Male fertility after VAPEC-B chemotherapy for Hodgkin's disease and non-Hodgkin's lymphoma.

Semen analysis was performed in 14 men a median of 13.5 months after completion of VAPEC-B chemotherapy for Hodgkin's disease or non-Hodgkin's lymphoma. Semen from 12 patients contained motile spermatozoa, and in nine cases the count was > 20 million ml-1. One patient was azoospermic (VAPEC-B followed by pelvic radiotherapy) and another had a count of 21 million ml-1 but sperm were non-motile. These findings suggest that, in the majority of cases, VAPEC-B chemotherapy does not cause permanent damage to the male germinal epithelium. A more detailed study of gonadal function in males and females before and after treatment with VAPEC-B for Hodgkin's disease is currently in progress

Fatigue, sexual function and mood following treatment for haematological malignancy: the impact of mild Leydig cell dysfunction

Fatigue, sexual dysfunction, anxiety and depression are all more common in patients who have previously been treated with cytotoxic chemotherapy and radiotherapy (XRT) for haematological malignancies. Following therapy, a significant proportion of men have biochemical evidence of Leydig cell dysfunction, defined by a raised luteinizing hormone level in the presence of a low/normal testosterone level. We postulated that mild testosterone deficiency may account for some of the long-term side-effects of treatment, and we have therefore assessed fatigue, mood and sexual function by questionnaire in 36 patients with Leydig cell dysfunction (group 1), and also in a group of 30 patients (group 2) with normal hormone levels who underwent the same treatment for cancer. There was no significant difference in anxiety and depression scores between the two groups although anxiety scores were higher than those previously reported for normal men. Eighty-seven per cent of group 2 were sexually active compared with only 69% of group 1 (P = 0.1), and patients in group 1 engaged less in sexual activity than those in group 2 (mean of 1.8 times per week compared with 3.2 times per week;P = 0.02) Fatigue scores were significantly higher in both groups compared with normal men, but there were no significant differences in any of the fatigue subscales between the two groups. We conclude that mild Leydig cell insufficiency following treatment with cytotoxic chemotherapy ± XRT is not associated with higher levels of fatigue and anxiety but may result in reduced sexual function. These results do not provide a convincing argument that androgen replacement therapy is mandatory to improve quality of life in the majority of these patients, although it may be beneficial in a minority. To establish criteria for selection of patients for a trial of androgen therapy a randomized placebo-controlled study will be necessary. © 2000 Cancer Research Campaig

The climate emergency across business, community and campaign groups: motivations and barriers to driving change for the common good

Initiatives to help tackle the climate emergency have tended to focus on large-scale actions that governments can take and smaller-scale actions for individuals, with relatively limited attention given to the mass of groups that form society between these two ends of the spectrum. The aim here is to help close that gap and the chosen areas of study are business, community, and campaign groups. The approach was to assess the existing literature and to conduct three focus groups to identify what motivates these groups to take actions on climate change, while also uncovering the barriers that may drive choices of inaction. The findings indicate that multiple factors motivate environmental engagements across business, community, and campaign groups, but personal ethics and concern for the future play the most vital roles. The most common barriers cited were difficulties in accessing support schemes, a lack of clear accessible information, and financial implications. Better networking and knowledge exchange are considered essential for meaningful progress. This research provides a new framework, upon which many organisations can be better motivated to take actions in helping deal with the global climate emergency facing humanity. Practical action guides may be developed from existing materials, and small taskforces could be trained to provide direct hands-on support to groups across society, especially those in SMEs and local communities. The energies of younger people and campaigners, combined with the experiences of other generations, would create a powerful force for good

Management actions to address the climate emergency: Motivations and barriers for SMEs and other societal micro/meso-level groups

Initiatives to tackle the climate emergency have tended to focus on large-scale actions that governments and investors (societal macro-levels) can take and smaller-scale individual habits, with limited attention given to the groups that form society between those ends of the spectrum (societal micro/meso-levels). This research aims to traverse that gap by studying three societal micro/meso-level groups; from the private, public and voluntary sectors, as represented by business, community and campaign groups. Existing literature and focus groups are used to identify what motivates actions on climate change, while exposing barriers that may drive choices of inaction. The study shows that concerns for the future and personal ethics play vital roles across business, community and campaign groups, while the principal barriers include difficulties in accessing support schemes and changes in political priorities. Better networking and knowledge exchange are considered essential for meaningful progress. This provides a new framework for management education to support organisations in tackling climate-related issues. Action guides may be developed and task-forces trained to provide hands-on support, especially for SMEs and local communities. The enthusiasm of younger people and campaigners, combined with others’ experiences, would create a powerful platform for climate emergency actions