• Cancer Nursing Research Unit

    The Cancer Nursing Research Unit (CNRU) is a partnership of the Sydney Cancer Centre, Cancer Institute NSW, the University of Sydney (Sydney Nursing School), and the Royal Prince Alfred Hospital Sydney Cancer Centre.

  • Overview

    The unit is comprised of academic staff, clinicians, research staff and research students and aims to support improved patient care through education and research among cancer and palliative care nurses. This is achieved by providing academic and research leadership in cancer nursing and engaging in collaborative, multidisciplinary research with clinicians and cancer researchers. 

    Core themes

    CNRU activities and research fall into four broad themes. CNRU researchers have been conducting innovative research into improving supportive care for patients receiving outpatient chemotherapy. This has included auditing unplanned presentations and admissions and piloting a community nurse-led intervention. Extensive work has also been undertaken in rural health care models, including after hours support for rural palliative care patients, mapping practical support needs and access to services for cancer patients, and developing a model of providing palliative care in small rural and remote communities. Other areas of interest include fast tracking surgery for gynaecological cancer patients and providing cancer and palliative care in disadvantaged and homeless populations.: supportive care; psychosocial and quality of life research; models of health care delivery; improving research capacity and skills for cancer and palliative care nurses. 

    Supportive care

    In the supportive care theme, CNRU researchers have conducted extensive work in lymphoedema, including two systematic reviews, the development of a quality of life tool, and the conduct of a randomised controlled trial of low-level laser therapy, with a new project underway looking at lymphoedema after vulval cancer. A range of projects have also been undertaken in survivorship and palliative care in specific groups, including children, the elderly, and people with neuro-degenerative conditions. Current research interests and activities in supportive care include patient-reported outcome measures, management and assessment of cutaneous toxicities associated with epidermal growth factor receptor inhibitor treatment, and nutrition and physical functioning during gynaecological cancer.  

    Psychosocial and quality of life

    The CNRU’s work in this theme has focused on the development of nursing roles or nursing interventions to improve care, such as a nurse-led education intervention on body image and sexuality for women with breast cancer, rural specialist breast nurses, and a nursing intervention for supportive parenting for women with breast cancer, and identifying ways to support the male partners of women with gynaecological cancer. Addressing the cultural needs of specific groups is another key area, with projects examining the breast cancer screening behaviours of Chinese-Australian women and awareness of cancer in the Chinese-Australian community.

    Models of health care delivery

    CNRU researchers have been conducting innovative research into improving supportive care for patients receiving outpatient chemotherapy. This has included auditing unplanned presentations and admissions and piloting a community nurse-led intervention. Extensive work has also been undertaken in rural health care models, including after hours support for rural palliative care patients, mapping practical support needs and access to services for cancer patients, and developing a model of providing palliative care in small rural and remote communities. Other areas of interest include fast tracking surgery for gynaecological cancer patients and providing cancer and palliative care in disadvantaged and homeless populations.

    Improving research capacity and skills for cancer and palliative care nurses

    The CNRU is undertaking a range of initiatives to improve the research capacity and skills for cancer and palliative care nurses. The CNRU supports clinical research fellowships and ongoing professional development opportunities in evidence-based practice to enhance the skills for this critical health care workforce group. CNRU researchers are also working to develop an evidence-based evaluation framework for nurse-sensitive outcomes and measures in cancer and palliative care and improve the uptake of evidence into practice in supportive care.

    CNRU Leader

    Professor Kate White

    Professor Kate White

    Cancer Institute NSW (CINSW) Chair of Cancer Nursing

    Prof Kate White has an extensive research background in cancer and palliative care, with a focus on supportive care and psychosocial/quality of life issues for cancer patients and their families. In 2009, she was named the CINSW Chair of Cancer Nursing, a new position funded by CINSW, Sydney Cancer Centre/RPAH and the Sydney Nursing School/University of Sydney. She was awarded a Churchill Fellowship in 2011.  Read her full profile on the University of Sydney website.

