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Vandag saam met SG Soms breek planne of drome. Soms breek vriendskappe. Soms breek harte. Jesus het dit so goed verstaan – die aand toe Jesus saam met sy vriende geëet het, het Hy die brood geneem, dit gebreek en gesê: “Dit is my liggaam wat vir julle gegee word. Gebruik dit om my te onthou.” Ons onthou vandag dat Jesus se liggaam ook gebreek is wanneer ons saam die nagmaal gebruik. Kry gerus vir jou tekens van die nagmaal voor jy na hierdie preek kyk of saam luister. … Luister hier na die klankopname of op die potgooi-platform van jou keuse. . . Of kyk hier saam:

"Until immunomodulators, patients [with myeloma] did not have a great overall survival rate. But when we introduced lenalidomide, we started seeing our patients have life expectancies between five and seven years—which was unheard of prior to these immunomodulators going forward. I think it's promising and allows patients to have quality of life versus therapy of life," ONS member Daniel Verina, DNP, RN, ACNP-BC, nurse practitioner for the multiple myeloma program at Mount Sinai Medical Center in New York, NY, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about immunomodulators. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.75 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by June 12, 2027. Daniel Verina is on the speakers' bureau for Johnson & Johnson, GlaxoSmithKline, and Pfizer. This financial relationship has been mitigated. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome:  Learners will report an increase in knowledge about the use of immunomodulators to treat cancer. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Pharmacology 101 series Episode 401: Multiple Myeloma Treatment Considerations for Oncology Nurses Episode 386: Interprofessional Navigation and the Oral Anticancer Medication Care Compass Episode 290: Cancer Symptom Management Basics: Peripheral Neuropathy ONS Voice articles: Maintain Oral Adherence With ONS Guidelines™ Multiple Myeloma Prevention, Screening, Treatment, and Survivorship Recommendations Sexual Considerations for Patients With Cancer Clinical Journal of Oncology Nursing article: Optimizing Transitions of Care in Multiple Myeloma Immunotherapy: Nurse Roles Oncology Nursing Forum articles: Changes in Health-Related Quality of Life During Multiple Myeloma Treatment: A Qualitative Interview Study Facilitators of Multiple Myeloma Treatment: A Qualitative Study ONS book: Multiple Myeloma: A Textbook for Nurses (third edition) ONS Symptom Intervention resource: Peripheral Neuropathy Risk Evaluation and Mitigation Strategies (REMS) Lenalidomide Pomalidomide Thalidomide International Myeloma Foundation: Using Immune Therapy to Fight Multiple Myeloma International Myeloma Society Multiple Myeloma Research Foundation: Treatments for Multiple Myeloma To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "We definitely want the diagnosis of multiple myeloma before initiating these drugs. We're going to look at serum protein electrophoresis. We want to make sure that we know the patient has serum free light chains and myeloma proteins to really confirm their disease. Plus, a bone marrow biopsy." TS 7:21 "Each immunomodulator has slightly different side effects. Thalidomide's biggest side effects are constipation, weakness, fatigue, somnolence, peripheral neuropathy, mood swings, hand tremors, and depression. With each generation, less of the side effects actually occurred. Most of lenalidomide's side effects, not discounting the deep vein thrombosis, are pancytopenia—the neutropenia, the anemia, and the thrombocytopenia. [The side effects] are very similar in pomalidomide." TS 15:40 "The REMS program is critical for oral immunomodulator therapies—thalidomide, pomalidomide, and lenalidomide. It was developed due to the risk of developing embryofetal toxicities. ... It is mandatory testing and counseling, so all females of reproductive potential must have two negative pregnancy tests prior to starting the therapy and then monthly pregnancy tests while on the therapy alone. Again, they must use two forms of effective contraceptives or abstain from heterosexual sex four weeks prior, during, and after. And the same thing for men. I focus on that because males may say, 'I have a vasectomy.' These therapies tend to bind to the semen. So, males must still use a latex or synthetic condom during any sexual contact with a female of reproductive potential, even if they did have a vasectomy." TS 18:31 "The capsule itself cannot be chewed, crushed, or opened. I bring that up because as healthcare professionals, we have educated our patients. If it's difficult to swallow capsules or tablets, we've always said to them, 'Oh, don't worry, just crush it into applesauce or open it up and sprinkle it on your mashed potatoes.' But because of this embryofetal toxicity, I advise my patients not to open the capsule. If they can't swallow it for any reason, they have a sore throat or they're just unable to, then [we tell them] to hold the therapy and then call us." TS 22:49 "We spoke about three generations already, but there's actually a fourth generation [of immunomodulators]. They're called cereblon E3 ligase modulators(CELMoDs). They're still in clinical trials but really showing promise in the therapy of myeloma. They're showing very good affinity to cereblons, just like the immunomodulators do. I think, in all cancer therapies, as newer generations come out or newer therapies move forward, some of the older generations might move aside, but they get integrated later on. So I don't think [immunomodulators] will disappear totally, but they will probably be modified." TS 36:39

Vergeet de maanlanding en de uitvinding van elektriciteit. Volgens Infantino is dit de grootste gebeurtenis in de geschiedenis van de mensheid. Naast het WK voetbal bedoelde Gianni ook zeer waarschijnlijk het WK-fé van De Derde Helft. Iedere vrijdag stijgt de Oranjekoorts in deze studio namelijk naar ongezonde hoogte. Ook wij gaan starten. Welkom bij het eerste WK-fé van 2026, met als eerste gast Humberto Tan.

Haut um Freiden ass den Asyl- a Migratiounspakt vun der EU a Kraaft getrueden. Esou just nach mat Zäit goufen déi entspriechend Gesetzer an der Chamber gestëmmt. Op Flüchtlingen, déi zu Lëtzebuerg Asyl ufroen, kommen domadder eng ganz Rëtsch Nodeeler duer, obwuel et och e puer punktuell Verbesserunge gëtt. Am Podcast erkläert d’woxx-Journalistin María Elorza Saralegui wat sech konkret ännert, wisou et vill Onsécherheete gëtt a wisou méi séier Asylprozeduren net méi Fairness fir d’Asyldemandeure bedeit. D’Artikelen, iwwert déi mir geschwat hunn: Pacte sur la migration et l'asile : Coups d'avance & EU-Migrationspakt tritt in Kraft: Wettlauf der SchäbigkeitenThe post Wat bedeit den Asyl- a Migratiounspakt fir Lëtzebuerg? first appeared on Radio ARA.

Hoewel die verlaging van die dieselprys verlede week ʼn bietjie verligting bied vir sommige huishoudings en sektore moet mens nie onderskat dat die gevolge April en Meimaand se brandstofprysskokke nog vir ʼn tydlank met ons gaan wees nie. Ekonome se groot bekommernis is dat dit tot meer algemene prysstygings sal lei en rentekoerse verder verhoog kan word. Dit sit huishoudings verder onder druk, maar hoe reageer hulle? Ons praat van ʼn substitusie-effek.

Send us Fan MailSpreuke 29:2 As 'n gelowige die mag oorneem, juig die mense. As slegte mense aan bewind kom, kla die volk. (DB) Dis deesdae moeilik om te weet watter nuus om te glo, nie waar nie? Baie van die inhoud van die media, wat voorheen hoofsaaklik betroubare joernalistiek weerspieël het, het in opruiende propaganda verval. Om dit net erger te maak, word ons gebombardeer deur die sosiale media-algoritmes wat baie mense in ‘n draaikolk van samesweringsteorieë intrek.Tydens die Rwandese volksmoord van 1994 het die media 'n verwoestende rol gespeel in die aanhitsing en versterking van die geweld. Die staatsgesteunde radio, televisie en gedrukte media het haatpropaganda uitgesaai en gedruk. Tutsi's is as "kakkerlakke" bestempel en daar is openlik gesê hulle moet vernietig word.Daardeur is aanvalle gekoördineer, wegkruipplekke onthul en gewone burgers aangemoedig om die vyand dood te maak. Eerder as om inligting te gee, het die media aktief volksmoord aangevuur en woorde in wapens omskep. Mense het die media geglo en daarop gereageer. Dit het byna 'n miljoen lewens in net 100 dae gekos. Dit is wat gebeur wanneer die skrikwekkende krag van propaganda sonder morele beperking gebruik word. Drie millennia gelede het Salomo die volgende geskryf:Spreuke 29:2 As 'n gelowige die mag oorneem, juig die mense. As slegte mense aan bewind kom, kla die volk. (DB)Daar word gesê dat die mense gewoonlik die regerings kry wat hulle verdien. Ek weet nie, maar watter regeringstelsel jy ook al onder leef, wees versigtig; wees baie versigtig oor wie jy ondersteun; wat jy kies om te glo, of te verwerp; en wat jy kies om te sê.Wat is ons plig? Ons werk is om die regverdiges te help om gesag te kry sodat die mense bly kan wees ... nie om blindelings die propaganda wat ons nuus en sosiale media vir ons opdis, te glo en na te boots nie.Dis God se Woord. Vars ... vir jou ... vandag.Support the showEnjoying The Content?For the price of a cup of coffee each month, you can enable Christianityworks to reach 10,000+ people with a message about the love of Jesus!DONATE R50 MONTHLY

11 Junie 2026: 60 Spookwerkers ontmasker in die Department van Openbare Werke en Infrastruktuur. Die gaping tussen werkloses en dié wat werk het, word al hoe kleiner. Ons praat met 'n sokkerkenner oor Bafana Bafana se kanse in die Wêreldbeker-toernooi.

10 Junie 2026: Die Staatsdienskommissie sê die ANC se studiegroepe in die parlement is problematies. Ons praat met werkgewers oor die regering se plan om maatskappye oor ongedokumenteerde buitelandse werkers vas te vat. Nuwe navorsing toon dat 77% van diabete ook aan angs en depressie ly.

