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Sample records for british oncological association

  1. Patient and carer unmet needs: a survey of the British association of head and neck oncology nurses.

    Science.gov (United States)

    Rogers, S N; Clifford, N; Lowe, D

    2011-07-01

    The aim of this survey was to ask members of the British Association of Head and Neck Oncology Nurses (BAHNON) about the identification of patients and carers unmet needs in the routine out-patient review clinic and the support services available during consultation. A national postal survey was sent out to the 210 current members of BAHNON in November 2009. Reminders were sent to non-responders in February 2010. The response rate was 61% (129/210). The vast majority (80%) were Clinical Nurse Specialists (CNS). The questionnaire data support the strong belief in attempts to identify unmet needs with over three-quarters feeling strongly about themselves being personally involved in attempting to identify unmet needs. Most of the responders used counselling and communication methods to elicit unmet concerns rather than specific tools such as questionnaires. The vast majority clearly felt that identifying unmet needs in clinic improves patients' perception of outcome post-treatment. Support services' readily' available at the time of consultation were as follows: H&N CNS (99%), Speech and Language (86%), Oncologist (84%), Dietician/Nutritionist (84%), Dentist (44%), Oral Rehabilitation consultant (27%), Dental Hygienist (26%), Physiotherapist (21%), Chaplain (20%), Emotional Support therapist (15%), Psychologist (15%), Occupational therapist (13%), Social worker (8%), other (11%). Although responders felt it very important to identify unmet needs in follow-up clinics, there is reliance on one to one discussion with the patient and carer. Hence in a busy clinic, needs might be easily missed and further research is required into ways to facilitate their identification. Copyright © 2010 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  2. A survey of techniques to reduce and manage external beam radiation-induced xerostomia in British oncology and radiotherapy departments

    Energy Technology Data Exchange (ETDEWEB)

    Macknelly, Andrew [Norfolk and Norwich University Hospital (United Kingdom); Day, Jane [Faculty of Health, Wellbeing and Science, University Campus Suffolk, Waterfront Building, Neptune Quay, Ipswich (United Kingdom)], E-mail: j.day@ucs.ac.uk

    2009-11-15

    Xerostomia is the most common side effect of external beam radiotherapy to the head and neck [Anand A, Jain J, Negi P, Chaudhoory A, Sinha S, Choudhury P, et-al. Can dose reduction to one parotid gland prevent xerostomia? - A feasibility study for locally advanced head and neck cancer patients treated with intensity-modulated radiotherapy. Clinical Oncology 2006;18(6):497-504.]. A survey was carried out in British oncology departments to determine what treatment regimes, to minimise xerostomia, are used for patients with head-and-neck cancers treated with external beam radiotherapy. A semi-structured questionnaire consisting of both quantitative and qualitative questions was designed that asked departments which of the identified methods they used, why a method might not be currently employed, and whether its use had ever been considered. The study found that there are wide disparities between the techniques employed by oncology departments to avoid and reduce xerostomia in patients with cancers of the head and neck. The National Institute of Clinical Health and Excellence, [National Institute for Clinical Health and Excellence (NICE). Improving outcomes in head and neck cancers: the manual. London: Office of Public Sector Information; 2004.] for example, recommends that patients are given dental care and dietary advice but some departments did not appear to be doing this. Less than half of departments stated that they offer complementary therapies and less than 40% prescribed pilocarpine, a saliva-stimulant. Only two respondents stated that they use amifostine, a radioprotector, during radiotherapy treatment to the head and neck. The results also suggested a move toward using Intensity Modulated Radiotherapy (IMRT) for treating head-and-neck cancers which offers better normal tissue sparing than three-dimensional conformal radiotherapy. [Anand A, Jain J, Negi P, Chaudhoory A, Sinha S, Choudhury P, et al. Can dose reduction to one parotid gland prevent xerostomia

  3. Periodontium destruction associated with oncology therapy. Five case reports

    Energy Technology Data Exchange (ETDEWEB)

    Wright, W.E.

    1987-08-01

    Radiation treatment to the head and neck and cytotoxic chemotherapy can produce deleterious side effects to the periodontium that are generally transient in nature, reversible, and do not result in permanently visible defects. However, combinations of the malignant disease itself, the direct and indirect effects of medical therapy and associated oral infections, along with local trauma can lead to periodontal tissue destruction with resulting permanent architectural defects. Five case reports illustrate destructive alterations of the periodontium that were associated with oncology therapy. Proposed guidelines for periodontal treatment of compromised individuals undergoing oncology therapies are suggested.

  4. Direct health care costs associated with asthma in British Columbia

    Science.gov (United States)

    Sadatsafavi, Mohsen; Lynd, Larry; Marra, Carlo; Carleton, Bruce; Tan, Wan C; Sullivan, Sean; FitzGerald, J Mark

    2010-01-01

    BACKGROUND: A better understanding of health care costs associated with asthma would enable the estimation of the economic burden of this increasingly common disease. OBJECTIVE: To determine the direct medical costs of asthma-related health care in British Columbia (BC). METHODS: Administrative health care data from the BC Linked Health Database and PharmaNet database from 1996 to 2000 were analyzed for BC residents five to 55 years of age, including the billing information for physician visits, drug dispensations and hospital discharge records. A unit cost was assigned to physician/emergency department visits, and government reimbursement fees for prescribed medications were applied. The case mix method was used to calculate hospitalization costs. All costs were reported in inflation-adjusted 2006 Canadian dollars. RESULTS: Asthma resulted in $41,858,610 in annual health care-related costs during the study period ($331 per patient-year). The major cost component was medications, which accounted for 63.9% of total costs, followed by physician visits (18.3%) and hospitalization (17.8%). When broader definitions of asthma-related hospitalizations and physician visits were used, total costs increased to $56,114,574 annually ($444 per patient-year). There was a statistically significant decrease in the annual per patient cost of hospitalizations (P<0.01) over the study period. Asthma was poorly controlled in 63.5% of patients, with this group being responsible for 94% of asthma-related resource use. CONCLUSION: The economic burden of asthma is significant in BC, with the majority of the cost attributed to poor asthma control. Policy makers should investigate the reason for lack of proper asthma control and adjust their policies accordingly to improve asthma management. PMID:20422063

  5. Difference in treatment outcome of British and Japanese surgical class III patients associated with mandibular setback

    OpenAIRE

    Nakamura, Koyo; Nagata, Norio; IIDA, YOSHIRO; Iida, Kayo; KAGEYAMA, TORU; Ishii, Nobuyuki

    2003-01-01

    The purpose of this clinical research was to examine the racial differences in skeletal morphology of skeletal Class III abnormalities and in the ortho-surgical treatment outcome of Class III malocclusion associated with mandibular setback sagittal osteotomy between Japanese and British Caucasian female adult Class III patients. The sample consisted of 35 Class III Japanese female surgical subjects in MDU Hospital and 30 Class III British subjects (23 female and 7 male). The operative procedu...

  6. Early Integration of Palliative Care in Oncology Practice: Results of the Italian Association of Medical Oncology (AIOM) Survey

    Science.gov (United States)

    Zagonel, Vittorina; Torta, Riccardo; Franciosi, Vittorio; Brunello, Antonella; Biasco, Guido; Cattaneo, Daniela; Cavanna, Luigi; Corsi, Domenico; Farina, Gabriella; Fioretto, Luisa; Gamucci, Teresa; Lanzetta, Gaetano; Magarotto, Roberto; Maltoni, Marco; Mastromauro, Cataldo; Melotti, Barbara; Meriggi, Fausto; Pavese, Ida; Piva, Erico; Sacco, Cosimo; Tonini, Giuseppe; Trentin, Leonardo; Ermacora, Paola; Varetto, Antonella; Merlin, Federica; Gori, Stefania; Cascinu, Stefano; Pinto, Carmine

    2016-01-01

    Background: Early integration of palliative care in oncology practice (“simultaneous care”, SC) has been shown to provide better care resulting in improved quality-of-life and also survival. We evaluated the opinions of Italian Association of Medical Oncology (AIOM) members. Patients and methods: A 37-item questionnaire was delivered to 1119 AIOM members. Main areas covered were: social, ethical, relational aspects of disease and communication, training, research, organizational and management models in SC. Three open questions explored the definition of Quality of Life, Medical Oncologist and Palliative Care. Results: Four hundred and forty-nine (40.1%) medical oncologists returned the questionnaires. Forty-nine percent stated they address non-curability when giving a diagnosis of metastatic tumor, and 43% give the information only to patients who clearly ask for it. Fifty-five percent say the main formative activity in palliative medicine came from attending meetings and 90% agree that specific palliative care training should be part of the core curriculum in oncology. Twenty-two percent stated they consulted guidelines for symptom management, 45% relied upon personal experience and 26% make a referral to a palliative care specialist. Seventy-four percent were in favor of more research in palliative medicine. An integration between Units of Oncology and Palliative Care Services early in the course of advanced disease was advocated by 86%. Diverse and multifaceted definitions were given for the concepts of Quality of Life, Palliative Care and Medical Oncologist. Conclusion: SC is felt as an important task, as well as training of medical oncologists in symptom management and research in this field. PMID:27877212

  7. The Association of Oncology Social Work's Project to Assure Quality Cancer Care (APAQCC).

    Science.gov (United States)

    Zebrack, Brad; Kayser, Karen; Oktay, Julianne; Sundstrom, Laura; Mayer Sachs, Alison

    2017-12-04

    In 2014, the Association for Oncology Social Work (AOSW) established A Project to Assure Quality Cancer Care (APAQCC), a group of oncology social workers representing sixty-five Commission on Cancer (CoC)-accredited cancer programs across the US (including two in Canada). Its aims were (1) to examine the capacity of cancer programs to provide quality psychosocial support services, and (2) to evaluate the implementation of distress screening. The purpose of this paper is to describe how this collaborative research program was created and implemented under the auspices of AOSW, and to report on its impact on the oncology social workers who participated.

  8. American Association of Physicists in Medicine Task Group 263: Standardizing Nomenclatures in Radiation Oncology.

    Science.gov (United States)

    Mayo, Charles S; Moran, Jean M; Bosch, Walter; Xiao, Ying; McNutt, Todd; Popple, Richard; Michalski, Jeff; Feng, Mary; Marks, Lawrence B; Fuller, Clifton D; Yorke, Ellen; Palta, Jatinder; Gabriel, Peter E; Molineu, Andrea; Matuszak, Martha M; Covington, Elizabeth; Masi, Kathryn; Richardson, Susan L; Ritter, Timothy; Morgas, Tomasz; Flampouri, Stella; Santanam, Lakshmi; Moore, Joseph A; Purdie, Thomas G; Miller, Robert C; Hurkmans, Coen; Adams, Judy; Jackie Wu, Qing-Rong; Fox, Colleen J; Siochi, Ramon Alfredo; Brown, Norman L; Verbakel, Wilko; Archambault, Yves; Chmura, Steven J; Dekker, Andre L; Eagle, Don G; Fitzgerald, Thomas J; Hong, Theodore; Kapoor, Rishabh; Lansing, Beth; Jolly, Shruti; Napolitano, Mary E; Percy, James; Rose, Mark S; Siddiqui, Salim; Schadt, Christof; Simon, William E; Straube, William L; St James, Sara T; Ulin, Kenneth; Yom, Sue S; Yock, Torunn I

    2018-03-15

    A substantial barrier to the single- and multi-institutional aggregation of data to supporting clinical trials, practice quality improvement efforts, and development of big data analytics resource systems is the lack of standardized nomenclatures for expressing dosimetric data. To address this issue, the American Association of Physicists in Medicine (AAPM) Task Group 263 was charged with providing nomenclature guidelines and values in radiation oncology for use in clinical trials, data-pooling initiatives, population-based studies, and routine clinical care by standardizing: (1) structure names across image processing and treatment planning system platforms; (2) nomenclature for dosimetric data (eg, dose-volume histogram [DVH]-based metrics); (3) templates for clinical trial groups and users of an initial subset of software platforms to facilitate adoption of the standards; (4) formalism for nomenclature schema, which can accommodate the addition of other structures defined in the future. A multisociety, multidisciplinary, multinational group of 57 members representing stake holders ranging from large academic centers to community clinics and vendors was assembled, including physicists, physicians, dosimetrists, and vendors. The stakeholder groups represented in the membership included the AAPM, American Society for Radiation Oncology (ASTRO), NRG Oncology, European Society for Radiation Oncology (ESTRO), Radiation Therapy Oncology Group (RTOG), Children's Oncology Group (COG), Integrating Healthcare Enterprise in Radiation Oncology (IHE-RO), and Digital Imaging and Communications in Medicine working group (DICOM WG); A nomenclature system for target and organ at risk volumes and DVH nomenclature was developed and piloted to demonstrate viability across a range of clinics and within the framework of clinical trials. The final report was approved by AAPM in October 2017. The approval process included review by 8 AAPM committees, with additional review by ASTRO

  9. Associations between etiologic factors and mortality after endometrial cancer diagnosis: the NRG Oncology/Gynecologic Oncology Group 210 trial.

    Science.gov (United States)

    Felix, Ashley S; Scott McMeekin, D; Mutch, David; Walker, Joan L; Creasman, William T; Cohn, David E; Ali, Shamshad; Moore, Richard G; Downs, Levi S; Ioffe, Olga B; Park, Kay J; Sherman, Mark E; Brinton, Louise A

    2015-10-01

    Few studies have analyzed relationships between risk factors for endometrial cancer, especially with regard to aggressive (non-endometrioid) histologic subtypes, and prognosis. We examined these relationships in the prospective NRG Oncology/Gynecologic Oncology Group 210 trial. Prior to surgery, participants completed a questionnaire assessing risk factors for gynecologic cancers. Pathology data were derived from clinical reports and central review. We used the Fine and Gray subdistribution hazards model to estimate subhazard ratios (HRs) and 95% confidence intervals (CIs) for associations between etiologic factors and cause-specific subhazards in the presence of competing risks. These models were stratified by tumor subtype and adjusted for stage and socioeconomic status indicators. Median follow-up was 60months after enrollment (range: 1day-118months). Among 4609 participants, a total of 854 deaths occurred, of which, 582 deaths were attributed to endometrial carcinoma. Among low-grade endometrioid cases, endometrial carcinoma-specific subhazards were significantly associated with age at diagnosis (HR=1.04, 95% CI=1.01-1.06 per year, P-trend) and BMI (class II obesity vs. normal BMI: HR=2.29, 95% CI=1.06-4.98, P-trend=0.01). Among high-grade endometrioid cases, endometrial carcinoma-specific subhazards were associated with age at diagnosis (HR=1.05, 95% CI=1.02-1.07 per year, P-trendendometrial carcinoma-specific subhazards were associated with parity relative to nulliparity among serous (HR=0.55, 95% CI=0.36-0.82) and carcinosarcoma cases (HR=2.01, 95% CI=1.00-4.05). Several endometrial carcinoma risk factors are associated with prognosis, which occurs in a tumor-subtype specific context. If confirmed, these results would suggest that factors beyond histopathologic features and stage are related to prognosis. ClinicalTrials.gov Identifier: NCT00340808. Published by Elsevier Inc.

  10. Associations between etiologic factors and mortality after endometrial cancer diagnosis: The NRG Oncology/Gynecologic Oncology Group 210 Trial

    Science.gov (United States)

    Felix, Ashley S; McMeekin, D Scott; Mutch, David; Walker, Joan L; Creasman, William T; Cohn, David E; Ali, Shamshad; Moore, Richard G; Downs, Levi S; Ioffe, Olga B; Park, Kay J; Sherman, Mark E; Brinton, Louise A

    2015-01-01

    Background Few studies have analyzed relationships between risk factors for endometrial cancer, especially with regard to aggressive (non-endometrioid) histologic subtypes, and prognosis. We examined these relationships in the prospective NRG Oncology/Gynecologic Oncology Group 210 trial. Methods Prior to surgery, participants completed a questionnaire assessing risk factors for gynecologic cancers. Pathology data were derived from clinical reports and central review. We used the Fine and Gray subdistribution hazards model to estimate subhazard ratios (HRs) and 95% confidence intervals (CIs) for associations between etiologic factors and cause-specific subhazards in the presence of competing risks. These models were stratified by tumor subtype and adjusted for stage and socioeconomic status indicators. Results Median follow-up was 60 months after enrollment (range: 1 day – 118 months). Among 4,609 participants, a total of 854 deaths occurred, of which, 582 deaths were attributed to endometrial carcinoma. Among low-grade endometrioid cases, endometrial carcinoma-specific subhazards were significantly associated with age at diagnosis (HR=1.04, 95% CI=1.01–1.06 per year, P-trend) and BMI (class II obesity vs. normal BMI: HR=2.29, 95% CI=1.06–4.98, P-trend=0.01). Among high-grade endometrioid cases, endometrial carcinoma-specific subhazards were associated with age at diagnosis (HR=1.05, 95% CI=1.02–1.07 per year, P-trend<0.001). Among non-endometrioid cases, endometrial carcinoma-specific subhazards were associated with parity relative to nulliparity among serous (HR=0.55, 95% CI=0.36–0.82) and carcinosarcoma cases (HR=2.01, 95% CI=1.00–4.05). Discussion Several endometrial carcinoma risk factors are associated with prognosis, which occurs in a tumor-subtype specific context. If confirmed, these results would suggest that factors beyond histopathologic features and stage are related to prognosis. PMID:26341710

  11. Inpatient Hematology-Oncology Rotation Is Associated With a Decreased Interest in Pursuing an Oncology Career Among Internal Medicine Residents.

    Science.gov (United States)

    McFarland, Daniel C; Holland, Jimmie; Holcombe, Randall F

    2015-07-01

    The demand for hematologists and oncologists is not being met. We hypothesized that an inpatient hematology-oncology ward rotation would increase residents' interest. Potential reasons mitigating interest were explored and included differences in physician distress, empathy, resilience, and patient death experiences. Agreement with the statement "I am interested in pursuing a career/fellowship in hematology and oncology" was rated by residents before and after a hematology-oncology rotation, with 0 = not true at all, 1 = rarely true, 2 = sometimes true, 3 = often true, and 4 = true nearly all the time. House staff rotating on a hematology-oncology service from November 2013 to October 2014 also received questionnaires before and after their rotations containing the Connors-Davidson Resilience Scale, the Impact of Events Scale-Revised, the Interpersonal Reactivity Index, demographic information, and number of dying patients cared for and if a sense of meaning was derived from that experience. Fifty-six residents completed both before- and after-rotation questionnaires (response rate, 58%). The mean interest score was 1.43 initially and decreased to 1.24 after the rotation (P = .301). Female residents' mean score was 1.13 initially and dropped to 0.81 after the rotation (P = .04). Male residents' mean score was 1.71 initially and 1.81 after the rotation (P = .65). Decreased hematology-oncology interest correlated with decreased empathy; male interest decrease correlated with decreased resilience. An inpatient hematology-oncology ward rotation does not lead to increased interest and, for some residents, may lead to decreased interest in the field. Encouraging outpatient hematology-oncology rotations and the cultivation of resilience, empathy, and meaning regarding death experiences may increase resident interest. Copyright © 2015 by American Society of Clinical Oncology.

  12. CYTOKINE GENE VARIATIONS ASSOCIATED WITH TRAIT AND STATE ANXIETY IN ONCOLOGY PATIENTS AND THEIR FAMILY CAREGIVERS

    Science.gov (United States)

    Miaskowski, Christine; Cataldo, Janine K.; Baggott, Christina R.; West, Claudia; Dunn, Laura B.; Dhruva, Anand; Merriman, John D.; Langford, Dale J.; Kober, Kord M.; Paul, Steven M.; Cooper, Bruce A.; Aouizerat, Bradley E.

    2017-01-01

    Purpose Anxiety is common among cancer patients and their family caregivers (FCs) and is associated with poorer outcomes. Recently, associations between inflammation and anxiety were identified. However, the relationship between variations in cytokine genes and anxiety warrants investigation. Therefore, phenotypic and genotypic characteristics associated with trait and state anxiety were evaluated in a sample of 167 oncology patients with breast, prostate, lung, or brain cancer and 85 of their FCs. Methods Using multiple regression analyses, the associations between participants’ demographic and clinical characteristics, as well as variations in cytokine genes and trait and state anxiety were evaluated. Results In the bivariate analyses, a number of phenotypic characteristics were associated with both trait and state anxiety (e.g., age, functional status). However, some associations were specific only to trait anxiety (e.g., number of comorbid conditions) or state anxiety (e.g., participation with a FC). Variations in three cytokine genes (i.e., interleukin (IL) 1 beta, IL1 receptor 2 (IL1R2), nuclear factor kappa beta 2 (NFKB2)) were associated with trait anxiety and variations in two genes (i.e., IL1R2, tumor necrosis factor alpha (TNFA)) were associated with state anxiety. Conclusions These findings suggest that both trait and state anxiety need to be assessed in oncology patients and their FCs. Furthermore, variations in cytokine genes may contribute to higher levels of anxiety in oncology patients and their FCs. PMID:25249351

  13. Updates from the British Association of Dermatologists 91st annual meeting, 5-7 July 2011, London, U.K.

    Science.gov (United States)

    De Mozzi, P; Alexandroff, A B; Johnston, G A

    2012-08-01

    This is a synopsis of the significant research and clinical papers presented at the British Association of Dermatologists (BAD) meeting held on the 5-7 July 2011 in London, U.K. The conference and satellite symposia highlighted the recent biological, epidemiological and therapeutic advances in dermatology. This report is not meant as a substitute for reading the conference proceedings and related references quoted in this article. © 2012 The Authors. BJD © 2012 British Association of Dermatologists.

  14. Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee.

    Science.gov (United States)

    Okosieme, Onyebuchi; Gilbert, Jackie; Abraham, Prakash; Boelaert, Kristien; Dayan, Colin; Gurnell, Mark; Leese, Graham; McCabe, Christopher; Perros, Petros; Smith, Vicki; Williams, Graham; Vanderpump, Mark

    2016-06-01

    The management of primary hypothyroidism with levothyroxine (L-T4) is simple, effective and safe, and most patients report improved well-being on initiation of treatment. However, a proportion of individuals continue to suffer with symptoms despite achieving adequate biochemical correction. The management of such individuals has been the subject of controversy and of considerable public interest. The American Thyroid Association (ATA) and the European Thyroid Association (ETA) have recently published guidelines on the diagnosis and management of hypothyroidism. These guidelines have been based on extensive reviews of the medical literature and include sections on the role of combination therapy with L-T4 and liothyronine (L-T3) in individuals who are persistently dissatisfied with L-T4 therapy. This position statement by the British Thyroid Association (BTA) summarises the key points in these guidelines and makes recommendations on the management of primary hypothyroidism based on the current literature, review of the published positions of the ETA and ATA, and in line with best principles of good medical practice. The statement is endorsed by the Association of Clinical Biochemistry, (ACB), British Thyroid Foundation, (BTF), Royal College of Physicians (RCP) and Society for Endocrinology (SFE). © 2015 John Wiley & Sons Ltd.

  15. Recommendations for the implementation of distress screening programs in cancer centers: report from the American Psychosocial Oncology Society (APOS), Association of Oncology Social Work (AOSW), and Oncology Nursing Society (ONS) joint task force.

    Science.gov (United States)

    Pirl, William F; Fann, Jesse R; Greer, Joseph A; Braun, Ilana; Deshields, Teresa; Fulcher, Caryl; Harvey, Elizabeth; Holland, Jimmie; Kennedy, Vicki; Lazenby, Mark; Wagner, Lynne; Underhill, Meghan; Walker, Deborah K; Zabora, James; Zebrack, Bradley; Bardwell, Wayne A

    2014-10-01

    In 2015, the American College of Surgeons (ACoS) Commission on Cancer will require cancer centers to implement screening programs for psychosocial distress as a new criterion for accreditation. A joint task force from the American Psychosocial Oncology Society, the Association of Oncology Social Work, and the Oncology Nursing Society developed consensus-based recommendations to guide the implementation of this requirement. In this review, the authors provide recommendations regarding each of the 6 components necessary to meet the ACoS standard: 1) inclusion of psychosocial representation on the cancer committee, 2) timing of screening, 3) method/mode of screening, 4) tools for screening, 5) assessment and referral, and 6) documentation. © 2014 American Cancer Society.

  16. DIAGNOSIS AND TREATMENT OF BREAST CANCER IN SITU. RUSSIAN ASSOCIATION OF ONCOLOGICAL MAMMOLOGY CLINICAL GUIDELINES (PROJECT

    Directory of Open Access Journals (Sweden)

    V. V. Semiglazov

    2017-01-01

    Full Text Available One of the first and foremost tasks of the Russian Association of Oncological Mammology (RAOM is to develop clinical guidelines on diagnosis and treatment of breast cancer taking into account international experience. The guidelines must also be applicable in all regions of the Russian Federation allowing all Russian specialist to be informed about the latest strategies of diagnosis and treatment.These clinical guidelines are based on the following consensus documents:• St. Gallen Expert Panel (2011, 2013,• Expert Panel of the IX International Conference “White Nights – 2012”,• Expert Panel of the RAOM (2013,• International consensus on treatment of metastatic breast cancer ABC 1,• NCCN (2014  and ESMO (2011 practical guidelines,as well as the results of large international randomized studies conducted in partnership with Russian oncological centers.The guidelines take into account the results of the analysis of a cumulative database on breast cancer treatment methods performed at• N.N. Petrov National Medical Research Oncology Center, Ministry of Health of Russia,• Saint  Petersburg City Clinical Oncological  Dispensary.Our guidelines are based on methods that are available everywhere in the Russian Federation, treatment schemes and drugs are presented in accordance with the marketing authorization of the Ministry of Health of Russia, drug therapy takes into account biological subtypes of breast cancer, different courses of the disease as well as nonuniform situation with drug availability in various regions of the Russian Federation.Obviously, such materials cannot serve as a direct guide for action (every patient’s disease is different, but they can lend a helping hand to a doctor striving to treat patients according to the latest achievements of modern oncology.All-Russian non-governmental organization Russian Association of Oncological Mammology. President of the RAOM, corresponding member of the RAS, Prof. V

  17. Causative Organisms and Associated Antimicrobial Resistance in Healthcare-Associated, Central Line-Associated Bloodstream Infections From Oncology Settings, 2009-2012.

    Science.gov (United States)

    See, Isaac; Freifeld, Alison G; Magill, Shelley S

    2016-05-15

    Recent antimicrobial resistance data are lacking from inpatient oncology settings to guide infection prophylaxis and treatment recommendations. We describe central line-associated bloodstream infection (CLABSI) pathogens and antimicrobial resistance patterns reported from oncology locations to the Centers for Disease Control and Prevention's National Healthcare Safety Network (NHSN). CLABSI data reported to NHSN from 2009 to 2012 from adult inpatient oncology locations were compared to data from nononcology adult locations within the same hospitals. Pathogen profile, antimicrobial resistance rates, and CLABSI incidence rates per 1000 central line-days were calculated. CLABSI incidence rates were compared using Poisson regression. During 2009-2012, 4654 CLABSIs were reported to NHSN from 299 adult oncology units. The most common organisms causing CLABSI in oncology locations were coagulase-negative staphylococci (16.9%), Escherichia coli (11.8%), and Enterococcus faecium (11.4%). Fluoroquinolone resistance was more common among E. coli CLABSI in oncology than nononcology locations (56.5% vs 41.5% of isolates tested; P oncology compared to nononcology locations for fluoroquinolone-resistant E. coli (rate ratio, 7.37; 95% confidence interval [CI], 6.20-8.76) and vancomycin-resistant E. faecium (rate ratio, 2.27, 95% CI, 2.03-2.53). However, resistance rates for some organisms, such as Klebsiella species and Pseudomonas aeruginosa, were lower in oncology than in nononcology locations. Antimicrobial-resistant E. coli and E. faecium have become significant pathogens in oncology. Practices for antimicrobial prophylaxis and empiric antimicrobial therapy should be regularly assessed in conjunction with contemporary antimicrobial resistance data. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  18. Evidence-based guidelines for the pharmacological treatment of anxiety disorders : recommendations from the British Association for Psychopharmacology

    NARCIS (Netherlands)

    Baldwin, DS; Anderson, IM; Nutt, DJ; Bandelow, B; Bond, A; Davidson, JRT; den Boer, JA; Fineberg, NA; Knapp, M; Scott, J; Wittchen, HU

    2005-01-01

    These British Association for Psychopharmacology guidelines cover the range and aims of treatment for anxiety disorders. They are based explicitly on the available evidence and are presented as recommendations to aid clinical decision making in primary and secondary medical care. They may also serve

  19. Prevalence of masturbation and associated factors in a British national probability survey.

    Science.gov (United States)

    Gerressu, Makeda; Mercer, Catherine H; Graham, Cynthia A; Wellings, Kaye; Johnson, Anne M

    2008-04-01

    A stratified probability sample survey of the British general population, aged 16 to 44 years, was conducted from 1999 to 2001 (N = 11,161) using face-to-face interviewing and computer-assisted self-interviewing. We used these data to estimate the population prevalence of masturbation, and to identify sociodemographic, sexual behavioral, and attitudinal factors associated with reporting this behavior. Seventy-three percent of men and 36.8% of women reported masturbating in the 4 weeks prior to interview (95% confidence interval 71.5%-74.4% and 35.4%-38.2%, respectively). A number of sociodemographic and behavioral factors were associated with reporting masturbation. Among both men and women, reporting masturbation increased with higher levels of education and social class and was more common among those reporting sexual function problems. For women, masturbation was more likely among those who reported more frequent vaginal sex in the last four weeks, a greater repertoire of sexual activity (such as reporting oral and anal sex), and more sexual partners in the last year. In contrast, the prevalence of masturbation was lower among men reporting more frequent vaginal sex. Both men and women reporting same-sex partner(s) were significantly more likely to report masturbation. Masturbation is a common sexual practice with significant variations in reporting between men and women.

  20. The association between functional movement and overweight and obesity in British primary school children.

    Science.gov (United States)

    Duncan, Michael J; Stanley, Michelle; Leddington Wright, Sheila

    2013-01-01

    The purpose of this study was to examine the association between functional movement and overweight and obesity in British children. Data were obtained from 90, 7-10 year old children (38 boys and 52 girls). Body mass (kg) and height (m) were assessed from which body mass index (BMI) was determined and children were classified as normal weight, overweight or obese according to international cut offs. Functional movement was assessed using the functional movement screen. Total functional movement score was significantly, negatively correlated with BMI (P = .0001). Functional movement scores were also significantly higher for normal weight children compared to obese children (P = .0001). Normal weight children performed significantly better on all individual tests within the functional movement screen compared to their obese peers (P Functional movement scores were not significantly different between boys and girls (P > .05) when considered as total scores. However, girls performed significantly better than boys on the hurdle step (P = .03) and straight leg raise (P = .004) but poorer than boys on the trunk stability push-up (P = .014). This study highlights that overweight and obesity are significantly associated with poorer functional movement in children and that girls outperform boys in functional movements.

  1. Higher Selenium Status is Associated with Adverse Blood Lipid Profile in British Adults1–3

    Science.gov (United States)

    Stranges, Saverio; Laclaustra, Martin; Ji, Chen; Cappuccio, Francesco P.; Navas-Acien, Ana; Ordovas, Jose M.; Rayman, Margaret; Guallar, Eliseo

    2010-01-01

    Recent findings have raised concern about possible associations of high selenium exposure with diabetes and hyperlipidemia in the US, a population with high selenium status. In the UK, a population with lower selenium status, there is little data on the association of selenium status with cardio-metabolic risk factors in the general population. We examined the association of plasma selenium concentration with blood lipids in a nationally representative sample of British adults. A cross-sectional study was conducted among 1042 white participants (aged 19–64 y) in the 2000–2001 UK National Diet and Nutrition Survey. Plasma selenium was measured by inductively coupled-plasma mass spectrometry. Total and HDL cholesterol were measured in nonfasting plasma samples. Mean plasma selenium concentration was 1.10 ± 0.19 μmol/L. The multivariate adjusted differences between the highest (≥1.20 μmol/L) and lowest (selenium were 0.39 (95% CI 0.18, 0.60) mmol/L for total cholesterol, 0.38 (0.17, 0.59) for non-HDL cholesterol, and 0.01 (−0.05, 0.07) for HDL cholesterol. Higher plasma selenium (i.e., ≥1.20 μmol/L) was associated with increased total and non-HDL cholesterol levels but not with HDL in the UK adult population. These findings raise additional concern about potential adverse cardio-metabolic effects of high selenium status. Randomized and mechanistic evidence is necessary to assess causality and to evaluate the impact of this association on cardiovascular risk. PMID:19906812

  2. Higher selenium status is associated with adverse blood lipid profile in British adults.

    Science.gov (United States)

    Stranges, Saverio; Laclaustra, Martin; Ji, Chen; Cappuccio, Francesco P; Navas-Acien, Ana; Ordovas, Jose M; Rayman, Margaret; Guallar, Eliseo

    2010-01-01

    Recent findings have raised concern about possible associations of high selenium exposure with diabetes and hyperlipidemia in the US, a population with high selenium status. In the UK, a population with lower selenium status, there is little data on the association of selenium status with cardio-metabolic risk factors in the general population. We examined the association of plasma selenium concentration with blood lipids in a nationally representative sample of British adults. A cross-sectional study was conducted among 1042 white participants (aged 19-64 y) in the 2000-2001 UK National Diet and Nutrition Survey. Plasma selenium was measured by inductively coupled-plasma mass spectrometry. Total and HDL cholesterol were measured in nonfasting plasma samples. Mean plasma selenium concentration was 1.10 +/- 0.19 micromol/L. The multivariate adjusted differences between the highest (> or =1.20 micromol/L) and lowest (selenium were 0.39 (95% CI 0.18, 0.60) mmol/L for total cholesterol, 0.38 (0.17, 0.59) for non-HDL cholesterol, and 0.01 (-0.05, 0.07) for HDL cholesterol. Higher plasma selenium (i.e., > or =1.20 micromol/L) was associated with increased total and non-HDL cholesterol levels but not with HDL in the UK adult population. These findings raise additional concern about potential adverse cardio-metabolic effects of high selenium status. Randomized and mechanistic evidence is necessary to assess causality and to evaluate the impact of this association on cardiovascular risk.

  3. Factors associated with the attitudes of oncology nurses toward hospice care in China

    Directory of Open Access Journals (Sweden)

    Yang F

    2017-05-01

    Full Text Available Fei-Min Yang,1 Zhi-Hong Ye,2 Lei-Wen Tang,3 Wei-Lan Xiang,3 Lin-Juan Yan,4 Min-Li Xiang5 1Department of General Surgery, 2Department of Nursing, 3Department of Nursing Education, 4Department of Surgical Oncology, 5Department of Medical Oncology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China Objective: To examine factors that are associated with the apprehension levels of oncology nurses toward hospice care. Factors examined in this study included demographics, nursing experience, education levels, title and post, personal experiences, and attitudes toward end-of-life care. Methods: Questionnaires were provided to nurses (n=201 from three first-tier hospitals in China. A quantitative scale, Professional End-of-life Care Attitude Scale (PEAS, was used to assess personal and professional apprehension levels toward hospice care. The PEAS was translated to Chinese with terms adapted to the cultural environment in China. Statistical analyses were performed to examine the relationships between the apprehension levels and various factors. Results: The total PEAS scores exhibited internal consistency and reliability, with a Cronbach α=0.897 and Pearson’s r=0.9030. Of the 201 nurses, 184 provided a valid response (91.5%. Education level was significantly correlated with personal (P<0.01 and professional apprehension levels (P<0.05. Higher apprehension level was found in nurses with less education. Conclusion: The PEAS quantitative survey is useful for evaluating apprehension levels of nurses toward hospice care. Nurses with more education experienced less anxiety when providing care for terminally ill patients. The findings suggested that education programs on hospice care could be strengthened to help nurses cope with negative attitudes toward end-of-life care. Keywords: end of life, nurses’ perspective, communication, palliative care, cancer patients, terminally ill

  4. Association of trial registration with the results and conclusions of published trials of new oncology drugs

    Directory of Open Access Journals (Sweden)

    Bero Lisa

    2009-12-01

    Full Text Available Abstract Background Registration of clinical trials has been introduced largely to reduce bias toward statistically significant results in the trial literature. Doubts remain about whether advance registration alone is an adequate measure to reduce selective publication, selective outcome reporting, and biased design. One of the first areas of medicine in which registration was widely adopted was oncology, although the bulk of registered oncology trials remain unpublished. The net influence of registration on the literature remains untested. This study compares the prevalence of favorable results and conclusions among published reports of registered and unregistered randomized controlled trials of new oncology drugs. Methods We conducted a cross-sectional study of published original research articles reporting clinical trials evaluating the efficacy of drugs newly approved for antimalignancy indications by the United States Food and Drug Administration (FDA from 2000 through 2005. Drugs receiving first-time approval for indications in oncology were identified using the FDA web site and Thomson Centerwatch. Relevant trial reports were identified using PubMed and the Cochrane Library. Evidence of advance trial registration was obtained by a search of clinicaltrials.gov, WHO, ISRCTN, NCI-PDQ trial databases and corporate trial registries, as well as articles themselves. Data on blinding, results for primary outcomes, and author conclusions were extracted independently by two coders. Univariate and multivariate logistic regression identified associations between favorable results and conclusions and independent variables including advance registration, study design characteristics, and industry sponsorship. Results Of 137 original research reports from 115 distinct randomized trials assessing 25 newly approved drugs for treating cancer, the 54 publications describing data from trials registered prior to publication were as likely to report

  5. Making Kew Observatory: the Royal Society, the British Association and the politics of early Victorian science.

    Science.gov (United States)

    Macdonald, Lee T

    2015-09-01

    Built in 1769 as a private observatory for King George III, Kew Observatory was taken over in 1842 by the British Association for the Advancement of Science (BAAS). It was then quickly transformed into what some claimed to be a 'physical observatory' of the sort proposed by John Herschel - an observatory that gathered data in a wide range of physical sciences, including geomagnetism and meteorology, rather than just astronomy. Yet this article argues that the institution which emerged in the 1840s was different in many ways from that envisaged by Herschel. It uses a chronological framework to show how, at every stage, the geophysicist and Royal Artillery officer Edward Sabine manipulated the project towards his own agenda: an independent observatory through which he could control the geomagnetic and meteorological research, including the ongoing 'Magnetic Crusade'. The political machinations surrounding Kew Observatory, within the Royal Society and the BAAS, may help to illuminate the complex politics of science in early Victorian Britain, particularly the role of 'scientific servicemen' such as Sabine. Both the diversity of activities at Kew and the complexity of the observatory's origins make its study important in the context of the growing field of the 'observatory sciences'.

  6. Who presents satisfied? Non-modifiable factors associated with patient satisfaction among gynecologic oncology clinic patients.

    Science.gov (United States)

    Barber, Emma L; Bensen, Jeannette T; Snavely, Anna C; Gehrig, Paola A; Doll, Kemi M

    2016-08-01

    To examine associations between non-modifiable patient factors and patient satisfaction (PS) among women presenting to a gynecologic oncology clinic. This is a cross sectional analysis of patients presenting for surgical management by a gynecologic oncologist at a tertiary care academic medical center. The Patient Satisfaction Questionnaire (PSQ-18) that measures PS in seven domains of health care was administered. Scores were converted to "satisfied" versus "unsatisfied/equivocal". Demographic and medical factors were obtained from the medical record. Chi-square, t-tests, and multivariable logistic regression were used. 208 patients completed the baseline patient satisfaction questionnaire and the median PSQ-18 score was 70.5 (range: 42-90). Median age was 58years (range: 22-93). Several non-modifiable factors were associated with PS. White patients had higher interpersonal PS than minorities (86% v 65%, p=0.002). The uninsured had lower interpersonal (60% v 86%, p=0.003) and accessibility PS (33% v 67%, p=0.03). Increasing education and less time travelled to care were both associated with higher interpersonal (p=0.03, p=0.05) and accessibility PS (p=0.01, p=0.01). There was no association between clinical factors (BMI, comorbidities, cancer) and PS. In multivariable analysis, the strongest predictor of interpersonal PS was white race while the strongest predictors of accessibility PS were time travelled to care and insurance status. Patient satisfaction scores among patients presenting to a gynecologic oncology clinic are associated with non-modifiable demographic, financial and geographic factors. Pay for performance measures that use summed patient satisfaction scores may penalize hospitals for patient-mix driven differences. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Association between psychological distress and cancer type in patients referred to a psycho-oncology service

    LENUS (Irish Health Repository)

    Lavelle, C

    2017-06-01

    Psychological distress is common in patients with cancer and psychological well-being is increasingly seen as an important component of cancer care. The aim of this study was to examine the relationship between cancer type and subjective distress. The following data were collected from a database of consecutive psycho-oncology referrals to the Liaison Psychiatry service in Cork University Hospital from 2006 to 2015: demographics, cancer diagnosis, Distress Thermometer (DT) score. 2102 out of 2384 referrals were assessed. Of those assessed, the most common cancer diagnoses were breast (23%, n=486) followed by haematological (21%, n=445). There were significant difference in DT score between the different cancer types, (χ2(13)=33.685, p=0.001, Kruskal–Wallis test). When adjusted for age, gender and whether or not the cancer was recently diagnosed, there was no significant association between cancer type and psychological distress. In conclusion, cancer type is not associated with level of distress in cancer.

  8. Saudi oncology society and Saudi urology association combined clinical management guidelines for prostate cancer

    Directory of Open Access Journals (Sweden)

    Ashraf Abusamra

    2016-01-01

    Full Text Available This is an update to the previously published Saudi guidelines for the evaluation, medical, and surgical management of patients diagnosed with prostate cancer. It is categorized according to the stage of the disease using the tumor node metastasis staging system 7th edition. The guidelines are presented with supporting evidence level, they are based on comprehensive literature review, several internationally recognized guidelines, and the collective expertise of the guidelines committee members (authors who were selected by the Saudi oncology society and Saudi urological association. Considerations to the local availability of drugs, technology, and expertise have been regarded. These guidelines should serve as a roadmap for the urologists, oncologists, general physicians, support groups, and health care policy makers in the management of patients diagnosed with adenocarcinoma of the prostate to.

  9. Saudi Oncology Society and Saudi Urology Association combined clinical management guidelines for testicular germ cell tumors

    Directory of Open Access Journals (Sweden)

    Mohammed Alotaibi

    2016-01-01

    Full Text Available This is an update to the previously published Saudi guidelines for the evaluation, medical, and surgical management of patients diagnosed with testicular germ cell tumors. It is categorized according to the stage of the disease using the tumor-node-metastasis staging system 7th edition. The guidelines are presented with supporting evidence level, they are based on comprehensive literature review, several internationally recognized guidelines, and the collective expertise of the guidelines committee members (authors who were selected by the Saudi Oncology Society and Saudi Urological Association. Considerations to the local availability of drugs, technology and expertise have been regarded. These guidelines should serve as a roadmap for the urologists, oncologists, general physicians, support groups, and health care policy makers in the management of patients diagnosed with testicular germ cell tumors.

  10. Saudi Oncology Society and Saudi Urology Association combined clinical management guidelines for renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Abdullah Alghamdi

    2016-01-01

    Full Text Available This is an update to the previously published Saudi guidelines for the evaluation, medical, and surgical management of patients diagnosed with renal cell carcinoma (RCC. It is categorized according to the stage of the disease using the tumor node metastasis staging system 7th edition. The guidelines are presented with supporting evidence level, they are based on comprehensive literature review, several internationally recognized guidelines, and the collective expertise of the guidelines committee members (authors who were selected by the Saudi Oncology Society and Saudi Urological Association. Considerations to the local availability of drugs, technology, and expertise have been regarded. These guidelines should serve as a roadmap for the urologists, oncologists, general physicians, support groups, and healthcare policy makers in the management of patients diagnosed with RCC.

  11. Saudi Oncology Society and Saudi Urology Association combined clinical management guidelines for renal cell carcinoma.

    Science.gov (United States)

    Alghamdi, Abdullah; Alkhateeb, Sultan; Alghamdi, Khalid; Bazarbashi, Shouki; Murshid, Esam; Alotaibi, Mohammed; Abusamra, Ashraf; Rabah, Danny; Ahmad, Imran; Al-Mansour, Mubarak; Saadeddin, Ahmad; Alsharm, Abdullah

    2016-01-01

    This is an update to the previously published Saudi guidelines for the evaluation, medical, and surgical management of patients diagnosed with renal cell carcinoma (RCC). It is categorized according to the stage of the disease using the tumor node metastasis staging system 7(th) edition. The guidelines are presented with supporting evidence level, they are based on comprehensive literature review, several internationally recognized guidelines, and the collective expertise of the guidelines committee members (authors) who were selected by the Saudi Oncology Society and Saudi Urological Association. Considerations to the local availability of drugs, technology, and expertise have been regarded. These guidelines should serve as a roadmap for the urologists, oncologists, general physicians, support groups, and healthcare policy makers in the management of patients diagnosed with RCC.

  12. Association of preresidency peer-reviewed publications with radiation oncology resident choice of academic versus private practice career.

    Science.gov (United States)

    McClelland, Shearwood; Thomas, Charles R; Wilson, Lynn D; Holliday, Emma B; Jaboin, Jerry J

    The decision of radiation oncology residents to pursue academic versus private practice careers plays a central role in shaping the present and future of the field, but factors that are potentially predictive of this decision are lacking. This study was performed to examine the role of several factors publicly available before residency on postresidency career choice, including preresidency peer-reviewed publications (PRPs), which have been associated with resident career choice in comparably competitive subspecialties such as neurosurgery. Using a combination of Internet searches, telephone interviews, and the 2015 Association of Residents in Radiation Oncology directory, a list of 2016 radiation oncology resident graduates was compiled, along with their postresidency career choice. PRP was defined as the number of PubMed publications encompassing the end of the calendar year (2010) in which residency applications were due; this number was then correlated with career choice. A total of 163 residents from 76 Accreditation Council for Graduate Medical Education-certified programs were examined: 78% were male, 22% were MDs/PhDs, and 79 graduates (48%) chose academic careers. Fifty-two percent of graduates had at least 1 PRP at the time of application to radiation oncology residency; 35% had more than 1 PRP. Regarding career choice, the difference between 0 and 1+ PRP was statistically significant (odds ratio, 3.3; P 1 PRP. Sex, PhD, or non-PhD dual degree status were not associated with career choice. Radiation oncology residency graduates with 1 or more PRPs at the time of residency application were roughly 2 times more likely to choose an academic career as their initial career choice than graduates with no preresidency PRPs. This information may prove useful to medical students, medical school advisors, and residency program directors and deserves further prospective investigation. Copyright © 2017 American Society for Radiation Oncology. Published by Elsevier

  13. Sensitization to wheat flour and enzymes and associated respiratory symptoms in British bakers.

    Science.gov (United States)

    Harris-Roberts, Joanne; Robinson, Edward; Waterhouse, Judith C; Billings, Catherine G; Proctor, Alison R; Stocks-Greaves, Micah; Rahman, Shamim; Evans, Gareth; Garrod, Andrew; Curran, Andrew D; Fishwick, David

    2009-02-01

    Current literature suggests that flour exposed workers continue to be at risk of allergic sensitization to flour dust and respiratory ill health. A cross-sectional study of 225 workers currently potentially exposed to flour dust in British bakeries was performed to identify predictors of sensitization to wheat flour and enzymes. Work-related nasal irritation was the most commonly reported symptom (28.9%) followed by eye irritation (13.3%) and work-related cough or chest tightness (both 10.2%). Work-related chest tightness was significantly associated (OR 7.9, 1.3-46.0) with co-sensitization to wheat flour and any added enzyme. Working at a bakery with inadequate control measures was not a risk factor for reporting work-related respiratory symptoms (OR 1.3, 0.4-3.7). Fifty-one workers were atopic and 23 (14%) were sensitized to workplace allergens. Atopy was the strongest predictive factor (OR 18.4, 5.3-64.3) determining sensitization. Current versus never smoking (OR 4.7, 1.1-20.8) was a significant risk factor for sensitization to wheat flour or enzymes in atopic workers only, corrected for current level and duration of exposure. This effect was not seen in non-atopic workers (OR 1.9, 0.2-17.9). Evidence of sensitization to less commonly encountered allergens was also seen to Aspergillus niger derived cellulase, hemicellulase and xylanase mix, in addition to glucose oxidase and amyloglucosidase mix. The combination of health surveillance and exposure control in this population has been insufficient to prevent clinically significant workplace sensitization. Smoking may pose an additional risk factor for sensitization in atopic workers. Am. J. Ind. Med. 52:133-140, 2009. (c) 2008 Crown copyright.

  14. Updates from the British Association of Dermatologists 89th Annual Meeting, 7-10 July 2009, Glasgow, U.K.

    Science.gov (United States)

    Alexandroff, A B; Flohr, C; Johnston, G A

    2010-07-01

    This is a synopsis of the significant research and clinical papers presented at the British Association of Dermatologists meeting held during 7-10 July 2009 in Glasgow, U.K. The conference and satellite symposia highlighted the recent biological, epidemiological and therapeutic advances in dermatology. This report is not meant as a substitute for reading the conference proceedings and related references quoted in this article.

  15. Becoming a Researcher: Forms of Capital Associated with "Research Capacity" Trajectories of Young British Social Anthropologists

    Science.gov (United States)

    Holligan, Chris

    2015-01-01

    The paper privileges the "voices" of British social anthropologists examining their perceptions of how their research expertise was acquired. Reference is made to the case of education research in Britain, which, by comparison with social anthropology, reveals limited capacity as measured through performance audits of scientific research…

  16. Burnout and associated factors among members of the Society of Gynecologic Oncology.

    Science.gov (United States)

    Rath, Kellie S; Huffman, Laura B; Phillips, Gary S; Carpenter, Kristen M; Fowler, Jeffrey M

    2015-12-01

    Burnout is specific to the work domain and in physicians is indicative of emotional exhaustion, depersonalization in relationships with coworkers and detachment from patients, and a sense of inadequacy or low personal accomplishment. The purpose of this study was to determine the burnout rate among gynecologic oncologists and evaluate other personal, professional, and psychosocial factors associated with this condition. This study used a cross-sectional design. Current members of the Society of Gynecologic Oncology were sent an anonymous email survey including 76 items measuring burnout, psychosocial distress, career satisfaction, and quality of life. A total of 1086 members were invited, 436 (40.1%) responded, and 369 (84.6%) of those completed the survey. Of physicians, 30% scored high for emotional exhaustion, 10% high for depersonalization, and 11% low for personal accomplishment. Overall, 32% of physicians scored above clinical cutoffs indicating burnout. In all, 33% screened positive for depression, 13% endorsed a history of suicidal ideation, 15% screened positive for alcohol abuse, and 34% reported impaired quality of life. Nonetheless, 70% reported high levels of personal accomplishment, and results suggested most were satisfied with their careers, as 89% would enter medicine again and 61% would encourage their child to enter medicine. Respondents with high burnout scores were less likely to report they would become a physician again (P = .002) or encourage a child to enter medicine (P quality of life (P career satisfaction in gynecologic oncologists. Burnout in obstetrics-gynecology and gynecologic oncology is of particular concern as young age and female gender are often identified as risk factors for this significant problem. Interventions targeted at improving quality of life, treatment of depression, or alcohol abuse may have an impact on burnout. However, significant barriers may exist as 44.5% of respondents in this study reported that they would be

  17. Results of the 2014 Survey of the Association of Directors of Radiation Oncology Programs (ADROP).

    Science.gov (United States)

    Jani, Ashesh B; Marshall, David; Vapiwala, Neha; Davis, Sara Beth; Langer, Mark

    2015-01-01

    In 2014, the Association of Directors of Radiation Oncology Programs (ADROP) conducted an in-depth survey of program directors along several axes. We report the results of this survey and compare the major findings with those of the 2007 ADROP survey. The survey was written and approved by ADROP leadership in 2012, announced online through broadcasts throughout 2013 and early 2014, and closed in mid-2014. The results based on question groups related to (1) hours spent in activities, (2) budget and nonprogram resources, (3) physics/biology didactics, (4) mock exams/didactics/research, (5) electives, (6) students, and (7) resources/challenges were tabulated. Descriptive comparisons with the 2007 survey were performed. There was 26% participation (23/88 programs). Major areas of time commitment were faculty and site organization, maintenance, and corrections (70 hours/year) and didactics/conferences and rounds (200 hours/year). The median program director protected time was 23% (range 0%-50%). All responding programs (100%) had biology and physics courses and assigned directors, but only approximately 20% of respondents had a threshold grade in these courses for graduation. Major resources desired were templates of goals/objectives by disease site, competency evaluations by level, journal club repository, and software for contouring, oral examination preparation, grant writing, publication writing, oral presentation, and effective teaching. Major activity challenges were Accreditation Council for Graduate Medical Education external review and time commitment. Overall, the 2014 results are similar to those of the 2007 survey. The average time commitment remains considerably higher than the 10% minimum required in the current ACGME program requirements. The survey results may guide ADROP membership in centralizing some of the identified resources needed. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  18. 2016 Laboratory guidelines for postvasectomy semen analysis: Association of Biomedical Andrologists, the British Andrology Society and the British Association of Urological Surgeons.

    Science.gov (United States)

    Hancock, P; Woodward, B J; Muneer, A; Kirkman-Brown, J C

    2016-07-01

    Post-vasectomy semen analysis (PVSA) is the procedure used to establish whether sperm are present in the semen following a vasectomy. PVSA is presently carried out by a wide variety of individuals, ranging from doctors and nurses in general practitioner (GP) surgeries to specialist scientists in andrology laboratories, with highly variable results.Key recommendations are that: (1) PVSA should take place a minimum of 12 weeks after surgery and after a minimum of 20 ejaculations. (2) Laboratories should routinely examine samples within 4 h of production if assessing for the presence of sperm. If non-motile sperm are observed, further samples must be examined within 1 h of production. (3) Assessment of a single sample is acceptable to confirm vasectomy success if all recommendations and laboratory methodology are met and no sperm are observed. Clearance can then be given. (4) The level for special clearance should be <100 000/mL non-motile sperm. Special clearance cannot be provided if any motile sperm are observed and should only be given after assessment of two samples in full accordance with the methods contained within these guidelines. Surgeons are responsible both preoperatively and postoperatively for the counselling of patients and their partners regarding complications and the possibility of late recanalisation after clearance. These 2016 guidelines replace the 2002 British Andrology Society (BAS) laboratory guidelines and should be regarded as definitive for the UK in the provision of a quality PVSA service, accredited to ISO 15189:2012, as overseen by the United Kingdom Accreditation Service (UKAS). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. Factors associated with increased academic productivity among US academic radiation oncology faculty.

    Science.gov (United States)

    Zhang, Catherine; Murata, Stephen; Murata, Mark; Fuller, Clifton David; Thomas, Charles R; Choi, Mehee; Holliday, Emma B

    Publication productivity metrics can help evaluate academic faculty for hiring, promotion, grants, and awards; however, limited benchmarking data exist, which makes intra- and interdepartmental comparisons difficult. Therefore, we sought to evaluate the scholarly activity of physician faculty at academic radiation oncology (RO) departments and establish factors associated with increased academic productivity. Citation database searches were performed for all physician-faculty in US residency-affiliated academic RO departments. Demographics, National Institutes of Health (NIH) funding, and bibliometrics (number of publications, Hirsch-[h]-index, and m-index [Hirsch index divided by the number of years since first publication]) were collected and stratified by academic rank. Senior academic rank was defined as full professor, professor, and/or chair. Junior academic rank was defined as all others. Logistic regression was performed to determine the association of academic rank and other factors with h- and m-indices. A total of 1191 academic RO physician faculty from 75 institutions were included in the analysis. The mean (standard deviation) number of publications and h- and m-indices were 48.2 (71.2), 14.5 (15), and 0.86 (0.83), respectively. The median (interquartile range) number of publications and h- and m-indices were 20 (6-61), 9 (4-20), and 0.69 (0.38-1.10), respectively. Recursive partitioning analysis revealed a statistically significant numeric h-index threshold of 21 between junior and senior faculty (LogWorth 114; receiver operating characteristic, 0.828). Senior faculty status, receipt of NIH funding, and a larger department size were associated with increased h- and m-indices. Current academic RO departments have relatively high objective metrics of scholastic productivity compared with prior benchmarking analyses of RO departments and compared with published metrics from other academic medicine subspecialties. An h-index of 21 or greater was

  20. Cytokine Gene Polymorphisms Associated With Symptom Clusters in Oncology Patients Undergoing Radiation Therapy.

    Science.gov (United States)

    Miaskowski, Christine; Conley, Yvette P; Mastick, Judy; Paul, Steven M; Cooper, Bruce A; Levine, Jon D; Knisely, Mitchell; Kober, Kord M

    2017-09-01

    Most of the reviews on the biological basis for symptom clusters suggest that inflammatory processes are involved in the development and maintenance of the symptom clusters. However, no studies have evaluated for associations between genetic polymorphisms and common symptom clusters (e.g., mood disturbance, sickness behavior). Examine the associations between cytokine gene polymorphisms and the severity of three distinct symptom clusters (i.e., mood-cognitive, sickness-behavior, treatment-related) in a sample of patients with breast and prostate cancer (n = 157) at the completion of radiation therapy. Symptom severity was assessed using the Memorial Symptom Assessment Scale. Symptom clusters were created using exploratory factor analysis. The associations between cytokine gene polymorphisms and the symptom cluster severity scores were evaluated using regression analyses. Polymorphisms in C-X-C motif chemokine ligand 8 (CXCL8), interleukin (IL13), and nuclear factor kappa beta 2 (NFKB2) were associated with severity scores for the mood-cognitive symptom cluster. In addition to interferon gamma (IFNG1), the same polymorphism in NFKB2 (i.e., rs1056890) that was associated with the mood-cognitive symptom cluster score was associated with the sickness-behavior symptom cluster. Polymorphisms in interleukin 1 receptor 1 (IL1R1), IL6, and NFKB1 were associated with severity factor scores for the treatment-related symptom cluster. Our findings support the hypotheses that symptoms that cluster together have a common underlying mechanism and the most common symptom clusters in oncology patients are associated polymorphisms in genes involved in a variety of inflammatory processes. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  1. Functional Movement Is Negatively Associated with Weight Status and Positively Associated with Physical Activity in British Primary School Children

    Directory of Open Access Journals (Sweden)

    Michael J. Duncan

    2012-01-01

    Full Text Available Although prior studies have suggested that overweight and obesity in childhood are associated with poorer functional movement performance, no study appears to have examined this issue in a pediatric population. The relations between BMI, ambulatory physical activity and functional movement screen (FMS performance were compared in 58, 10-11-year-old children. Total FMS score was significantly, negatively correlated with BMI (=.0001 and positively related to PA (=.029. Normal weight children scored significantly better for total FMS score compared to children classified as overweight/obese (=.0001. Mean ± S.D. of FMS scores were 15.5±2.2 and 10.6±2.1 in normal weight and overweight/obese children, respectively. BMI and PA were also significant predictors of functional movement (=.0001, Adjusted 2=.602 with BMI and PA predicting 52.9% and 7.3% of the variance in total FMS score, respectively. The results of this study highlight that ambulatory physical activity and weight status are significant predictors of functional movement in British children. Scientists and practitioners therefore need to consider interventions which develop functional movement skills alongside physical activity and weight management strategies in children in order to reduce the risks of orthopaedic abnormality arising from suboptimal movement patterns in later life.

  2. Association between metabolic syndrome, obesity, diabetes mellitus and oncological outcomes of bladder cancer: a systematic review.

    Science.gov (United States)

    Cantiello, Francesco; Cicione, Antonio; Salonia, Andrea; Autorino, Riccardo; De Nunzio, Cosimo; Briganti, Alberto; Gandaglia, Giorgio; Dell'Oglio, Paolo; Capogrosso, Paolo; Damiano, Rocco

    2015-01-01

    Metabolic syndrome is a cluster of several metabolic abnormalities, its prevalence is increasing worldwide. To summarize the most recent evidence regarding the relationship between metabolic syndrome, its components and the oncological outcomes in bladder cancer patients, a National Center for Biotechnology Information PubMed search for relevant articles either published or e-published up to March 2014 was carried out by combining the following Patient population, Intervention, Comparison, Outcome terms: metabolic syndrome, obesity, body mass index, hyperglycemia, insulin resistance, diabetes, hypertension, dyslipidemia, bladder cancer, risk, mortality, cancer specific survival, disease recurrence and progression. Metabolic syndrome is a complex, highly prevalent disorder, and central obesity, insulin resistance, dyslipidemia and hypertension are its main components. Published findings would suggest that metabolic syndrome per se might be associated with an increased risk of bladder cancer in male patients, but it did not seem to confer a risk of worse prognosis. Considering the primary components of metabolic syndrome (hypertension, obesity and dyslipidemia), available data are uncertain, and it is no possible to reach a conclusion yet on either a direct or an indirect association with bladder cancer risk and prognosis. Only with regard to type 2 diabetes mellitus, available data would suggest a potential negative correlation. However, as the evaluation of bladder cancer risk and prognosis in patients with metabolic disorders is certainly complex, further studies are urgently required to better assess the actual role of these metabolic disorders. © 2014 The Japanese Urological Association.

  3. Association between progression-free survival and health-related quality of life in oncology: a systematic review protocol.

    Science.gov (United States)

    Kovic, Bruno; Guyatt, Gordon; Brundage, Michael; Thabane, Lehana; Bhatnagar, Neera; Xie, Feng

    2016-09-02

    There is an increasing number of new oncology drugs being studied, approved and put into clinical practice based on improvement in progression-free survival, when no overall survival benefits exist. In oncology, the association between progression-free survival and health-related quality of life is currently unknown, despite its importance for patients with cancer, and the unverified assumption that longer progression-free survival indicates improved health-related quality of life. Thus far, only 1 study has investigated this association, providing insufficient evidence and inconclusive results. The objective of this study protocol is to provide increased transparency in supporting a systematic summary of the evidence bearing on this association in oncology. Using the OVID platform in MEDLINE, Embase and Cochrane databases, we will conduct a systematic review of randomised controlled human trials addressing oncology issues published starting in 2000. A team of reviewers will, in pairs, independently screen and abstract data using standardised, pilot-tested forms. We will employ numerical integration to calculate mean incremental area under the curve between treatment groups in studies for health-related quality of life, along with total related error estimates, and a 95% CI around incremental area. To describe the progression-free survival to health-related quality of life association, we will construct a scatterplot for incremental health-related quality of life versus incremental progression-free survival. To estimate the association, we will use a weighted simple regression approach, comparing mean incremental health-related quality of life with either median incremental progression-free survival time or the progression-free survival HR, in the absence of overall survival benefit. Identifying direction and magnitude of association between progression-free survival and health-related quality of life is critically important in interpreting results of oncology

  4. Large-scale automatic extraction of side effects associated with targeted anticancer drugs from full-text oncological articles.

    Science.gov (United States)

    Xu, Rong; Wang, QuanQiu

    2015-06-01

    Targeted anticancer drugs such as imatinib, trastuzumab and erlotinib dramatically improved treatment outcomes in cancer patients, however, these innovative agents are often associated with unexpected side effects. The pathophysiological mechanisms underlying these side effects are not well understood. The availability of a comprehensive knowledge base of side effects associated with targeted anticancer drugs has the potential to illuminate complex pathways underlying toxicities induced by these innovative drugs. While side effect association knowledge for targeted drugs exists in multiple heterogeneous data sources, published full-text oncological articles represent an important source of pivotal, investigational, and even failed trials in a variety of patient populations. In this study, we present an automatic process to extract targeted anticancer drug-associated side effects (drug-SE pairs) from a large number of high profile full-text oncological articles. We downloaded 13,855 full-text articles from the Journal of Oncology (JCO) published between 1983 and 2013. We developed text classification, relationship extraction, signaling filtering, and signal prioritization algorithms to extract drug-SE pairs from downloaded articles. We extracted a total of 26,264 drug-SE pairs with an average precision of 0.405, a recall of 0.899, and an F1 score of 0.465. We show that side effect knowledge from JCO articles is largely complementary to that from the US Food and Drug Administration (FDA) drug labels. Through integrative correlation analysis, we show that targeted drug-associated side effects positively correlate with their gene targets and disease indications. In conclusion, this unique database that we built from a large number of high-profile oncological articles could facilitate the development of computational models to understand toxic effects associated with targeted anticancer drugs. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Factors associated with the attitudes of oncology nurses toward hospice care in China.

    Science.gov (United States)

    Yang, Fei-Min; Ye, Zhi-Hong; Tang, Lei-Wen; Xiang, Wei-Lan; Yan, Lin-Juan; Xiang, Min-Li

    2017-01-01

    To examine factors that are associated with the apprehension levels of oncology nurses toward hospice care. Factors examined in this study included demographics, nursing experience, education levels, title and post, personal experiences, and attitudes toward end-of-life care. Questionnaires were provided to nurses (n=201) from three first-tier hospitals in China. A quantitative scale, Professional End-of-life Care Attitude Scale (PEAS), was used to assess personal and professional apprehension levels toward hospice care. The PEAS was translated to Chinese with terms adapted to the cultural environment in China. Statistical analyses were performed to examine the relationships between the apprehension levels and various factors. The total PEAS scores exhibited internal consistency and reliability, with a Cronbach α =0.897 and Pearson's r =0.9030. Of the 201 nurses, 184 provided a valid response (91.5%). Education level was significantly correlated with personal ( P education. The PEAS quantitative survey is useful for evaluating apprehension levels of nurses toward hospice care. Nurses with more education experienced less anxiety when providing care for terminally ill patients. The findings suggested that education programs on hospice care could be strengthened to help nurses cope with negative attitudes toward end-of-life care.

  6. Results of the 2013-2015 Association of Residents in Radiation Oncology Survey of Chief Residents in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Nabavizadeh, Nima, E-mail: nabaviza@ohsu.edu [Department of Radiation Medicine, Oregon Health and Science University, Portland, Oregon (United States); Burt, Lindsay M. [Department of Radiation Oncology, University of Utah, Salt Lake City, Utah (United States); Mancini, Brandon R. [Department of Therapeutic Radiology, Yale University, New Haven, Connecticut (United States); Morris, Zachary S. [Department of Human Oncology, University of Wisconsin, Madison, Wisconsin (United States); Walker, Amanda J. [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland (United States); Miller, Seth M. [Department of Radiation Oncology, University of North Carolina Chapel Hill, Chapel Hill, North Carolina (United States); Bhavsar, Shripal [Department of Radiation Oncology, Integris Cancer Institute, Oklahoma City, Oklahoma (United States); Mohindra, Pranshu [Department of Radiation Oncology, University of Maryland, Baltimore, Maryland (United States); Kim, Miranda B. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Kharofa, Jordan [Department of Radiation Oncology, University of Cincinnati, Cincinnati, Ohio (United States)

    2016-02-01

    Purpose: The purpose of this project was to survey radiation oncology chief residents to define their residency experience and readiness for independent practice. Methods and Materials: During the academic years 2013 to 2014 and 2014 to 2015, the Association of Residents in Radiation Oncology (ARRO) conducted an electronic survey of post-graduate year-5 radiation oncology residents in the United States during the final 3 months of training. Descriptive statistics are reported. Results: Sixty-six chief residents completed the survey in 2013 to 2014 (53% response rate), and 69 completed the survey in 2014 to 2015 (64% response rate). Forty to 85% percent of residents reported inadequate exposure to high-dose rate and low-dose rate brachytherapy. Nearly all residents in both years (>90%) reported adequate clinical experience for the following disease sites: breast, central nervous system, gastrointestinal, genitourinary, head and neck, and lung. However, as few as 56% reported adequate experience in lymphoma or pediatric malignancies. More than 90% of residents had participated in retrospective research projects, with 20% conducting resident-led prospective clinical trials and 50% conducting basic science or translational projects. Most chief residents reported working 60 or fewer hours per week in the clinical/hospital setting and performing fewer than 15 hours per week tasks that were considered to have little or no educational value. There was more than 80% compliance with Accreditation Council for Graduate Medical Education (ACGME) work hour limits. Fifty-five percent of graduating residents intended to join an established private practice group, compared to 25% who headed for academia. Residents perceive the job market to be more competitive than previous years. Conclusions: This first update of the ARRO chief resident survey since the 2007 to 2008 academic year documents US radiation oncology residents' experiences and conditions over a 2-year period

  7. The association between timing of initiation of adjuvant therapy and the survival of early stage ovarian cancer patients - An analysis of NRG Oncology/Gynecologic Oncology Group trials.

    Science.gov (United States)

    Chan, John K; Java, James J; Fuh, Katherine; Monk, Bradley J; Kapp, Daniel S; Herzog, Thomas; Bell, Jeffrey; Young, Robert

    2016-12-01

    To determine the association between timing of adjuvant therapy initiation and survival of early stage ovarian cancer patients. Data were obtained from women who underwent primary surgical staging followed by adjuvant therapy from two Gynecologic Oncology Group trials (protocols # 95 and 157). Kaplan-Meier estimates and Cox proportional hazards model adjusted for covariates were used for analyses. Of 497 stage I-II epithelial ovarian cancer patients, the median time between surgery and initiation of adjuvant therapy was 23days (25th-75th%: 12-33days). The time interval from surgery to initiation of adjuvant therapy was categorized into three groups: 4weeks. The corresponding 5-year recurrence-free survival rates were 72.8%, 73.9%, and 79.5% (p=0.62). The 5-year overall survival rates were 79.4%, 81.9%, and 82.8%, respectively (p=0.51; p=0.33 - global test). As compared to 4weeks. Age, stage, grade, and cytology were important prognostic factors. Timing of adjuvant therapy initiation was not associated with survival in early stage epithelial ovarian cancer patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Outbreak of cyclosporiasis in British Columbia associated with imported Thai basil.

    Science.gov (United States)

    Hoang, L M N; Fyfe, M; Ong, C; Harb, J; Champagne, S; Dixon, B; Isaac-Renton, J

    2005-02-01

    Sporadic outbreaks of cyclosporiasis, a common cause of protracted diarrhoea in underdeveloped countries, are often undetected and undiagnosed in industrial countries. In May 2001, an outbreak of Cyclospora cayetanensis gastroenteritis was identified in British Columbia, Canada, with 17 reported cases. We conducted a case-control study involving 12 out of the 17 reported and confirmed case patients. Eleven (92%) of the patients had consumed Thai basil, an essential ingredient in Vietnamese cuisine, compared to 3 out of 16 (19%) of the control patients (P = 0.003). Trace-back investigations implicated Thai basil imported via the United States as the vehicle for this outbreak. This is the first documented sporadic outbreak of cyclosporiasis linked to Thai basil in Canada, and the first outbreak of cyclosporiasis identified in an ethnic immigrant population. This outbreak provides the opportunity to increase our understanding of this emerging pathogen and improve on our prevention and control for future outbreaks.

  9. Potential risks associated with traditional herbal medicine use in cancer care: A study of Middle Eastern oncology health care professionals.

    Science.gov (United States)

    Ben-Arye, Eran; Samuels, Noah; Goldstein, Lee Hilary; Mutafoglu, Kamer; Omran, Suha; Schiff, Elad; Charalambous, Haris; Dweikat, Tahani; Ghrayeb, Ibtisam; Bar-Sela, Gil; Turker, Ibrahim; Hassan, Azza; Hassan, Esmat; Saad, Bashar; Nimri, Omar; Kebudi, Rejin; Silbermann, Michael

    2016-02-15

    The authors assessed the use of herbal medicine by Middle Eastern patients with cancer, as reported by their oncology health care professionals (HCPs). Herbal products identified by the study HCPs were evaluated for potential negative effects. Oncology HCPs from 16 Middle Eastern countries received a 17-item questionnaire asking them to list 5 herbal products in use by their patients with cancer. A literature search (PubMed, Micromedex, AltMedDex, and the Natural Medicine Comprehensive Database) was conducted to identify safety-related concerns associated with the products listed. A total of 339 HCPs completed the study questionnaire (response rate of 80.3%), identifying 44 herbal and 3 nonherbal nutritional supplements. Safety-related concerns were associated with 29 products, including herb-drug interactions with altered pharmacodynamics (15 herbs), direct toxic effects (18 herbs), and increased in vitro response of cancer cells to chemotherapy (7 herbs). Herbal medicine use, which is prevalent in Middle Eastern countries, has several potentially negative effects that include direct toxic effects, negative interactions with anticancer drugs, and increased chemosensitivity of cancer cells, requiring a reduction in dose-density. Oncology HCPs working in countries in which herbal medicine use is prevalent need to better understand the implications of this practice. The presence of integrative physicians with training in complementary and traditional medicine can help patients and their HCPs reach an informed decision regarding the safety and effective use of these products. © 2015 American Cancer Society.

  10. Bipolar disorder ignored by the Mental Health National Service framework but not forgotten by the British Association for Psychopharmacology.

    Science.gov (United States)

    McAllister-Williams, R H; Watson, S

    2003-12-01

    Bipolar disorder (BD) is a severe mental illness that has been largely ignored by the National Service Framework (NSF) for Mental Health. This is particularly notable because it is associated with a higher suicide rate than schizophrenia and has a greater burden of disability. The NSF offers little guidance on service models that specifically consider BD. This is of concern because of the complexities that are inherent in the management of BD. These deficiencies in the NSF may have far-reaching implications for resource allocation, service organization, and patient management and well-being. Moreover, the standards and performance targets laid out in the NSF will be difficult to meet if this important and common mental illness is not specifically catered for in mental health services. Local Implementation Teams would be well advised to take note of the recently published British Association for Psychopharmacology guidelines for the management of BD.

