Although peer and nurse couples-based interventions can increase use of medical treatments for ED, this may not translate into better sexual or relationship outcomes. More research is needed into the optimal timing of interventions to improve sexual outcomes for men with prostate cancer and to identify the subpopulations that will benefit from them.

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BackgroundWeb-based interventions present a potentially cost-effective approach to supporting self-management for cancer patients; however, further evidence for acceptability and effectiveness is needed.ObjectiveThe goal of our research was to assess the effectiveness of an individualized Web-based cognitive behavioral therapy (CBT) intervention on improving psychological and quality of life outcomes in cancer patients with elevated psychological distress.MethodsA total of 163 distressed cancer patients (111 female, 68.1%) were recruited through the Queensland Cancer Registry and the Cancer Council Queensland Cancer Helpline and randomly assigned to either a Web-based tailored CBT intervention (CancerCope) (79/163) or a static patient education website (84/163). At baseline and 8-week follow-up we assessed primary outcomes of psychological and cancer-specific distress and unmet psychological supportive care needs and secondary outcomes of positive adjustment and quality of life.ResultsIntention-to-treat analyses showed no evidence of a statistically significant intervention effect on primary or secondary outcomes. However, per-protocol analyses found a greater decrease for the CancerCope group in psychological distress (P=.04), cancer-specific distress (P=.02), and unmet psychological care needs (P=.03) from baseline to 8 weeks compared with the patient education group. Younger patients were more likely to complete the CancerCope intervention.ConclusionsThis online CBT intervention was associated with greater decreases in distress for those patients who more closely adhered to the program. Given the low costs and high accessibility of this intervention approach, even if only effective for subgroups of patients, the potential impact may be substantial.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12613001026718; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364768&isReview=true (Archived by WebCite at http://www.webcitation.org/6uPvpcovl)

The correlates of distress after the diagnosis of prostate cancer differ between patients and female partners. For men, masculine self-esteem may be most crucial, whereas for women, her partner's level of distress may matter most. Research to better understand these interactions is needed.

Objective Psychosexual morbidity is common after prostate cancer treatment, however, long‐term prospective research is limited. We report 5‐year outcomes from a couples‐based intervention in dyads with men treated for localised prostate cancer with surgery. Methods A randomised controlled trial was conducted involving 189 heterosexual couples, where the man received a radical prostatectomy for prostate cancer. The trial groups were peer support vs. nurse counselling versus usual care. Primary outcomes were sexual adjustment, unmet sexual supportive care needs, masculine self‐esteem, marital satisfaction, and utilisation of erectile aids at 2‐, 3‐, 4‐ and 5‐year follow‐up. Results The effects of the interventions varied across the primary outcomes. Partners in the peer group had higher sexual adjustment than those in the usual care and nurses group at 2 and 3 years (P = 0.002‐0.035). Men in usual care had lower unmet sexual supportive care needs than men in the peer and nurse groups (P = 0.001; P = 0.01) at 3 years. Women in usual care had lower sexual supportive care needs than women in the peer group at 2 and 3 years (P = 0.038; P = 0.001). Men in the peer and nurse group utilised sexual aids more than men in usual care; at 5 years 54% of usual care men versus 87% of men in peer support and 80% of men in the nurse group. Conclusion Peer and nurse‐administered psychosexual interventions have potential for increasing men's adherence to treatments for erectile dysfunction. Optimal effects may be achieved through an integrated approach applying these modes of support.