Send us Fan MailMatteus 16:13-16 Toe Jesus in die streke van Sesarea-Filippi kom, het Hy vir sy dissipels gevra: “Wie, sê die mense, is die Seun van die mens?” Hulle antwoord: “Party sê Johannes die Doper, party Elia, party Jeremia of een van die profete.” “Maar julle,” het Hy gevra, “wie, sê julle, is Ek?” Simon Petrus het geantwoord: “U is die Christus, die Seun van die lewende God.” Ons sien deesdae hoe oneerlike en onbetroubare verslaggewers dikwels bekende mense se karakters in die media wanvoorstel. Ons word blootgestel aan glanspersone se openbare beeld. Poets hulle sy beeld, of bestempel hulle hom as die grootste skarminkel bekend? Maar dan is daar die werklike persoon, wat waarskynlik net ‘n gewone mens soos ek en jy is. Dit is geensins 'n nuwe probleem nie. Jesus het op sy dag, ‘n groot opskudding veroorsaak. Mense was verward. Hulle kon nie vir hulself besluit wie Hy werklik was nie.Matteus 16:13-16 Toe Jesus in die streke van Sesarea-Filippi kom, het Hy vir sy dissipels gevra: “Wie, sê die mense, is die Seun van die mens?” Hulle antwoord: “Party sê Johannes die Doper, party Elia, party Jeremia of een van die profete.” “Maar julle,” het Hy gevra, “wie, sê julle, is Ek?” Simon Petrus het geantwoord: “U is die Christus, die Seun van die lewende God.”Sesarea Filippi was 'n heidense streek bekend vir sy aanbidding van 'n hele aantal gode. Dit gee ons konteks vir die agterdog van die mense. Hulle was gewoond aan die afgode en die heidense Romeinse heerskappy rondom hulle. Die Jode het ‘n Messias verwag. Hulle ‘n profeet verwag, wat hulle uit hulle vreeslike omstandighede gaan bevry. Ander mense het Jesus gesien as ‘n opstoker; ander as ‘n wonderwerker. Maar Jesus vra sy dissipels vir hulle persoonlike oortuigings.Wanneer Petrus sonder huiwering sê - “U is die Christus, die Seun van die lewende God”- is dit nie ‘n bloot intellektuele antwoord nie. Soos Jesus self later bevestig, is dit ‘n Gees-geopenbaarde waarheid. Ware geloof is 'n geskenk en 'n openbaring. In vandag se kultuur van botsende opinies en valse gode in ‘n wêreld van vervalle moraliteit en steeds groeiende verdeeldheid, word ware geloof gebou op hierdie belydenis: dat Jesus die Verlosser van die wêreld is. Die enigste Verlosser van die wêreld is.Dis God se Woord. Vars … vir jou … vandag.Support the showEnjoying The Content?For the price of a cup of coffee each month, you can enable Christianityworks to reach 10,000+ people with a message about the love of Jesus!DONATE R50 MONTHLY

Ben is in de Keuken Haikus aan het pellen, Nigel geraakt amper uit zijn seniorenslaap. Maar ze zijn er! Ons helden van de podcastwereld.

Send us Fan MailPsalm 56:9,10 U het my ellende raakgesien. U het my trane opgevang. U het dit opgeskryf in u boek. Die dag dat ek na U roep om hulp, val my vyande terug. Dat God aan my kant is, weet ek beslis. (NLV) Volgens opnames bid tussen die helfte en driekwart van alle mense in tye van persoonlike krisis - of hulle nou gelowiges is of nie. Wat sê dit vir jou?Gebed is vir my goud werd. Ek het al self te veel kragtige antwoorde op gebed gehad, om te wag totdat ek 'n krisis beleef, voordat ek bid - om nie eens te praat van die vrede en vreugde wat ek ervaar wanneer ek met die Here praat nie.Van tyd tot tyd beleef ons almal krisisse wat ons in ons broek laat bewe; wat ons harte breek en bitter trane laat stort. Maar te midde van teëspoed, het ek en so baie ander mense wat werklik ons vertroue in Jesus gestel het, gevind, dat ons te midde van die dreigende storm 'n wonderlike vrede beleef. Ons word oorweldig met die vaste wete dat God met ons is. Hier is Dawid se gebed in:Psalm 56:9,10 U het my ellende raakgesien. U het my trane opgevang. U het dit opgeskryf in u boek. Die dag dat ek na U roep om hulp, val my vyande terug. Dat God aan my kant is, weet ek beslis. (NLV)Die bekende prediker, Charles Spurgeon, het diep lyding en depressie geken, en tog het hy vurig aan God vasgeklou: “Ek het geleer,” het hy gesê, “om die golf te soen wat my teen die Rots van die Eeue gooi.” Ons vertaal dit as “kus die roede.” Dit beteken om pynlike beproewinge (die golwe) te omhels, want dit dwing jou om op Christus (die Rots van die Eeue) te vertrou, en krag in God te vind, eerder as om omstandighede te weerstaan.Spurgeon ontken nie die golf nie - die pyn en die trane nie -maar hy sien in daardie einste lyding die Hand van 'n getroue God wat Hom nader trek. Dit maak nie saak wat jou omstandighede, jou trane, en jou pyn is nie … God is met jou!Dis Sy Woord. Vars … vir jou … vandag.Support the showEnjoying The Content?For the price of a cup of coffee each month, you can enable Christianityworks to reach 10,000+ people with a message about the love of Jesus!DONATE R50 MONTHLY

NESTA EDIÇÃO. ONS aciona plano excepcional para evitar que excesso da geração comprometa a estabilidade do sistema elétrico. Copa do Mundo traz desafios adicionais para a operação. Opep+ relaxa cortes de produção. Raízen vende operações de refino, distribuição e venda de combustível na Argentina. ***Locução gerada por IA

8 Junie 2026: Ons ontleed die president se plan oor die xenofobiese drukpot. Kommer oor die groot getal polisiewapens wat in misdadigers se hande beland. Fitch het Suid-Afrika opgradeer - 'n ekonoom verduidelik watter voordele dit vir die land inhou.

Waarom vinden we het zo moeilijk om kwetsbaar te zijn? Wat kost het ons als we altijd de sterke willen uithangen? En hoe bouwen we opnieuw aan echte verbinding in een wereld die ons permanent overbevraagt? Jef Willem, host van Onbespreekbaar, een van de grootste Belgische podcasts. Samen met zijn beste vriend Nicolas Vermeiren bespreekt hij wat… onbespreekbaar lijkt. Jef schrijft boeken, geeft keynotes en praat al vijf jaar over de onderwerpen die we liever niet aansnijden: falen, eenzaamheid, kwetsbaarheid en mentale gezondheid. Volgens Jef is er een kloof tussen wie we lijken te zijn en wie we werkelijk zijn. Als dj, ondernemer en ouder zet hij ook dagelijks verschillende maskers op. Dat doen we allemaal. Hij vertelt ook over waarom we hulp willen ontvangen maar niet durven te vragen.  Wat blijft er over van onze identiteit als je alle titels, successen en ondernemingen wegneemt? De inzichten van Jef zijn voor iedereen die soms het gevoel heeft dat ze een les in gewoon mens zijn hebben overgeslagen.  Met veel dank aan onze partners: Deze podcast wordt mede mogelijk gemaakt door Koffie Kàn, voor als jij ook koffie nodig hebt om alle ballen in de lucht te houden. Klaar om jouw eigen stem te laten horen? Wij helpen experts zoals jij te groeien via podcasting. Ontdek hoe bij 50 Koffies Producties. Gekleed door Xandres, want stijl hoort er gewoon bij. Prachtige juwelen door Maudart voor die extra sparkle. Jouw mentale welzijn als ondernemer doet ertoe. Doe gratis een beroep op hulp via Acerta, onze trotse partner van het derde seizoen. Hier vind je meer info over hun welzijnsaanbod.  Ga via de tijdcodes hieronder naar een thema van deze aflevering(00:00:00) Introductie: hoe kwetsbaar zijn Jana en Nadia? (00:02:03) Wat was de zwaarste periode voor jouw mentale gezondheid? (00:03:53) Waar schaam jij je voor en heb je nog nooit hardop gezegd? (00:07:08) Introductie van Jef en de podcast Onbespreekbaar. (00:09:48) Waarom gaat het slechter, terwijl we meer praten over mentale gezondheid? (00:12:01) Identiteit in een geïndividualiseerde samenleving. (00:16:53) Wanneer stond Jef's mentale gezondheid het zwaarst onder druk? (00:18:50) De weg terug: van de Boiler Room op Pukkelpop naar de psycholoog. (00:21:25) Waarom mannen minder snel hulp zoeken dan vrouwen. (00:24:32) Waar worstelen we het meeste mee? (00:25:57) Controle willen in een oncontroleerbare wereld. (00:27:43) Burn-out als individueel probleem of als symptoom van een ziek systeem? (00:29:20) Imperfectie als het cement van echte verbinding. (00:33:22) Waarom we wel connectie willen maar geen kwetsbaarheid. (00:39:02) Waarom vinden we het zo moeilijk om kwetsbaar te zijn? (00:46:51) Wie ben je zonder je bedrijf, je dj-set of je boek? (00:54:20) De bijenkorf-metafoor: individu versus gemeenschap. (00:59:22) Externe validatie versus erbij horen. (01:06:20) Ons brein als rookmelder: de amygdala en het stresssysteem. (01:09:08) Einde van de aflevering.

Ons soek God dikwels in groot gebeurtenisse, terwyl Hy reeds teenwoordig is in die gewone ritme van elke dag.

Ek was onlangs deel van ʼn span veldwerkers wat met dagloners en straatkosverkopers gesels het. Ons het ook ʼn fotograaf op die span gehad en een van die skote wat hy wou kry is ʼn handvol kleingeld. Groot was ons verbasing dat kontant baie skaars is en die kiosk met kota's langs die groot pad in die nywerheidsgebied verkies dat jy met jou kaart of foon betaal. Dit gaan natuurlik oor die misdaadgevare van omkontant by jou te hê, maar daar is ʼn groter storie.