  11. Female Representation in the Academic Oncology Physician Workforce: Radiation Oncology Losing Ground to Hematology Oncology.

    Science.gov (United States)

    Ahmed, Awad A; Hwang, Wei-Ting; Holliday, Emma B; Chapman, Christina H; Jagsi, Reshma; Thomas, Charles R; Deville, Curtiland

    2017-05-01

    Our purpose was to assess comparative female representation trends for trainees and full-time faculty in the academic radiation oncology and hematology oncology workforce of the United States over 3 decades. Simple linear regression models with year as the independent variable were used to determine changes in female percentage representation per year and associated 95% confidence intervals for trainees and full-time faculty in each specialty. Peak representation was 48.4% (801/1654) in 2013 for hematology oncology trainees, 39.0% (585/1499) in 2014 for hematology oncology full-time faculty, 34.8% (202/581) in 2007 for radiation oncology trainees, and 27.7% (439/1584) in 2015 for radiation oncology full-time faculty. Representation significantly increased for trainees and full-time faculty in both specialties at approximately 1% per year for hematology oncology trainees and full-time faculty and 0.3% per year for radiation oncology trainees and full-time faculty. Compared with radiation oncology, the rates were 3.84 and 2.94 times greater for hematology oncology trainees and full-time faculty, respectively. Despite increased female trainee and full-time faculty representation over time in the academic oncology physician workforce, radiation oncology is lagging behind hematology oncology, with trainees declining in recent years in radiation oncology; this suggests a de facto ceiling in female representation. Whether such issues as delayed or insufficient exposure, inadequate mentorship, or specialty competitiveness disparately affect female representation in radiation oncology compared to hematology oncology are underexplored and require continued investigation to ensure that the future oncologic physician workforce reflects the diversity of the population it serves. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Female Representation in the Academic Oncology Physician Workforce: Radiation Oncology Losing Ground to Hematology Oncology

    Energy Technology Data Exchange (ETDEWEB)

    Ahmed, Awad A. [Sylvester Comprehensive Cancer Center University of Miami Health System, Miami, Florida (United States); Hwang, Wei-Ting [Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Holliday, Emma B. [Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Chapman, Christina H.; Jagsi, Reshma [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Thomas, Charles R. [Department of Radiation Medicine, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon (United States); Deville, Curtiland, E-mail: cdeville@jhmi.edu [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland (United States)

    2017-05-01

    Purpose: Our purpose was to assess comparative female representation trends for trainees and full-time faculty in the academic radiation oncology and hematology oncology workforce of the United States over 3 decades. Methods and Materials: Simple linear regression models with year as the independent variable were used to determine changes in female percentage representation per year and associated 95% confidence intervals for trainees and full-time faculty in each specialty. Results: Peak representation was 48.4% (801/1654) in 2013 for hematology oncology trainees, 39.0% (585/1499) in 2014 for hematology oncology full-time faculty, 34.8% (202/581) in 2007 for radiation oncology trainees, and 27.7% (439/1584) in 2015 for radiation oncology full-time faculty. Representation significantly increased for trainees and full-time faculty in both specialties at approximately 1% per year for hematology oncology trainees and full-time faculty and 0.3% per year for radiation oncology trainees and full-time faculty. Compared with radiation oncology, the rates were 3.84 and 2.94 times greater for hematology oncology trainees and full-time faculty, respectively. Conclusion: Despite increased female trainee and full-time faculty representation over time in the academic oncology physician workforce, radiation oncology is lagging behind hematology oncology, with trainees declining in recent years in radiation oncology; this suggests a de facto ceiling in female representation. Whether such issues as delayed or insufficient exposure, inadequate mentorship, or specialty competitiveness disparately affect female representation in radiation oncology compared to hematology oncology are underexplored and require continued investigation to ensure that the future oncologic physician workforce reflects the diversity of the population it serves.

  13. Brazilian Abstracts Presented at the American Urological Association Annual Meetings: Contribution, Publication Rates, and Comparison with Oncology Abstracts

    Directory of Open Access Journals (Sweden)

    Marco A. Arap

    2014-12-01

    Full Text Available Purpose Scientific research originating from Brazil appears to be rising in several medical fields. Research results are often presented at scientific meetings before publication in peer-reviewed journals. We investigated the publication rate of Brazilian studies presented in American Urological Association (AUA meetings and compared with the rate of publication of Brazilian oncological studies presented at the American Society of Clinical Oncology (ASCO meetings. Materials and Methods a hand search of 12,454 abstracts presented at aua meetings 2001-2007 was conducted. abstracts for which at least two-thirds of institutions were from brazil were considered as brazilian. final publication was searched in pubmed and lilacs databases. oncological abstracts were also hand searched in the asco meetings proceedings in the same years. Results There was no significant temporal trend in the proportion of AUA studies originating from Brazil along those 7 years. A total of 195 abstracts (1.57% were from Brazil. One hundred (51.3% abstracts were published in full, and the estimated 5-year publication rate was 48.2%. There was a progressive increase in publication rates for studies categorized as video, poster, and podium presentations. Considering abstracts presented in years 2001-2005, urologic publication rate was significantly higher than for abstracts presented at the ASCO meeting. Conclusions Our results suggest that the Brazilian contribution to AUA meetings is at a plateau and that the Brazilian literature contribution is greater in urology than in oncology. Efforts must be invested towards raising this plateau and understanding qualitative aspects of the urology scientific output from Brazil.

  14. Regional scale selenium loading associated with surface coal mining, Elk Valley, British Columbia, Canada.

    Science.gov (United States)

    Wellen, Christopher C; Shatilla, Nadine J; Carey, Sean K

    2015-11-01

    Selenium (Se) concentrations in surface water downstream of surface mining operations have been reported at levels in excess of water quality guidelines for the protection of wildlife. Previous research in surface mining environments has focused on downstream water quality impacts, yet little is known about the fundamental controls on Se loading. This study investigated the relationship between mining practices, stream flows and Se concentrations using a SPAtially Referenced Regression On Watershed attributes (SPARROW) model. This work is part of a R&D program examining the influence of surface coal mining on hydrological and water quality responses in the Elk Valley, British Columbia, Canada, aimed at informing effective management responses. Results indicate that waste rock volume, a product of mining activity, accounted for roughly 80% of the Se load from the Elk Valley, while background sources accounted for roughly 13%. Wet years were characterized by more than twice the Se load of dry years. A number of variables regarding placement of waste rock within the catchments, length of buried streams, and the construction of rock drains did not significantly influence the Se load. The age of the waste rock, the proportion of waste rock surface reclaimed, and the ratio of waste rock pile side area to top area all varied inversely with the Se load from watersheds containing waste rock. These results suggest operational practices that are likely to reduce the release of Se to surface waters. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. British passports

    CERN Multimedia

    IT Department

    2008-01-01

    Please note that from 01/01/2009, the passport section of the British Consulate will move from Geneva to Paris. This change is part of a global initiative to rationalize passport services and reduce administrative costs while ensuring that the quality of the service remains high. The aim is to issue new passports within 10 working days of receiving applications (excluding transit time). From 1st January 2009 passport applications should be sent by courier or registered post directly to: British Consulate General BP111-08 75363 Paris CEDEX 08 France For further information please refer to: http://ukinswitzerland.fco.gov.uk/en/passports/passport-move/

  16. British Columbia

    Science.gov (United States)

    Walton, Gerald

    2006-01-01

    The province of British Columbia has a dubious history where support for lesbian, gay, bisexual, and transgendered (LGBT) issues in education is concerned. Most notable is the Surrey School Board's decision in 1997 to ban three picture books for children that depict families with two moms or two dads. The North Vancouver School Board has also…

  17. Pharmacogenomics in Pediatric Oncology: Review of Gene—Drug Associations for Clinical Use

    Directory of Open Access Journals (Sweden)

    Vid Mlakar

    2016-09-01

    Full Text Available During the 3rd congress of the European Society of Pharmacogenomics and Personalised Therapy (ESPT in Budapest in 2015, a preliminary meeting was held aimed at establishing a pediatric individualized treatment in oncology and hematology committees. The main purpose was to facilitate the transfer and harmonization of pharmacogenetic testing from research into clinics, to bring together basic and translational research and to educate health professionals throughout Europe. The objective of this review was to provide the attendees of the meeting as well as the larger scientific community an insight into the compiled evidence regarding current pharmacogenomics knowledge in pediatric oncology. This preliminary evaluation will help steer the committee’s work and should give the reader an idea at which stage researchers and clinicians are, in terms of personalizing medicine for children with cancer. From the evidence presented here, future recommendations to achieve this goal will also be suggested.

  18. Self-Reported Sleep Duration, Napping, and Incident Heart Failure: Prospective Associations in the British Regional Heart Study.

    Science.gov (United States)

    Wannamethee, S Goya; Papacosta, Olia; Lennon, Lucy; Whincup, Peter H

    2016-09-01

    To examine the associations between self-reported nighttime sleep duration and daytime sleep and incident heart failure (HF) in men with and without preexisting cardiovascular disease (CVD). Population-based prospective study. General practices in 24 British towns. Men aged 60-79 without prevalent HF followed for 9 years (N = 3,723). Information on incident HF cases was obtained from primary care records. Assessment of sleep was based on self-reported sleep duration at night and daytime napping. Self-reported short nighttime sleep duration and daytime sleep of longer than 1 hour were associated with preexisting CVD, breathlessness, depression, poor health, physical inactivity, and manual social class. In all men, self-reported daytime sleep of longer than 1 hour duration was associated with significantly greater risk of HF after adjustment for potential confounders (adjusted hazard ratio (aHR) = 1.69, 95% CI = 1.06-2.71) than in those who reported no daytime napping. Self-reported nighttime sleep duration was not associated with HF risk except in men with preexisting CVD (napping of longer than 1 hour is associated with greater risk of HF in older men. Self-reported short sleep (<6 hours) in men with CVD is associated with particularly high risk of developing HF. © 2016 The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

  19. Impairments, activity limitations and participation restrictions: Prevalence and associations among persons living with HIV/AIDS in British Columbia

    Directory of Open Access Journals (Sweden)

    Braitstein Paula

    2004-09-01

    Full Text Available Abstract Background To measure the prevalence of and associations among impairments, activity limitations and participation restrictions in persons living with HIV in British Columbia to inform support and care programs, policy and research. Methods A cross-sectional population-based sample of persons living with HIV in British Columbia was obtained through an anonymous survey sent to members of the British Columbia Persons With AIDS Society. The survey addressed the experience of physical and mental impairments, and the experience and level of activity limitations and participation restrictions. Associations were measured in three ways: 1 impact of types of impairment on social restriction; 2 impact of specific limitations on social restriction; and 3 independent association of overall impairments and limitations on restriction levels. Logistic regression was used to measure associations with social restriction, while ordinal logistic regression was used to measure associations with a three-category measure of restriction level. Results The survey was returned by 762 (50.5% of the BCPWA participants. Over ninety percent of the population experienced one or more impairments, with one-third reporting over ten. Prevalence of activity limitations and participation restrictions was 80.4% and 93.2%, respectively. The presence of social restrictions was most closely associated with mental function impairments (OR: 7.0 for impairment vs. no impairment; 95% CI: 4.7 – 10.4. All limitations were associated with social restriction. Among those with ≤ 200 CD4 cells/mm3, odds of being at a higher restriction level were lower among those on antiretrovirals (OR: 0.3 for antiretrovirals vs. no antiretrovirals; 95% CI: 0.1–0.9, while odds of higher restriction were increased with higher limitation (OR: 3.6 for limitation score of 1–5 vs. no limitation, 95%CI: 0.9–14.2; OR: 24.7 for limitation score > 5 vs. no limitation, 95%CI: 4.9–125.0. Among those

  20. Climatic associations of British species distributions show good transferability in time but low predictive accuracy for range change.

    Directory of Open Access Journals (Sweden)

    Giovanni Rapacciuolo

    Full Text Available Conservation planners often wish to predict how species distributions will change in response to environmental changes. Species distribution models (SDMs are the primary tool for making such predictions. Many methods are widely used; however, they all make simplifying assumptions, and predictions can therefore be subject to high uncertainty. With global change well underway, field records of observed range shifts are increasingly being used for testing SDM transferability. We used an unprecedented distribution dataset documenting recent range changes of British vascular plants, birds, and butterflies to test whether correlative SDMs based on climate change provide useful approximations of potential distribution shifts. We modelled past species distributions from climate using nine single techniques and a consensus approach, and projected the geographical extent of these models to a more recent time period based on climate change; we then compared model predictions with recent observed distributions in order to estimate the temporal transferability and prediction accuracy of our models. We also evaluated the relative effect of methodological and taxonomic variation on the performance of SDMs. Models showed good transferability in time when assessed using widespread metrics of accuracy. However, models had low accuracy to predict where occupancy status changed between time periods, especially for declining species. Model performance varied greatly among species within major taxa, but there was also considerable variation among modelling frameworks. Past climatic associations of British species distributions retain a high explanatory power when transferred to recent time--due to their accuracy to predict large areas retained by species--but fail to capture relevant predictors of change. We strongly emphasize the need for caution when using SDMs to predict shifts in species distributions: high explanatory power on temporally-independent records

  1. Bringing Central Line–Associated Bloodstream Infection Prevention Home: Catheter Maintenance Practices and Beliefs of Pediatric Oncology Patients and Families

    Science.gov (United States)

    Rinke, Michael L.; Chen, Allen R.; Milstone, Aaron M.; Hebert, Lindsay C.; Bundy, David G.; Colantuoni, Elizabeth; Fratino, Lisa; Herpst, Cynthia; Kokoszka, Michelle; Miller, Marlene R.

    2015-01-01

    Background A study was conducted to investigate (1) the extent to which best-practice central line maintenance practices were employed in the homes of pediatric oncology patients and by whom, (2) caregiver beliefs about central line care and central line–associated blood stream infection (CLABSI) risk, (3) barriers to optimal central line care by families, and (4) educational experiences and preferences regarding central line care. Methods Researchers administered a survey to patients and families in a tertiary care pediatric oncology clinic that engaged in rigorous ambulatory and inpatient CLABSI prevention efforts. Results Of 110 invited patients and caregivers, 105 participated (95% response rate) in the survey (March–May 2012). Of the 50 respondents reporting that they or another caregiver change central line dressings, 48% changed a dressing whenever it was soiled as per protocol (many who did not change dressings per protocol also never personally changed dressings); 67% reported the oncology clinic primarily cares for their child’s central line, while 29% reported that an adult caregiver or the patient primarily cares for the central line. Eight patients performed their own line care “always” or “most of the time.” Some 13% of respondents believed that it was “slightly likely” or “not at all likely” that their child will get an infection if caregivers do not perform line care practices perfectly every time. Dressing change practices were the most difficult to comply with at home. Some 18% of respondents wished they learned more about line care, and 12% received contradictory training. Respondents cited a variety of preferences regarding line care teaching, although the majority looked to clinic nurses for modeling line care. Conclusions Interventions aimed at reducing ambulatory CLABSIs should target appropriate educational experiences for adult caregivers and patients and identify ways to improve compliance with best-practice care

  2. Associations of Power at V̇O2peak and Anaerobic Threshold with Rank in British High Performance Junior Surfers

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    Barlow Matthew John

    2015-03-01

    Full Text Available Purpose. The objective of this study was to determine the relationships of peak oxygen uptake ( V̇O2peak, power at V̇O2peak and power at the anaerobic threshold (AT with national ranking in a sample of British high performance junior surfers. Methods. Eighteen male surfers (aged 15.4 ± 1.4 years from the British Junior Surfing team were tested for V̇O2peak and AT using an adapted kayak ergometer; national ranking was used to indicate performance level. The AT was identified as the point at which V̇E/V̇O2 started to rise without a concomitant increase in V̇E/V̇CO2. Spearman’s rank (rs and partial correlations (rp controlling for age were used to identify the relationships between the physiological variables and national ranking. Results. Mean V̇O2peak was 3.1 ± 0.5 l · min-1 (47.7 ± 7.2 ml · kg-1 · min-1 and mean AT occurred at 48.1 ± 12.2 W. There were significant correlations between national ranking and power at V̇O2peak (rs = -0.549, p = 0.028, power at AT (rs = -0.646, p = 0.009, and age (rs = -0.579, p = 0.012. Significant partial correlations were established controlling for age between national ranking and power at V̇O2peak (rp = -0.839, p = 0.000 and power at AT (rp = -0.541, p < 0.046. Conclusions. The power outputs associated with V̇O2peak and AT were significantly related to surfer ranking in this sample. However, due to the low coefficient of determination associated with the AT/ranking relationship, AT does not discriminate well between the ranking of surfers. These findings support the inclusion of power at V̇O2peak in assessment batteries for junior competitive surfers.

  3. Demographics and disease characteristics of patients with psoriasis enrolled in the British Association of Dermatologists Biologic Interventions Register.

    Science.gov (United States)

    Iskandar, I Y K; Ashcroft, D M; Warren, R B; Yiu, Z Z N; McElhone, K; Lunt, M; Barker, J N W N; Burden, A D; Ormerod, A D; Reynolds, N J; Smith, C H; Griffiths, C E M

    2015-08-01

    The British Association of Dermatologists Biologic Interventions Register (BADBIR) is a prospective, observational cohort designed to assess the long-term safety of biologic and conventional systemic therapies used for adults with moderate-to-severe psoriasis in the U.K. and Republic of Ireland. To describe the demographics, disease severity and comorbidities of patients with psoriasis on enrolment into BADBIR, and to highlight differences in those commencing biologics compared with those on conventional systemic therapies. Baseline data were collected from 151 dermatology departments in the U.K. and Republic of Ireland. Descriptive analysis was conducted. As of August 2014, 8399 patients were registered with BADBIR; 5065 (60%) received biologics, of whom 52·8% received adalimumab, 24·6% etanercept, 18·7% ustekinumab and 3·9% infliximab. In the comparator cohort 44·1% received methotrexate, 23·1% ciclosporin, 18·0% acitretin and 7·6% fumaric acid esters. Overall 4897 (58%) were male. Patients on biologics had a higher mean ± SD age and disease duration than patients on conventional systemic therapies (46·3 ± 12·7 vs. 44·3 ± 14·3 years and 23·0 ± 12·6 vs. 19·0 ± 13·4 years, respectively; both P Psoriasis Area and Severity Index and Dermatology Life Quality Index scores for patients on biologics were higher than for those on conventional systemic therapies (31·0 ± 7·2 vs. 30·1 ± 7·3 kg m(-2) ; 16·4 ± 8·3 vs. 15·5 ± 7·9 and 17·4 ± 7·5 vs. 15·0 ± 7·1, respectively; all P < 0·001). In total 71% of all patients had comorbidities and 47% had more than one comorbidity. The most frequent comorbidities were obesity (42·1%), hypertension (25·7%), depression (22·1%) and psoriatic arthritis (17·1%). BADBIR is an invaluable resource to study the safety and effectiveness of both biologic and conventional systemic therapies. Understanding differences in baseline characteristics between cohorts is crucial in

  4. Computational oncology.

    Science.gov (United States)

    Lefor, Alan T

    2011-08-01

    Oncology research has traditionally been conducted using techniques from the biological sciences. The new field of computational oncology has forged a new relationship between the physical sciences and oncology to further advance research. By applying physics and mathematics to oncologic problems, new insights will emerge into the pathogenesis and treatment of malignancies. One major area of investigation in computational oncology centers around the acquisition and analysis of data, using improved computing hardware and software. Large databases of cellular pathways are being analyzed to understand the interrelationship among complex biological processes. Computer-aided detection is being applied to the analysis of routine imaging data including mammography and chest imaging to improve the accuracy and detection rate for population screening. The second major area of investigation uses computers to construct sophisticated mathematical models of individual cancer cells as well as larger systems using partial differential equations. These models are further refined with clinically available information to more accurately reflect living systems. One of the major obstacles in the partnership between physical scientists and the oncology community is communications. Standard ways to convey information must be developed. Future progress in computational oncology will depend on close collaboration between clinicians and investigators to further the understanding of cancer using these new approaches.

  5. The preferential association of dolomite with microbes in stalactites from Cayman Brac, British West Indies

    Science.gov (United States)

    Jones, Brian

    2010-04-01

    Nani Cave, located in dolostones of the Cayman Formation (Miocene) on Cayman Brac, contains numerous stalactites that are formed largely of aragonite and calcite along with lesser amounts of calcium-rich dolomite, gypsum, and minor amounts of Mg-Si needles. Morphologically, the dolomite is divided into blocky, filamentous mat, crust, and "beehive" types whereas the gypsum is divided into the tabular and sheet types. A diverse array of filamentous microbes and spores (probably actinomycetids) and their associated exopolysaccharides (EPS) are unevenly distributed throughout the stalactites. Although microbes are commonly present on the surfaces of the calcite and aragonite crystals, none were found inside these crystals. Similarly, no microbes were found with the gypsum. The common association of the dolomite and the Mg-Si needles with the microbes and their EPS suggests that the microbes played a formative role in the precipitation of the dolomite and Mg-Si needles. The intimate association of microbes and dolomite in these stalactites has significant implications for the origin of dolomite under low-temperature and low-pressure conditions.

  6. Sediment-associated aliphatic and aromatic hydrocarbons in coastal British Columbia, Canada: Concentrations, composition, and associated risks to protected sea otters

    Energy Technology Data Exchange (ETDEWEB)

    Harris, Kate A. [Fisheries and Oceans Canada, Institute of Ocean Sciences, P.O. Box 6000, Sidney BC V8L 4B2 (Canada); University of Victoria, School of Earth and Ocean Sciences, P.O. Box 1700 STN CSC, Victoria BC V8W 2Y2 (Canada); Yunker, Mark B. [7137 Wallace Dr., Brentwood Bay, BC V8M 1G9 (Canada); Dangerfield, Neil [Fisheries and Oceans Canada, Institute of Ocean Sciences, P.O. Box 6000, Sidney BC V8L 4B2 (Canada); Ross, Peter S., E-mail: Peter.S.Ross@dfo-mpo.gc.ca [Fisheries and Oceans Canada, Institute of Ocean Sciences, P.O. Box 6000, Sidney BC V8L 4B2 (Canada)

    2011-10-15

    Sediment-associated hydrocarbons can pose a risk to wildlife that rely on benthic marine food webs. We measured hydrocarbons in sediments from the habitat of protected sea otters in coastal British Columbia, Canada. Alkane concentrations were dominated by higher odd-chain n-alkanes at all sites, indicating terrestrial plant inputs. While remote sites were dominated by petrogenic polycyclic aromatic hydrocarbons (PAHs), small harbour sites within sea otter habitat and sites from an urban reference area reflected weathered petroleum and biomass and fossil fuel combustion. The partitioning of hydrocarbons between sediments and adjacent food webs provides an important exposure route for sea otters, as they consume {approx}25% of their body weight per day in benthic invertebrates. Thus, exceedences of PAH sediment quality guidelines designed to protect aquatic biota at 20% of the sites in sea otter habitat suggest that sea otters are vulnerable to hydrocarbon contamination even in the absence of catastrophic oil spills. - Highlights: > Sediment hydrocarbon signatures differed between remote and impacted coastal sites. > A natural background comprised terrestrial plant alkanes and petrogenic PAHs. > Impacted sites reflected a history of petrogenic and pyrogenic hydrocarbon inputs. > Hydrocarbons at some sites exceeded guidelines for the protection of aquatic life. > Protected sea otters may thus be at risk as they rely primarily on benthic prey. - Anthropogenically-derived hydrocarbons in coastal sediments in British Columbia may pose a risk to protected sea otters.

  7. Factors associated with low neighborhood cohesion among women living with HIV impacted by social-structural inequities in British Columbia.

    Science.gov (United States)

    Closson, Kalysha; Palmer, Alexis K; Collins, Alexandra B; Salters, Kate; Zhang, Wendy; Montaner, Julio S G; Hogg, Robert S; Parashar, Surita

    2018-03-01

    Built and social environments, including one's perception of their environment, are important determinants of health. The intersection of gender and HIV status may complicate the role of neighborhood cohesion in safety, personal well-being, and health outcomes for populations impacted by social and structural inequities. Among women in particular, social cohesion within the neighborhood they reside in may have a greater influence on health outcomes compared to their male counterparts. We sought to examine perception of neighborhood cohesion (validated scale with a range 0-100, with higher scores indicating higher perceived neighborhood cohesion) among women living with HIV, impacted by social-structural inequities, receiving combination antiretroviral therapy, and enrolled in the Longitudinal Investigations into Supportive Ancillary health services (LISA) study in British Columbia, Canada. Cross-sectional data on neighborhood cohesion and socio-demographic data were collected in an interviewer-administered survey. Of the 1,000 LISA participants interviewed, 908 (including 249 women and 659 men) had complete data for the variables of interest. At the bivariate level, women had worse perceived neighborhood cohesion scores compared to men (median: 56 [95% CI: 44-66] vs. 60 [95% CI: 47-71]). Multivariable model results indicated that for women living with HIV in our sample, greater neighborhood cohesion scores were positively associated with stable housing (β coefficient = 7.85; 95% CI: 3.61, 12.10, p cohesion.

  8. Evidence-based guidelines for treating bipolar disorder: revised third edition Recommendations from the British Association for Psychopharmacology

    Science.gov (United States)

    Goodwin, G.M.; Haddad, P. M.; Ferrier, I.N.; Aronson, J.K.; Barnes, T.R.H.; Cipriani, A.; Coghill, D.R.; Fazel, S.; Geddes, J.R.; Grunze, H.; Holmes, E.A.; Howes, O.; Hudson, S.; Hunt, N.; Jones, I.; Macmillan, I.C.; McAllister-Williams, H.; Miklowitz, D.M.; Morriss, R.; Munafò, M.; Paton, C.; Saharkian, B.J.; Saunders, K.E.A.; Sinclair, J.M.A.; Taylor, D.; Vieta, E.; Young, A.H.

    2016-01-01

    The British Association for Psychopharmacology guidelines specify the scope and targets of treatment for bipolar disorder. The third version is based explicitly on the available evidence and presented, like previous Clinical Practice Guidelines, as recommendations to aid clinical decision making for practitioners: it may also serve as a source of information for patients and carers, and assist audit. The recommendations are presented together with a more detailed review of the corresponding evidence. A consensus meeting, involving experts in bipolar disorder and its treatment, reviewed key areas and considered the strength of evidence and clinical implications. The guidelines were drawn up after extensive feedback from these participants. The best evidence from randomized controlled trials and, where available, observational studies employing quasi-experimental designs was used to evaluate treatment options. The strength of recommendations has been described using the GRADE approach. The guidelines cover the diagnosis of bipolar disorder, clinical management, and strategies for the use of medicines: in short-term treatment of episodes, relapse prevention and stopping treatment. The use of medication is integrated with a coherent approach to psychoeducation and behaviour change. PMID:26979387

  9. Clinical Research Abstracts of the British Equine Veterinary Association Congress 2015.

    Science.gov (United States)

    Getachew, M A; Innocent, G; Reid, S W J; Burden, F; Love, S

    2015-09-01

    Although fasciolosis is an important livestock disease worldwide, the public health importance of human fasciolosis has increased in recent years and it is recognised as an important re-emerging zoonotic disease, its epidemiology and pathogenicity in donkeys, and the epidemiological role they may play have not been determined. To investigate the epidemiology and pathogenicity of fasciolosis in donkeys. Cross-sectional coprological and retrospective post-mortem study. Faecal samples collected from 803 randomly selected working donkeys from the central region of Ethiopia were analysed by a sedimentation-centrifugation-flotation technique. Further data on liver-flukes and associated pathologies were obtained by routine post mortem examinations of 112 donkeys, subjected to euthanasia on welfare grounds or died. Data were analysed using a generalised linear model and multivariate binary logistic regression in R statistical package with significance level of statistical tests set at Psound control strategies and prevention of fasciolosis. Ethical animal research: The research underwent ethical review and the use of animals was approved by the Directors of The Donkey Sanctuary. Consent of the owners was obtained to use their animals. The Donkey Sanctuary. Competing interests: None declared. © 2015 The Author(s). Equine Veterinary Journal © 2015 EVJ Ltd.

  10. Anaesthesia-associated hypersensitivity reactions: seven years' data from a British bi-specialty clinic.

    Science.gov (United States)

    Low, A E; McEwan, J C; Karanam, S; North, J; Kong, K-L

    2016-01-01

    Our bi-specialty clinic was established to systematically investigate patients with suspected peri-operative hypersensitivity reactions. Four hundred and ten patients were studied; 316 following an intra-operative reaction ('postoperative' group) and 94 with a previous history of reaction, referred before undergoing anaesthesia ('pre-operative' group). In the postoperative group, 173 (54.7%) were diagnosed with IgE-mediated reactions: 65 (37.6%) to neuromuscular blocking drugs; 54 (31.2%) antibiotics; 15 (8.7%) chlorhexidine and 12 (6.9%) patent blue dye. Reactions were severe in 114 patients (65.9%). All reactions to patent blue dye were severe. We identified IgE sensitisation in 22 (13.2%) cases with isolated mucocutaneous reactions. Only 173 (54.7%) patients had serum tryptase samples taken. Referrers' suspected causal agent was confirmed in only 37.2% of patients. Of 94 patients reviewed 'pre-operatively', 29 (30.8%) were diagnosed with IgE-mediated hypersensitivity reactions, reinforcing the importance of investigating this group of patients. Knowledge of the range of causative agents identified in our study should guide the investigation of suspected peri-operative hypersensitivity reactions. © 2015 The Association of Anaesthetists of Great Britain and Ireland.

  11. Factors associated with risky sexual behaviour: a comparison of British, Spanish and German holidaymakers to the Balearics.

    Science.gov (United States)

    Downing, Jennifer; Hughes, Karen; Bellis, Mark A; Calafat, Amador; Juan, Montse; Blay, Nicole

    2011-06-01

    Previous studies exploring risk-taking behaviour on holiday are typically limited to single nationalities, confounding comparisons among countries. Here we examine the sexual behaviour of holidaymakers of three nationalities visiting Ibiza and Majorca. A comparative cross-sectional study design was used focusing on British, Spanish and German holidaymakers in the age range of 16-35 years. Overall, 3003 questionnaires were gathered at airports in Majorca and Ibiza from holidaymakers returning home. Of those surveyed, 71.1% were single (travelling without a current sexual partner) (Majorca, 74.3%; Ibiza, 68.0%). Overall, 34.1% of single holidaymakers had sex on holiday. Amongst single participants, factors associated with having sex on holiday were high levels of drunkenness, being Spanish and holidaying for over 2 weeks. Of those single and having sex on holiday, factors associated with multiple sexual partners were being male and age ≤19 years. Unprotected sex was predicted by being German and holidaying in Majorca, holidaying with members of the opposite sex and using four or more drugs on holiday. All sexual behaviours were predicted by a high number of sexual partners in the previous 12 months. Furthermore, single holidaymakers having sex abroad were more likely to prefer night-time venues facilitating casual sex and excessive alcohol consumption. Casual sex encounters in youth holiday resorts may be commonplace and mediated through substance use. Further focused public health efforts, including in bars/nightclubs, are needed to prevent sexual risk-taking which can increase the likelihood of poor sexual health outcomes and associated factors such as regretted sex.

  12. Clinical Research Abstracts of the British Equine Veterinary Association Congress 2015.

    Science.gov (United States)

    Hammersley, E; Duz, M; Marshall, J F

    2015-09-01

    Triamcinolone is commonly used in equine practice for the treatment of orthopaedic conditions. A serious potential adverse effect of triamcinolone is laminitis. However, evidence for the risk of laminitis associated with triamcinolone use is limited. To determine the risk of laminitis within 90 days of triamcinolone administration and compare with the risk of laminitis in a veterinary-attended horse population. Retrospective study of clinical records. Text mining and data extraction was performed using content analysis software (SimStat-WordStat v.6) on a database of anonymous digital clinical records from a convenience sample of North American equine practices (n = 9). Medical records were retrieved using a dictionary of keywords for 3 groups of horses: 1) treated with triamcinolone, 2) age and practice matched control population (no triamcinolone) and 3) all laminitic horses. Records of horses within Groups 1 and 2 were mined for evidence of laminitis within a 90-day period of treatment or a random date respectively. Data manipulation and analysis was performed using R v3.0.0 (R Development Core Team). The prevalence of laminitis within all groups was determined and relative risk of developing laminitis determined by single logistic regression. The clinical records of 225,777 horses were examined. Overall prevalence of laminitis within the database was 1.1% (n = 2533). Triamcinolone was administered to 12.4% (n = 27,898) horses and 0.07% of treated horses (n = 20) developed laminitis. In the control population (n = 56,695), 0.2% of horses (n = 134) developed laminitis. The risk of developing laminitis was significantly lower in the triamcinolone treatment group than the control population (OR 0.3 95%CI, 0.18-0.48 PVeterinary Medicine at the University of Glasgow. Owners gave informed consent for their horses' inclusion in the study. Sources of funding: John Crawford Endowment Fund, University of Glasgow. Competing interests

  13. Are Sitting Occupations Associated with Increased All-Cause, Cancer, and Cardiovascular Disease Mortality Risk? A Pooled Analysis of Seven British Population Cohorts

    OpenAIRE

    Emmanuel Stamatakis; Chau, Josephine Y.; Zeljko Pedisic; Adrian Bauman; Rona Macniven; Ngaire Coombs; Mark Hamer

    2013-01-01

    Background There is mounting evidence for associations between sedentary behaviours and adverse health outcomes, although the data on occupational sitting and mortality risk remain equivocal. The aim of this study was to determine the association between occupational sitting and cardiovascular, cancer and all-cause mortality in a pooled sample of seven British general population cohorts. Methods The sample comprised 5380 women and 5788 men in employment who were drawn from five Health Survey ...

  14. Guidelines, minimal requirements and standard of cancer care around the Mediterranean Area: report from the Collaborative AROME (Association of Radiotherapy and Oncology of the Mediterranean Area) working parties.

    Science.gov (United States)

    2011-04-01

    Guidelines are produced in oncology to facilitate clinical decision making and improve clinical practice. However, existing guidelines are mainly developed for countries with a certain availability of means and cultural aspects are rarely taken into account. Around the Mediterranean Area, countries share common cultural backgrounds but also great disparities with respect to availability of means; current guidelines by most societies are not applicable to all of those countries. Association of Radiotherapy and Oncology of the Mediterranean Area (AROME) is a scientific organization for the promotion and overcoming of inequalities in oncology clinical practice around the Mediterranean Area. In an effort to accomplish this goal, members of the AROME society have developed clinical recommendations for most common cancer sites in countries around the Mediterranean Area. The structure of these recommendations lies in the concept of minimal requirements vs. standard of care; they are being presented and discussed in the main text. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  15. Retrospective Evaluation of Colistin Associated Nephrotoxicity at Oncology Hospital Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Menşure Kaya

    2014-08-01

    Full Text Available Objective: The aim of our study, is to determine the nephrotoxicity rates and risk factors for the development of nephrotoxicity by retrospective evaluation of patients who were given colistin therapy oncology hospital intensive care unit. Material and Method: Total of 33 adult patients were included in the study. Renal function tests and hemodialysis requirements were recorded. In addition, patients age, gender, concurrently used drugs with colistin therapy, duration of colistin therapy and total colistin doses were noted. RIFLE criteria (risk, injury, failure, loss, end-stage kidney disease were used for evaluation of nephrotoxicity. Results: Nephrotoxicity was observed in 69,7% of patients (23 patients. According to RIFLE criteria nephrotoxicity rates were; risk 36,36%, injury 15,15% and failure 18,18%. In patients who developed nephrotoxicity, creatinine and blood urea nitrogen values were observed to rise significantly on the 5th day of colistin treatment (p≤0,05. In patients with malignancy, nephrotoxicity rate was 5.4 times higher than those without the diagnosis of malignancy. Concurrent use of diuretic, aminoglycoside, vancomycin and carbapenem did not increase the risk of nephrotoxicity. Conclusion: In our study, the rate of nephrotoxicity was higher than those in the literature. We found that underlying malignant tumor diagnosis increases the rate of nephrotoxicity.

  16. Prevention of central venous catheter-associated bloodstream infections in paediatric oncology patients using 70% ethanol locks : A randomised controlled multi-centre trial

    NARCIS (Netherlands)

    Schoot, Reineke A.; van Ommen, C. Heleen; Stijnen, Theo; Tissing, Wim J. E.; Michiels, Erna; Abbink, Floor C. H.; Raphael, Martine F.; Heij, Hugo A.; Lieverst, Jan A.; Spanjaard, Lodewijk; Zwaan, C. Michel; Caron, Huib N.; van de Wetering, Marianne D.

    Background: The prevention of central venous catheter (CVC) associated bloodstream infections (CABSIs) in paediatric oncology patients is essential. Ethanol locks can eliminate pathogens colonising CVCs and microbial resistance is rare. Aim of this study was to determine whether two hour 70% ethanol

  17. Cytokine gene associations with self-report ratings of morning and evening fatigue in oncology patients and their family caregivers.

    Science.gov (United States)

    Dhruva, Anand; Aouizerat, Bradley E; Cooper, Bruce; Paul, Steven M; Dodd, Marylin; West, Claudia; Wara, William; Lee, Kathryn; Dunn, Laura B; Langford, Dale J; Merriman, John D; Baggott, Christina; Cataldo, Janine; Ritchie, Christine; Kober, Kord M; Leutwyler, Heather; Miaskowski, Christine

    2015-03-01

    The purpose of this study was to evaluate for differences in variations in pro- and anti-inflammatory cytokine genes between participants who were classified as having low and high levels of morning and evening fatigue and to evaluate for differences in phenotypic characteristics between these two groups. In a sample of 167 oncology outpatients with breast, prostate, lung, or brain cancer and 85 of their family caregivers, growth mixture modeling was used to identify latent classes of individuals based on ratings of morning and evening fatigue obtained prior to, during, and for 4 months following completion of radiation therapy. Differences in single nucleotide polymorphisms and haplotypes in 15 cytokine genes were evaluated between the latent classes. Multiple logistic regression was used to assess the effect of phenotypic and genotypic characteristics on morning and evening fatigue class membership. Associations were found between morning fatigue and number of comorbidities as well as variations in tumor necrosis factor alpha (TNFA) rs1800629 and rs3093662. Evening fatigue was associated with caring for children at home and variations in interleukin 4 (IL4) rs2243248 and TNFA rs2229094. Younger age and lower performance status were associated with both morning and evening fatigue. These findings suggest that inflammatory mediators are associated with the development of morning and evening fatigue. However, because different phenotypic characteristics and genomic markers are associated with diurnal variations in fatigue, morning and evening fatigue may be distinct but related symptoms. © The Author(s) 2014.

  18. Cytokine Gene Associations with Self-report Ratings of Morning and Evening Fatigue in Oncology Patients and Their Family Caregivers

    Science.gov (United States)

    Dhruva, Anand; Aouizerat, Bradley E.; Cooper, Bruce; Paul, Steven M.; Dodd, Marylin; West, Claudia; Wara, William; Lee, Kathryn; Dunn, Laura B.; Langford, Dale J.; Merriman, John D.; Baggott, Christina; Cataldo, Janine; Ritchie, Christine; Kober, Kord M.; Leutwyler, Heather; Miaskowski, Christine

    2017-01-01

    The purpose of this study was to evaluate for differences in variations in pro- and anti-inflammatory cytokine genes between participants who were classified as having low and high levels of morning and evening fatigue and to evaluate for differences in phenotypic characteristics between these two groups. In a sample of 167 oncology outpatients with breast, prostate, lung, or brain cancer and 85 of their family caregivers, growth mixture modeling (GMM) was used to identify latent classes of individuals based on ratings of morning and evening fatigue obtained prior to, during, and for 4 months following completion of radiation therapy. Differences in single nucleotide polymorphisms (SNPs) and haplotypes in 15 cytokine genes were evaluated between the latent classes. Multiple logistic regression was used to assess the effect of phenotypic and genotypic characteristics on morning and evening fatigue class membership. Associations were found between morning fatigue and number of comorbidities as well as variations in TNFA rs1800629 and rs3093662. Evening fatigue was associated with caring for children at home and variations in IL4 rs2243248 and TNFA rs2229094. Younger age and lower performance status was associated with both morning and evening fatigue. These findings suggest that inflammatory mediators are associated with the development of morning and evening fatigue. However, because different phenotypic characteristics and genomic markers are associated with diurnal variations in fatigue, morning and evening fatigue may be distinct but related symptoms. PMID:24872120

  19. British Dietetic Association evidence-based guidelines for the protein requirements of adults undergoing maintenance haemodialysis or peritoneal dialysis.

    Science.gov (United States)

    Naylor, H L; Jackson, H; Walker, G H; Macafee, S; Magee, K; Hooper, L; Stewart, L; MacLaughlin, H L

    2013-08-01

    Existing nutritional guidelines suggest that protein requirements of adults with stage five chronic kidney disease undergoing haemodialysis (HD) or peritoneal dialysis (PD) are increased as a result of protein losses during dialysis. The present review aimed to update previous guidance and develop evidence-based practice guidelines on the protein requirements of adults undergoing maintenance dialysis. Following a PICO approach (Participants or Population, Intervention or Exposure, Comparison and Outcome), four research questions were formulated to investigate the total protein requirement and protein quality required by adults undergoing HD and PD. A comprehensive, systematic review was undertaken using the databases Medline, EMBASE and the Cochrane Library from 2005 to September 2009 for HD studies and from 1997 to September 2009 for PD studies. The literature search yielded 2931 studies, which were assessed for inclusion. Following appraisal, 19 studies in HD and 18 studies in PD met the inclusion criteria and were systematically reviewed. Limited good quality evidence supports the recommendations that: (i) adults undergoing maintenance HD require a minimum protein intake of 1.1 g kg(-1) ideal body weight (IBW) per day; and (ii) adults undergoing maintenance PD require a minimum protein intake of 1.0-1.2 kg(-1) IBW per day, in conjunction with an adequate energy intake. There were no studies that addressed the quality of protein for either HD or PD. Evidence suggests that nutritional status may be maintained with lower protein intakes than previously recommended. However, the evidence base is limited and further randomised controlled trials are required to establish the optimal protein intake for dialysis patients. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

  20. Resilience of internal medicine house staff and its association with distress and empathy in an oncology setting.

    Science.gov (United States)

    McFarland, Daniel C; Roth, Andrew

    2017-10-01

    Resilience is a beneficial trait for resident physicians who are exposed to adversity through their work with patients. Inpatient hematology-oncology produces vicarious trauma for physicians in training. Physician distress and empathy influence patient care and may be associated with respectively lower and greater levels of resilience. We collected measures of resilience (Connor-Davidson Resilience Scale), distress (Impact of Events Scale - Revised), and rotation-specific information (e.g., number of death encounters, death stress, and meaning) at the end of a routine hematology-oncology ward rotation. Empathy (Interpersonal Reactivity Index) was measured both before and after the rotation. Fifty-six out of 96 residents completed the study with an overall response rate of 58%. Resilience was negatively correlated with distress (r = -0.306, p = 0.023) but not with empathy (r = 0.172, p = 0.204) and nor with change in empathy over the course of the rotation (r = -0.122, p = 0.374). When separated by sex, male resilience was negatively correlated with distress (r = -0.389, p = 0.04), but female resilience was not. Resident distress levels were in a clinically significant (76%) or posttraumatic stress disorder range (17%), and resident empathy decreased during the rotation (p = 0.018). Resilience levels were similar in those who reported that death events were the most stressful experiences of the rotation and those who derived a sense of meaning from working with dying patients. Resident physicians experienced clinically relevant distress and a decrease in empathy. Resilient resident physicians were less likely to experience distress. This study provides evidence for the salutary effects of resilience on physician distress. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  1. Factors associated with the career choices of hematology and medical oncology fellows trained at academic institutions in the United States.

    Science.gov (United States)

    Horn, Leora; Koehler, Elizabeth; Gilbert, Jill; Johnson, David H

    2011-10-10

    Factors that influence hematology-oncology fellows' choice of academic medicine as a career are not well defined. We undertook a survey of hematology-oncology fellows training at cancer centers designated by the National Cancer Institute (NCI) and the National Comprehensive Cancer Network (NCCN) to understand the factors fellows consider when making career decisions. Program directors at all NCI and NCCN cancer centers were invited to participate in the study. For the purpose of analysis, fellows were grouped into three groups on the basis of interest in an academic career. Demographic data were tested with the Kruskal-Wallis test and χ² test, and nondemographic data were tested by using the multiscale bootstrap method. Twenty-eight of 56 eligible fellowship programs participated, and 236 fellows at participating institutions responded (62% response rate). Approximately 60% of fellows graduating from academic programs in the last 5 years chose academic career paths. Forty-nine percent of current fellows ranked an academic career as extremely important. Fellows choosing an academic career were more likely to have presented and published their research. Additional factors associated with choosing an academic career included factors related to mentorship, intellect, and practice type. Fellows selecting nonacademic careers prioritized lifestyle in their career decision. Recruitment into academic medicine is essential for continued progress in the field. Our data suggest that fewer than half the current fellows training at academic centers believe a career in academic medicine is important. Efforts to improve retention in academics should include focusing on mentorship, research, and career development during fellowship training and improving the image of academic physicians.

  2. Beverage consumption habits “24/7” among British adults: association with total water intake and energy intake

    Science.gov (United States)

    2013-01-01

    Background Various recommendations exist for total water intake (TWI), yet it is seldom reported in dietary surveys. Few studies have examined how real-life consumption patterns, including beverage type, variety and timing relate to TWI and energy intake (EI). Methods We analysed weighed dietary records from the National Diet and Nutrition Survey of 1724 British adults aged 19–64 years (2000/2001) to investigate beverage consumption patterns over 24 hrs and 7 days and associations with TWI and EI. TWI was calculated from the nutrient composition of each item of food and drink and compared with reference values. Results Mean TWI was 2.53 L (SD 0.86) for men and 2.03 L (SD 0.71) for women, close to the European Food Safety Authority “adequate Intake” (AI) of 2.5 L and 2 L, respectively. However, for 33% of men and 23% of women TWI was below AI and TWI:EI ratio was Beverages accounted for 75% of TWI. Beverage variety was correlated with TWI (r 0.34) and more weakly with EI (r 0.16). Beverage consumption peaked at 0800 hrs (mainly hot beverages/ milk) and 2100 hrs (mainly alcohol). Total beverage consumption was higher at weekends, especially among men. Overall, beverages supplied 16% of EI (men 17%, women 14%), alcoholic drinks contributed 9% (men) and 5% (women), milk 5-6%, caloric soft drinks 2%, and fruit juice 1%. In multi-variable regression (adjusted for sex, age, body weight, smoking, dieting, activity level and mis-reporting), replacing 100 g of caloric beverages (milk, fruit juice, caloric soft drinks and alcohol) with 100 g non-caloric drinks (diet soft drinks, hot beverages and water) was associated with a reduction in EI of 15 kcal, or 34 kcal if food energy were unchanged. Using within-person data (deviations from 7-day mean) each 100 g change in caloric beverages was associated with 29 kcal change in EI or 35 kcal if food energy were constant. By comparison the calculated energy content of caloric drinks consumed was

  3. Beverage consumption habits “24/7” among British adults: association with total water intake and energy intake

    Directory of Open Access Journals (Sweden)

    Gibson Sigrid

    2013-01-01

    Full Text Available Abstract Background Various recommendations exist for total water intake (TWI, yet it is seldom reported in dietary surveys. Few studies have examined how real-life consumption patterns, including beverage type, variety and timing relate to TWI and energy intake (EI. Methods We analysed weighed dietary records from the National Diet and Nutrition Survey of 1724 British adults aged 19–64 years (2000/2001 to investigate beverage consumption patterns over 24 hrs and 7 days and associations with TWI and EI. TWI was calculated from the nutrient composition of each item of food and drink and compared with reference values. Results Mean TWI was 2.53 L (SD 0.86 for men and 2.03 L (SD 0.71 for women, close to the European Food Safety Authority “adequate Intake” (AI of 2.5 L and 2 L, respectively. However, for 33% of men and 23% of women TWI was below AI and TWI:EI ratio was In multi-variable regression (adjusted for sex, age, body weight, smoking, dieting, activity level and mis-reporting, replacing 100 g of caloric beverages (milk, fruit juice, caloric soft drinks and alcohol with 100 g non-caloric drinks (diet soft drinks, hot beverages and water was associated with a reduction in EI of 15 kcal, or 34 kcal if food energy were unchanged. Using within-person data (deviations from 7-day mean each 100 g change in caloric beverages was associated with 29 kcal change in EI or 35 kcal if food energy were constant. By comparison the calculated energy content of caloric drinks consumed was 47 kcal/100 g. Conclusions TWI and beverage consumption are closely related, and some individuals appeared to have low TWI. Compensation for energy from beverages may occur but is partial. A better understanding of interactions between drinking and eating habits and their impact on water and energy balance would give a firmer basis to dietary recommendations.

  4. Beverage consumption habits "24/7" among British adults: association with total water intake and energy intake.

    Science.gov (United States)

    Gibson, Sigrid; Shirreffs, Susan M

    2013-01-10

    Various recommendations exist for total water intake (TWI), yet it is seldom reported in dietary surveys. Few studies have examined how real-life consumption patterns, including beverage type, variety and timing relate to TWI and energy intake (EI). We analysed weighed dietary records from the National Diet and Nutrition Survey of 1724 British adults aged 19-64 years (2000/2001) to investigate beverage consumption patterns over 24 hrs and 7 days and associations with TWI and EI. TWI was calculated from the nutrient composition of each item of food and drink and compared with reference values. Mean TWI was 2.53 L (SD 0.86) for men and 2.03 L (SD 0.71) for women, close to the European Food Safety Authority "adequate Intake" (AI) of 2.5 L and 2 L, respectively. However, for 33% of men and 23% of women TWI was below AI and TWI:EI ratio was milk) and 2100 hrs (mainly alcohol). Total beverage consumption was higher at weekends, especially among men. Overall, beverages supplied 16% of EI (men 17%, women 14%), alcoholic drinks contributed 9% (men) and 5% (women), milk 5-6%, caloric soft drinks 2%, and fruit juice 1%.In multi-variable regression (adjusted for sex, age, body weight, smoking, dieting, activity level and mis-reporting), replacing 100 g of caloric beverages (milk, fruit juice, caloric soft drinks and alcohol) with 100 g non-caloric drinks (diet soft drinks, hot beverages and water) was associated with a reduction in EI of 15 kcal, or 34 kcal if food energy were unchanged. Using within-person data (deviations from 7-day mean) each 100 g change in caloric beverages was associated with 29 kcal change in EI or 35 kcal if food energy were constant. By comparison the calculated energy content of caloric drinks consumed was 47 kcal/100 g. TWI and beverage consumption are closely related, and some individuals appeared to have low TWI. Compensation for energy from beverages may occur but is partial. A better understanding of interactions between drinking and eating

  5. Teleoncology uptake in British Columbia.

    Science.gov (United States)

    Clarke, Melissa; Barnett, Jeff

    2011-01-01

    Telehealth enables the delivery of specialized health care to patients living in isolated and remote regions. The purpose of this analysis is to determine the current uptake of teleoncology in mainland British Columbia. Patient appointment data was extracted from the Cancer Agency Information System (CAIS) for the 2009 calendar year. Three types of practitioners used teleoncology in 2009: Medical Oncologists, Genetic Counsellors and Medical Geneticists. In total, 712 telehealth encounters were conducted; Medical Oncologists conducted 595 encounters (83.6%), Genetic Counsellors conducted 112 encounters (15.7%) and Medical Geneticists conducted 5 encounters (0.7%). The most common oncology appointments were Gastro-Intestinal (11.4%) and Lymphoma (11.0%) follow-up appointments with a Medical Oncologist. Telehealth encounters were conducted by 46 individual health care providers however, a single Medical Oncologist conducted 418 encounters and this accounts for more than half (58.7%) of all telehealth appointments in 2009. Radiation Oncologists on the mainland up to this point are not using the technology. The Local Health Areas with the highest number of oncology telehealth appointments were: Kamloops: 203 encounters (34.1%), Penticton: 84 encounters (14.1%), Cranbrook: 58 encounters (9.7%) and the Southern Okanagan: 33 encounter (5.5%). Use of telehealth in rural and remote areas of BC is limited and there is significant room for growth. Further research will be required to identify barriers and restrictions to the use of telehealth in order to increase teleoncology adoption in British Columbia.

  6. [Galen's oncology].

    Science.gov (United States)

    Vigliani, R

    1995-10-01

    "Claudius Galenus" is the Author of "De tumoribus praeter naturam". The book was studied on the original Greek text with Latin version edited by K.G. Kühn ("Opera omnia Claudii Galeni": VII, 705-732). This Galen's clinical and pathological oncology was examined as far as categorization, classification, morphology, etiology, pathogenesis, morphogenesis, topography, behaviour (with related therapeutic and prognostic implications) and terminology are concerned. Problems, aspects and concepts, more or less clarified by Galen, were extensively discussed with special reference to the Galen's scientific knowledge and compared with the modern oncology.

  7. What Medical Oncologist Residents Think about the Italian Speciality Schools: A Survey of the Italian Association of Medical Oncology (AIOM on Educational, Clinical and Research Activities.

    Directory of Open Access Journals (Sweden)

    Anna Moretti

    Full Text Available Relevant heterogeneity exists among Postgraduate Schools in Medical Oncology, also within the same country. In order to provide a comprehensive overview of the landscape of Italian Postgraduate Schools in Medical Oncology, the Italian Association of Medical Oncology (AIOM undertook an online survey, inviting all the residents to describe their daily activities and to express their overall satisfaction about their programs.A team composed of five residents and three consultants in medical oncology prepared a 38 items questionnaire that was published online in a reserved section, accessible through a link sent by e-mail. Residents were invited to anonymously fill in the questionnaire that included the following sub-sections: quality of teaching, clinical and research activity, overall satisfaction.Three-hundred and eleven (57% out of 547 invited residents filled in the questionnaire. Two-hundred and twenty-three (72% participants declared that attending lessons was frequently difficult and 153 (49% declared they did not gain substantial improvement in their knowledge from them. Fifty-five percent stated that they did not receive lessons on palliative care. Their overall judgment about didactic activity was low in 63% of the interviewed. The satisfaction for clinical activity was in 86% of cases good: 84% recognized that, during the training period, they acquired a progressive independence on patients' management. About research activity, the majority (79% of participants in the survey was actively engaged in managing patients included in clinical trials but the satisfaction level for the involvement in research activities was quite low (54%. Overall, 246 residents (79% gave a positive global judgment of their Medical Oncology Schools.The landscape of Italian Postgraduate Schools in Medical Oncology is quite heterogeneous across the country. Some improvements in the organization of teaching and in the access to research opportunity are needed; the

  8. Guidelines, "minimal requirements" and standard of care in glioblastoma around the Mediterranean Area: A report from the AROME (Association of Radiotherapy and Oncology of the Mediterranean arEa) Neuro-Oncology working party.

    Science.gov (United States)

    2016-02-01

    Glioblastoma is the most common and the most lethal primary brain tumor in adults. Although studies are ongoing, the epidemiology of glioblastoma in North Africa (i.e. Morocco, Algeria and Tunisia) remains imperfectly settled and needs to be specified for a better optimization of the neuro-oncology healthcare across the Mediterranean area and in North Africa countries. Over the last years significant therapeutic advances have been accomplished improving survival and quality of life of glioblastoma patients. Indeed, concurrent temozolomide-radiotherapy (temoradiation) and adjuvant temozolomide has been established as the standard of care associated with a survival benefit and a better outcome. Therefore, considering this validated strategy and regarding the means and some other North Africa countries specificities, we decided, under the auspices of AROME (association of radiotherapy and oncology of the Mediterranean area; www.aromecancer.org), a non-profit organization, to organize a dedicated meeting to discuss the standards and elaborate a consensus on the "minimal requirements" adapted to the local resources. Thus, panels of physicians involved in daily multidisciplinary brain tumors management in the two borders of the Mediterranean area have been invited to the AROME neuro-oncology working party. We report here the consensus, established for minimal human and material resources for glioblastoma diagnosis and treatment faced to the standard of care, which should be reached. If the minimal requirements are not reached, the patients should be referred to the closest specialized medical center where at least minimal requirements, or, ideally, the standard of care should be guaranteed to the patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Association between prolonged neutropenia and reduced relapse risk in pediatric AML: A report from the children's oncology group.

    Science.gov (United States)

    Sung, Lillian; Aplenc, Richard; Alonzo, Todd A; Gerbing, Robert B; Wang, Yi-Cheng; Meshinchi, Soheil; Gamis, Alan S

    2016-11-01

    Objective was to describe the relationship between the number of sterile site infections and duration of neutropenia during the first four cycles of chemotherapy and the risk of recurrence and overall survival in children with newly diagnosed acute myeloid leukemia (AML). AAML0531 was a Children's Oncology Group randomized phase 3 clinical trial that included 1022 children with de novo AML. For this analysis, we focused on non-Down syndrome favorable and standard risk patients who completed at least 4 cycles of chemotherapy without recurrence or withdrawal during protocol therapy. Those receiving hematopoietic stem cell transplantation in first remission were excluded. Five hundred and sixty-nine patients were included; 274 (48.2%) were favorable risk. The median cumulative time with neutropenia between Induction II to completion of Intensification II was 96 (range 54-204) days. Number of sterile site infections did not influence the risk of relapse or overall survival. However, longer duration of neutropenia was associated with a lower risk of relapse (hazard ratio 0.81 per 20 days neutropenia, p = 0.007). Longer duration of neutropenia was associated with a reduced risk of relapse for children with favorable and standard risk AML. Toxicity may be influenced by pharmacogenomics suggesting that individualized chemotherapy dosing may be an effective strategy. © 2016 UICC.

  10. Guidelines for the use of long-term central venous catheter in children with hemato-oncological disorders. On behalf of supportive therapy working group of Italian Association of Pediatric Hematology and Oncology (AIEOP).

    Science.gov (United States)

    Carraro, F; Cicalese, M P; Cesaro, S; De Santis, R; Zanazzo, G; Tornesello, A; Giordano, P; Bergadano, A; Giacchino, M

    2013-10-01

    In the last 30 years, the use of long-term central venous catheters (CVC) is increased especially for children with hemato-oncological disorders. However, the use of CVC is associated to complications, as mechanical accidents, thrombosis, and infections that can determine a prolongation of hospital stay, an increase of costs, and sometimes life-threatening conditions that require urgent systemic treatment or CVC removal. CVC removal may be troublesome especially in neonates, infants, or any other "highly needed CVC patients"; in these selected cases, the prevention and treatment of CVC-related complications play a pivotal role and specific surveillance programs are crucial. While extensive literature is focused on CVC management in adults, no guidelines are available for children. To this aim, the first recommendations for the management of CVC infectious complication in pediatric age have been written after pediatric and adult literature review and collegial discussion among members of Supportive Therapy working group of Italian Association of Pediatric Hematology and Oncology. Compared to the adult age, the necessity of peripheral vein cultures for the diagnosis of CVC-related infection remains controversial in children because of the poorer venous asset and a conservative, pharmacologically focused management through CVC remains mandatory, with CVC removal to be performed only in selected cases.

  11. The multidimensionality of spiritual wellbeing: peace, meaning, and faith and their association with quality of life and coping in oncology.

    Science.gov (United States)

    Whitford, Hayley S; Olver, Ian N

    2012-06-01

    This study explored associations between the recently proposed three-factor structure of the 12-item Functional Assessment of Chronic Illness Therapy-Spiritual Well-being (FACIT-Sp) subscale (Peace, Meaning, and Faith), quality of life (QoL), and coping in an oncology population. A total of 999 newly diagnosed, study eligible, consecutive cancer patients completed the FACIT-Sp and the Mental Adjustment to Cancer (MAC) scale. Hierarchical multiple regressions revealed that Peace alone added 3% to the prediction of QoL and accounted for 15.8% of the overlap in Total Functional Assessment of Cancer Therapy--General (FACT-G) scores (both pMeaning alone added 1.3% to QoL prediction and accounted for 5.8% in overlap (both pPeace was most prominently associated with the QoL subscales of Functional (r = 0.64) and Emotional Wellbeing (r = 0.61) and the coping styles of Helpless/Hopeless (r = -0.53), Fighting Spirit (r = 0.47), and Anxious Preoccupation (r = -0.34). Meaning was also highly associated with Functional Wellbeing (r = 0.56), Helpless/Hopeless (r = -0.53), and Fighting Spirit (r = 0.54), but in addition, Social Wellbeing (r = 0.49). The three-factor model of spiritual wellbeing appears psychometrically superior to previous models as it further discriminates between which components are most highly associated with improved QoL facets and coping styles. This study provides normative data on newly diagnosed patients with cancer and further highlights the clinical contribution of such detailed assessment. Copyright © 2011 John Wiley & Sons, Ltd.

  12. Electronic nicotine delivery systems: a policy statement from the American Association for Cancer Research and the American Society of Clinical Oncology.

    Science.gov (United States)

    Brandon, Thomas H; Goniewicz, Maciej L; Hanna, Nasser H; Hatsukami, Dorothy K; Herbst, Roy S; Hobin, Jennifer A; Ostroff, Jamie S; Shields, Peter G; Toll, Benjamin A; Tyne, Courtney A; Viswanath, Kasisomayajula; Warren, Graham W

    2015-03-10

    Combustible tobacco use remains the number-one preventable cause of disease, disability, and death in the United States. Electronic nicotine delivery systems (ENDS), which include electronic cigarettes, are devices capable of delivering nicotine in an aerosolized form. ENDS use by both adults and youth has increased rapidly, and some have advocated these products could serve as harm-reduction devices and smoking cessation aids. ENDS may be beneficial if they reduce smoking rates or prevent or reduce the known adverse health effects of smoking. However, ENDS may also be harmful, particularly to youth, if they increase the likelihood that nonsmokers or former smokers will use combustible tobacco products or if they discourage smokers from quitting. The American Association for Cancer Research (AACR) and the American Society of Clinical Oncology (ASCO) recognize the potential ENDS have to alter patterns of tobacco use and affect the health of the public; however, definitive data are lacking. The AACR and ASCO recommend additional research on these devices, including assessing the health impacts of ENDS, understanding patterns of ENDS use, and determining what role ENDS have in cessation. Key policy recommendations include supporting federal, state, and local regulation of ENDS; requiring manufacturers to register with the US Food and Drug Administration and report all product ingredients, requiring childproof caps on ENDS liquids, and including warning labels on products and their advertisements; prohibiting youth-oriented marketing and sales; prohibiting child-friendly ENDS flavors; and prohibiting ENDS use in places where cigarette smoking is prohibited. This policy statement was developed by a joint writing group composed of members from the Tobacco and Cancer Subcommittee of the American Association for Cancer Research (AACR) Science Policy and Government Affairs (SPGA) Committee and American Society of Clinical Oncology (ASCO) Tobacco Cessation and Control

  13. Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder : A revision of the 2005 guidelines from the British Association for Psychopharmacology

    NARCIS (Netherlands)

    Baldwin, David S.; Anderson, Ian M.; Nutt, David J.; Allgulander, Christer; Bandelow, Borwin; den Boer, Johan A.; Christmas, David M.; Davies, Simon; Fineberg, Naomi; Lidbetter, Nicky; Malizia, Andrea; McCrone, Paul; Nabarro, Daniel; O'Neill, Catherine; Scott, Jan; van der Wee, Nic; Wittchen, Hans-Ulrich

    This revision of the 2005 British Association for Psychopharmacology guidelines for the evidence-based pharmacological treatment of anxiety disorders provides an update on key steps in diagnosis and clinical management, including recognition, acute treatment, longer-term treatment, combination

  14. Adjuvant and Salvage Radiation Therapy After Prostatectomy: American Society for Radiation Oncology/American Urological Association Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Valicenti, Richard K., E-mail: Richard.valicenti@ucdmc.ucdavis.edu [Department of Radiation Oncology, University of California, Davis School of Medicine, Davis, California (United States); Thompson, Ian [Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas (United States); Albertsen, Peter [Division of Urology, University of Connecticut Health Center, Farmington, Connecticut (United States); Davis, Brian J. [Department of Radiation Oncology, Mayo Medical School, Rochester, Minnesota (United States); Goldenberg, S. Larry [Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia (Canada); Wolf, J. Stuart [Department of Urology, University of Michigan, Ann Arbor, Michigan (United States); Sartor, Oliver [Department of Medicine and Urology, Tulane Medical School, New Orleans, Louisiana (United States); Klein, Eric [Glickman Urological Kidney Institute, Cleveland Clinic, Cleveland, Ohio (United States); Hahn, Carol [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Michalski, Jeff [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Roach, Mack [Department of Radiation Oncology, University of California, San Francisco, San Francisco, California (United States); Faraday, Martha M. [Four Oaks, Inc (United States)

    2013-08-01

    Purpose: The purpose of this guideline was to provide a clinical framework for the use of radiation therapy after radical prostatectomy as adjuvant or salvage therapy. Methods and Materials: A systematic literature review using PubMed, Embase, and Cochrane database was conducted to identify peer-reviewed publications relevant to the use of radiation therapy after prostatectomy. The review yielded 294 articles; these publications were used to create the evidence-based guideline statements. Additional guidance is provided as Clinical Principles when insufficient evidence existed. Results: Guideline statements are provided for patient counseling, use of radiation therapy in the adjuvant and salvage contexts, defining biochemical recurrence, and conducting a restaging evaluation. Conclusions: Physicians should offer adjuvant radiation therapy to patients with adverse pathologic findings at prostatectomy (ie, seminal vesicle invastion, positive surgical margins, extraprostatic extension) and salvage radiation therapy to patients with prostate-specific antigen (PSA) or local recurrence after prostatectomy in whom there is no evidence of distant metastatic disease. The offer of radiation therapy should be made in the context of a thoughtful discussion of possible short- and long-term side effects of radiation therapy as well as the potential benefits of preventing recurrence. The decision to administer radiation therapy should be made by the patient and the multidisciplinary treatment team with full consideration of the patient's history, values, preferences, quality of life, and functional status. The American Society for Radiation Oncology and American Urological Association websites show this guideline in its entirety, including the full literature review.

  15. Sediment-associated aliphatic and aromatic hydrocarbons in coastal British Columbia, Canada: concentrations, composition, and associated risks to protected sea otters.

    Science.gov (United States)

    Harris, Kate A; Yunker, Mark B; Dangerfield, Neil; Ross, Peter S

    2011-10-01

    Sediment-associated hydrocarbons can pose a risk to wildlife that rely on benthic marine food webs. We measured hydrocarbons in sediments from the habitat of protected sea otters in coastal British Columbia, Canada. Alkane concentrations were dominated by higher odd-chain n-alkanes at all sites, indicating terrestrial plant inputs. While remote sites were dominated by petrogenic polycyclic aromatic hydrocarbons (PAHs), small harbour sites within sea otter habitat and sites from an urban reference area reflected weathered petroleum and biomass and fossil fuel combustion. The partitioning of hydrocarbons between sediments and adjacent food webs provides an important exposure route for sea otters, as they consume ∼25% of their body weight per day in benthic invertebrates. Thus, exceedences of PAH sediment quality guidelines designed to protect aquatic biota at 20% of the sites in sea otter habitat suggest that sea otters are vulnerable to hydrocarbon contamination even in the absence of catastrophic oil spills. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. Common and Distinct Characteristics Associated With Trajectories of Morning and Evening Energy in Oncology Patients Receiving Chemotherapy.

    Science.gov (United States)

    Abid, Hamza; Kober, Kord M; Smoot, Betty; Paul, Steven M; Hammer, Marilyn; Levine, Jon D; Lee, Kathryn; Wright, Fay; Cooper, Bruce A; Conley, Yvette P; Miaskowski, Christine

    2017-05-01

    Although energy conservation strategies are recommended in clinical practice guidelines, little is known about changes in energy levels in oncology patients undergoing cancer treatment. The objective of this study was to identify variations in the trajectories of morning and evening energy levels and determine which characteristics predicted initial levels and the trajectories of morning and evening energy. Outpatients receiving chemotherapy (CTX) completed demographic and symptom questionnaires six times over two CTX cycles. Energy was assessed using the Lee Fatigue Scale. Hierarchical linear modeling was used to analyze the data. A large amount of interindividual variability was found in the morning and evening energy trajectories. Patients who lived alone, had childcare responsibilities, had a lower functional status, did not exercise on a regular basis, had lower hemoglobin levels, had lower attentional function, higher trait anxiety, and higher sleep disturbance reported lower morning energy levels at enrollment. Variations in the trajectories of morning energy were associated with a higher body mass index and higher levels of morning energy and higher sleep disturbance scores. For evening energy, patients who were female, white, had lower functional status, and had lower attentional function and higher sleep disturbance reported lower evening energy levels at enrollment. Evening energy levels at enrollment were associated with changes in evening energy over time. Patients undergoing CTX experience decrements in both morning and evening energy. The modifiable characteristics associated with these decrements can be used to design intervention studies to increase energy levels in these patients. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  17. The ABC of Physical Activity for Health: a consensus statement from the British Association of Sport and Exercise Sciences.

    Science.gov (United States)

    O'Donovan, Gary; Blazevich, Anthony J; Boreham, Colin; Cooper, Ashley R; Crank, Helen; Ekelund, Ulf; Fox, Kenneth R; Gately, Paul; Giles-Corti, Billie; Gill, Jason M R; Hamer, Mark; McDermott, Ian; Murphy, Marie; Mutrie, Nanette; Reilly, John J; Saxton, John M; Stamatakis, Emmanuel

    2010-04-01

    Our understanding of the relationship between physical activity and health is constantly evolving. Therefore, the British Association of Sport and Exercise Sciences convened a panel of experts to review the literature and produce guidelines that health professionals might use. In the ABC of Physical Activity for Health, A is for All healthy adults, B is for Beginners, and C is for Conditioned individuals. All healthy adults aged 18-65 years should aim to take part in at least 150 min of moderate-intensity aerobic activity each week, or at least 75 min of vigorous-intensity aerobic activity per week, or equivalent combinations of moderate- and vigorous-intensity activities. Moderate-intensity activities are those in which heart rate and breathing are raised, but it is possible to speak comfortably. Vigorous-intensity activities are those in which heart rate is higher, breathing is heavier, and conversation is harder. Aerobic activities should be undertaken in bouts of at least 10 min and, ideally, should be performed on five or more days a week. All healthy adults should also perform muscle-strengthening activities on two or more days a week. Weight training, circuit classes, yoga, and other muscle-strengthening activities offer additional health benefits and may help older adults to maintain physical independence. Beginners should work steadily towards meeting the physical activity levels recommended for all healthy adults. Even small increases in activity will bring some health benefits in the early stages and it is important to set achievable goals that provide success, build confidence, and increase motivation. For example, a beginner might be asked to walk an extra 10 min every other day for several weeks to slowly reach the recommended levels of activity for all healthy adults. It is also critical that beginners find activities they enjoy and gain support in becoming more active from family and friends. Conditioned individuals who have met the physical

  18. Association of systolic blood pressure drop with intravenous administration of itraconazole in children with hemato-oncologic disease.

    Science.gov (United States)

    Lee, Hyeong Jin; Lee, Bongjin; Park, June Dong; Jeong, Hyung Joo; Choi, Yu Hyeon; Ju, Hee Young; Hong, Che Ry; Lee, Ji Won; Kim, Hyery; Suh, Dong In; Park, Kyung Duk; Kang, Hyoung Jin; Shin, Hee Young; Ahn, Hyo Seop

    2015-01-01

    Although few adverse effects have been reported for itraconazole, a widely used antifungal therapy for febrile neutropenia, we found intravenous (IV) itraconazole to be associated with serious cases of blood pressure (BP) drop. We therefore evaluated the incidence and risk factors for BP drop during IV administration of the drug. We reviewed the medical records of children with hemato-oncologic disease who were treated with IV itraconazole from January 2012 to December 2013. By analyzing systolic BP (SBP) measurements made from 4 hours before through to 4 hours after itraconazole administration, we evaluated the changes in SBP and the risk factors for an SBP drop, especially clinically meaningful (≥ 20%) drops. Itraconazole was administered 2,627 times to 180 patients. The SBP during the 4 hours following itraconazole administration was lower than during the 4 hours before administration (104 [53.0-160.33 mmHg] versus 105 [59.8-148.3 mmHg]; Pdrop was seen in 5.37% (141 out of 2,627) of the administrations, and the use of inotropics (odds ratio [OR] 6.70, 95% confidence interval [CI] 3.22-13.92; P<0.001), reducing the dose of inotropics (OR 8.08; 95% CI 1.39-46.94; P=0.02), CRRT (OR 3.10, 95% CI 1.41-6.81; P=0.005), and bacteremia (OR 2.70, 95% CI 1.32-5.51; P=0.007) were risk factors, while age was a protective factor (OR 0.93, 95% CI 0.89-0.97; P<0.001). A decrease in SBP was associated with IV administration of itraconazole. It was particularly significant in younger patients with bacteremia using inotropic agents and during application of CRRT. Careful attention to hypotension is warranted during IV administration of itraconazole in this group of patients.

