined socioecological factors associated with CFS for infants under two in Nevada., Design: This cross-sectional study utilizing a survey, examined the five CFS-constructs: Responsive (RP), Non-Responsive (NRP) laissez-faire, NRP-pressuring, NRP-restrictive, and NRP-indulgent. Descriptive analysis and logistic regression following a hierarchical modeling approach were used to determine the associations between the CFS-constructs and socioecological factors (e.g., household, maternal mental health, and infant feeding)., Setting: Clark County, Nevada., Participants: 304 caregivers with infants under two., Results: NRP feeding styles were associated with low-income households (e.g., NRP-restrictive (AOR=2.60, 95% CI [1.01-6.71])), water insecurity (e.g., NRP-pressuring (AOR=2.46, 95% CI [1.00-6.06]), young mothers (e.g., NRP-laissez-faire (AOR=2.39, 95% CI [1.00-5.84])), lower maternal education (e.g., RP (AOR=0.58, 95% CI [0.33-1.00])), mild risk for depression (e.g., NRP-restrictive (AOR=0.50, 95% CI [0.28-0.90])) and a moderate to severe risk for anxiety (e.g., NRP-pressuring (AOR=0.32, 95% CI [0.14-0.74])). There were no associations between infant feeding factors and RP feeding., Conclusion: Our study identified socioecological factors associated with dissimilarities in CFS in Nevada. These findings can be used to tailor educational approaches to address disparities in early childhood obesity.

Background and Purpose: Lymphedema is a debilitating late effect of cancer treatments, yet its prevalence beyond breast cancer remains understudied. This study examined the prevalence of lymphedema symptoms across cancer diagnoses and their association with depression, pain interference, and health-related quality of life (HRQoL)., Patients/material and Methods: This cross-sectional study was conducted at the Department of Oncology, Copenhagen University Hospital, from February to April 2021, as part of a broader investigation into cancer-related late effects. Here, we present data from patients in follow-up who received online lymphedema symptom assesments (swelling, heaviness, or tightness). Utilized questionnaires were the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, the Major Depression Inventory, and the Brief Pain Inventory. Associations between lymphedema symptoms and depression, pain interference, and HRQoL were examined via multiple linear regression., Results: Of 1,901 patients in follow-up who received the lymphedema symptom items, 1,296 responded. Most participants had breast cancer (48%), followed by testicular (17%), gynecological (16%), and head/neck cancer (11%). One-third (n = 397) reported lymphedema symptoms, with 38% (n = 152) reporting moderate/severe symptoms. The highest symptom prevalence was seen in gynecological cancer (59%), followed by head/neck (41%), breast (21%), and testicular cancer (19%). Participants with moderate/severe lymphedema symptoms were significantly more likely to report higher depression and pain interference scores and lower HRQoL scores compared to those with no/mild symptoms., Interpretation: Lymphedema symptoms are highly prevalent among patients who have completed treatment for diverse cancers and associated with higher scores for depression and pain interference, and lower HRQoL.

Colorectal cancer (CRC) ranks third in terms of global cancer prevalence and is the second most common cause of cancer-related mortality. Although CRC rates are decreasing in the United States, inequalities still exist despite the effectiveness of invasive screening methods, such as colonoscopy, flexible sigmoidoscopy, and computed tomography (CT) colonography in detecting colorectal cancer. Many current interventions promoting CRC screening do not utilize a modern theory-based approach, which has led to the low utilization of these screening methods. This cross-sectional study aims to address the lack of theory-based treatments for promoting visual CRC screening examinations by applying the multi-theory model (MTM) of health behavior change to explicate the health-related factors for individuals to seek visual colorectal cancer screening examinations for CRC screening. A 57-item validated questionnaire assessing MTM constructs and CRC screening was administered online. The survey questionnaire was administered to a sample of 640 adults from the United States. The participants were between the ages of 45 and 75 years. Hierarchical multiple regression was used to assess the relationship between MTM constructs with the initiation and sustenance of CRC screening behaviors. Out of the total participants in this nationwide sample, 71.4% (n = 457) reported that they had undergone a visual CRC screening examination. MTM subscales, specifically participatory dialogue, changes in the physical environment along with age, recommendation for CRC screening from a healthcare provider, and previous experience with colonoscopy, were found to be significant factors in predicting the initiation of visual CRC screening behavior. These factors accounted for 22% of the variation in initiation among this group (R 2 = 0.222, F = 3.521, p < 0.001). The MTM can be a valuable framework for designing educational media, information media, social media platforms, and clinical interventions to promote visual colorectal cancer screening examinations.

Background and Purpose: We previously demonstrated positive effects on quality of life and mental health following breast cancer when comparing a nurse-led follow-up program without scheduled visits (MyHealth) to regular follow-up. This study aims to examine whether MyHealth also positively impacts self-reported work ability., Patients/material and Methods: A total of 288 patients, potentially active on the labour market, were randomized to MyHealth or control follow-up after primary treatment for early-stage breast cancer (2017-2019). MyHealth included individual self-management sessions, electronic symptom monitoring, and assistance with navigating healthcare services. Control follow-up consisted of biannual outpatient visits with a physician. Linear mixed-effect models were applied to evaluate the effect of MyHealth on self-reported work ability at 6, 12, 24, and 36 months after randomization as measured by the Work Ability Score (WAS)., Results: Work ability increased significantly in both groups during the first 6 months (mean WAS increase MyHealth: 1.64, 95% confidence interval [CI]: 1.26; 2.02 and control: 1.57, 95% CI: 1.17; 1.97) and continued to increase slightly but non-significantly (p-values > 0.13) until end of follow-up at 36 months. Improvement was especially pronounced among patients reporting poor work ability at baseline. Differences in mean WAS between patients in MyHealth and control follow-up were non-significant and close to zero at all time points (-0.21 to 0.48)., Interpretation: The MyHealth follow-up program had no additional effect on self-reported work ability compared to regular follow-up. Future interventions should target patients with poor work ability and include components specifically designed to enhance work ability.