Reproductive outcomes following a cancer diagnosis in female cancer survivors

Background: There has been an increase in survivorship as treatment for cancer continues to improve. The effects of a cancer diagnosis can cause complications during both pregnancy and birth, which can heighten risks for both mother and baby, after cancer. A major gap in the knowledge is the lack of evidence-based data on adverse obstetric and birth outcomes experienced by female survivors who become pregnant and give birth after a diagnosis of cancer. Objective: The primary objective was to explore pregnancy and birth risks and complications following a first cancer diagnosis and compare outcomes to a matched comparison group of women without cancer. Secondary objectives were to explore overall survival following a birth after a first cancer diagnosis compared to women without cancer (matched comparison group), as well as time to delivery after a first cancer diagnosis (study group 2). Methods: The study used a retrospective nested-cohort study design. Women identified with a first cancer diagnosis from January 1, 1994 and December 31, 2001 were included. Up to two women from the comparison group were matched with women with cancer. All women gave birth from January 1, 1994 and December 31, 2013. The study included (i) women with a previous cancer diagnosis who were pregnant or gave birth within one year of a cancer diagnosis (≤365 days) (study group 1); (ii) women with a previous cancer diagnosis who gave birth one year after a cancer diagnosis date (>365 days) (study group 2); and (iii) women without cancer who gave birth (matched comparison group in study group 3). Conclusion: Findings indicate the importance of providing a timely referral for cancer patients to consult with a reproductive specialist regarding the adverse late effects of cancer on a woman’s reproductive function, both prior to starting gonadotoxic treatment and in the survivorship period. Discussions should include potential risks and complications of a cancer diagnosis on pregnancy and birth in the survivorship period, for mother and baby. Furthermore, survivors who become pregnant after cancer require routine surveillance by a multidisciplinary team of health care professionals to reduce pregnancy and delivery complications

Deceased donor uterus transplantation: religious perceptions

BackgroundUterus transplant now offers an alternative deceased donation treatment option for women with uterine infertility. Limited research exists on religious opinions that may impact the addition of the uterus to current multi-organ deceased donor programsObjectiveTo explore the acceptability of uterus transplantation and deceased uterus donation across different religious groups.DesignA cross-sectional survey of 2,497 participants was conducted between October 2022 and January 2023 in NSW Australia. Australia is a culturally and religiously diverse nation with over 60% of people identifying with a religion, including Christianity (43%), Islam (3.2%), Buddhism (2.7%), Hinduism (2.4%). This survey captured awareness and attitudes towards deceased uterus donation. Descriptive statistics and regression analyses were used to explore factors influencing organ donation and next-of-kin perceptions.ResultsA total of 2,497 respondents completed the survey. Christians had greater awareness of organ donation but were less likely to be registered donors, or consent to uterus donation. Those of Hindu faith were less likely to be registered organ donors. Next-of-kin from the Islamic faith were reluctant to consent to organ donation if the donor's pre-death wishes were unknown, and less likely to consent to uterus donation. Participants identifying as Buddhist had a higher awareness of uterus transplantation.ConclusionOrgan donor awareness and consent rates varied across religious groups, including for uterus donation. Differences may stem from varying beliefs about bodily integrity, and reproductive rights, which may influence attitudes toward uterus donation. Tailored culturally and linguistically sensitive educational campaigns should address the unique aspects of uterus donation

A Study Protocol for Safeguards Child and Adolescent Mental Health Rapid Response Teams (‘;Safeguards Teams’) Service

Introduction: As the number of children and young people (CYP) presenting to Emergency Departments (ED) with acute mental health (MH) presentations has been steadily increasing over the years and further accelerated by the pandemic, there is an urgent need to develop and evaluate innovative solutions to respond to this growing challenge. Description: The evaluation of the Safeguards Teams Program (STP) aims to ascertain the impact, implementation and economic analysis of this acute rapid response recovery-focused, trauma-informed assessment and brief intervention for CYP (aged 0–17 years) presenting in acute MH crisis and their families/caregivers. The STP will support consumers (patients) and their families/caregivers to navigate the complex and often fragmented child and adolescent MH services (CAMHS) landscape, thereby avoiding unnecessary ED presentations or hospitalisations, and facilitating comprehensive assessment and appropriate care pathways for those who present in crisis. Discussion: The STP is expected to provide CYP in MH crisis and their support networks with early access to evidence-based specialist care at the right place and time. Conclusion: Implementation of the STP will assist with identifying and addressing gaps in acute care for CYP and provide the necessary evidence for service redesign in collaboration with consumers, service providers and other stakeholders

The development of an international oncofertility competency framework: a model to increase oncofertility implementation