  19. Nanomedicine in veterinary oncology.

    Science.gov (United States)

    Lin, Tzu-Yin; Rodriguez, Carlos O; Li, Yuanpei

    2015-08-01

    Nanomedicine is an interdisciplinary field that combines medicine, engineering, chemistry, biology and material sciences to improve disease management and can be especially valuable in oncology. Nanoparticle-based agents that possess functions such as tumor targeting, imaging and therapy are currently under intensive investigation. This review introduces the basic concept of nanomedicine and the classification of nanoparticles. Because of their favorable pharmacokinetics, tumor targeting properties, and resulting superior efficacy and toxicity profiles, nanoparticle-based agents can overcome several limitations associated with conventional diagnostic and therapeutic protocols in veterinary oncology. The two most important tumor targeting mechanisms (passive and active tumor targeting) and their dominating factors (i.e. shape, charge, size and nanoparticle surface display) are discussed. The review summarizes published clinical and preclinical studies that utilize different nanoformulations in veterinary oncology, as well as the application of nanoparticles for cancer diagnosis and imaging. The toxicology of various nanoformulations is also considered. Given the benefits of nanoformulations demonstrated in human medicine, nanoformulated drugs are likely to gain more traction in veterinary oncology. Published by Elsevier Ltd.

  20. Association of systolic blood pressure drop with intravenous administration of itraconazole in children with hemato-oncologic disease

    Directory of Open Access Journals (Sweden)

    Lee HJ

    2015-12-01

    Full Text Available Hyeong Jin Lee,1,* Bongjin Lee,2,* June Dong Park,2 Hyung Joo Jeong,2 Yu Hyeon Choi,2 Hee Young Ju,1 Che Ry Hong,1 Ji Won Lee,1 Hyery Kim,1 Dong In Suh,3 Kyung Duk Park,1 Hyoung Jin Kang,1 Hee Young Shin,1 Hyo Seop Ahn1 1Department of Pediatrics, Cancer Research Institute, 2Division of Pediatric Intensive Care, Department of Pediatrics, 3Division of Pulmonology, Department of Pediatrics, Seoul National University College of Medicine, Seoul National University, Seoul, South Korea *These authors contributed equally to this work Purpose: Although few adverse effects have been reported for itraconazole, a widely used antifungal therapy for febrile neutropenia, we found intravenous (IV itraconazole to be associated with serious cases of blood pressure (BP drop. We therefore evaluated the incidence and risk factors for BP drop during IV administration of the drug.Materials and methods: We reviewed the medical records of children with hemato-oncologic disease who were treated with IV itraconazole from January 2012 to December 2013. By analyzing systolic BP (SBP measurements made from 4 hours before through to 4 hours after itraconazole administration, we evaluated the changes in SBP and the risk factors for an SBP drop, especially clinically meaningful (≥20% drops.Results: Itraconazole was administered 2,627 times to 180 patients. The SBP during the 4 hours following itraconazole administration was lower than during the 4 hours before administration (104 [53.0–160.33 mmHg] versus 105 [59.8–148.3 mmHg]; P<0.001. The decrease in SBP was associated with the application of continuous renal replacement therapy (CRRT (P=0.012 and the use of inotropic (P=0.005 and hypotensive drugs (P=0.021. A clinically meaningful SBP drop was seen in 5.37% (141 out of 2,627 of the administrations, and the use of inotropics (odds ratio [OR] 6.70, 95% confidence interval [CI] 3.22–13.92; P<0.001, reducing the dose of inotropics (OR 8.08; 95% CI 1.39–46.94; P=0

  1. Risk for Health Care-Associated Bloodstream Infections in Pediatric Oncology Patients With Various Malignancies.

    Science.gov (United States)

    Thurman, Cara B; Abbott, Maura; Liu, Jinfang; Larson, Elaine

    This was a retrospective cohort study to identify the rates, predictors, and outcomes of health care-associated bloodstream infections (HA-BSI) among children with solid tumors, lymphoma, lymphoid leukemia, and myeloid leukemia. The study population included 4500 children ≤18 years old at a pediatric hospital in New York City from 2006 to 2014. A total of 147 HA-BSI cases were identified; using multivariable logistic regression modeling, children with a hematologic diagnosis (lymphoma, lymphoid leukemia, myeloid leukemia) were at greater risk for HA-BSI than those with a solid tumor diagnosis (all P values risk factor for HA-BSI, there was no significant difference in overall mortality from HA-BSI by tumor type ( P = .51).

  2. Factors associated with grade 3 or 4 treatment-related toxicity in women with advanced or recurrent cervical cancer: an exploratory analysis of NRG Oncology/Gynecologic Oncology Group trials 179 and 204.

    Science.gov (United States)

    Chase, Dana M; Kauderer, James; Wenzel, Lari; Ramondetta, Lois; Cella, David; Long, Harry J; Monk, Bradley J

    2015-02-01

    This study aimed to describe pretreatment patient characteristics and baseline quality-of-life scores as they relate to the development of grade 3 or 4 toxicity in patients receiving chemotherapy for advanced/recurrent cervical cancer. The study sample was drawn from Gynecologic Oncology Group protocols 179 and 204. Grade 3 or 4 toxicities were considered in 4 specified categories as follows: peripheral neuropathy, fatigue, hematological, and gastrointestinal (GI). The data variables explored included age, stage, pretreatment radiation, performance status (PS) at treatment initiation, and baseline Functional Assessment of Cancer Therapy-Cervix (FACT-Cx) score. A logistic regression model was developed with various adverse events as binary (0/1) outcomes. Six hundred seventy-three patient-reported questionnaires were used in the analyses. At baseline, pain was the most severe patient-reported symptom. Baseline line-item patient concerns did demonstrate specific correlations with the development of individual toxicities. In 401 patients who were enrolled on Gynecologic Oncology Group 204 (fatigue not measured on 179), a worse PS predicted the development of grade 3 or 4 fatigue (odds ratio, 2.78; 95% confidence interval, 1.66-4.68). Exposure to previous radiation, treatment regimen, and a worse FACT-Cx score were associated with the reporting of both grade 3 or 4 leukopenia (P < 0.05) and anemia (P < 0.0005). Performance status and treatment regimen (P < 0.05) were associated with the development of grade 3 or 4 thrombocytopenia. Age and treatment regimen (P < 0.05) were associated with the development of grade 3 or 4 neutropenia. The FACT-Cx score (P = 0.0016) predicted grade 3 or 4 GI toxicity. The development of fatigue, hematological, and GI toxicity might be predictable based on factors other than treatment assignment such as age, PS, and patient-reported quality-of-life measurement.

  3. STK39 polymorphisms and blood pressure: an association study in British Caucasians and assessment of cis-acting influences on gene expression

    Directory of Open Access Journals (Sweden)

    Koref Mauro

    2009-12-01

    Full Text Available Abstract Background Blood pressure (BP has significant heritability, but the genes responsible remain largely unknown. Single nucleotide polymorphisms (SNPs at the STK39 locus were recently associated with hypertension by genome-wide association in an Amish population; in vitro data from transient transfection experiments using reporter constructs suggested that altered STK39 expression might mediate the effect. However, other large studies have not implicated STK39 in hypertension. We determined whether reported SNPs influenced STK39 expression in vivo, or were associated with BP in a large British Caucasian cohort. Methods 1372 members of 247 Caucasian families ascertained through a hypertensive proband were genotyped for reported risk variants in STK39 (rs6749447, rs3754777, rs35929607 using Sequenom technology. MERLIN software was used for family-based association testing. Cis-acting influences on expression were assessed in vivo using allelic expression ratios in cDNA from peripheral blood cells in 35 South African individuals heterozygous for a transcribed SNP in STK39 (rs1061471 and quantified by mass spectrometry (Sequenom. Results No significant association was seen between the SNPs tested and systolic or diastolic BP in clinic or ambulatory measurements (all p > 0.05. The tested SNPs were all associated with allelic expression differences in peripheral blood cells (p -4. In individuals who were heterozygous for this SNP, on average the G allele showed 13% overexpression compared to the T allele. Conclusions STK39 expression is modified by polymorphisms acting in cis and the typed SNPs are associated with allelic expression of this gene, but there is no evidence for an association with BP in a British Caucasian cohort.

  4. Approach to cardio-oncologic patients with special focus on patients with cardiac implantable electronic devices planned for radiotherapy: results of the European Heart Rhythm Association survey.

    Science.gov (United States)

    Lenarczyk, Radoslaw; Potpara, Tatjana S; Haugaa, Kristina H; Deharo, Jean-Claude; Hernandez-Madrid, Antonio; Del Carmen Exposito Pineda, Maria; Kiliszek, Marek; Dagres, Nikolaos

    2017-09-01

    The aim of this European Heart Rhythm Association (EHRA) survey was to evaluate clinical practice regarding cardio-oncologic patients, with special focus on patients with cardiac implantable electronic devices (CIEDs) planned for anticancer radiotherapy (RT), among members of the EHRA electrophysiology research network. Of the 36 responding centres, 89% managed patients who were diagnosed or treated oncologically, and this diagnosis affected 1-5% of cardiovascular patients in majority of centres (57%). The main side effects of anticancer therapy in patients treated by cardiologists were thromboembolic complications and left ventricular dysfunction (both reported as 'frequent' by 43% of the centres). The main agents associated with complications were anthracyclines, RT, and monoclonal antibodies. Echocardiography was the most common method of screening for cardiovascular complications (93%), and 10% of the centres did not routinely screen for treatment-induced cardiotoxicity. Opinions on the safe radiation dose, methods of device shielding, and risk calculation prior to RT in CIED patients differed among centres. Precaution measures in high-risk CIED patients were very heterogeneous among centres. Our survey has shown that the awareness of cardiac consequences of anticancer therapy is high, despite relatively low proportion of patients treated oncologically among all cardiovascular patients. There is a consensus of which screening methods should be used for cardiotoxicity of anticancer treatment, but the apprehension of screening necessity is low. Methods of risk assessment and safety measures in CIED patients undergoing RT are very heterogeneous among the European centres, underscoring the need for standardization of the approach to cardio-oncologic patients. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For Permissions, please email: journals.permissions@oup.com.

  5. British Sign Name Customs

    Science.gov (United States)

    Day, Linda; Sutton-Spence, Rachel

    2010-01-01

    Research presented here describes the sign names and the customs of name allocation within the British Deaf community. While some aspects of British Sign Language sign names and British Deaf naming customs differ from those in most Western societies, there are many similarities. There are also similarities with other societies outside the more…

  6. Publish or perish? A survey of abstracts accepted for meetings of the British Association of Oral and Maxillofacial Surgeons, and subsequently published.

    Science.gov (United States)

    Collier, Jonathan M; Vig, Navin; Hammond, Douglas

    2010-10-01

    Publications are important for all surgeons, including those practising oral and maxillofacial surgery (OMFS). The results of relevant research are usually presented at the annual scientific meetings of the British Association of Oral and Maxillofacial Surgeons (BAOMS). The aim of this study was to find out how many abstracts that were accepted for presentation at the BAOMS go on to be published. Lists of abstracts accepted at BAOMS meetings 2002-2006 were obtained, and a thorough search was made for each article using the web-based search engine PubMed. Related publications were recorded. A total of 623 abstracts were accepted, of which only 147 (24%) resulted in peer-reviewed publication. Compared with clinical studies, scientific research was in the minority, but was more likely to appear in print and in journals with higher impact factors. Units with senior academic input had better records of publication. Currently only a small fraction of studies deemed worthy of presentation at the BAOMS become publications. This conversion from presentation to print is facilitated by strong academic support. Exposing trainees in OMFS training posts to basic research training might improve their ability to publish. Copyright © 2009 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. Prophylactic antibiotics for preventing Gram positive infections associated with long-term central venous catheters in oncology patients

    NARCIS (Netherlands)

    van de Wetering, Marianne D.; van Woensel, Job B. M.; Lawrie, Theresa A.

    2013-01-01

    This is an updated version of the review which was first published in the Cochrane Database of Systematic Reviews in 2006. Long-term central venous catheters (CVCs), including tunnelled CVCs (TCVCs) and totally implanted devices or ports (TIDs), are increasingly used when treating oncology patients.

  8. Results of the 2012-2013 Association of Residents in Radiation Oncology (ARRO) Job Search and Career Planning Survey of Graduating Residents in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Mattes, Malcolm D., E-mail: mdm9007@nyp.org [Department of Radiation Oncology, New York Methodist Hospital, Brooklyn, New York (United States); Kharofa, Jordan [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Zeidan, Youssef H. [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Tung, Kaity [Department of Radiation Oncology, New York Methodist Hospital, Brooklyn, New York (United States); Gondi, Vinai [Department of Radiation Oncology, University of Wisconsin Comprehensive Cancer Center, Madison, Wisconsin (United States); Department of Radiation Oncology, Central Dupage Hospital Cancer Center, Warrenville, Illinois (United States); Golden, Daniel W. [Department of Radiation Oncology, Pritzker School of Medicine, University of Chicago, Chicago, Illinois (United States)

    2014-01-01

    Purpose/Objective(s): To determine the timeline used by postgraduate year (PGY)-5 radiation oncology residents during the job application process and the factors most important to them when deciding on a first job. Methods and Materials: In 2012 and 2013, the Association of Residents in Radiation Oncology conducted a nationwide electronic survey of PGY-5 radiation oncology residents in the United States during the final 2 months of their training. Descriptive statistics are reported. In addition, subgroup analysis was performed. Results: Surveys were completed by 180 of 314 residents contacted. The median time to start networking for the purpose of employment was January PGY-4; to start contacting practices, complete and upload a curriculum vitae to a job search website, and use the American Society of Radiation Oncology Career Center was June PGY-4; to obtain letters of recommendation was July PGY-5; to start interviewing was August PGY-5; to finish interviewing was December PGY-5; and to accept a contract was January PGY-5. Those applying for a community position began interviewing at an earlier average time than did those applying for an academic position (P=.04). The most important factors to residents when they evaluated job offers included (in order from most to least important) a collegial environment, geographic location, emphasis on best patient care, quality of support staff and facility, and multidisciplinary approach to patient care. Factors that were rated significantly different between subgroups based on the type of position applied for included adequate mentoring, dedicated research time, access to clinical trials, amount of time it takes to become a partner, geographic location, size of group, starting salary, and amount of vacation and days off. Conclusions: The residents' perspective on the job application process over 2 years is documented to provide a resource for current and future residents and employers to use.

  9. Results of the 2005 to 2008 Association of Residents in Radiation Oncology surveys of chief residents in the United States: didactics and research experience.

    Science.gov (United States)

    Gondi, Vinai; Bernard, Johnny Ray; Jabbari, Siavash; Keam, Jennifer; de Amorim Bernstein, Karen L; Dad, Luqman K; Li, Linna; Poppe, Matthew M; Strauss, Jonathan B; Chollet, Casey T

    2012-02-01

    To analyze the didactics and research experience reported by chief residents during their residency training. During the academic years 2005 to 2006, 2006 to 2007, and 2007 to 2008, the Association of Residents in Radiation Oncology (ARRO) conducted a nationwide survey of all radiation oncology chief residents in the United States. Chi-square statistic was used to assess for changes in didactics and research experience over time. During the years surveyed, an increasing percentage of programs offered curriculum-based didactics in clinical oncology (P=0.042), with a similar trend of borderline significance observed in biostatistics (P = 0.056). Each year, the majority of programs offered >40 hours of curriculum-based training in clinical oncology and physics, >20 hours in radiobiology, and 10 hours or fewer in biostatistics. 11% to 13% of residents reported having no full-time equivalent radiation biologists affiliated with their training program. Less than 64% of programs incorporated mock oral boards into their training. An increasing percentage of programs evaluated residents in a "360 degree" manner, with a trend to significance (P=0.073). Over 80% of programs required resident participation in research activities and allocated dedicated elective research time, typically 4 months or longer. Though the vast majority of programs make clinical research activities available to interested residents, borderline significance (P = 0.051) was observed for a decreasing percentage of such programs during the years analyzed. Trends in didactics and research experience over three years are documented to allow residents and program directors to assess their residency training.

  10. Association of Surgical Approach and Margin Status With Oncologic Outcomes Following Gross Total Resection for Sinonasal Melanoma.

    Science.gov (United States)

    Sayed, Zafar; Migliacci, Jocelyn C; Cracchiolo, Jennifer R; Barker, Christopher A; Lee, Nancy Y; McBride, Sean M; Tabar, Viviane S; Ganly, Ian; Patel, Snehal G; Morris, Luc T; Roman, Benjamin R; Shoushtari, Alexander N; Cohen, Marc A

    2017-10-19

    Sinonasal mucosal melanoma (SMM) is a rare malignant neoplasm characterized by a poor prognosis despite aggressive intervention including wide surgical resection. Margin status has previously been cited as an important prognostic factor for local control and overall survival (OS) in patients who undergo either an open or endoscopic surgical approach. No comparisons have been made, however, in patients who have undergone gross total resection with or without positive margins. To assess the association of margin status and surgical approach with oncologic outcomes in patients with SMM undergoing gross total resection. In this cohort study, patients with SMM without evidence of regional or distant disease treated with curative intent in part or full at Memorial Sloan Kettering Cancer Center from 1998 through 2016 were retrospectively assessed. Demographic data, prognostic information, and surgical pathology were reviewed. Operative reports and imaging were used to confirm gross total resection of local disease. Surgical techniques including open maxillectomy, craniofacial resection, and endoscopic resection. Three-year local recurrence-free survival (LRFS), disease-free survival (DFS), and OS were calculated using the Kaplan-Meier method. Univariate and multivariable analyses of outcomes were carried out using the Cox proportional hazard regression method. Seventy-two patients (39 [54%] female; mean [SD] age, 67 [12] years) met the eligibility criteria. Thirty-eight patients (53%) underwent open partial or total maxillectomy with or without ethmoidectomy or sphenoidectomy via a transfacial approach. Fourteen patients (19%) had a more extensive craniofacial approach, and 20 patients (28%) underwent endoscopic resection. The 3-year OS for all patients was 52%. The absolute 3-year difference between patients with open/craniofacial resection vs endoscopic resection for LRFS, DFS, and OS was 11% (95% CI, -21% to 43%), 16% (95% CI, -7% to 39%), and 12% (95% CI, -18% to 41

  11. RECQ1 A159C Polymorphism Is Associated With Overall Survival of Patients With Resected Pancreatic Cancer: A Replication Study in NRG Oncology Radiation Therapy Oncology Group 9704

    Energy Technology Data Exchange (ETDEWEB)

    Li, Donghui, E-mail: dli@mdanderson.org [Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Moughan, Jennifer [NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania (United States); Crane, Christopher [Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hoffman, John P. [Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Regine, William F. [Department of Radiation Oncology, University of Maryland, Baltimore, Maryland (United States); Abrams, Ross A. [Rush University Medical Center, Chicago, Illinois (United States); Safran, Howard [Brown University Oncology Group, Providence, Rhode Island (United States); Liu, Chang; Chang, Ping [Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Freedman, Gary M. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Winter, Kathryn A. [NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania (United States); Guha, Chandan [Department of Radiation Oncology, Montefiore Medical Center, Bronx, New York (United States); Abbruzzese, James L. [Duke University Medical Center, Durham, North Carolina (United States)

    2016-03-01

    Purpose: To confirm whether a previously observed association between RECQ1 A159C variant and clinical outcome of resectable pancreatic cancer patients treated with preoperative chemoradiation is reproducible in another patient population prospectively treated with postoperative chemoradiation. Methods and Materials: Patients were selected, according to tissue availability, from eligible patients with resected pancreatic cancer who were enrolled on the NRG Oncology Radiation Therapy Oncology Group 9704 trial of 5-fluorouacil (5-FU)-based chemoradiation preceded and followed by 5-FU or gemcitabine. Deoxyribonucleic acid was extracted from paraffin-embedded tissue sections, and genotype was determined using the Taqman method. The correlation between genotype and overall survival was analyzed using a Kaplan-Meier plot, log-rank test, and multivariate Cox proportional hazards models. Results: In the 154 of the study's 451 eligible patients with evaluable tissue, genotype distribution followed Hardy-Weinberg equilibrium (ie, 37% had genotype AA, 43% AC, and 20% CC). The RECQ1 variant AC/CC genotype carriers were associated with being node positive compared with the AA carrier (P=.03). The median survival times (95% confidence interval [CI]) for AA, AC, and CC carriers were 20.6 (16.3-26.1), 18.8 (14.2-21.6), and 14.2 (10.3-21.0) months, respectively. On multivariate analysis, patients with the AC/CC genotypes were associated with worse survival than patients with the AA genotype (hazard ratio [HR] 1.54, 95% CI 1.07-2.23, P=.022). This result seemed slightly stronger for patients on the 5-FU arm (n=82) (HR 1.64, 95% CI 0.99-2.70, P=.055) than for patients on the gemcitabine arm (n=72, HR 1.46, 95% CI 0.81-2.63, P=.21). Conclusions: Results of this study suggest that the RECQ1 A159C genotype may be a prognostic or predictive factor for resectable pancreatic cancer patients who are treated with adjuvant 5-FU before and after 5-FU-based chemoradiation. Further study is

  12. Cytokine Gene Associations with Self-report Ratings of Morning and Evening Fatigue in Oncology Patients and Their Family Caregivers

    OpenAIRE

    Dhruva, Anand; Aouizerat, Bradley E.; Cooper, Bruce; Paul, Steven M.; Dodd, Marylin; West, Claudia; Wara, William; Lee, Kathryn; Dunn, Laura B.; Langford, Dale J; Merriman, John D.; Baggott, Christina; Cataldo, Janine; Ritchie, Christine; Kober, Kord M.

    2014-01-01

    The purpose of this study was to evaluate for differences in variations in pro- and anti-inflammatory cytokine genes between participants who were classified as having low and high levels of morning and evening fatigue and to evaluate for differences in phenotypic characteristics between these two groups. In a sample of 167 oncology outpatients with breast, prostate, lung, or brain cancer and 85 of their family caregivers, growth mixture modeling (GMM) was used to identify l...

  13. A review of trauma and trauma-related papers published in the British Journal of Oral and Maxillofacial Surgery in 2010-2011.

    Science.gov (United States)

    Payne, Karl F B; Tahim, Arpan; Goodson, Alexander M C; Colbert, Serryth; Brennan, Peter A

    2012-12-01

    This review summarises all trauma and related papers published in the British Journal of Oral and Maxillofacial Surgery (BJOMS) from January 2010 to December 2011. In total 45 articles were published, of which 42% (19) were full-length articles. These articles primarily focused on the management of mandibular condyle and orbital fractures, with several papers discussing maxillofacial surgery by the British military. There were no articles discussing midfacial fractures or massive facial trauma. The remaining papers included short communications, technical notes, and letters; and provided discussion of interesting cases, new surgical techniques and fracture classifications. The number of trauma papers published in BJOMS appears to be less than other sub-specialties such as head and neck oncology. The number of prospective and randomised studies remains low, highlighting a need to foster further research within maxillofacial trauma. Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  14. Oncological Outcomes of Laparoscopic Nephroureterectomy Versus Open Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: An European Association of Urology Guidelines Systematic Review.

    Science.gov (United States)

    Peyronnet, Benoit; Seisen, Thomas; Dominguez-Escrig, Jose-Luis; Bruins, Harman Max; Yuan, Cathy Yuhong; Lam, Thomas; Maclennan, Steven; N'dow, James; Babjuk, Marko; Comperat, Eva; Zigeuner, Richard; Sylvester, Richard J; Burger, Maximilian; Mostafid, Hugh; van Rhijn, Bas W G; Gontero, Paolo; Palou, Joan; Shariat, Sharokh F; Roupret, Morgan

    2017-11-15

    Most series have suggested better perioperative outcomes of laparoscopic radical nephroureterectomy (RNU) over open RNU. However, the oncological safety of laparoscopic RNU remains controversial. To systematically review all relevant literature comparing oncological outcomes of open versus laparoscopic RNU. A systematic literature search using the Medline, Embase, and Cochrane databases and clinicaltrial.gov was performed in December 2014 and updated in August 2016. Randomised controlled trials (RCTs) and prospective or retrospective nonrandomised comparative studies comparing the oncological outcomes of any laparoscopic RNU with those of open RNU were included. The primary outcome was cancer-specific survival. The risk of bias (RoB) was assessed using Cochrane RoB tools. A narrative synthesis of the evidence is presented. Overall, 42 studies were included, which accounted for 7554 patients: 4925 in the open groups and 2629 in the laparoscopic groups. Most included studies were retrospective comparative series. Only one RCT was found. RoB and confounding were high in most studies. No study compared the oncological outcomes of robotic RNU with those of open RNU. Bladder cuff excision in laparoscopic groups was performed via an open approach in most studies, with only three studies reporting laparoscopic removal of the bladder cuff. Port-site metastasis rates ranged from 0% to 2.8%. No significant difference in oncological outcomes was reported in most series. However, three studies, including the only RCT, reported significantly poorer oncological outcomes in patients who underwent laparoscopic RNU, especially in the subgroups of patients with locally advanced (pT3/pT4) or high-grade upper tract urothelial carcinoma (UTUC), as well as in instances when the bladder cuff was excised laparoscopically. The current available evidence suggests that the oncological outcomes of laparoscopic RNU may be poorer than those of open RNU when bladder cuff is excised

  15. Sociodemographic associations of the dietary proportion of ultra-processed foods in First Nations peoples in the Canadian provinces of British Columbia, Manitoba, Alberta and Ontario.

    Science.gov (United States)

    Batal, Malek; Johnson-Down, Louise; Moubarac, Jean-Claude; Ing, Amy; Fediuk, Karen; Sadik, Tonio; Chan, Hing Man; Willows, Noreen

    2017-12-18

    We investigated the food types consumed by 3276 First Nations citizens from the First Nations Food Nutrition and Environment Study (FNFNES) living on-reserve in Canada. Data from 24-h dietary recalls were classified into NOVA categories: fresh or minimally processed foods (MPF), processed culinary ingredients, processed foods, and ultra-processed foods (UPF). Individuals were classified as traditional food (TF) eaters if they ate MPF of their First Nations culture. UPF accounted for 54.0% of energy intake; 23% of participants ate TF. Increasing age and household size, living in British Columbia and TF eating were associated with a lower intake of energy from UPF. Eating TF appeared to be protective against intake of UPF.

  16. Quality of reporting in oncology phase II trials: A 5-year assessment through systematic review.

    Science.gov (United States)

    Langrand-Escure, Julien; Rivoirard, Romain; Oriol, Mathieu; Tinquaut, Fabien; Rancoule, Chloé; Chauvin, Frank; Magné, Nicolas; Bourmaud, Aurélie

    2017-01-01

    Phase II clinical trials are a cornerstone of the development in experimental treatments They work as a "filter" for phase III trials confirmation. Surprisingly the attrition ratio in Phase III trials in oncology is significantly higher than in any other medical specialty. This suggests phase II trials in oncology fail to achieve their goal. Objective The present study aims at estimating the quality of reporting in published oncology phase II clinical trials. A literature review was conducted among all phase II and phase II/III clinical trials published during a 5-year period (2010-2015). All articles electronically published by three randomly-selected oncology journals with Impact-Factors>4 were included: Journal of Clinical Oncology, Annals of Oncology and British Journal of Cancer. Quality of reporting was assessed using the Key Methodological Score. 557 articles were included. 315 trials were single-arm studies (56.6%), 193 (34.6%) were randomized and 49 (8.8%) were non-randomized multiple-arm studies. The Methodological Score was equal to 0 (lowest level), 1, 2, 3 (highest level) respectively for 22 (3.9%), 119 (21.4%), 270 (48.5%) and 146 (26.2%) articles. The primary end point is almost systematically reported (90.5%), while sample size calculation is missing in 66% of the articles. 3 variables were independently associated with reporting of a high standard: presence of statistical design (p-value <0.001), multicenter trial (p-value = 0.012), per-protocol analysis (p-value <0.001). Screening was mainly performed by a sole author. The Key Methodological Score was based on only 3 items, making grey zones difficult to translate. This literature review highlights the existence of gaps concerning the quality of reporting. It therefore raised the question of the suitability of the methodology as well as the quality of these trials, reporting being incomplete in the corresponding articles.

  17. Systematic review of primary osseointegrated dental implants in head and neck oncology.

    Science.gov (United States)

    Barber, A J; Butterworth, C J; Rogers, S N

    2011-01-01

    The aim of this paper is to provide a systematic review of articles concerning primary osseointegrated dental implants in the head and neck oncology setting. We searched MEDLINE (1950 to March 2009) and Embase (1980 to March 2009) using the terms head and neck, oral, maxillofacial, craniofacial, jaws, mandible, maxilla, zygoma, dental implants, osseointegrated implants, implants, tumour, cancer, oncology, immediate, simultaneous, and primary. Two authors independently reviewed the abstracts, and all those written in the English language that referred to the placement of primary dental implants in patients with cancer of the head neck were included. Articles that referred to craniofacial or extraoral implants were excluded. Of 892 abstracts 83 were eligible for further consideration; the full articles were evaluated, and 41 that complied fully with the inclusion criteria are presented as a tabulated summary. There are three case reports, 13 reviews, and 25 clinical studies. Eight of the clinical studies refer solely to the insertion of dental implants at the time of primary oncological resection, and only two were of a prospective design. We have concisely summarised publications concerning primary dental implants, and our findings will help to inform head and neck cancer teams, particularly oncological surgeons, restorative dentists, and maxillofacial prosthodontists of the evidence base surrounding this approach to oral rehabilitation. Copyright © 2010 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. Earthquakes in British Columbia

    National Research Council Canada - National Science Library

    1991-01-01

    This pamphlet provides information about the causes of earthquakes, where earthquakes occur, British Columbia plate techtonics, earthquake patterns, earthquake intensity, geology and earthquake impact...

  19. The prospective association between childhood cognitive ability and somatic symptoms and syndromes in adulthood : the 1958 British birth cohort

    NARCIS (Netherlands)

    Kingma, Eva M.; Rosmalen, Judith G. M.; White, Peter D.; Stansfeld, Stephen A.; Clark, Charlotte

    2013-01-01

    BACKGROUND: Cognitive ability is negatively associated with functional somatic symptoms (FSS) in childhood. Lower childhood cognitive ability might also predict FSS and functional somatic syndromes in adulthood. However, it is unknown whether this association would be modified by subjective and

  20. Associations between socioeconomic, parental and home environment factors and fruit and vegetable consumption of children in grades five and six in British Columbia, Canada.

    Science.gov (United States)

    Attorp, Adrienne; Scott, Jenny E; Yew, Ann C; Rhodes, Ryan E; Barr, Susan I; Naylor, Patti-Jean

    2014-02-11

    Regular fruit and vegetable (FV) consumption has been associated with reduced chronic disease risk. Evidence from adults shows a social gradient in FV consumption. Evidence from pre-adolescent children varies and there is little Canadian data. This study assessed the FV intake of school children in British Columbia (BC), Canada to determine whether socio-economic status (SES), parental and the home environment factors were related to FV consumption. As part of the BC School Fruit and Vegetable Nutrition Program, 773 British Columbia fifth-and sixth-grade school children (Mean age 11.3 years; range 10.3-12.5) and their parents were surveyed to determine FV consumption and overall dietary intake. Students completed a web-based 24-hour dietary food recall, and a student measure of socio-economic status (The Family Affluence Scale). Parents completed a self-administered survey about their education, income, home environment and perceptions of their neighbourhood and children's eating habits. Correlations and multiple regression analyses were used to examine the association between SES, parental and home environment factors and FV consumption. Approximately 85.8% of children in this study failed to meet minimum Canadian guidelines for FV intake (6 servings). Parent income and education were not significantly associated with child FV consumption but were associated with each other, child-reported family affluence, neighbourhood environment, access to FV, and eating at the table or in front of the television. Significant positive associations were found between FV consumption and child-reported family affluence, meal-time habits, neighbourhood environment and parent perceptions of the healthiness of their child's diet; however, these correlations were weak (ranging from .089-.115). Multiple regression analysis showed that only child-reported family affluence significantly predicted FV consumption (std-β = 0.096 95% CI = 0.01 to 0.27). The majority of children in

  1. [Dyadic Coping of Patients with Haemato-Oncological Diseases and their Partners: Discrepancy Indexes and Association with Social Support and Psychological Distress].

    Science.gov (United States)

    Osin, Rinat; Pankrath, Anna-Luise; Niederwieser, Dietger; Döhner, Hartmut; Hönig, Klaus; Vogelhuber, Martin; Mehnert, Anja; Weißflog, Gregor; Ernst, Jochen

    2018-02-01

    Cancer is often associated with negative psychosocial consequences not only for patients but also for their partners. These consequences are also influenced by the applied coping strategies. The study examines the influence of Dyadic Coping (DC) on social support and psychological distress (symptoms of depression and anxiety) in haemato-oncological patients and their partners. Of particular interest is the significance of dyadic accordance (conformity) of the assessment of DC ("discrepancy indexes"). The study investigates 330 couples (haemato-oncological patients and their partners, average age patient 57.0 years, 63.3 percent male, 25.8 percent acute leukemia). In addition to Dyadic Coping Inventory (DCI), standardized instruments are used. Research data is being analyzed with t-tests, partial correlation and regression. Patients and partners use similar dyadic coping strategies, whereby partners assess coping behaviors of patients more accurately than vice versa. Regarding social support, the DC total score plays a more decisive role than discrepancy indexes, in particular with patients (R 2 =20.4%). Conversely, discrepancy indexes explain a large part of the patients' variance (R 2 =10.2%); regarding psychological stress, the DC total score shows no effects in this model. The results demonstrate the relevance of the DC discrepancy indexes as a measure for interpersonal accordance for psychosocial outcomes, especially for psychological distress. Further application-related research is necessary to generate reliable statements about these associations. © Georg Thieme Verlag KG Stuttgart · New York.

  2. Maturity-associated variation in physical activity and health-related quality of life in British adolescent girls: moderating effects of peer acceptance.

    Science.gov (United States)

    Pindus, Dominika M; Cumming, Sean P; Sherar, Lauren B; Gammon, Catherine; Coelho e Silva, Manuel; Malina, Robert M

    2014-01-01

    Using a Biocultural Model of Maturity-Associated Variance in physical activity (PA) as a conceptual framework, the main and interactive effects of biological maturity status and perceived peer acceptance on PA and health-related quality of life (HRQoL) in adolescent girls were examined. Three hundred forty-two female British students in years 7 to 9 (13.2±0.83 years) participated in the study. All participants completed the PA Questionnaire for Adolescents and KIDSCREEN-10, a measure of HRQoL. Self-reported perceptions of peer acceptance were measured by items from the National Longitudinal Study of Adolescent Health.Maturity status was estimated as the percentage of predicted adult (mature) height attained at the time of observation. Analysis of covariance suggested an influence of peer acceptance on maturity-associated differences in PA, but not on HRQoL. Girls early and "on time" in maturation with higher perceptions of peer acceptance reported greater involvement in PA than girls early and "on time" in maturation with lower perceptions of peer acceptance. A reverse association was observed for late-maturing girls. Peer acceptance is an important moderator of maturity-associated variation in PA.

  3. Diagnosis of Upper Quadrant Lymphedema Secondary to Cancer: Clinical Practice Guideline From the Oncology Section of the American Physical Therapy Association.

    Science.gov (United States)

    Levenhagen, Kimberly; Davies, Claire; Perdomo, Marisa; Ryans, Kathryn; Gilchrist, Laura

    2017-07-01

    The Oncology Section of the American Physical Therapy Association (APTA) developed a clinical practice guideline to aid the clinician in diagnosing secondary upper quadrant cancer-related lymphedema. Following a systematic review of published studies and a structured appraisal process, recommendations were written to guide the physical therapist and other health care clinicians in the diagnostic process. Overall clinical practice recommendations were formulated based on the evidence for each diagnostic method and were assigned a grade based on the strength of the evidence for different patient presentations and clinical utility. In an effort to maximize clinical applicability, recommendations were based on the characteristics as to the location and stage of a patient's upper quadrant lymphedema. © American Physical Therapy Association 2017. Published by Oxford University Press [on behalf of the American Physical Therapy Association].

  4. Oncology Drug Dosing in Gilbert Syndrome Associated with UGT1A1: A Summary of the Literature.

    Science.gov (United States)

    Ha, Vincent H; Jupp, Jennifer; Tsang, Roger Y

    2017-08-01

    Gilbert syndrome (GS) is a hereditary condition that affects ~10% of the population. It is characterized by intermittent, unconjugated hyperbilirubinemia in the absence of hepatocellular damage and hemolysis. Although GS is often described as a benign laboratory finding, it may alter drug metabolism by decreasing the ability to conjugate drugs. Genetic polymorphisms, specifically the UGT1A1*28 allele, may reduce glucuronidation by 30% that severely impacts the ability to metabolize certain medications. Antineoplastic agents used in oncologic settings have toxic side effects, and alterations in metabolism may result in severe or even life-threatening toxicities. Many of the drug monographs provided by manufacturers contain dose adjustment parameters for hepatic function, using serum bilirubin as a surrogate marker. However, in patients with GS, hepatic function remains normal in the setting of hyperbilirubinemia, and scant literature is available to provide guidance on empirical dosage adjustment. In this review, we conducted a literature search of routinely used oncology medications and assessed the need for empirical dose adjustments in the setting of GS. © 2017 Pharmacotherapy Publications, Inc.

  5. Review of orthognathic surgery and related papers published in the British Journal of Oral and Maxillofacial Surgery 2011-2012.

    Science.gov (United States)

    Goodson, Alexander M C; Payne, Karl F B; Tahim, Arpan; Colbert, Serryth; Brennan, Peter A

    2015-04-01

    This review summarises all orthognathic and related papers published between January 2011 and December 2012 in the British Journal of Oral and Maxillofacial Surgery (BJOMS). A total of 36 articles were published, a high proportion of which (78%) were full-length papers. The remainder consisted of short communications and technical notes. The topics included operative planning and postoperative outcomes, and there was a strong focus on distraction osteogenesis. There were fewer orthognathic articles published in BJOMS than articles on other subspecialties such as trauma or head and neck oncology. Only 8 (29%) of the full-length articles were prospective studies or randomised trials, which highlights a need for well-designed clinical studies in orthognathic research. Copyright © 2013 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  6. Revising on the run or studying on the sofa: prospective associations between physical activity, sedentary behaviour, and exam results in British adolescents.

    Science.gov (United States)

    Corder, Kirsten; Atkin, Andrew J; Bamber, Diane J; Brage, Soren; Dunn, Valerie J; Ekelund, Ulf; Owens, Matthew; van Sluijs, Esther M F; Goodyer, Ian M

    2015-09-04

    We investigated prospective associations between physical activity/sedentary behaviour (PA/SED) and General Certificate of Secondary Education (GCSE) results in British adolescents. Exposures were objective PA/SED and self-reported sedentary behaviours (screen (TV, Internet, Computer Games)/non-screen (homework, reading)) measured in 845 adolescents (14·5y ± 0·5y; 43·6 % male). GCSE results at 16y were obtained from national records. Associations between exposures and academic performance (total exam points) were assessed using multilevel mixed-effects linear regression adjusted for mood, BMI z-score, deprivation, sex, season and school; potential interactions were investigated. PA was not associated with academic performance. One-hour more accelerometer-assessed SED was associated with (β(95 % CI)) 6·9(1·5,12·4) more GCSE points. An extra hour of screen time was associated with 9.3(-14·3,-4·3) fewer points whereas an extra hour of non-screen time (reading/homework) was associated with 23·1(14·6,31·6) more points. Screen time was still associated with poorer scores after adjusting for objective PA/SED and reading/homework. An extra hour/day of screen time at 14·5y is approximately equivalent to two fewer GCSE grades (e.g., from B to D) at 16y. Strategies to achieve the right balance between screen and non-screen time may be important for improving academic performance. Concerns that encouraging more physical activity may result in decreased academic performance seem unfounded.

  7. Cross Sectional Associations between Socio-Demographic Factors and Cognitive Performance in an Older British Population: The European Investigation of Cancer in Norfolk (EPIC-Norfolk Study.

    Directory of Open Access Journals (Sweden)

    Shabina A Hayat

    Full Text Available Cognition covers a range of abilities, such as memory, response time and language, with tests assessing either specific or generic aspects. However differences between measures may be observed within the same individuals.To investigate the cross-sectional association of cognitive performance and socio-demographic factors using different assessment tools across a range of abilities in a British cohort study.Participants of the European Prospective Investigation of Cancer (EPIC in Norfolk Study, aged 48-92 years, underwent a cognitive assessment between 2006 and 2011 (piloted between 2004 and 2006 and were investigated over a different domains using a range of cognitive tests.Cognitive measures were available on 8584 men and women. Though age, sex, education and social class were all independently associated with cognitive performance in multivariable analysis, different associations were observed for different cognitive tests. Increasing age was associated with increased risk of a poor performance score in all of the tests, except for the National Adult Reading Test (NART, an assessment of crystallized intelligence. Compared to women, men were more likely to have had poor performance for verbal episodic memory, Odds Ratio, OR = 1.99 (95% Confidence Interval, 95% CI 1.72, 2.31, attention OR = 1.62, (95% CI 1.39, 1.88 and prospective memory OR = 1.46, (95% CI 1.29, 1.64; however, no sex difference was observed for global cognition, OR = 1.07 (95%CI 0.93, 1.24. The association with education was strongest for NART, and weakest for processing speed.Age, sex, education and social class were all independently associated with performance on cognitive tests assessing a range of different domains. However, the magnitude of associations of these factors with different cognitive tests differed. The varying relationships seen across different tests may help explain discrepancies in results reported in the current literature, and provides insights into

  8. Nanotechnology in radiation oncology.

    Science.gov (United States)

    Wang, Andrew Z; Tepper, Joel E

    2014-09-10

    Nanotechnology, the manipulation of matter on atomic and molecular scales, is a relatively new branch of science. It has already made a significant impact on clinical medicine, especially in oncology. Nanomaterial has several characteristics that are ideal for oncology applications, including preferential accumulation in tumors, low distribution in normal tissues, biodistribution, pharmacokinetics, and clearance, that differ from those of small molecules. Because these properties are also well suited for applications in radiation oncology, nanomaterials have been used in many different areas of radiation oncology for imaging and treatment planning, as well as for radiosensitization to improve the therapeutic ratio. In this article, we review the unique properties of nanomaterials that are favorable for oncology applications and examine the various applications of nanotechnology in radiation oncology. We also discuss the future directions of nanotechnology within the context of radiation oncology. © 2014 by American Society of Clinical Oncology.

  9. Neuro-Oncology Branch

    Science.gov (United States)

    ... BTTC are experts in their respective fields. Neuro-Oncology Clinical Fellowship This is a joint program with ... can increase survival rates. Learn more... The Neuro-Oncology Branch welcomes Dr. Mark Gilbert as new Branch ...

  10. Positive body image is positively associated with hedonic (Emotional) and eudaimonic (Psychological and Social) well-being in british adults.

    Science.gov (United States)

    Swami, Viren; Weis, Laura; Barron, David; Furnham, Adrian

    2017-10-20

    Studies examining associations between positive body image and well-being have used a limited array of measures of each construct. To rectify this, we asked an online sample of 1148 UK adults to complete a range of measures of positive body image (body appreciation, body image flexibility, body pride, body acceptance from others) and a multi-dimensional measure of well-being (emotional, psychological, and social). Results showed that, once the effects of age and body mass index (BMI) had been accounted for, body appreciation significantly predicted all dimensions of well-being. Other positive body image measures emerged as significant predictors, but patterns of associations were mixed across sex and well-being dimension. Additional analyses showed that women had significantly lower scores than men on most body image measures, and that BMI was negatively associated with all body image measures. These results have implications for the promotion of well-being, which we discuss.

  11. Oncology Nursing Society

    Science.gov (United States)

    ... 21st Century Nursing Leadership , and navigate through the issues of nursing practice that matter most. New to Oncology? Here's ... Nurse Quality-of-Life Issues Quality-of-Life Issues—Oncology ... in Oncology Nursing: Highlights from the ONS 41st Annual Congress Certification ...

  12. Prospective association between cancer risk and an individual dietary index based on the British Food Standards Agency Nutrient Profiling System.

    Science.gov (United States)

    Donnenfeld, Mathilde; Julia, Chantal; Kesse-Guyot, Emmanuelle; Méjean, Caroline; Ducrot, Pauline; Péneau, Sandrine; Deschasaux, Mélanie; Latino-Martel, Paule; Fezeu, Léopold; Hercberg, Serge; Touvier, Mathilde

    2015-11-28

    The Food Standards Agency Nutrient Profiling System (FSA-NPS) constitutes the basis for the Five-Colour Nutrition Label suggested in France to be put on the front-of-pack of food products. At the individual level, a dietary index (FSA-NPS DI) has been derived and validated and corresponds to a weighted mean of all FSA-NPS scores of foods usually consumed by the individual, reflecting the nutritional quality of his/her diet. Our aim was to investigate the association between the FSA-NPS DI and cancer risk in a large cohort. This prospective study included 6435 participants to the SUpplémentation en VItamines et Minéraux AntioXydants cohort (1994-2007) who completed at least six 24 h dietary records during the first 2 years of follow-up. FSA-NPS DI was computed for each subject (higher values representing lower nutritional quality of the diet). After a median follow-up of 12·6 years, 453 incident cancers were diagnosed. Associations were characterised by multivariate Cox proportional hazards models. The FSA-NPS DI was directly associated with overall cancer risk (hazard ratio (HR)for a 1-point increment=1·08 (95 % CI 1·01, 1·15), P trend=0·02; HRQ5 v. Q1=1·34 (95 % CI 1·00, 1·81), P trend=0·03). This association tended to be more specifically observed in subjects with moderate energy intake (≤median, HRfor a 1-point increment=1·10 (95 % CI 1·01-1·20), P trend=0·03). No association was observed in subjects with higher energy intake (P trend=0·3). Results were not statistically significant for breast and prostate cancer risks. For the first time, this study investigated the prospective association between the FSA-NPS individual score and cancer risk. The results suggest that unhealthy food choices may be associated with a 34 % increase in overall cancer risk, supporting the public health relevance of developing front-of-pack nutrition labels based on this score.

  13. Association between diet and physical activity and sedentary behaviours in 9-10-year-old British White children.

    Science.gov (United States)

    Vissers, P A J; Jones, A P; van Sluijs, E M F; Jennings, A; Welch, A; Cassidy, A; Griffin, S J

    2013-03-01

    To examine the association between diet and physical activity and sedentary behaviours in 9-10-year-old children. A cross-sectional study using data from the SPEEDY (Sport, Physical activity and Eating behaviour: Environmental Determinants in Young People) study undertaken in Norfolk, UK. Data from 4-day food diaries and 7 days of accelerometery were matched on concurrent days. Time spent in moderate-to-vigorous physical activity (MVPA), time spent in sedentary behaviour and various measures of dietary intake were collected. Covariates included age, sex, weight status, family socio-economic status, and energy intake reporting quality. Multivariable regression models, adjusted for clustering of children by school and stratified by sex, were fitted to examine the associations between dietary measures and physical activity and sedentary outcomes. In total, 1317 children (584 boys and 733 girls) provided concurrent data. Boys in the highest quartile of energy percentage from protein spent approximately 6 min [95% confidence interval (CI) 0-12] less in MVPA compared with boys in the lowest quartile. Those in the highest quartiles of fruit and vegetable intake and fruit juice intake had respective average activity counts per minute that were 56 above (95% CI 8-105) and 48 below (95% CI 2-95) those in the lowest quartiles, whilst those in the highest quartile of fizzy drink consumption spent approximately 7 min (95% CI 2-13) more in MVPA and approximately 14 min (95% CI 5-24 min) less in sedentary behaviour. Boys in the highest quartile of savoury snack consumption spent approximately 8 min (95% CI 2-13 min) more in MVPA per day, and approximately 12 min (95% CI 2-23) less in sedentary behaviour. No significant associations were apparent among girls. Few associations were detected, and the directions of those that were apparent were mainly counterintuitive. The extent to which this reflects a true lack of association or is associated with the measurement methods used for

  14. Are sitting occupations associated with increased all-cause, cancer, and cardiovascular disease mortality risk? A pooled analysis of seven British population cohorts.

    Directory of Open Access Journals (Sweden)

    Emmanuel Stamatakis

    Full Text Available There is mounting evidence for associations between sedentary behaviours and adverse health outcomes, although the data on occupational sitting and mortality risk remain equivocal. The aim of this study was to determine the association between occupational sitting and cardiovascular, cancer and all-cause mortality in a pooled sample of seven British general population cohorts.The sample comprised 5380 women and 5788 men in employment who were drawn from five Health Survey for England and two Scottish Health Survey cohorts. Participants were classified as reporting standing, walking or sitting in their work time and followed up over 12.9 years for mortality. Data were modelled using Cox proportional hazard regression adjusted for age, waist circumference, self-reported general health, frequency of alcohol intake, cigarette smoking, non-occupational physical activity, prevalent cardiovascular disease and cancer at baseline, psychological health, social class, and education.In total there were 754 all-cause deaths. In women, a standing/walking occupation was associated with lower risk of all-cause (fully adjusted hazard ratio [HR] = 0.68, 95% CI 0.52-0.89 and cancer (HR = 0.60, 95% CI 0.43-0.85 mortality, compared to sitting occupations. There were no associations in men. In analyses with combined occupational type and leisure-time physical activity, the risk of all-cause mortality was lowest in participants with non-sitting occupations and high leisure-time activity.Sitting occupations are linked to increased risk for all-cause and cancer mortality in women only, but no such associations exist for cardiovascular mortality in men or women.

  15. Low Calorie Beverage Consumption Is Associated with Energy and Nutrient Intakes and Diet Quality in British Adults

    Directory of Open Access Journals (Sweden)

    Sigrid A. Gibson

    2016-01-01

    Full Text Available It is unclear whether consumption of low-calorie beverages (LCB leads to compensatory consumption of sweet foods, thus reducing benefits for weight control or diet quality. This analysis investigated associations between beverage consumption and energy intake and diet quality of adults in the UK National Diet and Nutrition Survey (NDNS (2008–2011; n = 1590, classified into: (a non-consumers of soft drinks (NC; (b LCB consumers; (c sugar-sweetened beverage (SSB consumers; or (d consumers of both beverages (BB, based on 4-day dietary records. Within-person data on beverage consumption on different days assessed the impact on energy intake. LCB consumers and NC consumed less energy and non-milk extrinsic sugars than other groups. Micronutrient intakes and food choices suggested higher dietary quality in NC/LCB consumers compared with SSB/BB consumers. Within individuals on different days, consumption of SSB, milk, juice, and alcohol were all associated with increased energy intake, while LCB and tea, coffee or water were associated with no change; or reduced energy intake when substituted for caloric beverages. Results indicate that NC and LCB consumers tend to have higher quality diets compared with SSB or BB consumers and do not compensate for sugar or energy deficits by consuming more sugary foods.

  16. Factors associated with the development of progressive massive fibrosis in British coalminers: a case-control study

    Energy Technology Data Exchange (ETDEWEB)

    MacLaren, W.M.; Hurley, J.F.; Collins, H.P.R.; Cowie, A.J. (Institute of Occupational Medicine, Edinburgh (UK))

    1989-09-01

    Possible associations between the incidence of progressive massive fibrosis (PMF) over periods of average length 11 years during 1963-80 and a range of explanatory variables, both environmental and medical, were examined in a study group of 4772 miners and ex-miners using case-control methods. Cases were members of the study group who developed PMF during the study period, controls were men who remained free of the disease. Cases and controls were matched on cumulative dust exposure to the start of the study period, colliery of employment, and whether or not employment before and during the study period had been at a single colliery only. Age and category of simple pneumoconiosis were each found to be associated with the incidence of PMF. Quetelet's index of body mass was found to differ considerably between cases and controls, cases tending to be lighter for their height. The difference did not vary significantly between three groups of collieries, defined by coal rank. Regression analysis confirmed the high level of statistical significance of the difference (p {lt}0.001), allowing for the effects of age and prior category of simple pneumoconiosis. Of the environmental factors considered, an index of residence time of dust in the lungs was found to have the most statistically significant association with the incidence of PMF. In low and medium rank collieries there were large differences between the proportion of cases and controls showing a range of respiratory symptoms, cases consistently displaying a higher prevalence. In the high rank collieries of South Wales, however, symptoms occurred with equal frequency in cases and controls, the prevalence at these collieries being the same as among cases generally. 35 refs., 7 tabs.

  17. Nanotechnology in Radiation Oncology

    Science.gov (United States)

    Wang, Andrew Z.; Tepper, Joel E.

    2014-01-01

    Nanotechnology, the manipulation of matter on atomic and molecular scales, is a relatively new branch of science. It has already made a significant impact on clinical medicine, especially in oncology. Nanomaterial has several characteristics that are ideal for oncology applications, including preferential accumulation in tumors, low distribution in normal tissues, biodistribution, pharmacokinetics, and clearance, that differ from those of small molecules. Because these properties are also well suited for applications in radiation oncology, nanomaterials have been used in many different areas of radiation oncology for imaging and treatment planning, as well as for radiosensitization to improve the therapeutic ratio. In this article, we review the unique properties of nanomaterials that are favorable for oncology applications and examine the various applications of nanotechnology in radiation oncology. We also discuss the future directions of nanotechnology within the context of radiation oncology. PMID:25113769

  18. Body image and personality among British men: associations between the Big Five personality domains, drive for muscularity, and body appreciation.

    Science.gov (United States)

    Benford, Karis; Swami, Viren

    2014-09-01

    The present study examined associations between the Big Five personality domains and measures of men's body image. A total of 509 men from the community in London, UK, completed measures of drive for muscularity, body appreciation, the Big Five domains, and subjective social status, and provided their demographic details. The results of a hierarchical regression showed that, once the effects of participant body mass index (BMI) and subjective social status had been accounted for, men's drive for muscularity was significantly predicted by Neuroticism (β=.29). In addition, taking into account the effects of BMI and subjective social status, men's body appreciation was significantly predicted by Neuroticism (β=-.35) and Extraversion (β=.12). These findings highlight potential avenues for the development of intervention approaches based on the relationship between the Big Five personality traits and body image. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. The association between campylobacteriosis, agriculture and drinking water: a case-case study in a region of British Columbia, Canada, 2005-2009.

    Science.gov (United States)

    Galanis, E; Mak, S; Otterstatter, M; Taylor, M; Zubel, M; Takaro, T K; Kuo, M; Michel, P

    2014-10-01

    We studied the association between drinking water, agriculture and sporadic human campylobacteriosis in one region of British Columbia (BC), Canada. We compared 2992 cases of campylobacteriosis to 4816 cases of other reportable enteric diseases in 2005-2009 using multivariate regression. Cases were geocoded and assigned drinking water source, rural/urban environment and socioeconomic status (SES) according to the location of their residence using geographical information systems analysis methods. The odds of campylobacteriosis compared to enteric disease controls were higher for individuals serviced by private wells than municipal surface water systems (odds ratio 1·4, 95% confidence interval 1·1-1·8). In rural settings, the odds of campylobacteriosis were higher in November (P = 0·014). The odds of campylobacteriosis were higher in individuals aged ⩾15 years, especially in those with higher SES. In this region of BC, campylobacteriosis risk, compared to other enteric diseases, seems to be mediated by vulnerable drinking water sources and rural factors. Consideration should be given to further support well-water users and to further study the microbiological impact of agriculture on water.

  20. Impact on practice of a British Association for Sexual Health and HIV Sexually Transmitted Infections Foundation (STIF) course: an audit of the first four years in Ireland.

    Science.gov (United States)

    Calamai, A; Howard, R; Kelly, R; Lambert, J

    2013-02-01

    In order to investigate the overall impact of the British Association for Sexual Health and HIV (BASHH) Sexually Transmitted Infections Foundation (STIF) course taught in Ireland since 2007, attendees were sent two questionnaires to investigate the overall impact of the course, its effect on clinical practice and the need for further education. Response rate was 19.4%. The majority found the course beneficial and that it did cover their practice needs (96.4%), with 83.6% saying that their confidence and technique in sexual history taking had improved. There was a 3.7% increase in the provision of HIV testing from precourse levels, although only 80% did so routinely; a 12.7% increase in syphilis testing; a 5.4% increase in testing for Chlamydia and a 12.7% increase for gonorrhoea. Some confusion seems to persist in relation to sexually transmitted infection (STI) risk factors. The second questionnaire tested STI knowledge. Most respondents scored well (average 81% correct answers); however, respondents who attended four years previously scored, on average, 7% worse than the others, suggesting the need for a periodic update in the area of STI education.

  1. Guideline on Muscle-Invasive and Metastatic Bladder Cancer (European Association of Urology Guideline): American Society of Clinical Oncology Clinical Practice Guideline Endorsement.

    Science.gov (United States)

    Milowsky, Matthew I; Rumble, R Bryan; Booth, Christopher M; Gilligan, Timothy; Eapen, Libni J; Hauke, Ralph J; Boumansour, Pat; Lee, Cheryl T

    2016-06-01

    To endorse the European Association of Urology guideline on muscle-invasive (MIBC) and metastatic bladder cancer. The American Society of Clinical Oncology (ASCO) has a policy and set of procedures for endorsing clinical practice guidelines that have been developed by other professional organizations. The guideline on MIBC and metastatic bladder cancer was reviewed for developmental rigor by methodologists. The ASCO Endorsement Panel then reviewed the content and recommendations. The ASCO Endorsement Panel determined that the recommendations from the European Association of Urology guideline on MIBC and metastatic bladder cancer, published online in March 2015, are clear, thorough, and based on the most relevant scientific evidence. ASCO endorses the guideline on MIBC and metastatic bladder cancer and has added qualifying statements, including highlighting the use of chemoradiotherapy for select patients with MIBC and recommending a preference for clinical trials in the treatment of metastatic disease in the second-line setting. Multidisciplinary care for patients with MIBC and metastatic bladder cancer is critical. The standard treatment of MIBC (cT2-T4a N0M0) is neoadjuvant cisplatin-based combination chemotherapy followed by radical cystectomy. In cisplatin-ineligible patients, radical cystectomy alone is recommended. Adjuvant cisplatin-based chemotherapy may be offered to high-risk patients who have not received neoadjuvant therapy. Chemoradiotherapy may be offered as an alternative to cystectomy in appropriately selected patients with MIBC and in some patients for whom cystectomy is not an option. Metastatic disease should be treated with cisplatin-containing combination chemotherapy or with carboplatin combination chemotherapy or single agents in patients ineligible for cisplatin.Additional information is available at http://www.asco.org/endorsements/MIBC and www.asco.org/guidelineswiki. © 2016 by American Society of Clinical Oncology.

  2. Electronic nicotine delivery systems: a policy statement from the American Association for Cancer Research and the American Society of Clinical Oncology.

    Science.gov (United States)

    Brandon, Thomas H; Goniewicz, Maciej L; Hanna, Nasser H; Hatsukami, Dorothy K; Herbst, Roy S; Hobin, Jennifer A; Ostroff, Jamie S; Shields, Peter G; Toll, Benjamin A; Tyne, Courtney A; Viswanath, Kasisomayajula; Warren, Graham W

    2015-02-01

    Combustible tobacco use remains the number one preventable cause of disease, disability, and death in the United States. Electronic nicotine delivery systems (ENDS), which include e-cigarettes, are devices capable of delivering nicotine in an aerosolized form. ENDS use by both adults and youth has increased rapidly, and some have advocated these products could serve as harm-reduction devices and smoking cessation aids. ENDS may be beneficial if they reduce smoking rates or prevent or reduce the known adverse health effects of smoking. However, ENDS may also be harmful, particularly to youth, if they increase the likelihood that nonsmokers or formers smokers will use combustible tobacco products or if they discourage smokers from quitting. The American Association for Cancer Research (AACR) and the American Society of Clinical Oncology (ASCO) recognize the potential ENDS have to alter patterns of tobacco use and affect the public's health; however, definitive data are lacking. AACR and ASCO recommend additional research on these devices, including assessing the health impacts of ENDS, understanding patterns of ENDS use, and determining what role ENDS have in cessation. Key policy recommendations include supporting federal, state, and local regulation of ENDS; requiring manufacturers to register with the FDA and report all product ingredients, requiring childproof caps on ENDS liquids, and including warning labels on products and their advertisements; prohibiting youth-oriented marketing and sales; prohibiting child-friendly ENDS flavors; and prohibiting ENDS use in places where cigarette smoking is prohibited. ©2015 American Association for Cancer Research and American Society of Clinical Oncology.

  3. Results of the 2005-2008 Association of Residents in Radiation Oncology Survey of Chief Residents in the United States: Clinical Training and Resident Working Conditions

    Energy Technology Data Exchange (ETDEWEB)

    Gondi, Vinai, E-mail: gondi@humonc.wisc.edu [Department of Radiation Oncology, University of Wisconsin Comprehensive Cancer Center, Madison, Wisconsin (United States); Bernard, Johnny Ray [Mayo Clinic Jacksonville, Jacksonville, Florida (United States); Jabbari, Siavash [University of California San Francisco, San Francisco, California (United States); Keam, Jennifer [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Amorim Bernstein, Karen L. de [Albert Einstein College of Medicine, Bronx, New York (United States); Dad, Luqman K. [SUNY Roswell Park Cancer Institute, Buffalo, New York (United States); Li, Linna [Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Poppe, Matthew M. [University of Utah Huntsman Cancer Hospital (United States); Strauss, Jonathan B. [Northwestern University Feinberg School of Medicine, Chicago, Illinois (United States); Chollet, Casey T. [Loyola University Medical Center, Maywood, Illinois (United States)

    2011-11-15

    Purpose: To document clinical training and resident working conditions reported by chief residents during their residency. Methods and Materials: During the academic years 2005 to 2006, 2006 to 2007, and 2007 to 2008, the Association of Residents in Radiation Oncology conducted a nationwide survey of all radiation oncology chief residents in the United States. Chi-square statistics were used to assess changes in clinical training and resident working conditions over time. Results: Surveys were completed by representatives from 55 programs (response rate, 71.4%) in 2005 to 2006, 60 programs (75.9%) in 2006 to 2007, and 74 programs (93.7%) in 2007 to 2008. Nearly all chief residents reported receiving adequate clinical experience in commonly treated disease sites, such as breast and genitourinary malignancies; and commonly performed procedures, such as three-dimensional conformal radiotherapy and intensity-modulated radiotherapy. Clinical experience in extracranial stereotactic radiotherapy increased over time (p < 0.001), whereas clinical experience in endovascular brachytherapy (p <0.001) decreased over time. The distribution of gynecologic and prostate brachytherapy cases remained stable, while clinical case load in breast brachytherapy increased (p = 0.006). A small but significant percentage of residents reported receiving inadequate clinical experience in pediatrics, seeing 10 or fewer pediatric cases during the course of residency. Procedures involving higher capital costs, such as particle beam therapy and intraoperative radiotherapy, and infrequent clinical use, such as head and neck brachytherapy, were limited to a minority of institutions. Most residency programs associated with at least one satellite facility have incorporated resident rotations into their clinical training, and the majority of residents at these programs find them valuable experiences. The majority of residents reported working 60 or fewer hours per week on required clinical duties

  4. A Population-Based Evaluation of a Publicly Funded, School-Based HPV Vaccine Program in British Columbia, Canada: Parental Factors Associated with HPV Vaccine Receipt

    Science.gov (United States)

    Ogilvie, Gina; Anderson, Maureen; Marra, Fawziah; McNeil, Shelly; Pielak, Karen; Dawar, Meena; McIvor, Marilyn; Ehlen, Thomas; Dobson, Simon; Money, Deborah; Patrick, David M.; Naus, Monika

    2010-01-01

    Background Information on factors that influence parental decisions for actual human papillomavirus (HPV) vaccine receipt in publicly funded, school-based HPV vaccine programs for girls is limited. We report on the level of uptake of the first dose of the HPV vaccine, and determine parental factors associated with receipt of the HPV vaccine, in a publicly funded school-based HPV vaccine program in British Columbia, Canada. Methods and Findings All parents of girls enrolled in grade 6 during the academic year of September 2008–June 2009 in the province of British Columbia were eligible to participate. Eligible households identified through the provincial public health information system were randomly selected and those who consented completed a validated survey exploring factors associated with HPV vaccine uptake. Bivariate and multivariate analyses were conducted to calculate adjusted odds ratios to identify the factors that were associated with parents' decision to vaccinate their daughter(s) against HPV. 2,025 parents agreed to complete the survey, and 65.1% (95% confidence interval [CI] 63.1–67.1) of parents in the survey reported that their daughters received the first dose of the HPV vaccine. In the same school-based vaccine program, 88.4% (95% CI 87.1–89.7) consented to the hepatitis B vaccine, and 86.5% (95% CI 85.1–87.9) consented to the meningococcal C vaccine. The main reasons for having a daughter receive the HPV vaccine were the effectiveness of the vaccine (47.9%), advice from a physician (8.7%), and concerns about daughter's health (8.4%). The main reasons for not having a daughter receive the HPV vaccine were concerns about HPV vaccine safety (29.2%), preference to wait until the daughter is older (15.6%), and not enough information to make an informed decision (12.6%). In multivariate analysis, overall attitudes to vaccines, the impact of the HPV vaccine on sexual practices, and childhood vaccine history were predictive of parents having a

  5. A population-based evaluation of a publicly funded, school-based HPV vaccine program in British Columbia, Canada: parental factors associated with HPV vaccine receipt.

    Directory of Open Access Journals (Sweden)

    Gina Ogilvie

    2010-05-01

    Full Text Available BACKGROUND: Information on factors that influence parental decisions for actual human papillomavirus (HPV vaccine receipt in publicly funded, school-based HPV vaccine programs for girls is limited. We report on the level of uptake of the first dose of the HPV vaccine, and determine parental factors associated with receipt of the HPV vaccine, in a publicly funded school-based HPV vaccine program in British Columbia, Canada. METHODS AND FINDINGS: All parents of girls enrolled in grade 6 during the academic year of September 2008-June 2009 in the province of British Columbia were eligible to participate. Eligible households identified through the provincial public health information system were randomly selected and those who consented completed a validated survey exploring factors associated with HPV vaccine uptake. Bivariate and multivariate analyses were conducted to calculate adjusted odds ratios to identify the factors that were associated with parents' decision to vaccinate their daughter(s against HPV. 2,025 parents agreed to complete the survey, and 65.1% (95% confidence interval [CI] 63.1-67.1 of parents in the survey reported that their daughters received the first dose of the HPV vaccine. In the same school-based vaccine program, 88.4% (95% CI 87.1-89.7 consented to the hepatitis B vaccine, and 86.5% (95% CI 85.1-87.9 consented to the meningococcal C vaccine. The main reasons for having a daughter receive the HPV vaccine were the effectiveness of the vaccine (47.9%, advice from a physician (8.7%, and concerns about daughter's health (8.4%. The main reasons for not having a daughter receive the HPV vaccine were concerns about HPV vaccine safety (29.2%, preference to wait until the daughter is older (15.6%, and not enough information to make an informed decision (12.6%. In multivariate analysis, overall attitudes to vaccines, the impact of the HPV vaccine on sexual practices, and childhood vaccine history were predictive of parents having

  6. Evidence of associations between cytokine genes and subjective reports of sleep disturbance in oncology patients and their family caregivers.

    Directory of Open Access Journals (Sweden)

    Christine Miaskowski

    Full Text Available The purposes of this study were to identify distinct latent classes of individuals based on subjective reports of sleep disturbance; to examine differences in demographic, clinical, and symptom characteristics between the latent classes; and to evaluate for variations in pro- and anti-inflammatory cytokine genes between the latent classes. Among 167 oncology outpatients with breast, prostate, lung, or brain cancer and 85 of their FCs, growth mixture modeling (GMM was used to identify latent classes of individuals based on General Sleep Disturbance Scale (GSDS obtained prior to, during, and for four months following completion of radiation therapy. Single nucleotide polymorphisms (SNPs and haplotypes in candidate cytokine genes were interrogated for differences between the two latent classes. Multiple logistic regression was used to assess the effect of phenotypic and genotypic characteristics on GSDS group membership. Two latent classes were identified: lower sleep disturbance (88.5% and higher sleep disturbance (11.5%. Participants who were younger and had a lower Karnofsky Performance status score were more likely to be in the higher sleep disturbance class. Variation in two cytokine genes (i.e., IL6, NFKB predicted latent class membership. Evidence was found for latent classes with distinct sleep disturbance trajectories. Unique genetic markers in cytokine genes may partially explain the interindividual heterogeneity characterizing these trajectories.

  7. Lower Circulating B12 Is Associated with Higher Obesity and Insulin Resistance during Pregnancy in a Non-Diabetic White British Population.

    Directory of Open Access Journals (Sweden)

    Bridget Ann Knight

    Full Text Available Vitamin B12 and folate are critical micronutrients needed to support the increased metabolic demands of pregnancy. Recent studies from India have suggested that low vitamin B12 and folate concentrations in pregnancy are associated with increased obesity; however differences in diet, antenatal vitamin supplementation, and socioeconomic status may limit the generalisability of these findings. We aimed to explore the cross-sectional relationship of circulating serum vitamin B12 and folate at 28 weeks' gestation with maternal adiposity and related biochemical markers in a white non diabetic UK obstetric cohort.Anthropometry and biochemistry data was available on 995 women recruited at 28 weeks gestation to the Exeter Family Study of Childhood Health. Associations between B12 and folate with maternal BMI and other obesity-related biochemical factors (HOMA-R, fasting glucose, triglycerides, HDL and AST were explored using regression analysis, adjusting for potential confounders (socioeconomic status, vegetarian diet, vitamin supplementation, parity, haemodilution (haematocrit.Higher 28 week BMI was associated with lower circulating vitamin B12 (r = -0.25; P<0.001 and folate (r = -0.15; P<0.001. In multiple regression analysis higher 28 week BMI remained an independent predictor of lower circulating B12 (β (95% CI = -0.59 (-0.74, -0.44 i.e. for every 1% increase in BMI there was a 0.6% decrease in circulating B12. Other markers of adiposity/body fat metabolism (HOMA-R, triglycerides and AST were also independently associated with circulating B12. In a similar multiple regression AST was the only independent obesity-related marker associated with serum folate (β (95% CI = 0.16 (0.21, 0.51.In conclusion, our study has replicated the previous Indian findings of associations between lower serum B12 and higher obesity and insulin resistance during pregnancy in a non-diabetic White British population. These findings may have important implications for

  8. Obesity-associated severe asthma represents a distinct clinical phenotype: analysis of the British Thoracic Society Difficult Asthma Registry Patient cohort according to BMI.

    Science.gov (United States)

    Gibeon, David; Batuwita, Kannangara; Osmond, Michelle; Heaney, Liam G; Brightling, Chris E; Niven, Rob; Mansur, Adel; Chaudhuri, Rekha; Bucknall, Christine E; Rowe, Anthony; Guo, Yike; Bhavsar, Pankaj K; Chung, Kian Fan; Menzies-Gow, Andrew

    2013-02-01

    Obesity has emerged as a risk factor for the development of asthma and it may also influence asthma control and airway inflammation. However, the role of obesity in severe asthma remains unclear. Thus, our objective was to explore the association between obesity (defied by BMI) and severe asthma. Data from the British Thoracic Society Difficult Asthma Registry were used to compare patient demographics, disease characteristics, and health-care utilization among three BMI categories (normal weight: 18.5-24.99; overweight: 25-29.99; obese: 30) in a well-characterized group of adults with severe asthma. The study population consisted of 666 patients with severe asthma; the group had a median BMI of 29.8 (interquartile range, 22.5-34.0). The obese group exhibited greater asthma medication requirements in terms of maintenance corticosteroid therapy (48.9% vs 40.4% and 34.5% in the overweight and normal-weight groups, respectively), steroid burst therapy, and short-acting b 2 -agonist use per day. Significant differences were seen with gastroesophageal reflux disease (53.9% vs 48.1% and 39.7% in the overweight and normal weight groups, respectively) and proton pump inhibitor use. Bone density scores were higher in the obese group, while pulmonary function testing revealed a reduced FVC and elevated carbon monoxide transfer coefficient. Serum IgE levels decreased with increasing BMI and the obese group was more likely to report eczema, but less likely to have a history of nasal polyps. Patients with severe asthma display particular characteristics according to BMI that support the view that obesity-associated severe asthma may represent a distinct clinical phenotype.

  9. Acute oncological emergencies.

    LENUS (Irish Health Repository)

    Gabriel, J

    2012-01-01

    The number of people receiving systemic anti-cancer treatment and presenting at emergency departments with treatment-related problems is rising. Nurses will be the first point of contact for most patients and need to be able to recognise oncological emergencies to initiate urgent assessment of patients and referral to the acute oncology team so that the most appropriate care can be delivered promptly. This article discusses the role of acute oncology services, and provides an overview of the most common acute oncological emergencies.

  10. Oncological emergencies for the internist

    Directory of Open Access Journals (Sweden)

    Umesh Das

    2015-01-01

    Full Text Available An oncologic emergency is defined as any acute, potentially life-threatening event, either directly or indirectly related to a patient′s cancer (ca or its treatment. It requires rapid intervention to avoid death or severe permanent damage. Most oncologic emergencies can be classified as metabolic, hematologic, structural, or side effects from chemotherapy agents. Tumor lysis syndrome is a metabolic emergency that presents as severe electrolyte abnormalities. The condition is treated with aggressive hydration, allopurinol or urate oxidase to lower uric acid levels. Hypercalcemia of malignancy is treated with aggressive rehydration, furosemide, and intravenous (IV bisphosphonates. Syndrome of inappropriate antidiuretic hormone should be suspected if a patient with ca presents with normovolemic hyponatremia. This metabolic condition usually is treated with fluid restriction and furosemide. Febrile neutropenia is a hematologic emergency that usually requires inpatient therapy with broad-spectrum antibiotics, although outpatient therapy may be appropriate for low-risk patients. Hyperviscosity syndrome usually is associated with Waldenstrφm′s macroglobulinemia, which is treated with plasmapheresis and chemotherapy. Structural oncologic emergencies are caused by direct compression of surrounding structures or by metastatic disease. Superior vena cava syndrome is the most common structural oncological emergency. Treatment options include chemotherapy, radiation, and IV stenting. Epidural spinal cord compression can be treated with dexamethasone, radiation, or surgery. Malignant pericardial effusion, which often is undiagnosed in ca patients, can be treated with pericardiocentesis or a pericardial window procedure.