    CNRU Academic Researchers, Staff and Affiliates

    Natalie D'abrew

    Ms Natalie D'Abrew

    Senior Project Manager 

    Ms Natalie D’Abrew has been engaged in research projects in health service research, cancer and palliative care. Natalie's research interests are in the areas of research project management, cancer and psychosocial care. She is experienced in qualitative and quantitative data collection and analysis and has a particular interest in sensitive interviewing.
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    Judith Fethney

    Ms Judith Fethney

    Biostatistician 

     Ms Judith Fethney specialises in multivariate data analysis, and has a strong background in providing statistical advice. She provides statistical expertise to researchers at all stages of the research process, from grant development to project analysis. Judith has primarily been involved in research that explores the physical and psychosocial impact of illness or injury in people’s lives, with a view to improving practice and patient outcomes.
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    Lillian Hayes

    Dr Lillian Hayes 

    Senior Lecturer  

    Dr Lillian Hayes’ research interests are in community nursing, care for socially disadvantaged populations, and quantitative methods. She is working with the CNRU team on a nurse-led intervention for chemotherapy outpatients and community nurses’ involvement with Chinese cancer patients. Read more. 

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    Cannas Kwok

    Dr Cannas Kwok

    Academic Affiliate

    Dr Cannas Kwok has research interests and expertise in ethnic health, particularly in the areas of breast and cervical cancer. She was awarded the prestigious Early Career Development Fellowship from the Cancer Institute NSW. With other members of the CNRU team, she is leading research into survivorship for Chinese-Australian women suffering from breast cancer, and developing a culturally sensitive instrument to measure the beliefs, attitudes and knowledge of breast cancer and breast screening practices of Chinese-Australian women.

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    Heather McKenzie

    Professor Heather McKenzie

    Associate Professor 

    Dr Heather McKenzie has research interests in cancer care and cancer illness experiences, health services research and community nursing. With other CNRU team members, she is currently leading a project about a nurse-led intervention for chemotherapy outpatients and works with other CNRU team members on a project involving community nurses and Chinese cancer patients. Read more.  

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    Jessica Roydhouse

    Ms Jessica Roydhouse

    Senior Research Officer 

    Ms Jessica Roydhouse has been engaged in research projects in health service research and cancer with a focus on statistical analysis. Her research interests are in the areas of health promotion, public health and health services research.  She has experience in grant writing and quantitative data analysis.

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    Kathleen Scott

    Dr Kathleen Scott

    Academic Affiliate 

    Dr Kathleen Scott is currently leading a project related to the management of cutaneous toxicities associated with epidermal growth factor receptor inhibitors (EGFRIs) in cancer treatment and also assessment and management of treatment related neurotoxicity. She has research interests in cancer symptom management and the development of new curriculum in clinical trials. Read more.  

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    Moira Stephens

    Ms Moira Stephens

    Academic Affiliate 

    Ms Moira Stephens has research interests in the care and management of haematological malignancies. She serves as President of the Haematological Society of Australia and New Zealand Nurses’ Group and is a member of the Cancer Institute NSW Chemotherapy Education Project Steering Committee. Read more.

    CNRU Clinical Researchers

    Keith Cox

    Mr Keith Cox

    Nurse Pracitioner, Sydney Cancer Centre  

    Mr Keith Cox was the first Nurse Practitioner in Cancer in NSW, and received the Order of Australia Medal in 2007 in recognition of his extensive work in cancer. He has led and contributed to multidisciplinary research at the Sydney Cancer Centre, and is working with the CNRU team on projects relating to the management of cutaneous toxicities associated with epidermal growth factor receptor inhibitors (EGFRIs) in cancer treatment and a nurse-led intervention for chemotherapy outpatients.

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    Star of Hope

    Ms Sarah Davies

    Clinical Nurse Consultant, Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital  

    Ms Sarah Davies has research interests in smoking cessation for head and neck cancer. Her pilot study testing the acceptability of a smoking cessation clinic led to educating all members of the multidisciplinary team about nicotine addiction, and has integrated assessment of the need for smoking counselling into routine clinical practice.