© AlphaMed Press 2019 Background: Despite international evidence about fertility preservation (FP), several barriers still prevent the implementation of equitable FP practice. Currently, oncofertility competencies do not exist. The aim of this study was to develop an oncofertility competency framework that defines the key components of oncofertility care, develops a model for prioritizing service development, and defines the roles that health care professionals (HCPs) play. Materials and Method: A quantitative modified Delphi methodology was used to conduct two rounds of an electronic survey, querying and synthesizing opinions about statements regarding oncofertility care with HCPs and patient and family advocacy groups (PFAs) from 16 countries (12 high and 4 middle income). Statements included the roles of HCPs and priorities for service development care across ten domains (communication, oncofertility decision aids, age-appropriate care, referral pathways, documentation, oncofertility training, reproductive survivorship care and fertility-related psychosocial support, supportive care, and ethical frameworks) that represent 33 different elements of care. Results: The first questionnaire was completed by 457 participants (332 HCPs and 125 PFAs). One hundred and thirty-eight participants completed the second questionnaire (122 HCPs and 16 PFAs). Consensus was agreed on 108 oncofertility competencies and the roles HCPs should play in oncofertility care. A three-tier service development model is proposed, with gradual implementation of different components of care. A total of 92.8% of the 108 agreed competencies also had agreement between high and middle income participants. Conclusion: FP guidelines establish best practice but do not consider the skills and requirements to implement these guidelines. The competency framework gives HCPs and services a structure for the training of HCPs and implementation of care, as well as defining a model for prioritizing oncofertility service development. Implications for Practice: Despite international evidence about fertility preservation (FP), several barriers still prevent the implementation of equitable FP practice. The competency framework gives 108 competencies that will allow health care professionals (HCPs) and services a structure for the development of oncofertility care, as well as define the role HCPs play to provide care and support. The framework also proposes a three-tier oncofertility service development model which prioritizes the development of components of oncofertility care into essential, enhanced, and expert services, giving clear recommendations for service development. The competency framework will enhance the implementation of FP guidelines, improving the equitable access to medical and psychological oncofertility care

#380 : Clickbait in Uterine Transplant Surgery

Background and Aims: The proliferation of social media platforms has led to the emergence of diverse online communities, presenting unique challenges in terms of patient autonomy and quality of care within the field of uterine transplantation. This research delves into the psychosocial implications of social media communities throughout the uterine transplant patient journey. The absence of standardized guidelines in these virtual spaces presents a novel landscape for healthcare professionals to navigate. This study sheds light on the evolving nature of social media and its impact on the uterine transplant journey, emphasizing the need for healthcare providers to adapt to these unfamiliar territories. Moreover, social media communities introduce additional complexities by increasing the risk of undue influence and coercion on potential donors and transplant candidates. This study will highlight the importance of exploring these themes to ensure the integrity of the transplant process. This study aims to examine the social media discourse surrounding the experiences of both donors and recipients who have undergone uterine transplant surgery. Method: A qualitative research design was employed to observe and reflect on social media posts related to donor and recipient surgeries enrolled in our uterine transplant research study program. Thematic analysis was utilised to identify recurring themes and patterns within the data collected from both recipients and donors. Results: The analysis of social media posts revealed a range of experiences shared by donors and recipients undergoing uterine transplant surgery. Both recipients and donors often expressed mixed feelings associated with their unique transplant experience. Conclusion: Future research and guidelines are needed to navigate the evolving landscape of social media in the uterine transplantation field, safeguarding the well-being of all stakeholders

Evaluating the role of visual attention bias in emotion dysregulation of young children

Background: This study aims to determine whether visual attention bias is associated with the level of emotion dysregulation (ED) in children and which individual attributes may modify their relationship. Methods: A community-based sample of 50 children aged 3-8 years old was recruited. The level of ED in children was measured using the parental report measures: Child Behaviour Checklist and Temper Tantrum Scale. Visual attention bias measured as eye gaze fixation time in response to images showing various emotional expressions was measured using an eye-tracking task. Generalized linear models were used to evaluate whether visual attention bias was associated with ED when social function (measured with the Social Responsiveness Scale, gender, age, and attention problem (measured from the CBCL subscale), were adjusted. The modifying effect on visual attention bias was evaluated using the interaction analysis in the generalized linear model. Results: The level of visual attention bias, indicated by the proportion of eye gaze fixation time on areas of interest (AOIs) in images displaying unpleasant emotions (such as anger), was inversely associated with the level of externalising problem behaviours (p = .014). Additionally, the association of eye gaze fixation time for AOI displaying negative emotional cues with the level of externalising problem behaviours varied by age (p = .04), with younger children (aged <70 months) demonstrating a stronger association than older children (aged ≥ 70 months). Conclusions: There is a significant inverse correlation between visual attention bias towards unpleasant emotional cues and ED in younger children. However, this relationship is attenuated as children age. While further research is needed, these results have implications for the development of objective biomarkers incorporating eye-tracking tasks for prediction and targeted support for ED-related mental health issues in the early years

Evaluating the role of visual attention bias in emotion dysregulation of young children

Background: This study aims to determine whether visual attention bias is associated with the level of emotion dysregulation (ED) in children and which individual attributes may modify their relationship. Methods: A community-based sample of 50 children aged 3-8 years old was recruited. The level of ED in children was measured using the parental report measures: Child Behaviour Checklist and Temper Tantrum Scale. Visual attention bias measured as eye gaze fixation time in response to images showing various emotional expressions was measured using an eye-tracking task. Generalized linear models were used to evaluate whether visual attention bias was associated with ED when social function (measured with the Social Responsiveness Scale, gender, age, and attention problem (measured from the CBCL subscale), were adjusted. The modifying effect on visual attention bias was evaluated using the interaction analysis in the generalized linear model.Results: The level of visual attention bias, indicated by the proportion of eye gaze fixation time on areas of interest (AOIs) in images displaying unpleasant emotions (such as anger), was inversely associated with the level of externalising problem behaviours (p = .014). Additionally, the association of eye gaze fixation time for AOI displaying negative emotional cues with the level of externalising problem behaviours varied by age (p = .04), with younger children (aged &amp;lt;70 months) demonstrating a stronger association than older children (aged ≥ 70 months). Conclusions: There is a significant inverse correlation between visual attention bias towards unpleasant emotional cues and ED in younger children. However, this relationship is attenuated as children age. While further research is needed, these results have implications for the development of objective biomarkers incorporating eye-tracking tasks for prediction and targeted support for ED-related mental health issues in the early years.</p