  11. Trace element and isotopic composition of apatite in carbonatites from the Blue River area (British Columbia, Canada) and mineralogy of associated silicate rocks

    Science.gov (United States)

    Mitchell, Roger; Chudy, Thomas; McFarlane, Christopher R. M.; Wu, Fu-Yuan

    2017-08-01

    Apatites from the Verity, Fir, Gum, Howard Creek and Felix carbonatites of the Blue River (British Columbia, Canada) area have been investigated with respect to their paragenesis, cathodoluminescence, trace element and Sr-Nd isotopic composition. Although all of the Blue River carbonatites were emplaced as sills prior to amphibolite grade metamorphism and have undergone deformation, in many instances magmatic textures and mineralogy are retained. Attempts to constrain the U-Pb age of the carbonatites by SIMS, TIMS and LA-ICP-MS studies of zircon and titanite were inconclusive as all samples investigated have experienced significant Pb loss during metamorphism. The carbonatites are associated with undersaturated calcite-titanite amphibole nepheline syenite only at Howard Creek although most contain clasts of disaggregated phoscorite-like rocks. Apatite from each intrusion is characterized by distinct, but wide ranges, in trace element composition. The Sr and Nd isotopic compositions define an array on a 87Sr/86Sr vs²Nd diagram at 350 Ma indicating derivation from depleted sub-lithospheric mantle. This array could reflect mixing of Sr and Nd derived from HIMU and EM1 mantle sources, and implies that depleted mantle underlies the Canadian Cordillera. Although individual occurrences of carbonatites in the Blue River region are mineralogically and geochemically similar they are not identical and thus cannot be considered as rocks formed from a single batch of parental magma at the same stage of magmatic evolution. However, a common origin is highly probable. The variations in the trace element content and isotopic composition of apatite from each occurrence suggest that each carbonatite represents a combination of derivation of the parental magma(s) from mineralogically and isotopically heterogeneous depleted mantle sources coupled with different stages of limited differentiation and mixing of these magmas. We do not consider these carbonatites as primary direct

  12. Differential Drug Survival of Biologic Therapies for the Treatment of Psoriasis: A Prospective Observational Cohort Study from the British Association of Dermatologists Biologic Interventions Register (BADBIR).

    Science.gov (United States)

    Warren, Richard B; Smith, Catherine H; Yiu, Zenas Z N; Ashcroft, Darren M; Barker, Jonathan N W N; Burden, A David; Lunt, Mark; McElhone, Kathleen; Ormerod, Anthony D; Owen, Caroline M; Reynolds, Nick J; Griffiths, Christopher E M

    2015-11-01

    Drug survival reflects a drug's effectiveness, safety, and tolerability. We assessed the drug survival of biologics used to treat psoriasis in a prospective national pharmacovigilance cohort (British Association of Dermatologists Biologic Interventions Register (BADBIR)). The survival rates of the first course of biologics for 3,523 biologic-naive patients with chronic plaque psoriasis were compared using survival analysis techniques and predictors of discontinuation analyzed using a multivariate Cox proportional hazards model. Data for patients on adalimumab (n=1,879), etanercept (n=1,098), infliximab (n=96), and ustekinumab (n=450) were available. The overall survival rate in the first year was 77%, falling to 53% in the third year. Multivariate analysis showed that female gender (hazard ratio (HR) 1.22; 95% confidence interval (CI): 1.09-1.37), being a current smoker (HR 1.19; 95% CI: 1.03-1.38), and a higher baseline dermatology life quality index (HR 1.01; 95% CI: 1.00-1.02) were predictors of discontinuation. Presence of psoriatic arthritis (HR 0.82; 95% CI: 0.71-0.96) was a predictor for drug survival. As compared with adalimumab, patients on etanercept (HR 1.63; 95% CI: 1.45-1.84) or infliximab (HR 1.56; 95% CI: 1.16-2.09) were more likely to discontinue therapy, whereas patients on ustekinumab were more likely to persist (HR 0.48; 95% CI: 0.37-0.62). After accounting for relevant covariates, ustekinumab had the highest first-course drug survival. The results of this study will aid clinical decision making when choosing biologic therapy for psoriasis patients.

  13. Chronocentrism and British criminology.

    Science.gov (United States)

    Rock, Paul

    2005-09-01

    Criminologists display a largely unexamined propensity to ignore writings that are more than fifteen or so years old, with evident consequences for the public presentation and validation of expert knowledge. A citation study was combined with detailed observations from British criminologists to ascertain quite how that disavowal of the past was accomplished.

  14. Sleep quality and its association with fatigue, symptom burden, and mood in patients with advanced cancer in a clinic for early-phase oncology clinical trials.

    Science.gov (United States)

    George, Goldy C; Iwuanyanwu, Eucharia C; Anderson, Karen O; Yusuf, Alizeh; Zinner, Ralph G; Piha-Paul, Sarina A; Tsimberidou, Apostolia M; Naing, Aung; Fu, Siqing; Janku, Filip; Subbiah, Vivek; Cleeland, Charles S; Mendoza, Tito R; Hong, David S

    2016-11-15

    Limited data exist about sleep quality for patients with advanced cancer in phase 1 clinical trials. Poor sleep quality is often not captured as an adverse event, and its association with fatigue, one of the most frequently reported adverse events, is not documented routinely. This article describes sleep quality and its relation with fatigue, symptom burden, and mood in patients recruited from an early-phase clinic for targeted therapy. Sleep, fatigue, symptom burden, and mood were assessed with the Pittsburgh Sleep Quality Index (PSQI), the Brief Fatigue Inventory, the MD Anderson Symptom Inventory (MDASI), and the Brief Profile of Mood States, respectively; the Eastern Cooperative Oncology Group (ECOG) performance status (PS) was determined from medical records. The sample (n = 256) was 51.2% female, 90% had an ECOG PS of 0 or 1, and the mean age was 58 ± 0.8 years. Poor sleepers (global PSQI score > 5) constituted 64% of the sample. In separate multiple regression models, poor sleepers had higher levels of fatigue (P associated with greater fatigue, symptom burden, and mood disturbance. Sleep quality should be routinely assessed in patients with advanced cancer who are participating in early-phase clinical trials. Cancer 2016;122:3401-3409. © 2016 American Cancer Society. © 2016 American Cancer Society.

  15. Clinical practice guidelines of the French Association for Supportive Care in Cancer and the French Society for Psycho-oncology: refusal of treatment by adults afflicted with cancer.

    Science.gov (United States)

    Faivre, J C; Adam, V; Block, V; Metzger, M; Salleron, J; Dauchy, S

    2017-11-01

    The study's purpose was to develop practical guidelines for assessment and management of refusal of treatment by adults afflicted with cancer. The French Association for Supportive Care in Cancer and the French Society for Psycho-oncology gathered a task force that applied a consensus methodology to draft guidelines studied predisposing situations, the diagnosis, regulatory aspects, and the management of refusal of treatment by adults afflicted with cancer. We propose five guidelines: (1) be aware of the conditions/profiles of patients most often associated with refusal of treatment so as to adequately underpin the care and support measures; (2) understand the complexity of the process of refusal and knowing how to accurately identify the type and the modalities of the refused treatments; (3) apply a way to systematically analyze refusal, thereby promoting progression from a situation of disaccord toward a consensual decision; (4) devise procedures, according to the legal context, to address refusal of treatment that safeguards the stakeholders in situations of sustained disaccord; and (5) know the indications for ethical collective decision-making. The quality of the relationship between patients and health professionals, and the communication between them are essential components involved in reaching a point of consent or refusal of treatment. A process of systematic analysis of refusal is recommended as the only way to ensure that all of the physiological, psychological, and contextual elements that are potentially involved are taken into account.

  16. Factors associated with use of falls risk-increasing drugs among patients of a geriatric oncology outpatient clinic in Australia: a cross-sectional study.

    Science.gov (United States)

    Turner, Justin P; Tervonen, Hanna E; Shakib, Sepehr; Singhal, Nimit; Prowse, Robert; Bell, J Simon

    2017-04-01

    Older people with cancer are at increased risk of falling. Falls risk-increasing drugs (FRIDs), comprising psychotropics and medications that cause orthostatic hypotension, are a potentially modifiable risk factor for falls. The objective of this study was to determine the prevalence and factors associated with use of FRIDs in older people with cancer. Patients aged ≥70 years who presented to a hospital outpatient clinic between January 2009 and July 2010 were included in the study. Information on current medication use, falls in previous 6 months, and frailty criteria was collected. Multinomial logistic regression was used to compute odds ratios (OR) and 95% confidence intervals (CIs) for factors associated with levels of FRID use. Overall, 76.1% (n = 293) of 383 patients used FRIDs. This comprised psychotropics (31.2%, n = 120) and medications causing orthostatic hypotension (69.9%, n = 269). In total, 24.0% (n = 92) patients reported falling in the previous 6 months. Risk factors for falling were associated with use of psychotropics but not orthostatic hypotension drugs. Patients with a history of falls had increased odds of using psychotropics (≥3 psychotropics; OR 13.50; 95%CI, 2.64-68.94). Likewise, frail patients had increased odds of using psychotropics (≥3 psychotropics; OR 27.78; 95%CI, 6.06-127.42). Risk factors for falling were associated with the use of psychotropics. This suggests that clinicians either do not recognize or underestimate the contribution of medications to falls in this high-risk patient group. Further efforts are needed to rationalize medication regimens at the time of patients' first presentation to outpatient oncology services. © 2016 John Wiley & Sons, Ltd.

  17. Frequency of a FAS ligand gene variant associated with inherited feline autoimmune lymphoproliferative syndrome in British shorthair cats in New Zealand.

    Science.gov (United States)

    Aberdein, D; Munday, J S; Dittmer, K E; Heathcott, R W; Lyons, L A

    2017-11-01

    AIMS To determine the frequency of the FAS-ligand gene (FASLG) variant associated with feline autoimmune lymphoproliferative syndrome (FALPS) and the proportion of carriers of the variant in three British shorthair (BSH) breeding catteries in New Zealand. METHODS Buccal swabs were collected from all cats in two BSH breeding catteries from the South Island and one from the North Island of New Zealand. DNA was extracted and was tested for the presence of the FASLG variant using PCR. Cats with the FASLG variant were identified and the frequency of the FASLG variant allele calculated. Pedigree analysis was performed and inbreeding coefficients were calculated for cats with the FASLG variant. RESULTS Of 32 BSH cats successfully tested for the presence of the FASLG variant, one kitten (3%) was homozygous (FALPS-affected), and seven (22%) cats were heterozygous (carriers) for the FASLG variant allele, and 24 (75%) cats were homozygous for the wild type allele. The overall frequency of the FASLG variant allele in these 32 cats was 0.14. Cats carrying the FASLG variant were from all three breeding catteries sampled, including two catteries that had not previously reported cases of FALPS. Pedigree analysis revealed common ancestry of FALPS-affected and carrier cats within six generations, as well as frequent inbreeding, with inbreeding coefficients >0.12 for five cats with the FASLG variant. CONCLUSIONS AND CLINICAL RELEVANCE There was a high frequency of the FASLG variant allele (0.14) in this small sample of BSH cats, with 22% of healthy cats identified as carriers of the FASLG variant. For an inherited disease, lethal at a young age, in a small population in which inbreeding is common, these results are significant. To prevent future cases of disease and stop further spread of the FASLG variant allele within the BSH population in New Zealand, it is recommended that all BSH and BSH-cross cats be tested for the presence of the FASLG variant before mating. Cats identified as

  18. Cancer Patients and Oncology Nursing: Perspectives of Oncology ...

    African Journals Online (AJOL)

    Background and Aim: Burnout and exhaustion is a frequent problem in oncology nursing. The aim of this study is to evaluate the aspects of oncology nurses about their profession in order to enhance the standards of oncology nursing. Materials and Methods: This survey was conducted with 70 oncology nurses working at ...

  19. Oncology Advanced Practitioners Bring Advanced Community Oncology Care.

    Science.gov (United States)

    Vogel, Wendy H

    2016-01-01

    Oncology care is becoming increasingly complex. The interprofessional team concept of care is necessary to meet projected oncology professional shortages, as well as to provide superior oncology care. The oncology advanced practitioner (AP) is a licensed health care professional who has completed advanced training in nursing or pharmacy or has completed training as a physician assistant. Oncology APs increase practice productivity and efficiency. Proven to be cost effective, APs may perform varied roles in an oncology practice. Integrating an AP into an oncology practice requires forethought given to the type of collaborative model desired, role expectations, scheduling, training, and mentoring.

  20. Characteristics of bacteremia in pediatric oncology patients based on pathogen classification as associated with the gastrointestinal mucosa or skin.

    Science.gov (United States)

    Flagg, Aron; Worley, Sarah; Foster, Charles B

    2015-06-01

    Factors favoring blood stream infections associated with gastrointestinal mucosa versus skin organisms were explored. An observed difference was attributable to bacteremia from oral flora in patients with acute myelogenous leukemia or mucositis. Our data do not support the conclusion that isolation of enteric Gram-negatives is unrelated to the central catheter.

  1. The Teachable Moment After Cancer Diagnosis: Perceptions From Oncology Nurses.

    Science.gov (United States)

    Karvinen, Kristina; Bruner, Brenda; Truant, Tracy

    2015-11-01

    To determine oncology nurses' perspectives of the receptiveness of survivors to receiving health behavior guidance, with secondary purposes to (a) explore other elements of oncology nurses' perceptions of the teachable moment and (b) examine differences in outcomes between American and Canadian nurses
. Cross-sectional survey.
 In- and outpatient oncology nursing departments in the United States and Canada. 310 members of the Canadian Association of Nurses in Oncology (CANO/ACIO) and the Oncology Nursing Society (ONS) who currently care for patients
. Oncology nurses recruited through emails distributed through the CANO/ACIO and ONS Listservs completed online investigator-developed surveys. Measures related to oncology nurses' perceptions of survivors' receptiveness to health behavior change counseling and the teachable moment (i.e., general receptiveness, perceived benefits, guidance and referral seeking, long- and short-term effectiveness, best time, and best resources). Oncology nurses reported that survivors were receptive to receiving guidance on health behaviors, particularly during teachable moments after diagnosis and during treatment. They also perceived that a fairly low percentage of survivors asked for guidance about health behavior change; relatively few made improvements to their health behaviors.
 Survivors are reported to be interested in receiving guidance concerning health behavior change during key teachable moments. Oncology nurses may need to initiate conversations with survivors, offer education regarding the benefits of positive health behavior change, and provide ongoing support throughout the cancer trajectory. Oncology nurses may use findings from the current study to guide their health behavior change counseling with survivors
.

  2. Age at cancer diagnosis, non-O blood group and asparaginase therapy are independently associated with deep venous thrombosis in pediatric oncology patients: A risk model.

    Science.gov (United States)

    Spavor, Maria; Halton, Jacqueline; Dietrich, Kevin; Israels, Sara; Shereck, Evan; Yong, Jian; Yasui, Yutaka; Mitchell, Lesley Gayle

    2016-08-01

    Pediatric oncology patients are at increased risk for deep venous thrombosis (DVT). Determining the sub-population of children at increased DVT risk is critical for optimum clinical management. Therefore, the aim of the current study was to identify clinical risk factors for DVT which are easily identifiable at cancer diagnosis. A Canadian multicenter case control study in survivors of childhood cancer. Survivors who had DVT (Cases) while being treated for pediatric cancer where matched by center with a minimum of two survivors who did not experience DVT (Controls). Clinical information including age at diagnosis, type of cancer and chemotherapy were collected. Genotyping of blood group was done by single nucleotide polymorphisms analysis. 218 subjects were recruited at 4 Canadian pediatric centers. Multivariable analysis demonstrated 3 significant variables (reported as Odds Ratio (OR), (95% CI), p value): age at diagnosis p2-≤7years, >7≤10years, >10years. A significant association with DVT were seen in children 0-≤2years (OR 3.1 (1.1-8.3) p=0.026) and >10years (OR 3.8, 1.7-8.5 p=0.001). Significant associations with DVT remained for non-O blood group, OR 2.2 (1.2-4.4) p=0.016 and asparaginase treatment, OR 2.1 (1.1-4.0) p=0.027. The value for the clinical risk model receiver operating characteristics curve was 0.67. We have shown 3 independent risk factors for DVT in childhood cancer. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Refining the American Urological Association and American Society for Radiation Oncology guideline for adjuvant radiotherapy after radical prostatectomy using the pathologic Gleason score

    Directory of Open Access Journals (Sweden)

    Wan Song

    2017-01-01

    Full Text Available Recently, it has been suggested that the guideline for adjuvant radiotherapy (ART following radical prostatectomy (RP sponsored by the American Urological Association and American Society for Radiation Oncology (AUA/ASTRO may result in a significant overtreatment. Thus, the objective of the present study was to refine the AUA/ASTRO guideline for ART in patients at risk for biochemical recurrence (BCR after RP. To this end, we reviewed our prospectively maintained database and selected 193 patients who met the AUA/ASTRO ART criteria. With a median follow-up of 24.0 months, BCR rate was 17.6% (34/193. When stratified by the Gleason score, BCR rate in men with Gleason score 6 was 6.8%. There was no significant association between BCR-free survival and surgical margin (P = 0.690 and pathologic stage (P = 0.353 in patients with the Gleason score 6. However, in patients with positive surgical margins (PSMs/pathologic stage ≥T3, there was a significant difference in BCR-free survival according to Gleason score (≤ 7 vs 8-10, P = 0.047. Multivariate Cox regression analysis demonstrated that pathologic stage ≥T3 (HR = 2.106; P= 0.018, PSMs (HR = 2.411; P= 0.003, and pathologic Gleason score 8-10 (HR = 4.715; P< 0.001 were independent predictors of BCR after RP. Therefore, in addition to pathologic stage ≥T3 and PSMs, Gleason score 8-10 predicts BCR after RP. In patients with Gleason score 6, observation rather than ART may be more appropriate regardless of stage and surgical margin status.

  4. Refining the American Urological Association and American Society for Radiation Oncology guideline for adjuvant radiotherapy after radical prostatectomy using the pathologic Gleason score.

    Science.gov (United States)

    Song, Wan; Kwon, Young Suk; Jeon, Seong Soo; Kim, Isaac Yi

    2017-01-01

    Recently, it has been suggested that the guideline for adjuvant radiotherapy (ART) following radical prostatectomy (RP) sponsored by the American Urological Association and American Society for Radiation Oncology (AUA/ASTRO) may result in a significant overtreatment. Thus, the objective of the present study was to refine the AUA/ASTRO guideline for ART in patients at risk for biochemical recurrence (BCR) after RP. To this end, we reviewed our prospectively maintained database and selected 193 patients who met the AUA/ASTRO ART criteria. With a median follow-up of 24.0 months, BCR rate was 17.6% (34/193). When stratified by the Gleason score, BCR rate in men with Gleason score 6 was 6.8%. There was no significant association between BCR-free survival and surgical margin (P = 0.690) and pathologic stage (P = 0.353) in patients with the Gleason score 6. However, in patients with positive surgical margins (PSMs)/pathologic stage ≥T3, there was a significant difference in BCR-free survival according to Gleason score (≤ 7 vs 8-10, P = 0.047). Multivariate Cox regression analysis demonstrated that pathologic stage ≥T3 (HR = 2.106; P= 0.018), PSMs (HR = 2.411; P= 0.003), and pathologic Gleason score 8-10 (HR = 4.715; PGleason score 8-10 predicts BCR after RP. In patients with Gleason score 6, observation rather than ART may be more appropriate regardless of stage and surgical margin status.

  5. BAPS prize lecture: New insight into mechanisms of parenteral nutrition-associated cholestasis: role of plant sterols. British Association of Paediatric Surgeons.

    Science.gov (United States)

    Iyer, K R; Spitz, L; Clayton, P

    1998-01-01

    Infants on long-term parenteral nutrition frequently will have progressive cholestatic liver disease, the cause of which remains largely unknown. The aim of this study is to establish a possible role for plant sterols (phytosterols) in the pathogenesis of parenteral nutrition-associated cholestasis (PNAC). Two experimental studies were used: (1) A study on neonatal piglets involved the daily injection of plant sterols; measurement of their concentrations in serum, liver, and bile during a 14-day period; and determination of serum bile acid concentrations, bile acid secretion, and bile flow at the end of the 14-day period. (2) Isolated rat hepatocyte couplets were used to study the effects of sterols on canalicular secretion. The daily injection of phytosterols (in amounts similar to those given to infants who receive parenteral nutrition) led to their progressive accumulation in the piglets' serum, liver, and bile. Serum bile acid levels were significantly higher in the sterol-treated piglets. Maximal bile acid excretion was significantly lower in the sterol group. Phytosterols caused a significant inhibition of secretory function in isolated rat hepatocyte couplets. Important contaminants of commercial lipid emulsions (phytosterols) have been identified as a possible cause of PNAC.

  6. Problem Gambling Treatment within the British National Health Service

    Science.gov (United States)

    Rigbye, Jane; Griffiths, Mark D.

    2011-01-01

    According to the latest British Gambling Prevalence Survey, there are approximately 300,000 adult problem gamblers in Great Britain. In January 2007, the "British Medical Association" published a report recommending that those experiencing gambling problems should receive treatment via the National Health Service (NHS). This study…

  7. BCASP and the Evolution of School Psychology in British Columbia

    Science.gov (United States)

    Agar, Douglas J.

    2016-01-01

    Since 1992, the British Columbia Association of School Psychologists (BCASP) has been the professional body for school psychologists in British Columbia. In the intervening 24 years, BCASP has been very successful in performing the dual roles of a certifying body and a professional development organization for school psychologists in British…

  8. British scorched earth and concentration camp policies.

    African Journals Online (AJOL)

    Nick

    THE BRITISH SCORCHED EARTH AND. CONCENTRATION CAMP POLICIES IN THE. POTCHEFSTROOM REGION, 1899–1902. 1. Prof GN van den Bergh. Research Associate, North-West University. Abstract. The continued military resistance of the Republics after the occupation of. Bloemfontein and Pretoria and ...

  9. Molecular Biomarkers for the Evaluation of Colorectal Cancer: Guideline From the American Society for Clinical Pathology, College of American Pathologists, Association for Molecular Pathology, and American Society of Clinical Oncology.

    Science.gov (United States)

    Sepulveda, Antonia R; Hamilton, Stanley R; Allegra, Carmen J; Grody, Wayne; Cushman-Vokoun, Allison M; Funkhouser, William K; Kopetz, Scott E; Lieu, Christopher; Lindor, Noralane M; Minsky, Bruce D; Monzon, Federico A; Sargent, Daniel J; Singh, Veena M; Willis, Joseph; Clark, Jennifer; Colasacco, Carol; Rumble, R Bryan; Temple-Smolkin, Robyn; Ventura, Christina B; Nowak, Jan A

    2017-03-01

    To develop evidence-based guideline recommendations through a systematic review of the literature to establish standard molecular biomarker testing of colorectal cancer (CRC) tissues to guide epidermal growth factor receptor (EGFR) therapies and conventional chemotherapy regimens. The American Society for Clinical Pathology, College of American Pathologists, Association for Molecular Pathology, and American Society of Clinical Oncology convened an expert panel to develop an evidence-based guideline to establish standard molecular biomarker testing and guide therapies for patients with CRC. A comprehensive literature search that included more than 4,000 articles was conducted. Twenty-one guideline statements were established. Evidence supports mutational testing for EGFR signaling pathway genes, since they provide clinically actionable information as negative predictors of benefit to anti-EGFR monoclonal antibody therapies for targeted therapy of CRC. Mutations in several of the biomarkers have clear prognostic value. Laboratory approaches to operationalize CRC molecular testing are presented. Key Words: Molecular diagnostics; Gastrointestinal; Histology; Genetics; Oncology. Copyright © 2017 American Society for Clinical Pathology, College of American Pathologists, Association for Molecular Pathology, American Society for Clinical Oncology, and American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  10. Adjuvant radiation therapy is associated with better oncological outcome compared with salvage radiation therapy in patients with pN1 prostate cancer treated with radical prostatectomy.

    Science.gov (United States)

    Tilki, Derya; Preisser, Felix; Tennstedt, Pierre; Tober, Patrick; Mandel, Philipp; Schlomm, Thorsten; Steuber, Thomas; Huland, Hartwig; Schwarz, Rudolf; Petersen, Cordula; Graefen, Markus; Ahyai, Sascha

    2017-05-01

    To analyse the comparative effectiveness of no treatment (NT) or salvage radiation therapy (sRT) at biochemical recurrence (BCR) vs adjuvant radiation therapy (aRT) in patients with lymph node (LN)-positive prostate cancer (PCa) after radical prostatectomy (RP). A total of 773 patients with LN-positive PCa at RP, with or without additional radiation therapy (RT), in the period 2005-2013, were retrospectively analysed. Cox regression analysis was used to assess factors influencing BCR and metastasis-free survival (MFS). Propensity score-matched analyses were performed. The median follow-up for the entire patient group was 33.8 months. Four-year BCR-free and MFS rates were 43.3% and 86.6%, respectively, for all patients. In multivariate analysis, NT/sRT (n = 505) was an independent risk factor for BCR and metastasis compared with aRT (n = 213). The superiority of aRT was confirmed after propensity score matching. The 4-year MFS in the matched cohort was 82.5% vs 91.8% for the NT/sRT and aRT groups, respectively (P = 0.02). Early sRT (pre-RT prostate-specific antigen [PSA] ≤0.5 ng/mL) compared with sRT at PSA >0.5 ng/mL was significantly associated with a lower risk of metastasis. Patients with LN-positive PCa who received aRT had a significantly better oncological outcome than patients with NT/sRT, independent of tumour characteristics. Patients with early sRT had higher rates of response and better MFS than patients with pre-RT PSA >0.5 ng/mL. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

  11. Evaluating application of the National Healthcare Safety Network central line-associated bloodstream infection surveillance definition: a survey of pediatric intensive care and hematology/oncology units.

    Science.gov (United States)

    Gaur, Aditya H; Miller, Marlene R; Gao, Cuilan; Rosenberg, Carol; Morrell, Gloria C; Coffin, Susan E; Huskins, W Charles

    2013-07-01

    To evaluate the application of the National Healthcare Safety Network (NHSN) central line-associated bloodstream infection (CLABSI) definition in pediatric intensive care units (PICUs) and pediatric hematology/oncology units (PHOUs) participating in a multicenter quality improvement collaborative to reduce CLABSIs; to identify sources of variability in the application of the definition. Online survey using 18 standardized case scenarios. Each described a positive blood culture in a patient and required a yes- or-no answer to the question "Is this a CLABSI?" NHSN staff responses were the reference standard. Sixty-five US PICUs and PHOUs. Staff who routinely adjudicate CLABSIs using NHSN definitions. Sixty responses were received from 58 (89%) of 65 institutions; 78% of respondents were infection preventionists, infection control officers, or infectious disease physicians. Responses matched those of NHSN staff for 78% of questions. The mean (SE) percentage of concurring answers did not differ for scenarios evaluating application of 1 of the 3 criteria ("known pathogen," 78% [1.7%]; "skin contaminant, >1 year of age," 76% [SE, 2.5%]; "skin contaminant, ≤1 year of age," 81% [3.8%]; [Formula: see text]). The mean percentage of concurring answers was lower for scenarios requiring respondents to determine whether a CLABSI was present or incubating on admission (64% [4.6%]; [Formula: see text]) or to distinguish between primary and secondary bacteremia (65% [2.5%]; [Formula: see text]). The accuracy of application of the CLABSI definition was suboptimal. Efforts to reduce variability in identifying CLABSIs that are present or incubating on admission and in distinguishing primary from secondary bloodstream infection are needed.

  12. War of the British Worlds

    DEFF Research Database (Denmark)

    Mercau, Ezequiel

    2016-01-01

    The 1982 Falklands War was shrouded in symbolism, bringing to the fore divergent conceptions of Britishness, kinship, and belonging. This article casts light on the persistent purchase of the idea of Greater Britain long after the end of empire, addressing a case that would normally be deemed...... outside its spatial and temporal boundaries. By highlighting the inherent contradictions of this transnational bond, the South Atlantic conflict had a profound effect on an underexposed British community with a lingering attachment to a “British world”: the Anglo-Argentines. As they found themselves...... different “British worlds” against each other....

  13. Proceedings of the 34. annual British Columbia mine reclamation symposium and 35. annual Canadian Land Reclamation Association meeting : reclamation from planning to closure

    Energy Technology Data Exchange (ETDEWEB)

    Price, W.; Wambolt, T.; Van Zyl, D.; Riordan, B.; Hargreaves, J.; Pomeroy, K.; Beckett, P.; Giasson, M.; Polster, D.; Howell, C. (eds.)

    2010-07-01

    This conference provided an opportunity to exchange information on mine reclamation and related issues affecting coal mining in British Columbia and oil sand mining in Alberta. The reclamation of lands disturbed by mineral extraction and processing or by other industrial activity is aimed at returning the land to a level that is equivalent to its pre-industrial activity. The environmental impacts of mine development were discussed along with opportunities to rehabilitate disturbed lands using new remedial methods for soil conservation, water protection and carbon sequestration. A broad range of reclamation, restoration and remediation methods for oil sand mining, coal mining and metals in soils were also discussed. The conference featured 30 presentations, including posters, of which 9 have been catalogued separately for inclusion in this database. refs., tabs., figs.

  14. Conference Proceedings: Photography and Britishness

    Directory of Open Access Journals (Sweden)

    Sean Willcock

    2016-11-01

    Full Text Available The video-recordings presented here were made at the conference Photography and Britishness, held at the Yale Center for British Art on November 4 – 5, 2016. The conference was the result of a collaboration between the Yale Center for British Art, New Haven, the Paul Mellon Centre for Studies in British Art, London, and the Huntington Library, Art Collections, and Botanical Gardens in San Marino—three research institutions that have a converging interest in British art. The conference sought to investigate the various ways in which notions of “Britishness” have been communicated, inflected, and contested through the photographic image. It was not a conference about the history of photography in Britain, or about British photography. Rather, it sought to consider the nature of the relationship between photography and Britishness: the notion that photography can capture images of Britishness, at the same time that our sense of what Britishness constitutes is produced by the photographic image. A key question for the conference was whether Britishness can have a photographic referent—or whether it is itself an effect of representation. Speakers at the conference approached these questions from a wide range of perspectives and focusing on a diverse number of photographic materials—from family albums and studio portraits to advertisements, reportage, and aerial photography—which demonstrated the complexities and instabilities not only of the term Britishness, but also of the medium of photography. The conference was opened with an introduction by John Tagg. The videos included here are presented in the order they were delivered.

  15. Constipation in paediatric oncology.

    Science.gov (United States)

    Selwood, Karen

    2006-02-01

    Constipation is a common problem encountered by many children during treatment for childhood cancer. It can be distressing and impact on the quality of life for the child. However, the advice and information they and their families receive can vary enormously. The clinical practice group (a subgroup of the paediatric oncology nurses forum (PONF)) decided to examine the management of constipation throughout the paediatric oncology units in the UK. This paper presents the findings and the subsequent action taken and highlights the need for further work.

  16. Contemporary Trends in Radiation Oncology Resident Research

    Energy Technology Data Exchange (ETDEWEB)

    Verma, Vivek [Department of Radiation Oncology, University of Nebraska, Omaha, Nebraska (United States); Burt, Lindsay [Department of Radiation Oncology, University of Utah, Salt Lake City, Utah (United States); Gimotty, Phyllis A. [Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Ojerholm, Eric, E-mail: eric.ojerholm@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2016-11-15

    Purpose: To test the hypothesis that recent resident research productivity might be different than a decade ago, and to provide contemporary information about resident scholarly activity. Methods and Materials: We compiled a list of radiation oncology residents from the 2 most recent graduating classes (June 2014 and 2015) using the Association of Residents in Radiation Oncology annual directories. We queried the PubMed database for each resident's first-authored publications from postgraduate years (PGY) 2 through 5, plus a 3-month period after residency completion. We abstracted corresponding historical data for 2002 to 2007 from the benchmark publication by Morgan and colleagues (Int J Radiat Oncol Biol Phys 2009;74:1567-1572). We tested the null hypothesis that these 2 samples had the same distribution for number of publications using the Wilcoxon rank-sum test. We explored the association of demographic factors and publication number using multivariable zero-inflated Poisson regression. Results: There were 334 residents publishing 659 eligible first-author publications during residency (range 0-17; interquartile range 0-3; mean 2.0; median 1). The contemporary and historical distributions were significantly different (P<.001); contemporary publication rates were higher. Publications accrued late in residency (27% in PGY-4, 59% in PGY-5), and most were original research (75%). In the historical cohort, half of all articles were published in 3 journals; in contrast, the top half of contemporary publications were spread over 10 journals—most commonly International Journal of Radiation Oncology • Biology • Physics (17%), Practical Radiation Oncology (7%), and Radiation Oncology (4%). Male gender, non-PhD status, and larger residency size were associated with higher number of publications in the multivariable analysis. Conclusion: We observed an increase in first-author publications during training compared with historical data from the mid-2000s. These

  17. Contemporary Trends in Radiation Oncology Resident Research.

    Science.gov (United States)

    Verma, Vivek; Burt, Lindsay; Gimotty, Phyllis A; Ojerholm, Eric

    2016-11-15

    To test the hypothesis that recent resident research productivity might be different than a decade ago, and to provide contemporary information about resident scholarly activity. We compiled a list of radiation oncology residents from the 2 most recent graduating classes (June 2014 and 2015) using the Association of Residents in Radiation Oncology annual directories. We queried the PubMed database for each resident's first-authored publications from postgraduate years (PGY) 2 through 5, plus a 3-month period after residency completion. We abstracted corresponding historical data for 2002 to 2007 from the benchmark publication by Morgan and colleagues (Int J Radiat Oncol Biol Phys 2009;74:1567-1572). We tested the null hypothesis that these 2 samples had the same distribution for number of publications using the Wilcoxon rank-sum test. We explored the association of demographic factors and publication number using multivariable zero-inflated Poisson regression. There were 334 residents publishing 659 eligible first-author publications during residency (range 0-17; interquartile range 0-3; mean 2.0; median 1). The contemporary and historical distributions were significantly different (Presearch (75%). In the historical cohort, half of all articles were published in 3 journals; in contrast, the top half of contemporary publications were spread over 10 journals-most commonly International Journal of Radiation Oncology • Biology • Physics (17%), Practical Radiation Oncology (7%), and Radiation Oncology (4%). Male gender, non-PhD status, and larger residency size were associated with higher number of publications in the multivariable analysis. We observed an increase in first-author publications during training compared with historical data from the mid-2000s. These contemporary figures may be useful to medical students considering radiation oncology, current residents, training programs, and prospective employers. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Global geriatric oncology: Achievements and challenges.

    Science.gov (United States)

    Soto-Perez-de-Celis, Enrique; de Glas, Nienke A; Hsu, Tina; Kanesvaran, Ravindran; Steer, Christopher; Navarrete-Reyes, Ana Patricia; Battisti, Nicolo Matteo Luca; Chavarri-Guerra, Yanin; O'Donovan, Anita; Avila-Funes, Jose Alberto; Hurria, Arti

    2017-09-01

    The aging of the population is a global challenge. The number of older adults is rapidly growing, leading to an increase in the prevalence of noncommunicable diseases associated with aging, such as cancer. Worldwide, older adults account for approximately half of all cancer cases, and this proportion is projected to increase globally. Furthermore, the majority of older adults live in less developed regions, where health systems are generally ill-equipped to provide care for complex chronic conditions. Worldwide, there is paucity of geriatric training, and most of the oncology workforce lacks the skills and knowledge to provide comprehensive care for older patients. Various initiatives aimed at providing adequate clinical care for older adults, increasing the geriatric skills and knowledge of healthcare professionals, and developing geriatric oncology research, have been successfully implemented. However, most developments in geriatric oncology have taken place in high-income countries, and there are still large inequalities in the availability of clinical, educational, and research initiatives across different regions of the world. This article provides an overview of geriatric oncology initiatives in Asia, Europe, Australia and New Zealand, Latin America, and the United States and Canada. Understanding the achievements and challenges of geriatric oncology around the world, and fostering international collaboration in research and training are essential for improving the care of all older adults with cancer. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Fish Oncology: Diseases, Diagnostics, and Therapeutics.

    Science.gov (United States)

    Vergneau-Grosset, Claire; Nadeau, Marie-Eve; Groff, Joseph M

    2017-01-01

    The scientific literature contains a wealth of information concerning spontaneous fish neoplasms, although ornamental fish oncology is still in its infancy. The occurrence of fish neoplasms has often been associated with oncogenic viruses and environmental insults, making them useful markers for environmental contaminants. The use of fish, including zebrafish, as models of human carcinogenesis has been developed and knowledge gained from these models may also be applied to ornamental fish, although more studies are required. This review summarizes information available about fish oncology pertaining to veterinary clinicians. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Exercise-based oncology rehabilitation: leveraging the cardiac rehabilitation model.

    Science.gov (United States)

    Dittus, Kim L; Lakoski, Susan G; Savage, Patrick D; Kokinda, Nathan; Toth, Michael; Stevens, Diane; Woods, Kimberly; OʼBrien, Patricia; Ades, Philip A

    2015-01-01

    The value of exercise and rehabilitative interventions for cancer survivors is increasingly clear, and oncology rehabilitation programs could provide these important interventions. However, a pathway to create oncology rehabilitation has not been delineated. Community-based cardiac rehabilitation (CR) programs staffed by health care professionals with experience in providing rehabilitation and secondary prevention services to individuals with coronary heart disease are widely available and provide a potential model and location for oncology rehabilitation programs. Our purpose was to outline the rehabilitative needs of cancer survivors and demonstrate how oncology rehabilitation can be created using a CR model. We identify the impairments associated with cancer and its therapy that respond to rehabilitative interventions. Components of the CR model that would benefit cancer survivors are described. An example of an oncology rehabilitation program using a CR model is presented. Cancer survivors have impairments associated with cancer and its therapy that improve with rehabilitation. Our experience demonstrates that effective rehabilitation services can be provided utilizing an existing CR infrastructure. Few adjustments to current CR models would be needed to provide oncology rehabilitation. Preliminary evidence suggests that cancer survivors participating in an oncology rehabilitation program experience improvements in psychological and physiologic parameters. Utilizing the CR model of rehabilitative services and disease management provides a much needed mechanism to bring oncology rehabilitation to larger numbers of cancer survivors.

  1. Practising oncology via telemedicine.

    Science.gov (United States)

    Doolittle, G C; Allen, A

    1997-01-01

    Although there are increasing numbers of telemedicine programmes in the USA, few have offered teleoncology services, so that the role of telemedicine in the practice of clinical oncology has yet to be fully defined. Telemedicine has been used successfully for direct patient care in Kansas. It is also a method of providing supportive care for the cancer patient, including assessments of pain and nutrition. In addition, televised tumour conferences and nursing education courses can help smaller communities develop a level of expertise that allows patients to be treated locally. Telemedicine may well be used in future for access to national and international cancer experts, and for participation in new cancer treatment protocols through cooperative group trials. When practising oncology via telemedicine, there are unique problems, including issues regarding technology (interactive video and radiograph review) and practice (patient/oncologist preferences and doctor-patient communication). Very little has been published in the area of tele-oncology so far, and studies concerning its efficacy, cost-effectiveness and the best organizational structure are still in progress. However, telemedicine appears to be a useful technique in the practice of oncology.

  2. Maternal prenatal blood mercury is not adversely associated with offspring IQ at 8 years provided the mother eats fish: A British prebirth cohort study.

    Science.gov (United States)

    Golding, Jean; Hibbeln, Joseph R; Gregory, Steven M; Iles-Caven, Yasmin; Emond, Alan; Taylor, Caroline M

    2017-10-01

    Conflicting evidence concerning possible harm from mercury (Hg) in regard to offspring cognition if the woman eats fish has prompted this study to examine evidence from a British pre-birth cohort to investigate the relationship between the two. Pregnant women (median prenatal blood mercury 1.86μg/L) resident in the study area with delivery between April 1991 and December 1992 were followed up and verbal, performance and total intelligence quotient (IQ) of 2062 offspring were measured at age 8. Analysis treated IQ as (a) continuous and (b) the lowest 25% of the distribution. Multiple and logistic regression analyses took account of social and demographic variables. Stratification considered children of fish eaters separately. Before adjustment, mean full-scale IQ increased with increasing Hg (change with 1SD of Hg=+2.02; 95%CI+1.40,+2.64 IQ points; P mercury and offspring IQ appears to be benign provided the mother consumes fish. Copyright © 2017 The Authors. Published by Elsevier GmbH.. All rights reserved.

  3. Virus characterization, clinical presentation, and pathology associated with H7N3 avian influenza in British Columbia broiler breeder chickens in 2004.

    Science.gov (United States)

    Bowes, V A; Ritchie, S J; Byrne, S; Sojonky, K; Bidulka, J J; Robinson, J H

    2004-12-01

    Low-pathogenicity avian influenza (LPAI) subtype H7N3 was diagnosed on a two-age broiler breeder farm in Abbotsford, British Columbia (BC), in early February 2004. The presenting complaint in the older index flock was feed refusal, with 0.5% mortality over 72 hr that resolved over the following week Ten days after the initial complaint in the index flock, a younger flock in an adjacent barn experienced an abrupt spike in mortality (25% in 48 hr). The gross lesions of tracheal hyperemia and hilar pulmonary consolidation were subtle and nonspecific, and the diagnosis of avian influenza required laboratory confirmation. Two different viruses were isolated from the index farm: a LPAI (H7N3) was isolated from the older flock and a high-pathogenicity avian influenza (HPAI) (H7N3), which had an additional 21 base insertion at the hemagglutinin-cleavage site, was isolated from the younger flock. The presence of this insertion sequence and the similarity of adjacent sequences indicate that the LPAI had mutated into HPAI at some point between the first and second barn. Despite enhanced on-farm biosecurity measures, the virus was not contained on the index farm and eventually spread to over 40 commercial poultry facilities before massive depopulation efforts enabled its eradication.

  4. Molecular imaging in oncology

    Energy Technology Data Exchange (ETDEWEB)

    Schober, Otmar; Riemann, Burkhard (eds.) [Universitaetsklinikum Muenster (Germany). Klinik fuer Nuklearmedizin

    2013-02-01

    Considers in detail all aspects of molecular imaging in oncology, ranging from basic research to clinical applications in the era of evidence-based medicine. Examines technological issues and probe design. Discusses preclinical studies in detail, with particular attention to multimodality imaging. Presents current clinical use of PET/CT, SPECT/CT, and optical imagingWritten by acknowledged experts. The impact of molecular imaging on diagnostics, therapy, and follow-up in oncology is increasing significantly. The process of molecular imaging includes key biotarget identification, design of specific molecular imaging probes, and their preclinical evaluation, e.g., in vivo using small animal studies. A multitude of such innovative molecular imaging probes have already entered clinical diagnostics in oncology. There is no doubt that in future the emphasis will be on multimodality imaging in which morphological, functional, and molecular imaging techniques are combined in a single clinical investigation that will optimize diagnostic processes. This handbook addresses all aspects of molecular imaging in oncology, ranging from basic research to clinical applications in the era of evidence-based medicine. The first section is devoted to technology and probe design, and examines a variety of PET and SPECT tracers as well as multimodality probes. Preclinical studies are then discussed in detail, with particular attention to multimodality imaging. In the third section, diverse clinical applications are presented, and the book closes by looking at future challenges. This handbook will be of value to all who are interested in the revolution in diagnostic oncology that is being brought about by molecular imaging.

  5. 2016 Updated American Society of Clinical Oncology/Oncology Nursing Society Chemotherapy Administration Safety Standards, Including Standards for Pediatric Oncology.

    Science.gov (United States)

    Neuss, Michael N; Gilmore, Terry R; Belderson, Kristin M; Billett, Amy L; Conti-Kalchik, Tara; Harvey, Brittany E; Hendricks, Carolyn; LeFebvre, Kristine B; Mangu, Pamela B; McNiff, Kristen; Olsen, MiKaela; Schulmeister, Lisa; Von Gehr, Ann; Polovich, Martha

    2016-12-01

    Purpose To update the ASCO/Oncology Nursing Society (ONS) Chemotherapy Administration Safety Standards and to highlight standards for pediatric oncology. Methods The ASCO/ONS Chemotherapy Administration Safety Standards were first published in 2009 and updated in 2011 to include inpatient settings. A subsequent 2013 revision expanded the standards to include the safe administration and management of oral chemotherapy. A joint ASCO/ONS workshop with stakeholder participation, including that of the Association of Pediatric Hematology Oncology Nurses and American Society of Pediatric Hematology/Oncology, was held on May 12, 2015, to review the 2013 standards. An extensive literature search was subsequently conducted, and public comments on the revised draft standards were solicited. Results The updated 2016 standards presented here include clarification and expansion of existing standards to include pediatric oncology and to introduce new standards: most notably, two-person verification of chemotherapy preparation processes, administration of vinca alkaloids via minibags in facilities in which intrathecal medications are administered, and labeling of medications dispensed from the health care setting to be taken by the patient at home. The standards were reordered and renumbered to align with the sequential processes of chemotherapy prescription, preparation, and administration. Several standards were separated into their respective components for clarity and to facilitate measurement of adherence to a standard. Conclusion As oncology practice has changed, so have chemotherapy administration safety standards. Advances in technology, cancer treatment, and education and training have prompted the need for periodic review and revision of the standards. Additional information is available at http://www.asco.org/chemo-standards .

  6. 1970 British Cohort Study

    Directory of Open Access Journals (Sweden)

    Matt Brown

    2014-10-01

    Full Text Available The 1970 British Cohort Study (BCS70 is one of Britain’s world famous national longitudinal birth cohort studies, three of which are run by the Centre for Longitudinal Studies at the Institute of Education, University of London.  BCS70 follows the lives of more than 17,000 people born in England, Scotland and Wales in a single week of 1970. Over the course of cohort members lives, the BCS70 has collected information on health, physical, educational and social development, and economic circumstances among other factors. Since the birth survey in 1970, there have been nine ‘sweeps’ of all cohort members at ages 5, 10, 16, 26, 30, 34, 38 and most recently at 42. Data has been collected from a number of different sources (the midwife present at birth, parents of the cohort members, head and class teachers, school health service personnel and the cohort members themselves. The data has been collected in a variety of ways including via paper and electronic questionnaires, clinical records, medical examinations, physical measurements, tests of ability, educational assessments and diaries. The majority of BCS70 survey data can be accessed by bona fide researchers through the UK Data Service at the University of Essex.

  7. British Society of Gastroenterology/Association of Coloproctologists of Great Britain and Ireland guidelines for the management of large non-pedunculated colorectal polyps.

    Science.gov (United States)

    Rutter, Matthew D; Chattree, Amit; Barbour, Jamie A; Thomas-Gibson, Siwan; Bhandari, Pradeep; Saunders, Brian P; Veitch, Andrew M; Anderson, John; Rembacken, Bjorn J; Loughrey, Maurice B; Pullan, Rupert; Garrett, William V; Lewis, Gethin; Dolwani, Sunil

    2015-12-01

    These guidelines provide an evidence-based framework for the management of patients with large non-pedunculated colorectal polyps (LNPCPs), in addition to identifying key performance indicators (KPIs) that permit the audit of quality outcomes. These are areas not previously covered by British Society of Gastroenterology (BSG) Guidelines.A National Institute of Health and Care Excellence (NICE) compliant BSG guideline development process was used throughout and the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool was used to structure the guideline development process. A systematic review of literature was conducted for English language articles up to May 2014 concerning the assessment and management of LNPCPs. Quality of evaluated studies was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) Methodology Checklist System. Proposed recommendation statements were evaluated by each member of the Guideline Development Group (GDG) on a scale from 1 (strongly agree) to 5 (strongly disagree) with >80% agreement required for consensus to be reached. Where consensus was not reached a modified Delphi process was used to re-evaluate and modify proposed statements until consensus was reached or the statement discarded. A round table meeting was subsequently held to finalise recommendations and to evaluate the strength of evidence discussed. The GRADE tool was used to assess the strength of evidence and strength of recommendation for finalised statements.KPIs, a training framework and potential research questions for the management of LNPCPs were also developed. It is hoped that these guidelines will improve the assessment and management of LNPCPs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. Microcomputing in British planning education

    OpenAIRE

    I Masser; G Teet

    1988-01-01

    The findings of a survey of British planning schools carried out during spring 1986 suggest that the number of microcomputers available in British planning schools has increased by at least two-and-a-half times over an eighteen-month period. However, compulsory courses on computer applications and information management in these schools still tend to be linked with quantitative methods teaching and few opportunities are provided for more advanced training in information management in most sch...

  9. [Introduction to geriatric oncology].

    Science.gov (United States)

    Wedding, U; Höffken, K

    2002-01-01

    The demographic changes will result in a profound increase of the number of elderly people within the next years. As a consequence of the age dependent increase of the incidence and mortality rate of cancer these changes will bring an increase in the number of elderly people with cancer. There is a number of differences between young and old patients diagnosed with cancer. This must result in an adaption of standardised oncological procedures, mainly designed for younger patients, to the special situation of elderly patients. The differences between young and old patients with cancer may be depicted by a structured geriatric assessment. Suggestions for the structure of such an assessment exist. Ongoing clinical trials have to demonstrate, whether or not the inclusion of a geriatric oncological assessment in the decision making process will result in an improvement of treatment results in elderly cancer patients diagnosed with cancer.

  10. Oncologic outcome and morbidity

    OpenAIRE

    Musik, Thabea

    2011-01-01

    Background and Purpose: Compared to laparotomic surgery, laparoscopically assisted radical vaginal hysterectomy (LARVH) offers a decreased blood-loss during surgery and faster convalescence of the patient post-operatively while at the same time delivering similar oncologic results. However, there is no data on outcome and toxicity of LARVH followed by (chemo)radiotherapy. Patients and Methods: Retrospective analysis of 55 patients (age: 28-78 years, median: 48 years; BMI:...

  11. Integrative oncology: an overview.

    Science.gov (United States)

    Deng, Gary; Cassileth, Barrie

    2014-01-01

    Integrative oncology, the diagnosis-specific field of integrative medicine, addresses symptom control with nonpharmacologic therapies. Known commonly as "complementary therapies" these are evidence-based adjuncts to mainstream care that effectively control physical and emotional symptoms, enhance physical and emotional strength, and provide patients with skills enabling them to help themselves throughout and following mainstream cancer treatment. Integrative or complementary therapies are rational and noninvasive. They have been subjected to study to determine their value, to document the problems they ameliorate, and to define the circumstances under which such therapies are beneficial. Conversely, "alternative" therapies typically are promoted literally as such; as actual antitumor treatments. They lack biologic plausibility and scientific evidence of safety and efficacy. Many are outright fraudulent. Conflating these two very different categories by use of the convenient acronym "CAM," for "complementary and alternative therapies," confuses the issue and does a substantial disservice to patients and medical professionals. Complementary and integrative modalities have demonstrated safety value and benefits. If the same were true for "alternatives," they would not be "alternatives." Rather, they would become part of mainstream cancer care. This manuscript explores the medical and sociocultural context of interest in integrative oncology as well as in "alternative" therapies, reviews commonly-asked patient questions, summarizes research results in both categories, and offers recommendations to help guide patients and family members through what is often a difficult maze. Combining complementary therapies with mainstream oncology care to address patients' physical, psychologic and spiritual needs constitutes the practice of integrative oncology. By recommending nonpharmacologic modalities that reduce symptom burden and improve quality of life, physicians also enable

  12. Encyclopedia of radiation oncology

    Energy Technology Data Exchange (ETDEWEB)

    Brady, Luther W. [Drexel Univ. College of Medicine, Philadelphia, PA (United States); Yaeger, Theodore E. (eds.) [Wake Forest Univ. School of Medicine, Winston-Salem, NC (United States). Dept. of Radiation Oncology

    2013-02-01

    The simple A to Z format provides easy access to relevant information in the field of radiation oncology. Extensive cross references between keywords and related articles enable efficient searches in a user-friendly manner. Fully searchable and hyperlinked electronic online edition. The aim of this comprehensive encyclopedia is to provide detailed information on radiation oncology. The wide range of entries are written by leading experts. They will provide basic and clinical scientists in academia, practice and industry with valuable information about the field of radiation oncology. Those in related fields, students, teachers, and interested laypeople will also benefit from the important and relevant information on the most recent developments. Please note that this publication is available as print only or online only or print + online set. Save 75% of the online list price when purchasing the bundle. For more information on the online version please type the publication title into the search box above, then click on the eReference version in the results list.

  13. Pediatric oncology in Turkey.

    Science.gov (United States)

    Kebudi, Rejin

    2012-03-01

    The survival of children with cancer has increased dramatically in the last decades, as a result of advances in diagnosis, treatment and supportive care. Each year in Turkey, 2500-3000 new childhood cancer cases are expected. According to the Turkish Pediatric Oncology Group and Turkish Pediatric Hematology Societies Registry, about 2000 new pediatric cancer cases are reported each year. The population in Turkey is relatively young. One fourth of the population is younger than 15 years of age. According to childhood mortality, cancer is the fourth cause of death (7.2%) after infections, cardiac deaths and accidents. The major cancers in children in Turkey are leukemia (31%), lymphoma (19%), central nervous system (CNS) neoplasms (13%), neuroblastomas (7%), bone tumors (6.1%), soft tissue sarcomas (6%), followed by renal tumors, germ cell tumors, retinoblastoma, carcinomas-epithelial neoplasms, hepatic tumors and others. Lymphomas rank second in frequency as in many developing countries in contrast to West Europe or USA, where CNS neoplasms rank second in frequency. The seven-year survival rate in children with malignancies in Turkey is 65.8%. The history of modern Pediatric Oncology in Turkey dates back to the 1970's. Pediatric Oncology has been accepted as a subspecialty in Turkey since 1983. Pediatric Oncologists are all well trained and dedicated. All costs for the diagnosis and treatment of children with cancer is covered by the government. Education and infrastructure for palliative care needs improvement.

  14. Mineral Chemistry of Silicate Phases From the Summit Creek Stock, Southeastern British Columbia: Evidence for Associated "Xenolith" Origin and Dyke Emplacement

    Science.gov (United States)

    Morrison, C. A.; Owen, J. P.

    2009-05-01

    The Summit Creek stock is a Mid-Cretaceous aged granitic intrusion that is located within the Cordilleran Omineca belt in the southeastern corner of British Columbia. Included within the stock are numerous xenoliths of intermediate composition that range in size from 5cm to 2m, as well as a prominent 1m-wide mafic dyke. According to the QAP diagram, the stock is classified as a muscovite-biotite monzogranite, with a typical sample containing 35% quartz, 25% plagioclase, 30% K-feldspar, 7% biotite, 2% muscovite, and 1% accessory phases. Minor accessory phases identified in this study include pyrite, molybdenite, apatite, magnetite, ilmenite, monazite, and zircon. Samples collected from the stock proper are predominantly equigranular; however the xenoliths are porphyritic and contain phenocrysts of both quartz and plagioclase, as well as glomerophyric aggregates of biotite. New investigation into the mineral chemistry of the stock, xenoliths, and dyke indicates that the xenoliths have a strong geochemical similarity to the main body of the stock. Plagioclase feldspar compositions from the xenolith overlap with those from the stock, and REE abundances in the stock and the xenoliths are indistinguishable (LREE 100x chondrite; HREE 10x chondrite). In thin section, the boundary between the xenoliths and the stock is very irregular, and protruding grains of plagioclase and biotite can be found piercing into both the granitic host, as well as into the xenolith itself. This evidence suggests that these inclusions are better termed autoliths rather than xenoliths, as it appears that they are derivatives of the same parent magma as the main stock. The mafic dyke differs in both mineralogy and geochemistry from the stock, and is characterized by low SiO2 content (48.98 wt.%), high REE abundances (30-40x chondrite), presence of rare euhedral hornblende, and greater variation in mineral chemistry. Samples from the dyke contain plagioclase with cores ranging from bytownite to

  15. Technology for Innovation in Radiation Oncology

    Energy Technology Data Exchange (ETDEWEB)

    Chetty, Indrin J. [Department of Radiation Oncology, Henry Ford Hospital, Detroit, Michigan (United States); Martel, Mary K., E-mail: mmartel@mdanderson.org [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Jaffray, David A. [Departments of Radiation Oncology and Medical Biophysics, Princess Margaret Hospital, Toronto, Ontario (Canada); Benedict, Stanley H. [Department of Radiation Oncology, University of California – Davis Cancer Center, Sacramento, California (United States); Hahn, Stephen M. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Berbeco, Ross [Department of Radiation Oncology, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Deye, James [Radiation Research Programs, National Cancer Institute, Bethesda, Maryland (United States); Jeraj, Robert [Department of Medical Physics, University of Wisconsin, Madison, Wisconsin (United States); Kavanagh, Brian [Department of Radiation Oncology, University of Colorado, Aurora, Colorado (United States); Krishnan, Sunil [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Lee, Nancy [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Low, Daniel A. [Department of Radiation Oncology, University of California – Los Angeles, Los Angeles, California (United States); Mankoff, David [Department of Radiology, University of Washington Medical School, Seattle, Washington (United States); Marks, Lawrence B. [Department of Radiation Oncology, University of North Carolina Hospitals, Chapel Hill, North Carolina (United States); Ollendorf, Daniel [Institute for Clinical and Economic Review, Boston, Massachusetts (United States); and others

    2015-11-01

    Radiation therapy is an effective, personalized cancer treatment that has benefited from technological advances associated with the growing ability to identify and target tumors with accuracy and precision. Given that these advances have played a central role in the success of radiation therapy as a major component of comprehensive cancer care, the American Society for Radiation Oncology (ASTRO), the American Association of Physicists in Medicine (AAPM), and the National Cancer Institute (NCI) sponsored a workshop entitled “Technology for Innovation in Radiation Oncology,” which took place at the National Institutes of Health (NIH) in Bethesda, Maryland, on June 13 and 14, 2013. The purpose of this workshop was to discuss emerging technology for the field and to recognize areas for greater research investment. Expert clinicians and scientists discussed innovative technology in radiation oncology, in particular as to how these technologies are being developed and translated to clinical practice in the face of current and future challenges and opportunities. Technologies encompassed topics in functional imaging, treatment devices, nanotechnology, and information technology. The technical, quality, and safety performance of these technologies were also considered. A major theme of the workshop was the growing importance of innovation in the domain of process automation and oncology informatics. The technologically advanced nature of radiation therapy treatments predisposes radiation oncology research teams to take on informatics research initiatives. In addition, the discussion on technology development was balanced with a parallel conversation regarding the need for evidence of efficacy and effectiveness. The linkage between the need for evidence and the efforts in informatics research was clearly identified as synergistic.

  16. Technology for Innovation in Radiation Oncology.

    Science.gov (United States)

    Chetty, Indrin J; Martel, Mary K; Jaffray, David A; Benedict, Stanley H; Hahn, Stephen M; Berbeco, Ross; Deye, James; Jeraj, Robert; Kavanagh, Brian; Krishnan, Sunil; Lee, Nancy; Low, Daniel A; Mankoff, David; Marks, Lawrence B; Ollendorf, Daniel; Paganetti, Harald; Ross, Brian; Siochi, Ramon Alfredo C; Timmerman, Robert D; Wong, John W

    2015-11-01

    Radiation therapy is an effective, personalized cancer treatment that has benefited from technological advances associated with the growing ability to identify and target tumors with accuracy and precision. Given that these advances have played a central role in the success of radiation therapy as a major component of comprehensive cancer care, the American Society for Radiation Oncology (ASTRO), the American Association of Physicists in Medicine (AAPM), and the National Cancer Institute (NCI) sponsored a workshop entitled "Technology for Innovation in Radiation Oncology," which took place at the National Institutes of Health (NIH) in Bethesda, Maryland, on June 13 and 14, 2013. The purpose of this workshop was to discuss emerging technology for the field and to recognize areas for greater research investment. Expert clinicians and scientists discussed innovative technology in radiation oncology, in particular as to how these technologies are being developed and translated to clinical practice in the face of current and future challenges and opportunities. Technologies encompassed topics in functional imaging, treatment devices, nanotechnology, and information technology. The technical, quality, and safety performance of these technologies were also considered. A major theme of the workshop was the growing importance of innovation in the domain of process automation and oncology informatics. The technologically advanced nature of radiation therapy treatments predisposes radiation oncology research teams to take on informatics research initiatives. In addition, the discussion on technology development was balanced with a parallel conversation regarding the need for evidence of efficacy and effectiveness. The linkage between the need for evidence and the efforts in informatics research was clearly identified as synergistic. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Patterns of Performance of Oncologic Surgery by North American Pediatric Urologists: A Report from the Pediatric Urologic Oncology Working Group of the Society for Pediatric Urology.

    Science.gov (United States)

    Cost, Nicholas G; Ross, Jonathan H; Ferrer, Fernando A; Lorenzo, Armando J; Shnorhavorian, Margarett; Routh, Jonathan C; Kieran, Kathleen; Ritchey, Michael L

    2017-05-01

    Objective data on patterns of oncology practice among pediatric urologists are lacking. We reviewed surgical case logs submitted to the American Board of Urology by those self-reporting as pediatric urologists. We hypothesized that logs would reveal a low oncology volume (fewer than 5 cases) and identify orchiectomy as the most common oncology cases, and that less than 25% of logs would show nephrectomy for renal tumor. Case logs submitted for American Board of Urology certification, recertification or pediatric subspecialty certification were reviewed and standardized to represent 12-month practice. Data were collected on pediatric oncologic surgeries as noted by procedure codes linked with oncologic diagnosis codes for patients up to age 30 years. We identified 281 case logs meeting study criteria. A total of 364 oncology cases were logged and 131 logs (46.6%) listed at least 1 oncology case, while 150 (53.4%) contained no oncology cases. The 75th, 90th and 95th percentiles of oncology volume were represented by reporting 2, 3 and 4 cases, respectively. A total of 13 logs (4.6%) accounted for more than a third of all oncology cases (35.9%). The most frequent oncology case logged was orchiectomy, which was documented in 83 logs (29.5%). On Poisson regression surgeon variables associated with higher oncology volume included male gender (IRR 2.8, 95% CI 2.1-3.9), 2010 log year (IRR 2.4, 95% CI 1.3-4.4), 2015 log year (IRR 3.7, 95% CI 2.1-6.4) and nonpediatric subspecialty certification log (IRR 1.6, 95% CI 1.2-2.3). Few pediatric urologists perform a high volume of oncologic surgeries based on surgical case logs submitted to the American Board of Urology. A small cohort of pediatric urologists logged the majority of such cases. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  18. Preemptive Ethanol Lock Therapy in Pediatric Hematology/Oncology Patients With Catheter-Associated Bloodstream Infection: Impact on Length of Stay, Cost, and Catheter Salvage.

    Science.gov (United States)

    McGrath, Eric; Du, Wei; Rajpurkar, Madhvi

    2018-03-01

    Ethanol lock therapy (ELT) with systemic antimicrobial therapy is a promising therapy for catheter-related infection (CRI). The impact of ELT timing on treatment efficacy and costs is unknown. A prospective study was conducted in the Hematology/Oncology Unit at the Children's Hospital of Michigan. Patients with suspected CRI were randomized to Preemptive ELT arm or Rescue ELT arm after positive culture. Five cases in Preemptive arm and 9 in Rescue arm had a confirmed CRI. All cases cleared infection with line salvage with no adverse events due to ELT or recurrence within 14 days. Our data showed a trend toward 36% reduction in average hospital costs and 40% reduction in average length of stay in Preemptive arm over Rescue arm. Although a small study, our data on preemptive ELT with systemic antimicrobial therapy suggest a potentially important treatment strategy in reducing length of stay as well as hospital costs.

  19. Cancer Patients and Oncology Nursing: Perspectives of Oncology ...

    African Journals Online (AJOL)

    2017-10-26

    Oct 26, 2017 ... Cancer patients and oncology nursing: Perspectives of oncology nurses in ... burnout, they are insufficient in managing work stress and giving psychological ... problems.[2] A research on exhaustion in 1970s revealed the concept of burnout by Freudenberg,[3] and after introduction of this novel concept, ...

  20. Quality of life is significantly associated with survival in women with advanced epithelial ovarian cancer: An ancillary data analysis of the NRG Oncology/Gynecologic Oncology Group (GOG-0218) study.

    Science.gov (United States)

    Phippen, N T; Secord, A A; Wolf, S; Samsa, G; Davidson, B; Abernethy, A P; Cella, D; Havrilesky, L J; Burger, R A; Monk, B J; Leath, C A

    2017-10-01

    Evaluate association between baseline quality of life (QOL) and changes in QOL measured by FACT-O TOI with progression-free disease (PFS) and overall survival (OS) in advanced epithelial ovarian cancer (EOC). Patients enrolled in GOG-0218 with completed FACT-O TOI assessments at baseline and at least one follow-up assessment were eligible. Baseline FACT-O TOI scores were sorted by quartiles (Q1-4) and outcomes compared between Q1 and Q2-4 with log-rank statistic and multivariate Cox regression adjusting for age, stage, post-surgical residual disease size, and performance status (PS). Trends in FACT-O TOI scores from baseline to the latest follow-up assessment were evaluated for impact on intragroup (Q1 or Q2-4) outcome by log-rank analysis. Of 1152 eligible patients, 283 formed Q1 and 869 formed Q2-4. Mean baseline FACT-O TOI scores were 47.5 for Q1 vs. 74.7 for Q2-4 (P<0.001). Q1 compared to Q2-4 had worse median OS (37.5 vs. 45.6months, P=0.001) and worse median PFS (12.5 vs. 13.1months, P=0.096). Q2-4 patients had decreased risks of disease progression (HR 0.974, 95% CI 0.953-0.995, P=0.018), and death (HR 0.963, 95% CI 0.939-0.987, P=0.003) for each five-point increase in baseline FACT-O TOI. Improving versus worsening trends in FACT-O TOI scores were associated with longer median PFS (Q1: 12.7 vs. 8.6months, P=0.001; Q2-4: 16.7 vs. 11.1months, P<0.001) and median OS (Q1: 40.8 vs. 16months, P<0.001; Q2-4: 54.4 vs. 33.6months, P<0.001). Baseline FACT-O TOI scores were independently prognostic of PFS and OS while improving compared to worsening QOL was associated with significantly better PFS and OS in women with EOC. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Palliative surgical oncology.

    Science.gov (United States)

    Hanna, Nader N; Bellavance, Emily; Keay, Timothy

    2011-04-01

    Palliative surgical oncology is a relatively new concept, but builds on a long tradition in surgery. As the field of palliative medicine grows and becomes its own specialty, surgeons have been receiving some specialized training in palliative care; devising specific palliative surgical procedures; and reevaluating the ethics of their interactions with patients, especially for the selection of palliative surgical procedures. This is leading to a new form of surgical practice in which the emphasis is on relief of present or anticipated symptoms, even if the interventions do not prolong a patient's life span. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. Medicinal cannabis in oncology.

    Science.gov (United States)

    Engels, Frederike K; de Jong, Floris A; Mathijssen, Ron H J; Erkens, Joëlle A; Herings, Ron M; Verweij, Jaap

    2007-12-01

    In The Netherlands, since September 2003, a legal medicinal cannabis product, constituting the whole range of cannabinoids, is available for clinical research, drug development strategies, and on prescription for patients. To date, this policy, initiated by the Dutch Government, has not yet led to the desired outcome; the amount of initiated clinical research is less than expected and only a minority of patients resorts to the legal product. This review aims to discuss the background for the introduction of legal medicinal cannabis in The Netherlands, the past years of Dutch clinical experience in oncology practice, possible reasons underlying the current outcome, and future perspectives.

  3. On the importance of multidimensional evaluation of elderly oncologic patients.

    Science.gov (United States)

    Di Mauro, S; Distefano, A; Di Fazio, I; Leotta, C; Malaguarnera, M

    2000-01-01

    The role of comorbidity and the psycho-affective attitudes have been studied in 108 elderly oncological patients, in comparison with 25 elderly subjects without tumor pathologies. The results have revealed positive correlations between the activity of daily living (ADL), as well as the instrumental activity of daily living (IADL) scales and the comorbidity both in the oncological subjects and the controls. The performance status defined by the eastern cooperative oncology group (ECOG-PS) positively correlated with the parameters of ADL and IADL scales, demonstrating an increased vulnerability and fragility of the oncological patients in their everyday activities. An increased psychological fragility of the oncological patients has also been revealed by the scores of the geriatric depression scale (GDS), which might be cause and consequence at the same time of the disease itself. In addition, the polypathologies are not associated with an increased gravity of the tumor stage, although there have been 2.5 accompanying pathologies, mainly diseases of osteoarticular and cardial character. The correction of functional damages of various organs due to aging or concomitant or previous diseases is a period of fundamental importance for an adequate oncological therapy. The principal goal of any intervention in the elderly oncological patient should certainly be an improvement of the quality of life, including an alleviation of the impact of the diagnostic and therapeutic procedures on it.

  4. Abstracts to be Delivered at the 2014 Annual Conference of the Association of Medical Microbiology and Infectious Disease Canada, April 3 to 5, Victoria, British Columbia, Alphabetized According to the Surname of the First Author. Full-text Abstracts Can be Accessed at www.pulsus.com

    Directory of Open Access Journals (Sweden)

    2014-01-01

    Full Text Available This document presents the titles of the abstracts to be presented at the 2014 Annual Conference of the Association of Medical Microbiology and Infectious Disease Canada (April 3 to 5, Victoria, British Columbia. The full-text abstracts are available online.

  5. Nurses’ Burnout in Oncology Hospital Critical Care Unit

    OpenAIRE

    Yeliz İrem Tunçel; Menşure Kaya; Rukiye Neslihan Kuru; Saadet Menteş; Süheyla Ünver

    2014-01-01

    Objective: Burnout is common in intensive care units (ICU) because of high demands and difficult working conditions. The aim of this study was to analyse nurses’ burnout in our oncology ICU and to determine which factors are associated with. Material and Method: The study was carried out in Ankara Oncology Hospital ICU. A self- reporting questionnaire in an envelope was used for the evaluation of burnout (Turkish- language version of Maslach Burnout Inventory) and depression (Beck Depressi...

  6. The British Monarchy On Screen

    OpenAIRE

    Merck, Mandy

    2016-01-01

    Moving images of the British monarchy, in fact and fiction, are almost as old as the moving image itself, dating back to an 1895 American drama, The Execution of Mary Queen of Scots. British monarchs even appeared in the new ‘animated photography’ from 1896, led by Queen Victoria. Half a century later, the 1953 coronation of Elizabeth II was a milestone in the adoption of television, watched by 20 million Britons and 100 million North Americans. At the century’s end, Princess Diana’s funeral ...

  7. A Survey of Nursing Home Organizational Characteristics Associated with Potentially Avoidable Hospital Transfers and Care Quality in One Large British Columbia Health Region

    Science.gov (United States)

    McGregor, Margaret J.; Baumbusch, Jennifer; Abu-Laban, Riyad B.; McGrail, Kimberlyn M.; Andrusiek, Dug; Globerman, Judith; Berg, Shannon; Cox, Michelle B.; Salomons, Kia; Volker, Jan; Ronald, Lisa

    2011-01-01

    Hospitalization of nursing home residents can be futile as well as costly, and now evidence indicates that treating nursing home residents in place produces better outcomes for some conditions. We examined facility organizational characteristics that previous research showed are associated with potentially avoidable hospital transfers and with…

  8. Association of Mediterranean diet and other health behaviours with barriers to healthy eating and perceived health among British adults of retirement age.

    Science.gov (United States)

    Lara, Jose; McCrum, Leigh-Ann; Mathers, John C

    2014-11-01

    Health behaviours including diet, smoking, alcohol consumption, and physical activity, predict health risks at the population level. We explored health behaviours, barriers to healthy eating and self-rated health among individuals of retirement age. Study design 82 men and 124 women participated in an observational, cross-sectional online survey. Main outcome measures A 14-item Mediterranean diet score (MDPS), perceived barriers to healthy eating (PBHE), self-reported smoking, physical activity habits, and current and prior perceived health status (PHS) were assessed. A health behaviours score (HBS) including smoking, physical activity, body mass index (BMI) and MDPS was created to evaluate associations with PHS. Two-step cluster analysis identified natural groups based on PBHE. Analysis of variance was used to evaluate between group comparisons. PBHE number was associated with BMI (r=0.28, Pbad/fair, good, and very good, reported mean HBS of 2.0, 2.4 and 3.0, respectively (P<0.001). Compared with the previous year, no significant associations between PHS and HBS were observed. PBHE clusters were associated with BMI, MDPS and PHS and could be a useful tool to tailor interventions for those of peri-retirement age. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  9. Molecular radio-oncology

    Energy Technology Data Exchange (ETDEWEB)

    Baumann, Michael; Krause, Mechthild; Cordes, Nils (eds.) [Technische Univ. Dresden (Germany). Faculty of Medicine and University Hospital

    2016-07-01

    This book concisely reviews our current understanding of hypoxia, molecular targeting, DNA repair, cancer stem cells, and tumor pathophysiology, while also discussing novel strategies for putting these findings into practice in daily clinical routine. Radiotherapy is an important part of modern multimodal cancer treatment, and the past several years have witnessed not only substantial improvements in radiation techniques and the use of new beam qualities, but also major strides in our understanding of molecular tumor biology and tumor radiation response. Against this backdrop, the book highlights recent efforts to identify reasonable and clinically applicable biomarkers using broad-spectrum tissue microarrays and high-throughput systems biology approaches like genomics and epigenomics. In particular, it describes in detail how such molecular information is now being exploited for diagnostic imaging and imaging throughout treatment using the example of positron emission tomography. By discussing all these issues in the context of modern radiation oncology, the book provides a broad, up-to-date overview of the molecular aspects of radiation oncology that will hopefully foster its further optimization.