Births in England and Wales have fallen again, for the fourth record-low year in a row, and the numbers are not exactly whispering. They are standing in the kitchen at midnight, holding a mug of tea, saying, “We may have a problem here.”In this episode of Mark and Pete, we look at the dramatic fall in the birth rate, the latest ONS figures, and what they reveal about family, fertility, money, housing, culture, marriage, and the strange modern habit of treating children as both priceless blessings and impossible luxury goods.England and Wales recorded 585,396 live births in 2025, down from 594,677 in 2024. The total fertility rate fell to around 1.39 children per woman, far below the usual replacement level of about 2.1. Back in 1970, there were 784,486 live births and the fertility rate was around 2.40. In plain English, we are having far fewer babies than we used to, and not by a polite little margin either.We also discuss the wider fertility picture, including studies suggesting sperm counts may have fallen sharply since the 1970s. That does not prove the birth-rate collapse is biological, and no, we are not about to blame the entire thing on plastic bottles and sad sandwiches. But it does suggest the story may be deeper than lifestyle choice alone.So why are people having fewer children? Is it housing? Childcare costs? Delayed marriage? Economic anxiety? Cultural exhaustion? A loss of hope? Or simply the fact that modern life appears to have been designed by a committee of accountants who once saw a family from a distance?From a Christian perspective, children are not merely demographic units. They are gifts, blessings, futures, interruptions, joys, terrors, and little walking reminders that life is meant to continue.A sharp, thoughtful and sardonic look at Britain's falling birth rate, fertility decline, family life, and what happens when a nation quietly stops expecting tomorrow.

Het Nederlands elftal trainde vrijdag voor het eerst op Amerikaanse bodem. Ons team was erbij en in de AD Voetbalpodcast praten Etienne Verhoeff en Maarten Wijffels je vanuit New York bij over Oranje en de WK-sfeer in de Verenigde Staten. Ook het overlijden van voormalig teammanager Hans Jorritsma komt aan bod. Verder praten ze over outsider Noorwegen, de man van 150 miljoen en de fout van Marc van Hintum bij Go Ahead Eagles. De technisch directeur stuurde de vertrekkende trainer Melvin Boel per abuis de lijst met mogelijke opvolgers via WhatsApp. Beluister de AD Voetbalpodcast via AD.nl, de AD App of jouw favoriete podcastplatform. Bestel het boek De vraag van Vandaag hier: https://webwinkel.ad.nl/product/de-vraag-van-vandaagSupport the show: https://krant.nl/See omnystudio.com/listener for privacy information.

Vandag saam met SG Ons gee vandag ‘n volgende tree op die spoor van die Gees se beweging in die boek Handelinge. Wanneer jy jou Bybel sou oopmaak daar in die begin van Handelinge dan sal jy sien daar staan “Die Handelinge van die apostels”. Tog, as jy Handelinge lees, kom jy agter dat dit eintlik Die Handelinge van die Gees is en die apostels (gestuurdes) en die kerk moet die heeltyd skarrel om by te bly by die uitkringende beweging van die Gees. Ons het sover gesien: Die Gees gee, vorm, stuur… Die Gees gee (Homself soos Jesus, gee krag, insig, gawes…), die Gees vorm (individue & die kerk), die Gees stuur (soos André so mooi gesê het, na elke plek waar ons reeds is maar Hy stuur ons op 'n nuwe manier daarheen). Vandag ontdek ons “Die Gees verruim” … Luister hier na die klankopname of op die potgooi-platform van jou keuse. . . Of kyk hier saam:

"Radiation therapy is often extremely well tolerated in colorectal cancer. Technology has really changed things. But location of the tumor can affect side effects, such as radiation dermatitis. If a patient has a low-lying tumor, if it's less than six centimeters from the anal verge, the patient is likely to have some skin reaction. It's good to be proactive if that's the case," ONS member Lorraine Drapek, DNP, FNP-BC, AOCNP®, nurse practitioner in the Department of Radiation Oncology at Massachusetts General Hospital in Boston, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about radiation side effects in colorectal cancer. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by June 5, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to the side effects of radiation to treat colorectal cancer. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Episode 374: Colorectal Cancer Treatment Considerations for Nurses Episode 301: Radiation Oncology: Side Effect and Care Coordination Best Practices Episode 194: Sex Is a Component of Patient-Centered Care ONS Voice articles: Frank Conversations Enhance Sexual and Reproductive Health Support During Cancer High-Fiber Diet Reduces Diarrhea in Colorectal Cancer Survivors Hyperbaric Oxygen Therapy Shows Promise for Certain Radiation Side Effects Increasing Incidence of Colorectal Cancer in Younger Adults Is a Call to Action for Oncology Nurses Oncology Drug Reference Sheet: 5-Fluorouracil Oncology Drug Reference Sheet: Oxaliplatin Oncology Nurses Are Key in Sexual Health Conversations With Minority Women Sexual Considerations for Patients With Cancer The Intersection of Pelvic Health and Oncology Optimizes Sexual Symptom Management ONS book: Manual for Radiation Oncology Nursing Practice and Education (fifth edition) ONS courses: ONS/ONCC® Radiation Therapy Certificate™ ONS ROCN™ Certification Review™ Clinical Journal of Oncology Nursing articles: Sexual Dysfunction: Common Side Effect Updated Interventions for Radiation-Induced Diarrhea: Putting Evidence Into Practice With the Oncology Nursing Society Physical Activity: A Systematic Review to Inform Nurse Recommendations During Treatment for Colorectal Cancer ONS Learning Libraries: Colorectal Cancer Radiation Advanced Practitioner Society for Hematology and Oncology American Society for Radiation Oncology American Society of Clinical Oncology Clinical Practice Guidelines Colontown Colorectal Cancer Alliance To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "In recent years, there has been more nonsurgical management of rectal cancer, especially in what we call the low-lying population. This is the population of patients who would likely end up with a permanent colostomy because their cancer is so low in terms of being close to or involving the anal verge. There is now a regimen where these patients can get their chemotherapy followed by their chemoradiation and then be monitored on close surveillance without surgery." TS 2:23 "Another assessment would be to assess what effects have they had from their chemotherapy that they're bringing with them. FOLFOX-based treatment is commonly used, and the platinum therapy oxaliplatin often causes peripheral neuropathy. What is the patient having? What are those symptoms like? Are they having peripheral neuropathy? If they are that is likely not going to get better or improve during their whole course of radiation. In fact, sometimes when oxaliplatin therapy stops, the peripheral neuropathy can get worse as patients are going through other treatments." TS 5:42 "If the patient has a low-lying tumor, if it's less than six centimeters from the anal verge, the patient is likely to have some skin reaction. It's good to be proactive if that's the case. And then proactively minimizing radiation dermatitis effects, such as keeping the area clean, good washing of the area, and prophylactically starting them on or having someone start them on steroid creams a couple of times a day to minimize that radiation dermatitis effect in the long run." TS 7:25 "I have a sexual health clinic for women with these effects. It's very important as nurses that if you can develop the comfort to ask patients about their sexual activity—it's hard, but it really needs to be done. And I will tell you that the healthcare providers are not doing it. They don't have time, and like us as nurses, we don't get this in school, and neither do they. The other providers don't get it in school either, but it's important. Patients are getting more and more worried about their sexual health. They're coming to us at a younger age, and this is really, really important to address." TS 15:35 "I would say that working with your advanced practice providers and education for advanced practice providers has definitely been focusing on [sexual health] more. Your PAs and your NPs—I think they're going to have the ears and the wherewithal to be able to be your allies and colleagues in this. By and large, it's my APP colleagues and nursing that I talk to the most about this. … Again, it's not an easy thing to bring forward, having dilators in place. But I will tell you in the department that I work in, it was me and couple of nurses who pushed this issue with the physicians for two years and finally got it put in place. It can be done. There's a lot more centers out there doing that." TS 21:51

We hebben in deze wereld te maken met diepe pijn en verlies, maar daarin wordt de vraag zichtbaar: waar is onze hoop eigenlijk op gebaseerd? De Bijbel laat zien dat er twee soorten hoop zijn: een tijdelijke hoop die zich richt op dit leven, en een hemelse hoop die eeuwig, zeker en verankerd is in Christus. Ons leven hier op aarde is kort in vergelijking met de eeuwigheid, en daarom worden we uitgedaagd om niet alleen voor het zichtbare nu te leven, maar voor wat blijft. Wie deze hemelse hoop werkelijk omarmt, leeft anders: met focus, toewijding en vertrouwen, ook midden in een wereld die vaak een andere richting opgaat. Uiteindelijk draait het om deze vraag: leef je voor het kleine stukje nu, of voor de eeuwigheid die komt?

In deze aflevering deel ik samen met mijn vrouw Margriet ons eigen verhaal: het begin van het pad naar de geboorte van onze dochter Sofia. Dit is deel 1 van 3, en gaat helemaal over hoe het allemaal begon: de weg naar zwanger worden.Margriet blikt terug op haar drie snelle thuisbevallingen en vertelt eerlijk hoe haar verwachtingen haar beleving kleurden. Tussen haar eerste en tweede bevalling deed ze een doula-opleiding en stapte ze later de geboortezorg in. Dat is waar wij elkaar leerden kennen.Ik vertel over mijn sterke kinderwens, en hoe we samen de grote vragen bespraken: wie van ons zou zwanger worden, en hoe zouden we aan een donor komen? Ik neem je mee in onze zoektocht: van een teleurstellende ervaring met een online donor (en de rode vlaggen die we onderweg tegenkwamen), naar het inschrijven bij een Nederlandse donorbank, tot we uiteindelijk via een platform een donor vonden met open communicatie en een betrokken partner. Na drie cycli thuisinseminatie was het in maart zover: ik was zwanger.Ons eigen eerlijke en kwetsbare verhaal over onze kinderwens, donorkeuze en zwanger worden als vrouw-vrouw koppel. In deel 2 en 3 hoor je hoe de zwangerschap en de bevalling verliepen.Wil je meer weten over hoe het nu gaat? Volg me dan op instagram @medisienWil je meer weten over mijn aanbod? Neem dan een kijkje op www.medisien.nl

