Sample records for cancer center support

  1. Pediatric Oncology Branch - Support Services | Center for Cancer Research (United States)

    Support Services As part of the comprehensive care provided at the NCI Pediatric Oncology Branch, we provide a wide range of services to address the social, psychological, emotional, and practical facets of pediatric cancer and to support patients and families while they are enrolled in clinical research protocols.

  2. Home medication support for childhood cancer: family-centered design and testing. (United States)

    Walsh, Kathleen E; Biggins, Colleen; Blasko, Deb; Christiansen, Steven M; Fischer, Shira H; Keuker, Christopher; Klugman, Robert; Mazor, Kathleen M


    Errors in the use of medications at home by children with cancer are common, and interventions to support correct use are needed. We sought to (1) engage stakeholders in the design and development of an intervention to prevent errors in home medication use, and (2) evaluate the acceptability and usefulness of the intervention. We convened a multidisciplinary team of parents, clinicians, technology experts, and researchers to develop an intervention using a two-step user-centered design process. First, parents and oncologists provided input on the design. Second, a parent panel and two oncology nurses refined draft materials. In a feasibility study, we used questionnaires to assess usefulness and acceptability. Medication error rates were assessed via monthly telephone interviews with parents. We successfully partnered with parents, clinicians, and IT experts to develop Home Medication Support (HoMeS), a family-centered Web-based intervention. HoMeS includes a medication calendar with decision support, a communication tool, adverse effect information, a metric conversion chart, and other information. The 15 families in the feasibility study gave HoMeS high ratings for acceptability and usefulness. Half recorded information on the calendar to indicate to other caregivers that doses were given; 34% brought it to the clinic to communicate with their clinician about home medication use. There was no change in the rate of medication errors in this feasibility study. We created and tested a stakeholder-designed, Web-based intervention to support home chemotherapy use, which parents rated highly. This tool may prevent serious medication errors in a larger study. Copyright © 2014 by American Society of Clinical Oncology.

  3. A survey of National Cancer Institute-designated comprehensive cancer centers' oral health supportive care practices and resources in the USA. (United States)

    Epstein, Joel B; Parker, Ira R; Epstein, Matthew S; Gupta, Anurag; Kutis, Susan; Witkowski, Daniela M


    The oral complications and morbidity resulting from overall cancer therapy utilizing radiation, chemotherapy, and/or stem cell transplantation can have significant impact on a patient's health, quality of life, cost of care, and cancer management. There has been minimal health services research focusing on the status of medically necessary, oral supportive services at US cancer centers. A pre-tested, survey questionnaire was distributed to the directors of National Cancer Institute (NCI)-designated comprehensive cancer centers to assess each institution's resource availability and clinical practices, as it relates to the prevention and management of oral complications during cancer treatment. Sixteen of the 39 comprehensive cancer centers responded to the survey. Of the respondents, 56% of the centers did not have a dental department. The sites of delivery of oral supportive care services range from the provision of in-house dental care to community-based, private practice sites. No standard protocols were in place for either oral preventive care or for supportive services for oral complications during or after cancer therapy. Fifty percent of the responding comprehensive cancer centers reported orally focused research and/or clinical trial activities. Comprehensive cancer care must include an oral care component, particularly for those cancer patients who are at high risk for oral complications. This requires a functional team of oral care providers collaborating closely within the oncology team. Considering the number of cancer patients receiving aggressive oncologic treatment that may result in oral toxicity, the impact of oral conditions on a compromised host, and the potential lack of appropriate resources and healthcare personnel to manage these complications, future research efforts are needed to identify the strengths and weaknesses of present oral supportive care delivery systems at both NCI-designated cancer centers and community-based oncology practices.

  4. [Pharmacist involvement in supporting care in patients receiving oral anticancer therapies: A situation report in French cancer centers]. (United States)

    Occhipinti, Sandrine; Petit-Jean, Emilie; Pinguet, Frédéric; Beaupin, Cécile; Daouphars, Mikaël; Parent, Damien; Donamaria, Catherine; Bertrand, Claude; Divanon, Fabienne; Benard-Thiery, Isabelle; Chevrier, Régine


    The increasing prescription of oral anticancer therapies has significantly changed inpatient care to outpatient care. This transformation requires an excellent coordination between different professionals to ensure healthcare channel security. We performed a prospective study in 18 French cancer centers from March to April 2016. The aim of this study was to identify resources deployed to support patients receiving oral anticancer therapies and to assess pharmacist's involvement. More than half of the centers have developed patient education program and/or practice pharmaceutical consultations. In total, 54.5% have deployed an oral anticancer drugs program and the pharmacist is involved in multidisciplinary teams. In total, 44.4% of the centers have developed hospital-to-community coordination actions but all of them highlight the time-consuming character of those programs. Administrative burdens are seriously hindering patient education program's development. Multidisciplinary consultations can offer an attractive alternative because of easy implementation modalities. Finally, hospital-to-community coordination actions seem hard to implement and require harmonization of communication practices, and need more technical and financial means. Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  5. NCI Designated Cancer Centers (United States)