  10. Oncology in Cambodia.

    Science.gov (United States)

    Eav, S; Schraub, S; Dufour, P; Taisant, D; Ra, C; Bunda, P

    2012-01-01

    Cambodia, a country of 14 million inhabitants, was devastated during the Khmer Rouge period and thereafter. The resources of treatment are rare: only one radiotherapy department, renovated in 2003, with an old cobalt machine; few surgeons trained to operate on cancer patients; no hematology; no facilities to use intensive chemotherapy; no nuclear medicine department and no palliative care unit. Cervical cancer incidence is one of the highest in the world, while in men liver cancer ranks first (20% of all male cancers). Cancers are seen at stage 3 or 4 for 70% of patients. There is no prevention program - only a vaccination program against hepatitis B for newborns - and no screening program for cervical cancer or breast cancer. In 2010, oncology, recognized as a full specialty, was created to train the future oncologists on site at the University of Phnom Penh. A new National Cancer Center will be built in 2013 with modern facilities for radiotherapy, medical oncology, hematology and nuclear medicine. Cooperation with foreign countries, especially France, and international organizations has been established and is ongoing. Progress is occurring slowly due to the shortage of money for Cambodian institutions and the lay public. Copyright © 2012 S. Karger AG, Basel.

  11. What makes oncology nursing special? Walking the road together.

    Science.gov (United States)

    Haberman, M R; Germino, B B; Maliski, S; Stafford-Fox, V; Rice, K

    1994-09-01

    To identify the factors that influence oncology nurses' decisions to enter nursing and specialize in oncology and to describe the role dimensions of oncology nursing practice. Multi-institutional, descriptive, qualitative. Six sites in different regions of the United States; rural and urban cancer and noncancer centers. 38 oncology nurses (mean age = 35 years; average time in nursing = 10 years and in oncology = 7 years; 47% bachelor's degree in nursing, 29% diploma, 13% associate degree in nursing, and 11% master's prepared). Phenomenological; content analysis of interviews. Life events, career decision-making, personal and professional rewards, role dimensions of practice, caring behaviors. Nurses said that their decisions to specialize in oncology were based on family experiences with cancer, the challenges of administering sophisticated cancer therapies, and influential role models. They reported that professional rewards are derived from valuing each patients as a 'whole person' and providing family-centered care. Nurses find that personal rewards and career survivorship are embedded in several ongoing discoveries: work offers a unique laboratory for learning about life in general, distancing maneuvers are necessary for self-preservation, and the fuzzy boundary between work and personal life must be constantly renegotiated. Oncology nurses find the best in the worst of situations, live fully the cancer experience by embracing their patients' heartaches and triumphs, share a collective sense of pride in their specialty, and report a high level of job satisfaction. Caring for the dying person with cancer is the most difficult aspect of oncology nursing practice and being with--being present in the moment, no matter what the outcome--is the most rewarding and ubiquitous caring behavior of oncology nurses.

  12. Biosimilars: Considerations for Oncology Nurses
.

    Science.gov (United States)

    Vizgirda, Vida; Jacobs, Ira

    2017-04-01

    Biosimilars are developed to be highly similar to and treat the same conditions as licensed biologics. As they are approved and their use becomes more widespread, oncology nurses should be aware of their development and unique considerations. This article reviews properties of biosimilars; their regulation and approval process; the ways in which their quality, safety, and efficacy are evaluated; their postmarketing safety monitoring; and their significance to oncology nurses and oncology nursing.
. A search of PubMed and regulatory agency websites was conducted for references related to the development and use of biosimilars in oncology. 
. Because biologics are large, structurally complex molecules, biosimilars cannot be considered generic equivalents to licensed biologic products. Consequently, regulatory approval for biosimilars is different from approval for small-molecule generics. Oncology nurses are in a unique position to educate themselves, other clinicians, and patients and their families about biosimilars to ensure accurate understanding, as well as optimal and safe use, of biosimilars.

  13. Why do thin people have elevated all-cause mortality? Evidence on confounding and reverse causality in the association of adiposity and COPD from the British Women's Heart and Health Study.

    Science.gov (United States)

    Dale, Caroline; Nüesch, Eveline; Prieto-Merino, David; Choi, Minkyoung; Amuzu, Antoinette; Ebrahim, Shah; Casas, Juan P; Davey-Smith, George

    2015-01-01

    Low adiposity has been linked to elevated mortality from several causes including respiratory disease. However, this could arise from confounding or reverse causality. We explore the association between two measures of adiposity (BMI and WHR) with COPD in the British Women's Heart and Health Study including a detailed assessment of the potential for confounding and reverse causality for each adiposity measure. Low BMI was found to be associated with increased COPD risk while low WHR was not (OR = 2.2; 95% CI 1.3-3.1 versus OR = 1.2; 95% CI 0.7-1.6). Potential confounding variables (e.g. smoking) and markers of ill-health (e.g. unintentional weight loss) were found to be higher in low BMI but not in low WHR. Women with low BMI have a detrimental profile across a broad range of health markers compared to women with low WHR, and women with low WHR do not appear to have an elevated COPD risk, lending support to the hypothesis that WHR is a less confounded measure of adiposity than BMI. Low adiposity does not in itself appear to increase the risk of respiratory disease, and the apparent adverse consequences of low BMI may be due to reverse causation and confounding.

  14. Why Do Thin People Have Elevated All-Cause Mortality? Evidence on Confounding and Reverse Causality in the Association of Adiposity and COPD from the British Women’s Heart and Health Study

    Science.gov (United States)

    Dale, Caroline; Nüesch, Eveline; Prieto-Merino, David; Choi, Minkyoung; Amuzu, Antoinette; Ebrahim, Shah; Casas, Juan P.; Davey-Smith, George

    2015-01-01

    Low adiposity has been linked to elevated mortality from several causes including respiratory disease. However, this could arise from confounding or reverse causality. We explore the association between two measures of adiposity (BMI and WHR) with COPD in the British Women’s Heart and Health Study including a detailed assessment of the potential for confounding and reverse causality for each adiposity measure. Low BMI was found to be associated with increased COPD risk while low WHR was not (OR = 2.2; 95% CI 1.3 – 3.1 versus OR = 1.2; 95% CI 0.7 – 1.6). Potential confounding variables (e.g. smoking) and markers of ill-health (e.g. unintentional weight loss) were found to be higher in low BMI but not in low WHR. Women with low BMI have a detrimental profile across a broad range of health markers compared to women with low WHR, and women with low WHR do not appear to have an elevated COPD risk, lending support to the hypothesis that WHR is a less confounded measure of adiposity than BMI. Low adiposity does not in itself appear to increase the risk of respiratory disease, and the apparent adverse consequences of low BMI may be due to reverse causation and confounding. PMID:25884834

  15. Associations of specific types of sports and exercise with all-cause and cardiovascular-disease mortality: a cohort study of 80 306 British adults.

    Science.gov (United States)

    Oja, Pekka; Kelly, Paul; Pedisic, Zeljko; Titze, Sylvia; Bauman, Adrian; Foster, Charlie; Hamer, Mark; Hillsdon, Melvyn; Stamatakis, Emmanuel

    2017-05-01

    Evidence for the long-term health effects of specific sport disciplines is scarce. Therefore, we examined the associations of six different types of sport/exercise with all-cause and cardiovascular disease (CVD) mortality risk in a large pooled Scottish and English population-based cohort. Cox proportional hazards regression was used to investigate the associations between each exposure and all-cause and CVD mortality with adjustment for potential confounders in 80 306 individuals (54% women; mean±SD age: 52±14 years). Significant reductions in all-cause mortality were observed for participation in cycling (HR=0.85, 95% CI 0.76 to 0.95), swimming (HR=0.72, 95% CI 0.65 to 0.80), racquet sports (HR=0.53, 95% CI 0.40 to 0.69) and aerobics (HR=0.73, 95% CI 0.63 to 0.85). No significant associations were found for participation in football and running. A significant reduction in CVD mortality was observed for participation in swimming (HR=0.59, 95% CI 0.46 to 0.75), racquet sports (HR=0.44, 95% CI 0.24 to 0.83) and aerobics (HR=0.64, 95% CI 0.45 to 0.92), but there were no significant associations for cycling, running and football. Variable dose-response patterns between the exposure and the outcomes were found across the sport disciplines. These findings demonstrate that participation in specific sports may have significant benefits for public health. Future research should aim to further strengthen the sport-specific epidemiological evidence base and understanding of how to promote greater sports participation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  16. Role of lifetime body mass index in the association between age at puberty and adult lipids: findings from men and women in a British birth cohort.

    Science.gov (United States)

    Pierce, Mary B; Kuh, Diana; Hardy, Rebecca

    2010-09-01

    Why early puberty is associated with worse cardiovascular outcomes is unknown. The relationship between puberty and lipids is unclear. Our aim was to assess whether age at puberty was associated with triglyceride and total low-density lipoprotein and high-density lipoprotein cholesterol at age 53 years. Participants in a national birth cohort were examined at 15 years, when pubertal stage for boys was assessed and age at menarche reported by the girls' mothers. At 53 years, 3035 were interviewed in their homes by research nurses, where blood was taken. There was a significant inverse relationship in women but not men between age at puberty (in years) and triglycerides (regression coefficient -0.2.9, 95% confidence interval -5.5, to -0.04, p = .02), age at puberty, and age at puberty and adult body mass index (BMI; p puberty and lipids were completely explained by BMI or waist circumference at 53 years. In both sexes earlier maturation was associated with greater BMI and waist circumference in later life, which resulted in greater triglycerides and cholesterol in women. We suggest that intervention after puberty to help avoid obesity in early maturing women may improve their later cardiovascular health. Copyright 2010 Elsevier Inc. All rights reserved.

  17. Impact of alcohol-impregnated port protectors and needleless neutral pressure connectors on central line-associated bloodstream infections and contamination of blood cultures in an inpatient oncology unit.

    Science.gov (United States)

    Sweet, Michael A; Cumpston, Aaron; Briggs, Frank; Craig, Michael; Hamadani, Mehdi

    2012-12-01

    A major risk factor for the development of bloodstream infection is the presence of a central venous catheter (CVC), especially in immunocompromised patients. CVC hub contamination is a risk factor for central line-associated bloodstream infection (CLABSI). This observational before-after trial in a tertiary care hospital's oncology unit included adult patients with a CVC. During the intervention period, the practice of central line hub care was changed from cleaning with alcohol wipes to using alcohol-impregnated port protectors. To accommodate the protectors, the needless hubs were changed to a neutral pressure connector. The intervention period (January-July 2010) was compared with a historical control (January-December 2009). A total of 3,005 central line-days and 1 CLABSI (a rate of 0.3 infections/1,000 central line-days) were documented during the intervention period, compared with 6,851 central line-days and 16 CLABSIs (2.3 infections/1,000 central line-days) during the control period (relative risk, 0.14; 95% confidence interval [CI], 0.02-1.07; P = .03). The rate of contaminated blood cultures (CBCs) from central lines was 2.5% (17 of 692) during the control period, but only 0.2% (1 of 470) during the intervention period (relative risk, 0.09; 95% CI, 0.01-0.65; P = .002). The implementation of alcohol-impregnated port protectors and needleless neutral pressure connectors significantly reduced the rates of CLABSIs and CBCs in our oncology patient population. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  18. Young British Art / Hanno Soans

    Index Scriptorium Estoniae

    Soans, Hanno, 1974-

    2001-01-01

    1990ndate kunsti muutumisest. Inglise kunstniku Peter Daviese maalist "Kuum esimene sada" (1996), Gavin Turki vahakujuna valminud autoportreest "Pop". "Young British Art'i" uuskunstist ja Jasper Zoova installatsioonist "F1". Eri analüüsivõimalusi pakkuvatest töödest (Marko Laimre & Ene-Liis Semperi 2000. a. novembri ühisnäituse osa töid).

  19. Medical slang in British hospitals.

    Science.gov (United States)

    Fox, Adam T; Fertleman, Michael; Cahill, Pauline; Palmer, Roger D

    2003-01-01

    The usage, derivation, and psychological, ethical, and legal aspects of slang terminology in medicine are discussed. The colloquial vocabulary is further described and a comprehensive glossary of common UK terms provided in appendix. This forms the first list of slang terms currently in use throughout the British medical establishment.

  20. Influence of maternal and paternal IQ on offspring health and health behaviours: evidence for some trans-generational associations using the 1958 British birth cohort study.

    Science.gov (United States)

    Whitley, E; Gale, C R; Deary, I J; Kivimaki, M; Singh-Manoux, A; Batty, G D

    2013-05-01

    Individuals scoring poorly on tests of intelligence (IQ) have been reported as having increased risk of morbidity, premature mortality, and risk factors such as obesity, high blood pressure, poor diet, alcohol and cigarette consumption. Very little is known about the impact of parental IQ on the health and health behaviours of their offspring. We explored associations of maternal and paternal IQ scores with offspring television viewing, injuries, hospitalisations, long standing illness, height and BMI at ages 4 to 18 using data from the National Child Development Study (1958 birth cohort). Data were available for 1446 mother-offspring and 822 father-offspring pairs. After adjusting for potential confounding/mediating factors, the children of higher IQ parents were less likely to watch TV (odds ratio (95% confidence interval) for watching 3+ vs. less than 3hours per week associated with a standard deviation increase in maternal or paternal IQ: 0.75 (0.64, 0.88) or 0.78 (0.64, 0.95) respectively) and less likely to have one or more injuries requiring hospitalisation (0.77 (0.66, 0.90) or 0.72 (0.56, 0.91) respectively for maternal or paternal IQ). Children whose parents have low IQ scores may have poorer selected health and health behaviours. Health education might usefully be targeted at these families. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  1. Associations between Familial Factor, Trait Conscientiousness, Gender and the Occurrence of Type 2 Diabetes in Adulthood: Evidence from a British Cohort.

    Directory of Open Access Journals (Sweden)

    Helen Cheng

    Full Text Available To investigate social, familial, and psychological factors in influencing the occurrence of type 2 diabetes in adulthood.Some 17,415 babies born in Great Britain in 1958 and followed up at 7, 11, 33, and 50 years of age. The prevalence of type 2 diabetes at age 50 years was the outcome measure.Some 5,032 participants with data on parental social class, childhood cognitive ability tests scores at age 11 years, educational qualifications at age 33 years, personality traits, occupational levels, and type 2 diabetes (all measured at age 50 years were included in the study. Available information also included whether cohort members' parents or siblings had diabetes. Using logistic regression analyses, results showed that sex (OR=0.63: 0.42-0.92, p<.05, family history (OR=3.40: 1.76-6.55, p<.01, and trait conscientiousness (OR=0.76: 0.64-0.90, p<.001 were all significantly and independently associated with the occurrence of type 2 diabetes in adulthood. It appears that the occurrence of type 2 diabetes is greater among men than women (4.3% vs 2.5%.Familial (genetic and non-genetic and psychological factors are significantly associated with the prevalence of type 2 diabetes in adulthood.

  2. Negative emotions and alcohol dependence symptoms in British Indian and White college students.

    Science.gov (United States)

    Brar, Amandip; Moneta, Giovanni B

    2009-03-01

    This study investigated cross-cultural differences in the association between negative emotions and alcohol dependence symptoms in British Indian and White college students. Based on a study of levels of alcohol consumption (Spada & Moneta, 2004), it was hypothesized that the association between negative emotions and alcohol dependence symptoms would be present only in British White students. A sample of 150 British Indian students and 150 British White students completed the Alcohol Use Disorders Identification Test (AUDIT) and the Hospital Anxiety and Depression Scale (HADS). Structural regression modeling indicated that negative emotions predict higher levels of alcohol dependence symptoms in British White students, and do not predict alcohol dependence symptoms in British Indian students. The implications of the findings are discussed.

  3. Multicriteria decision analysis in oncology.

    Science.gov (United States)

    Adunlin, Georges; Diaby, Vakaramoko; Montero, Alberto J; Xiao, Hong

    2015-12-01

    There has been a growing interest in the development and application of alternative decision-making frameworks within health care, including multicriteria decision analysis (MCDA). Even though the literature includes several reviews on MCDA methods, applications of MCDA in oncology are lacking. The aim of this paper is to discuss a rationale for the use of MCDA in oncology. In this context, the following research question emerged: How can MCDA be used to develop a clinical decision support tool in oncology? In this paper, a brief background on decision making is presented, followed by an overview of MCDA methods and process. The paper discusses some applications of MCDA, proposes research opportunities in the context of oncology and presents an illustrative example of how MCDA can be applied to oncology. Decisions in oncology involve trade-offs between possible benefits and harms. MCDA can help analyse trade-off preferences. A wide range of MCDA methods exist. Each method has its strengths and weaknesses. Choosing the appropriate method varies depending on the source and nature of information used to inform decision making. The literature review identified eight studies. The analytical hierarchy process (AHP) was the most often used method in the identified studies. Overall, MCDA appears to be a promising tool that can be used to assist clinical decision making in oncology. Nonetheless, field testing is desirable before MCDA becomes an established decision-making tool in this field. © 2014 John Wiley & Sons Ltd.

  4. Mathematical oncology 2013

    CERN Document Server

    Gandolfi, Alberto

    2014-01-01

    With chapters on free boundaries, constitutive equations, stochastic dynamics, nonlinear diffusion–consumption, structured populations, and applications of optimal control theory, this volume presents the most significant recent results in the field of mathematical oncology. It highlights the work of world-class research teams, and explores how different researchers approach the same problem in various ways. Tumors are complex entities that present numerous challenges to the mathematical modeler. First and foremost, they grow. Thus their spatial mean field description involves a free boundary problem. Second, their interiors should be modeled as nontrivial porous media using constitutive equations. Third, at the end of anti-cancer therapy, a small number of malignant cells remain, making the post-treatment dynamics inherently stochastic. Fourth, the growth parameters of macroscopic tumors are non-constant, as are the parameters of anti-tumor therapies. Changes in these parameters may induce phenomena that a...

  5. Advances in oncologic imaging.

    Science.gov (United States)

    Towbin, Alexander J; Trout, Andrew T; Roebuck, Derek J

    2014-12-01

    Over the past two decades, there has been an increased reliance on radiologic imaging to diagnose and stage malignancies. This increased reliance on imaging has occurred because the quality of imaging has improved markedly. Currently, modalities such as MRI and CT allow the radiologist to obtain highly detailed images of the human body with a resolution of less than 1mm. More recently, researchers have shifted their focus from anatomic imaging to functional imaging. This burgeoning field of radiology strives to provide quantitative information regarding the behavior of tumors (or other pathology) to deliver patients and clinicians with prognostic information regarding the disease process. The purpose of this article is to describe the recent advances in pediatric oncologic imaging. Georg Thieme Verlag KG Stuttgart · New York.

  6. Chlamydial partner notification in the British Association for Sexual Health and HIV (BASHH) 2011 UK national audit against the BASHH Medical Foundation for AIDS and Sexual Health Sexually Transmitted Infections Management Standards.

    Science.gov (United States)

    McClean, H; Carne, C A; Sullivan, A K; Radcliffe, K W; Ahmed-Jushuf, I

    2012-10-01

    This paper reports on chlamydial partner notification (PN) performance in the 2011 BASHH national audit against the British Association for Sexual Health and HIV (BASHH) Medical Foundation for AIDS Sexual Health (MedFASH) Sexually Transmitted Infection Management Standards (STIMS). There was wide regional variation in level 3 clinic PN performance against the current standard of index case-reported chlamydial PN, with 43% (regional range 0-80%) of clinics outside London meeting the ≥0.6 contacts seen per index standard, and 85% of clinics (regional range 82-88%) in London meeting the ≥0.4 standard. For level 2 clinics, 39% (regional range 0-100%) of clinics outside London met the ≥0.6 standard, and 43% (regional range 40-50%) of clinics in London met the ≥0.4 standard. Performance for health-care worker (HCW)-verified contact attendance is also reported. New standards for each of these performance measures are proposed for all level 3 clinics: ≥0.6 contacts seen per index case based on index case report, and ≥0.4 contacts seen per index case based on HCW verification, both within four weeks of the first partner notification interview. The results are discussed with regard to the importance of adoption of standards by commissioners of services, relevance to national quality agendas, and the need for development of a national system of PN quality assurance measurement and reporting.

  7. UK national audit against the key performance indicators in the British Association for Sexual Health and HIV Medical Foundation for AIDS and Sexual Health Sexually Transmitted Infections Management Standards.

    Science.gov (United States)

    McClean, H; Sullivan, A K; Carne, C A; Warwick, Z; Menon-Johansson, A; Clutterbuck, D

    2012-10-01

    A national audit of practice performance against the key performance indicators in the British Association for Sexual Health and HIV (BASHH) and HIV Medical Foundation for AIDS Sexual Health Standards for the Management of Sexually Transmitted Infections (STIs) was conducted in 2011. Approximately 60% and 8% of level 3 and level 2 services, respectively, participated. Excluding partner notification performance, the five lowest areas of performance for level 3 clinics were the STI/HIV risk assessment, care pathways linking care in level 2 clinics to local level 3 services, HIV test offer to patients with concern about STIs, information governance and receipt of chlamydial test results by clinicians within seven working days (the worst area of performance). The five lowest areas of performance for level 2 clinics were participating in audit, having an audit plan for the management of STIs for 2009-2010, the STI/HIV risk assessment, HIV test offer to patients with concern about STIs and information governance. The results are discussed with regard to the importance of adoption of the standards by commissioners of services because of their relevance to other national quality assurance drivers, and the need for development of a national system of STI management quality assurance measurement and reporting.

  8. Global curriculum in surgical oncology.

    Science.gov (United States)

    Are, C; Berman, R S; Wyld, L; Cummings, C; Lecoq, C; Audisio, R A

    2016-06-01

    The significant global variations in surgical oncology training paradigms can have a detrimental effect on tackling the rising global cancer burden. While some variations in training are essential to account for the differences in types of cancer and biology, the fundamental principles of providing care to a cancer patient remain the same. The development of a global curriculum in surgical oncology with incorporated essential standards could be very useful in building an adequately trained surgical oncology workforce, which in turn could help in tackling the rising global cancer burden. The leaders of the Society of Surgical Oncology and European Society of Surgical Oncology convened a global curriculum committee to develop a global curriculum in surgical oncology. A global curriculum in surgical oncology was developed to incorporate the required domains considered to be essential in training a surgical oncologist. The curriculum was constructed in a modular fashion to permit flexibility to suit the needs of the different regions of the world. Similarly, recognizing the various sociocultural, financial and cultural influences across the world, the proposed curriculum is aspirational and not mandatory in intent. A global curriculum was developed which may be considered as a foundational scaffolding for training surgical oncologists worldwide. It is envisioned that this initial global curriculum will provide a flexible and modular scaffolding that can be tailored by individual countries or regions to train surgical oncologists in a way that is appropriate for practice in their local environment. Copyright © 2016 Society of Surgical Oncology, European Society of Surgical Oncology. Published by Elsevier Ltd.. All rights reserved.

  9. Improving patient safety in radiation oncology.

    Science.gov (United States)

    Hendee, William R; Herman, Michael G

    2011-01-01

    Beginning in the 1990s, and emphasized in 2000 with the release of an Institute of Medicine report, healthcare providers and institutions have dedicated time and resources to reducing errors that impact the safety and well-being of patients. But in January 2010 the first of a series of articles appeared in the New York Times that described errors in radiation oncology that grievously impacted patients. In response, the American Association of Physicists in Medicine and the American Society of Radiation Oncology sponsored a working meeting entitled "Safety in Radiation Therapy: A Call to Action." The meeting attracted 400 attendees, including medical physicists, radiation oncologists, medical dosimetrists, radiation therapists, hospital administrators, regulators, and representatives of equipment manufacturers. The meeting was cohosted by 14 organizations in the United States and Canada. The meeting yielded 20 recommendations that provide a pathway to reducing errors and improving patient safety in radiation therapy facilities everywhere.

  10. A system of tele-oncology at the University of Wisconsin Hospital and Clinics and regional oncology affiliate institutions.

    Science.gov (United States)

    Stitt, J A

    1998-01-01

    Collaborative associations between academic medical centers and community hospitals can use telemedicine to promote and enhance cancer treatment and clinical research. It is expensive to duplicate communications technology at all sites, but it is possible to share technologies using telemedicine. This paper describes a system in evolution that provides regional oncology services at the University of Wisconsin Hospital and Clinics and regional oncology affiliates. The system requires integrated hardware and software to provide Internet access, videoconferencing, and data transmission. This system is comprised of several forms of technology that promote education and training, continuing medical education, patient evaluation and protocol eligibility, data transfer for radiation therapy treatment planning, and clinical and technologic quality assurance and peer review programs for medical oncology and radiation oncology.

  11. Global Health in Radiation Oncology

    DEFF Research Database (Denmark)

    Rodin, Danielle; Yap, Mei Ling; Grover, Surbhi

    2017-01-01

    programs. However, formalized training and career promotion tracks in global health within radiation oncology have been slow to emerge, thereby limiting the sustained involvement of students and faculty, and restricting opportunities for leadership in this space. We examine here potential structures...... and benefits of formalized global health training in radiation oncology. We explore how defining specific competencies in this area can help trainees and practitioners integrate their activities in global health within their existing roles as clinicians, educators, or scientists. This would also help create...... and funding models might be used to further develop and expand radiation oncology services globally....

  12. Screening for type 2 diabetes is feasible, acceptable, but associated with increased short-term anxiety: A randomised controlled trial in British general practice

    Directory of Open Access Journals (Sweden)

    Prevost A Toby

    2008-10-01

    Full Text Available Abstract Background To assess the feasibility and uptake of a diabetes screening programme; to examine the effects of invitation to diabetes screening on anxiety, self-rated health and illness perceptions. Methods Randomised controlled trial in two general practices in Cambridgeshire. Individuals aged 40–69 without known diabetes were identified as being at high risk of having undiagnosed type 2 diabetes using patient records and a validated risk score (n = 1,280. 355 individuals were randomised in a 2 to 1 ratio into non-invited (n = 238 and invited (n = 116 groups. A stepwise screening programme confirmed the presence or absence of diabetes. Six weeks after the last contact (either test or invitation, a questionnaire was sent to all participants, including non-attenders and those who were not originally invited. Outcome measures included attendance, anxiety (short-form Spielberger State Anxiety Inventory-STAI, self-rated health and diabetes illness perceptions. Results 95 people (82% of those invited attended for the initial capillary blood test. Six individuals were diagnosed with diabetes. Invited participants were more anxious than those not invited (37.6 vs. 34.1 STAI, p-value = 0.015, and those diagnosed with diabetes were considerably more anxious than those classified free of diabetes (46.7 vs. 37.0 STAI, p-value = 0.031. Non-attenders had a higher mean treatment control sub-scale (3.87 vs. 3.56, p-value = 0.016 and a lower mean emotional representation sub-scale (1.81 vs. 2.68, p-value = 0.001 than attenders. No differences in the other five illness perception sub-scales or self-rated health were found. Conclusion Screening for type 2 diabetes in primary care is feasible but may be associated with higher levels of short-term anxiety among invited compared with non-invited participants. Trial registration ISRCTN99175498

  13. Association of British Clinical Diabetologists (ABCD): survey of specialist diabetes care services in the UK, 2000. 3. Podiatry services and related foot care issues.

    Science.gov (United States)

    Winocour, P H; Morgan, J; Ainsworth, A; Williams, D R R

    2002-07-01

    To examine the provision of, and variations in, podiatry and other services for diabetic foot care in the UK. A postal survey of secondary care providers of diabetes services in the UK in 2000. Following two reminders a 77% response rate was achieved. The responses indicated that 97% had a state-registered podiatrist attached to the service, providing three (median) sessions each week for diabetes care, although only 44% had availability at all diabetic clinics, and only 3% had availability at paediatric diabetic services. Podiatry access at all diabetic clinics increased the likelihood of associated preventative as opposed to reactive ('trouble shooting') care (P podiatry input to patient education was common (84%), only 6% had received formal training in education. Guidelines and strategies for management of active foot problems were available in 50-74% of cases. Orthotic input was highly variable, and absent in 15% of responses. Podiatrist fitting and application of foot protective apparatus was only recorded in 22-61% of responses. Access to isotopic and/or MR foot imaging and peripheral angiography and angioplasty was recorded in 75-83% of responses. Separate specialist foot clinics were available in 49%, and where this was the case the use of newer foot ulcer healing applications was higher (P podiatry support to diabetes care over the last 10 years, the level of access and the nature of the services provided is much less than recommended in many advisory documents. The strategy of a co-ordinated 'team' approach to foot care still takes place in less than 50% of centres. There are clear regional differences in diabetes foot care services. Both providers and purchasers of diabetes services may not have given sufficient attention to this area, given the relatively small number of documented bids for service improvements in this area, and the very low success rate of such bids.

  14. Capecitabine-Associated Loss of Fingerprints: Report of Capecitabine-Induced Adermatoglyphia in Two Women with Breast Cancer and Review of Acquired Dermatoglyphic Absence in Oncology Patients Treated with Capecitabine.

    Science.gov (United States)

    Cohen, Philip R

    2017-01-09

    Capecitabine, an oral 5-fluorouracil prodrug, is currently used in the treatment of metastatic colorectal carcinoma and breast cancer. Fingerprints, also referred to as dermatoglyphics and characterized by the pattern of ridges and furrows on the fingertips, are used for identification by government agencies and personal electronic devices. Two women with breast cancer who were treated with capecitabine and developed drug-associated loss of their fingerprints are described. PubMed was used to search the following terms separately and in combination: absence, adermatoglyphia, breast, cancer, capecitabine, carcinoma, colon, colorectal, dermatoglyphics, fingerprint, fluorouracil, foot, hand, loss, malignancy, nasopharyngeal, oncology, reaction, rectal, skin, syndrome, tumor, and xeloda. The papers identified were reviewed and appropriate references were evaluated. The characteristics of capecitabine-induced adermatoglyphia in 20 oncology patients are reviewed. Most of the patients received either 2000 mg/m(2) or 3500 mg, in divided doses, each day. Hand-foot syndrome, varying in severity from grade 1 to grade 4, always preceded the onset of fingerprint loss. The discovery of adermatoglyphia occurred as early as two weeks to as late as 3½ years after starting capecitabine. Patients were often unaware of their fingerprint loss until they experienced delays attempting to enter the United States, were unable to process government documents or obtain a driver's license, or could not obtain access to their telephone, computer or gym which required fingerprint identification scanning. The loss of fingerprints was reversible for some of the individuals; however, several of the patients did not recover their dermatoglyphics, the functional quality of their fingerprints, or both after discontinuing the drug. The significance of capecitabine-induced adermatoglyphia will continue to increase as fingerprint identification continues to advance not only in scanning technology

  15. [Oncologic gynecology and the Internet].

    Science.gov (United States)

    Gizler, Robert; Bielanów, Tomasz; Kulikiewicz, Krzysztof

    2002-11-01

    The strategy of World Wide Web searching for medical sites was presented in this article. The "deep web" and "surface web" resources were searched. The 10 best sites connected with the gynecological oncology, according to authors' opinion, were presented.

  16. Exercise Promotion in Geriatric Oncology.

    Science.gov (United States)

    Burhenn, Peggy S; Bryant, Ashley Leak; Mustian, Karen M

    2016-09-01

    Evidence of the benefits of exercise for people with cancer from diagnosis through survivorship is growing. However, most cancers occur in older adults and little exercise advice is available for making specific recommendations for older adults with cancer. Individualized exercise prescriptions are safe, feasible, and beneficial for the geriatric oncology population. Oncology providers must be equipped to discuss the short- and long-term benefits of exercise and assist older patients in obtaining appropriate exercise prescriptions. This review provides detailed information about professionals and their roles as it relates to functional assessment, intervention, and evaluation of the geriatric oncology population. This review addresses the importance of functional status assessment and appropriate referrals to other oncology professionals.

  17. Creating opportunities to support oncology nursing practice: surviving and thriving.

    Science.gov (United States)

    Rashleigh, Laura; Cordon, Charissa; Wong, Jiahui

    2011-01-01

    There is a growing body of evidence to support that specialization in nursing leads to improved outcomes for patients, including increased QOL, improved symptom management, and fewer hospital admissions. Oncology nurses face several challenges in pursuing specialization, due to individual and system issues such as limited time and resources. To address these challenges, de Souza Institute launched a province-wide study group for nurses in Ontario who planned to write the Canadian Nurses Association (CNA) Oncology Certification Exam. The study group was led by educators from de Souza and Princess Margaret Hospital and drew expertise from nursing leaders across Ontario who shared the same vision of oncology nursing excellence. The study group was innovative by embracing telemedicine and web-based technology, which enabled flexibility for nurses' work schedules, learning styles, physical location and practice experience. The study group utilized several theoretical perspectives and frameworks to guide the curriculum: Adult Learning Theories, Cooperative Learning, Generational Learning Styles, CANO standards for practice and the CNA exam competencies. This approach enabled 107 oncology nurses across the province in 17 different sites to connect, as a group, study interactively and fully engage in their learning. A detailed evaluation method was utilized to assess baseline knowledge, learning needs, cooperative group process, exam success rates, and document unexpected outcomes. Ninety-four per cent of participants passed the CNA Oncology Exam. Lessons learned and future implications are discussed. The commitment remains to enable thriving through generating new possibilities, building communities of practice, mentoring nurses and fostering excellence in oncology practice.

  18. The association of the PON1 Q192R polymorphism with coronary heart disease: findings from the British Women's Heart and Health cohort study and a meta-analysis

    Directory of Open Access Journals (Sweden)

    Kiessling Matthew

    2004-06-01

    Full Text Available Abstract Background There have been inconsistent results from case-control studies assessing the association of the PON1 Q192R polymorphism with coronary heart disease (CHD. Most studies have included predominantly men and the association in women is unclear. Since lipid levels vary between the sexes the antioxidant effect of PON1 and any genes associated with it may also vary by sex. We have examined the association of the PON1 Q192R polymorphism with CHD in a large cohort of British women and combined the results from our cohort study with those from all other published studies. Results The distribution of genotypes was the same among women with CHD and those without disease. The odds ratio (95% confidence interval of having CHD comparing those with either the QR or RR genotype to those with QQ genotype (dominant model of association was 1.03 (0.89, 1.21 and the per allele odds ratio was 0.98 (0.95, 1.01. In a meta-analysis of this and 38 other published studies (10,738 cases and 17,068 controls the pooled odds ratio for the dominant effect was 1.14 (1.08, 1.20 and for the per allele effect was 1.10 (1.06, 1.13. There was evidence of small study bias in the meta-analyses and the dominant effect among those studies with 500 or more cases was 1.05 (0.96, 1.15. Ethnicity and reporting of whether the genotyping was done blind to the participants clinical status also contributed to heterogeneity between studies, but there was no difference in effect between studies with 50% or more women compared to those with fewer women and no difference between studies of healthy populations compared to those at high risk (with diabetes, renal disease of familial hypercholesterolaemia. Conclusion There is no robust evidence that the PON1 Q192R polymorphism is associated with CHD risk in Caucasian women or men.

  19. Report of the Association of Coloproctology of Great Britain and Ireland/British Society of Gastroenterology Colorectal Polyp Working Group: the development of a complex colorectal polyp minimum dataset.

    Science.gov (United States)

    Chattree, A; Barbour, J A; Thomas-Gibson, S; Bhandari, P; Saunders, B P; Veitch, A M; Anderson, J; Rembacken, B J; Loughrey, M B; Pullan, R; Garrett, W V; Lewis, G; Dolwani, S; Rutter, M D

    2017-01-01

    The management of large non-pedunculated colorectal polyps (LNPCPs) is complex, with widespread variation in management and outcome, even amongst experienced clinicians. Variations in the assessment and decision-making processes are likely to be a major factor in this variability. The creation of a standardized minimum dataset to aid decision-making may therefore result in improved clinical management. An official working group of 13 multidisciplinary specialists was appointed by the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and the British Society of Gastroenterology (BSG) to develop a minimum dataset on LNPCPs. The literature review used to structure the ACPGBI/BSG guidelines for the management of LNPCPs was used by a steering subcommittee to identify various parameters pertaining to the decision-making processes in the assessment and management of LNPCPs. A modified Delphi consensus process was then used for voting on proposed parameters over multiple voting rounds with at least 80% agreement defined as consensus. The minimum dataset was used in a pilot process to ensure rigidity and usability. A 23-parameter minimum dataset with parameters relating to patient and lesion factors, including six parameters relating to image retrieval, was formulated over four rounds of voting with two pilot processes to test rigidity and usability. This paper describes the development of the first reported evidence-based and expert consensus minimum dataset for the management of LNPCPs. It is anticipated that this dataset will allow comprehensive and standardized lesion assessment to improve decision-making in the assessment and management of LNPCPs. Colorectal Disease © 2016 The Association of Coloproctology of Great Britain and Ireland.

  20. Larch sawfly in British Columbia

    Energy Technology Data Exchange (ETDEWEB)

    Unger, L.

    1992-01-01

    Summary of the history of infestations in British Columbia of the larch sawfly, first introduced into the province in 1930. Information is based on the Forest Insect and Diseases Survey records and data and preliminary observations on the impact of defoliation on growth of western larch. The report describes biology; history of outbreaks in western larch and tamarack; sampling, population assessments, and predictions; damage appraisal; and controls, including parasites, predators, and weather.

  1. A National Radiation Oncology Medical Student Clerkship Survey: Didactic Curricular Components Increase Confidence in Clinical Competency

    Energy Technology Data Exchange (ETDEWEB)

    Jagadeesan, Vikrant S. [Department of Radiation and Cellular Oncology, Pritzker School of Medicine, University of Chicago, Chicago, Illinois (United States); Raleigh, David R. [Department of Radiation Oncology, School of Medicine, University of California–San Francisco, San Francisco, California (United States); Koshy, Matthew; Howard, Andrew R.; Chmura, Steven J. [Department of Radiation and Cellular Oncology, Pritzker School of Medicine, University of Chicago, Chicago, Illinois (United States); Golden, Daniel W., E-mail: dgolden@radonc.uchicago.edu [Department of Radiation and Cellular Oncology, Pritzker School of Medicine, University of Chicago, Chicago, Illinois (United States)

    2014-01-01

    Purpose: Students applying to radiation oncology residency programs complete 1 or more radiation oncology clerkships. This study assesses student experiences and perspectives during radiation oncology clerkships. The impact of didactic components and number of clerkship experiences in relation to confidence in clinical competency and preparation to function as a first-year radiation oncology resident are evaluated. Methods and Materials: An anonymous, Internet-based survey was sent via direct e-mail to all applicants to a single radiation oncology residency program during the 2012-2013 academic year. The survey was composed of 3 main sections including questions regarding baseline demographic information and prior radiation oncology experience, rotation experiences, and ideal clerkship curriculum content. Results: The survey response rate was 37% (70 of 188). Respondents reported 191 unique clerkship experiences. Of the respondents, 27% (19 of 70) completed at least 1 clerkship with a didactic component geared towards their level of training. Completing a clerkship with a didactic component was significantly associated with a respondent's confidence to function as a first-year radiation oncology resident (Wilcoxon rank–sum P=.03). However, the total number of clerkships completed did not correlate with confidence to pursue radiation oncology as a specialty (Spearman ρ P=.48) or confidence to function as a first year resident (Spearman ρ P=.43). Conclusions: Based on responses to this survey, rotating students perceive that the majority of radiation oncology clerkships do not have formal didactic curricula. Survey respondents who completed a clerkship with a didactic curriculum reported feeling more prepared to function as a radiation oncology resident. However, completing an increasing number of clerkships does not appear to improve confidence in the decision to pursue radiation oncology as a career or to function as a radiation oncology resident. These

  2. A national radiation oncology medical student clerkship survey: Didactic curricular components increase confidence in clinical competency

    Science.gov (United States)

    Jagadeesan, Vikrant S.; Raleigh, David R.; Koshy, Matthew; Howard, Andrew R.; Chmura, Steven J.; Golden, Daniel W.

    2014-01-01

    Purpose/Objectives Students applying to radiation oncology residency programs complete one or more radiation oncology clerkships. This study assesses student experiences and perspectives during radiation oncology clerkships. The impact of didactic components and number of clerkship experiences in relation to confidence in clinical competency and preparation to function as a first year radiation oncology resident are evaluated. Methods and Materials An anonymous, internet-based survey was sent via direct e-mail to all applicants to a single radiation oncology residency program during the 2012–2013 academic year. The survey was composed of three main sections including questions regarding baseline demographic information and prior radiation oncology experience, rotation experiences, and ideal clerkship curriculum content. Results The survey response rate was 37% (70/188). Respondents reported 191 unique clerkship experiences. 27% of respondents (19/70) completed at least one clerkship with a didactic component geared towards their level of training. Completing a clerkship with a didactic component was significantly associated with a respondent’s confidence to function as a first- year radiation oncology resident (Wilcoxon rank-sum p = 0.03). However, the total number of clerkships completed did not correlate with confidence to pursue radiation oncology as a specialty (Spearman’s rho p = 0.48) or confidence to function as a first year resident (Spearman’s rho p = 0.43). Conclusions Based on responses to this survey, rotating students perceive that the majority of radiation oncology clerkships do not have formal didactic curricula. Survey respondents who completed a clerkship with a didactic curriculum reported feeling more prepared to function as a radiation oncology resident. However, completing an increasing number of clerkships does not appear to improve confidence in the decision to pursue radiation oncology as a career or to function as a radiation

  3. Oncology nurses awareness of drug interactions.

    Science.gov (United States)

    Karahan, Azize; Isik, Sevcan Avcı; Kav, Sultan; Abbasoglu, Aysel

    2015-01-01

    The aim of this study was to determine oncology nurses awareness of drug interactions. This descriptive study was conducted with nurses working in the oncology clinics who are a member of Oncology Nursing Association of Turkey. A total of 115 nurses (response rate %20) were responded to the online survey that consists of 28 questions. The mean age of the nurses was 33 ± 6.8. The majority of nurses work in university hospital (60%) as a clinical nurse (62.6%) and have a Bachelor Degree in Nursing (63.5%). The mean working years in oncology was 4 years. Half of them stated receiving information on drug interactions mostly through in-service education and courses/congresses in last 5 years. The majority of them (84.3%) indicated that they are considering the possibility of drug interactions when they are scheduling the medication administration time. More than half of the responders (59.1%) encountered drug interactions; however, few explored drug interactions with food, drinks, and nutritional supplements. Their practices to assess possibility of drug interactions were reviewing the drug prospectus (78.3%); consulting with their colleagues (58.3%) and searching on the available website (42.6%) and looking at the drug interaction (39.1%). More than half (65.2%) stated lack of any system to identify drug interactions in their workplace. Nearly half of them indicated to including the drug interaction into patient education mostly for food-drug (73.9%) and drug-drug (63.5%) interactions. Almost all indicated the needs for further education on drug interactions and suggested to have guideline/packet guide.

  4. Oncology nurses awareness of drug interactions

    Directory of Open Access Journals (Sweden)

    Azize Karahan

    2015-01-01

    Full Text Available Objective: The aim of this study was to determine oncology nurses awareness of drug interactions. Methods: This descriptive study was conducted with nurses working in the oncology clinics who are a member of Oncology Nursing Association of Turkey. A total of 115 nurses (response rate %20 were responded to the online survey that consists of 28 questions. Results: The mean age of the nurses was 33 ± 6.8. The majority of nurses work in university hospital (60% as a clinical nurse (62.6% and have a Bachelor Degree in Nursing (63.5%. The mean working years in oncology was 4 years. Half of them stated receiving information on drug interactions mostly through in-service education and courses/congresses in last 5 years. The majority of them (84.3% indicated that they are considering the possibility of drug interactions when they are scheduling the medication administration time. More than half of the responders (59.1% encountered drug interactions; however, few explored drug interactions with food, drinks, and nutritional supplements. Their practices to assess possibility of drug interactions were reviewing the drug prospectus (78.3%; consulting with their colleagues (58.3% and searching on the available website (42.6% and looking at the drug interaction (39.1%. More than half (65.2% stated lack of any system to identify drug interactions in their workplace. Nearly half of them indicated to including the drug interaction into patient education mostly for food-drug (73.9% and drug-drug (63.5% interactions. Conclusions: Almost all indicated the needs for further education on drug interactions and suggested to have guideline/packet guide.

  5. Micronutrients in Oncological Intervention.

    Science.gov (United States)

    Gröber, Uwe; Holzhauer, Peter; Kisters, Klaus; Holick, Michael F; Adamietz, Irenäus A

    2016-03-12

    Nutritional supplements are widely used among patients with cancer who perceive them to be anticancer and antitoxicity agents. Depending on the type of malignancy and the gender 30%-90% of the cancer patients supplement their diets with antioxidant and immuno-stabilizing micronutrients, such as selenium, vitamin C, and vitamin D, often without the knowledge of the treating physician. From the oncological viewpoint, there are justifiable concerns that dietary supplements decrease the effectiveness of chemotherapy and radiotherapy. Recent studies, however, have provided increasing evidence that treatment is tolerated better-with an increase in patient compliance and a lower rate of treatment discontinuations-when micronutrients, such as selenium, are added as appropriate to the patient's medication. Nutritional supplementation tailored to an individual's background diet, genetics, tumor histology, and treatments may yield benefits in subsets of patients. Clinicians should have an open dialogue with patients about nutritional supplements. Supplement advice needs to be individualized and come from a credible source, and it is best communicated by the physician.

  6. Micronutrients in Oncological Intervention

    Directory of Open Access Journals (Sweden)

    Uwe Gröber

    2016-03-01

    Full Text Available Nutritional supplements are widely used among patients with cancer who perceive them to be anticancer and antitoxicity agents. Depending on the type of malignancy and the gender 30%–90% of the cancer patients supplement their diets with antioxidant and immuno-stabilizing micronutrients, such as selenium, vitamin C, and vitamin D, often without the knowledge of the treating physician. From the oncological viewpoint, there are justifiable concerns that dietary supplements decrease the effectiveness of chemotherapy and radiotherapy. Recent studies, however, have provided increasing evidence that treatment is tolerated better—with an increase in patient compliance and a lower rate of treatment discontinuations—when micronutrients, such as selenium, are added as appropriate to the patient’s medication. Nutritional supplementation tailored to an individual’s background diet, genetics, tumor histology, and treatments may yield benefits in subsets of patients. Clinicians should have an open dialogue with patients about nutritional supplements. Supplement advice needs to be individualized and come from a credible source, and it is best communicated by the physician.

  7. [Economic limits in oncology].

    Science.gov (United States)

    Hellriegel, K P

    2000-12-01

    Economic aspects require consideration even in oncology. However, they have to be seen in context with open questions concerning especially the evaluation of therapeutic effectiveness, of methodology, and particularly of ethics. Medical procedures and achievements should primarily be measured against objective results, against effectiveness and benefits. Consequently, the suitability of diagnostic and therapeutic strategies has to be evaluated. Overall objective of medical achievements should be their optimalization, not their maximization. For a physician being aware of his responsibility, the optimal care for his patients always has highest priority. Medical guidelines for diagnosis, treatment and follow-up are the basis for effective and economic patient care. They have to undergo economic evaluation and permanent updating. For systematic collection, documentation and evaluation, the clinical register is the appropriate instrument. For the assessment of medical care, a continuous monitoring of its processes has to be established. The documentation of medical care processes should lead to sustainable cost reductions together with an optimalization of the quality of care.

  8. What impact has tendering had on trainees? Results of a national survey by British Association for Sexual Health and HIV Trainees' Collaborative for audit, research and quality improvement projects.

    Science.gov (United States)

    Wiggins, Helen; Hartley, Anna; Clarke, Emily; Foley, Elizabeth; Nandwani, Rak; Carlin, Elizabeth; Waters, Laura; Ahmed, Nadia

    2017-01-01

    In April 2013, local authorities gained responsibility for commissioning sexual health services in England. With many services going out to tender and resultant change in services or service provider, there is anecdotal evidence that this has impacted on the education, training and morale of genitourinary medicine (GUM) trainees. The aim of this study was to evaluate the impact of tendering on GUM trainees. An electronic survey designed by the British Association for Sexual Health and HIV Trainees' Collaborative for Audit, Research and Quality Improvement Projects (T-CARQ) was distributed to GUM trainees and newly appointed consultants. Eighty-two individuals responded (74% GUM trainees, 25% newly appointed consultants, 1% locum appointed for service). Sixty-three per cent (45/72) had experience of training within a service which was being tendered. Of these, 59% (24/41) felt their training was not considered during the tendering process and 20% (8/41) felt that it was. Forty-four per cent (18/41) felt adequately supported. Thirty per cent (12/40) reported active participation in the tendering process. On a scale of 0 (no impact) to 5 (major impact), the median score for impact of tendering on training was 2. The positive/negative impact of tendering on different training elements was rated: other than management experience the overall impact on all parameters was negative, namely morale, senior support and education. In conclusion, this survey describes the variable impact of service tendering on GUM training. Our recommendations for maintaining training standards despite tendering include actively involving trainees and education partners, inclusion of specialist GUM training in service specifications, development of guidance for commissioners and services for the management of GUM training within tendering.

  9. Dairy intake, blood pressure and incident hypertension in a general British population: the 1946 birth cohort

    NARCIS (Netherlands)

    Heraclides, A.; Mishra, G.D.; Hardy, R.J.; Geleijnse, J.M.; Black, S.; Prynne, C.J.; Kuh, D.; Soedamah-Muthu, S.S.

    2012-01-01

    Purpose: We aimed to examine the association between intake of different subgroups of dairy products and blood pressure and incident hypertension 10 years later, adjusting for confounding factors. Methods: We studied 1,750 British men and women from the 1946 British birth cohort from 1989 to 1999

  10. Guidelines for 18F-FDG PET and PET-CT imaging in paediatric oncology

    DEFF Research Database (Denmark)

    Stauss, J.; Franzius, C.; Pfluger, T.

    2008-01-01

    tomography ((18)F-FDG PET) in paediatric oncology. The Oncology Committee of the European Association of Nuclear Medicine (EANM) has published excellent procedure guidelines on tumour imaging with (18)F-FDG PET (Bombardieri et al., Eur J Nucl Med Mol Imaging 30:BP115-24, 2003). These guidelines, published...

  11. Nutrition in oncology: the case of micronutrients (review).

    Science.gov (United States)

    Ströhle, Alexander; Zänker, Kurt; Hahn, Andreas

    2010-10-01

    In the course of cancer disease, many oncological patients develop tumor-associated malnutrition characterized by an insufficient supply of macro- and micronutrients. The inadequate nutritional status and the cancer anorexia-cachexia syndrome related to it are clinically relevant, as the response to antineoplastic measures, such as radiation and chemotherapy, is diminished, their side effects aggravated and the patient's quality of life and prognosis negatively affected. Therefore, the supportive nutrition care of oncological patients is of central importance. In this context, vitamins, minerals and long-chain omega -3 fatty acids are becoming more and more relevant in oncology although the benefit of such supplements is discussed controversially. Starting from a description of the etiopathogenesis and the pathophysiological consequences of cancer-associated malnutrition, the present study provides an overview of the importance of micronutrients for oncological patients. In the case of reduced food intake and/or inappropriate food choice the use of a multi-vitamin-multimineral supplement administered in physiological doses, i.e. nutrient quantities approximately corresponding to the recommended daily allowances, can be generally recommended. However, to enhance postoperative wound healing, it seems that cancer patients require higher amounts of micronutrients than healthy individuals. Because vitamin D deficiency is highly prevalent in oncological patients, improvement of vitamin D status is of special interest.

  12. Geriatric Oncology Program Development and Gero-Oncology Nursing.

    Science.gov (United States)

    Lynch, Mary Pat; DeDonato, Dana Marcone; Kutney-Lee, Ann

    2016-02-01

    To provide a critical analysis of current approaches to the care of older adults with cancer, outline priority areas for geriatric oncology program development, and recommend strategies for improvement. Published articles and reports between 1999 and 2015. Providing an interdisciplinary model that incorporates a holistic geriatric assessment will ensure the delivery of patient-centered care that is responsive to the comprehensive needs of older patients. Nursing administrators and leaders have both an opportunity and responsibility to shape the future of geriatric oncology. Preparations include workforce development and the creation of programs that are designed to meet the complex needs of this population. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. The Future of Gero-Oncology Nursing.

    Science.gov (United States)

    Kagan, Sarah H

    2016-02-01

    To project the future of gero-oncology nursing as a distinct specialty, framed between analysis of current challenges and explication of prospective solutions. Peer-reviewed literature, policy directives, web-based resources, and author expertise. Oncology nursing faces several challenges in meeting the needs of older people living with cancer. Realigning cancer nursing education, practice, and research to match demographic and epidemiological realities mandates redesign. Viewing geriatric oncology as an optional sub-specialty limits oncology nursing, where older people represent the majority of oncology patients and cancer survivors. The future of gero-oncology nursing lies in transforming oncology nursing itself. Specific goals to achieve transformation of oncology nursing into gero-oncology nursing include assuring integrated foundational aging and cancer content across entry-level nursing curricula; assuring a gero-competent oncology nursing workforce with integrated continuing education; developing gero-oncology nurse specialists in advanced practice roles; and cultivating nurse leadership in geriatric oncology program development and administration along with expanding the scope and sophistication of gero-oncology nursing science. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. What do we measure in oncology PET?

    Energy Technology Data Exchange (ETDEWEB)

    Pak, Kyoung June; Kim, Seong Jang [Dept. of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan (Korea, Republic of)

    2017-09-15

    Positron emission tomography (PET) has come to the practice of oncology. It is known that {sup 18}F-fluorodeoxyglucose (FDG) PET is more sensitive for the assessment of treatment response than conventional imaging. In addition, PET has an advantage in the use of quantitative analysis of the study. Nowadays, various PET parameters are adopted in clinical settings. In addition, a wide range of factors has been known to be associated with FDG uptake. Therefore, there has been a need for standardization and harmonization of protocols and PET parameters. We will introduce PET parameters and discuss major issues in this review.

  15. Re: Long-Term Analysis of Oncological Outcomes after Laparoscopic Radical Cystectomy in Europe: Results from a Multicentre Study by the European Association of Urology (EAU Section of Uro-Technology

    Directory of Open Access Journals (Sweden)

    Simone Albisinni

    2015-06-01

    Full Text Available Open radical cystectomy (ORC is the gold standard treatment option for muscle-invasive urothelial carcinoma. However, evolution is still going on. Nowadays, there is a growing interest for laparoscopic (LRC and robotic-assisted radical cystectomy (RARC as well as in kidney and prostate procedures. In the European Urology Association (EAU guidelines, LRC or RARC are still accepted as investigational options. This remarkable study presented long-term oncological results after LRC. In this multicentric study, 503 patients were included with a mean age of 68 years and median follow-up of 50 months. In previous studies with LRC, patients were younger and with lower stage of disease which was accepted as a bias in reviews. Pathological stage distribution was about 1/3 for groups except pT4 (9%. Median number of retrieved lymph nodes was 14. Although extent of lymphadenectomy in this study was not same between centers and it should be a limitation; median number of nodes was acceptable according to the EAU guidelines (<10. Bricker technique was the most urinary diversion type in this study (69%. The most interesting part in this study was elevated complications. 60 patients (12% were re-operated within first 30 days. Minor complication rate was 36% (Clavien 1+2. Major complication rate was similar with ORC studies. Conversion rate was 3.4%. Overall positive surgical margin rate was 5.8% (29 patients while it was a little bit high in pT2b disease (3 of 29. This result should be questioned. It might be explained by ‘learning curve’. Techniques were not standardized between centers although experienced surgeons were in the study. This was one of the limitations of this study. Global recurrence-free survival (RFS, cancer-specific survival (CSS and overall survival (OS9 rates at five years were 66%, 75% and 62%, respectively. These results were comparable with open series in the literature. Lack of randomization is another limitation. All patients had a

  16. Basic oral care for hematology-oncology patients and hematopoietic stem cell transplantation recipients : a position paper from the joint task force of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) and the European Society for Blood and Marrow Transplantation (EBMT)

    NARCIS (Netherlands)

    Elad, Sharon; Raber-Durlacher, Judith E.; Brennan, Michael T.; Saunders, Deborah P.; Mank, Arno P.; Zadik, Yehuda; Quinn, Barry; Epstein, Joel B.; Blijlevens, Nicole M. A.; Waltimo, Tuomas; Passweg, Jakob R.; Correa, M. Elvira P.; Dahllof, Goran; Garming-Legert, Karin U. E.; Logan, Richard M.; Potting, Carin M. J.; Shapira, Michael Y.; Soga, Yoshihiko; Stringer, Jacqui; Stokman, Monique A.; Vokurka, Samuel; Wallhult, Elisabeth; Yarom, Noam; Jensen, Siri Beier

    Hematology-oncology patients undergoing chemotherapy and hematopoietic stem cell transplantation (HSCT) recipients are at risk for oral complications which may cause significant morbidity and a potential risk of mortality. This emphasizes the importance of basic oral care prior to, during and

  17. Basic oral care for hematology-oncology patients and hematopoietic stem cell transplantation recipients: a position paper from the joint task force of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) and the European Society for Blood and Marrow Transplantation (EBMT)

    NARCIS (Netherlands)

    Elad, Sharon; Raber-Durlacher, Judith E.; Brennan, Michael T.; Saunders, Deborah P.; Mank, Arno P.; Zadik, Yehuda; Quinn, Barry; Epstein, Joel B.; Blijlevens, Nicole M. A.; Waltimo, Tuomas; Passweg, Jakob R.; Correa, M. Elvira P.; Dahllöf, Göran; Garming-Legert, Karin U. E.; Logan, Richard M.; Potting, Carin M. J.; Shapira, Michael Y.; Soga, Yoshihiko; Stringer, Jacqui; Stokman, Monique A.; Vokurka, Samuel; Wallhult, Elisabeth; Yarom, Noam; Jensen, Siri Beier

    2015-01-01

    Hematology-oncology patients undergoing chemotherapy and hematopoietic stem cell transplantation (HSCT) recipients are at risk for oral complications which may cause significant morbidity and a potential risk of mortality. This emphasizes the importance of basic oral care prior to, during and

  18. Metaphyseal osteopathy in a British Shorthair cat.

    Science.gov (United States)

    Adagra, Carl; Spielman, Derek; Adagra, Angela; Foster, Darren J

    2015-04-01

    Metaphyseal osteopathy, otherwise known as hypertrophic osteodystrophy, is a disease that causes pyrexia and lethargy accompanied by pain in the thoracic and pelvic limbs of rapidly growing large-breed dogs. While metaphyseal osteopathy has been descibed in association with slipped capital femoral epiphysis in cats, it has not previously been reported as a cause of limb pain and pyrexia in this species. A 7-month-old British Shorthair cat presented with a 1 month history of pyrexia, lethargy and pain in all limbs. Investigation included radiographs of the limbs and chest, abdominal ultrasound, serum biochemical analysis, haematology, bone biopsy, joint fluid aspiration and cytology. Findings were consistent with a diagnosis of metaphyseal osteopathy. The cat's clinical signs resolved following the administration of prednisolone. Symptoms recurred 1 month after the cessation of prednisolone therapy, but resolved when administration was resumed. © ISFM and AAFP 2014.

  19. American Society of Pediatric Hematology/Oncology

    Science.gov (United States)

    ... Learn More Explore career opportunities in pediatric hematology/oncology Visit the ASPHO Career Center. Learn More Join ... Privacy Policy » © The American Society of Pediatric Hematology/Oncology

  20. Geriatric oncology in the Netherlands: a survey of medical oncology specialists and oncology nursing specialists.

    Science.gov (United States)

    Jonker, J M; Smorenburg, C H; Schiphorst, A H; van Rixtel, B; Portielje, J E A; Hamaker, M E

    2014-11-01

    To identify ways to improve cancer care for older patients, we set out to examine how older patients in the Netherlands are currently being evaluated prior to oncological treatment and to explore the potential obstacles in the incorporation of a geriatric evaluation, using a web-based survey sent to Dutch medical oncology specialists and oncology nursing specialists. The response rate was 34% (183 out of 544). Two-thirds of respondents reported that a geriatric evaluation was being used, although primarily on an ad hoc basis only. Most respondents expressed a desire for a routine evaluation or more intensive collaboration with the geriatrician and 86% of respondents who were not using a geriatric evaluation expressed their interest to do so. The most important obstacles were a lack of time or personnel and insufficient availability of a geriatrician to perform the assessment. Thus, over 30% of oncology professionals in the Netherlands express an interest in geriatric oncology. Important obstacles to a routine implementation of a geriatric evaluation are a lack of time, or insufficient availability of geriatricians; this could be overcome with policies that acknowledge that quality cancer care for older patients requires the investment of time and personnel. © 2014 John Wiley & Sons Ltd.

  1. Interpersonal perception in Japanese and British observers.

    Science.gov (United States)

    Kito, Tsuneo; Lee, Billy

    2004-01-01

    We compared performance of Japanese and British observers in deciphering images depicting Japanese interpersonal relationships. 201 Japanese and 215 British subjects were assessed by means of a test consisting of 31 photograph problems accompanied by two or three alternative solutions one of which was correct. Japanese subjects outperformed British subjects on the test overall (z = 3.981, p interpersonal relationships, but it may sometimes cause specific errors. Differences in the perceptual cues used suggest that British subjects had difficulty reading Japanese facial expressions.

  2. 76 FR 61713 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2011-10-05

    ... HUMAN SERVICES Food and Drug Administration Pediatric Oncology Subcommittee of the Oncologic Drugs... (FDA). The meeting will be open to the public. Name of Committee: Pediatric Oncology Subcommittee of..., are in late stage development for an adult oncology indication, or in late stage development in...

  3. 77 FR 57095 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2012-09-17

    ... HUMAN SERVICES Food and Drug Administration Pediatric Oncology Subcommittee of the Oncologic Drugs... (FDA). The meeting will be open to the public. Name of Committee: Pediatric Oncology Subcommittee of... plans for four products that are in development for an adult oncology indication. The subcommittee will...

  4. 75 FR 66773 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2010-10-29

    ... HUMAN SERVICES Food and Drug Administration Pediatric Oncology Subcommittee of the Oncologic Drugs... (FDA). The meeting will be open to the public. Name of Committee: Pediatric Oncology Subcommittee of... were either recently approved by FDA or, are in late stage development for an adult oncology indication...

  5. PET/MR in oncology

    DEFF Research Database (Denmark)

    Balyasnikova, Svetlana; Löfgren, Johan; de Nijs, Robin

    2012-01-01

    of the challenges inherent in this new technology, but focus on potential applications for simultaneous PET/MR in the field of oncology. Methods and tracers for use with the PET technology will be familiar to most readers of this journal; thus this paper aims to provide a short and basic introduction to a number...... be applied together with PET increasing the amount of information about the tissues of interest. The potential clinical benefit of applying PET/MR in staging, radiotherapy planning and treatment evaluation in oncology, as well as the research perspectives for the use of PET/MR in the development of new...

  6. Reconstruction of Peripelvic Oncologic Defects.

    Science.gov (United States)

    Weichman, Katie E; Matros, Evan; Disa, Joseph J

    2017-10-01

    After studying this article, the participant should be able to: 1. Understand the anatomy of the peripelvic area. 2. Understand the advantages and disadvantages of performing peripelvic reconstruction in patients undergoing oncologic resection. 3. Select the appropriate local, pedicled, or free-flap reconstruction based on the location of the defect and donor-site characteristics. Peripelvic reconstruction most commonly occurs in the setting of oncologic ablative surgery. The peripelvic area contains several distinct reconstructive regions, including vagina, vulva, penis, and scrotum. Each area provides unique reconstructive considerations. In addition, prior or future radiation therapy or chemotherapy along with cancer cachexia can increase the complexity of reconstruction.

  7. [Vitamins and Minerals in Oncology].

    Science.gov (United States)

    Holch, Julian Walter; Michl, Marlies; Heinemann, Volker; Erickson, Nicole

    2017-06-01

    The use of vitamins and minerals to prevent cancer as well as their supportive use in oncological patients is widespread and often occurs without the knowledge of the treating physician. Beyond general recommendations with regard to a balanced and healthy diet, no evidence exists supporting the use of vitamins and minerals in the prevention of cancer. Furthermore, the diet of oncological patients should contain vitamins and minerals of the same quantity as for healthy individuals. In particular, there is currently no rationale for a high-dosage administration of antioxidants. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Establishment of the Asia Oncology Nursing Society (AONS

    Directory of Open Access Journals (Sweden)

    Kazuko Onishi

    2014-06-01

    Full Text Available Over the past several years, whenever an informal group of Asian oncology nurses gathered, they talked about their mutual desire to create an organization closer to their homes that would be similar to the European Oncology Nursing Society (EONS. They saw this as a means for more of their colleagues to learn about the latest in cancer nursing and to have a time and place to network among themselves. This message continued to gain strength whenever these nurses met at other international meetings such as the International Conference on Cancer Nursing (ICCN, the Multinational Association of Supportive Care in Cancer (MASCC and the Oncology Nursing Society in US. A definite and planned step toward forming an Asian organization as the first meeting was taken on June 24 2011 when several Asian nurses were attending a MASCC meeting in Greece. The second meeting was held in Prague, Czech Republic, in conjunction with the 17 th ICCN meeting on September 10 2012, where the participants of the meeting included 21 oncology nurses from Asian countries. Finally, the first official meeting of the board directors from nine countries was held on November 21 2013 in Bangkok, Thailand. Now, and in the future, sharing and collaborating in the practice, education and research for oncology nursing in Asia is needed.

  9. Establishment of the Asia Oncology Nursing Society (AONS

    Directory of Open Access Journals (Sweden)

    Kazuko Onishi

    2014-01-01

    Full Text Available Over the past several years, whenever an informal group of Asian oncology nurses gathered, they talked about their mutual desire to create an organization closer to their homes that would be similar to the European Oncology Nursing Society (EONS. They saw this as a means for more of their colleagues to learn about the latest in cancer nursing and to have a time and place to network among themselves. This message continued to gain strength whenever these nurses met at other international meetings such as the International Conference on Cancer Nursing (ICCN, the Multinational Association of Supportive Care in Cancer (MASCC and the Oncology Nursing Society in US. A definite and planned step toward forming an Asian organization as the first meeting was taken on June 24 2011 when several Asian nurses were attending a MASCC meeting in Greece. The second meeting was held in Prague, Czech Republic, in conjunction with the 17 th ICCN meeting on September 10 2012, where the participants of the meeting included 21 oncology nurses from Asian countries. Finally, the first official meeting of the board directors from nine countries was held on November 21 2013 in Bangkok, Thailand. Now, and in the future, sharing and collaborating in the practice, education and research for oncology nursing in Asia is needed.

  10. The Pocketable Electronic Devices in Radiation Oncology (PEDRO) Project

    DEFF Research Database (Denmark)

    De Bari, Berardino; Franco, Pierfrancesco; Niyazi, Maximilian

    2016-01-01

    ) members of the national radiation or clinical oncology associations of the countries involved in the study. The 15 items investigated diffusion of MEDs (smartphones and/or tablets), their impact on daily clinical activity, and the differences perceived by participants along time. Results: A total of 386...... in young professionals working in radiation oncology. Looking at these data, it is important to verify the consistency of information found within apps, in order to avoid potential errors eventually detrimental for patients. “Quality assurance” criteria should be specifically developed for medical apps...

  11. Measurement of nurses' workload in an oncology outpatient clinic

    Directory of Open Access Journals (Sweden)

    Célia Alves de Souza

    2014-02-01

    Full Text Available The growing demand and the degree of patient care in oncological outpatient services, as well as the complexity of treatment have had an impact on the workload of nurses. This study aimed at measuring the workload and productivity of nurses in an oncological outpatient service. An observational study using a work sampling technique was conducted and included seven nurses working in an oncological outpatient service in the south-eastern region of Brazil. A total of 1,487 intervention or activity samples were obtained. Nurses used 43.2% of their time on indirect care, 33.2% on direct care, 11.6% on associated activities, and 12% on personal activities. Their mean productivity was 88.0%. The findings showed that nurses in this service spend most of their time in indirect care activities. Moreover, the productivity index in this study was above that recommended in the literature.

  12. Frontiers in robot-assisted retroperitoneal oncological surgery.

    Science.gov (United States)

    Ludwig, Wesley W; Gorin, Michael A; Pierorazio, Phillip M; Allaf, Mohamad E

    2017-12-01

    Robot assistance has been rapidly adopted by urological surgeons and has become particularly popular for oncological procedures involving the retroperitoneal space. The wide dissemination of robot assistance probably reflects the limited amount of operating space available within the retroperitoneum and the advantages provided by robot-assisted approaches, including 3D imaging, wristed instrumentation and the shorter learning curve compared with that associated with the equivalent laparoscopic techniques. Surgical procedures that have traditionally been performed using an open or laparoscopic approach, such as partial nephrectomy, radical nephrectomy, retroperitoneal lymph node dissection, nephroureterectomy and adrenalectomy, are now often being performed using robot assistance. The frontiers of robot-assisted retroperitoneal oncological surgery are constantly expanding, with an emphasis on maintaining oncological and functional outcomes, while minimizing the level of surgical invasiveness.

  13. Body Image and the Female Adolescent Oncology Patient.

    Science.gov (United States)

    Burg, Alison Joy

    2016-01-01

    Female adolescent oncology patients undergo many physical changes throughout treatment that have challenging psychological, emotional, and social implications. Body image for this population is a subject that tends to be overlooked in the midst of the cancer experience. This article will examine the complex concept of body image and discuss why female adolescent patients are at such high risk for negative body image. Assessment and care strategies are needed to foster a positive body image, resiliency, and overall well-being. Although survivorship studies may offer insightful information about the effects of the cancer journey on long-term body image, focus should be on prevention and holistic care as part of the treatment itself. The health care team, especially nursing professionals, should acknowledge, recognize, and address this vital issue as a critical part of oncology care. © 2015 by Association of Pediatric Hematology/Oncology Nurses.

  14. Association of MYCN copy number with clinical features, tumor biology, and outcomes in neuroblastoma: A report from the Children's Oncology Group.

    Science.gov (United States)

    Campbell, Kevin; Gastier-Foster, Julie M; Mann, Meegan; Naranjo, Arlene H; Van Ryn, Collin; Bagatell, Rochelle; Matthay, Katherine K; London, Wendy B; Irwin, Meredith S; Shimada, Hiroyuki; Granger, M Meaghan; Hogarty, Michael D; Park, Julie R; DuBois, Steven G

    2017-11-01

    High-level MYCN amplification (MNA) is associated with poor outcome and unfavorable clinical and biological features in patients with neuroblastoma. To the authors' knowledge, less is known regarding these associations in patients with low-level MYCN copy number increases. In this retrospective study, the authors classified patients has having tumors with MYCN wild-type tumors, MYCN gain (2-4-fold increase in MYCN signal compared with the reference probe), or MNA (>4-fold increase). Tests of trend were used to investigate ordered associations between MYCN copy number category and features of interest. Log-rank tests and Cox models compared event-free survival and overall survival by subgroup. Among 4672 patients, 3694 (79.1%) had MYCN wild-type tumors, 133 (2.8%) had MYCN gain, and 845 (18.1%) had MNA. For each clinical/biological feature, the percentage of patients with an unfavorable feature was lowest in the MYCN wild-type category, intermediate in the MYCN gain category, and highest in the MNA category (Pbiological features, with 11q aberration being an exception. Patients with MYCN gain appear to have inferior outcomes, especially in otherwise more favorable groups. Cancer 2017;123:4224-4235. © 2017 American Cancer Society. © 2017 American Cancer Society.

  15. Temporary ovarian suppression during chemotherapy to preserve ovarian function and fertility in breast cancer patients: A GRADE approach for evidence evaluation and recommendations by the Italian Association of Medical Oncology.

    Science.gov (United States)

    Lambertini, Matteo; Cinquini, Michela; Moschetti, Ivan; Peccatori, Fedro A; Anserini, Paola; Valenzano Menada, Mario; Tomirotti, Maurizio; Del Mastro, Lucia

    2017-01-01

    The development of premature ovarian failure and subsequent infertility are possible consequences of chemotherapy use in pre-menopausal women with early-stage breast cancer. Among the available strategies for fertility preservation, pharmacological protection of the ovaries using luteinising hormone-releasing hormone analogues (LHRHa) during chemotherapy has the potential to restore ovarian function and fertility after anticancer treatments; however, the possible efficacy and clinical application of this strategy has been highly debated in the last years. Following the availability of new data on this controversial topic, the Panel of the Italian Association of Medical Oncology (AIOM) Clinical Practice Guideline on fertility preservation in cancer patients decided to apply the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) methodology around the relevant and current question on the clinical utility of temporary ovarian suppression with LHRHa during chemotherapy as a strategy to preserve ovarian function and fertility in breast cancer patients. To answer this question, preservation of ovarian function and fertility were judged as critical outcomes for the decision-making. Three possible outcomes of harm were identified: LHRHa-associated toxicities, potential antagonism between concurrent LHRHa and chemotherapy, and lack of the prognostic impact of chemotherapy-induced premature ovarian failure. According to the GRADE evaluation conducted, the result was a strong positive recommendation in favour of using this option to preserve ovarian function and fertility in breast cancer patients. The present manuscript aims to update and summarise the evidence for the use of this strategy in light of the new data published up to January 2016, according to the GRADE process. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Telemedicine in oncology: European perspective.

