A randomised controlled trial of a cognitive behavioural intervention for men who have hot flushes following prostate cancer treatment (MANCAN):trial protocol

Background:- This randomised controlled trial (RCT) aims to evaluate the effectiveness of a guided self-help cognitive behavioural intervention to alleviate problematic hot flushes (HF) and night sweats (NS) in men who are undergoing prostate cancer treatment. The trial and the self-help materials have been adapted from a previous RCT, which showed that a cognitive behavioural intervention reduced the self-reported problem-rating of hot flushes in women with menopausal symptoms, and in women undergoing breast cancer treatment. We hypothesize that guided self-help will be more effective than usual care in reducing HF/NS problem-rating at post treatment assessment. Methods/Design:- Seventy men who are undergoing treatment for prostate cancer and who have been experiencing more than ten HF/NS weekly for over a month are recruited into the trial from urology clinics in London. They are randomly allocated to either a four-week self-help cognitive behavioural therapy (CBT) treatment or to their usual care (control group). The treatment includes information and discussion about hot flushes and night sweats in the context of prostate cancer, monitoring and modifying precipitants, relaxation and paced respiration, stress management, cognitive therapy for unhelpful thoughts and beliefs, managing sleep and night sweats, and advice on maintaining these changes.Prior to randomisation, men attend a clinical interview, undergo 24-48-hour sternal skin conductance monitoring, and complete pre-treatment questionnaires (e.g., problem-rating and frequency of hot flushes and night sweats; quality of life; mood; hot flush beliefs and behaviours). Post-treatment measures (sternal skin conductance and the above questionnaires) are collected four-six weeks later, and again at a six-month follow-up. Discussion:- MANCAN is the first randomised controlled trial of cognitive behavioural therapy for HF/NS for men that measures both self-reported and physiologically indexed symptoms. The results will inform future clinical practice by evaluating an evidence-based, non-medical treatment, which can be delivered by trained health professionals. Trial registration:- UK Clinical Research Network UKCRN10904

A randomised controlled trial of a brief cognitive behavioural intervention for men who have hot flushes following prostate cancer treatment (MANCAN)

OBJECTIVE: Hot flushes and night sweats (HFNS) are experienced by up to 80% of prostate cancer patients undergoing androgen deprivation therapy (ADT). This study evaluates the effects of a guided self-help cognitive behavioural therapy (CBT) intervention on HFNS problem-rating (primary outcome), HFNS frequency, mood and health-related quality of life (secondary outcomes) in patients undergoing ADT. METHODS: Patients reporting treatment-induced HFNS were randomly assigned to CBT (n = 33) or treatment as usual (TAU) (n = 35), stratified for cancer type. The CBT intervention included a booklet, CD plus telephone contact during a 4-week period. Validated self-report questionnaires were completed at baseline, 6 weeks and 32 weeks after randomisation. The primary outcome was HFNS problem rating (perceived burden of HFNS) at 6 weeks after randomisation. Potential moderators and mediators were examined. Data analysis was conducted on a modified intention-to-treat basis. RESULTS: Compared with TAU, CBT significantly reduced HFNS problem rating (adjusted mean difference: -1.33, 95% CI -2.07 to -0.58; p = 0.001) and HFNS frequency (-12.12, 95% CI -22.39 to -1.84; p = 0.02) at 6 weeks. Improvements were maintained at 32 weeks, but group differences did not reach significance. There were significant reductions in negative HFNS Beliefs and Behaviours following CBT, but not in mood or quality of life. CONCLUSIONS: Guided self-help CBT appears to be a safe and effective brief treatment for men who have problematic HFNS following prostate cancer treatments. Further research might test the efficacy of the intervention in a multicentre trial

Men's experience of a guided self-help intervention for hot flushes associated with prostate cancer treatment

Up to 80% of men who receive androgen deprivation therapy report hot flushes and for many these are associated with reduced quality of life. However it is recognised that there are a number of barriers to men’s engagement with support to manage symptoms and improve quality of life. This qualitative study was embedded within a larger randomised controlled trial (MANCAN) of a guided self-help cognitive behavioural intervention to manage hot flushes resulting among men receiving androgen deprivation therapy. The study aimed to explore the engagement and experiences with the guided self-help intervention. Twenty men recruited from the treatment arm of the MANCAN trial participated in a semi-structured interview exploring acceptability of the intervention, factors affecting engagement and perceived usefulness of the intervention. Interviews were audio-recorded, transcribed verbatim and analysed using a Framework approach. Over two thirds of respondents (69%) reported reading the intervention booklet in full and over 90% reporting practising the relaxation CD at least once a week. Analysis of the interviews identified three super-ordinate themes and these related to changes in hot flush symptomatology (learned to cope with hot flushes in new ways), the skills that participants had derived from the intervention (promoting relaxation and reducing stressors), and to a broader usefulness of the intervention (broader impact of the intervention and skills). The present study identified positive engagement with a guided self-help intervention and that men applied the skills developed through the intervention to help them undertake general lifestyle changes. Psycho-educational interventions (e.g. cognitive behaviour therapy, relaxation, and positive lifestyle elements) offer the potential to be both effective and well received by male cancer survivors

White paper: Research Challenges at the Intersection of Energy and Equity in the Energy Transition

Summary report from NSF2026: Conference Workshops to Identify Research Challenges at the Intersection of Energy and Equity in the Energy Transitio

Public acceptance of nature-based solutions for natural hazard risk reduction: survey findings from three study sites in europe