Send us Fan MailSpreuke 2:3-6 indien jy na insig in die alledaagse lewe smag en meer kennis begeer oor hoe om te leef, indien jy heeltyd hierna soek soos 'n mens na kosbare silwer of na skatte soek, sal jy die Here se liefde begin verstaan. Jy sal weet hoe om wys en gelukkig te leef. Onthou egter net een saak: wysheid om reg te leef kom net van die Here af. Kennis en insig is net by Hom te kry. (DB) Wanneer ons by die punt kom waar ons glo dat ons alles weet, is daar een ding seker: ons is regtig te onnosel om te weet wat ons nie weet nie! Ons is so verblind deur ons eie opgeblase sin van ons eie slimmigheid, dat ons blind is vir die feit dat ons minder as niks weet nie. En kom ons wees eerlik, ons is almal al deur so ‘n vernederende proses.Die meeste van ons het daardie een ding waarin ons regtig uitblink; daardie een ding waarin ons beter is as die meeste mense rondom ons. Miskien is jy een van daardie mense wat, anders as ek, intuïtief aanvoel hoe ander voel? Dit is dus maklik vir jou om minagtend na iemand anders te kyk wat nie dieselfde talent as jy het nie en te dink: Wat is fout met hom? Ek is soveel beter as hy!Ek kan so vinnig soos die wind skryf. Ek kan komplekse idees bymekaarbring en dit op 'n eenvoudige maar boeiende manier verduidelik. Hoe maklik is dit dan nie vir my, om met my neus in die lug na ander te kyk wat sukkel om vlot te skryf?Wanneer ons so optree, vertroebel ons trots ons oordeel en ons weet mos hoogmoed kom tot ‘n val. So, hier is God se alternatief:Spreuke 2:3-6 ...indien jy na insig in die alledaagse lewe smag en meer kennis begeer oor hoe om te leef, indien jy heeltyd hierna soek soos 'n mens na kosbare silwer of na skatte soek, sal jy die Here se liefde begin verstaan. Jy sal weet hoe om wys en gelukkig te leef. Onthou egter net een saak: wysheid om reg te leef kom net van die Here af. Kennis en insig is net by Hom te kry. (DB)Slim mense gee slim antwoorde, maar wyse mense vra slim vrae. Hulle is nederig, hulle is leerbaar, en dit is presies wat God van ons verwag. Vra Hom om vir jou kennis en wysheid te gee.Dis Sy Woord. Vars ... vir jou ... vandag.Support the showEnjoying The Content?For the price of a cup of coffee each month, you can enable Christianityworks to reach 10,000+ people with a message about the love of Jesus!DONATE R50 MONTHLY

4 Junie 2026: Samewerking tussen Suid-Afrika en Mosambiek was die sleutel tot die inhegtenisneming van twee verdagtes vir die moord op 'n egpaar in die Krugerwildtuin. Uitleweringsprosedures begin nou sodat hulle hier tereg kan staan. Johannesburg se finansies word as 'n 'gruwelvertoning' beskryf. Ons hoor wat die jongste in die Kougastreek is waar sekere inwoners gevra is om te ontrium weens oorstromings. Die March and March-beweging wat teen ongedokumenteerde buitelanders betoog, se beweegredes word krities bekyk.

Hierdie week gesels Jean-Louis met Anette Rheeder oor die Winter Wenner, A.Vogel Echinaforce. Ons kyk na wat hierdie produk so uniek maak en waarom die werking daarvan so doeltreffend is. A.Vogel Echinaforce is beskikbaar op die rak in jou naaste apteek. Vir meer inligting of navrae kan jy ons per e-pos kontak by info@sanatural.co.za.

Send us Fan MailDaniël 3:17-18 Ons het ons God vir wie ons dien. Hy het die mag om ons te red uit die brandende oond, en Hy sal ons ook red uit u mag. Selfs as Hy dit nie doen nie, moet u weet dat ons u god nie sal dien nie, die goue beeld wat u laat oprig het, nie sal aanbid nie.” In tye van uiterse teëspoed moet ons elkeen besluit: Sal ek aanhou om op God te vertrou ... of moet ek maar opgee? En, laat ons dit duidelik stel, dis een van die moeilikste besluite wat jy ooit sal moet neem. Die skrywer, ‘n opregte gelowige, John White, vertel hoe hy, sy vrou en baba seuntjie, van die VSA na Bolivia moes vlieg. Hy moes, as gevolg van ander verpligtinge, ‘n later vlug haal. Hy het 'n nare voorgevoel gehad dat sy gesin tydens die vlug as gevolg van ‘n vliegtuigongeluk gaan sterf; maar hy het dit nie met sy vrou bespreek nie. Nadat sy gesin opgestyg het, het hy gevoelens van vrees, skaamte, skuld en naarheid ervaar. Bewend het hy gebid. En God het hom geantwoord deur te vra: Wat is fout? Kan jy my nie vertrou nie? Ja, ek sal U vertrou as U hulle veilig aan my teruggee.En as ek hulle nie teruggee nie, sal jy ophou om my te vertrou? Kan jy hulle nie aan my toevertrou in die dood sowel as die lewe nie?In geloof het White geantwoord: Ek sal u wil doen; wat dit vir my, of vir hulle, ook al mag kos. Ek sal U vertrou. Hulle vliegtuig het inderdaad neergestort en almal aan boord is dood. Maar sy vrou het ook 'n ongerustheid in haar hart gehad en besluit om haar vlug te onderbreek. Sy was nie op die laaste been van die vlug aan boord toe die tragedie plaasgevind het nie. Na die tyd het John gesê: Ek sou getreur het indien hulle dood was. Maar ek sou nie spyt gewees het oor my besluit om ten volle op Christus te vertrou nie.Kyk wat Sadrag, Mesag en Abednego vir koning Nebukadnesar gesê het:Daniël 3:17-18 Ons het ons God vir wie ons dien. Hy het die mag om ons te red uit die brandende oond, en Hy sal ons ook red uit u mag. Selfs as Hy dit nie doen nie, moet u weet dat ons u god nie sal dien nie, die goue beeld wat u laat oprig het, nie sal aanbid nie.My vriend, vertrou op God .. in jou donkerste uur; selfs al hang die uitkoms in die weegskaal; selfs al gebeur die ergste. Vertrou op God. Dis Sy Woord. Vars ... vir jou ... vandag. Support the showEnjoying The Content?For the price of a cup of coffee each month, you can enable Christianityworks to reach 10,000+ people with a message about the love of Jesus!DONATE R50 MONTHLY

Send us Fan MailGoeiemôre aan al ons VARS-vriende. Ek is Jokkie Gauché en hier is VARSVANDAG se Eerste Nuusbrief vir die Junie. Ag nee, hier kom dit! Hulle vra seker vir geld...  Vandag is 'n bietjie anders. Ons wil jou vandag uitnooi na 'n dieper vennootskap met die VARS-familie — 'n vennootskap waar jou gebede, bemoediging en ondersteuning help om die hoop van Jesus elke dag oor die luggolwe te dra. Hierdie bediening word nie deur een stem alleen gebou nie.  In 1 Korintiërs 3:6-7 lees ons:Ek het geplant, Apollos het natgegooi, maar dit is God wat laat groei het. Elkeen van ons het 'n rol om te speel. Sommige plant, sommige gooi nat, sommige bid, sommige bemoedig, en sommige gee - maar uiteindelik is dit God wat die transformasie in mense se harte teweegbring. Deur die radio en media het ons die voorreg om die Evangelie te deel met mense wat dalk nooit by 'n kerk sal instap nie, maar wat die hoop, bemoediging en waarheid van God se Woord desperaat nodig het. Ons het onlangs hierdie boodskap van 'n lojale luisteraar ontvang: “Ek het my werk verloor en ontvang net 'n pensioen. Ek kan nie met 'n finansiële bydrae help nie, maar ek sal voortgaan om te bid vir seën en uitbreiding van VARS.”  Wat 'n pragtige herinnering dat hierdie vennootskap nie slegs finansieel gemeet word nie. Gebed is kragtig. Bemoediging maak ‘n verskil. Getrouheid is deurslaggewend. Ons is opgewonde om Bianca De Sousa by die VARS-familie te verwelkom. Bianca sluit by ons aan om ons verhoudings met radiostasies uit te bou en nog meer luisteraars met Jesus se boodskap te bereik. Bid asseblief saam vir die Here Jesus se wysheid, krag en guns oor haar lewe en hierdie nuwe taak. Wil Jy 'n Vennoot van VARS Word? As die Here dit op jou hart lê om die bediening finansieel te ondersteun; sal jou bydrae ons help om voort te gaan om inspirerende, praktiese Bybelwaarhede oor die luggolwe te deel. Ons bankbesonderhede verskyn hieronder. Ons wil jou veral bedank vir jou getroue gebede en bemoediging. Dit is 'n voorreg om hierdie reis saam met jou aan te pak. Saam dra ons die hoop van Jesus oor die luggolwe, een luisteraar op 'n slag. Seënwense en mooi loopVan Jokkie, Annelie en die VARS-spanSupport the showEnjoying The Content?For the price of a cup of coffee each month, you can enable Christianityworks to reach 10,000+ people with a message about the love of Jesus!DONATE R50 MONTHLY

Ons martelaarschap getuigt van kracht,' vertelde een vervolgde christen. De vervolgde kerk heeft het zwaar. Evangelist Oscar Lohuis zet zich actief in voor vervolgde christenen en ziet het lijden dat daarbij komt kijken. Hij bezoekt verschillende landen om vervolgde christenen te ontmoeten. Daar hoort hij hun indrukwekkende verhalen, ziet hij de saamhorigheid onder gelovigen en ervaart hij de kracht van God tijdens hun samenkomsten.