    Science.gov (United States)

    Mohr, Markus

    2008-01-01

    Telemedicine in oncology or teleoncology integrates many so far well-known telemedicine elements such as teleconsultation, telesupport, telesurgery and telerobotics, teleeducation, and many others and is integral part of many disciplines such as internal medicine, surgery, dermatology, but also dentistry and psychooncology/psychiatry. Changes in ICT, new developments in oncology, the need to think and work interdisciplinarily, geographic and economic challenges as well as the transgression of sectoral boundaries as elements of modern teleoncology. Whereas the northern parts of Europe show a well-developed telemedicine infrastructure with a growing tendency to incorporate teleoncology for documentation, data analysis and quality assurance, in more southern countries this process is still underway and often marked by project status. Modern technology using xDSL and other terrestrial network lines but also satellite connectivity is at hand to cover a wide variety of telemedicine applications and services from which teleoncology benefits. More and more specifically designed software applications can be used to assess the medical workflow of an oncological patient and determine a life-long oncological electronic patient record. The trend, however, goes to the systemic integration of single applications and services into clinical information systems with a telemedicine approach. Although past evaluations of telemedicine applications and services have shown very positive results, only the right financial funding determines their survival and wide-spread usability in daily routine medical use. Formerly identifiable barriers for this use nowadays can be overcome more easily.

  17. Important advances in oncology 1987

    Energy Technology Data Exchange (ETDEWEB)

    1987-01-01

    This book contains 15 chapters. Some of the chapter titles are: Immunoglobulin and T-Cell Receptor Genes Reveal the Clonality, Lineage, and Translocations of Lymphoid Neoplasms; Patterns of Proto-Oncogene Expression: A Novel Approach to the Development of Tumor Markers; and Nuclear Magnetic Resonance Imaging in Oncology.

  18. Naturopathic Oncology Modified Delphi Panel.

    Science.gov (United States)

    Hill, Jacob; Hodsdon, Wendy; Schor, Jacob; McKinney, Neil; Rubin, Daniel; Seely, Dugald; Parmar, Gurdev; Birdsall, Tim; Alschuler, Lise; Lamson, Davis; Birdsall, Shauna; Zwickey, Heather

    2016-03-01

    Naturopathic oncology is a relatively new and emerging field capable of providing professional integrative or alternative services to cancer patients. Foundational research is critical to identify topics in the clinical and research development of naturopathic oncology for future growth of the field. This study implements a modified Delphi protocol to develop expert consensus regarding ethics, philosophy, and research development in naturopathic oncology. The modified protocol implements a nomination process to select a panel of 8 physicians and to assist in question formulation. The protocol includes an in-person discussion of 6 questions with multiple iterations to maintain the concept of the Delphi methodology as well as a postdiscussion consensus survey. The protocol identified, ranked, and established consensus for numerous themes per question. Underlying key topics include integration with conventional medicine, evidence-based medicine, patient education, patient safety, and additional training requirements for naturopathic oncologists. The systematic nomination and questioning of a panel of experts provides a foundational and educational resource to assist in clarification of clinical ethics, philosophy, and research development in the emerging field of naturopathic oncology. © The Author(s) 2015.

  19. Bacteraemia in a paediatric oncology unit in South Africa

    NARCIS (Netherlands)

    van de Wetering, M. D.; Poole, J.; Friedland, I.; Caron, H. N.

    2001-01-01

    To identify the morbidity and mortality due to infections in a South African paediatric oncology unit, and to identify risk factors associated with first bacteraemic episodes in this unit. A retrospective cohort study was done in a large regional referral paediatric cancer centre from 1991-1995, of

  20. Oncology Social Workers' Attitudes toward Hospice Care and Referral Behavior

    Science.gov (United States)

    Becker, Janet E.

    2004-01-01

    Members of the Association of Oncology Social Workers completed a survey, which included the Hospice Philosophy Scale (HPS) assessing the likelihood of the worker referring a terminally ill patient to hospice, background and experience, and demographics. The respondents held overwhelmingly favorable attitudes toward hospice philosophy and care,…

  1. British Celtic influence on English phonology

    NARCIS (Netherlands)

    Laker, Stephen

    2010-01-01

    The dissertation assesses the influence of British Celtic on the phonological development of English during and shortly after the Anglo-Saxon settlement period, ca. AD 450–700. By reconstructing and then comparing the phonological systems of both British Celtic and English at the time of contact, an

  2. Relationship satisfaction among Turkish and British adults

    OpenAIRE

    Celenk, O.; Van de Vijver, F.J.R.; Goodwin, R.

    2011-01-01

    We tested three theories (adult attachment, autonomy/relatedness, and gender roles) to understand relationship satisfaction among 150 British and 170 Turkish adults, all involved in romantic relationships. Avoidance, relatedness, autonomy–relatedness, and masculinity mediated the relationship between culture and romantic relationship satisfaction. Additionally, as anticipated, Turkish participants scored lower on relationship satisfaction and autonomy whereas British participants scored lower...

  3. Utilisation of British University Research Reactors.

    Science.gov (United States)

    Duncton, P. J.; And Others

    British experience relating to the employment of university research reactors and subcritical assemblies in the education of nuclear scientists and technologists, in the training of reactor operators and for fundamental pure and applied research in this field is reviewed. The facilities available in a number of British universities and the uses…

  4. British African Caribbean Women and Depression

    Science.gov (United States)

    Adkison-Bradley, Carla; Maynard, Donna; Johnson, Phillip; Carter, Stephaney

    2009-01-01

    Depression is a common condition among women in the United Kingdom. However, little is known about the context of depression among British African Caribbean women. This article offers a preliminary discussion regarding issues and information pertaining to depression among British African Caribbean women. Characteristics and symptoms of depression…

  5. Indian Education Programs in British Columbia.

    Science.gov (United States)

    Kelly, Reg

    The British North America Act of 1867, the founding constitution of Canada, provides that all matters pertaining to Indians and Indian lands are under Federal jurisdiction. Because of this, the province of British Columbia (BC) has not felt it could do much for native peoples and little attention has been paid to the extension of provincial…

  6. [Glamour and poverty of oncology].

    Science.gov (United States)

    Vorlícek, J

    2004-10-01

    The problematics of oncology is staying at the fore of the health problems in our republic. Every third of us falls ill with malignant tumour and every fourth dies of it. There were 37,000 malignant tumours diagnosed in our republic in 1977, in 1999 it was 59,500 and the amount is expected to increase up to 70,000 in 2004. Our results regarding the relative 5-year survival of the patients with all the oncologic diagnoses from 15 to 44 years are below European average. The most frequent tumour is lung cancer and bronchial cancer in males, breast cancer in females and the most frequent malignant tumour in both sexes is the colorectal cancer, the absolute rate of which has unambiguously the leading position. Czech republic stands at the forefront in Europe as for the incidence of all the tumours except the skin tumours. Among all the European males it is just Czech males who have a large probability of colorectal cancer. Moreover, regarding malignant renal cancer our republic is in the first position in both males and females. What do these epidemiologic dates imply? The risk of the development of malignant disease imminently endangers each of us. For Czech republic the malignant disease constitutes a big load as personal hardship and disability, increased need for hospital bed capacities and consequent increased economic costs. In 2003, the Czech oncologic society of Czech medical company of J. E. Purkyne created the National oncologic programme (NOP) of the Czech republic. Further there are named its aims, strategy and tasks. In the conclusion we mention what is the "glamour" and the "poverty" of oncology.

  7. Oncological outcomes of renal pelvic and ureteral cancer patients registered in 2005: the first large population report from the Cancer Registration Committee of the Japanese Urological Association.

    Science.gov (United States)

    Fujimoto, Hiroyuki; Nakanishi, Hiroyuki; Miki, Tsuneharu; Kanayama, Hiro-Omi; Ohyama, Chikara; Suzuki, Kazuhiro; Nishiyama, Hiroyuki; Eto, Masatoshi; Naito, Seiji; Fukumori, Tomoharu; Kubota, Yoshinobu; Takahashi, Satoru; Homma, Yukio; Kamoi, Kazumi

    2014-05-01

    To describe the clinical and pathological characteristics and the outcomes of renal pelvic and ureteral cancer patients diagnosed in 2005 in Japan. In 2011, data were collected from renal pelvic and ureteral cancer patients diagnosed in 2005. A total of 1509 registered patients from 348 institutions were analyzed. Epidemiology and survival were analyzed based on each cancer location and on cancer multiplicity. The 5-year overall survival of the 1509 patients was estimated at 0.64. Open surgery was carried out in 409 renal pelvic cancer cases (66.9%) and 315 ureteral cancer cases (63.0%). The retroperitoneal approach was common, and lymph node dissection was carried out in approximately one-third of open surgery cases and one-fifth of laparoscopic cases. Approximately 60% of the operated unilateral renal pelvic or ureteral cancer was diagnosed as invasive, and just 14.6% was diagnosed as stage pTa. Distribution of the estimated worst tumor grade was significantly different for renal pelvic cancer and ureteral cancer. This article presents the first large population report of survival data in Japanese renal pelvic and ureteral cancer patients. In comparison with the Japanese bladder cancer database report in 1999-2001 from the Cancer Registration Committee of the Japanese Urological Association, the pathological characteristics of renal pelvic and ureteral cancer were diagnosed as aggressive. © 2013 The Japanese Urological Association.

  8. Basic oral care for hematology?oncology patients and hematopoietic stem cell transplantation recipients: a position paper from the joint task force of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) and the European Society for Blood and Marrow Transplantation (EBMT)

    OpenAIRE

    Elad, Sharon; Raber-Durlacher, Judith E.; Brennan, Michael T.; Saunders, Deborah P.; Mank, Arno P.; Zadik, Yehuda; Quinn, Barry; Epstein, Joel B.; Blijlevens, Nicole M. A.; Waltimo, Tuomas; Passweg, Jakob R.; Correa, M. Elvira P.; Dahll?f, G?ran; Garming-Legert, Karin U. E.; Logan, Richard M.

    2014-01-01

    Purpose Hematology?oncology patients undergoing chemotherapy and hematopoietic stem cell transplantation (HSCT) recipients are at risk for oral complications which may cause significant morbidity and a potential risk of mortality. This emphasizes the importance of basic oral care prior to, during and following chemotherapy/HSCT. While scientific evidence is available to support some of the clinical practices used to manage the oral complications, expert opinion is needed to shape the current ...

  9. Industry Funding Among Leadership in Medical Oncology and Radiation Oncology in 2015.

    Science.gov (United States)

    Yoo, Stella K; Ahmed, Awad A; Ileto, Jan; Zaorsky, Nicholas G; Deville, Curtiland; Holliday, Emma B; Wilson, Lynn D; Jagsi, Reshma; Thomas, Charles R

    2017-10-01

    To quantify and determine the relationship between oncology departmental/division heads and private industry vis-à-vis potential financial conflict of interests (FCOIs) as publicly reported by the Centers for Medicare and Medicaid Services Open Payments database. We extracted the names of the chairs/chiefs in medical oncology (MO) and chairs of radiation oncology (RO) for 81 different institutions with both RO and MO training programs as reported by the Association of American Medical Colleges. For each leader, the amount of consulting fees and research payments received in 2015 was determined. Logistic modeling was used to assess associations between the 2 endpoints of receiving a consulting fee and receiving a research payment with various institution-specific and practitioner-specific variables included as covariates: specialty, sex, National Cancer Institute designation, PhD status, and geographic region. The majority of leaders in MO were reported to have received consulting fees or research payments (69.5%) compared with a minority of RO chairs (27.2%). Among those receiving payments, the average (range) consulting fee was $13,413 ($200-$70,423) for MO leaders and $6463 ($837-$16,205) for RO chairs; the average research payment for MO leaders receiving payments was $240,446 ($156-$1,234,762) and $295,089 ($160-$1,219,564) for RO chairs. On multivariable regression when the endpoint was receipt of a research payment, those receiving a consulting fee (odds ratio [OR]: 5.34; 95% confidence interval [CI]: 2.22-13.65) and MO leaders (OR: 5.54; 95% CI: 2.62-12.18) were more likely to receive research payments. Examination of the receipt of consulting fees as the endpoint showed that those receiving a research payment (OR: 5.41; 95% CI: 2.23-13.99) and MO leaders (OR: 3.06; 95% CI: 1.21-8.13) were more likely to receive a consulting fee. Leaders in academic oncology receive consulting or research payments from industry. Relationships between oncology leaders and

  10. [Organization of management of and role of clinical prognosis in the childhood oncological service of Russia].

    Science.gov (United States)

    Durnov, L A; Bondar', I V; Valenteĭ, L V

    2001-01-01

    Cancer control service cannot be managed without having a clear idea of trends and changes in the incidence of malignant neoplasms and associated death rates. These studies become a basis for setting up oncological facilities for both children and adults, having an adequate infrastructure (final fund, the profile of units, a list of staff, the volume of work). Pediatric oncological rooms to collect statistics, to make a primary diagnosis, a follow-up, and outpatient chemotherapy in children with malignant neoplasms, and to do methological work with pediatric and non-oncological specialized children's out- and inpatient units have been opened in most administrative, regional, territorial, and republican centers. Notification is much more complete where specialized pediatric oncological rooms (Moscow) register such children. Unfortunately, such rooms are still few and so such ill children are registered by regional and city oncological dispensaries (and, as shown, 50% of the patients are outside registration).

  11. Molecular Biomarkers for the Evaluation of Colorectal Cancer: Guideline From the American Society for Clinical Pathology, College of American Pathologists, Association for Molecular Pathology, and the American Society of Clinical Oncology.

    Science.gov (United States)

    Sepulveda, Antonia R; Hamilton, Stanley R; Allegra, Carmen J; Grody, Wayne; Cushman-Vokoun, Allison M; Funkhouser, William K; Kopetz, Scott E; Lieu, Christopher; Lindor, Noralane M; Minsky, Bruce D; Monzon, Federico A; Sargent, Daniel J; Singh, Veena M; Willis, Joseph; Clark, Jennifer; Colasacco, Carol; Rumble, R Bryan; Temple-Smolkin, Robyn; Ventura, Christina B; Nowak, Jan A

    2017-05-01

    Purpose Molecular testing of colorectal cancers (CRCs) to improve patient care and outcomes of targeted and conventional therapies has been the center of many recent studies, including clinical trials. Evidence-based recommendations for the molecular testing of CRC tissues to guide epidermal growth factor receptor (EGFR) -targeted therapies and conventional chemotherapy regimens are warranted in clinical practice. The purpose of this guideline is to develop evidence-based recommendations to help establish standard molecular biomarker testing for CRC through a systematic review of the literature. Methods The American Society for Clinical Pathology (ASCP), College of American Pathologists (CAP), Association for Molecular Pathology (AMP), and the American Society of Clinical Oncology (ASCO) convened an Expert Panel to develop an evidence-based guideline to help establish standard molecular biomarker testing, guide targeted therapies, and advance personalized care for patients with CRC. A comprehensive literature search that included over 4,000 articles was conducted to gather data to inform this guideline. Results Twenty-one guideline statements (eight recommendations, 10 expert consensus opinions and three no recommendations) were established. Recommendations Evidence supports mutational testing for genes in the EGFR signaling pathway, since they provide clinically actionable information as negative predictors of benefit to anti-EGFR monoclonal antibody therapies for targeted therapy of CRC. Mutations in several of the biomarkers have clear prognostic value. Laboratory approaches to operationalize molecular testing for predictive and prognostic molecular biomarkers involve selection of assays, type of specimens to be tested, timing of ordering of tests and turnaround time for testing results. Additional information is available at: www.asco.org/CRC-markers-guideline and www.asco.org/guidelineswiki.

  12. Knowledge, attitudes, and practice on the prevention of central line-associated bloodstream infections among nurses in oncological care: A cross-sectional study in an area of southern Italy.

    Directory of Open Access Journals (Sweden)

    Maria Rosaria Esposito

    Full Text Available The objectives of the cross-sectional study were to delineate the knowledge, attitudes, and behavior among nurses regarding the prevention of central line-associated bloodstream infections (CLABSIs and to identify their predisposing factors. A questionnaire was self-administered from September to November 2011 to nurses in oncology and outpatient chemotherapy units in 16 teaching and non-teaching public and private hospitals in the Campania region (Italy. The questionnaire gathered information on demographic and occupational characteristics; knowledge about evidence-based practices for the prevention of CLABSIs; attitudes towards guidelines, the risk of transmitting infections, and hand-washing when using central venous catheter (CVC; practices about catheter site care; and sources of information. The vast majority of the 335 nurses answered questions correctly about the main recommendations to prevent CLABSIs (use sterile gauze or sterile transparent semipermeable dressing to cover the catheter site, disinfect the needleless connectors before administer medication or fluid, disinfect with hydrogen peroxide the catheter insertion site, and use routinely anticoagulants solutions. Nurses aged 36 to 50 years were less likely to know these main recommendations to prevent CLABSIs, whereas this knowledge was higher in those who have received information about the prevention of these infections from courses. Nurses with lower education and those who do not know two of the main recommendations on the site's care to prevent the CLABSIs, were more likely to perceive the risk of transmitting an infection. Higher education, attitude toward the utility allow to dry antiseptic, and the need of washing hands before wearing gloves for access to port infusion were predictors of performing skin antiseptic and aseptic technique for dressing the catheter insertion site. Educational interventions should be implemented to address the gaps regarding knowledge and

  13. Tracking the 2015 Gastrointestinal Cancers Symposium: bridging cancer biology to clinical gastrointestinal oncology

    Directory of Open Access Journals (Sweden)

    Aprile G

    2015-05-01

    Full Text Available Giuseppe Aprile,1 Francesco Leone,2,3 Riccardo Giampieri,4 Mariaelena Casagrande,1 Donatella Marino,2,3 Luca Faloppi,4 Stefano Cascinu,4 Gianpiero Fasola,1 Mario Scartozzi5,6 1Department of Oncology, University and General Hospital, Udine, Italy; 2Medical Oncology Department, University of Turin, 3Institute for Cancer Research and Treatment, Candiolo, Turin, Italy; 4Medical Oncology Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Universita Politecnica delle Marche, Ancona, Italy; 5Medical Oncology Department, University of Cagliari, 6General Hospital, Cagliari, Italy Abstract: The 2015 Gastrointestinal Cancers Symposium (San Francisco, CA, USA; January 15–17 is the world-class conference co-sponsored by the American Society of Clinical Oncology, the American Society for Radiation Oncology, the American Gastroenterological Association Institute, and the Society of Surgical Oncology, in which the most innovative research results in digestive tract oncology are presented and discussed. In its twelfth edition, the meeting has provided new insights focusing on the underpinning biology and clinical management of gastrointestinal malignancies. More than 3,400 health care professionals gathered from all over the world to share their experiences on how to bridge the recent novelties in cancer biology with everyday medical practice. In this article, the authors report on the most significant advances, didactically moving on three different anatomic tracks: gastroesophageal malignancies, pancreatic and biliary cancers, and colorectal adenocarcinomas. Keywords: colorectal cancer, gastric cancer, ramucirumab, pembrolizumab, target therapy, onartuzumab, AMG 337

  14. International Society of Geriatric Oncology Consensus on Geriatric Assessment in Older Patients With Cancer

    Science.gov (United States)

    Wildiers, Hans; Heeren, Pieter; Puts, Martine; Topinkova, Eva; Janssen-Heijnen, Maryska L.G.; Extermann, Martine; Falandry, Claire; Artz, Andrew; Brain, Etienne; Colloca, Giuseppe; Flamaing, Johan; Karnakis, Theodora; Kenis, Cindy; Audisio, Riccardo A.; Mohile, Supriya; Repetto, Lazzaro; Van Leeuwen, Barbara; Milisen, Koen; Hurria, Arti

    2014-01-01

    Purpose To update the International Society of Geriatric Oncology (SIOG) 2005 recommendations on geriatric assessment (GA) in older patients with cancer. Methods SIOG composed a panel with expertise in geriatric oncology to develop consensus statements after literature review of key evidence on the following topics: rationale for performing GA; findings from a GA performed in geriatric oncology patients; ability of GA to predict oncology treatment–related complications; association between GA findings and overall survival (OS); impact of GA findings on oncology treatment decisions; composition of a GA, including domains and tools; and methods for implementing GA in clinical care. Results GA can be valuable in oncology practice for following reasons: detection of impairment not identified in routine history or physical examination, ability to predict severe treatment-related toxicity, ability to predict OS in a variety of tumors and treatment settings, and ability to influence treatment choice and intensity. The panel recommended that the following domains be evaluated in a GA: functional status, comorbidity, cognition, mental health status, fatigue, social status and support, nutrition, and presence of geriatric syndromes. Although several combinations of tools and various models are available for implementation of GA in oncology practice, the expert panel could not endorse one over another. Conclusion There is mounting data regarding the utility of GA in oncology practice; however, additional research is needed to continue to strengthen the evidence base. PMID:25071125

  15. Can We Predict the Surgical Margin Positivity in Patients Treated with Radical Prostatectomy? A Multicenter Cohort of Turkish Association of Uro-Oncology

    Directory of Open Access Journals (Sweden)

    Deniz Bolat

    2015-03-01

    Full Text Available Objective To analyze the parameters that predict the surgical margin positivity after radical prostatectomy for localized prostate cancer. Materials and Methods In this multicenter study, the data of 1607 consecutive patients undergoing radical prostatectomy for localized prostate cancer in 12 different clinics in Turkey between 1993-2011 were assessed. Patients who had neoadjuvant treatment were excluded. We assessed the relationship between potential predictive factors and surgical margin status after radical prostatectomy such as age, cancer characteristics, history of transurethral prostate resection, surgical experience and nerve-sparing technique by using univariate and multivariate Cox regression analyses and t test. Results The overall surgical margin positivity rate was 22.6% (359 patients. In univariate analyses, preoperative prostate specific antigen level, clinical stage, biopsy Gleason score, percentage of tumor involvement per biopsy specimen, transurethral prostate resection history, surgical experience and nerve-sparing technique were significantly associated with positive surgical margin rate. In multivariate analyses, preoperative prostate specific antigen level (OR: 1.03, p=0.06, percentage of tumor involvement per biopsy specimen (OR: 7,14, p<0,001, surgical experience (OR: 2.35, p=0.011 and unilateral nerve-sparing technique (OR: 1.81, p=0.018 were independent predictive factors for surgical margin positivity. Conclusion Preoperative prostate specific antigen level, percentage of tumor involvement per biopsy specimen, surgical experience and nerve-sparing technique are the most important predictive factors of surgical margin positivity in patients undergoing radical prostatectomy for localized prostate cancer.

  16. Patient/Family Education for Newly Diagnosed Pediatric Oncology Patients.

    Science.gov (United States)

    Landier, Wendy; Ahern, JoAnn; Barakat, Lamia P; Bhatia, Smita; Bingen, Kristin M; Bondurant, Patricia G; Cohn, Susan L; Dobrozsi, Sarah K; Haugen, Maureen; Herring, Ruth Anne; Hooke, Mary C; Martin, Melissa; Murphy, Kathryn; Newman, Amy R; Rodgers, Cheryl C; Ruccione, Kathleen S; Sullivan, Jeneane; Weiss, Marianne; Withycombe, Janice; Yasui, Lise; Hockenberry, Marilyn

    There is a paucity of data to support evidence-based practices in the provision of patient/family education in the context of a new childhood cancer diagnosis. Since the majority of children with cancer are treated on pediatric oncology clinical trials, lack of effective patient/family education has the potential to negatively affect both patient and clinical trial outcomes. The Children's Oncology Group Nursing Discipline convened an interprofessional expert panel from within and beyond pediatric oncology to review available and emerging evidence and develop expert consensus recommendations regarding harmonization of patient/family education practices for newly diagnosed pediatric oncology patients across institutions. Five broad principles, with associated recommendations, were identified by the panel, including recognition that (1) in pediatric oncology, patient/family education is family-centered; (2) a diagnosis of childhood cancer is overwhelming and the family needs time to process the diagnosis and develop a plan for managing ongoing life demands before they can successfully learn to care for the child; (3) patient/family education should be an interprofessional endeavor with 3 key areas of focus: (a) diagnosis/treatment, (b) psychosocial coping, and (c) care of the child; (4) patient/family education should occur across the continuum of care; and (5) a supportive environment is necessary to optimize learning. Dissemination and implementation of these recommendations will set the stage for future studies that aim to develop evidence to inform best practices, and ultimately to establish the standard of care for effective patient/family education in pediatric oncology.

  17. Patterns of Referral to Radiation Oncology among Patients with Bladder Cancer: a Population-based Study.

    Science.gov (United States)

    Quirt, J S; Siemens, D R; Zaza, K; Mackillop, W J; Booth, C M

    2017-03-01

    Radical radiotherapy is a reasonable alternative to cystectomy for some patients with invasive bladder cancer, and postoperative radiotherapy may be indicated in patients at high risk of local recurrence. Here we describe pre- and postoperative radiation oncology consultation among patients with bladder cancer in Ontario. Records of radiotherapy and surgery were linked to the Ontario Cancer Registry (OCR) to identify all patients who received treatment with curative intent for bladder cancer between 1994 and 2008. Billing records were linked to the OCR to determine which patients were seen by radiation oncology before radical therapy or after cystectomy. Factors associated with radiation oncology consultation were explored by logistic regression. In total, 5259 patients with bladder cancer underwent treatment with curative intent in Ontario between 1994 and 2008. Of these, 3879 had primary cystectomy and 1380 had primary radiotherapy. Thirty-two per cent (1698/5259) of all patients were seen by radiation oncology. Independent factors associated with radiation oncology consultation included advanced age (P oncology consultation. Ten per cent of patients treated by cystectomy (386/3879) were seen by radiation oncology in the postoperative setting; rates varied widely across regions (range 6-44%). These geographical variations were highly significant in the multivariate analysis (P oncology consultation (all P oncology consultation. One third of all patients with muscle-invasive bladder cancer in routine practice were seen in consultation by radiation oncology. Few patients who undergo cystectomy have the benefit of either a preoperative or a postoperative opinion about the potential role of radiotherapy in their management. Closer collaboration between radiation oncologists and urologists is warranted. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  18. Radiation Oncology Physics and Medical Physics Education

    Science.gov (United States)

    Bourland, Dan

    2011-10-01

    Medical physics, an applied field of physics, is the applications of physics in medicine. Medical physicists are essential professionals in contemporary healthcare, contributing primarily to the diagnosis and treatment of diseases through numerous inventions, advances, and improvements in medical imaging and cancer treatment. Clinical service, research, and teaching by medical physicists benefits thousands of patients and other individuals every day. This talk will cover three main topics. First, exciting current research and development areas in the medical physics sub-specialty of radiation oncology physics will be described, including advanced oncology imaging for treatment simulation, image-guided radiation therapy, and biologically-optimized radiation treatment. Challenges in patient safety in high-technology radiation treatments will be briefly reviewed. Second, the educational path to becoming a medical physicist will be reviewed, including undergraduate foundations, graduate training, residency, board certification, and career opportunities. Third, I will introduce the American Association of Physicists in Medicine (AAPM), which is the professional society that represents, advocates, and advances the field of medical physics (www.aapm.org).

  19. [Health services research in psycho-oncology].

    Science.gov (United States)

    Mehnert, A; Hartung, T J

    2015-03-01

    Given the increasing incidence of cancer and improved diagnostics and cancer treatments, the number of cancer patients in industrialized nations is increasing worldwide. Multimodal treatment regimens, which contribute to a tumor-free survival or extend patients life expectancy can, however, alone or in combination increase the risk of physical and psychosocial long-term problems or late complications. For many patients cancer has become a chronic disease and is associated with significant physical and psychosocial problems that affect the quality of life in the medium and longer-term perspective. Common problems of cancer patients in the longer course of the disease include chronic and post-cancer pain, cancer-specific fatigue, psychosocial distress and impairment in self-management and activities of daily living, work participation and quality of life. Current developments with respect to both curative and palliative oncological care have various implications for health services research in psycho-oncology. These questions relate to issues of care needs, service provision and the appropriateness of care, issues of development, implementation and scientific evaluation of patient-centered and affordable support programs for different groups of cancer patients with different supportive care needs, issues of access and utilization of supportive care services, as well as questions of appropriate outcome criteria of health services research.

  20. Nuclear medical oncology; Nuklearmedizinische Onkologie

    Energy Technology Data Exchange (ETDEWEB)

    Krause, Bernd J.; Buck, Andreas K.; Schwaiger, Markus (eds.) [Technische Univ. Muenchen (Germany). Nuklearmedizinische Klinik und Poliklinik

    2007-07-01

    Modern nuclear oncology is based on molecular imaging techniques and radiotherapy. The book is aimed to integrate efficiently nuclear medical diagnostics and therapy into oncologic patient management. The book covers the following topics: Chapter 1: basics: instrumentation (SPECT, PET, PET/CT), digital image processing, radiopharmaceuticals, radiation protection, nuclear medical dosimetry, radiotherapy planning. Chapter 2: diagnostics: PET and PET/CT, skeleton metastases diagnostics, lymphoma diagnostics in case of mammary carcinomas and malign melanoma, MIBG (metaiodobenzylguanidin) diagnostics. Chapter 3: therapy: Radiotherapy of thyroid carcinomas, radioimmunotherapy of malign melanomas and in haematology, MIBG therapy, radiotherapy of neuroendocrine tumors, radiotherapy of skeleton metastases, intercavitary and locoregional therapy, 32{sup 3}2 phosphor therapy of polycythaemia vera.

  1. PET/MR in oncology

    DEFF Research Database (Denmark)

    Balyasnikova, Svetlana; Löfgren, Johan; de Nijs, Robin

    2012-01-01

    After more than 20 years of research, a fully integrated PET/MR scanner was launched in 2010 enabling simultaneous acquisition of PET and MR imaging. Currently, no clinical indication for combined PET/MR has been established, however the expectations are high. In this paper we will discuss some...... of the challenges inherent in this new technology, but focus on potential applications for simultaneous PET/MR in the field of oncology. Methods and tracers for use with the PET technology will be familiar to most readers of this journal; thus this paper aims to provide a short and basic introduction to a number...... be applied together with PET increasing the amount of information about the tissues of interest. The potential clinical benefit of applying PET/MR in staging, radiotherapy planning and treatment evaluation in oncology, as well as the research perspectives for the use of PET/MR in the development of new...

  2. [Comorbidity oriented oncology - an overview].

    Science.gov (United States)

    Simanek, Ralph; Wuensch, Michael; Edlinger, Roland; Hammerl-Ferrari, Bernhard; Kramer, Ludwig; Geissler, Klaus

    2010-04-01

    Increasing life expectancy results in an increased number of elderly cancer patients. Comorbidities and functional impairment influence the patient's course of disease and the choice of antineoplastic treatment. The Comprehensive Geriatric Assessment (CGA) supports the appraisal of the patient's individual health characteristics, especially due to the fact that chronologic age does not always correlate with the patient's health. Next to the appraisal of comorbidities and functional impairment, nutritional state, cognitive impairment, psychological state, social support, quality of life and the patient's medication are recorded. The Society of Geriatric Oncology (SIOG) recommends the CGA in cancer patients older than seventy years. While planning a systemic antineoplastic therapy, renal, hepatic, cardiac and bone marrow insufficiencies have to be considered. Renal and hepatic impairment often cause in dose reduced antineoplastic treatment, whereas in patients with cardiac insufficiency liposomale substances and in patients with decreased bone marrow function growth factors are available. Additionally to the oncological treatment, an early involvement of palliative care specialists should be considered.

  3. PET/MR in oncology

    DEFF Research Database (Denmark)

    Balyasnikova, Svetlana; Löfgren, Johan; de Nijs, Robin

    2012-01-01

    be applied together with PET increasing the amount of information about the tissues of interest. The potential clinical benefit of applying PET/MR in staging, radiotherapy planning and treatment evaluation in oncology, as well as the research perspectives for the use of PET/MR in the development of new......After more than 20 years of research, a fully integrated PET/MR scanner was launched in 2010 enabling simultaneous acquisition of PET and MR imaging. Currently, no clinical indication for combined PET/MR has been established, however the expectations are high. In this paper we will discuss some...... of the challenges inherent in this new technology, but focus on potential applications for simultaneous PET/MR in the field of oncology. Methods and tracers for use with the PET technology will be familiar to most readers of this journal; thus this paper aims to provide a short and basic introduction to a number...

  4. A model for rural oncology.

    Science.gov (United States)

    Heifetz, Laurence J; Christensen, Scott D; Devere-White, Ralph W; Meyers, Fredrick J

    2011-05-01

    Small rural hospitals in the United States have had challenging issues developing sustainable oncology programs. This is a report on the development of a successful rural oncology program. In 2006, the Tahoe Forest Health System in Truckee, CA, a remote mountain resort town, started a cancer program that was focused on addressing patient and family fears that are common to all cancer patients but more frightening in the rural setting. Four years later, it is a thriving program with significant community support, a creative academic affiliation, and a central focus of the future of the hospital. The Tahoe Forest Cancer Center developed a sustainable model for high quality cancer care that overcomes geographic, cultural and financial barriers. This structure may serve as a model for national rural health care.

  5. The British warning; L'avertissement britannique

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    2002-09-01

    Just as the Stone Age did not come to an end for want of stones, the end of the LPG Age will not occur due to a shortage of LPG. This witticism, offered by Tom Fidell (the Director-General of the British LP Gas Association) conceals a serious warming: these needs to be a fast response in terms of technology, as the advantages of autogas are being reduced by competing fuels and their supporting technologies. (authors)

  6. Generalities of the oncological pain

    Directory of Open Access Journals (Sweden)

    Sarah María Regueira Betancourt

    2015-09-01

    Full Text Available Cancer pain can be caused by a malignant tumor, by the therapy used to treat it, or by both causes. It begins with an acute onset that goes towards healing or chronicity. Together with the manifestations of a chronic pain, acute episodes may appear. A bibliographic study was carried out on the oncological pain, using the resources available in the Infomed network, specifically Ebsco, The Cochrane Librery, PubMed, Hinari and SciELO, by means of which the following databases were accessed: MEDLINE, AcademicSearch Premier and MedicLatina. The presence of pain in an oncological process is variable and it depends on the type and extension of the disease, as well as on each person's own individual tolerance. The terminal intense oncological pain is a circumstance both foreseeable and necessarily avoidable. Its relief is a priority in the cancer program of the World Health Organization. To know the classification of pain, its causes, the assessment scales and the way in which it may be described provides a comprehensive treatment for cancer pain. It also helps to optimize the comprehensive care to the patients suffering from this condition and improve their quality of life.

  7. Owners' attitudes and practices regarding nutrition of dogs diagnosed with cancer presenting at a referral oncology service in Ontario, Canada.

    Science.gov (United States)

    Rajagopaul, S; Parr, J M; Woods, J P; Pearl, D L; Coe, J B; Verbrugghe, A

    2016-09-01

    To investigate owner attitudes and dietary practices following cancer diagnosis in a dog. A retrospective cross-sectional survey of 75 dog owners presenting with their dogs to a tertiary referral oncology service through a demographic questionnaire and in-person or telephone interviews regarding the dog's nutrition. Conventional diets (71%) were most commonly fed as a single diet to canine cancer patients followed by homemade cooked (7%) and homemade raw (4%). Several owners (18%) provided combinations of these diets. Owners reported some distrust towards conventional diets (51%). Appetite loss occurred in 35% of dogs and diet changes reported for 25% of dogs in the study involved exclusion of a conventional (63%) and/or inclusion of a homemade (54%) component. 90% of owners noted the diet change was associated with the cancer diagnosis. Supplements were given by 39% of owners. 85% of owners highly valued veterinary nutritional advice. Following a cancer diagnosis, dog owners appear to change their approach to managing their dog's nutrition. Given the value owners place on veterinary nutritional advice, veterinarians have a key role in guiding nutritional management of the canine cancer patient. © 2016 British Small Animal Veterinary Association.

  8. The use of blood products in paediatric oncology units in the UK.

    Science.gov (United States)

    Nathan, Martina; Selwood, Karen

    2006-09-01

    The clinical practice group of the Royal College of Nursing paediatric oncology nurses' forum carried out an exploratory study to examine practice in administration of blood products in children's cancer centres across the UK to identify any variances in practice. A questionnaire covering the use and administration of red cells, platelets and other supportive measures was distributed to each of the 22 UK Children's Cancer Study Groups centres of which 14 responded (63 per cent). Variations among the units were found in all aspects of blood product administration including decisions about when to transfuse, methods of transfusion, treatment of adverse reactions and use of supportive products. There were some differences between the practices reported and guidance for transfusion in neonates and older children published by the British Committee for Standards in Haematology Transfusion Task Force (2004); many of these differences were attributable to the specific needs of oncology patients. The development of national guidance or minimum safe standards specifically for paediatric oncology patients could assist in reducing practice variations. This study was undertaken in children's cancer units where administration of blood products is a daily occurrence. Variations in practice that were identified here are likely to be found in non oncology/haematology settings.

  9. Libraries in British Columbia: MedlinePlus

    Science.gov (United States)

    ... this page: https://medlineplus.gov/libraries/britishcolumbia.html Libraries in British Columbia To use the sharing features ... George University Hospital of Northern BC Northern Health Library Services Learning & Development Centre 1475 Edmonton Street Prince ...

  10. British and American attitudes toward credit cards.

    Science.gov (United States)

    Yang, Bijou; James, Simon; Lester, David

    2006-04-01

    American university students owned more than twice as many credit cards as British university students. However, scores on a credit card attitude scale predicted the number of cards owned by respondents in both countries.

  11. Retrenchment in British Universities: Lessons Learned.

    Science.gov (United States)

    Simpson, William A.

    1985-01-01

    A study of 14 British universities that underwent severe retrenchment in 1981-1984 is reported, and successful policies, procedures, philosophies, and techniques that may be applicable to institutions in many countries are outlined. (MSE)

  12. Politics, policy and government in British Columbia

    National Research Council Canada - National Science Library

    Carty, R. Kenneth

    1996-01-01

    ... and Gerry Kristiansonvi Contents Part 3: Governing the Province 9 The Government of the Day: The Premier and Cabinet in British Columbia / 143 Terence Morley 10 Provincial Governance and the Pu...

  13. [Definition and outline on geriatric oncology].

    Science.gov (United States)

    Terret, C; Droz, J-P

    2009-11-01

    Geriatric oncology is the concept for management of elderly cancer patients. It is an equal approach of the health status problems and of cancer in a patient considered as a whole. Therefore it is not a subspecialty but a practice which can be translated in the elderly cancer patient's care. The treatment of cancer is based on the same principles than this of younger patients; recommendations used are those of the scientific oncological societies. Health problems of elderly patients are screened by specific tools. Patients without major health problems are managed by the oncological team in the routine; those for whom screening have demonstrated problems are first evaluated in the geriatrics setting and then oncological decisions are adapted to the patient situation. Decisions are made in specific geriatric oncology conferences. Specific clinical trials are required to build an Evidence Based Medicine background. Geriatric oncology teaching programs are warranted. (c) 2009 Elsevier Masson SAS. All rights reserved.

  14. Palliative Care: Delivering Comprehensive Oncology Nursing Care.

    Science.gov (United States)

    Dahlin, Constance

    2015-11-01

    To describe palliative care as part of comprehensive oncology nursing care. A review of the palliative care, oncology, and nursing literature over the past 10 years. Palliative care is mandated as part of comprehensive cancer care. A cancer diagnosis often results in distress in the physical, psychosocial, spiritual, and emotional domains of care. Oncology nurses are essential in providing palliative care from diagnosis to death to patients with cancer. They address the myriad aspects of cancer. With palliative care skills and knowledge, oncology nurses can provide quality cancer care. There are many opportunities in which oncology nurses can promote palliative care. Oncology nurses must obtain knowledge and skills in primary palliative care to provide comprehensive cancer care. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Does general surgery residency prepare surgeons for community practice in British Columbia?

    Science.gov (United States)

    Hwang, Hamish

    2009-06-01

    Preparing surgeons for clinical practice is a challenging task for postgraduate training programs across Canada. The purpose of this study was to examine whether a single surgeon entering practice was adequately prepared by comparing the type and volume of surgical procedures experienced in the last 3 years of training with that in the first year of clinical practice. During the last 3 years of general surgery training, I logged all procedures. In practice, the Medical Services Plan (MSP) of British Columbia tracks all procedures. Using MSP remittance reports, I compiled the procedures performed in my first year of practice. I totaled the number of procedures and broke them down into categories (general, colorectal, laparoscopic, endoscopic, hepatobiliary, oncologic, pediatric, thoracic, vascular and other). I then compared residency training with community practice. I logged a total of 1170 procedures in the last 3 years of residency. Of these, 452 were performed during community rotations. The procedures during residency could be broken down as follows: 392 general, 18 colorectal, 242 laparoscopic, 103 endoscopic, 85 hepatobiliary, 142 oncologic, 1 pediatric, 78 thoracic, 92 vascular and 17 other. I performed a total of 1440 procedures in the first year of practice. In practice the break down was 398 general, 15 colorectal, 101 laparoscopic, 654 endoscopic, 2 hepatobiliary, 77 oncologic, 10 pediatric, 0 thoracic, 70 vascular and 113 other. On the whole, residency provided excellent preparation for clinical practice based on my experience. Areas of potential improvement included endoscopy, pediatric surgery and "other," which comprised mostly hand surgery.

  16. Graduate education in oncology nursing for minorities.

    Science.gov (United States)

    Houldin, Arlene D; Reville, Barbara; Boland, Barbara A; Jacobs, Linda A; Hayes, Sandra L

    2002-01-01

    Cancer statistics reveal disturbing morbidity and mortality rates among minorities, especially African Americans. A program to recruit and train minority nurses as Oncology Advanced Practice Nurses was developed at the University of Pennsylvania School of Nursing. Since 1992, 30 African American, five Asian/Pacific Islander, and five Hispanic nurses have been supported during advanced oncology nursing study. Graduates have assumed positions of clinical and academic leadership in oncology nursing. This project strengthened the ability of a graduate program in oncology nursing to respond to needs related to the education of minority students and to the care of minority populations with cancer.

  17. Music therapy services in pediatric oncology: a national clinical practice review.

    Science.gov (United States)

    Tucquet, Belinda; Leung, Maggie

    2014-01-01

    This article presents the results of a national clinical practice review conducted in Australia of music therapy services in pediatric oncology hospitals. Literature specifically related to music therapy and symptom management in pediatric oncology is reviewed. The results from a national benchmarking survey distributed to all music therapists working with children with cancer in Australian pediatric hospitals are discussed. Patient and family feedback provided from a quality improvement activity conducted at a major pediatric tertiary hospital is summarized, and considerations for future growth as a profession and further research is proposed. © 2014 by Association of Pediatric Hematology/Oncology Nurses.

  18. 78 FR 25304 - Siemens Medical Solutions, USA, Inc., Oncology Care Systems (Radiation Oncology), Including On...

    Science.gov (United States)

    2013-04-30

    ... Employment and Training Administration Siemens Medical Solutions, USA, Inc., Oncology Care Systems (Radiation Oncology), Including On-Site Leased Workers From Source Right Solutions, Concord, California, Now Located... 5, 2012, applicable to workers of Siemens Medical Solutions, USA, Inc., Oncology Care Systems...

  19. 76 FR 58520 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2011-09-21

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Pediatric Oncology Subcommittee of the Oncologic Drugs... (FDA). The meeting will be open to the public. Name of Committee: Pediatric Oncology Subcommittee of...

  20. Oncological hadrontherapy and the TERA project

    CERN Document Server

    Amaldi, Ugo

    1996-01-01

    The first hour is devoted to a review of the techniques of conventional radiotherapy and of the European statistics on cancer treated and cured with the various techniques. In the second lesson the most recent applications of hadron accelerators to t Italian "Hadrontherapy Project" is introduced. This project (described in detail in the last lesson) foresees three independent but coherent activities :i) the construction of a large National Centre for Oncological Hadrontherary; (ii) the design and development of relatively small and "cheap" proton accelerators ("compact accelerators"), with which various centres could be equipped within reasonable cost boundaries; (iii) a multimedia information network (RITA) connecting a large number of Associated Centres with the Centres having hadron beams, so to select before any travelling the patients to be irradiated.

  1. CAM, free speech, and the British legal system: overstepping the mark?

    Science.gov (United States)

    Milgrom, Lionel R

    2009-10-01

    The British Chiropractic Association recently won a libel case against the science writer and CAM 'skeptic' Dr Simon Singh for publishing an article in a British newspaper in which he accused them of promoting 'bogus' treatments. This has ignited a campaign in the UK to 'keep the libel laws out of science'. In this article, the tension between media freedom of expression and defamation law is examined, and possible ramifications for CAM in the UK explored.

  2. Do Formal Inspections Ensure that British Zoos Meet and Improve on Minimum Animal Welfare Standards?

    OpenAIRE

    Draper, Chris; Browne, William; Harris, Stephen

    2013-01-01

    Simple Summary Key aims of the formal inspections of British zoos are to assess compliance with minimum standards of animal welfare and promote improvements in animal care and husbandry. We compared reports from two consecutive inspections of 136 British zoos to see whether these goals were being achieved. Most zoos did not meet all the minimum animal welfare standards and there was no clear evidence of improving levels of compliance with standards associated with the Zoo Licensing Act 1981. ...

  3. Fecal Carriage of Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae Strains Is Associated with Worse Outcome in Patients Hospitalized in the Pediatric Oncology Unit of Beni-Messous Hospital in Algiers, Algeria.

    Science.gov (United States)

    Medboua-Benbalagh, Chafiaa; Touati, Abdelaziz; Kermas, Rachida; Gharout-Sait, Alima; Brasme, Lucien; Mezhoud, Halima; Touati, Djamila; Guillard, Thomas; de Champs, Christophe

    2017-09-01

    The current study aimed to investigate extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) fecal carriage in children with different cancers admitted in the pediatric oncology unit of Beni-Messous Hospital (Algiers, Algeria). Rectal swabs from children with cancer were sampled from February 2012 to May 2013 within 48 hours following their admission. After species identification and detection of ESBL production by double-disk synergy test (DD test), antibiotic susceptibility was determined by the standard disk diffusion method. Antibiotic resistance genes, including bla genes and plasmid-mediated quinolone resistance (PMQR) genes, were investigated by polymerase chain reaction (PCR). The phylogenetic grouping of Escherichia coli strains was determined by PCR. Of the 171 children studied, 93 (54%) were ESBL carriers. An antibiotic treatment for the last 3 months before admission (p = 0.01), hematological malignancies (p = 0.003), and death (p = 0.0003) were more frequent in the ESBL-E group than in the non-ESBL group. Multivariate analysis showed that hematological malignancies (odds ratio [OR]: 3.9; confidence interval [CI]: 1.1-14.1; p = 0.04) and ESBL-E carriage (OR: 6.2; CI: 1.7-22.00; p = 0.005) were two independent factors associated with increased risk of death. A total of 103 ESBL-E isolates were obtained. Klebsiella pneumoniae and E. coli isolates were the most frequently isolated. PCR amplification showed that all the isolates produced a CTX-M ESBL (CTX-M-15, CTX-M-14, and CTX-M-3). The PMQR genes detected were qnrB, qnrS, and aac(6')-Ib-cr. E. coli isolates were assigned to four major extraintestinal pathogenic E. coli phylogroups, including B2 and D. This study provides, for the first time, insight into epidemiology of the ESBL-E fecal carriage among children with cancer in Algeria.

  4. Osteonecrose dos maxilares associada ao uso de bisfosfonatos: importante complicação do tratamento oncológico Bisphosphonate-associated jaws osteonecrosis: an important complication of oncology treatment

    Directory of Open Access Journals (Sweden)

    Marco Antonio T. Martins

    2009-02-01

    Full Text Available Os bisfosfonatos são um grupo de medicamentos utilizados no tratamento de doenças malignas metastáticas e em outras doenças ósseas como osteoporose e doença de Paget. A despeito dos seus benefícios, uma importante complicação denominada de osteonecrose dos maxilares vem sendo observada nos pacientes usuários crônicos dos bisfosfonatos que se caracteriza clinicamente por exposições ósseas na região maxilofacial persistente, acompanhadas de osteomielite, geralmente sintomáticas e cujo tratamento é complexo. Este estudo tem por objetivo revisar a literatura sobre a osteonecrose associada ao uso dos bisfosfonatos, em especial, em oncologia, no período de 2003 a 2008. Serão apresentados e discutidos os fatores de risco, aspectos etiopatogênicos, clínicos, imagenológicos, terapêuticos e preventivos desta doença. Devido à dificuldade de tratamento da osteonecrose associada aos bisfosfonatos, o foco deve ser a prevenção, sendo o ideal a eliminação de quadros infecciosos orais antes da terapia com os bisfosfonatos ter sido iniciada e minimizar traumas em boca após o uso destes medicamentos.Bisphosphonates are drugs used in the treatment of malignant metastatic diseases and in other bone lesions such as osteoporosis and Paget´s disease. Besides their benefits, jaw osteonecrosis, an important side effect, has been observed in long-term users of these drugs. Jaw osteonecrosis is clinically characterized by prolonged maxillary and mandible bone exposure accompanied by osteomyelitis. These lesions are usually symptomatic and difficult to treat. This study has the objective of reviewing publications from 2003 to 2008 about bisphosphonate-associated jaw osteonecrosis, in particular in relation to oncology. Risk factors, and etiopathological, clinical, radiographic, therapeutic, and preventive aspects of this condition are presented and discussed. Due to the difficulty to treat this disease, the focus must be prevention, with the

  5. [Burn out syndrome in oncology].

    Science.gov (United States)

    Schraub, Simon; Marx, E

    2004-09-01

    SEPS or burnout syndrome was described among health care workers. Oncology care givers--physicians and nurses--can be concerned. Burnout is a chronical stress reaction. Emotional exhaustion and depersonalisation are more prevalent than low personal accomplishment. Burnout is essentially assessed by questionnaires. Oncologists report an higher level of burnout, than AIDS medical or palliative care staff. Causes of burn out are numerous: insufficient personal time, sense of failure,... followed by poorly management and difficulties in staff or institution relationships. Prevention and therapy of burn out can be considered on three levels: personal, (psychotherapy, advices on health way of life), team (improvement in communication) and institution (support meetings and talking groups).

  6. Introduction to veterinary clinical oncology

    Energy Technology Data Exchange (ETDEWEB)

    Weller, R.E.

    1991-10-01

    Veterinary clinical oncology involves a multidisciplinary approach to the recognition and management of spontaneously occurring neoplasms of domestic animals. This requires some knowledge of the causes, incidence, and natural course of malignant disease as it occurs in domestic species. The purpose of this course is to acquaint you with the more common neoplastic problems you will encounter in practice, so that you can offer your clients an informed opinion regarding prognosis and possible therapeutic modalities. A major thrust will be directed toward discussing and encouraging treatment/management of malignant disease. Multimodality therapy will be stressed. 10 refs., 3 tabs.

  7. Work-related stress and reward: an Australian study of multidisciplinary pediatric oncology healthcare providers.

    Science.gov (United States)

    Bowden, M J; Mukherjee, S; Williams, L K; DeGraves, S; Jackson, M; McCarthy, M C

    2015-11-01

    Managing staff stress and preventing long-term burnout in oncology staff are highly important for both staff and patient well-being. Research addressing work-related stress in adult oncology is well documented; however, less is known about this topic in the pediatric context. This study examined sources of work-related stress and reward specific to multidisciplinary staff working in pediatric oncology in Australia. Participants were 107 pediatric oncology clinicians, including medical, nursing, and allied health staff from two Australian pediatric oncology centers. Participants completed an online survey using two newly developed measures: the work stressors scale-pediatric oncology and the work rewards scale-pediatric oncology. The most commonly reported sources of both stress and reward are related to patient care and interactions with children. Results indicated that levels of work-related stress and reward were similar between the professional disciplines and between the two hospitals. Regression analyses revealed no demographic or organizational factors that were associated with either stress or reward. Work-related stress and reward are not mutually exclusive; particular situations and events can be simultaneously stressful and rewarding for healthcare providers. Although patient care and interactions with children was found to be the most stressful aspect of working in this speciality, it was also the greatest source of reward. Results are discussed in relation to workplace approaches to staff well-being and stress reduction. Copyright © 2015 John Wiley & Sons, Ltd.

  8. Exercise in cancer care in Ireland: a survey of oncology nurses and physiotherapists.

    Science.gov (United States)

    O'Hanlon, E; Kennedy, N

    2014-09-01

    Little is known about the extent of exercise prescription within cancer care. This cross-sectional survey aims to identify Irish oncology nurses and physiotherapists' current knowledge and practice in prescribing exercise for cancer care and barriers to such prescription. An online survey was distributed to the Chartered Physiotherapists in Oncology and Palliative Care (n = 35) and the Irish Association for Nurses in Oncology (n = 170). The response rate was 74% (26/35) for physiotherapists and 34% (58/170) for oncology nurses. Three quarters of physiotherapists recommended/prescribed exercise with 81% or more of cancer patients in the past 6 months, with the exercises prescribed largely in line with current guidelines. Patients' family/friends advising rest was the most commonly reported exercise barrier by physiotherapists [89% (17/19)], with a lack of exercise guidelines for cancer patients being most problematic for oncology nurses [93% (50/54)]. Only 33% (18/54) of oncology nurses felt they had sufficient knowledge regarding exercise in cancer care. In conclusion, exercise prescription by physiotherapists largely corresponds with current guidelines. A minority of nurses felt they had sufficient knowledge of exercise for this population. Further formal postgraduate educational opportunities are needed for oncology nurses and physiotherapists in this area. © 2014 John Wiley & Sons Ltd.

  9. Falls in Older Adults With Cancer: Evaluation by Oncology Providers.

    Science.gov (United States)

    Guerard, Emily J; Deal, Allison M; Williams, Grant R; Jolly, Trevor A; Nyrop, Kirsten A; Muss, Hyman B

    2015-11-01

    Falls in older adults are common. Screening for falls is quick, simple, and important because falls increase the risk of morbidity and mortality in older patients with cancer. The aim of this study was to evaluate oncology providers' recognition of and response to falls in older patients with cancer. From a sample of older patients with cancer who completed a geriatric assessment blinded to oncology providers, we identified patients who self-reported falls within the past 6 months. Their history and physical and/or clinic notes completed by an oncology provider were reviewed for the following: documentation of falls, gait assessment, referral to geriatrics or physical and/or occupational therapy, and measurement of 25-hydroxy vitamin D level. In our sample of older patients with cancer who reported at least one recent fall (N = 125), the average age was 72 years (range, 65 to 93 years), 78% were female, and 62% had a breast cancer diagnosis. Chart reviews showed that 13 (10%) had falls documented, 25 (20%) had a gait assessment, eight (6%) were referred, and 21 (17%) had vitamin D level measured. We found that only 10% of older patients with cancer who self-reported a recent fall had appropriate medical record documentation. Oncologists are often the primary care providers for older patients and are largely unfamiliar with the frequency and impact of falls in this population. There is a need to increase awareness of falls prevalence and consequences among oncology providers in order to provide timely interventions to reduce the risks associated with falls. Copyright © 2015 by American Society of Clinical Oncology.

  10. Possibly impossible patients: management of difficult behavior in oncology outpatients

    National Research Council Canada - National Science Library

    Peteet, John R; Meyer, Fremonta L; Miovic, Michael K

    2011-01-01

    .... We offer oncology clinicians guidance in dealing with difficult outpatients by discussing the differential diagnosis and multidisciplinary management of treatment-disrupting behavior in the ambulatory oncology...

  11. British Teachers' Transnational Work within and beyond the British Empire after the Second World War

    Science.gov (United States)

    Whitehead, Kay

    2017-01-01

    Focusing on British graduates from Gipsy Hill Training College (GHTC) in London, this article illustrates transnational history's concerns with the reciprocal flows of people and ideas within and beyond the British Empire. GHTC's progressive curriculum and culture positioned women teachers as agents of change, and the article highlights the lives…

  12. Dispositional Optimism and Therapeutic Expectations in Early Phase Oncology Trials

    Science.gov (United States)

    Jansen, Lynn A.; Mahadevan, Daruka; Appelbaum, Paul S.; Klein, William MP; Weinstein, Neil D.; Mori, Motomi; Daffé, Racky; Sulmasy, Daniel P.

    2016-01-01

    Purpose Prior research has identified unrealistic optimism as a bias that might impair informed consent among patient-subjects in early phase oncology trials. Optimism, however, is not a unitary construct – it can also be defined as a general disposition, or what is called dispositional optimism. We assessed whether dispositional optimism would be related to high expectations for personal therapeutic benefit reported by patient-subjects in these trials but not to the therapeutic misconception. We also assessed how dispositional optimism related to unrealistic optimism. Methods Patient-subjects completed questionnaires designed to measure expectations for therapeutic benefit, dispositional optimism, unrealistic optimism, and the therapeutic misconception. Results Dispositional optimism was significantly associated with higher expectations for personal therapeutic benefit (Spearman r=0.333, poptimism was weakly associated with unrealistic optimism (Spearman r=0.215, p=0.005). In multivariate analysis, both dispositional optimism (p=0.02) and unrealistic optimism (poptimism (p=.0001), but not dispositional optimism, was independently associated with the therapeutic misconception. Conclusion High expectations for therapeutic benefit among patient-subjects in early phase oncology trials should not be assumed to result from misunderstanding of specific information about the trials. Our data reveal that these expectations are associated with either a dispositionally positive outlook on life or biased expectations about specific aspects of trial participation. Not all manifestations of optimism are the same, and different types of optimism likely have different consequences for informed consent in early phase oncology research. PMID:26882017

  13. A comprehensive overview on the surgical management of secondary lymphedema of the upper and lower extremities related to prior oncologic therapies

    OpenAIRE

    Garza, Ramon; Skoracki, Roman; Hock, Karen; Povoski, Stephen P.

    2017-01-01

    Secondary lymphedema of the upper and lower extremities related to prior oncologic therapies, including cancer surgeries, radiation therapy, and chemotherapy, is a major cause of long-term morbidity in cancer patients. For the upper extremities, it is most commonly associated with prior oncologic therapies for breast cancer, while for the lower extremities, it is most commonly associated with oncologic therapies for gynecologic cancers, urologic cancers, melanoma, and lymphoma. Both non-surgi...

  14. A Comprehensive Definition for Integrative Oncology.

    Science.gov (United States)

    Witt, Claudia M; Balneaves, Lynda G; Cardoso, Maria J; Cohen, Lorenzo; Greenlee, Heather; Johnstone, Peter; Kücük, Ömer; Mailman, Josh; Mao, Jun J

    2017-11-01

    Integrative oncology, which is generally understood to refer to the use of a combination of complementary medicine therapies in conjunction with conventional cancer treatments, has been defined in different ways, but there is no widely accepted definition. We sought to develop and establish a consensus for a comprehensive definition of the field of integrative oncology. We used a mixed-methods approach that included a literature analysis and a consensus procedure, including an interdisciplinary expert panel and surveys, to develop a comprehensive and acceptable definition for the term "integrative oncology." The themes identified in the literature and from the expert discussion were condensed into a two-sentence definition. Survey respondents had very positive views on the draft definition, and their comments helped to shape the final version. The final definition for integrative oncology is: "Integrative oncology is a patient-centered, evidence-informed field of cancer care that utilizes mind and body practices, natural products, and/or lifestyle modifications from different traditions alongside conventional cancer treatments. Integrative oncology aims to optimize health, quality of life, and clinical outcomes across the cancer care continuum and to empower people to prevent cancer and become active participants before,during, and beyond cancer treatment." This short and comprehensive definition for the term integrative oncology will facilitate a better understanding and communication of this emerging field. This definition will also drive focused and cohesive effort to advance the field of integrative oncology.

  15. Adverse event development in clinical oncology trials

    NARCIS (Netherlands)

    Walraven, I.; Aaronson, N.; Sonke, J.-J.; Verheij, M.; Belderbos, J.

    Gita Thanarajasingam and colleagues' Article1 in The Lancet Oncology reports on a novel longitudinal approach for adverse event analysis and reporting. Comprehensive adverse event reporting in clinical oncology trials is essential to monitor tolerability of new cancer treatments. In view of the

  16. Clinical Oncology Assistantship Program for Medical Students.

    Science.gov (United States)

    Neilan, Barbara A.; And Others

    1985-01-01

    The Clinical Oncology Assistantship Program at the University of Arkansas for Medical Sciences is described, along with student reactions to the program. The summer elective program involves cancer lectures (one week) and clinical exposure (nine weeks) in medical, surgical, and pediatric oncology services, as well as self-directed learning…

  17. Nursing 436A: Pediatric Oncology for Nurses.

    Science.gov (United States)

    Jackman, Cynthia L.

    A description is provided of "Pediatric Oncology for Nurses," the first in a series of three courses offered to fourth-year nursing students in pediatric oncology. The first section provides a course overview, discusses time assignments, and describes the target student population. Next, a glossary of terms, and lists of course goals, long-range…

  18. [Sedation using ketamine for pain procedures in Pediatric Oncology.].

    Science.gov (United States)

    Ricard, C; Tichit, R; Troncin, R; Bernard, F

    2009-09-01

    Procedural sedation and analgesia for children is widely practiced. Since 2005 to 2007, we evaluated the safety and efficacy of ketamine to control pain induced by diagnostic procedures in pediatric oncology patients. Eight hundred fifty procedures were carried out in 125 patients aged 2 to 16 years. We associated EMNO (inhaled equimolar mixture of nitrous oxide and oxygen), atropin (oral or rectal), midazolam (oral or rectal) and ketamin (intravenous). An anesthesiologist injected ketamin. Average dose of ketamine was 0.33 to 2 mg/kg depending on number and invasiveness of procedures. This method requires careful monitoring and proper precautions. With these conditions, no complication was observed. All patients were effectively sedated. These results indicate that ketamine - in association with EMNO, atropine and midazolam - is safe and effective in pain management induced by diagnostic procedures in pediatric oncology patients. The sedative regimen of intravenous ketamine has greatly reduced patient, family and practitioners anxiety for diagnostic and therapeutic procedures.

  19. Big data in oncologic imaging.

    Science.gov (United States)

    Regge, Daniele; Mazzetti, Simone; Giannini, Valentina; Bracco, Christian; Stasi, Michele

    2017-06-01

    Cancer is a complex disease and unfortunately understanding how the components of the cancer system work does not help understand the behavior of the system as a whole. In the words of the Greek philosopher Aristotle "the whole is greater than the sum of parts." To date, thanks to improved information technology infrastructures, it is possible to store data from each single cancer patient, including clinical data, medical images, laboratory tests, and pathological and genomic information. Indeed, medical archive storage constitutes approximately one-third of total global storage demand and a large part of the data are in the form of medical images. The opportunity is now to draw insight on the whole to the benefit of each individual patient. In the oncologic patient, big data analysis is at the beginning but several useful applications can be envisaged including development of imaging biomarkers to predict disease outcome, assessing the risk of X-ray dose exposure or of renal damage following the administration of contrast agents, and tracking and optimizing patient workflow. The aim of this review is to present current evidence of how big data derived from medical images may impact on the diagnostic pathway of the oncologic patient.

  20. [Therapeutic Aggressiveness and Liquid Oncology].

    Science.gov (United States)

    Barón Duarte, F J; Rodríguez Calvo, M S; Amor Pan, J R

    2017-01-01

    Aggressiveness criteria proposed in the scientific literature a decade ago provide a quality judgment and are a reference in the care of patients with advanced cancer, but their use is not generalized in the evaluation of Oncology Services. In this paper we analyze the therapeutic aggressiveness, according to standard criteria, in 1.001 patients with advanced cancer who died in our Institution between 2010 and 2013. The results seem to show that aggressiveness at the end of life is present more frequently than experts recommend. About 25% of patients fulfill at least one criterion of aggressiveness. This result could be explained by a liquid Oncology which does not prioritize the patient as a moral subject in the clinical appointment. Medical care is oriented to necessities and must be articulated in a model focused on dignity and communication. Its implementation through Advanced Care Planning, consideration of patient's values and preferences, and Limitation of therapeutic effort are ways to reduce aggressiveness and improve clinical practice at the end of life. We need to encourage synergic and proactive attitudes, adding the best of cancer research with the best clinical care for the benefit of human being, moral subject and main goal of Medicine.

  1. E-learning programs in oncology

    DEFF Research Database (Denmark)

    Degerfält, Jan; Sjöstedt, Staffan; Fransson, Per

    2017-01-01

    BACKGROUND: E-learning is an established concept in oncological education and training. However, there seems to be a scarcity of long-term assessments of E-learning programs in oncology vis-á-vis their structural management and didactic value. This study presents descriptive, nationwide data from...... 2005 to 2014. E-learning oncology programs in chemotherapy, general oncology, pain management, palliative care, psycho-social-oncology, and radiotherapy, were reviewed from our databases. Questionnaires of self-perceived didactic value of the programs were examined 2008-2014. RESULTS: The total number...... of trainees were 4693, allocated to 3889 individuals. The trainees included medical doctors (MDs; n = 759), registered nurses (RNs; n = 2359), radiation therapy technologists (n = 642), and, social and health care assistants (SHCAs; n = 933). The E-learning covered 29 different program classifications...

  2. Surgical Oncology Nursing: Looking Back, Looking Forward.

    Science.gov (United States)

    Crane, Patrick C; Selanders, Louise

    2017-02-01

    To provide a historical perspective in the development of oncology nursing and surgical oncology as critical components of today's health care system. Review of the literature and Web sites of key organizations. The evolution of surgical oncology nursing has traversed a historical journey from that of a niche subspecialty of nursing that had very little scientific underpinning, to a highly sophisticated discipline within a very short time. Nursing continues to contribute its expertise to the encyclopedic knowledge base of surgical oncology and cancer care, which have helped improve the lives of countless patients and families who have had to face the difficulties of this diagnosis. An understanding of the historical context for which a nursing specialty such as surgical oncology nursing evolves is critical to gaining an appreciation for the contributions of nursing. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Models of Care in Geriatric Oncology Nursing.

    Science.gov (United States)

    Burhenn, Peggy S; Perrin, Sylvie; McCarthy, Alexandra L

    2016-02-01

    To review models of care for older adults with cancer, with a focus on the role of the oncology nurse in geriatric oncology care. International exemplars of geriatric oncology nursing care are discussed. Published peer reviewed literature, Web-based resources, professional society materials, and the authors' experience. Nursing care for older patients with cancer is complex and requires integrating knowledge from multiple disciplines that blend the sciences of geriatrics, oncology, and nursing, and which recognizes the dimensions of quality of life. Oncology nurses can benefit from learning key skills of comprehensive geriatric screening and assessment to improve the care they provide for older adults with cancer. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. ONCOLOGY

    African Journals Online (AJOL)

    2012, at the Combined Breast Cancer Clinic at Groote Schuur Hospital. Patients with a ... This may frequently be the first time that the patient has a clinical breast examination, a discussion on breast awareness and risk factors with the ... patients (52%) were noted to have isolated microcalcifications. The average size of the ...

  5. Phonemic Transcriptions in British and American Dictionaries

    Directory of Open Access Journals (Sweden)

    Rastislav Šuštaršič

    2005-06-01

    Full Text Available In view of recent criticisms concerning vowel symbols in some British English dictionaries (in particular by J. Windsor Lewis in JIPA (Windsor Lewis, 2003, with regard to the Oxford Dictionary of Pronunciation (Upton, 2001, this article extends the discussion on English phonemic transcriptions by including those that typically occur in standard American dictionaries, and by comparing the most common conventions of British and American dictionaries. In addition to symbols for both vowels and consonants, the paper also deals with the different representations of word accentuation and the issue of consistency regarding application of phonemic (systemic, broad, rather than phonetic (allophonic, narrow transcription. The different transcriptions are assessed from the points of view of their departures from the International Phonetic Alphabet, their overlapping with orthographic representation (spelling and their appropriateness in terms of reflecting actual pronunciation in standard British and/or American pronunciation.

  6. The British Library's Vulnerable Collection Items Project

    Directory of Open Access Journals (Sweden)

    Kimberly C. Kowal

    2008-09-01

    Full Text Available The British Library embarked on a project in 2007 to better protect collection materials considered vulnerable. Following thefts of maps contained within books, a methodology was developed to firmly identify the unique copies of rare and valuable British Library holdings, using a range of security photography and copy-specific descriptive metadata. The outcome of the project not only served to improve the security of the selected maps, but by revealing these hidden collections, access to and knowledge of them is enhanced.

  7. Four Centuries of British Economic Growth

    DEFF Research Database (Denmark)

    Madsen, Jakob B.; Ang, James B.; Banerjee, Rajabrata

    2010-01-01

    of two competing second-generation endogenous growth models to account for the British growth experience. The results suggest that innovative activity was an important force in shaping the Industrial Revolution and that the British growth experience is consistent with Schumpeterian growth theory.......Using long historical data for Britain over the period 1620–2006, this paper seeks to explain the importance of innovative activity, population growth and other factors in inducing the transition from the Malthusian trap to the post-Malthusian growth regime. Furthermore, the paper tests the ability...

  8. A critical history of British earthquakes

    OpenAIRE

    R. M. W. Musson

    2004-01-01

    This paper reviews the history of the study of historical British earthquakes. The publication of compendia of British earthquakes goes back as early as the late 16th Century. A boost to the study of earthquakes in Britain was given in the mid 18th Century as a result of two events occurring in London in 1750 (analogous to the general increase in earthquakes in Europe five years later after the 1755 Lisbon earthquake). The 19th Century saw a number of significant studies, culminating in th...

  9. CRITERIA OF BRITISH TEACHERS’ COMMUNICATION CULTURE FORMEDNESS

    Directory of Open Access Journals (Sweden)

    Yesipov Mikhail Alekseevich

    2013-01-01

    Full Text Available Communication culture formation belongs to most essential problems for pedagogical theory and practice. The level of a teacher’s communication culture influences greatly the efficiency of his professional communication with colleagues and students. The peculiarities of teachers’ communication culture formation in the British educational system are considered. Main characteristics of a communication-oriented teacher are mentioned. Criteria for specifying the level of British teachers’ communication culture formedness as well as brief description of these levels are given in this article.

  10. Illness perception differences between Russian- and Hebrew-speaking Israeli oncology patients.

    Science.gov (United States)

    Popov, Nadia; Heruti, Irit; Levy, Sigal; Lulav-Grinwald, Doron; Bar-Sela, Gil

    2014-03-01

    Illness perception influences health and illness behaviors. This study was designed to estimate illness perception differences between Russian-speaking and Hebrew-speaking Israeli oncology patients. Changes in illness perception associated with time spent in Israel among Russian-speaking patients were also evaluated. Additionally, we evaluated differences in illness perception of patients exposed to Chernobyl's consequences. A total of 144 oncology patients (77 Hebrew-speaking, 67 Russian-speaking) completed personal data questionnaires and The illness perception questionnaire revised, translated into Russian for this study. Significantly more Russian-speaking oncology patients perceived their illness as chronic and having negative consequences on life (p speaking oncology patients tend to have a more negative perception of cancer compared to Hebrew-speaking patients. Time spent in Israel may create more positive perceptions of cancer among these patients. No illness perception differences were found concerning Chernobyl consequences.

  11. Cultural and age differences in beliefs about depression: British Bangladeshis vs. British Whites.

    Science.gov (United States)

    McClelland, Alastair; Khanam, Shopnara; Furnham, Adrian

    2014-03-01

    This study examines beliefs about depression as a function of ethnic background (British Bangladeshis vs. British Whites) and age. A total of 364 participants completed a 65-item questionnaire, containing general questions regarding depression and anti-depressive behaviour; the causes of depression, and treatments for depression. The hypotheses were broadly supported; there were significant interactions between ethnicity and age, which generally revealed an increasingly negative attitude towards depression with increasing age amongst British Bangladeshis. Older British Bangladeshis believed depression was an illness that brought a sense of shame and loss of dignity to the individual and his or her family, and they also favoured a lay referral system for sufferers. They also had more superstitious beliefs about depression than both younger British Bangladeshis and British Whites. A pattern of increasing negativity with increasing age was not evident amongst the British Whites, but older individuals in both groups tended to believe that depression was not helped by psychological intervention. The attitudes towards depression in the young was similar (and generally positive) in both ethnic groups. These findings highlight the necessity to provide more culturally sensitive and accessible services for migrant communities - particularly amongst older individuals.