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    Star of Hope

    Ms Tracy King

    Myeloma Clinical Nurse Consultant, Institute of Haematology, Royal Prince Alfred Hospital 

    Ms Tracy King’s research interests are in supportive care for people affected by myeloma and the development of educational initiatives in particular. She is a member of the Myeloma UK Nurse Guidelines working group and the co-founder and secretary of the Haematological Society of Australia and New Zealand Nurses Group. In 2010, Tracy received a CINSW Clinical Fellowship to examine patient and carer experiences of steroid therapy for multiple myeloma and develop guidelines and educational initiatives on this topic.

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    Peta McVey

    Dr Peta McVey

    Clinical Nurse Consultant, Neringah Palliative Care Service, Hope Healthcare

    Peta recently completed a PhD at the Sydney Nursing School under the supervision of Prof Kate White and Dr Heather McKenzie exploring the palliative approach for people with declining health living in hostel accommodation. Her work was supported by a National Health and Medical Research Council Round Three Palliative Care Scholarship.Read more 

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    Star of Hope

    Ms Anne Mellon

    Clinical Nurse Consultant, John Hunter Hospital

    Ms Anne Mellon has research interests in vulval cancer and lymphoedema. With other researchers from CNRU, she is working on a project relating to vulval cancer and quality of life.

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    Kath Nattress

    Ms Kathryn Nattress

    Clinical Nurse Consultant, Sydney Cancer Centre, Royal Prince Alfred Hospital 

    Ms Kathryn Nattress’ research interests focus on the survivorship needs of women with gynaecological cancers and the development of nurse led initiatives to address these needs

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    Star of Hope

    Clinical Associate Professor Libba O’Riordan

    Clinical Nurse Consultant, Children’s Hospital Westmead 

    Dr Libba O’Riordan has research interests in paediatric oncology, specifically parental perspectives and support. She recently presented a study of friendships among patients’ parents in the paediatric oncology setting. Libba is a member of the Cochrane Wounds Group.

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    Star of Hope

    Ms Justine Oates

    Clinical Nurse Consultant, Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital 

    Ms Justine Oates has been undertaking prospective quality of life assessment as part of standard clinical practice for head and neck cancer patients. Her research interests focus on quality of life and interventions to address unmet needs related to quality of life.

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    Shannon Philp

    Ms Shannon Philp

    Clinical Nurse Consultant, Sydney Cancer Centre, Royal Prince Alfred Hospital 

    Ms Shannon Philp is currently working on a project entitled Fast Track Surgery in Gynaecological Oncology –Patient Experience and Satisfaction and a project relating to vulval cancer and quality of life. Her research interests include nurse-led follow up in gynaecological cancer.

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    Star of Hope

    Clinical Associate Professor Mary Ryan

    Clinical Nurse Consultant, Royal Hospital for Women 

    Clinical Associate Professor Mary Ryan was recently awarded a prestigious NHMRC NICS CA-NCGC to support her project improving the nutritional status and physical conditioning of women affected by gynaecological cancer. She has research interests in evidence implementation, illness experience, management of the effects of cancer treatment and survivorship issues.

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    Timohy Wand

    Dr Timothy Wand

    Nurse Practitioner in Mental Health Liaison, Emergency Department, Royal Prince Alfred Hospital and Clinical Senior Lecturer (Mental Health), Sydney Nursing School

    Tim recently completed a PhD at the Sydney Nursing School under the supervision of Prof Kate White. His PhD work built on his MN (Hons) research, which was a scoping study of an ED-based Mental Health Nurse Practitioner (MHNP) outpatient service. In his PhD, he developed, implemented and evaluated the MHNP outpatient service from patient and staff perspectives.

    CNRU Affiliated Students

    Star of Hope

    Ms Thilakavathi Chengodu

    Details forthcoming, watch this space.

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    Elisha McLaren

    Ms Elisha McLaren

    Elisha is currently enrolled in a PhD at the Sydney Nursing School exploring the potential health benefits of implementing an exercise health promotion strategy for women with type 1 endometrial cancer. Read more.  

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    Star of Hope

    Mr Nickolas Yu

    Details forthcoming, watch this space.

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    Publications (2010 - present)

    CNRU staff and affiliates have published on a range of topics in respected journals. A sample of recent publications is provided below. A complete list of all past publications can be found on staff member pages at the School’s website.