Send us Fan Mail1 Petrus 4:10 God het aan elkeen van julle uitsonderlike talente gegee. Moenie dink dit is julle wat so goed is nie. Nee, dit is God wat eintlik so goed vir julle is. Daarom moet julle julle talente gebruik om ander te help. (DB) Weet jy hoekom ek van jou hou? Ek is mal oor die feit dat jy so anders as ek is. Jou motivering is heeltemal anders en jy het ander vermoëns wat in jou DNS ingebed is. Jy het ook unieke ervarings deurgemaak, wat jou gevorm het. Ongelukkig is daar baie mense wat hul gawes en hul vermoëns met ander vergelyk en hulself as minderwaardig beskou. Maar dis 'n groot fout!Tydens die Kubaanse Missielkrisis van 1962, was Vasily Arkhipov tweede in bevel op 'n Sowjet-duikboot gewapen met kernwapens. Omdat hulle geglo het dat die oorlog reeds uitgebreek het, het die bemanning alles gereed gekry om ‘n kernwapen te lanseer. Twee senior offisiere het dit goedgekeur - maar die Sowjet-protokol het drie vereis. Arkhipov was die enigste een wat geweier het. Hy het daarop aangedring om na die oppervlak te kom en op bevele te wag.Hy was nie die offisier met die hoogste rang aan boord nie, ook nie 'n politikus of wetenskaplike nie - net 'n gedissiplineerde vlootoffisier met die morele moed van sy oortuiging en die vermoë om kalm te bly onder druk. Sy selfbeheersing, wat deur sommige mense as ‘n swakheid beskou is en deur sy mede offisiere as vrees bestempel is, het die wêreld van vernietiging gered.1 Petrus 4:10 God het aan elkeen van julle uitsonderlike talente gegee. Moenie dink dit is julle wat so goed is nie. Nee, dit is God wat eintlik so goed vir julle is. Daarom moet julle julle talente gebruik om ander te help. (DB)Kom ons sê jy is Vasily in daardie duikboot. Die spanning loop hoog. Jou kaptein beveel jou om te gehoorsaam. Hoe belangrik beskou jy jou vermoë om op daardie oomblik kalm te bly? Jy het natuurlike gawes en vermoëns ontvang wat diegene rondom jou nie het nie. En die taak wat God jou gegee het, is om dit te gebruik; al is dit oënskynlik onbeduidend vir jou. Ons het jou nodig. Reik uit en gee dít, wat jy ontvang het, asseblief aan na die volgende persoon!Dis God se Woord. Vars ... vir jou ... vandag.Support the showEnjoying The Content?For the price of a cup of coffee each month, you can enable Christianityworks to reach 10,000+ people with a message about the love of Jesus!DONATE R50 MONTHLY

Send us Fan MailHebreërs 9:27-28 'n Mens is bestem om net een maal te sterf, en daarna kom die oordeel. So is Christus ook net een maal geoffer om die sondes van baie weg te neem. As Hy die tweede keer verskyn, kom Hy nie in verband met sonde nie, maar om verlossing te bring vir dié wat Hom verwag. Hoe voel jy oor die bonatuurlike dimensie van die lewe? Bestaan daar so iets? Of is dit net 'n klomp outydse bygelowe, 'n onwelkome oorblyfsel van die Middeleeue? Wat dink jy?Wanneer ons na ons lewens kyk; lyk ons almal maar net na menslike wesens: Ons word gebore, ons word groot, ons gaan skool toe, ons doen wat ons nou doen, en eendag ... sal ons lewens op hierdie aarde tot 'n einde kom. Dis hoe dit gaan...Soos ons grootword, kom ons in aanraking met verskillende invloede. Kan jy dit as bonatuurlik bestempel? Ek dink nie so nie. Natuurlik het ons elkeen 'n morele raamwerk nodig waarvolgens ons kan leef ... sommige mense kies sekulêre humanisme, Boeddhisme, Islam, Sjinto ... en 'n hele paar mense kies Christenskap.Maar ons weet dat Christenskap nie net 'n morele raamwerk is om saam met die ander oor te debatteer nie. In sy kern gaan dit geheel en al oor ‘n bonatuurlike verlossing.Hebreërs 9:27-28 'n Mens is bestem om net een maal te sterf, en daarna kom die oordeel. So is Christus ook net een maal geoffer om die sondes van baie weg te neem. As Hy die tweede keer verskyn, kom Hy nie in verband met sonde nie, maar om verlossing te bring vir dié wat Hom verwag.Jesus is nie bloot 'n wyse ou profeet met goeie sedes nie. Hy is die Seun van God wat aan 'n kruis gesterf het om die prys vir ons sonde te betaal, sodat ons deur God vergewe kan word. En geen hoeveelheid goeie sedes sal jou ooit in die hemel kry nie. Die hemel is immers 'n bonatuurlike ryk wat 'n bonatuurlike sleutel vereis. Jesus is die sleutel.Dis God se Woord. Vars ... vir jou ... vandag. Support the showEnjoying The Content?For the price of a cup of coffee each month, you can enable Christianityworks to reach 10,000+ people with a message about the love of Jesus!DONATE R50 MONTHLY

"There are a lot of specifics that nurses need to keep in mind as they are administering this herpes simplex modified virus to patients because accidental exposure is of concern both to the patient, to their family members, as well as to healthcare workers. I always recommend nurses wear personal protective equipment, such as a gown, safety glasses, gloves, and/or a face shield," Heidi Finnes, PharmD, RPh, BCOP, director of clinical ambulatory practice at Mayo Clinic and assistant professor of pharmacy at Mayo Clinic Alix School of Medicine in Rochester, MN, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about oncolytic viral therapy.  Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by May 29, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge about the use of oncolytic viruses to treat cancer. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Pharmacology 101 series Episode 338: High-Volume Subcutaneous Injections: The Oncology Nurse's Role Episode 330: Stay Up to Date on Safe Handling of Hazardous Drugs Episode 273: Updates in Chemotherapy and Immunotherapy ONS Voice articles: Cutaneous Malignancies Have High Response to Oncolytic Virus Plus Immunotherapy Oncolytic Virus Kills Tumor Cells While Supporting T Cells What Nurses Need to Know About Talimogene Laherparepvec for Advanced Melanoma Clinical Journal of Oncology Nursing articles: Intralesional Therapy: Consensus Statements for Best Practices in Administration From the Melanoma Nursing Initiative Safe and Effective Standards of Care: Supporting the Administration of T-VEC for Patients With Advanced Melanoma in the Outpatient Oncology Setting Oncology Nursing Forum article: Administration and Handling of Talimogene Laherparepvec: An Intralesional Oncolytic Immunotherapy for Melanoma ONS book: Guide to Cancer Immunotherapy (second edition) ONS clinical practice resource: Safe Handling of Oncolytic Viruses ONS Huddle Card: Immunotherapy Association of Community Cancer Centers (ACCC) Drugs@FDA Hematology/Oncology Pharmacy Association (HOPA) Network for Collaborative Oncology Development and Advancement (NCODA) Patient Education Sheets To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "[Oncolytic viruses] can have direct lysis to the tumor cells themselves, or they can cause immunogenic activation. They release tumor-associated antigens and then proinflammatory signals, so think of T cells, natural killer cells, those sorts of things, that can convert to immunologically cold tumors. Those are tumors that are immune silenced into hot tumors which are now immune activated. By doing that, they recruit those T cells and other cells to the area to attack both the primary tumors. But that's also thought to be how they work on distant or noninjected sites as well. This immunomodulatory capacity has led to the reclassification of oncolytic viruses as a form of cancer immunotherapy. So, think of it kind of similarly to how we think of immune checkpoint inhibitors in recruiting immune cells and leaving our immune system in the on position. This is also kind of a form of immunotherapy." TS 4:35 "One of the toxicities I know that is of significant concern to patients, family members, and healthcare workers is the incidence of herpes infections. Systemic herpetic infections are extremely rare and usually more common in patients who may be immunocompromised. In patients who also have other immune-related diseases—such as vitiligo, vasculitis, pneumonitis, sometimes worsening psoriasis—because you're mounting an immune response with these types of things, sometimes you can see a worsening of those types of immune symptoms. But for the most part, these types of side effects are very well tolerated in most patients." TS 9:07 "Talimogene is generally transmitted via bodily fluids or touch. It's not airborne. Herpes simplex virus isn't an airborne type of virus. Another thing to consider is where are you going to inject this? Are you going to do this in your infusion therapy unit? Are you going to do it in a dedicated room? Who's going to escort the patient to the room? How is the virus going to arrive at the room? How will you clean the room and all of the laboratory equipment or any of the exam tables that may be in there? I think having all of that discussed and assigned mitigates the consternation that can sometimes occur—the fear that occurs with administering a virus that is thought to be fairly communicable." TS 15:44 "Helping patients understand how this works [is important] because hearing that you're receiving a virus, particularly a herpes simplex virus, can be scary to a patient. I think understanding that it's modified or essentially we're taking the parts out of it so that we can directly inject a portion that recruits immune cells to that area, because the goal is for the oncolytic virus to attack cancer cells and then destroy them by triggering an immune response in the body." TS 20:51 "Sometimes patients are very concerned about urine in the toilet, bodily fluids, kissing loved ones, holding hands, hugging, you know, am I going to infect my loved one because I'm getting this type of an oncolytic virus therapy? I like to reassure patients that they can continue to hold hands and hug their loved ones as normal. Viral DNA is usually only present on the injection site. And as I mentioned previously, we want to cover that injection site with an occlusive dressing, at least with talimogene, for up to seven days. And particularly, if those injection sites are at all oozing or weeping, active virus is usually only on that injection site itself." TS 24:14

Ons demonstratierecht is een belangrijk en kostbaar recht. Het is naast de vrijheid van meningsuiting een collectieve manier om als groep een bepaalde mening kenbaar te maken. Naast het rapport van de Nationale ombudsman, die stelt dat het demonstratierecht in ons land onder druk staat, debatteert de kamer binnenkort over een mogelijk algeheel verbod op gezichtsbedekkende kleding tijdens demonstraties, terwijl in een rapport van afgelopen jaar nog geconcludeerd werd dat wijzigingen van het demonstratierecht onnodig en ineffectief zullen zijn. Waarom wil het kabinet dit dan toch? En wat voor gevolgen heeft de inperking van ons demonstratierecht? Te gast: Rian de Jong, universitair hoofddocent Staatsrecht aan de Radboud Universiteit.