  12. Robotic surgery in gynecologic oncology.

    Science.gov (United States)

    Bandera, Christina A; Magrina, Javier F

    2009-02-01

    Robotic surgery is rapidly taking the place of laparoscopy in many gynecologic oncology practices. Numerous practitioners have published their experience with this new technology. A review of their findings is timely and relevant. The majority of case series of robotic surgery for hysterectomy and lymphadenectomy show that the procedure is feasible and at least comparable to laparoscopic surgery. Similarly, case series of robotic radical hysterectomy for cervical cancer also compare favorably to laparoscopic surgery. Less common procedures such as robotic trachelectomy, parametrectomy, and retroperitoneal lymphadenectomy have also been described. Numerous patient and practitioner advantages are discussed in this review. Robotic surgery is a minimally invasive alternative to laparoscopy for the surgical treatment of endometrial cancer and cervical cancer. Its role in ovarian cancer is just starting to be explored.

  13. A journey to citizenship: constructions of citizenship and identity in the British Citizenship Test.

    Science.gov (United States)

    Gray, Debra; Griffin, Christine

    2014-06-01

    The British Citizenship Test was introduced in 2005 as one of a raft of new procedures aimed at addressing the perceived problems of integration and social cohesion in migrant communities. In this study, we argue that this new citizenship procedure signals a shift in British political discourse about citizenship - particularly, the institutionalization of a common British citizen identity that is intended to draw citizens together in a new form of political/national community. In line with this, we examine the British Citizenship Test from a social psychological perspective to interrogate the ways in which the test constitutes identity, constitutes citizenship, and constitutes citizenship-as-identity. Analysis of the test and its associated documents highlights three ways in which Britishness-as-identity is constituted, that is, as a collective identity, as a superordinate and national identity, and finally as both a destination and a journey. These findings are discussed in terms of their implications for models of citizenship and models of identity. © 2013 The British Psychological Society.

  14. [Treatment Refusal in Pediatric Oncology].

    Science.gov (United States)

    Špótová, A; Husáková, K; Hrašková, A; Mikesková, M; Puškáčová, J; Hederová, S; Jamárik, M; Rabenseifertová, E; Jalovecká, Z; Kolenová, A; Šubová, Z

    2017-01-01

    Pediatric oncologists are often faced with situations in which parents or guardians refuse recommended treatment for curable childhood cancer. Deciding how to proceed in such situations is an ethical dilemma. The aim of this article is to consider optimal approaches when parents are strongly against oncological treatment, potentially compromising their childrens rights for health care and to the chance for cure. In this paper, we report two cases of treatment refusal from our department and the impact of such decisions on the children themselves. Case no. 1 describes a child with retinoblastoma whose parents refused standard treatment in order to seek alternative treatment abroad. Case no. 2 describes a patient with a primary lymphoma of bone who received treatment by a court order after parental refusal. When parents refuse a treatment for potentially curable cancer, the medical team often focuses on the certainty of death without treatment. In the background, there is a smaller but still significant risk that - even if the treatment is eventually accepted or compelled - the child will still die from treatment-related complications or refractory disease, possibly with considerable suffering. The reasons for refusing a treatment vary. The entire medical team is tasked with trying to respectfully understand the reasoning behind the parents unwillingness to accept the treatment, in order to address all possible misunderstandings and to propose solutions that could be acceptable for the parents. In some situations however, it is necessary to resolve the dilemma by legal means in order to protect the life of the child.Key words: oncology - ethics - decision making - treatment refusal - legal guardians The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 7. 8. 2017Accepted: 7. 9. 2017.

  15. Radiation protection in medical imaging and radiation oncology

    CERN Document Server

    Stoeva, Magdalena S

    2016-01-01

    Radiation Protection in Medical Imaging and Radiation Oncology focuses on the professional, operational, and regulatory aspects of radiation protection. Advances in radiation medicine have resulted in new modalities and procedures, some of which have significant potential to cause serious harm. Examples include radiologic procedures that require very long fluoroscopy times, radiolabeled monoclonal antibodies, and intravascular brachytherapy. This book summarizes evidence supporting changes in consensus recommendations, regulations, and health physics practices associated with these recent advances in radiology, nuclear medicine, and radiation oncology. It supports intelligent and practical methods for protection of personnel, the public, and patients. The book is based on current recommendations by the International Commission on Radiological Protection and is complemented by detailed practical sections and professional discussions by the world’s leading medical and health physics professionals. It also ...

  16. Oncologic Outcomes After Transoral Robotic Surgery

    Science.gov (United States)

    Magnuson, J. Scott; Smith, Richard V.; Moore, Eric; Lawson, Georges; Remacle, Marc; Ganly, Ian; Kraus, Dennis H.; Teng, Marita S.; Miles, Brett A.; White, Hilliary; Duvvuri, Umamaheswar; Ferris, Robert L.; Mehta, Vikas; Kiyosaki, Krista; Damrose, Edward J.; Wang, Steven J.; Kupferman, Michael E.; Koh, Yoon Woo; Genden, Eric M.; Holsinger, F. Christopher

    2016-01-01

    IMPORTANCE Large patient cohorts are necessary to validate the efficacy of transoral robotic surgery (TORS) in the management of head and neck cancer. OBJECTIVES To review oncologic outcomes of TORS from a large multi-institutional collaboration and to identify predictors of disease recurrence and disease-specific mortality. DESIGN, SETTING, AND PARTICIPANTS A retrospective review of records from 410 patients undergoing TORS for laryngeal and pharyngeal cancers from January 1, 2007, through December 31, 2012, was performed. Pertinent data were obtained from 11 participating medical institutions. INTERVENTIONS Select patients received radiation therapy and/or chemotherapy before or after TORS. MAIN OUTCOMES AND MEASURES Locoregional control, disease-specific survival, and overall survival were calculated. We used Kaplan-Meier survival analysis with log-rank testing to evaluate individual variable association with these outcomes, followed by multivariate analysis with Cox proportional hazards regression modeling to identify independent predictors. RESULTS Of the 410 patients treated with TORS in this study, 364 (88.8%) had oropharyngeal cancer. Of these 364 patients, information about post-operative adjuvant therapy was known about 338: 106 (31.3) received radiation therapy alone, and 72 (21.3%) received radiation therapy with concurrent chemotherapy. Neck dissection was performed in 323 patients (78.8%). Mean follow-up time was 20 months. Local, regional, and distant recurrence occurred in 18 (4.4%), 15 (3.7%), and 10 (2.4%) of 410 patients, respectively. Seventeen (4.1%) died of disease, and 13 (3.2%) died of other causes. The 2-year locoregional control rate was 91.8% (95% CI, 87.6%-94.7%), disease-specific survival 94.5% (95% CI, 90.6%-96.8%), and overall survival 91% (95% CI, 86.5%-94.0%). Multivariate analysis identified improved survival among women (P = .05) and for patients with tumors arising in tonsil (P = .01). Smoking was associated with worse overall

  17. British Higher Education and Its Older Clients.

    Science.gov (United States)

    Woodley, Alan; Wilson, Jane

    2002-01-01

    Using results from a survey of British graduates, examined outcomes of higher education for older students, including their current employment situation, relationship of degree to job, and student satisfaction. Found that mature students are an extremely heterogeneous group, with differences in outcomes by age and mode of study. (EV)

  18. Earnings Returns to the British Education Expansion

    Science.gov (United States)

    Devereux, Paul J.; Fan, Wen

    2011-01-01

    We study the effects of the large expansion in British educational attainment that took place for cohorts born between 1970 and 1975. Using the Quarterly Labour Force Survey, we find that the expansion caused men to increase education by about a year on average and gain about 8% higher wages; women obtained a slightly greater increase in education…

  19. British Technology Education. An American View.

    Science.gov (United States)

    Hutchinson, John

    1986-01-01

    The author describes the British Craft, Design and Technology (CDT) curriculum, which is comparable to American technology education. According to the author, CDT is characterized by creative thinking and experimentation. He states, however, that little national coordination or cooperation is evident. (CH)

  20. Considerations for Education Reform in British Columbia

    Science.gov (United States)

    Santos, Ana

    2012-01-01

    Countries around the world refer to twenty-first century education as essential to maintaining personal and national economic advantage and draw on this discourse to advocate for and embark on educational reform. This paper examines issues around education reform, particularly in British Columbia. It argues that reformers should give careful…

  1. British physics Newton's law of funding

    CERN Multimedia

    2007-01-01

    In Britain, fundamental physics is in a pickle ISAAC NEWTON, besides being the founder of modern physics, was also master of Britain's mint. That is a precedent which many British physicists must surely wish had become traditional. At the moment, money for physics is in short supply in Britain.

  2. British used Congreve Rockets to Attack Napoleon

    Science.gov (United States)

    2004-01-01

    Sir William Congreve developed a rocket with a range of about 9,000 feet. The incendiary rocket used black powder, an iron case, and a 16-foot guide stick. In 1806, British used Congreve rockets to attack Napoleon's headquarters in France. In 1807, Congreve directed a rocket attack against Copenhagen.

  3. Spitsbergen - Imperialists beyond the British Empire

    NARCIS (Netherlands)

    Kruse, Frigga; Hacquebord, Louwrens

    2012-01-01

    This paper looks at the relationship between Spitsbergen in the European High Arctic and the global British Empire in the first quarter of the twentieth century. Spitsbergen was an uninhabited no man's land and comprised an unknown quantity of natural resources. The concepts of geopolitics and New

  4. Telephone Operators' Resistance to British Colonial Administration ...

    African Journals Online (AJOL)

    This paper aims to write the history of yet another form of resistance to colonial rule in British Africa with a focus on telephone operators in the erstwhile Cameroons Province. The pith and kernel of the paper therefore is to show how telephone operators resisted the colonial administration. This typology of resistance is yet to ...

  5. The Royal Navy and British Security Policy.

    Science.gov (United States)

    1983-12-01

    development or production. To Kennedy and MacNamara , the decision to cancel the SKYBOLT program in 1962 was only a measure to improve the cost...Kennedy- MacNamara decision to cancel SKYBOLT. Kennedy suc- cessfully solved the British dilemma by offering to sell them the American POLARIS submarine

  6. Demand for wildlife hunting in British Columbia

    NARCIS (Netherlands)

    Sun, L.; Kooten, van G.C.; Voss, G.M.

    2005-01-01

    We present estimates of the demand for hunting licenses by residents and nonresidents in British Columbia for the period 19712000. We obtain estimates of both short-run and long-run price elasticities and discuss their revenue implications for future fee increases. We find the demand by nonresidents

  7. HIV Prevalence among Aboriginal British Columbians

    Directory of Open Access Journals (Sweden)

    Strathdee Steffanie

    2005-12-01

    Full Text Available Abstract Context There is considerable concern about the spread of HIV disease among Aboriginal peoples in British Columbia. Objective To estimate the number of Aboriginal British Columbians infected with HIV. Design and setting A population-based analysis of Aboriginal men and women in British Columbia, Canada from 1980 to 2001. Participants Epidemic curves were fit for gay and bisexual men, injection drug users, men and women aged 15 to 49 years and persons over 50 years of age. Main outcome measures HIV prevalence for the total Aboriginal population was modeled using the UNAIDS/WHO Estimation and Projection Package (EPP. Monte Carlo simulation was used to estimate potential number infected for select transmission group in 2001. Results A total of 170,025 Aboriginals resided in British Columbia in 2001, of whom 69% were 15 years and older. Of these 1,691 (range 1,479 – 1,955 men and women aged 15 years and over were living with HIV with overall prevalence ranging from 1.26% to 1.66%. The majority of the persons infected were men. Injection drug users (range 1,202 – 1,744 and gay and bisexual men (range 145, 232 contributed the greatest number of infections. Few persons infected were from low risk populations. Conclusion More than 1 in every 100 Aboriginals aged 15 years and over was living with HIV in 2001. Culturally appropriate approaches are needed to tailor effective HIV interventions to this community.

  8. Drivers of Cousin Marriage among British Pakistanis

    Science.gov (United States)

    Shaw, Alison

    2014-01-01

    Background/Aim Why has the apparently high rate of cousin marriage among Bradford Pakistanis been sustained, 50 years since Pakistani migration to Britain began? Methods A review of the anthropological literature on Pakistani migration and settlement, British Pakistani marriage patterns and the phenomenon of transnational marriage. Results British Pakistanis are diverse in regional origins and social class characteristics, with many Bradford Pakistanis originating from the Mirpur district and northern Punjab. British Pakistani marriages often involve a partner from Pakistan who joins a spouse in the UK. Transnational marriage of first cousins offers relatives in Pakistan opportunities for a ‘better’ life in the West and are important for British Pakistanis for economic, social, cultural and emotional reasons. These processes are also differentially influenced by region of origin and class characteristics in Pakistan as well as by education, employment and locality in Britain. The pattern observed in Bradford may not be applicable nationally. Conclusion Further research examining marital decisions over several generations in families differing by social class, region of origin in Pakistan and locality in Britain is necessary to contextualise the findings from Bradford. PMID:25060267

  9. Four former British mining settlements on Spitsbergen

    NARCIS (Netherlands)

    Kruse, Frigga; Claughton, P.; Mills, C.

    2011-01-01

    The LASHIPA project participated in the recent International Polar Year to evaluate the large-scale historical exploitation of polar areas. This sub-project looks at the role of British actors in the economic and geopolitical development of the European High Arctic during the early twentieth

  10. African Centered Knowledge: A British Perspective.

    Science.gov (United States)

    Christian, Mark

    2001-01-01

    Considers the impact of African centered knowledge within the United Kingdom. Recent development of African Diaspora studies has forged links between various black Atlantic communities. The United Kingdom has experienced positive grassroots community response to the work of noted African centered scholars, yet within the British academy,…

  11. ARCTIC VECTOR OF BRITISH ENERGETIC STRATEGY

    Directory of Open Access Journals (Sweden)

    Natalia Valerievna Eremina

    2017-03-01

    Full Text Available The aim of the article is to reveal the forms, methods, content of British strategy in Arctic. Arctic is becoming the area of international cooperation among, first of all, Arctic states. Britain has ambitions to get the status of so-called “subarctic state” to prove its international leadership and acquire guarantees of energetic security. Now Britain has been elaborating the two strategies: military and scientific ones. The main instrument to solve the tasks for Britain is to participate in international structures, connected with Arctic. The article pays attention to the aspects that were not previously analyzed, such as: reasons of British interests in Arctic, bilateral and multilateral relationships between Britain and its partners, first of all, cooperation between Russia and Britain; British institutions; positive and negative aspects of British Arctic strategy; factors that have impact on its evolution, mainly EU and Scottish factors. The research allowed to make the conclusion that Britain does not have enough instruments to have a strong disposition in Arctic, though it plans to accelerate its participation in Arctic organizations. The article is based upon system and structural analysis.

  12. subordination across ghanaian and british newspaper editorials

    African Journals Online (AJOL)

    Empirical research in this area is scanty, though this theoretical argumentation is not without contention, especially cross-culturally. Empirical investigation is therefore ... Frimpong: Subordination Across Ghanaian and British Newspaper Editorials: A Register. Perspective. 78. Figure 1: The Components in a register analysis.

  13. Locating Ancestry in Notions of Britishness/Germanness

    Directory of Open Access Journals (Sweden)

    Andreas Pöllmann

    2012-11-01

    Full Text Available This article focuses on ancestry as a controversial marker of Britishness/Germanness. Considering developments in nationality law and large-scale survey data for England and Germany, it illustrates that macrocontextual distinctions into civic and ethnic nations tend to overestimate cross-national differences, while underestimating important within-country variations according to people’s educational background. The fact that—in both countries—higher levels of formal education are strongly associated with more ethnically inclusive notions of legitimate national membership underlines the formative potential of formal education in contemporary multicultural societies.

  14. AMCP Partnership Forum: Driving Value and Outcomes in Oncology.

    Science.gov (United States)

    2017-05-01

    Innovation in cancer treatment has provided a wealth of recently available therapeutic agents and a healthy drug pipeline that promises to change the way we approach this disease and the lives of those affected in the years to come. However, the majority of these new agents, many of which are targeted to specific genomic features of various tumors, may challenge the health care system's ability to afford cancer care. This innovation drives the need to focus on the value of the treatments provided to patients with cancer and on methods to optimize the efficiency of the dollars we spend, in addition to the clinical value itself. The Academy of Managed Care Pharmacy (AMCP) convened a Partnership Forum to address how to improve value and outcomes in cancer care. In this multistakeholder forum, several areas were addressed: current methods for assessing the value of oncology products, the need for balancing population management with precision medicine, and the outlook for value-based contracting for oncology medications in managed care settings. Participants recommended ways in which stakeholders can work toward solutions in these areas. The forum brought together stakeholders from health plans, integrated delivery systems, pharmacy benefit managers, clinical practice, biopharmaceutical industry, and laboratory companies. Also participating were representatives from trade and professional associations. During this 1.5-day forum, participants identified current challenges, readiness, and ways to address value and improve outcomes in cancer therapy. Some of the challenges identified include choosing a viable (and practical) outcome target for value-based contracting in oncology, the development and use of value frameworks and clinical pathways, managing cancer diagnostics, utilization of alternative payment systems, moving from a large evidence base to a small clinical trial base in considering targeted treatments, and lack of best practices in value-based payment

  15. Does Cancer Literature Reflect Multidisciplinary Practice? A Systematic Review of Oncology Studies in the Medical Literature Over a 20-Year Period.

    Science.gov (United States)

    Holliday, Emma B; Ahmed, Awad A; Yoo, Stella K; Jagsi, Reshma; Hoffman, Karen E

    2015-07-15

    Quality cancer care is best delivered through a multidisciplinary approach requiring awareness of current evidence for all oncologic specialties. The highest impact journals often disseminate such information, so the distribution and characteristics of oncology studies by primary intervention (local therapies, systemic therapies, and targeted agents) were evaluated in 10 high-impact journals over a 20-year period. Articles published in 1994, 2004, and 2014 in New England Journal of Medicine, Lancet, Journal of the American Medical Association, Lancet Oncology, Journal of Clinical Oncology, Annals of Oncology, Radiotherapy and Oncology, International Journal of Radiation Oncology, Biology, Physics, Annals of Surgical Oncology, and European Journal of Surgical Oncology were identified. Included studies were prospectively conducted and evaluated a therapeutic intervention. A total of 960 studies were included: 240 (25%) investigated local therapies, 551 (57.4%) investigated systemic therapies, and 169 (17.6%) investigated targeted therapies. More local therapy trials (n=185 [77.1%]) evaluated definitive, primary treatment than systemic (n=178 [32.3%]) or targeted therapy trials (n=38 [22.5%]; Pliterature. Further research and attention are necessary to guide efforts promoting appropriate representation of all oncology studies in high-impact, broad-readership journals. Copyright © 2015. Published by Elsevier Inc.

  16. [Palliative geriatrics. What are the differences between oncologic and non-oncologic palliative geriatric inpatients?].

    Science.gov (United States)

    Genz, H; Jenetzky, E; Hauer, K; Oster, P; Pfisterer, M H-D

    2010-12-01

    Analysis of differences between oncologic and non-oncologic patients in the first German hospital-based special care unit for palliative geriatrics. Systematic analysis of patients' records according to a standardized protocol. A total of 217 patients from a hospital-based special care unit for palliative geriatrics (56.7% women, 43.4% men) were included over a retrospective period of 1.5 years. Patients were categorized as non-oncologic (53.4%, n=116) or oncologic (46.5%, n=101). Non-oncologic patients were older than oncologic patients (84.0 vs. 76.8 years, p=0.02), and showed a higher degree of functional dependence (pfeeding (31% vs. 9%, p=0.001). Oncologic patients experienced more often symptoms of pain, constipation, agitation, diarrhea, vomiting, and nausea. There are clinically relevant differences between oncologic and non-oncologic palliative geriatric inpatients regarding the constellation of symptoms, care, mortality, and the prevalence of concerns about hydration and feeding. These differences ought to be taken into account for further education, as well as further improvement of the healthcare system, to enable an appropriate standard of palliative care for geriatric patients.

  17. An interprofessionally developed geriatric oncology curriculum for hematology–oncology fellows

    Science.gov (United States)

    Eid, Ahmed; Hughes, Caren; Karuturi, Meghan; Reyes, Connie; Yorio, Jeffrey; Holmes, Holly

    2016-01-01

    Objective Because the cancer population is aging, interprofessional education incorporating geriatric principles is essential to providing adequate training for oncology fellows. We report the targeted needs assessment, content, and evaluation tools for our geriatric oncology curriculum at MD Anderson Cancer Center. Methods A team comprising a geriatrician, a medical oncologist, an oncology PharmD, an oncology advanced nurse practitioner, and two oncology chief fellows developed the geriatric oncology curriculum. First, a general needs assessment was conducted by reviewing the literature and medical societies’ publications and by consulting experts. A targeted needs assessment was then conducted by reviewing the fellows’ evaluations of the geriatric oncology rotation and by interviewing fellows and recently graduated oncology faculty. Results Geriatric assessment, pharmacology, and psychosocial knowledge skills were the three identified areas of educational need. Curriculum objectives and an evaluation checklist were developed to evaluate learners in the three identified areas. The checklist content was validated by consulting experts in the field. Online materials, including a curriculum, a geriatric pharmacology job aid, and pharmacology cases, were also developed and delivered as part of the curriculum. Conclusion An interprofessional team approach was a successful method for identifying areas of learners’ educational needs, which in turn helped us develop an integrated geriatric oncology curriculum. The curriculum is currently being piloted and evaluated. PMID:25487037

  18. An interprofessionally developed geriatric oncology curriculum for hematology-oncology fellows.

    Science.gov (United States)

    Eid, Ahmed; Hughes, Caren; Karuturi, Meghan; Reyes, Connie; Yorio, Jeffrey; Holmes, Holly

    2015-03-01

    Because the cancer population is aging, interprofessional education incorporating geriatric principles is essential to providing adequate training for oncology fellows. We report the targeted needs assessment, content, and evaluation tools for our geriatric oncology curriculum at MD Anderson Cancer Center. A team comprising a geriatrician, a medical oncologist, an oncology PharmD, an oncology advanced nurse practitioner, and two oncology chief fellows developed the geriatric oncology curriculum. First, a general needs assessment was conducted by reviewing the literature and medical societies' publications and by consulting experts. A targeted needs assessment was then conducted by reviewing the fellows' evaluations of the geriatric oncology rotation and by interviewing fellows and recently graduated oncology faculty. Geriatric assessment, pharmacology, and psychosocial knowledge skills were the three identified areas of educational need. Curriculum objectives and an evaluation checklist were developed to evaluate learners in the three identified areas. The checklist content was validated by consulting experts in the field. Online materials, including a curriculum, a geriatric pharmacology job aid, and pharmacology cases, were also developed and delivered as part of the curriculum. An interprofessional team approach was a successful method for identifying areas of learners' educational needs, which in turn helped us develop an integrated geriatric oncology curriculum. The curriculum is currently being piloted and evaluated. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Cultural and age differences in beliefs about depression: British Bangladeshis vs. British Whites

    OpenAIRE

    McClelland, A.; S. Khanam; Furnham, A.

    2013-01-01

    This study examines beliefs about depression as a function of ethnic background (British Bangladeshis vs. British Whites) and age. A total of 364 participants completed a 65-item questionnaire, containing general questions regarding depression and anti-depressive behaviour; the causes of depression, and treatments for depression. The hypotheses were broadly supported; there were significant interactions between ethnicity and age, which generally revealed an increasingly negative attitude towa...

  20. A BRITISH TOUCH ON TANZIMAT: ARCHITECT WILLIAM JAMES SMITH

    Directory of Open Access Journals (Sweden)

    Esma İgüs

    2015-07-01

    Full Text Available This article examines the life and works of British architect William James Smith and outlines his contributions to nineteenth century Ottoman architecture and presents his prominence as an architectural historian of nineteenth century British architectural work.

  1. The Evolution of Gero-Oncology Nursing.

    Science.gov (United States)

    Bond, Stewart M; Bryant, Ashley Leak; Puts, Martine

    2016-02-01

    This article summarizes the evolution of gero-oncology nursing and highlights key educational initiatives, clinical practice issues, and research areas to enhance care of older adults with cancer. Peer-reviewed literature, position statements, clinical practice guidelines, Web-based materials, and professional organizations' resources. Globally, the older adult cancer population is rapidly growing. The care of older adults with cancer requires an understanding of their diverse needs and the intersection of cancer and aging. Despite efforts to enhance competence in gero-oncology and to develop a body of evidence, nurses and health care systems remain under-prepared to provide high-quality care for older adults with cancer. Nurses must take a leadership role in integrating gerontological principles into oncology settings. Working closely with interdisciplinary team members, nurses should utilize available resources and continue to build evidence through gero-oncology nursing research. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Challenges and opportunities to advance pediatric neuro-oncology care in the developing world.

    Science.gov (United States)

    Chan, Michael H; Boop, Frederick; Qaddoumi, Ibrahim

    2015-08-01

    As the morbidity and mortality associated with communicable diseases continue to decrease in the developing world, the medical burden of childhood cancer continues to expand. Although international aid and relief groups such as the World Health Organization recognize the importance of childhood cancer, their main emphasis is on the more easily treated malignancies, such as leukemias and lymphomas, and not pediatric brain tumors, which are the second most common malignancy in children and the leading cause of cancer-related deaths in the pediatric population. Addressing the needs of these children is a growing concern of several professional neuro-oncology-related societies. Thus, the goal of this review is to describe the current state of pediatric neuro-oncology care in the developing world, address the current and future needs of the field, and help guide professional societies' efforts to contribute in a more holistic and multidisciplinary manner. We reviewed the literature to compare the availability of neuro-oncology care in various regions of the developing world with that in higher income nations, to describe examples of successful initiatives, and to present opportunities to improve care. The current challenges, previous successes, and future opportunities to improve neuro-oncology care are presented. The multidisciplinary nature of neuro-oncology depends on large teams of highly specialized individuals, including neuro-oncologists, neurosurgeons, neurologists, radiologists, radiation oncologists, pathologists, palliative care specialists, oncology nurses, physical therapists, occupational therapists, speech therapists, pediatric intensivists, and social workers, among others. Pediatric neuro-oncology is one of the most complex types of medical care to deliver, as it relies on numerous specialists, subspecialists, support staff, and physical resources and infrastructure. However, with increasing collaboration and advancing technologies, developed nations

  3. Implementation of a Novel Medical School Multidisciplinary and Interprofessional Oncology Curriculum: a Mixed Method Study.

    Science.gov (United States)

    McKillip, Ryan P; Hahn, Olwen M; Bartkowiak, Bartlomiej; Rosenberg, Carol A; Olopade, Olufunmilayo I; Arora, Vineet M; Golden, Daniel W

    2017-08-22

    As the population of patients with cancer and survivors grows, physician knowledge of oncology clinical care and research is increasingly important. Despite this patient population growth, medical students and non-oncology physicians report insufficient oncologic and survivorship care training. First-year students at a single US medical school completing a summer research experience were invited to participate in integrated Scholars in Oncology-Associated Research (SOAR) program. SOAR seeks to broaden students' understanding of multidisciplinary and interprofessional oncology clinical care and research. SOAR consists of three components: structured didactics, multidisciplinary tumor board attendance, and interprofessional shadowing. A mixed-methods approach investigated whether student knowledge improved after SOAR. Thirty-three students enrolled in SOAR (20 in 2015, 13 in 2016) and completed pre-assessments. Twenty-five (75.8%) students completed SOAR and post-assessments. Self-reported understanding of clinical (2[2, 3] vs. 4[4], p work will focus on expanding SOAR into a longitudinal oncology curriculum.

  4. A survey of the educational environment for oncologists as perceived by surgical oncology professionals in India

    Directory of Open Access Journals (Sweden)

    Are Chandrakanth

    2012-01-01

    Full Text Available Abstract Background The current educational environment may need enhancement to tackle the rising cancer burden in India. The aim of this study was to conduct a survey of Surgical Oncologists to identify their perceptions of the current state of Oncology education in India. Methods An Institutional Review Board approved questionnaire was developed to target the audience of the 2009 annual meeting of the Indian Association of Surgical Oncology in India. The survey collected demographic information and asked respondents to provide their opinions about Oncology education in India. Results A total of 205 out of 408 attendee's participated in the survey with a 42.7% response rate. The majority of respondents felt that Oncology education was poor to fair during medical school (75%, residency (56% and for practicing physicians (71%. The majority of participants also felt that the quality of continuing medical education was poor and that minimal emphasis was placed on evidence based medicine. Conclusions The results of our survey demonstrate that the majority of respondents feel that the current educational environment for Oncology in India should be enhanced. The study identified perceptions of several gaps and needs, which can be the targets for implementing measures to enhance the training of Oncology professionals.

  5. Development and implementation of an interdisciplinary oncology program in a community hospital.

    Science.gov (United States)

    Chung, Clement; Collins, Angela; Cui, Nancy

    2011-09-15

    The development and implementation of an interdisciplinary oncology program in a community hospital are described. Before the program was established, clinical pharmacists responsible for order entry and verification did not have a defined structure and resource to effectively communicate with medical oncologists and nurses on patient care issues and oncology drug information. The practice model did not meet practice needs, departmental safety, quality, or cost-saving goals. An interdisciplinary team was established to determine where current processes and procedures were needed to decrease errors and improve efficiency associated with chemotherapy services. Three stages of practice development were planned, and an interdisciplinary oncology program involving nursing and pharmacy team members and medical oncologists was established. Standardized order forms, various pharmacy collaborative agreements, protocols, improved oncology nursing and pharmacy processes, and established standards in order writing, dispensing, administration, and monitoring were developed. An oncology pharmacist specialist position was requested, and this pharmacist played an essential role in helping the hospital realize significant cost savings and improve the quality of care provided to patients receiving chemotherapy services. Data were collected for 96 chemotherapy orders before program implementation and for 75 orders after program implementation, and a 45% reduction in total error related to chemotherapy drugs was observed (p cause of errors was missing information, typically an omitted duration or frequency, dose, route, or premedication (63% of all errors documented). The development and implementation of an interdisciplinary oncology program resulted in decreased medication-error rates, expanded pharmacy services, and cost savings.

  6. Pediatric oncology and the future of oncological imaging.

    Science.gov (United States)

    Voss, Stephan D

    2011-05-01

    The future of pediatric oncology will be influenced by changes in drug design and treatment strategy, with genomic medicine and molecular-based diagnostics and therapeutics playing increasingly important roles. The role of imaging as a means of measuring response to therapy has also evolved, with the development of new technologies and higher sensitivity means of detecting tumors. Conventional anatomical imaging techniques are being increasingly supplemented with functional techniques, including FDG-PET imaging and diffusion-weighted MR imaging. The risk-adapted treatment regimens of the past, which led to improved event-free and overall survival in many pediatric cancers, have paved the way for new response-based treatment paradigms. Response-based approaches seek to identify patients with a high likelihood of cure, treating them less aggressively, while those not responding to therapy are identified early and redirected into more aggressive therapeutic regimens. These advances will require concurrent development of imaging biomarkers as surrogates of early response to therapy. Incorporating these techniques into new response-directed treatment algorithms will be crucial as personalized medicine and molecular-targeted, tumor-specific therapies gain acceptance for the treatment of children with cancer.

  7. [Interests of applied anthropology to oncology].

    Science.gov (United States)

    Soum-Pouyalet, Fanny; Hubert, Annie; Dilhuydy, Jean-Marie

    2008-01-01

    From now on the introduction of social and human sciences studies in the field of oncology has not always been conclusive. This article aims to analyze the bounds that border the meeting and the understanding between physicians, patients and anthropologists. It also treats the problems due to the introduction of applied anthropology in the field of oncology and points up the interests and practical contributions that this disciplinary bring and could bring.

  8. Communication problems on an oncology ward.

    Science.gov (United States)

    De Valck, C; Van de Woestijne, K P

    1996-11-01

    Within the field of oncology, the communication of an unfavourable diagnosis is regarded as a stressful event that affects all members of the oncology team, as well as the patient. In this exploratory study we found that the communication problems between doctors, patients and nursing staff were related to insufficient information exchange. A psychosocial registration sheet was developed in order to improve communication on the ward. The effects of the new approach are briefly commented upon.

  9. British Asians, Covert Racism and Exclusion in English Professional Football

    OpenAIRE

    Daniel Kilvington

    2013-01-01

    This article examines the exclusion of British Asians from English professional football. At present, there are eight British Asians with professional contracts out of over 4,000 players. This statistic is increasingly noteworthy when we consider that, first, football is extremely popular across British Asian groups and, second, Britain is home to over 4 million British Asians (the UK’s largest minority ethnic group). Following a brief introduction as well as a discussion of racisms, the work...

  10. The impact of physician posture during oncology patient encounters.

    Science.gov (United States)

    Gupta, Arjun; Harris, Samar; Naina, Harris V

    2015-06-01

    Non-verbal communication is an important component of the physician-patient interaction. Oncology patients face specific emotional and psychological issues requiring additional physician emotional support. Multiple studies in oncology patients have revealed that patients perceive physicians seated during the medical interview to be more compassionate, caring, and likely to spend more time with the patients. These are all associated with improved patient outcomes. Barriers to sitting may be due to those imposed by time, space, and reduced perceived benefit of sitting by the physician. Although a sitting posture alone is unlikely to compensate for poor communication skills, assessing patient preference to physician posture, and following their preference, can be a simple way of improving communication, and thus patient outcomes, especially in oncology patients. The widespread introduction of the electronic medical record (EMR) system over the last decade has added a "third wheel" to the original dyadic physician-patient relationship. Physician posture and eye gaze towards to the EMR and its components has a deleterious effect on communication. Appropriate training and sensitization in this regard should be provided for physicians.

  11. Information Needs of Hepato-Pancreato-Biliary Surgical Oncology Patients.

    Science.gov (United States)

    Gillespie, Jacqueline; Kacikanis, Anna; Nyhof-Young, Joyce; Gallinger, Steven; Ruthig, Elke

    2017-09-01

    A marked knowledge gap exists concerning the information needs of hepato-pancreato-biliary (HPB) surgical oncology patients. We investigated the comprehensive information needs of this patient population, including the type and amount of information desired, as well as the preferred method of receiving information. A questionnaire was administered to patients being treated surgically for cancers of the liver, pancreas, gallbladder, or bile ducts at Toronto General Hospital, part of the University Health Network, in Toronto, Canada. The questionnaire examined patients' information needs across six domains of information: medical, practical, physical, emotional, social, and spiritual. Among 36 respondents, the importance of information and amount of information desired differed significantly by domain (both p information in the medical and physical domains as most important, though they also desired specific items of information from the emotional, practical, and social domains. Patients' overwhelming preference was to receive information via a one-on-one consultation with a healthcare provider. It is important for healthcare providers working with HPB surgical oncology patients to be comprehensive when providing information related to patients' cancer diagnosis, prognosis, associated symptoms, and side effects of treatment. Certain emotional, practical, and social issues (e.g., fears of cancer recurrence, drug coverage options, relationship changes) should be addressed as well. Face-to-face interactions should be the primary mode of delivering information to patients. Our findings are being used to guide the training of healthcare providers and the development of educational resources specific to HPB surgical oncology patients.

  12. Burnout and its relationship with personality factors in oncology nurses.

    Science.gov (United States)

    De la Fuente-Solana, Emilia I; Gómez-Urquiza, José L; Cañadas, Gustavo R; Albendín-García, Luis; Ortega-Campos, Elena; Cañadas-De la Fuente, Guillermo A

    2017-10-01

    To assess burnout levels in oncology nurses, to evaluate at what stage of burnout suffering they are and to analyze the relationship between burnout with personality factors. A quantitative, observational, cross-sectional multicenter study was done. Oncology nurses (n = 101) from the Andalusian Health Service (Andalusia, Spain) were included. The main variables were personality factors, assessed with the NEO-FFI questionnaire, anxiety and depression, assessed with the Educational-Clinical Questionnaire: Anxiety and Depression, and burnout, evaluated with the Maslach Burnout Inventory. Student t-statistic was used for hypothesis contrasts and Pearson's correlation coefficient was used to establish the association between personality factors and burnout. According to the burnout phases model, 29.6% of the sample is in the most severe phases. Emotional exhaustion and depersonalization are positively correlated with neuroticism and negatively correlated with agreeableness, conscientiousness, extraversion and openness. Personal accomplishment has a negative correlation with neuroticism and negative correlations with agreeableness, conscientiousness, extraversion and openness. Finally, emotional exhaustion and depersonalization have a positive correlation with anxiety and depression, while personal accomplishment has a negative correlation with anxiety and depression. A significant number of oncology nurses are in the most severe stages of burnout suffering. Personality factors have a key role in burnout development. The importance of personality factors in burnout development should be taken into account. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Port-site metastases: Considerations for laparoscopic oncologic surgeries

    Directory of Open Access Journals (Sweden)

    LIU Quanda

    2013-03-01

    Full Text Available Although rare, port-site metastasis (PSM following laparoscopic oncologic surgery has negative impact on patient prognosis and survival. While PSM occurrence has been associated with advanced disease status in some studies, its etiology and pathogenesis in various oncologic and surgical situations remain to be fully understood. Several biologic- and technique-related factors have been implicated in development of PSMs, suggesting a multifactorial process. In this review of the collective PSM case reports and experimental investigations in the literature, we discuss the putative etiologic factors and their potential mechanisms to gain a better understanding of this detrimental consequence of an otherwise beneficial (minimally invasive technique. In particular, the roles of tumor-related factors (such as invasiveness, wound-related factors (such as tumor cell contamination acting as tumor seeding, gas-related conditions (such as hypoxia and pressure, immunomodulatory factors (such as stimulation/suppression of the inflammatory response, and surgery-related factors (such as the surgeon's skill are detailed. This information is intended to not only improve our understanding of the causes of PSMs, but to promote the safety and efficacy of the application of laparoscopy in oncologic surgery.

  14. Radiation oncology: An Irish hospitals approach to supporting patients

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Caragh [Cork University Hospital (Ireland)], E-mail: caragh.miller@tcd.ie

    2009-02-15

    Despite advances in medical technology, cancer is still one of the leading causes of death globally, leaving many patients to deal with the emotional and psychological aspects associated with cancer and its treatment [Department of Health and Children. A strategy for cancer control in Ireland. National Cancer Forum. Dublin; 2006]. The recognition and management of psychological conditions are an integral part of comprehensive cancer care. As a result, the Health Services Executive as part of the continuing expansion of Cork Radiation Oncology Department created the role of Information and Support Radiation Therapist. This post was specially created during June 2005 to facilitate the smooth entry into the treatment for patients and family members experiencing radiotherapy for the first time. Working alongside the oncology nurses and other health professionals the Information and Support Radiation Therapist aims to provide vital education/information and support to patients and their families. The provision of this new service for patients enables departments to adopt a holistic approach to treatment. This research identifies the cancer services and psychological support services in Ireland. Up-to-date audits of the new patient services established in the Cork Radiation Oncology Department and their psychological contribution towards cancer development and treatment are also discussed.

  15. A Primer on Health Economic Evaluations in Thoracic Oncology.

    Science.gov (United States)

    Whittington, Melanie D; Atherly, Adam J; Bocsi, Gregary T; Camidge, D Ross

    2016-08-01

    There is growing interest for economic evaluation in oncology to illustrate the value of multiple new diagnostic and therapeutic interventions. As these analyses have started to move from specialist publications into mainstream medical literature, the wider medical audience consuming this information may need additional education to evaluate it appropriately. Here we review standard practices in economic evaluation, illustrating the different methods with thoracic oncology examples where possible. When interpreting and conducting health economic studies, it is important to appraise the method, perspective, time horizon, modeling technique, discount rate, and sensitivity analysis. Guidance on how to do this is provided. To provide a method to evaluate this literature, a literature search was conducted in spring 2015 to identify economic evaluations published in the Journal of Thoracic Oncology. Articles were reviewed for their study design, and areas for improvement were noted. Suggested improvements include using more rigorous sensitivity analyses, adopting a standard approach to reporting results, and conducting complete economic evaluations. Researchers should design high-quality studies to ensure the validity of the results, and consumers of this research should interpret these studies critically on the basis of a full understanding of the methodologies used before considering any of the conclusions. As advancements occur on both the research and consumer sides, this literature can be further developed to promote the best use of resources for this field. Copyright © 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

  16. Exploring resilience in paediatric oncology nursing staff.

    Science.gov (United States)

    Zander, Melissa; Hutton, Alison; King, Lindy

    2013-01-01

    Resilience has been suggested as an important coping strategy for nurses working in demanding settings, such as paediatric oncology. This qualitative study explored paediatric oncology nurses' perceptions of their development of resilience and how this resilience underpinned their ability to deal with work-related stressors. Five paediatric oncology nurses were interviewed about their understanding of the concept of resilience, their preferred coping mechanisms, and their day-today work in paediatric oncology. Using thematic analysis, the interviews were subsequently grouped together into seventeen initial themes. These themes were then grouped into seven major aspects that described how the participants perceived resilience underpinned their work. These "seven aspects of forming resilience" contributed to an initial understanding of how paediatric oncology nurses develop resilience in the face of their personal and professional challenges. Several key strategies derived from the findings, such as improved rostering, support to a nurse's friend and family, and a clinical support nursing role, could be implemented at an organizational level to support resilience development within the paediatric oncology setting.

  17. Burnout in United States Academic Chairs of Radiation Oncology Programs

    Energy Technology Data Exchange (ETDEWEB)

    Kusano, Aaron S. [Department of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington (United States); Thomas, Charles R., E-mail: thomasch@ohsu.edu [Department of Radiation Medicine, Knight Cancer Institute/Oregon Health and Science University, Portland, Oregon (United States); Bonner, James A. [Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama (United States); DeWeese, Theodore L. [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland (United States); Formenti, Silvia C. [Department of Radiation Oncology, New York University, New York, New York (United States); Hahn, Stephen M. [Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania (United States); Lawrence, Theodore S. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Mittal, Bharat B. [Department of Radiation Oncology, Northwestern University, Chicago, Ilinois (United States)

    2014-02-01

    Purpose: The aims of this study were to determine the self-reported prevalence of burnout in chairs of academic radiation oncology departments, to identify factors contributing to burnout, and to compare the prevalence of burnout with that seen in other academic chair groups. Methods and Materials: An anonymous online survey was administered to the membership of the Society of Chairs of Academic Radiation Oncology Programs (SCAROP). Burnout was measured with the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Results: Questionnaires were returned from 66 of 87 chairs (76% response rate). Seventy-nine percent of respondents reported satisfaction with their current positions. Common major stressors were budget deficits and human resource issues. One-quarter of chairs reported that it was at least moderately likely that they would step down in the next 1 to 2 years; these individuals demonstrated significantly higher emotional exhaustion. Twenty-five percent of respondents met the MBI-HSS criteria for low burnout, 75% for moderate burnout, and none for high burnout. Group MBI-HSS subscale scores demonstrated a pattern of moderate emotional exhaustion, low depersonalization, and moderate personal accomplishment, comparing favorably with other specialties. Conclusions: This is the first study of burnout in radiation oncology chairs with a high response rate and using a validated psychometric tool. Radiation oncology chairs share similar major stressors to other chair groups, but they demonstrate relatively high job satisfaction and lower burnout. Emotional exhaustion may contribute to the anticipated turnover in coming years. Further efforts addressing individual and institutional factors associated with burnout may improve the relationship with work of chairs and other department members.

  18. A scoping review of the nurse practitioner workforce in oncology.

    Science.gov (United States)

    Coombs, Lorinda A; Hunt, Lauren; Cataldo, Janine

    2016-08-01

    The quality of cancer care may be compromised in the near future because of work force issues. Several factors will impact the oncology health provider work force: an aging population, an increase in the number of cancer survivors, and expansion of health care coverage for the previously uninsured. Between October 2014 and March 2015, an electronic literature search of English language articles was conducted using PubMed(®) , the Cumulative Index to Nursing and Allied Health Sciences (CINAHL(®) ), Web of Science, Journal Storage (JSTOR(®) ), Google Scholar, and SCOPUS(®) . Using the scoping review criteria, the research question was identified "How much care in oncology is provided by nurse practitioners (NPs)?" Key search terms were kept broad and included: "NP" AND "oncology" AND "workforce". The literature was searched between 2005 and 2015, using the inclusion and exclusion criteria, 29 studies were identified, further review resulted in 10 relevant studies that met all criteria. Results demonstrated that NPs are utilized in both inpatient and outpatient settings, across all malignancy types and in a variety of roles. Academic institutions were strongly represented in all relevant studies, a finding that may reflect the Accreditation Council for Graduate Medical Education (ACGME) duty work hour limitations. There was no pattern associated with state scope of practice and NP representation in this scoping review. Many of the studies reviewed relied on subjective information, or represented a very small number of NPs. There is an obvious need for an objective analysis of the amount of care provided by oncology NPs. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  19. British International Schools: The Deployment and Training of Teaching Assistants

    Science.gov (United States)

    Tarry, Estelle

    2011-01-01

    This article reports on research carried out on behalf of the Council of British International Schools (COBIS) as to the role and deployment of British international school teaching assistants. Through questionnaires and a follow up open discussion with headteachers from British international schools it was found that, due to the differing…

  20. The 'British-Imperial' Model of administration: Assembling the South ...

    African Journals Online (AJOL)

    The 'British-Imperial' Model of administration: Assembling the South African constabulary, 1900-1902. ... Scientia Militaria: South African Journal of Military Studies ... to the colonies but sought guidance from existing institutions throughout the British Isles and Empire in a single 'British-Imperial' model of administration.

  1. The West African currency board and economic integration of British ...

    African Journals Online (AJOL)

    WACB) as an economic integration effort in British West Africa. Through a collaborative effort between this public institution and a private company, the Bank of British West Africa, British West African colonies were not only unified but also the way ...

  2. 78 FR 72598 - Airworthiness Directives; British Aerospace Regional Aircraft Airplanes

    Science.gov (United States)

    2013-12-03

    ... directive (AD) for British Aerospace Regional Aircraft Jetstream Series 3101 and Jetstream Model 3201... ADs None. (c) Applicability This AD applies to British Aerospace Regional Aircraft Jetstream Series... instructions of British Aerospace Jetstream Series 3100 & 3200 Service Bulletin 32-JM7862, Revision 1, dated...

  3. the relationship between british war correspondents in the field

    African Journals Online (AJOL)

    Lenovo

    on the British side and British Military Intelligence during the Anglo-Boer War, particularly during the formal ... press corps in the field and British Military Intelligence, especially in the initial and formal part of the Anglo-Boer ..... recognised and acknowledged the Value and Power of the Press by establishing a Newspaper as ...

  4. Negative connotations in speech behaviour of the british and american men and women (british and american drama

    Directory of Open Access Journals (Sweden)

    Е М Люльчева

    2008-03-01

    Full Text Available Use of special linguistic means in the British and American men and women speech is researched in this article. Various linguistic means are typical of the British and American men and women negative emotional speech.

  5. Explaining British Political Stability After 1832

    Directory of Open Access Journals (Sweden)

    Donagh Davis

    2017-12-01

    Full Text Available Though not its main focus, Goldstone's Revolution and Rebellion in the Early Modern World (1991 threw considerable new light on 19th century Europe's revolutions and near-revolutions. While Goldstone stresses the role of an expanding and industrializing economy in absorbing 19th century England's demographic shocks, we accept this analysis but argue alongside it for similar attention to the vector of emigration, settler-colonialism, and imperial state expansion into which at least some of the exhaust fumes of the population explosion were vented. Furthermore, it is important to note the crucial role of a highly interventionist state and 'big' government in the background to these dynamics—a far cry from the light-touch, laissez-faire qualities with which the 19th century British state is often associated. To make our case, this article takes advantage of secondary literature and raw data not available prior to the publication of Goldstone's book. Of crucial importance here is our unique dataset of fatality-inducing political violence events in Britain and Ireland from 1785 to 1900. This is the first research paper to utilise this dataset. We draw upon this in the following section, which seeks to establish what the real level of political instability was in 19th century Britain—thus cross-referencing Goldstone's account with more recent data—before moving on in the following section to a more detailed overview of the socio-economic conditions underlying events at the political level. This is followed by our account of the emigration-settler-colonialism-imperial state expansion vector and the interventionist state policy behind it, which we argue was crucial to making 19th century Britain relatively 'revolution-proof'—alongside the expanding economic opportunities rightly highlighted by Goldstone. Lastly come our brief concluding remarks, which lay out the implications, as we see them, of this article's findings for research on

  6. Selenium in oncology: from chemistry to clinics.

    Science.gov (United States)

    Micke, Oliver; Schomburg, Lutz; Buentzel, Jens; Kisters, Klaus; Muecke, Ralph

    2009-10-12

    The essential trace element selenium, which is a crucial cofactor in the most important endogenous antioxidative systems of the human body, is attracting more and more the attention of both laypersons and expert groups. The interest of oncologists mainly focuses in the following clinical aspects: radioprotection of normal tissues, radiosensitizing in malignant tumors, antiedematous effect, prognostic impact of selenium, and effects in primary and secondary cancer prevention. Selenium is a constituent of the small group of selenocysteine-containing selenoproteins and elicits important structural and enzymatic functions. Selenium deficiency has been linked to increased infection risk and adverse mood states. It has been shown to possess cancer-preventive and cytoprotective activities in both animal models and humans. It is well established that Se has a key role in redox regulation and antioxidant function, and hence in membrane integrity, energy metabolism and protection against DNA damage. Recent clinical trials have shown the importance of selenium in clinical oncology. Our own clinical study involving 48 patients suggest that selenium has a positive effect on radiation-associated secondary lymphedema in patients with limb edemas, as well as in the head and neck region, including endolaryngeal edema. Another randomized phase III study of our group was performed to examine the cytoprotective properties of selenium in radiation oncology. The aim was to evaluate whether sodium selenite is able to compensate a preexisting selenium deficiency and to prevent radiation induced diarrhea in adjuvant radiotherapy for pelvic gynecologic malignancies. Through this study, the significant benefits of sodium selenite supplementation with regards to selenium deficiency and radiotherapy induced diarrhea in patients with cervical and uterine cancer has been shown for the first time in a prospective randomized trial. Survival data imply that supplementation with selenium does not

  7. Selenium in Oncology: From Chemistry to Clinics

    Directory of Open Access Journals (Sweden)

    Oliver Micke

    2009-10-01

    Full Text Available The essential trace element selenium, which is a crucial cofactor in the most important endogenous antioxidative systems of the human body, is attracting more and more the attention of both laypersons and expert groups. The interest of oncologists mainly focuses in the following clinical aspects: radioprotection of normal tissues, radiosensitizing in malignant tumors, antiedematous effect, prognostic impact of selenium, and effects in primary and secondary cancer prevention. Selenium is a constituent of the small group of selenocysteine-containing selenoproteins and elicits important structural and enzymatic functions. Selenium deficiency has been linked to increased infection risk and adverse mood states. It has been shown to possess cancer-preventive and cytoprotective activities in both animal models and humans. It is well established that Se has a key role in redox regulation and antioxidant function, and hence in membrane integrity, energy metabolism and protection against DNA damage. Recent clinical trials have shown the importance of selenium in clinical oncology. Our own clinical study involving 48 patients suggest that selenium has a positive effect on radiation-associated secondary lymphedema in patients with limb edemas, as well as in the head and neck region, including endolaryngeal edema. Another randomized phase III study of our group was performed to examine the cytoprotective properties of selenium in radiation oncology. The aim was to evaluate whether sodium selenite is able to compensate a preexisting selenium deficiency and to prevent radiation induced diarrhea in adjuvant radiotherapy for pelvic gynecologic malignancies. Through this study, the significant benefits of sodium selenite supplementation with regards to selenium deficiency and radiotherapy induced diarrhea in patients with cervical and uterine cancer has been shown for the first time in a prospective randomized trial. Survival data imply that supplementation with

  8. Hereditary colorectal cancer syndromes: American Society of Clinical Oncology Clinical Practice Guideline endorsement of the familial risk-colorectal cancer: European Society for Medical Oncology Clinical Practice Guidelines.

    Science.gov (United States)

    Stoffel, Elena M; Mangu, Pamela B; Gruber, Stephen B; Hamilton, Stanley R; Kalady, Matthew F; Lau, Michelle Wan Yee; Lu, Karen H; Roach, Nancy; Limburg, Paul J

    2015-01-10

    To provide recommendations on prevention, screening, genetics, treatment, and management for people at risk for hereditary colorectal cancer (CRC) syndromes. The American Society of Clinical Oncology (ASCO) has a policy and set of procedures for endorsing clinical practice guidelines that have been developed by other professional organizations. The Familial Risk-Colorectal Cancer: European Society for Medical Oncology Clinical Practice Guideline published in 2013 on behalf of the European Society for Medical Oncology (ESMO) Guidelines Working Group in Annals of Oncology was reviewed for developmental rigor by methodologists, with content and recommendations reviewed by an ASCO endorsement panel. The ASCO endorsement panel determined that the recommendations of the ESMO guidelines are clear, thorough, and based on the most relevant scientific evidence. The ASCO panel endorsed the ESMO guidelines and added a few qualifying statements. Approximately 5% to 6% of patient cases of CRC are associated with germline mutations that confer an inherited predisposition for cancer. The possibility of a hereditary cancer syndrome should be assessed for every patient at the time of CRC diagnosis. A diagnosis of Lynch syndrome, familial adenomatous polyposis, or another genetic syndrome can influence clinical management for patients with CRC and their family members. Screening for hereditary cancer syndromes in patients with CRC should include review of personal and family histories and testing of tumors for DNA mismatch repair deficiency and/or microsatellite instability. Formal genetic evaluation is recommended for individuals who meet defined criteria. © 2014 by American Society of Clinical Oncology.

  9. Stress and burnout in oncology.

    Science.gov (United States)

    Kash, K M; Holland, J C; Breitbart, W; Berenson, S; Dougherty, J; Ouellette-Kobasa, S; Lesko, L

    2000-11-01

    This article identifies the professional stressors experienced by nurses, house staff, and medical oncologists and examines the effect of stress and personality attributes on burnout scores. A survey was conducted of 261 house staff, nurses, and medical oncologists in a cancer research hospital, and oncologists in outside clinical practices. It measured burnout, psychological distress, and physical symptoms. Each participant completed a questionnaire that quantified life stressors, personality attributes, burnout, psychological distress, physical symptoms, coping strategies, and social support. The results showed that house staff experienced the greatest burnout. They also reported greater emotional exhaustion, a feeling of emotional distance from patients, and a poorer sense of personal accomplishment. Negative work events contributed significantly to level of burnout; however, having a "hardy" personality helped to alleviate burnout. Nurses reported more physical symptoms than house staff and oncologists. However, they were less emotionally distant from patients. Women reported a lower sense of accomplishment and greater distress. The four most frequent methods of relaxing were talking to friends, using humor, drinking coffee or eating, and watching television. One unexpected finding was that the greater the perception of oneself as religious, the lower the level of burnout. Thus, while the rewards of working in oncology are usually sufficient to keep nurses and doctors in the field, they also experience burnout symptoms that vary by gender and personal attributes. House staff are most stressed and report the greatest and most severe symptoms of stress. Interventions are needed that address the specific problems of each group.

  10. Oncology information on the Internet.

    Science.gov (United States)

    Goto, Yasushi; Nagase, Takahide

    2012-05-01

    Owing to new developments in Internet technologies, the amount of available oncology information is growing. Both patients and caregivers are increasingly using the Internet to obtain medical information. However, while it is easy to provide information, ensuring its quality is always a concern. Thus, many instruments for evaluating the quality of health information have been created, each with its own advantages and disadvantages. The increasing importance of online search engines such as Google warrants the examination of the correlation between their rankings and medical quality. The Internet also mediates the exchange of information from one individual to another. Mailing lists of advocate groups and social networking sites help spread information to patients and caregivers. While text messages are still the main medium of communication, audio and video messages are also increasing rapidly, accelerating the communication on the Internet. Future health information developments on the Internet include merging patients' personal information on the Internet with their traditional health records and facilitating the interaction among patients, caregivers and health-care providers. Through these developments, the Internet is expected to strengthen the mutually beneficial relationships among all stakeholders in the field of medicine.

  11. Rationale for Cardio-Oncology Units.

    Science.gov (United States)

    Nhola, Lara F; Villarraga, Hector R

    2017-07-01

    With the rapidly rising number of patients surviving cancer, often in the setting of new or pre-existing cardiovascular disease and risk factors, a need has arisen for a specialty within the realm of cardiovascular care that can evaluate and manage these patients along with our colleagues in oncology and hematology. By the same token, all health care providers involved in the care of cancer patients with heart disease must be fully aware of the impact of adverse cardiovascular effects on the survival of these patients. Collaboration is required to mitigate the effect of cardiovascular toxicity associated with these necessary life-saving cancer therapies. The cardio-oncologist plays a pivotal role in bridging the 2 specialties, by creating a comprehensive plan to address the comorbidities as well as to provide guidance on the optimal choice of therapy. In this 3-part review, we will outline: a) the significant impact of cancer therapies on the cardiovascular health of patients with cancer and cancer survivors, b) the advantage of a multidisciplinary team in addressing these cardiovascular complications, and c) the delivery of clinical care to patients with cancer and heart disease. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  12. Provincial land use planning in British Columbia

    Energy Technology Data Exchange (ETDEWEB)

    Mitchell, W. [British Columbia Ministry of Finance, Victoria, BC (Canada). Land Use Coordination Office

    1998-12-31

    The efforts being made to include Aboriginal communities in land use planning in British Columbia are discussed. British Columbia is in the midst of historic changes with respect to land and resource allocation, use and management. Historic trends in land use allocation and management are contrasted with land use planning and resource management of today. The impact of provincial government moves to double park space within the province, and the Protected Areas Strategy initiative will have on the natural gas and petroleum industry is discussed. New efforts being made to include First Nations directly in land use planning discussions in ways that do not prejudice treaty negotiations, are reviewed. Creation of a new Oil and Gas Commission in the Fort St. John area, is cited as the most recent example of the interconnections between First Nations communities and other public and industry stakeholders in land use planning in the province.

  13. Russian-British Symposium on Quantum Technologies

    Science.gov (United States)

    Zadkov, V. N.; Kolachevsky, N. N.; Naumov, A. V.

    2017-09-01

    In the year 2017, declared 'The Year of Science and Education', the Russian Federation (RF) and the United Kingdom (UK) implemented the Promotion of UK-RF Joint Research in the Field of Quantum Technologies Project. In the framework of this project, Russian scientists from various scientific and science educational institutions in Moscow, Novosibirsk, Kazan, Nizhnii Novgorod and St. Petersburg and their British colleagues from scientific centres in London, Birmingham and Glasgow exchanged visits.

  14. Metaphor and creativity in British magazine advertising

    OpenAIRE

    Lundmark, Carita

    2005-01-01

    This thesis is a cognitive linguistic study of the various ways in which conceptual metaphor and related cognitive processes are exploited for creative purposes in advertising texts and accompanying images. The material consists of advertisements collected from British magazines between the years 1996 and 2002, and is classified into four main categories according to how the metaphorical content is signalled in the advertisement. These categories include polysemous words, idiomatic expression...

  15. Did Senior British Officers Effectively Lead Change?

    Science.gov (United States)

    2014-12-12

    must create a vision, devise a strategy, and implement it. They require buy -in from the wider Army but this support is not guaranteed. Indeed, many...investigate. However, there is a compulsion element to any change in the British Army. Orders are orders after all. How much room there is to...support for change evident throughout? Whether Senior Leaders had any power to influence change is important due to the compulsion aspect of the

  16. Peer Victimization in British Columbia Youth

    OpenAIRE

    Van Blyderveen, Sherry Lynn

    2003-01-01

    Peer victimization is an issue which has recently received considerable attention from the media, the school system, and academic literature. The present study examines a number of expected correlates, both risk factors and outcomes, of peer victimization through the use of the Adolescent Health Survey - II conducted by the McCreary Centre Society in the province of British Columbia. Approximately 25,800 youth, from grades 7 through 12, from various regions of the province completed the quest...

  17. Early Oncologic Failure after Robot-Assisted Radical Cystectomy: Results from the International Robotic Cystectomy Consortium.

    Science.gov (United States)

    Hussein, Ahmed A; Saar, Matthias; May, Paul R; Wijburg, Carl J; Richstone, Lee; Wagner, Andrew; Wilson, Timothy; Yuh, Bertram; Redorta, Joan Palou; Dasgupta, Prokar; Khan, Mohammad Shamim; Menon, Mani; Peabody, James O; Hosseini, Abolfazl; Gaboardi, Franco; Mottrie, Alexandre; Rha, Koon-Ho; Hemal, Ashok; Stockle, Michael; Kelly, John; Maatman, Thomas J; Canda, Abdullah Erdem; Wiklund, Peter; Guru, Khurshid A

    2017-06-01

    We sought to investigate the prevalence and variables associated with early oncologic failure. We retrospectively reviewed the IRCC (International Radical Cystectomy Consortium) database of patients who underwent robot-assisted radical cystectomy since 2003. The final cohort comprised a total of 1,894 patients from 23 institutions in 11 countries. Early oncologic failure was defined as any disease relapse within 3 months of robot-assisted radical cystectomy. All institutions were surveyed for the pneumoperitoneum pressure used, breach of oncologic surgical principles, and techniques of specimen and lymph node removal. A multivariate model was fit to evaluate predictors of early oncologic failure. The Kaplan-Meier method was applied to depict disease specific and overall survival, and Cox proportional regression analysis was used to evaluate predictors of disease specific and overall survival. A total of 305 patients (22%) experienced disease relapse, which was distant in 220 (16%), local recurrence in 154 (11%), peritoneal carcinomatosis in 17 (1%) and port site recurrence in 5 (0.4%). Early oncologic failure developed in 71 patients (5%) at a total of 10 institutions. The incidence of early oncologic failure decreased from 10% in 2006 to 6% in 2015. On multivariate analysis the presence of any complication (OR 2.87, 95% CI 1.38-5.96, p = 0.004), pT3 or greater disease (OR 3.73, 95% CI 2.00-6.97, p <0.001) and nodal involvement (OR 2.14, 95% CI 1.21-3.80, p = 0.008) was a significant predictor of early oncologic failure. Patients with early oncologic failure demonstrated worse disease specific and overall survival (23% and 13%, respectively) at 1 and 3 years compared to patients who experienced later or no recurrences (log rank p <0.001). The incidence of early oncologic failure following robot-assisted radical cystectomy has decreased with time. Disease related rather than technical related factors have a major role in early oncologic failure after robot

  18. Does general surgery residency prepare surgeons for community practice in British Columbia?

    Science.gov (United States)

    Hwang, Hamish

    2009-01-01

    Background Preparing surgeons for clinical practice is a challenging task for postgraduate training programs across Canada. The purpose of this study was to examine whether a single surgeon entering practice was adequately prepared by comparing the type and volume of surgical procedures experienced in the last 3 years of training with that in the first year of clinical practice. Methods During the last 3 years of general surgery training, I logged all procedures. In practice, the Medical Services Plan (MSP) of British Columbia tracks all procedures. Using MSP remittance reports, I compiled the procedures performed in my first year of practice. I totaled the number of procedures and broke them down into categories (general, colorectal, laparoscopic, endoscopic, hepatobiliary, oncologic, pediatric, thoracic, vascular and other). I then compared residency training with community practice. Results I logged a total of 1170 procedures in the last 3 years of residency. Of these, 452 were performed during community rotations. The procedures during residency could be broken down as follows: 392 general, 18 colorectal, 242 laparoscopic, 103 endoscopic, 85 hepatobiliary, 142 oncologic, 1 pediatric, 78 thoracic, 92 vascular and 17 other. I performed a total of 1440 procedures in the first year of practice. In practice the break down was 398 general, 15 colorectal, 101 laparoscopic, 654 endoscopic, 2 hepatobiliary, 77 oncologic, 10 pediatric, 0 thoracic, 70 vascular and 113 other. Conclusion On the whole, residency provided excellent preparation for clinical practice based on my experience. Areas of potential improvement included endoscopy, pediatric surgery and “other,” which comprised mostly hand surgery. PMID:19503663

  19. Hematology-Oncology Fellows' Training in Geriatrics and Geriatric Oncology: Findings From an American Society of Clinical Oncology-Sponsored National Survey.

    Science.gov (United States)

    Maggiore, Ronald J; Dale, William; Hurria, Arti; Klepin, Heidi D; Chapman, Andrew; Dotan, Efrat; Mohile, Supriya G; Naeim, Arash; Gajra, Ajeet; Buss, Mary K

    2017-11-01

    Older adults compose the majority of patients with cancer in the United States; however, it is unclear how well geriatrics or geriatric oncology training is being incorporated into hematology-oncology (hem-onc) fellowships. A convenience sample of hem-onc fellows completed a (written or electronic) survey assessing their education, clinical experiences, and perceived proficiency in geriatric oncology during training; knowledge base in geriatric oncology; confidence in managing older adults with cancer; and general attitudes toward geriatric oncology principles. Forty-five percent of respondents (N = 138) were female, 67% were based in the United States, and most (60%) were past their first year of training. Most fellows rated geriatric oncology as important or very important (84%); however, only 25% reported having access to a geriatric oncology clinic and more than one half (53%) reported no lectures in geriatric oncology. Fellows reported fewer educational experiences in geriatric oncology than in nongeriatric oncology. For example, among procedure-based activities, 12% learned how to perform a geriatric assessment but 78% learned how to perform a bone marrow biopsy ( P geriatric oncology. The high value fellows place on geriatric oncology suggests that they would be receptive to additional training in this area.

  20. The Diasporic Dimensions of British Caribbean Federation in the Early Twentieth Century

    Directory of Open Access Journals (Sweden)

    Eric D. Duke

    2009-12-01

    Full Text Available [Second and third pragraph] While much has been written on the significance of British Caribbean activists in various movements associated with black diaspora politics in the twentieth century, particularly their important roles in Pan-African struggles, little has been written on how the various British Caribbean colonies themselves were envisioned among diaspora activists and within the scope of black diaspora politics. Did such Caribbean activists, especially those interested in and connected to diasporic movements beyond the British Caribbean, and their African American and African counterparts forsake the British West Indies as a focus of political engagement for other lands and causes? If not, what was the place of “West Indian liberation” and nation building in the British Caribbean in relation to black diasporic struggles in the early twentieth century? This article address these questions through an examination of how the idea of a united “West Indian nation” (via a federation or closer union among British Caribbean colonies was envisioned within black diaspora politics from the turn of the twentieth century through the 1920s, and the ways in which racial consciousness and motivations informed conceptualizations of such a nation among black political activists of the British Caribbean and other parts of the diaspora. This study argues that efforts to create a federation in the Anglophone Caribbean were much more than simply imperial or regional nation-building projects. Instead, federation was also a diasporic, black nation-building endeavor intricately connected to notions of racial unity, racial uplift, and black self-determination.

  1. Radiation Oncology and Online Patient Education Materials: Deviating From NIH and AMA Recommendations.

    Science.gov (United States)

    Prabhu, Arpan V; Hansberry, David R; Agarwal, Nitin; Clump, David A; Heron, Dwight E

    2016-11-01

    Physicians encourage patients to be informed about their health care options, but much of the online health care-related resources can be beneficial only if patients are capable of comprehending it. This study's aim was to assess the readability level of online patient education resources for radiation oncology to conclude whether they meet the general public's health literacy needs as determined by the guidelines of the United States National Institutes of Health (NIH) and the American Medical Association (AMA). Radiation oncology-related internet-based patient education materials were downloaded from 5 major professional websites (American Society for Radiation Oncology, American Association of Physicists in Medicine, American Brachytherapy Society, RadiologyInfo.org, and Radiation Therapy Oncology Group). Additional patient education documents were downloaded by searching for key radiation oncology phrases using Google. A total of 135 articles were downloaded and assessed for their readability level using 10 quantitative readability scales that are widely accepted in the medical literature. When all 10 assessment tools for readability were taken into account, the 135 online patient education articles were written at an average grade level of 13.7 ± 2.0. One hundred nine of the 135 articles (80.7%) required a high school graduate's comprehension level (12th-grade level or higher). Only 1 of the 135 articles (0.74%) met the AMA and NIH recommendations for patient education resources to be written between the third-grade and seventh-grade levels. Radiation oncology websites have patient education material written at an educational level above the NIH and AMA recommendations; as a result, average American patients may not be able to fully understand them. Rewriting radiation oncology patient education resources would likely contribute to the patients' understanding of their health and treatment options, making each physician-patient interaction more productive

  2. The characteristics of oncology social work in Australia: Implications for workforce planning in integrated cancer care.

    Science.gov (United States)

    Pockett, Rosalie; Peate, Michelle; Hobbs, Kim; Dzidowska, Monika; L Bell, Melanie; Baylock, Brandi; Epstein, Irwin

    2016-12-01

    To describe the demographics, professional characteristics, self-reported professional development needs and research involvement of oncology social workers in Australia and to describe perceived barriers to provision of quality psychosocial care. A cross-sectional online survey was administered to social workers working in the oncology field who were contacted through three professional organizations; the Australian Association of Social Workers, Oncology Social Work Australia and the Psycho-oncology Co-operative Research Group, the University of Sydney. A snowball recruitment method was adopted to maximize the sample size. Two thirds of respondents had over 10 years professional practice experience but with lesser experience in oncology settings. Twenty-eight percent had post-graduate qualifications. Professional development needs were reported as moderate or high by 68% of respondents. No association between professional needs and work setting was found. Years of experience in oncology practice and living in an urban area increased the likelihood of involvement in research. Barriers to psychosocial care included poor understandings of the social work role, time constraints and an inadequate number of social work positions. In this first Australian study of the social work oncology workforce, the results demonstrated active, well-qualified and experienced social workers providing frontline services to people with cancer and their caregivers in geographically diverse locations across Australia. Inadequate resources and a lack of integrated psychosocial care were identified as barriers to comprehensive cancer care. The need for Aboriginal and Torres Strait Islander social workers was identified as an urgent workforce priority. © 2016 John Wiley & Sons Australia, Ltd.

  3. Knowledge, Perceived Ability and Practice Behaviors Regarding Oral Health among Pediatric Hematology and Oncology Nurses.

    Science.gov (United States)

    Perry, Antiana D; Iida, Hiroko; Patton, Lauren L; Wilder, Rebecca S

    2015-08-01

    Oral complications are common in children undergoing head and neck radiation and chemotherapy. The purpose of this study is to examine the knowledge, perceived ability and practice behaviors of pediatric oncology and hematology nurses in assisting with the various oral health care needs of pediatric oncology patients and to identify pediatric oncology nurses' previous training/education, practice types and other demographic characteristics that are related to their oral health competencies. A survey of a convenience sample of Pediatric Oncology and Hematology Nurses was conducted during the Association of Pediatric Oncology and Hematology Nurses' (APHON) 36(th) Annual Conference and Exhibit. Descriptive analysis and the exploratory factor analyses were performed using SAS version 9.2 (SAS Institute, Inc., Cary, NC). Among the 300 surveys that were distributed, 235 surveys were completed (78% response rate) by pediatric oncology or hematology nurses who provide direct patient care in the U.S. Approximately 75% reported receiving less than 3 hours of oral health related education/training. Sixty percent did not have a clinical requirement regarding the assessment of the teeth and gums during their nursing school education. Bivariate analyses indicated that nurses who had clinical requirements regarding oral health assessment during nursing education/training presented greater overall oral health competencies including having greater confidence in examining oral complications than those who did not. Pediatric oncology nurses' knowledge, perceived ability and practice in assisting patient's oral hygiene care, preventing and managing oral complications vary by topic and might reflect their educational preparedness. This study may provide valuable information pertaining to the need and opportunity for interprofessional oral health care education and collaboration with nursing and dental professionals, in order to increase access to comprehensive oral care for pediatric

  4. British Gujarati Indian immigrants' and British Caucasians' beliefs about health and illness.

    Science.gov (United States)

    Jobanputra, Rena; Furnham, Adrian

    2005-12-01

    This study examined cultural differences in beliefs about health and illness to explore differences in younger and older British Caucasians' and British Gujarati Indian immigrants' beliefs about health and illness. This study required a matched group consisting of first- and second-generation Gujarati Indian immigrants and native British Caucasians to complete a questionnaire assessing their beliefs concerning health and illness. Factor analysis of the health beliefs questionnaire identified six clear factors accounting for 36.04% of the variance. Subsequent ANCOVAs conducted on the factor scores, partialling out the demographic differences between the participants, revealed that Gujarati Indian immigrants agreed with items reflecting supernatural explanations of ill health more than indigenous British Caucasian participants. Older Indian immigrants also rated chance-related factors as more important than older Caucasian immigrants. There were no significant differences between the Gujarati Indian immigrants and British Caucasians in terms of attributions made to psychological factors and self-responsibility, social factors and life circumstances, medical treatment and physical vulnerability and the external environment. Findings are discussed in relation to the model proposed by Helman (2001) and the impact of migration on health beliefs systems; practical implications of the findings are also highlighted.

  5. Frailty and cancer: Implications for oncology surgery, medical oncology, and radiation oncology.

    Science.gov (United States)

    Ethun, Cecilia G; Bilen, Mehmet A; Jani, Ashesh B; Maithel, Shishir K; Ogan, Kenneth; Master, Viraj A

    2017-09-01

    Answer questions and earn CME/CNE The concept of frailty has become increasingly recognized as one of the most important issues in health care and health outcomes and is of particular importance in patients with cancer who are receiving treatment with surgery, chemotherapy, and radiotherapy. Because both cancer itself, as well as the therapies offered, can be significant additional stressors that challenge a patient's physiologic reserve, the incidence of frailty in older patients with cancer is especially high-it is estimated that over one-half of older patients with cancer have frailty or prefrailty. Defining frailty can be challenging, however. Put simply, frailty is a state of extreme vulnerability to stressors that leads to adverse health outcomes. In reality, frailty is a complex, multidimensional, and cyclical state of diminished physiologic reserve that results in decreased resiliency and adaptive capacity and increased vulnerability to stressors. In addition, over 70 different measures of frailty have been proposed. Still, it has been demonstrated that frail patients are at increased risk of postoperative complications, chemotherapy intolerance, disease progression, and death. Although international standardization of frailty cutoff points are needed, continued efforts by oncology physicians and surgeons to identify frailty and promote multidisciplinary decision making will help to develop more individualized management strategies and optimize care for patients with cancer. CA Cancer J Clin 2017;67:362-377. © 2017 American Cancer Society. © 2017 American Cancer Society.