Climate change is one factor increasing the risk of hydro-meteorological hazards globally. The use of nature-based solutions (NbS), and more specifically ecosystem-based disaster risk reduction measures (Eco-DRR), has become a popular response for risk reduction that also provides highly-valued co-benefits. Public acceptance is of particular importance for NbS since they often rely on local collaborative implementation, management, and monitoring, as well as long-term protection against competing societal interests. Although public engagement is a common goal of NbS projects, it is rarely carried out with a sufficient understanding of the (de)motivating factors tied to public perceptions. Successful collaboration demands consideration of societal attitudes and values in relation to risk, nature, and place. However, existing research does not sufficiently explore these themes together, their interactions, and their implications for the public acceptance of NbS. This may lead to misaligned public expectations and failed participatory initiatives, while jeopardizing the success of NbS projects and their continued funding and uptake. We conducted citizen surveys within local NbS “host” communities to determine the degree of pro-NbS attitudes and behavior, associated variables, and how these may be leveraged to increase acceptance. We compared results across sites, relying primarily on correlations and regression models along with survey comments and expert knowledge. Three distinct rural NbS being implemented within the OPERANDUM project aim to reduce risk from (socio-)natural hazards in Scotland (landslides and coastal erosion; n = 66 respondents), Finland (eutrophication and algal blooms; n = 204) and Greece (river flooding and water scarcity; n = 84). Our research thus centers on rural NbS for risk reduction within a large EU project. Trust in implementers is a consistent factor for defining attitudes towards the NbS across the sites, and attitudes are strongly associated with respondents’ commitment to nature and behavioral acceptance (i.e., willingness to engage). Behaviorial acceptance is most consistently predicted by connectedness to place and the extent of expected future impacts. Skepticism of NbS effectiveness leads to high public demand for relevant evidence. To increase public acceptance, we recommend greater framing of NbS in relation to place-based values as well as demonstration of the effectiveness of NbS for risk reduction. However, distinct hazard types, proposed NbS, and historical characteristics must be considered for developing strategies aimed at increasing acceptance. An understanding of these characteristics and their interactions leads to evidence-based recommendations for our study sites and for successful NbS deployment in Europe and beyond

Towards an operationalisation of nature-based solutions for natural hazards

Nature-based solutions (NBS) are being promoted as adaptive measures against predicted increasing hydrometeorological hazards (HMHs), such as heatwaves and floods which have already caused significant loss of life and economic damage across the globe. However, the underpinning factors such as policy framework, end-users' interests and participation for NBS design and operationalisation are yet to be established. We discuss the operationalisation and implementation processes of NBS by means of a novel concept of Open-Air Laboratories (OAL) for its wider acceptance. The design and implementation of environmentally, economically, technically and socio-culturally sustainable NBS require inter- and transdisciplinary approaches which could be achieved by fostering co-creation processes by engaging stakeholders across various sectors and levels, inspiring more effective use of skills, diverse knowledge, manpower and resources, and connecting and harmonising the adaptation aims. The OAL serves as a benchmark for NBS upscaling, replication and exploitation in policy-making process through monitoring by field measurement, evaluation by key performance indicators and building solid evidence on their short- and long-term multiple benefits in different climatic, environmental and socio-economic conditions, thereby alleviating the challenges of political resistance, financial barriers and lack of knowledge. We conclude that holistic management of HMHs by effective use of NBS can be achieved with standard compliant data for replicating and monitoring NBS in OALs, knowledge about policy silos and interaction between research communities and end-users. Further research is needed for multi-risk analysis of HMHs and inclusion of NBS into policy frameworks, adaptable at local, regional and national scales leading to modification in the prevalent guidelines related to HMHs. The findings of this work can be used for developing synergies between current policy frameworks, scientific research and practical implementation of NBS in Europe and beyond for its wider acceptance

Motivation and treatment engagement intervention trial (MotivaTe-IT): The effects of motivation feedback to clinicians on treatment engagement in patients with severe mental illness

Background: Treatment disengagement and non-completion poses a major problem for the successful treatment of patients with severe mental illness. Motivation for treatment has long been proposed as a major determinant of treatment engagement, but exact mechanisms remain unclear. This current study serves three purposes: 1) to determine whether a feedback intervention based on the patients' motivation for treatment is effective at improving treatment engagement (TE) of severe mentally ill patients in outpatient psychiatric treatment, 2) to gather insight into motivational processes and pos

Towards operationalisation of nature-based solutions for natural hazards

Nature-based solutions (NBS) are being promoted as adaptive measures against predicted increasing hydrometeorological hazards (HMHs), such as heatwaves and floods which have already caused significant loss of life and economic damage across the globe. However, the underpinning factors such as policy framework, end-users' interests and participation for NBS design and operationalisation are yet to be established. We discuss the operationalisation and implementation processes of NBS by means of a novel concept of Open-Air Laboratories (OAL) for its wider acceptance. The design and implementation of environmentally, economically, technically and socio-culturally sustainable NBS require inter- and transdisciplinary approaches which could be achieved by fostering co-creation processes by engaging stakeholders across various sectors and levels, inspiring more effective use of skills, diverse knowledge, manpower and resources, and connecting and harmonising the adaptation aims. The OAL serves as a benchmark for NBS upscaling, replication and exploitation in policy-making process through monitoring by field measurement, evaluation by key performance indicators and building solid evidence on their short- and long-term multiple benefits in different climatic, environmental and socio-economic conditions, thereby alleviating the challenges of political resistance, financial barriers and lack of knowledge. We conclude that holistic management of HMHs by effective use of NBS can be achieved with standard compliant data for replicating and monitoring NBS in OALs, knowledge about policy silos and interaction between research communities and end-users. Further research is needed for multi-risk analysis of HMHs and inclusion of NBS into policy frameworks, adaptable at local, regional and national scales leading to modification in the prevalent guidelines related to HMHs. The findings of this work can be used for developing synergies between current policy frameworks, scientific research and practical implementation of NBS in Europe and beyond for its wider acceptance