"When you have benign conditions, we're actually treating 3 gray, so a significant difference [versus doses of 60 gray for brain cancer]. Typically, when you treat at a high dose, the goal is to destroy tissue, like cancer tissue or cancer cells. But when we give a low dose, the goal is actually to modulate inflammation. And what it does is it slows down those inflammatory cells or those cells that release the chemicals that cause pain and inflammation," Amanda Meyer, DNP, APRN, CNP, family nurse practitioner in the Department of Radiation Oncology at the Mayo Clinic in Rochester, MN, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about radiation therapy for noncancer indications. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.25 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by May 22, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge about the use of radiation to treat noncancerous conditions. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Episode 365: Radiation-Associated Secondary Cancers Episode 301: Radiation Oncology: Side Effect and Care Coordination Best Practices ONS Voice articles: Augmented Reality Simulations Reduce Patient Anxiety by Teaching Them About Radiation Therapy Highly Localized, Precision Radiation Therapies Require Nurses to Drive Care Coordination, Patient Education Quick Quiz: Test Your Knowledge of Radiation Care Coordination ONS book: Manual for Radiation Oncology Nursing Practice and Education (fifth edition) ONS courses: ONS Radiation Oncology Conference Recordings Bundle™ ONS ROCN™ Certification Review™ Radiation Oncology 101: 2024 ONS Bridge™ Session ONS/ONCC® Radiation Therapy Certificate™ Clinical Journal of Oncology Nursing articles: Findings From the 2023 Radiation Oncology Nursing Role Delineation Study to Shape the Future of the Subspecialty The Role of Advanced Practice Providers in Radiation Oncology in 2025 ONS Huddle Cards: Radiation Radiobiology German Society for Radiation Oncology (DEGRO): Guidelines in Radiotherapy: Radiotherapy for Benign Diseases To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "We always typically think of it as cancer treatment, but we can use radiation for noncancerous conditions, as well. And radiation was actually used for benign diseases right after the discovery of x-rays. By the 1920s it was used a lot for different types of musculoskeletal, dermatologic issues, and different types of inflammatory conditions. And over time, since the 1920s, we've actually really gotten a really good understanding of it." TS 1:37 "When we're looking at what are good candidate characteristics, we do typically like older patients, so patients over the age of 65. And the rationale behind that is we know that there is a potential for a secondary risk of a skin cancer about 20 to 30 years after getting low-dose radiation, like a basal cell or squamous cell skin cancer. The older the patient is, the less likely they are to have any adverse effects from that." TS 8:22 "When we do the low-dose radiation, they've tried other measures that haven't been successful. However, we don't want a patient who is so severe that they're ready for surgery, when they're bone on bone, because we know that radiation isn't as effective when they are that severe. So there's this sweet window where low-dose radiation works best in these patients." TS 9:39 "When we're treating with a little bit higher dose for like a Dupuytren's or a Ledderhose, because it's an anti-proliferative dose, those patients, they do get more skin redness, more dry skin. That's very temporary, and it resolves within a week or two after treatment. But really, we don't see any acute side effects. The long-term side effect of the radiation-induced malignancy, again, is a very low—0.05% according to some of the European guidelines." TS 12:34 "I really wish people appreciated how interdisciplinary this is. We need to get referrals from family medicine and from primary care and internal medicine and pain medicine physicians and inflammatory physicians and podiatry and pain specialists. And we really need to use this multidisciplinary approach to get earlier referrals for patients because there is this sweet window of time where low-dose radiation works the best." TS 18:40

Gemotiveerd PSV wint door nieuwe regel van Pepijn, Robin Trump vindt geen verrijkt uranium in Zwolle en Dick Schreuder krijgt loon na staalvlechten. Verder blijkt Ajax net zo matig in waterpolo als in voetbal, eindigt Utrecht wéér geen zevende en schiet Ronald Koeman Telstar in Volendam in veilige haven. Het is maandagavond, op naar de seizoensfinale van De Derde Helft. ✉️ Op vrijdag kunnen jullie met ons via Substack vooruitblikken op het aankomende Eredivisie-weekend. Gijs, Tim, Snijboon, Pepijn en RogierPablo zullen hier allemaal één ding delen waar ze naar uitkijken in de aankomende speelronde. https://substack.com/@dederdehelft

"We want to make sure that we discuss the details of the treatment and what treatments there are, whether it's an oral drug, whether it's a subcutaneous injection or an IV injection, [the patient's] potential for responding, whether this treatment is curative or supportive, and what the number of visits are. All of those different pieces of information that go into the decision-making process are really important," ONS member Sara Tinsley-Vance, PhD, APRN, AOCN®, nurse practitioner and quality-of-life researcher at Moffitt Cancer Center in Tampa, FL, told Lenise Taylor, MN, RN, AOCNS®, TCTCN™, oncology clinical specialist at ONS, during a conversation about myelodysplastic syndrome (MDS) treatment considerations. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by May 15, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge about the treatment considerations for MDS. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Episode 411: An Overview of Myelodysplastic Syndrome for Oncology Nurses Episode 256: Cancer Symptom Management Basics: Hematologic Complications ONS Voice articles: FDA Approves Luspatercept-Aamt for Anemia in Adults With MDS Infection Prevention for Oncology Nurses Manage Cancer-Associated Anemia With Erythropoietin-Stimulating Agents Whole-Genome Sequencing May Guide Treatment Choices for AML and MDS Clinical Journal of Oncology Nursing articles:  Reducing Effects of Hospital-Associated Deconditioning in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation Resilience in Older Adults Diagnosed With Cancer and Receiving Chemotherapy Targeted Drug Therapies: Beyond Blood Counts and Chemistries Oncology Nursing Forum article: Frailty in Patients With Hematologic Malignancies and Those Undergoing Transplantation: A Scoping Review ONS books:  BMTCN™ Certification Review Manual (second edition) Hematopoietic Stem Cell Transplantation: A Manual for Nursing Practice (third edition) ONS course: Hematopoietic Stem Cell Transplantation™ ONS Learning Library: Hematology, Cellular Therapy, and Stem Cell Transplantation ONS Symptom Intervention resources: Prevention of Infection: General Prevention of Infection: Transplant Aplastic Anemia and MDS International Foundation: MDS Drugs and Treatments Blood Cancer United: MDS Treatment HealthTree Foundation Myelodysplastic Syndromes Foundation To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "The goals that I try to consolidate to make sure they're consistent with the patient's goals are to improve their counts, especially the anemia or cytopenias. If they're getting blood transfusions, we want to reduce the number of transfusions that they receive because we know that's linked to reduced overall survival, and it really impacts quality of life. ... And then for high-risk patients, it's a more serious discussion because we know that they are the ones who can progress to acute myeloid leukemia (AML). And we're trying to delay progression to AML. That means we're trying to improve their survival and we're also trying to manage their cytopenias and decrease their infection risk." TS 2:28 "If we look at approvals for low-risk disease and high-risk disease, those were really made based on the Revised International Prognostic Scoring System (IPSS-R) and sometimes the International Prognostic Scoring System (IPSS). Under those classification systems, when we think of lower-risk MDS, we think of patients who are primarily anemic but don't have increased blasts in their bone marrow. ... For higher-risk MDS, we want to have that discussion with those patients because their life expectancy is much shorter than patients with lower-risk MDS. We want to see if hematopoietic stem cell transplant would be something that they would be interested in if they don't have a lot of comorbidities and are relatively healthy." TS 11:41 "There are a lot of things to consider—[patients'] blood counts, comorbidities, whether they're frail, and what their goals are. There are some patients where there's no way they would want to go through transplant. And some patients want to be cured, so it just depends on your patient." TS 14:22 "I think of hematopoietic allogeneic transplants as a treatment for more of the patients with higher-risk MDS. ... With the Molecular International Prognostic Scoring System (IPSS-M), a patient can have pretty good blood counts and not have increased blasts in the bone marrow. You could send them for a transplant referral upfront without having to give them additional treatment. ... There is a recent publication that said if a patient doesn't have more than 10% blast, you could refer to transplant as a first option. ... Also, if you had a lower-risk patient who is relatively young and doesn't have any other treatment options, this would also be a patient that you could refer to transplant to see if we could care for them, and then they wouldn't have to be getting transfused all the time." TS 21:12 "I think that we often think low-risk, no treatment needed, but it depends on the person. They often need ongoing supportive care to manage their symptoms even if they're not getting treatment. And just because we're not treating them, active observation, bringing them in to see how they're doing, if they've had infections, if their blood counts are changing, that is paying attention to them and doing something. Just because they're low-risk doesn't mean they don't need anything and we can just schedule for a one-year follow-up." TS 26:30

In Oostenrijk is het Eurovisie Songfestival gestart, zonder Nederland. Ons land boycot het festival samen met vier anderen vanwege de deelname van Israël. En er is ophef rondom de Israëlische Eurovisie-marketing, die tegen de regels is. Melanie zoekt voor je uit hoe de deelname van Israël het Songfestival onder hoogspanning zet.

Politieke partye reageer op minister Sisisi Tolashe se afdanking. Ons praat ook met die DA se federale leier Geordin Hill-Lewis hieroor. Oudpresident Jacob Zuma appeleer teen 'n hooggeregshofuitspraak wat poog om 'n einde aan die gesloer in sy wapentransaksie-korrupsiesaak te bring. Die MK, EFF en ATM verlaat die Nasionale Vergadering voor president Ramaphosa vrae beantwoord.

In this episode, host Shikha Jain, MD, speaks with Jessica MacIntyre, DNP, about her role and goals as president of the Oncology Nursing Society, multidisciplinary focuses within cancer care and more. ·       Welcome to another exciting episode of Oncology Overdrive 1:22 ·       About Jessica MacIntyre, DNP, MBA, APRN, AOCNP, FAANP 1:34 ·       The interview 2:50 ·       Tell me about how you got to where you are today […] What was your journey to becoming a nurse practitioner, and into the leadership role you hold today? 3:15 ·       What is Oncology Nursing Society (ONS)? What does it do, and how did you become president?  5:17 ·       What are your goals as president of ONS? 9:08 ·       Jain and MacIntyre on the importance of multidisciplinary approaches to cancer care. 12:28 ·       What excites you about the role of nurses and nurse practitioners, and the future of the oncology team as a whole? 14:34 ·       Where do you see the future of patient navigation going? […] Where do you see AI playing a role in all of this? 17:42 ·       What do you say to people who are scared of AI becoming all-encompassing? 20:41 ·       Jain and MacIntyre on embracing and improving the use of AI in cancer care. 22:14 ·       What do you recommend to nurses as they embark on their careers? […] How can we make sure nurses are working to the top of their license while supporting the cancer care team? 24:09 ·       Jain and MacIntyre on the increasing importance of advocacy in health care. 26:55 ·       If someone could only listen to the last minute of this episode, what would you want listeners to take away? 28:31 ·       How to contact MacIntyre 30:00 ·       Thanks for listening 30:56 Jessica MacIntyre, DNP, MBA, APRN, AOCNP, FAANP, is president of the Oncology Nursing Society and executive director of clinical operations at Sylvester Comprehensive Cancer Center, part of University of Miami Miller School of Medicine. We'd love to hear from you! Send your comments/questions to Dr. Jain at oncologyoverdrive@healio.com. Follow Healio on X and LinkedIn: @HemOncToday and https://www.linkedin.com/company/hemonctoday/. Follow Dr. Jain on X: @ShikhaJainMD. MacIntyre can be reached on LinkedIn, or via email jmacintyre@med.miami.edu. Jain reports no relevant financial disclosures. MacIntyre reports compensation from Johnson & Johnson for participation on a nursing panel.