    Forthcoming

    Grimison P, Phillips F, Butow P, White K, Yip D, Sardelic F, Underhill C, Tse R, Simes R, Turley K, Raymond C, Goldstein D (provisional acceptance Aug 2012), Are Visiting Oncologists Enough? A Qualitative Study of the Needs of Australian Rural and Regional Cancer Patients, Carers and Health Professional, Asia-Pacific Journal of Clinical Oncology

    Dall-Armi L, Simpson G, Forstner D, Simpson T, Roydhouse J & White K (accepted Aug 2012), The information needs of patients with head and neck cancer and their caregivers: a short report of instrument development and testing, Applied Nursing Research

    Roydhouse JK, Allman-Farinelli M, McGeechan K, Ferrar KE & Olds T (accepted October 2011) An exploratory analysis of active and low energy behaviour in Australian adolescents, Australian Journal of Primary Health

    Al-Sheyab NA, Gallagher R, Roydhouse JK, Crisp J & Shah S (accepted March 2011), Feasibility of a peer-led, school-based asthma education program for adolescents in Jordan, Eastern Mediterranean Health Journal 

    2012

    Morrison V, Bennett P, Butow P, Mullan B & White K. (2012). Introduction to Health Psychology in Australia: 2nd edition. Pearson: Frenchs Forest.

    Peate M, Saunders C, Gregson J, Thewes B, D’Abrew N, Meiser B, White K & Hickey M. (2012). Development and evaluation of an information booklet about breast cancer and early menopause, The Breast Journal 18(1): 95 – 96

    Koo FK, Kwok C, White K, D’Abrew N & Roydhouse JK. (2012). Strategies for piloting a breast health promotion program within the Chinese-Australian population, Preventing Chronic Disease [Internet]; 9:100293, doi: 10.5888/pcd9.100293

    Kwok C, Fethney J & White K. (2012), Breast cancer screening practices among Chinese-Australian women, European Journal of Oncology Nursing 16: 247 – 252

    Kwok C, Fethney J & White K (2012), Mammographic screening practices among Chinese-Australian women, Journal of Nursing Scholarship 44(1):11 – 18

    Kwok C, Fethney J & White K (2012), Confirmatory factor analysis of the Chinese Breast Cancer Screening Beliefs Questionnaire, Cancer Nursing, doi: 10.1097/NCC.0b013e31823fcb6a

    Fong DYT, Kwok C & White K (2012), Psychometric properties of the Chinese Breast Cancer Screening Beliefs questionnaire, European Journal of Oncology Nursing doi:10.1016/j.ejon.2012.01.001

    Wand T, White K, Patching J, Dixon J & Green T (2012) Outcomes from the evaluation of an emergency department-based mental health nurse practitioner outpatient service in Australia, Journal of the American Academy of Nurse Practitioners doi: 10.1111/j.1745-7599.2011.00709.x

    White K, D’Abrew N, Katris P, O’Connor M & Emery L (2012), Mapping the Psychosocial and Practical Support Needs of Cancer Patients in Western Australia, European Journal of Cancer Care, 21(1): 107 – 116

    Butow PN, Phillips F, Schweder J, White K, Underhill C & Goldstein D (2012), Psychosocial wellbeing and supportive care needs of cancer patients living in urban and rural/regional areas: A systematic review, Supportive Care in Cancer 20(1): 1 – 22

    2011

    Ryan M, White K, Roydhouse JK & Fethney J (2011). A description of the nutritional status and quality of life of Australian gynaecological cancer patients over time, European Journal of Oncology Nursing, doi:10.1016/j.ejon.2011.10.007

    Scott K, White K, Johnson C & Roydhouse JK (2011), Knowledge and Skills of Cancer Clinical Trials Nurses in Australia, Journal of Advanced Nursing, doi: 10.1111/j.1365-2648.2011.05816.x

    White KJ, Roydhouse JK, D’Abrew N, Katris P, O’Connor M & Emery L (2011), The unmet psychological and practical needs of patients with cancer in rural and remote areas of Western Australia, Rural and Remote Health 11 (online): 1784, http://www.rrh.org.au/articles/showarticleAust.asp?ArticleID=1784 