  6. Part of the British Mainstream? British Muslim Students and Islamic Student Associations

    Science.gov (United States)

    Song, Miri

    2012-01-01

    In recent years, fear of "the other" has focused particularly on "home grown" second-generation Muslims. In the aftermath of the 7 July 2005 bombings in London, there was particular horror and incredulity expressed about the fact that many of the bombers had been born and raised in Britain, and universities have been…

  7. Comprehensive geriatric assessment and its clinical impact in oncology.

    Science.gov (United States)

    Maas, Huub A A M; Janssen-Heijnen, Maryska L G; Olde Rikkert, Marcel G M; Machteld Wymenga, A N

    2007-10-01

    Comprehensive geriatric assessment (CGA) is a process that consists of a multidimensional data-search and a process of analyzing and linking patient characteristics creating an individualized intervention-plan, carried out by a multidisciplinary team. In general, the positive health care effects of CGA are established, but in oncology both CGA and the presence of geriatric syndromes still have to be implemented to tailor oncological therapies to the needs of elderly cancer patients. In this paper the conceptualization of geriatric syndromes, their relationship to CGA and results of clinical studies using CGA in oncology are summarized. Geriatric syndromes are associated with increased vulnerability and refer to highly prevalent, mostly single symptom states (falls, incontinence, cognitive impairment, dizziness, immobility or syncope). Multifactorial analysis is common in geriatric syndromes and forms part of the theoretical foundation for using CGA. In oncology patients, we reviewed the value of CGA on the following endpoints: recognition of health problems, tolerance to chemotherapy and survival. Most studies performed CGA to identify prognostic factors and did not include an intervention. The ability of CGA to detect relevant health problems in an elderly population is reported consistently but no randomized studies are available. CGA should explore the pre-treatment presence of (in)dependence in Instrumental Activities of Daily Living (IADL), poor or moderately poor quality of life, depressive symptoms and cognitive decline, and thereby may help to predict survival. However, if scored by the Charlson comorbidity-index, comorbidities are not convincingly related to survival. The few studies that included a CGA-linked intervention show inconsistent results with regard to survival but compared to usual care quality of life is improved in the surviving period. Functional performance scores and dependency at home appeared to be independent predictive factors for

  8. Oncology providers’ perspectives on endocrine therapy prescribing and management

    Directory of Open Access Journals (Sweden)

    Wheeler SB

    2016-09-01

    Full Text Available Stephanie B Wheeler,1,2 Megan C Roberts,1 Diane Bloom,1 Katherine E Reeder-Hayes,2,3 Maya Espada,1 Jeffrey Peppercorn,4 Carol E Golin,5,6 Jo Anne Earp2,5 1Department of Health Policy and Management, 2Lineberger Comprehensive Cancer Center, 3Division of Hematology and Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 4Division of Hematology/Oncology, Massachusetts General Hospital, Boston, MA, 5Department of Health Behavior, 6Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Purpose: Adjuvant endocrine therapy (ET can reduce the risk of recurrence among females with hormone receptor-positive breast cancer. Overall, initiation and adherence to ET are suboptimal, though reasons are not well described. The study’s objective was to better understand ET decision making, prescribing, and patient management from oncology providers’ perspectives.Methods: Using purposive sampling, we recruited oncology providers who saw five or more breast cancer patients per week (n=20. We conducted 30–45-minute telephone interviews, using a semistructured guide to elicit perspectives on ET use. We used thematic content analysis to systematically identify categories of meaning and double-coded transcripts using Atlas.ti.Results: Providers recommend ET to all eligible patients except those with contraindications or other risk factors. Providers base their ET prescribing decisions on the patient’s menopausal status, side effects, and comorbidities. ET is typically discussed multiple times: at the onset of breast cancer treatment and in more detail after other treatment completion. Providers felt that the associated recurrence risk reduction is the most compelling argument for patients during ET decision making. While providers rarely perceived noninitiation as a problem, nonadherence was prevalent, often due to unresolvable side effects.Conclusion: From the clinicians’ perspectives, side effects from

  9. National Study of Burnout and Career Satisfaction Among Physician Assistants in Oncology: Implications for Team-Based Care.

    Science.gov (United States)

    Tetzlaff, Eric Daniel; Hylton, Heather Marie; DeMora, Lyudmila; Ruth, Karen; Wong, Yu-Ning

    2017-11-30

    A high rate of burnout has been reported in oncology physicians. Physician assistants (PAs) may also face similar risks of burnout. We sought to measure the personal and professional characteristics associated with burnout and career satisfaction and the potential impact on the oncology PA workforce. A national survey of PAs in oncology was completed by using the Maslach Burnout Inventory from September 2015 to January 2016. In all, 855 PAs were contacted and 250 submitted complete surveys (response rate, 29.2%). Respondents were representative of PAs in oncology with a mean age of 41.8 years, females (88.8%), academic practice (55.2%), urban location (61.2%), outpatient (74.4%), medical oncology (75.2%), worked 41 to 50 hours per week (52.8%), and had a mean of 9.6 years as a PA in oncology. Burnout was reported in 34.8% of PAs, 30.4% reported high emotional exhaustion, 17.6% reported high depersonalization, and 19.6% reported a low sense of personal accomplishment. In multivariable analysis, age, time spent on indirect patient care, oncology subspecialty, and relationship with collaborating physician were factors associated with burnout. Career and specialty satisfaction was high (86.4% and 88.8%, respectively). In the next 2 years, only 3.6% of PAs plan to pursue a different career or specialty and only 2.0% plan to retire. Despite high career and specialty satisfaction, burnout is reported in one third of PAs in oncology. Further exploration of the relationship between PAs and collaborating physicians may provide insight on methods to decrease burnout. Negligible short-term attrition of the current oncology PA workforce is anticipated.

  10. Integrating Geriatrics Into Oncology Ambulatory Care Clinics.

    Science.gov (United States)

    Overcash, Janine

    2015-08-01

    Geriatric oncology offers specialized care that incorporates comprehensive geriatric assessment (CGA) and multidisciplinary teams (MDTs) with oncology care. Geriatric syndromes, comorbidities, and caregiver concerns are relevant to the oncology assessment in older adult patients to make treatment decisions, which should be based not on age but on health and functional status, as well as on life expectancy. Developing a geriatric oncology ambulatory care clinic (GOACC) requires numerous resources and entails planning for longer patient encounter times, devising collaboration strategies with community care providers, and establishing dedicated time for team members. The purpose of this article is to provide information regarding the construction and sustainability of a GOACC. A comprehensive review of literature published from 1991-2015 was conducted using the following key words. Oncology primary care nurses and advanced practice nurses have a large role in the development and maintenance of GOACCs. Managing comorbidities, identifying patients who likely would benefit from a CGA, providing caregiver support, conducting a CGA, and creating an MDT are core elements of developing a sustainable GOACC.

  11. Psycho-oncology: Searching for practical wisdom?

    Science.gov (United States)

    Butlin, Helen

    2015-10-01

    The debate is vigorous in psycho-oncology about whether spiritual, existential, and psychosocial are the most comprehensive terms for academic research discourses investigating meaning and purpose. A call-to-action email from the International Society of Psycho-Oncology included the term soul. The current essay highlights the historical and contemporary uses of "soul" to suggest that the re-emergent soul signifies a tacit quest for an "intangible" that seems missing in current constructs of clinical domains reflected in the vigor of the debates. It is suggested that the re-emergence of the pre-Medieval meaning(s) of the notion of soul affirms a growing need for integrative paradigms on "being human" to guide psycho-oncology practitioners and their research. As a paradigmatic example, a clinical support group entitled Soul Medicine is described as employing the term soul to open up the more marginal discourses about experiences of illness arising from philosophical reflection, arts, humanities, and spirituality within a clinical oncology context. A link between soul and wisdom is suggested for further exploration with the view that phronesis ("the virtue of practical wisdom"), an emerging concept in health professional education research, is of ultimate value to the people psycho-oncology seeks to serve. This group holds that garnering wisdom from the expertise of those living with cancer should be a central aim of our field.

  12. Ethnic inequalities in periodontal disease among British adults.

    Science.gov (United States)

    Delgado-Angulo, Elsa K; Bernabé, Eduardo; Marcenes, Wagner

    2016-11-01

    To explore ethnic inequalities in periodontal disease among British adults, and the role of socioeconomic position (SEP) in those inequalities. We analysed data on 1925 adults aged 16-65 years, from the East London Oral Health Inequality (ELOHI) Study, which included a random sample of adults living in an ethnically diverse and socially deprived area. Participants completed a questionnaire and were clinically examined for the number of teeth with periodontal pocket depth (PPD)≥4 mm and loss of attachment (LOA)≥4 mm. Ethnic inequalities in periodontal measures were assessed in negative binomial regression models before and after adjustment for demographic (gender and age groups) and SEP indicators (education and socioeconomic classification). Compared to White British, Pakistani, Indian, Bangladeshi and Asian Others had more teeth with PPD≥4 mm whereas White East European, Black African and Bangladeshi had more teeth with LOA≥4 mm, after adjustments for demographic and SEP measures. The association of ethnicity with periodontal disease was moderated by education, but not by socioeconomic classification. Stratified analysis showed that ethnic disparities in the two periodontal measures were limited to more educated groups. This study showed considerable ethnic disparities in periodontal disease between and within the major ethnic categories. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Tracking the workforce: the American Society of Clinical Oncology workforce information system.

    Science.gov (United States)

    Kirkwood, M Kelsey; Kosty, Michael P; Bajorin, Dean F; Bruinooge, Suanna S; Goldstein, Michael A

    2013-01-01

    In anticipation of oncologist workforce shortages projected as part of a 2007 study, the American Society of Clinical Oncology (ASCO) worked with a contractor to create a workforce information system (WIS) to assemble the latest available data on oncologist supply and cancer incidence and prevalence. ASCO plans to publish findings annually, reporting on new data and tracking trends over time. THE WIS REPORT IS COMPOSED OF THREE SECTIONS: supply, new entrants, and cancer incidence and prevalence. Tabulations of the number of oncologists in the United States are derived mainly from the American Medical Association Physician Masterfile. Information on fellows and residents in the oncology workforce pipeline come from published sources such as Journal of the American Medical Association. Incidence and prevalence estimates are published by the American Cancer Society and National Cancer Institute. The WIS reports a total of 13,084 oncologists working in the United States in 2011. Oncologists are defined as those physicians who designate hematology, hematology/oncology, or medical oncology as their specialty. The WIS compares the characteristics of these oncologists with those of all physicians and tracks emerging trends in the physician training pipeline. Observing characteristics of the oncologist workforce over time allows ASCO to identify, prioritize, and evaluate its workforce initiatives. Accessible figures and reports generated by the WIS can be used by ASCO and others in the oncology community to advocate for needed health care system and policy changes to help offset future workforce shortages.

  14. Information exchange in oncological inpatient care--patient satisfaction, participation, and safety.

    Science.gov (United States)

    Kullberg, Anna; Sharp, Lena; Johansson, Hemming; Bergenmar, Mia

    2015-04-01

    This prospective pilot study aimed to investigate patients' perception of information exchange and its associations with patient satisfaction, participation and safety at inpatient oncology wards. Consecutive patients with cancer who spent ≥3 days at an oncological inpatient ward at the Department of Oncology, Karolinska University Hospital during the study period (March-August 2013) were invited to respond to EORTC-INPATSAT32 measuring patient satisfaction and a study specific questionnaire. Data on changes in medication and fall risk assessments was collected from the patients' electronic health records. A total of 104 patients (58%) participated in the study. Patients rated doctors' and nurses' information provision lower than their technical and interpersonal skills, and 13% considered the information exchange "excellent". Changes in medication were registered for 83% of participating patients, which 56% of the patients were aware of. Fall risk assessment was registered for 73% of responding patients, and 39% reported having discussed risk of falling during the hospital stay. The Downton Fall Risk Index scores were not associated with actual falls or fall prevention actions. Deficits were found on information exchange and information provision between health care professionals and patients. This might have a negative impact on known patient safety risks such as medication errors and falls. More effective strategies to perform fall risk assessments in an oncological inpatient setting are needed. Further studies evaluating interventions to improve participation and information exchange are necessary to increase patient satisfaction, participation and safety in oncological inpatient care. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Tracking the Workforce: The American Society of Clinical Oncology Workforce Information System

    Science.gov (United States)

    Kirkwood, M. Kelsey; Kosty, Michael P.; Bajorin, Dean F.; Bruinooge, Suanna S.; Goldstein, Michael A.

    2013-01-01

    Purpose: In anticipation of oncologist workforce shortages projected as part of a 2007 study, the American Society of Clinical Oncology (ASCO) worked with a contractor to create a workforce information system (WIS) to assemble the latest available data on oncologist supply and cancer incidence and prevalence. ASCO plans to publish findings annually, reporting on new data and tracking trends over time. Methods: The WIS report is composed of three sections: supply, new entrants, and cancer incidence and prevalence. Tabulations of the number of oncologists in the United States are derived mainly from the American Medical Association Physician Masterfile. Information on fellows and residents in the oncology workforce pipeline come from published sources such as Journal of the American Medical Association. Incidence and prevalence estimates are published by the American Cancer Society and National Cancer Institute. Results: The WIS reports a total of 13,084 oncologists working in the United States in 2011. Oncologists are defined as those physicians who designate hematology, hematology/oncology, or medical oncology as their specialty. The WIS compares the characteristics of these oncologists with those of all physicians and tracks emerging trends in the physician training pipeline. Conclusion: Observing characteristics of the oncologist workforce over time allows ASCO to identify, prioritize, and evaluate its workforce initiatives. Accessible figures and reports generated by the WIS can be used by ASCO and others in the oncology community to advocate for needed health care system and policy changes to help offset future workforce shortages. PMID:23633965

  16. Interpreting the economic literature in oncology.

    Science.gov (United States)

    Grusenmeyer, Patrick A; Wong, Yu-Ning

    2007-01-10

    New treatment options provide hope for patients with localized and advanced cancer. However, these advances are associated with cost, both in terms of treatment-related expenditures and effects on quality of life. It is important that patients, physicians, insurers, and policymakers understand the relationship between costs and outcomes of new cancer treatments. Various methods of cost analysis can provide a structured manner to assess cost. Cost-effectiveness analysis (CEA) compares the cost of the intervention with the effect, resulting in a cost per effect (eg, cost per year of life gained) that can be compared across interventions. In this article, we review three recent CEAs in the oncology literature, including chemoprevention in breast cancer, adjuvant endocrine therapy in early-stage breast cancer, and salvage chemotherapy in advanced ovarian cancer. The important elements of CEA, including the recommendations of the US Public Health Service Panel on Cost Effectiveness in Health and Medicine as they relate to cancer treatments, are discussed. Many well-done CEAs in cancer treatment have been performed during the last decade. As with clinical trials, the rigor and methods of the analysis are critical to the reliability of the results. Therapies with high cost and small incremental improvement in survival and/or quality of life may find it difficult to meet the societal thresholds for what is considered cost effective. CEA is a method to assess the cost and effect of cancer treatments, providing important insights into the best use (ie, obtaining the most value for) of health care expenditures. As the literature indicates, one must be cognizant of the fact that there can be extraordinary costs associated with some newer cancer therapies that provide small incremental clinical benefit. Better understanding of the cancer economic literature can help lead to an informed dialogue on the health policy implications of resource allocation in cancer care.

  17. [Principal infections in the oncology patient: practical treatment].

    Science.gov (United States)

    Fortún, J

    2004-01-01

    Infectious complications are one of the most important causes of morbi-mortality in oncology patients. Neutropenia is the most important risk factor for developing infection in the oncology patient. Although the highest mortalities continue to be associated with infections due to enterobacterias and Pseudomonas aeruginosa, the frequency of infections due to gram-positives is higher. Deep fungic infections, like those produced by resistant or infrequent bacteria usually occur in late periods of protracted neutropenias. In recent years different studies have shown the efficiency of antibiotic patterns in monotherapy in the treatment of the neutropenic patient with fever. Cellular immunosuppression is not usually as relevant as neutropenia in oncology patients without complications. However, the use of high doses of steroids in some patients and above all the use of purine analogues and monoclonal antibodies has changed this situation in recent years. With these patients it is recommendable to use prophylactic measures directed against Cytomegalovirus, Varicela-zoster virus, P.carinii (or jirovecii) and fungic infections. Bacteraemia associated with endovascular catheterisation is the principal cause of bacteraemia in these patients, above all due to gram-positive micro-organisms. In case of infection, it is always advisable to remove the catheter. However, under certain circumstances, where the placing of a new catheter might be risky given the patient's characteristics and where there are agents of low virulence (e.g. coagulase-negative staphylococcus), a conservative treatment can be tried. A persistence of fever or bacteraemia following removal of the catheter should lead to suspicion of the presence of a deep infection, fundamentally suppurated thrombophlebitis or endocarditis. An adequate understanding of the infectious complications in these patients and their correct treatment and prevention are decisive in reducing the high mortality associated with these

  18. No Exit: Identifying Avoidable Terminal Oncology Intensive Care Unit Hospitalizations.

    Science.gov (United States)

    Daly, Bobby; Hantel, Andrew; Wroblewski, Kristen; Balachandran, Jay S; Chow, Selina; DeBoer, Rebecca; Fleming, Gini F; Hahn, Olwen M; Kline, Justin; Liu, Hongtao; Patel, Bhakti K; Verma, Anshu; Witt, Leah J; Fukui, Mayumi; Kumar, Aditi; Howell, Michael D; Polite, Blase N

    2016-10-01

    Terminal oncology intensive care unit (ICU) hospitalizations are associated with high costs and inferior quality of care. This study identifies and characterizes potentially avoidable terminal admissions of oncology patients to ICUs. This was a retrospective case series of patients cared for in an academic medical center's ambulatory oncology practice who died in an ICU during July 1, 2012 to June 30, 2013. An oncologist, intensivist, and hospitalist reviewed each patient's electronic health record from 3 months preceding terminal hospitalization until death. The primary outcome was the proportion of terminal ICU hospitalizations identified as potentially avoidable by two or more reviewers. Univariate and multivariate analysis were performed to identify characteristics associated with avoidable terminal ICU hospitalizations. Seventy-two patients met inclusion criteria. The majority had solid tumor malignancies (71%), poor performance status (51%), and multiple encounters with the health care system. Despite high-intensity health care utilization, only 25% had documented advance directives. During a 4-day median ICU length of stay, 81% were intubated and 39% had cardiopulmonary resuscitation. Forty-seven percent of these hospitalizations were identified as potentially avoidable. Avoidable hospitalizations were associated with factors including: worse performance status before admission (median 2 v 1; P = .01), worse Charlson comorbidity score (median 8.5 v 7.0, P = .04), reason for hospitalization (P = .006), and number of prior hospitalizations (median 2 v 1; P = .05). Given the high frequency of avoidable terminal ICU hospitalizations, health care leaders should develop strategies to prospectively identify patients at high risk and formulate interventions to improve end-of-life care.

  19. Polycystic kidney disease in four British shorthair cats with successful treatment of bacterial cyst infection.

    Science.gov (United States)

    Nivy, R; Lyons, L A; Aroch, I; Segev, G

    2015-09-01

    Polycystic kidney disease is the most common inherited disorder in cats. Renal cysts progressively increase in size and number, resulting in a gradual decrease in kidney function. An autosomal dominant mutation in exon 29 of the polycystin-1 gene has been identified, mostly in Persian and Persian-related breeds. This case study describes polycystic kidney disease in four British shorthair cats, of which two had the same genetic mutation reported in Persian and Persian-related cats. This likely reflects introduction of this mutation into the British shorthair breeding line because of previous outcrossing with Persian cats. An infected renal cyst was diagnosed and successfully treated in one of the cats. This is a commonly reported complication in human polycystic kidney disease, and to the authors' knowledge has not previously been reported in cats with polycystic kidney disease. © 2015 British Small Animal Veterinary Association.

  20. Red squirrels in the British Isles are infected with leprosy bacilli.

    Science.gov (United States)

    Avanzi, Charlotte; Del-Pozo, Jorge; Benjak, Andrej; Stevenson, Karen; Simpson, Victor R; Busso, Philippe; McLuckie, Joyce; Loiseau, Chloé; Lawton, Colin; Schoening, Janne; Shaw, Darren J; Piton, Jérémie; Vera-Cabrera, Lucio; Velarde-Felix, Jesùs S; McDermott, Fergal; Gordon, Stephen V; Cole, Stewart T; Meredith, Anna L

    2016-11-11

    Leprosy, caused by infection with Mycobacterium leprae or the recently discovered Mycobacterium lepromatosis, was once endemic in humans in the British Isles. Red squirrels in Great Britain (Sciurus vulgaris) have increasingly been observed with leprosy-like lesions on the head and limbs. Using genomics, histopathology, and serology, we found M. lepromatosis in squirrels from England, Ireland, and Scotland, and M. leprae in squirrels from Brownsea Island, England. Infection was detected in overtly diseased and seemingly healthy animals. Phylogenetic comparisons of British and Irish M. lepromatosis with two Mexican strains from humans show that they diverged from a common ancestor around 27,000 years ago, whereas the M. leprae strain is closest to one that circulated in Medieval England. Red squirrels are thus a reservoir for leprosy in the British Isles. Copyright © 2016, American Association for the Advancement of Science.

  1. Methods of Academic Course Planning for Cancer Biology PhD Students to Enhance Knowledge of Clinical Oncology.

    Science.gov (United States)

    Mattes, Malcolm D; Swart, Elizabeth; Markwell, Steven M; Wen, Sijin; Vona-Davis, Linda C

    2017-09-15

    Little is known about how clinical oncology concepts are taught to PhD students or the most effective methods of doing so. In this study, electronic surveys were sent to faculty and students at PhD training programs, assessing their institution's methods of clinical oncology education and their perspective on optimal approaches to clinical oncology education. Only 40.0% of students reported any clinical oncology component to their institution's training, and only 26.5% had a clinician on their graduate advisory committee. Forty-three percent of students believed that they had a good understanding for translating basic science research into clinical practice, and 77.2% of all participants believed dual degree MD/PhD students were superior to PhD students in this regard. Lectures on clinical oncology research topics were the most valuable type of experience for all participants and were also the most common type of experience utilized. Working with a clinician to develop a clinical trial with correlative endpoints was also highly valued, but was only utilized by approximately 10% of programs. Faculty rated the value of nearly all types of clinical oncology exposure significantly lower than did students. Inclusion of the approaches identified in this study is likely to enhance PhD training in oncology-related disciplines. Cancer Res; 77(18); 4741-4. ©2017 AACR. ©2017 American Association for Cancer Research.

  2. A survey of evidence in the Journal of Veterinary Internal Medicine oncology manuscripts from 1999 to 2007.

    Science.gov (United States)

    Sahora, A; Khanna, C

    2010-01-01

    To survey and monitor trends in evidence for oncology manuscripts published in the Journal of Veterinary Internal Medicine (JVIM) between 1999 and 2007 based on an evidence-based medicine (EBM) standard. All veterinary oncology-related articles published in JVIM and 7 other high-impact journals from 1999 to 2007 were collected by database searches. Relevant manuscripts then were characterized including investigator affiliation, subject matter investigated, retrospective or prospective study design, manuscript type, and classifications of manuscripts using an EBM standard. A total of 172 relevant veterinary oncology manuscripts were identified in JVIM between 1999 and 2007. The proportion of oncology manuscripts published each year rose with the total number of manuscripts published in JVIM (mean, 13%; range, 8-15%). The author affiliations and subject matter were similar during this evaluation period. Case series represented the most common manuscript type (40%). With the exception of a progressive increase in prospective manuscripts and a reduction in case reports, no significant changes in the classification of manuscripts using EBM standards were seen. During this same period, veterinary oncology manuscripts published in 7 high-impact journals were associated with higher standards of evidence including prospective studies and randomized trials. The standards of evidence for veterinary oncology manuscripts published in JVIM have remained static between 1999 and 2007. This survey provides an informative benchmark for the state of evidence in previous JVIM oncology manuscripts and may be useful in identifying specific opportunities that may raise the standards of evidence in future publications in JVIM.

  3. Comprehending Sentences with the Body: Action Compatibility in British Sign Language?

    Science.gov (United States)

    Vinson, David; Perniss, Pamela; Fox, Neil; Vigliocco, Gabriella

    2017-01-01

    Previous studies show that reading sentences about actions leads to specific motor activity associated with actually performing those actions. We investigate how sign language input may modulate motor activation, using British Sign Language (BSL) sentences, some of which explicitly encode direction of motion, versus written English, where motion…

  4. Gender Trends in Radiation Oncology in the United States: A 30-Year Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Ahmed, Awad A. [Temple University School of Medicine, Philadelphia, Pennsylvania (United States); Egleston, Brian [Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Holliday, Emma [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Eastwick, Gary [Temple University School of Medicine, Philadelphia, Pennsylvania (United States); Takita, Cristiane [Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, Florida (United States); Jagsi, Reshma, E-mail: rjagsi@med.umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States)

    2014-01-01

    Purpose: Although considerable research exists regarding the role of women in the medical profession in the United States, little work has described the participation of women in academic radiation oncology. We examined women's participation in authorship of radiation oncology literature, a visible and influential activity that merits specific attention. Methods and Materials: We examined the gender of first and senior US physician-authors of articles published in the Red Journal in 1980, 1990, 2000, 2004, 2010, and 2012. The significance of trends over time was evaluated using logistic regression. Results were compared with female representation in journals of general medicine and other major medical specialties. Findings were also placed in the context of trends in the representation of women among radiation oncology faculty and residents over the past 3 decades, using Association of American Medical Colleges data. Results: The proportion of women among Red Journal first authors increased from 13.4% in 1980 to 29.7% in 2012, and the proportion among senior authors increased from 3.2% to 22.6%. The proportion of women among radiation oncology full-time faculty increased from 11% to 26.7% from 1980 to 2012. The proportion of women among radiation oncology residents increased from 27.1% to 33.3% from 1980 to 2010. Conclusions: Female first and senior authorship in the Red Journal has increased significantly, as has women's participation among full-time faculty, but women remain underrepresented among radiation oncology residents compared with their representation in the medical student body. Understanding such trends is necessary to develop appropriately targeted interventions to improve gender equity in radiation oncology.

  5. Robot-assisted surgery in gynecological oncology

    DEFF Research Database (Denmark)

    Kristensen, Steffen E; Mosgaard, Berit J; Rosendahl, Mikkel

    2017-01-01

    INTRODUCTION: Robot-assisted surgery has become more widespread in gynecological oncology. The purpose of this systematic review is to present current knowledge on robot-assisted surgery, and to clarify and discuss controversies that have arisen alongside the development and deployment. MATERIAL...... AND METHODS: A database search in PubMed and EMBASE was performed up until 4 March 2016. The search strategy was developed in collaboration with an information specialist, and by application of the PRISMA guidelines. Human participants and English language were the only restrictive filters applied. Selection...... was performed by screening of titles and abstracts, and by full text scrutiny. From 2001 to 2016, a total of 76 references were included. RESULTS: Robot-assisted surgery in gynecological oncology has increased, and current knowledge supports that the oncological safety is similar, compared with previous...

  6. The Evolution of Gero-Oncology Nursing

    Science.gov (United States)

    Bond, Stewart M.; Bryant, Ashley Leak; Puts, Martine

    2016-01-01

    Objectives This article summarizes the evolution of gero-oncology nursing and highlights key educational initiatives, clinical practice issues, and research areas to enhance care of older adults with cancer. Data Sources Peer-reviewed literature, position statements, clinical practice guidelines, web-based materials, and professional organizations’ resources. Conclusion Globally, the older adult cancer population is rapidly growing. The care of older adults with cancer requires an understanding of their diverse needs and the intersection of cancer and aging. Despite efforts to enhance competence in gerooncology and to develop a body of evidence, nurses and healthcare systems remain under-prepared to provide high quality care for older adults with cancer. Implications for Nursing Practice Nurses need to take a leadership role in integrating gerontological principles into oncology settings. Working closely with interdisciplinary team members, nurses should utilize available resources and continue to build evidence through gero-oncology nursing research. PMID:26830263

  7. The Danish Neuro-Oncology Registry

    DEFF Research Database (Denmark)

    Hansen, Steinbjørn

    2016-01-01

    advantage of reporting indicators is the related multidisciplinary discussions giving a better understanding of what actually is going on, thereby facilitating the work on adjusting the national guidelines in the Danish Neuro-Oncology Group. CONCLUSION: The establishment of DNOR has optimized the quality...... in handling primary brain tumor patients in Denmark by reporting indicators and facilitating a better multidisciplinary collaboration at a national level. DNOR provides a valuable resource for research.......AIM OF DATABASE: The Danish Neuro-Oncology Registry (DNOR) was established by the Danish Neuro-Oncology Group as a national clinical database. It was established for the purpose of supporting research and development in adult patients with primary brain tumors in Denmark. STUDY POPULATION: DNOR has...

  8. Palliative care communication in oncology nursing.

    Science.gov (United States)

    Goldsmith, Joy; Ferrell, Betty; Wittenberg-Lyles, Elaine; Ragan, Sandra L

    2013-04-01

    Oncology nurses consistently exhibit distress when communicating about end-of-life topics with patients and families. Poor communication experiences and processes correlate with emotional distress, moral distress, and work-related stress. The National Consensus Project (NCP) for Quality Palliative Care developed clinical practice guidelines to establish quality standards for the practice of palliative care. NCP's guidelines are expressly intended as an interdisciplinary document and are representative of the inherent interdisciplinary nature of palliative care. Communication's value to palliative and oncology nursing is unique because those two specialties include a high frequency of challenging interactions for patients, families, and healthcare professionals. The COMFORT communication curriculum, a holistic model for narrative clinical communication in practice developed for use in early palliative care, is posed as a resource for oncology nurses with a series of practice case examples presented against the backdrop of NCP's eight domains of quality palliative care.

  9. [Bipolar disorders in oncology: Characteristics and management].

    Science.gov (United States)

    Reich, Michel; Kotecki, Nuria

    2017-05-01

    Bipolar disorders belong to the spectrum of mood disorders and represent a serious psychiatric comorbidity. Behaviors adopted by bipolar patients can foster cancer occurrence but also impact its management, especially during acute depressive or manic episode. Oncologists must adapt their protocols in order to obtain the best compliance for treatment and avoid any possible mood destabilization, with the inherent risk of suicidal attempt. Potential interactions between mood-stabilizing agents (lithium, divalproate, atypical antipsychotics, and anticonvulsivants) and oncologic treatment (chemotherapy, targeted therapy, immunotherapy, corticotherapy) will be particularly watched. To do so, a closely collaboration with the oncopsychiatrist but also with the referent or liaison psychiatry team is necessary during the patient's oncologic care. Some clinical vignettes will illustrate the modalities of care of bipolar disorders in oncology. Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  10. The American Society for Radiation Oncology's 2010 Core Physics Curriculum for Radiation Oncology Residents

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    Xiao Ying, E-mail: ying.xiao@jefferson.edu [Thomas Jefferson University Hospital, Philadelphia, PA (United States); De Amorim Bernstein, Karen [Montefiore Medical Center, Bronx, NY (United States); Chetty, Indrin J. [Henry Ford Health System, Detroit, MI (United States); Eifel, Patricia [M. D. Anderson Cancer Center, Houston, TX (United States); Hughes, Lesley [Cooper University Hospital, Camden, NJ (United States); Klein, Eric E. [Washington University, Saint Louis, MO (United States); McDermott, Patrick [William Beaumont Hospital, Royal Oak, MI (United States); Prisciandaro, Joann [University of Michigan, Ann Arbor, MI (United States); Paliwal, Bhudatt [University of Wisconsin, Madison, WI (United States); Price, Robert A. [Fox Chase Cancer Center, Philadelphia, PA (United States); Werner-Wasik, Maria [Thomas Jefferson University Hospital, Philadelphia, PA (United States); Palta, Jatinder R. [University of Florida, Gainesville, FL (United States)

    2011-11-15

    Purpose: In 2004, the American Society for Radiation Oncology (ASTRO) published its first physics education curriculum for residents, which was updated in 2007. A committee composed of physicists and physicians from various residency program teaching institutions was reconvened again to update the curriculum in 2009. Methods and Materials: Members of this committee have associations with ASTRO, the American Association of Physicists in Medicine, the Association of Residents in Radiation Oncology, the American Board of Radiology (ABR), and the American College of Radiology. Members reviewed and updated assigned subjects from the last curriculum. The updated curriculum was carefully reviewed by a representative from the ABR and other physics and clinical experts. Results: The new curriculum resulted in a recommended 56-h course, excluding initial orientation. Learning objectives are provided for each subject area, and a detailed outline of material to be covered is given for each lecture hour. Some recent changes in the curriculum include the addition of Radiation Incidents and Bioterrorism Response Training as a subject and updates that reflect new treatment techniques and modalities in a number of core subjects. The new curriculum was approved by the ASTRO board in April 2010. We anticipate that physicists will use this curriculum for structuring their teaching programs, and subsequently the ABR will adopt this educational program for its written examination. Currently, the American College of Radiology uses the ASTRO curriculum for their training examination topics. In addition to the curriculum, the committee updated suggested references and the glossary. Conclusions: The ASTRO physics education curriculum for radiation oncology residents has been updated. To ensure continued commitment to a current and relevant curriculum, the subject matter will be updated again in 2 years.

  11. Board-Certified Oncology Pharmacists: Their Potential Contribution to Reducing a Shortfall in Oncology Patient Visits.

    Science.gov (United States)

    Ignoffo, Robert; Knapp, Katherine; Barnett, Mitchell; Barbour, Sally Yowell; D'Amato, Steve; Iacovelli, Lew; Knudsen, Jasen; Koontz, Susannah E; Mancini, Robert; McBride, Ali; McCauley, Dayna; Medina, Patrick; O'Bryant, Cindy L; Scarpace, Sarah; Stricker, Steve; Trovato, James A

    2016-04-01

    With an aging US population, the number of patients who need cancer treatment will increase significantly by 2020. On the basis of a predicted shortage of oncology physicians, nonphysician health care practitioners will need to fill the shortfall in oncology patient visits, and nurse practitioners and physician assistants have already been identified for this purpose. This study proposes that appropriately trained oncology pharmacists can also contribute. The purpose of this study is to estimate the supply of Board of Pharmacy Specialties-certified oncology pharmacists (BCOPs) and their potential contribution to the care of patients with cancer through 2020. Data regarding accredited oncology pharmacy residencies, new BCOPs, and total BCOPs were used to estimate oncology residencies, new BCOPs, and total BCOPs through 2020. A Delphi panel process was used to estimate patient visits, identify patient care services that BCOPs could provide, and study limitations. By 2020, there will be an estimated 3,639 BCOPs, and approximately 62% of BCOPs will have completed accredited oncology pharmacy residencies. Delphi panelists came to consensus (at least 80% agreement) on eight patient care services that BCOPs could provide. Although the estimates given by our model indicate that BCOPs could provide 5 to 7 million 30-minute patient visits annually, sensitivity analysis, based on factors that could reduce potential visit availability resulted in 2.5 to 3.5 million visits by 2020 with the addition of BCOPs to the health care team. BCOPs can contribute to a projected shortfall in needed patient visits for cancer treatment. BCOPs, along with nurse practitioners and physician assistants could substantially reduce, but likely not eliminate, the shortfall of providers needed for oncology patient visits. Copyright © 2016 by American Society of Clinical Oncology.

  12. Integrated biophotonics in endoscopic oncology

    Science.gov (United States)

    Muguruma, Naoki; DaCosta, Ralph S.; Wilson, Brian C.; Marcon, Norman E.

    2009-02-01

    endoscopic diagnosis is likely to be impacted by a combination of biomarkers and technology, and 'endoscopic molecular imaging' should be defined as "visualization of molecular characteristics with endoscopy". These innovations will allow us not only to locate a tumor or dysplastic lesion but also to visualize its molecular characteristics (e.g., DNA mutations and polymorphisms, gene and/or protein expression), and the activity of specific molecules and biological processes that affect tumor behavior and/or its response to therapy. In the near future, these methods should be promising technologies that will play a central role in gastrointestinal oncology.

  13. Gender Opportunities in Psychosocial Oncology.

    Science.gov (United States)

    Loscalzo, Matthew; Clark, Karen

    2018-01-01

    So much has happened since the original publication of this chapter. In some ways, the progress made in appreciating the full spectrum of sexual and gender expression has been uneven and in some nations, there has been serious regression and resulting repression. But overall, especially in the industrialized countries, there is much greater awareness of sex and gender and its importance in health and well being. In this updated chapter, we put sex and gender into a historical context that is relevant to psycho-oncology and that openly accepts that society overall, is highly conflicted when it comes to how women and men get the best out of each other, never mind how to best integrate lesbian, gay, bisexual, and transgender (LGBT) communities. With the advent of more tailored treatments and strategic medicine, sex becomes much more important as a variable and this has led to greater scientific requirements to create protocols that integrate sex into all aspects of health from prevention, diagnosis, treatment, survivorship, and death. But we still have a very far way to go. There is a serious dearth of data on sex and gender in science overall and in cancer medicine specifically. Avoidance of discussions of sex and gender in medicine reflects the larger lingering societal discomfort with any discussion that links potential sex and gender differences with superiority. The data shows that there is more intrasexual than intersexual variation in men and women. When speaking about sex and gender the literature reflects that, on average, there are many differences, and although they are small, that when taken together, the impact may be quite robust. Sex and gender differences are relevant to how individuals, couples, and families experience and cope with serious illness; however these important and obvious variables are seldom taken into account when counseling seriously ill patients and their families. Cancer is a complex disease that brings into sharp relief the

  14. The Labour Party and British Republicanism

    Directory of Open Access Journals (Sweden)

    Kenneth O. MORGAN

    2003-10-01

    Full Text Available The famous detective, Sherlock Holmes, once solved a case by referring to “the dog that did not bark.” In the past 250 years of British history, republicanism is another dog that did not bark. This is particularly true of supposedly our most radical major political party, the Labour Party. Over the monarchy, as over constitutional matters generally, Labour’s instincts have been conservative. Even after 1997, when the party, led by Lord Irvine, has indeed embarked upon major constitutional ref...

  15. Oncology of Reptiles: Diseases, Diagnosis, and Treatment.

    Science.gov (United States)

    Christman, Jane; Devau, Michael; Wilson-Robles, Heather; Hoppes, Sharman; Rech, Raquel; Russell, Karen E; Heatley, J Jill

    2017-01-01

    Based on necropsy review, neoplasia in reptiles has a comparable frequency to that of mammals and birds. Reptile neoplasia is now more frequently diagnosed in clinical practice based on increased use of advanced diagnostic techniques and improvements in reptilian husbandry allowing greater longevity of these species. This article reviews the current literature on neoplasia in reptiles, and focuses on advanced diagnostics and therapeutic options for reptilian patientssuffering neoplastic disease. Although most applied clinical reptile oncology is translated from dog and cat oncology, considerations specific to reptilian patients commonly encountered in clinical practice (turtles, tortoises, snakes, and lizards) are presented. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Checkpoint inhibitors: a cutting edge in oncology.

    Science.gov (United States)

    Jago, C

    2017-07-01

    The checkpoint inhibitor field, and indeed the whole of immuno-oncology, is fast-paced and fascinating, with huge clinical and commercial potential. The challenge in the coming years will be to define the best type and combination of immunotherapy, and the best target population to receive it. Keytruda's ground-breaking approval for a biomarker-based rather than location-based indication is a solid step in this direction, and is likely to be followed by other such approvals. As the field develops, it is to be hoped that immuno-oncology therapeutics will continue to deliver the significant improvements in patient outcome that have been seen so far.

  17. Integrative oncology in Indian subcontinent: an overview.

    Science.gov (United States)

    Ramamoorthy, Ananthalakshmi; Janardhanan, Sunitha; Jeevakarunyam, Sathiyajeeva; Jeddy, Nadheem; Eagappan, Senthil

    2015-03-01

    Integrative oncology is a combination of one where complementary and alternative medicine (CAM) with conventional cancer treatment modalities is used to manage symptoms, control side-effects and improve the state of mental wellbeing. The ancient Indian medicinal approach in cancer treatment and management has a wide array of herbs and practices. There is an increasing demand for traditional and natural medicine by the cancer patients. The conventional oncologic surgeons and physicians should be aware of the role of cCAM that are available in Indian subcontinent and provide a treatment that focuses on the physical and mental state of wellness in combating cancer.

  18. Role of music therapy in integrative oncology.

    Science.gov (United States)

    Magill, Lucanne

    2006-01-01

    Music therapy is an evidence-based complementary therapy that enhances quality of life in cancer patients and their caregivers. The role of music therapy in integrative oncology encompassed care and treatment of patients and family members , ongoing collaboration with the health care team, and the provision of music therapy services that may benefit the cancer center community. Clinical work includes ongoing assessment and the implementation of specific music therapy techniques aimed at reducing challenging symptoms and enhancing overall well-being and quality of life. This article outlines music therapy methods and the role that the music therapist has in integrative oncology programs.

  19. Oncology nursing in Cuba: report of the delegation.

    Science.gov (United States)

    Sheldon, Lisa Kennedy; Leonard, Kathleen; Gross, Anne; Hartnett, Erin; Poage, Ellen; Squires, Jennifer; Ullemeyer, Vicki; Schueller, Mary; Stary, Susan; Miller, Mary Alice

    2012-08-01

    In December 2011, the first delegation of oncology nurses from the United States visited Havana, Cuba. The delegation included oncology nurses, educators, and leaders from across America and provided opportunities to learn about the healthcare system, cancer, and oncology nursing in Cuba. Delegation members attended lectures, toured facilities, and enjoyed Cuban culture. This exchange highlighted the similarities in cancer care and oncology nursing between countries and opened doors for future collaborations.

  20. Current status of medical oncology in Japan--reality gleaned from a questionnaire sent to designated cancer care hospitals.

    Science.gov (United States)

    Takiguchi, Yuichi; Sekine, Ikuo; Iwasawa, Shunichiro; Kurimoto, Ryota; Sakaida, Emiko; Tamura, Kenji

    2014-07-01

    Medical oncology in Japan has a relatively short history, with specialist certification starting in 2006, resulting in 867 certified medical oncologists as of 2014. Although the national government has appointed 397 Designated Cancer Care Hospitals, little is known about the actual situations of medical oncology services at these institutions. Questionnaires regarding the presence of a medical oncology department, the number of physicians in the department, the presence of certified medical oncologists and the degree of the medical oncologists' responsibilities for drug therapies in adults with solid cancers were sent to all 397 institutions between 21 January and 1 May 2013. The response rate was 68.0%. Among the responses, 39.4% of the institutions had medical oncology departments with a median of three physicians. Most of the medical oncology departments were primarily responsible, as evaluated according to patient number, for the treatment of limited disease categories. The medical oncologists were significantly more responsible for molecular-targeted therapy than for chemotherapy in head and neck cancer or for cytokine therapy in renal cell carcinoma. The wide variety of adverse events associated with molecular-targeted therapy might have enhanced the roles of medical oncologists. As the proportion of hospitals with a medical oncology department increased according to the number of certified medical oncologists working at the institution, cultivating medical oncologists seems to be an urgent task for advancing medical oncology in Japan. The present study provides fundamental data for the future development of medical oncology in Japan. The present study is to uncover the current situation of medical oncology in Japan. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. ExCEL in Social Work: Excellence in Cancer Education & Leadership: An Oncology Social Work Response to the 2008 Institute of Medicine Report.

    Science.gov (United States)

    Otis-Green, Shirley; Jones, Barbara; Zebrack, Brad; Kilburn, Lisa; Altilio, Terry A; Ferrell, Betty

    2015-09-01

    ExCEL in Social Work: Excellence in Cancer Education & Leadership was a multi-year National Cancer Institute (NCI)-funded grant for the development and implementation of an innovative educational program for oncology social workers. The program's curriculum focused upon six core competencies of psychosocial-spiritual support necessary to meet the standard of care recommended by the 2008 Institute of Medicine (IOM) Report: Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. The curriculum was delivered through a collaborative partnership between the City of Hope National Medical Center and the two leading professional organizations devoted exclusively to representing oncology social workers--the Association of Oncology Social Work and the Association of Pediatric Oncology Social Workers. Initial findings support the feasibility and acceptability of this tailored leadership skills-building program for participating oncology social workers.

  2. ExCEL in Social Work: Excellence in Cancer Education & Leadership An Oncology Social Work Response to the 2008 Institute of Medicine Report

    Science.gov (United States)

    Otis-Green, Shirley; Jones, Barbara; Zebrack, Brad; Kilburn, Lisa; Altilio, Terry A.; Ferrell, Betty

    2014-01-01

    ExCEL in Social Work : Excellence in Cancer Education & Leadership was a multi-year National Cancer Institute (NCI)-funded grant for the development and implementation of an innovative educational program for oncology social workers. The program’s curriculum focused upon six core competencies of psychosocial-spiritual support necessary to meet the standard of care recommended by the 2008 Institute of Medicine (IOM) Report: Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. The curriculum was delivered through a collaborative partnership between the City of Hope National Medical Center and the two leading professional organizations devoted exclusively to representing oncology social workers - the Association of Oncology Social Work and the Association of Pediatric Oncology Social Workers. Initial findings support the feasibility and acceptability of this tailored leadership skills-building program for participating oncology social workers. PMID:25146345

  3. Geographic Analysis of the Radiation Oncology Workforce

    Energy Technology Data Exchange (ETDEWEB)

    Aneja, Sanjay [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT (United States); Cancer Outcomes, Policy, and Effectiveness Research Center at Yale, New Haven, CT (United States); Smith, Benjamin D. [University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Gross, Cary P. [Cancer Outcomes, Policy, and Effectiveness Research Center at Yale, New Haven, CT (United States); Department of General Internal Medicine, Yale University School of Medicine, New Haven, CT (United States); Wilson, Lynn D. [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT (United States); Haffty, Bruce G. [Cancer Institute of New Jersey, New Brunswick, NJ (United States); Roberts, Kenneth [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT (United States); Yu, James B., E-mail: james.b.yu@yale.edu [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT (United States); Cancer Outcomes, Policy, and Effectiveness Research Center at Yale, New Haven, CT (United States)

    2012-04-01

    Purpose: To evaluate trends in the geographic distribution of the radiation oncology (RO) workforce. Methods and Materials: We used the 1995 and 2007 versions of the Area Resource File to map the ratio of RO to the population aged 65 years or older (ROR) within different health service areas (HSA) within the United States. We used regression analysis to find associations between population variables and 2007 ROR. We calculated Gini coefficients for ROR to assess the evenness of RO distribution and compared that with primary care physicians and total physicians. Results: There was a 24% increase in the RO workforce from 1995 to 2007. The overall growth in the RO workforce was less than that of primary care or the overall physician workforce. The mean ROR among HSAs increased by more than one radiation oncologist per 100,000 people aged 65 years or older, from 5.08 per 100,000 to 6.16 per 100,000. However, there remained consistent geographic variability concerning RO distribution, specifically affecting the non-metropolitan HSAs. Regression analysis found higher ROR in HSAs that possessed higher education (p = 0.001), higher income (p < 0.001), lower unemployment rates (p < 0.001), and higher minority population (p = 0.022). Gini coefficients showed RO distribution less even than for both primary care physicians and total physicians (0.326 compared with 0.196 and 0.292, respectively). Conclusions: Despite a modest growth in the RO workforce, there exists persistent geographic maldistribution of radiation oncologists allocated along socioeconomic and racial lines. To solve problems surrounding the RO workforce, issues concerning both gross numbers and geographic distribution must be addressed.

  4. The British Monarchy. On the Teaching of British Affairs at College and School Level

    Science.gov (United States)

    Campbell-Doherty, Julian

    1974-01-01

    Deals with "area study" aspects of the teaching of English in schools and colleges. Using as an example the British monarchy, it is shown how "area study" elements are handled in schoolbooks in use today. Suggestions relating to the subject are also offered. (IFS/WGA)

  5. The experiential world of the Oncology nurse

    Directory of Open Access Journals (Sweden)

    Laetitia le Roux

    2008-03-01

    Full Text Available In her experiential world, the oncology nurse experiences unique, challenging and rewarding relationships in a multidimensional, dynamic way. The aim of this study was to describe, from her viewpoint and perspective, how she experiences and reacts to this world. Through this study the researcher wants the oncology nurse’s voice to be heard, the richness of her story acknowledged and the derived data to be applied to the benefit of the field of oncology. In-depth, unstructured phenomenological interviews provided the saturated data from which the uniqueness of the world of the oncology nurse unfolded as the uniqueness of the oncology patients and their world emerged clearly. Findings show that the oncology nurse, attending to the cancer patients and their family, experiences many different relationships. The uniqueness of the oncology nurse-patient relationship is described as unlike any other nurse-patient relationship. The challenging interpersonal relationships with management and other members of the multiprofessional team, as experienced from the perspective of the oncology nurse, are also highlighted. Furthermore, a unifying intrapersonal relationship with the self was identified. This enables the oncology nurse to be both on the giving and receiving end of the intensely emotional environment she works in, explaining, at least partly, the high job satisfaction that permeated the interviews in this study. Recommendations for nursing practice, education and research were formulated. Opsomming In haar leefwêreld ondervind onkologieverpleegkundige unieke, uitdagende en belonende verhoudinge op ‘n multidimensionele en dinamiese wyse. Die doel van hierdie studie was om ‘n beskrywing van die onkologieverpleegkundige se ervarings van en reaksie op haar leefwêreld vanuit haar oogpunt en perspektief. Deur middel van hierdie studie wil die navorser die stem van die onkologieverpleegkundige gehoor laat word, die rykdom van haar verhaal

  6. The experiential world of the Oncology nurse

    Directory of Open Access Journals (Sweden)

    Dalena van Rooyen

    2008-11-01

    Full Text Available In her experiential world, the oncology nurse experiences unique, challenging and rewarding relationships in a multidimensional, dynamic way. The aim of this study was to describe, from her viewpoint and perspective, how she experiences and reacts to this world. Through this study the researcher wants the oncology nurse’s voice to be heard, the richness of her story acknowledged and the derived data to be applied to the benefit of the field of oncology. In-depth, unstructured phenomenological interviews provided the saturated data from which the uniqueness of the world of the oncology nurse unfolded as the uniqueness of the oncology patients and their world emerged clearly. Findings show that the oncology nurse, attending to the cancer patients and their family, experiences many different relationships. The uniqueness of the oncology nurse-patient relationship is described as unlike any other nurse-patient relationship. The challenging interpersonal relationships with management and other members of the multiprofessional team, as experienced from the perspective of the oncology nurse, are also highlighted. Furthermore, a unifying intrapersonal relationship with the self was identified. This enables the oncology nurse to be both on the giving and receiving end of the intensely emotional environment she works in, explaining, at least partly, the high job satisfaction that permeated the interviews in this study. Recommendations for nursing practice, education and research were formulated. Opsomming In haar leefwêreld ondervind onkologieverpleegkundige unieke, uitdagende en belonende verhoudinge op ‘n multidimensionele en dinamiese wyse. Die doel van hierdie studie was om ‘n beskrywing van die onkologieverpleegkundige se ervarings van en reaksie op haar leefwêreld vanuit haar oogpunt en perspektief. Deur middel van hierdie studie wil die navorser die stem van die onkologieverpleegkundige gehoor laat word, die rykdom van haar verhaal erken en

  7. Oncology nurses' recognition of supportive care needs and symptoms of their patients undergoing chemotherapy.

    Science.gov (United States)

    Nakaguchi, Tomohiro; Okuyama, Toru; Uchida, Megumi; Ito, Yoshinori; Komatsu, Hirokazu; Wada, Makoto; Akechi, Tatsuo

    2013-04-01

    To assess the accuracy of oncology nurses' recognition of supportive care needs and symptoms of their patients undergoing chemotherapy. The participants comprised randomly selected cancer outpatients receiving chemotherapy in an ambulatory setting and 17 oncology nurses working in two chemotherapy units in Japan. For assessment of the patients' supportive care needs and symptoms, the patients were asked to respond to a validated self-administered questionnaire. The oncology nurses completed a survey in which they indicated their perception of the level of the same set of needs or symptoms. The two data sets obtained from the patients and nurses were compared statistically to assess the accuracy of the oncology nurses' recognition of their patients' needs and symptoms. Complete data sets were available for 439 patients. The most common primary cancers were breast cancer (36.0%), followed by colorectal (24.4%) and lung (12.3%) cancers. Nurses' awareness of their patients' supportive care needs and physical and psychological symptoms were less than optimal in routine care. In particular, psychological symptoms and support needs for these symptoms were markedly under-recognized. Physical symptoms associated with chemotherapy, such as hair loss, appetite loss and fatigue, were better recognized than symptoms not specific to chemotherapy, such as constipation, insomnia, dyspnea and pain. Oncology nurses' recognition may not accurately reflect their patients' supportive care needs and symptoms in routine practice. In clinical practice, it may be beneficial to conduct routine screening of patients' perceived needs and symptoms comprehensively using self-administered questionnaires.

  8. Immunotherapy response assessment in neuro-oncology: a report of the RANO working group.

    Science.gov (United States)

    Okada, Hideho; Weller, Michael; Huang, Raymond; Finocchiaro, Gaetano; Gilbert, Mark R; Wick, Wolfgang; Ellingson, Benjamin M; Hashimoto, Naoya; Pollack, Ian F; Brandes, Alba A; Franceschi, Enrico; Herold-Mende, Christel; Nayak, Lakshmi; Panigrahy, Ashok; Pope, Whitney B; Prins, Robert; Sampson, John H; Wen, Patrick Y; Reardon, David A

    2015-11-01

    Immunotherapy is a promising area of therapy in patients with neuro-oncological malignancies. However, early-phase studies show unique challenges associated with the assessment of radiological changes in response to immunotherapy reflecting delayed responses or therapy-induced inflammation. Clinical benefit, including long-term survival and tumour regression, can still occur after initial disease progression or after the appearance of new lesions. Refinement of the response assessment criteria for patients with neuro-oncological malignancies undergoing immunotherapy is therefore warranted. Herein, a multinational and multidisciplinary panel of neuro-oncology immunotherapy experts describe immunotherapy Response Assessment for Neuro-Oncology (iRANO) criteria based on guidance for the determination of tumour progression outlined by the immune-related response criteria and the RANO working group. Among patients who demonstrate imaging findings meeting RANO criteria for progressive disease within 6 months of initiating immunotherapy, including the development of new lesions, confirmation of radiographic progression on follow-up imaging is recommended provided that the patient is not significantly worse clinically. The proposed criteria also include guidelines for the use of corticosteroids. We review the role of advanced imaging techniques and the role of measurement of clinical benefit endpoints including neurological and immunological functions. The iRANO guidelines put forth in this Review will evolve successively to improve their usefulness as further experience from immunotherapy trials in neuro-oncology accumulate. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Testing the stress-response sequence model in paediatric oncology nursing.

    Science.gov (United States)

    Hinds, P S; Sanders, C B; Srivastava, D K; Hickey, S; Jayawardene, D; Milligan, M; Olson, M S; Puckett, P; Quargnenti, A; Randall, E A; Tyc, V

    1998-11-01

    The causes and intensity of role-related stress experienced by paediatric oncology nurses, the nurses' ability to respond to the stressors, and the professional and personal consequences of those stressors for the nurses are issues of concern for administrators and staff. The concern evolves from the anticipated relationships among stressors, the ability to cope with role-related stressors, and the expected negative outcomes such as resignation. However, the relationships among these components have not been previously measured concurrently in paediatric oncology nurses. The primary purpose of this study was to test the complete stress-response sequence model in a sample of paediatric oncology nurses by obtaining concurrent measures of the model's individual components: nurses' stressors, reactions, mediators, and consequences. A total of 126 nurses completed six questionnaires (Stressor Scale for Paediatric Oncology Nurses, Perceived Stress Scale, Measure of Job Satisfaction, Organized Commitment Questionnaire, Group Cohesion Scale, and Intent to Leave) and a demographic sheet. The majority of participating nurses were married, worked full-time and had worked 5 or more years in oncology. Qualitative data were analysed using a semantic content analysis technique. Relationships among the components of the model were examined using a two-stage least squares technique. The components were only weakly associated and unable to explain significant variation in each other. The combined qualitative and quantitative data indicate that an important explanatory variable - role-related meaning - is missing in the content model.

  10. 75 FR 81283 - Oncologic Drugs Advisory Committee; Cancellation

    Science.gov (United States)

    2010-12-27

    ... HUMAN SERVICES Food and Drug Administration Oncologic Drugs Advisory Committee; Cancellation AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The meeting of the Oncologic Drugs Advisory... of December 6, 2010 (75 FR 75680). On February 9, 2011, the Oncologic Drugs Advisory Committee was...

  11. The British Geological Survey seismic monitoring system

    Science.gov (United States)

    Ottemoller, L.; Baptie, B.; Luckett, R.

    2009-04-01

    The British Geological Survey (BGS) monitors the seismicity in and around the British Isles. The seismic network was started in the seventies and built up over the years to 146 short-period stations. An upgrade of this network started a few years ago and will result in a modern network with broadband seismometers, high dynamic range digitizers and real-time communication (Internet, ADSL, satellite). In total the network will comprise about 50 stations, with only few short-period stations remaining. Equipment is used from both Guralp and Nanometrics, and their respective software for data acquisition is used to bring the data to the centre in near real-time. The automated data processing is done through Earthworm. Event data are analysed using SEISAN. Continuous data are kept for all broadband stations and checked for quality and completeness. Real-time data is also exchanged with neighbouring networks. The data is used for routine monitoring, but also research. The main research objectives are to understand distribution of seismicity and relating earthquakes to tectonics, develop velocity and attenuation models and study the seismic hazard and earthquake effects.

  12. The Ruins of the British Welfare State

    Directory of Open Access Journals (Sweden)

    Tahl Kaminer

    2014-08-01

    Full Text Available The subjects of Owen Hatherley’s A Guide to the New Ruins of Great Britain are architecture and urban development. The book addresses also some broader cultural, political and economic references, as well as personal anecdotes and memories. It includes many encounters with the remnants of the British welfare state.As an extension to his blog postings and a sequel of sorts to his previous Militant Modernism, Hatherley’s antagonist here is the semi-official architecture of New Labour, which he terms ‘pseudomodernism’: an unimaginative, inferior, and, in its own specific way, also tacky architecture of white stucco, steel and glass. He attacks the Faustian bargain of Richard Rogers and his allies with neoliberalism, a pact that produces a modernism devoid of social content, reflected by the unimaginative, speculation-driven architectural design. While Hatherley produces the promised indictment of recent British architecture, the book is, at the end of the day, primarily a eulogy to the disappearing postwar architecture he so evidently loves.

  13. Suicide reporting within British newspapers' arts coverage.

    Science.gov (United States)

    Pitman, Alexandra; Stevenson, Fiona

    2015-01-01

    Many suicide prevention strategies promote media guidelines on suicide reporting, given evidence that irresponsible reporting of suicide can influence imitative suicidal behavior. Due to limited resources, monitoring of guideline adherence has tended to focus on news outputs, with a risk of neglecting other journalistic content. To determine whether British newspapers' arts coverage adheres to media guidelines on suicide reporting. Purposive sampling was used to capture current national practice on suicide reporting within newspapers' arts coverage of exhibitions. Recent major UK exhibitions by artists who had died by suicide were identified: Kirchner, Rothko, Gorky, and Van Gogh. Content analysis of all UK national newspaper coverage of these exhibitions was performed to measure the articles' adherence to widely accepted media guidelines. In all, 68 newspaper reviews satisfied inclusion criteria, with 100% failing to show full adherence to media guidelines: 21% used inappropriate language; 38% provided explicit descriptions of the suicide; 7% employed simplistic explanations for suicide triggers; 27% romanticized the suicide; and 100% omitted information on sources of support. British newspapers' arts coverage of exhibitions deviates considerably from media guidelines on the reporting of suicide. The findings suggest scope to improve journalists' awareness of the importance of this component of suicide prevention strategies.

  14. The truth behind british politeness: some misinterpretations

    Directory of Open Access Journals (Sweden)

    Peixoto, Rafael Marcos Tort

    2014-01-01

    Full Text Available The purpose of this paper is to analyse a chart published by the British newspaper The Telegraphabout the most common misunderstandings foreigners face while making use of English as their second language. L2 speakers are said to take every word at face value and therefore making some pragmatic mistakes. Sometimes there can be another meaning behind the spoken words, like it is unsaid for a reason. The pragmatics theories of irony in Attardo (1999 shed light on these translating and intercultural awareness issues by explaining what is behind the misunderstanding which is the secret ofthe so famous British politeness. Some considerations will be made upon the chart so as to understand it, such as an analysis of irony and native speakers’ perspectives on it. In addition to that, we will take into account the opinion of some native speakers of English to unveil some details and clarify how meaningful some sentences may be and if the researched chart is actually accurate

  15. Policy and priorities for national cancer control planning in low- and middle-income countries: Lessons from the Association of Southeast Asian Nations (ASEAN) Costs in Oncology prospective cohort study.

    Science.gov (United States)

    2017-03-01

    Evidence to guide policymakers in developing affordable and equitable cancer control plans are scarce in low- and middle-income countries (LMIC). The 2012-2014 ASEAN Costs in Oncology Study prospectively followed-up 9513 newly diagnosed cancer patients from eight LMIC in Southeast Asia for 12 months. Overall and country-specific incidence of financial catastrophe (out-of-pocket health costs ≥ 30% of annual household income), economic hardship (inability to make necessary household payments), poverty (living below national poverty line), and all-cause mortality were determined. Stepwise multinomial regression was used to estimate the extent to which health insurance, cancer stage and treatment explained these outcomes. The one-year incidence of mortality (12% in Malaysia to 45% in Myanmar) and financial catastrophe (24% in Thailand to 68% in Vietnam) were high. Economic hardship was reported by a third of families, including inability to pay for medicines (45%), mortgages (18%) and utilities (12%), with 28% taking personal loans, and 20% selling assets (not mutually exclusive). Out of households that initially reported incomes above the national poverty levels, 4·9% were pushed into poverty at one year. The adverse economic outcomes in this study were mainly attributed to medical costs for inpatient/outpatient care, and purchase of drugs and medical supplies. In all the countries, cancer stage largely explained the risk of adverse outcomes. Stage-stratified analysis however showed that low-income patients remained vulnerable to adverse outcomes even when diagnosed with earlier cancer stages. The LMIC need to realign their focus on early detection of cancer and provision of affordable cancer care, while ensuring adequate financial risk protection, particularly for the poor. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Respiratory motion in positron emission tomography for oncology applications: Problems and solutions

    Energy Technology Data Exchange (ETDEWEB)

    Visvikis, D. [INSERM U650, LaTIM, University Hospital Medical School, F-29609, Brest (France)]. E-mail: Visvikis.Dimitris@univ-brest.fr; Lamare, F. [INSERM U650, LaTIM, University Hospital Medical School, F-29609, Brest (France); Bruyant, P. [INSERM U650, LaTIM, University Hospital Medical School, F-29609, Brest (France); Boussion, N. [INSERM U650, LaTIM, University Hospital Medical School, F-29609, Brest (France); Cheze Le Rest, C. [INSERM U650, LaTIM, University Hospital Medical School, F-29609, Brest (France)

    2006-12-20

    The effect of physiological motion in emission tomography is a reduction in overall image contrast and loss of sensitivity. In particular, respiratory motion affects imaging in the thoracic and the upper abdomen area, leading to a reduction in lesion detection as a result of the associated blurring. Furthermore, respiratory motion leads to a compromise in quantitative accuracy in terms of functional volume determination and activity concentration recovery for oncology imaging. This paper presents a review of the current state of the art in the implementation of respiratory motion compensation techniques in positron emission tomography (PET) imaging for oncology applications.

  17. Oncological management and obstetric and neonatal outcomes for women diagnosed with cancer during pregnancy

    DEFF Research Database (Denmark)

    de Haan, Jorine; Verheecke, Magali; Van Calsteren, Kristel

    2018-01-01

    BACKGROUND: Awareness is growing that cancer can be treated during pregnancy, but the effect of this change on maternal and neonatal outcomes is unknown. The International Network on Cancer, Infertility and Pregnancy (INCIP) registers the incidence and maternal, obstetric, oncological, and neonatal...... outcomes of cancer occurring during pregnancy. We aimed to describe the oncological management and obstetric and neonatal outcomes of patients registered in INCIP and treated in the past 20 years, and assess associations between cancer type or treatment modality and obstetric and neonatal outcomes. METHODS......: This descriptive cohort study included pregnant patients with cancer registered from all 37 centres (from 16 countries) participating in the INCIP registry. Oncological, obstetric, and neonatal outcome data of consecutive patients diagnosed with primary invasive cancer during pregnancy between Jan 1, 1996, and Nov...

  18. Cardio-oncology: what you need to know now for clinical practice and echocardiography.

    Science.gov (United States)

    Larsen, Carolyn M; Mulvagh, Sharon L

    2017-03-01

    Cardio-oncology is a rapidly growing field aimed at minimizing the effects of cardiovascular morbidity and mortality in cancer survivors. To meet this aim, patients are assessed at baseline to define their risk of cardiotoxicity and then followed closely during and after chemotherapy to assess for early signs or symptoms of cardiovascular disease. Cardiac imaging, and in particular, transthoracic echocardiography, plays an essential role in the baseline assessment and serial follow-up of cardio-oncology patients. The objectives of this paper are to review the mechanisms of cardiotoxicity of several common chemotherapeutic agents associated with an increased risk for left ventricular systolic dysfunction and to outline recommendations regarding the baseline assessment and serial follow-up of cardio-oncology patients with a focus on the role of echocardiography. © 2017 The authors.

  19. AllergoOncology - the impact of allergy in oncology: EAACI position paper

    Czech Academy of Sciences Publication Activity Database

    Jensen-Jarolim, E.; Bax, H. J.; Bianchini, R.; Capron, M.; Corrigan, C.; Castells, M.; Dombrowicz, D.; Daniels-Wells, T. R.; Fazekas, J.; Fiebiger, E.; Gatault, S.; Gould, H. J.; Janda, Jozef; Josephs, D. H.; Karagiannis, P.; Levi-Schaffer, F.; Meshcheryaková, A.; Mechtcheriakova, D.; Mekori, Y.; Mungenast, F.; Nigro, E. A.; Penichet, M. L.; Redegeld, F.; Saul, L.; Singer, J.; Spicer, J. F.; Siccardi, A. G.; Spillner, E.; Turner, M. C.; Untersmayr, E.; Vangelista, L.; Karagiannis, S. N.

    2017-01-01

    Roč. 72, č. 6 (2017), s. 866-887 ISSN 0105-4538 Institutional support: RVO:67985904 Keywords : allergooncology * allergy * atopy Subject RIV: FD - Oncology ; Hematology Impact factor: 7.361, year: 2016

  20. Comparison of access to services in rural emergency departments in Quebec and British Columbia.

    Science.gov (United States)

    Fleet, Richard; Audette, Louis-David; Marcoux, Jérémie; Villa, Julie; Archambault, Patrick; Poitras, Julien

    2014-11-01

    Although emergency departments (EDs) in Canada's rural areas serve approximately 20% of the population, a serious problem in access to health care services has emerged. The objective of this project was to compare access to support services in rural EDs between British Columbia and Quebec. Rural EDs were identified through the Canadian Healthcare Association's Guide to Canadian Healthcare Facilities. We selected hospitals with 24/7 ED physician coverage and hospitalization beds that were located in rural communities (using the rural and small town definition from Statistics Canada). Data were collected from ministries of health, local health authorities, and ED statistics. A telephone interview was administered to collect denominative user data statistics and determine the status of services. British Columbia has more rural EDs (n  =  34) than Quebec (n  =  26). EDs in Quebec have higher volumes (19,310 versus 7,793 annual visits). With respect to support services, 81% of Quebec rural EDs have a 24/7 on-call general surgeon compared to 12% for British Columbia. Nearly 75% of Quebec rural EDs have 24/7 access to computed tomography versus only 3% for British Columbia. Rural EDs in Quebec are also supported by a greater proportion of intensive care units (88% versus 15%); however, British Columbia appears to have more medevac aircraft/helicopters than Quebec. The results suggest that major differences exist in access to support services in rural EDs in British Columbia and Quebec. A nationwide study is justified to address this issue of variability in rural and remote health service delivery and its impact on interfacility transfers and patient outcomes.

  1. As seen on TV: observational study of cardiopulmonary resuscitation in British television medical dramas

    Science.gov (United States)

    Gordon, P N; Williamson, S; Lawler, P G

    1998-01-01

    Objective: To determine the frequency and accuracy with which cardiopulmonary resuscitation is portrayed in British television medical dramas. Design: Observational study. Subjects: 64 episodes of three major British television medical dramas: Casualty, Cardiac Arrest, and Medics. Main outcome measures: Frequency of cardiopulmonary resuscitation shown on television; age, sex, and diagnosis of the patients undergoing resuscitation; rate of survival through resuscitation. Results: Overall 52 patients had a cardiorespiratory arrest on screen and 3 had a respiratory arrest alone, all the arrests occurring in 40 of the 64 episodes. Of the 52 patients having cardiorespiratory arrest, 32 (62%) underwent an attempt at cardiopulmonary resuscitation; 8 attempts were successful. All 3 of the patients having respiratory arrests alone received ventilatory support and survived. On 48% of occasions, victims of cardiac arrest seemed to be less than 35 years old. Conclusions: Cardiorespiratory resuscitation is often depicted in British television medical dramas. Patients portrayed receiving resuscitation are likely to be in a younger age group than in real life. Though the reasons for resuscitation are more varied and more often associated with trauma than in reality, the overall success rate is nevertheless realistic. Widespread overoptimism of patients for survival after resuscitation cannot necessarily be blamed on British television medical dramas. Key messagesA quarter of patients in British television medical dramas who received cardiopulmonary resuscitation on screen seemed to surviveThis figure is comparable to initial survival rates in a series of patients in real lifePatients on television are more likely to suffer cardiac arrest as a result of trauma than in real life, and patients undergoing resuscitation are likely to be younger than patients in real lifeThe overall survival rate of patients after cardiopulmonary resuscitation in British television medical drama seems

  2. Comparative oncology: Integrating human and veterinary medicine ...

    African Journals Online (AJOL)

    Cancer constitutes the major health problem both in human and veterinary medicine. Comparative oncology as an integrative approach offers to learn more about naturally occurring cancers across different species. Canine models have many advantages as they experience spontaneous disease, have many genes similar ...

  3. Clinical PET/MR Imaging in Oncology

    DEFF Research Database (Denmark)

    Kjær, Andreas; Torigian, Drew A.

    2016-01-01

    . The question, therefore, arises regarding what the future clinical applications of PET/MR imaging will be. In this article, the authors discuss ways in which PET/MR imaging may be used in future applications that justify the added cost, predominantly focusing on oncologic applications. The authors suggest...

  4. Managing integrated oncology treatment in virtual networks.

    Science.gov (United States)

    Stanicki, Verena; Becker, Matthias; Böckmann, Britta

    2015-01-01

    Interdisciplinary and intersectoral coordinated healthcare management based on Clinical Practice Guidelines is essential to achieve high quality in oncological networks. The objective of our research project is to create a cookbook, which can be used by oncological networks as a template. The cookbook is based on guideline-compliant care processes. To develop these care processes, the three S3-guidelines breast, colon and prostate carcinoma have been formalized. The thus-obtained platform-independent process fragments were transformed into an underlying metamodel, which is based on HL7 and can be used for modeling clinical pathways. Additional, qualitative guided interviews were chosen to capitalize on the experts' (e.g. chief residents, resident specialists) wide knowledge and experience in oncological health care management. One of these use cases (tumor board scheduling) is developed for a healthcare management platform which is linked to a national electronic case record. The projected result of our approach is a cookbook which shows, how the treatment can be controlled by interdisciplinary and intersectoral care processes in an oncological network.

  5. Ethical problems experienced by oncology nurses.

    Science.gov (United States)

    da Luz, Kely Regina; Vargas, Mara Ambrosina de Oliveira; Schmidtt, Pablo Henrique; Barlem, Edison Luiz Devos; Tomaschewski-Barlem, Jamila Geri; da Rosa, Luciana Martins

    2015-01-01

    To know the ethical problems experienced by oncology nurses. Descriptive and exploratory study with a qualitative approach, performed in inpatient units and in chemotherapy out-patients units that provide assistance to oncological patients in two capitals in the South region of Brazil. Eighteen nurses participated in this study, selected by snowball sampling type. For data collection, semi-structured interviews were carried out, which were recorded and transcribed, and then analyzed by thematic analysis. Two categories were established: when informing or not becomes a dilemma - showing the main difficulties related to oncological treatment information regarding health staff, health system, and infrastructure; to invest or not - dilemmas related to finitude - showing situations of dilemmas related to pain and confrontation with finitude. For the effective confrontation of the ethical problems experienced by oncology nurses to