What does it actually take to modernize healthcare? Dr. Mark Camel has spent decades confronting this question — not as a consultant or outsider, but as a surgeon and builder of one of the most operationally sophisticated independent physician groups in musculoskeletal healthcare.In this episode, host Usman Rabbani sits down with Dr. Camel, co-founder of Orthopedic & Neurosurgery Specialists (ONS), to discuss the lessons learned scaling ONS from a seven-surgeon practice into a 175-physician, four-state platform. Together, they explore the operational decisions that transformed ONS into one of the most technology-forward provider groups, years before digitization and AI became mainstream healthcare priorities.Their conversation spans the realities of building technology inside healthcare organizations, the hard-earned lessons behind buy-versus-build software decisions, why most healthcare technology struggles to achieve broad adoption, and where AI is already delivering measurable operational ROI today.For anyone building, investing in, or evaluating healthcare technology, this episode offers an insider's perspective on how meaningful change actually happens inside one of the world's most complex and resistant industries. Hosted on Acast. See acast.com/privacy for more information.

Ons herdenk vandag die opstanding van Jesus Christus. Oral in Namibië vul kerke vandag met lofgesang en herinnering aan Sy ewige belofte. Mag hierdie spesiale dag vir jou en jou gesin vol vrede, hoop en seëninge wees, en geniet die betekenisvolle rusdag saam met geliefdes. Kosmos 94.1 Nuus het met dominee Dubois du Toit van die NG Kerk Suiderhof gepraat. Hy het 'n boodskap.

(1) Ons leger heeft voor 20 miljoen nieuwe helikopters gekocht (2) Het Ontbreekwoord: de opluchting die je voelt na een nachtmerrie (3) Vraag het aan Gilles: waarom tellen dansers anders dan muzikanten? (4) Geeuwen is aanstekelijk en dat begint al in de baarmoeder (5) Nico Dijkshoorn

Ons ons onsdag er her igjen og i dag med Kathrine, Daniela og Monica. Me snakker om ting som skjer i Bergen. Streik i servicebransjen, Bergen Street food, og Nattjazz som er rett rundt hjørnet!. Tanker rundt det og tenker rundt ny VM låt av Shakira. Me tar også opp at folk må tracke mindre av livet sitt og leve meir fritt. Litt hate på dei som hater aka (rasistiske dumme folk) også litt hate på influensere på Snap som tjener penger av å ligge på sofaen... Håper du vil høre på oss! Ansvarlig Redaktør: Vilde Havn

PSV met vliegende Perisic langs de Eagles, Feyenoord ondanks dubbele valse start naar de Champions League en Schreuder blijft met blauwe ballen achter in the Battle of the Dicks. Verder moet Ajax nu al hun geld inzetten op een overwinning van FC Twente en hebben we te maken met een klassieke salonremise. Het is maandagavond, op naar een nieuwe aflevering van De Derde Helft. ✉️ Op vrijdag kunnen jullie met ons via Substack vooruitblikken op het aankomende Eredivisie-weekend. Gijs, Tim, Snijboon, Pepijn en RogierPablo zullen hier allemaal één ding delen waar ze naar uitkijken in de aankomende speelronde. https://substack.com/@dederdehelft

"Skin reactions, such as redness, dryness, and just irritation of the skin, can occur. Since we're irradiating the lung, we can also cause a cough, and that's due to the inflammation from the radiation. Patients can also get esophagitis if the tumor that we're treating is close to the midline of the chest near the esophagus. And probably the most common side effect that we see is fatigue," ONS member Amy MacRostie, RN, OCN®, radiation oncology nurse at St. Charles Cancer Center in Bend, OR, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about radiation side effects in lung cancer. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.25 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by May 8, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to the side effects of radiation to treat lung cancer. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Episode 369: Lung Cancer Survivorship Considerations for Nurses Episode 363: Lung Cancer Treatment Considerations for Nurses Episode 359: Lung Cancer Screening, Early Detection, and Disparities Episode 313: Cancer Symptom Management Basics: Other Pulmonary Complications Episode 295: Cancer Symptom Management Basics: Pulmonary Embolism, Pneumonitis, and Pleural Effusion ONS Voice article: Highly Localized, Precision Radiation Therapies Require Nurses to Drive Care Coordination, Patient Education ONS book: Manual for Radiation Oncology Nursing Practice and Education (fifth edition) ONS courses: ONS/ONCC® Radiation Therapy Certificate™ ONS ROCN™ Certification Review™ ONS Radiation Learning Library ONS Guidelines™ and Symptom Intervention Resources National Comprehensive Cancer Network LUNGevity Foundation Inspire Lung Cancer Survivors Community To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "The types of radiation that can be used are external beam radiation and stereotactic body radiation treatment, or SBRT. External beam radiation is often used in combination with other treatment modalities, like chemotherapy, immunotherapy, and targeted therapy, to treat these cancers. And SBRT is usually done solo, and it's a highly precise treatment for inoperable or early-stage lung cancers." TS 1:52 "[Physicians and] providers can also help prevent side effects by reducing the dose to the heart and reducing the dose to the good lung tissue, if you will, as much as they possibly can. And this is done using intensity-modulated techniques, or IMRT. And that's where the linear accelerator sculpts the radiation beams conforming to the shape of the tumor itself." TS 6:37 "I think overall cancer treatment can lead to decreased libido and decreased sexual interest. Depression and fear can definitely play a role in this. And with lung radiation, specifically, fatigue and possibly shortness of breath with the exertion may decrease sexual interest. Nurses and providers should support the patient in their desire or lack thereof in sexual activities. We should have open discussions … and these can take place with patients about intimacy and how that can be approached in a different way that can accommodate for the side effects that the patients might be experiencing." TS 8:57 "Post-radiation scans will be abnormal. Post-radiation imaging can be misread as a progression of disease or residual disease. And I tell patients, 'Don't panic. Talk to your radiation oncologist so they can read the imaging themselves and interpret the results.' Oftentimes what's read as progression is radiation treatment sequela of scarring or fibrosis." TS 11:25

Ons kry koud en dit gaan vir die volgende paar dae voortgaan met ‘n rits koue stelsels wat oor die land in beweeg en teen môreoggend, kan Windhoek ryp verwag. Weerkenner George van der Merwe.

Ajax vormt een erehaag als een boer met kiespijn, Feyenoord is weer de lachende derde voor plaats twee, en de overperform-derby eindigt onbeslist. Verder zijn de prehistorische druiven zuur voor Mammoet-John, en degradeert NAC officieus doordat paspoortgate - in ieder geval in Nederland - gestrand lijkt. Het is maandagavond, yallah naar een nieuwe aflevering van De Derde Helft. ✉️ Op vrijdag kunnen jullie met ons via Substack vooruitblikken op het aankomende Eredivisie-weekend. Gijs, Tim, Snijboon, Pepijn en RogierPablo zullen hier allemaal één ding delen waar ze naar uitkijken in de aankomende speelronde. https://substack.com/@dederdehelft

"We thought, from a nursing standpoint, 'What is our goal for doing this?' What we wanted was first, education of the patient. Can we successfully educate the patient to prepare them? Can we alleviate as much anxiety as possible so that they feel comfortable coming in and having this done? The second goal is to preserve kidney function throughout the treatment. To date, we've been successful with that. And the third goal is to complete treatment without infection," ONS member Chris Amoroso, BSN, RN, OCN®, registered nurse at Fox Chase Cancer Center in Philadelphia, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about intrarenal administration for upper urothelial tract disease. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.75 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by May 1, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Nurses caring for people with cancer require knowledge of the different routes for drug administration, including intrarenal administration via a percutaneous nephrostomy. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Episode 141: Care Coordination for Urothelial Cancer Episode 133: Treatment Advancements for Advanced or Metastatic Urothelial Cancer ONS Voice articles: A Primer on Urothelial Cancer Chemo Combo May Be a Bladder Cancer Treatment Alternative During BCG Shortage Nurses Are Key to Patients Navigating Genitourinary Cancers Clinical Journal of Oncology Nursing articles: Avelumab First-Line Maintenance Therapy: Managing Patients With Advanced Urothelial Carcinoma Percutaneous Nephrostomy Infusion: Nursing Considerations for Treatment of Upper Urinary Tract Urothelial Carcinoma ONS Learning Libraries: Cancer of the Genitourinary Tract Safe Handling of Hazardous Drugs To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "In an office setting, it's not something we can really visualize. Patients will present with hematuria or flank pain, obstructions in the ureter, some hydronephrosis, they may be having a lot of urinary tract infections. And a routine cystoscopy in the office is not going to visualize the ureters. We can do biopsies like a ureteroscopy, a computerized tomography urogram, or a urine cytology. And those are usually the main ways of diagnosing upper tract disease—again, because it's rare." TS 2:33 "We ask patients to get into a comfortable position where they can sit or lay for an hour without too much movement. The movement of their body position can interfere with the flow of the medication going in. ... When we're ready to start, we're cleaning the ends of the nephrostomy tube and the IV tubing with a chlorhexidine solution. We're instilling this using micro drip tubing. The tubing has to be microchipped so we can accurately control the flow. The IV bag with medication is hung about 10 inches above kidney level. And the reason we do that is because we do not want to increase the intrarenal pressure. ... We want a slow infusion via gravity over about an hour. We're watching throughout the procedure to make sure that there's no leakage, no discomfort, really just watching the patient and having that communication with the patient. Are they feeling anything different? Do we notice a difference in the flow rate? Is it slowing down? And if so, why is it? Did the patient change position? If we have any [instance] where the patient says, 'I can feel something there,' or we see leakage, we stop that infusion immediately, emphasizing that it has to be gravity, never on a pump." TS 7:30 "We go over all the bacillus Calmette-Guérin (BCG) precautions because this is the drug that we're giving. As if we were doing traditional intravesical therapy such as placing a catheter up into the bladder, we're still giving patients BCG. So, we need them to follow the special precautions. We ask every patient, regardless of the drug we're giving them, to sit down to urinate, pour two cups of bleach in the toilet, let it sit for about 15 minutes, then close the lid and flush twice. Even though we're giving this for upper tract disease, it's still being excreted into the urine. So, precautions need to be followed. Sitting down to urinate to avoid splashing of the drug, putting the two cups of bleach in every time they urinate for a duration of six hours, closing the lid, and then flushing that toilet twice. The same precautions, whether it's traditional intravesical or intrarenal." TS 14:20 "The induction phase is the first six installations. So, the first time we give this drug, we're doing it once a week for six weeks. And during those six weeks, we're communicating with the patient. We'll do a follow-up phone call and ask, 'How are you feeling? Any issues?' And we do get to know our patients really well. ... If they call, we're going to send them for a urine culture and make sure there's nothing there. ... After those six weeks, we make sure the patient understands that this is not one course and done. We want to continue to do this to give them the best chance at preventing recurrence. After we've done those six, we'll wait about four to six weeks, and then we'll do a cystoscopy and ureteroscopy in the operating room to make sure we have the response we're looking for. Again, letting the patients know because sometimes they don't understand that this is going to continue—it's not six treatments and done." TS 23:08 "You can't think of this as the same as bladder cancer. This is in the upper tract. We can't approach it as if it was non-muscular invasive bladder cancer. The diagnosis is different. It's harder to diagnose. Again, we're not visualizing the ureters in a routine office cystoscopy.  ... You can't resect it out. When I was talking to our surgeon, he said, 'You can't resect the urothelial disease in the ureters like you would in a bladder tumor.' You can't go and just pick it apart. It's a little bit more complex than that. You can't go in and resect out lesions in the ureter itself." TS 36:20