    Kwok C, White K & Roydhouse JK. (2011), Chinese-Australian women’s knowledge, facilitators and barriers related to cervical cancer screening: A qualitative study, Journal of Immigrant and Minority Health 13(6): 1076 – 1083, doi:10.1007/s10903-011-9491-4

    Kwok C & White K. (2011). Cultural and linguistic isolation: The breast cancer experience of Chinese-Australian women – A qualitative study, Contemporary Nurse 39(1): 85 – 94

    Wand T, White K & Patching J. (2011). Realistic evaluation of an emergency department-based mental health nurse practitioner outpatient service, Nursing & Health Sciences, doi: 10.1111/j.1442-2018.2011.00601.x

    Kwok C, Koo FK, White K, D’Abrew N & Roydhouse JK. (2011) East Meets West: A brief report of a culturally sensitive breast health education program for Chinese-Australian Women, Journal of Cancer Education 26: 540 – 546, doi: 10.1007/s13187-011-0212-4

    Wand T, White K, Patching J, Dixon J & Green T. (2011). An emergency department-based mental health nurse practitioner outpatient service: Part2, staff evaluation, International Journal of Mental Health Nursing, doi: 10.1111/j.1447-0349.2011.00743.x

    Wand T, White K, Patching J, Dixon J & Green T. (2011). An emergency department-based mental health nurse practitioner outpatient service: Part1, participant evaluation, International Journal of Mental Health Nursing, doi: 10.1111/j.1447-0349.2011.00744.x

    White K, Roydhouse JK & Scott K. (2011). Psychosocial impact of cutaneous toxicities associated with epidermal growth factor receptor inhibitor treatment: implications for research and practice, Clinical Journal of Oncology Nursing 15(1): 88 – 96

    Walsh J, Young JM, Harrison JD, Butow PN, Solomon MJ, Masya L & White K. (2011). What is important in care coordination? A qualitative investigation, European Journal of Cancer Care 20: 220 – 227

    McKenzie H, Hayes L, White K, Cox K, Fethney J, Boughton M & Dunn J. (2011). Chemotherapy outpatients' unplanned presentations to hospital: A retrospective study. Supportive Care in Cancer 19(7): 963 – 969, doi: 10.1007/s00520-010-0913-y

    Kassab MI, Roydhouse JK, Foureur M & Fowler C. (2011). The effectiveness of glucose in reducing needle-related procedural pain in infants, Journal of Pediatric Nursing, doi:10.1016/j.pedn.2010.10.008

    Chiarella M & Roydhouse JK. (2011). “Hospital churn and casemix instability: implications for planning and educating the nursing workforce,” Australian Health Review 35(1): 95 – 98

    Projects

    A full list of projects can be found on the School website. Selected projects from each core theme are listed below.

    Supportive care

    Cutaneous toxicities 

    • The prevalence, assessment and management of cutaneous toxicities caused by epidermal growth factor receptor inhibitors (EGFRIs) in Australia

    Gynaecological cancer 

    • The impact of gynaecological cancer and the associated multi-modality treatment on nutritional status, exercise pattern and quality of life in women
    • Nurse led follow up intervention following gynaecological cancer
    • Health promotion intervention for women diagnosed with endometrial cancer
    • Vulval cancer quality of life study
    • Supporting the supporters: the experiences of male partners of women with gynaecological cancer

    Haematological malignancies 

    • A qualitative study of the experience of multiple myeloma
    • A clinical practice initiative to improve the management of adverse effects of steroid therapy associated with the treatment of multiple myeloma

    Palliative care 

    • Palliative care needs of children with life threatening illnesses
    • Bereavement needs of parents
    • Perceptions of palliative care in aged care settings
    • Needs of Chinese carers of palliative care patients
    • Psychosocial needs and community cancer awareness
    • Community based cancer awareness in Chinese community
    • Needs of Afghani women diagnosed with cancer

    Supportive care needs and measurement tools 

    • Patient Reported Outcome Measures (PROMs)
    • Patient and carer education side effects of treatment
    • State wide survey unmet supportive care needs