BackgroundProstate cancer is the most common male cancer in developed countries and diagnosis and treatment carries with it substantial morbidity and related unmet supportive care needs. These difficulties may be amplified by physical inactivity and obesity. We propose to apply a multimodal intervention approach that targets both unmet supportive care needs and physical activity.Methods/designA two arm randomised controlled trial will compare usual care to a multimodal supportive care intervention "Living with Prostate Cancer" that will combine self-management with tele-based group peer support. A series of previously validated and reliable self-report measures will be administered to men at four time points: baseline/recruitment (when men are approximately 3-6 months post-diagnosis) and at 3, 6, and 12 months after recruitment and intervention commencement. Social constraints, social support, self-efficacy, group cohesion and therapeutic alliance will be included as potential moderators/mediators of intervention effect. Primary outcomes are unmet supportive care needs and physical activity levels. Secondary outcomes are domain-specific and health-related quality of life (QoL); psychological distress; benefit finding; body mass index and waist circumference. Disease variables (e.g. cancer grade, stage) will be assessed through medical and cancer registry records. An economic evaluation will be conducted alongside the randomised trial.DiscussionThis study will address a critical but as yet unanswered research question: to identify a population-based way to reduce unmet supportive care needs; promote regular physical activity; and improve disease-specific and health-related QoL for prostate cancer survivors. The study will also determine the cost-effectiveness of the intervention.Trial RegistrationACTRN12611000392965

The objective of this study was to investigate the effect of chemical and environmental exposures during deployment on tinnitus among Australian Defence Force personnel previously deployed to Bougainville and East Timor. Participants were asked to self-report recent occurrence and severity of "ringing in the ears," and identify any chemical and environmental exposures during their deployment. Self-reported exposure to loud noises, heavy metals, intense smoke, engine exhaust, solvents and degreasing agents, and chemical spills increased the risk of self-assessed moderate or severe tinnitus. Daily exposure to 4 or more ototoxic factors was associated with 2- to 4-fold increase in the risk. In addition to loud noises, chemical exposures may also play a role in the development of tinnitus among Australian Defence Force personnel serving overseas.

<p>Studies examining the health of military personnel deployed overseas have been published by research teams in the United States and the United Kingdom. This research has examined the effects of combat on the mental and physical health of those who have been deployed.1-8 Recently, a research program on the health of deployed personnel began in Australia.9,10 Here we present data from the 2007 Solomon Islands Health Study, which focuses on a peace-keeping deployment between 2003 and 2005. We draw comparisons with data from major contemporaneous post-deployment epidemiological cohort studies from the United States and the United Kingdom, where deployments were in the same global political environment, but with greatly differing local hazards and exposures. These studies have particularly focused on the rates of posttraumatic stress disorder (PTSD) and alcohol abuse, which are recognized as major adverse health effects of deployment.</p> <h4>ABOUT THE AUTHORS</h4> <p>Annabel McGuire, PhD; Michael Waller, MSc; Colleen Loos, MedSci; Christine McClintock, PhD; Lisa Nielsen, Grad. Dip. Public Health; Susan A. Treloar, PhD; Annette Dobson PhD, are at the University of Queensland, Centre for Military and Veterans’ Health. Alexander C. McFarlane, MD, FRANZCP, is at the University of Adelaide, Centre for Military and Veterans’ Health. Catherine D’Este, PhD, is at University of Newcastle, Australia.</p> <p>Address correspondence to: Annabel McGuire, PhD, University of Queensland, Centre for Military and Veterans’ Health, Mayne Medical School QLD 4072 Australia; fax 61 7 3346 5239; or e-mail <a href="mailto:a.mcguire@uq.edu.au">a.mcguire@uq.edu.au</A>.</p> <p>Dr. McGuire, Mr. Waller, Ms. Loos, Dr. McClintock, Prof. McFarlane, Ms. Nielsen, Assoc. Prof. Treloar, Prof. Dobson, and Prof. D’Este have disclosed no relevant financial relationships.</p> <p>Acknowledgments: The research on which this paper is based was undertaken as part of the Deployment Health Surveillance Program, conducted by the Centre for Military and Veterans’ Health, the University of Queensland, and the University of Adelaide. The authors are grateful to the Australian Government Department of Defence for funding and to those men and women who are currently serving, those who served, and who provided the survey data. We are indebted to the current and past members of the Scientific Research Team.</p> <h4>EDUCATIONAL OBJECTIVES</h4> <ol><li>Identify factors that minimize the development of posttraumatic stress disorder (PTSD) in deployed service members. </li> <li>Review the differences between Australian, United States, and United Kingdom service members’ rates of PTSD and alcohol abuse. </li> <li>Identify the measures used to assess the health and well-being of the Australian Defence Force (ADF). </li></ol>