Enkele weken geleden waren we te gast op Supernova waar de enige echte Arnold Schwarzenegger een avondje kwam spreken. Een geweldig event met een heerlijk grappige Arnold in de waagnatie in Antwerpen.Ons verslag krijg je in deze aflevering alsook de laatste updates over het leven van jouw favoriete podcasthosts. Op 16 mei kan je in de 4AD in Diksmuide gaan kijken naar "De Wereld in een busje" . De eerste solo voorstelling van Andries. Alle info op www.andriesbeckers.beSee omnystudio.com/listener for privacy information.

"They are small, powerful little nuggets. They are actually small signaling proteins that our immune cells use to communicate. They really help regulate immune activation or inflammation and even the growth and survival of immune cells. When cytokines are used therapeutically in oncology, they help to stimulate immune cells such as T cells or natural killer cells to better recognize and attack cancer cells," Maribel Pereiras, PharmD, BCPS, BCOP, clinical pharmacy specialist at the John Theurer Cancer Center of Hackensack University Medical Center in New Jersey, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the cytokine drug class. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours (including 30 minutes of pharmacotherapeutic content) of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by April 24, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Nurses caring for people with cancer require knowledge of cytokines to provide appropriate education and to safely administer related therapies. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Pharmacology 101 series Episode 256: Cancer Symptom Management Basics: Hematologic Complications Episode 196: Oncologic Emergencies 101: Bleeding and Thrombosis ONS Voice articles: FDA Approves Nogapendekin Alfa Inbakicept-Pmln for BCG-Unresponsive Non–Muscle Invasive Bladder Cancer Manage Cancer-Associated Anemia With Erythropoietin-Stimulating Agents Oncology Drug Reference Sheet: Motixafortide ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) and 2024 Drug Supplement Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition) Guide to Cancer Immunotherapy (second edition) Clinical Journal of Oncology Nursing article: Tumor-Infiltrating Lymphocyte Therapy for Melanoma: Nursing Considerations What's Old Is New Again, Unfortunately ONS Symptom Interventions Colony-Stimulating Factors Including Biosimilars for At-Risk Patients for Prevention of Infection: General Platelet Growth Factors for Prevention of Bleeding National Comprehensive Cancer Network To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "Cytokines are actually among some of the earliest forms of immunotherapy used in the treatment of cancer, and it really goes back to the 1980s and the 1990s. We're talking therapies like interferon [alpha] or interleukin-2 that were used to stimulate the immune system, with the idea that they would recognize and attack cancer cells, particularly in diseases like metastatic melanoma and renal cell carcinoma. What made these therapies unique was that although the overall response rates were relatively modest, when patients did respond, those responses could be very durable and sometimes long lasting. And that observation was really important for the field of oncology, because it was part of the process that demonstrated that the immune system could potentially control cancer in really meaningful ways." TS 1:49 "One nice new example of an engineered cytokine is nogapendekin alfa inbakicept, which is quite the tongue twister to say. … This agent is really interesting because it's an engineered interleukin-15 receptor agonist that works on stimulating natural killer cells and CD8-positive T cells. And what makes this so interesting is that it's used in combination with a medication that probably some of us are familiar with—good old BCG—for patients specifically with invasive bladder cancer. The other really interesting thing about this new therapy is the fact that it is one of our first ones to be engineered in a combination fashion. So the nogapendekin alfa is combined with a receptor component that is called inbakicept. And what happens is it forms a complex to enhance signaling and prolong the activity of the cytokine." TS 7:50 "When you're looking at our therapeutic cytokines, those tend to produce larger-scale systemic inflammatory effects leading to much more global side effect reactions, while your supportive care cytokines are more commonly associated with either bone marrow stimulation effects or hematologic changes." TS 14:01 "Regardless of what type of cytokine therapy may you be using, across the board, early recognition of the symptoms and proactive supportive care are really important. And this is where many of our oncology nurses play such a critical role in identifying changes that are happening in real time to the patient's condition and helping to coordinate, relay information to the rest of the providing team so that timely interventions can occur for the best care of the patient." TS 18:01 "The other fascinating thing about these cytokines is that they're not being used as monotherapy anymore. They're now being looked at in combination with other therapies or even other immunotherapies like our checkpoint inhibitors. They're being looked at in the sense that they may be able to help expand and further activate immune cells that our current therapies rely on. And so it's really interesting that while cytokines were some of the earliest forms of cancer immunotherapy, they're now being reimagined as part of modern combination strategies designed to really further help enhance the immune responses against cancer." TS 29:08

"Not every patient with myelodysplastic syndrome (MDS) is going to progress and die. Only 10%–20% of them will evolve into acute myeloid leukemia. And not all of them need blood transfusions. Some present with low platelet count. It's not just people who are anemic that have MDS—it's different depending on what type of MDS they have. These are averages. We're giving you statistics based on averages, and you're an individual, so we want to treat you as an individual," ONS member Sara Tinsley-Vance, PhD, APRN, AOCN®, nurse practitioner and quality-of-life researcher at Moffitt Cancer Center in Tampa, FL, told Lenise Taylor, MN, RN, AOCNS®, TCTCN™, oncology clinical specialist at ONS, during a conversation about myelodysplastic syndrome. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by April 17, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Nurses caring for people with myelodysplastic syndrome require knowledge of its pathophysiology, the presenting symptoms, and its diagnosis. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Episode 339: A Lesson on Labs: How to Monitor and Educate Patients With Cancer Episode 302: Patient Navigation Eliminates Disparities in Cancer Care Episode 256: Cancer Symptom Management Basics: Hematologic Complications ONS Voice articles: Manage Cancer-Associated Anemia With Erythropoietin-Stimulating Agents Whole-Genome Sequencing May Guide Treatment Choices for AML and MDS Clinical Journal of Oncology Nursing articles:  Deciphering TP53 Mosaic Variants on Germline Biomarker Testing: Implications for Oncology Nurses Myeloid Malignancies: Recognizing the Risk of Germline Predisposition and Supporting Patients and Families Oncology Nursing Forum article: Impact of a Hematologic Malignancy Diagnosis and Treatment on Patients and Their Family Caregivers ONS book: BMTCN™ Certification Review Manual (second edition) ONS Clinical Practice resource: Genomics Taxonomy Genomics and Precision Oncology Learning Library American Cancer Society: Myelodysplastic Syndrome Prognostic Scores Aplastic Anemia and MDS International Foundation Blood Cancer United: MDS Diagnosis HealthTree Foundation Myelodysplastic Syndromes Foundation: What Is MDS? To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "In the bone marrow maturation process, you have a pluripotent stem cell. You have myeloid and lymphoid, and then on the myeloid side, you make your white blood cells, your red blood cells, and your platelets. And during that maturation process, there's this problem that arises. It's called a clonal variation. Or something goes wrong as the cells go through that process year after year. It's called ineffective hematopoiesis. ... That process of becoming mature, functioning cells, arising from that hematopoietic stem cell is broken, and this leads to low blood counts. Usually, it's anemia, so the hemoglobin is low. You can see that the mean corpuscular volume (MCV) is really high, and those are clues that a patient might have MDS—anemia with a high MCV." TS 3:05 "The International Prognostic Scoring System (IPSS) was the first way that we staged MDS into lower-risk and higher-risk disease. Now we have the IPSS-R, which is the revised system. And that was intended to be a way of classifying patients into lower-risk or higher-risk disease, where we talked about the goals being different. And it's really looking at the depth of the cytopenias, so how low are those neutrophils? How low is the hemoglobin and the platelet level? What percentage of blast does the patient have in their bone marrow? [This] gauges whether they have lower-risk or higher-risk disease. And now that we have the Molecular International Prognostic Scoring System (IPSS-M), we also take into account the variants that a patient has and that can really change whether you think they have lower-risk or higher-risk disease." TS 8:46 "During a person's lifetime, if they were a heavy smoker, we always think of lung cancer, but it can actually predispose a person to MDS. If they worked heavily in chemicals. I can remember more than one patient who worked for pesticide companies. Repeated exposure to these things that can affect our blood cells cumulatively, they can make a person more prone to MDS. Also, patients who have family members who have had bone marrow problems." TS 13:39 "The way I explain it to patients who say, 'What does dysplasia mean?' I say, 'Well, if you had a picture of a face. If the cell has too many eyes, or one eye above the other or below the other, or too many ears, or they're just disfigured. They don't look right and they don't mature normally.' And so, the descriptions I frequently see are nuclear budding and micromegakaryocytes. Once you read a lot of the reports, you start to pick out, 'Okay, these are the terms that go along with dysplastic red blood cells or dysplastic megakaryocytes,' which are your precursors to platelets." TS 21:28 "The cytogenetics and the variants—that's a hard concept to explain to patients. And staying current on how we understand the disease and how it evolves. Now we have pre-MDS states called clonal cytopenia of undetermined significance. That was new to me. And then clonal hematopoiesis of indeterminate significance. And some of those clones have other healthcare problems that go along with them." TS 30:52