    Psychosocial and quality of life

    Breast cancer 

    • Nurse led intervention for sexuality and body image
    • Impact of premature menopause of women with breast cancer
    • Gestational breast cancer
    • An intervention for supportive parenting for women with breast cancer
    • Decision aid for breast reconstruction
    • Australian Chinese women’s attitude to participation in cancer screening

    Head and neck cancer 

    • Prospective assessment of health related quality of life in patients with oropharyngeal cancer
    • Patterns of information needs for people with head and neck cancer and their family members

    Models of health care delivery

    Rural health 

    • The support needs of rural palliative care patients: after hours support, information access to services
    • A model for providing allied health support in rural community
    • Developing a model of providing palliative care in small rural and remote communities
    • The needs of rural patients while in city for treatment

    Improving care and access to care 

    • Improving supportive care for patients receiving outpatient chemotherapy
    • Cancer and palliative care in disadvantaged and homeless populations
    • Improving sexual function outcomes post cancer
    • Long term follow up after cancer
    • Mapping the practical support needs and access of cancer patients
    • Respite after hours in the home (not rural)
    • Comparison of two approaches to providing allied health palliative care support
    • Fast track surgery for gynaecological cancer patients
    • Patients seen by the Nurse Practitioner in the chemotherapy unit – a six month review
    • Nurse-led models of care in cancer: a systematic review

    Improving research capacity and skills for cancer and palliative care nurses 

    • Nurse sensitive outcome measures in cancer and palliative care
    • Development of audit and evaluation skills
    • Clinical research fellowships
    • Ongoing professional development opportunities in evidence based practice
    • Evaluation of initiatives undertaken
    • Development of a tool for assessing the knowledge and skills of cancer clinical trials nurses

    Highlights

    CNRU Clinical Research Fellow wins Best Abstract Prize at the European Group for Blood & Marrow Transplantation Annual Scientific Meeting

    CNRU Clinical Research Fellow Tracy King won the Best Abstract Prize for her presentation of the preliminary findings from her research about the information needs and experience of patients receiving high-dose steroids as part of anti-myeloma therapy regimens. Ms King’s work has been supported by the Cancer Institute of NSW Training Fellowship (Haematology).

    King T, White K, Stephens M, D’Abrew N, Ferrar N, Lindsay T & Acret L. “‘The Devil’s Tic Tac’s’ – Understanding the adverse events of steroid therapy associated with the treatment of multiple myeloma.” 38th Annual Meeting of the European Group for Blood & Marrow Transplantation, Geneva, 1 – 4 April 2012.

    CNRU celebrated at formal launch

    The CNRU was formally launched on 26 May 2011 at Royal Prince Alfred Hospital by Professor David Currow, Chief Cancer Officer and Chief Executive Officer, Cancer Institute NSW (CINSW), and Professor Jill White AM, Dean of Sydney Nursing School.

    CNRU_Highlight_Pic1 

    The launch was attended by staff and students from the University, nurse clinicians from Royal Prince Alfred Hospital and senior hospital staff including Associate Professor Michael Boyer AM, Medical Director of Lifehouse at RPA. The launch showcased current CNRU projects and achievements.

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    CNRU leader awarded Churchill Fellowship

    Professor Kate White received one of the 27 Churchill Fellowships awarded in NSW in 2011. These fellowships enable the “best and brightest” in a range of fields in Australia to gain further expertise overseas and develop international collaborations. Professor White will be travelling to Marsden Hospital and Kings College London in the UK to examine a model of nurse-led clinics focussed on intervention strategies for sexual dysfunction in cancer patients and to assess the applicability of this model to the Australian context.

    CNRU student poster selected for ‘Best of the Best’ session at the Clinical Oncological Society of Australia

    “It’s a forgotten one...Unmet needs for psychosocial support for people affected by pancreatic cancer,” a poster by PhD student Ms Helen Gooden and her colleagues and supervisors, including Professor Kate White, was selected for inclusion in the ‘Best of the Best’ poster session on Decision Making and Education at the 38th Annual Scientific Meeting in 2011.

    Upcoming Activities

    The CNRU is planning a course on evidence-based practice for cancer nurses to be delivered in 2012. Watch this space for details in the coming months.