    ... Types Bladder Cancer Breast Cancer Colorectal Cancer Kidney (Renal Cell) Cancer Leukemia Liver Cancer Lung Cancer Lymphoma Pancreatic Cancer Prostate Cancer Skin Cancer Thyroid Cancer Uterine Cancer All ...

  6. Neuro-Oncology Branch patient emotional support services | Center for Cancer Research (United States)

    Emotional Support Services The diagnosis of a brain tumor elicits many different and sometimes difficult emotions, not only for the patient, but also for their family members. Patients may encounter changes in cognitive functioning and language, a diminished ability to focus or make decisions, or short-term memory loss, all of which can greatly affect their personal and professional lives. We are dedicated to helping patients and their families deal with the physical and emotional facets of this disease.

  7. Palliative care content on cancer center websites. (United States)

    Vater, Laura B; Rebesco, Gina; Schenker, Yael; Torke, Alexia M; Gramelspacher, Gregory


    Professional guidelines recommend that palliative care begin early in advanced cancer management, yet integration of palliative and cancer care remains suboptimal. Cancer centers may miss opportunities to provide palliative care information online. In this study, we described the palliative care content on cancer center websites. We conducted a systematic content analysis of 62 National Cancer Institute- (NCI) designated cancer center websites. We assessed the content of center homepages and analyzed search results using the terms palliative care, supportive care, and hospice. For palliative and supportive care webpages, we assessed services offered and language used to describe care. Two researchers analyzed all websites using a standardized coding manual. Kappa values ranged from 0.78 to 1. NCI-designated cancer center homepages presented information about cancer-directed therapy (61%) more frequently than palliative care (5%). Ten percent of cancer centers had no webpage with palliative care information for patients. Among centers with information for patients, the majority (96%) defined palliative or supportive care, but 30% did not discuss delivery of palliative care alongside curative treatment, and 14% did not mention provision of care early in the disease process. Cancer center homepages rarely mention palliative care services. While the majority of centers have webpages with palliative care content, they sometimes omit information about early use of care. Improving accessibility of palliative care information and increasing emphasis on early provision of services may improve integration of palliative and cancer care.

  8. Engineering Technical Support Center (ETSC) (United States)

    ETSC is EPA’s technical support and resource centers responsible for providing specialized scientific and engineering support to decision-makers in the Agency’s ten regional offices, states, communities, and local businesses.

  9. The Personal Patient Profile-Prostate decision support for men with localized prostate cancer: a multi-center randomized trial. (United States)

    Berry, Donna L; Halpenny, Barbara; Hong, Fangxin; Wolpin, Seth; Lober, William B; Russell, Kenneth J; Ellis, William J; Govindarajulu, Usha; Bosco, Jaclyn; Davison, B Joyce; Bennett, Gerald; Terris, Martha K; Barsevick, Andrea; Lin, Daniel W; Yang, Claire C; Swanson, Greg


    The purpose of this trial was to compare usual patient education plus the Internet-based Personal Patient Profile-Prostate, vs. usual education alone, on conflict associated with decision making, plus explore time-to-treatment, and treatment choice. A randomized, multi-center clinical trial was conducted with measures at baseline, 1-, and 6 months. Men with newly diagnosed localized prostate cancer (CaP) who sought consultation at urology, radiation oncology, or multi-disciplinary clinics in 4 geographically-distinct American cities were recruited. Intervention group participants used the Personal Patient Profile-Prostate, a decision support system comprised of customized text and video coaching regarding potential outcomes, influential factors, and communication with care providers. The primary outcome, patient-reported decisional conflict, was evaluated over time using generalized estimating equations to fit generalized linear models. Additional outcomes, time-to-treatment, treatment choice, and program acceptability/usefulness, were explored. A total of 494 eligible men were randomized (266 intervention; 228 control). The intervention reduced adjusted decisional conflict over time compared with the control group, for the uncertainty score (estimate -3.61; (confidence interval, -7.01, 0.22), and values clarity (estimate -3.57; confidence interval (-5.85,-1.30). Borderline effect was seen for the total decisional conflict score (estimate -1.75; confidence interval (-3.61,0.11). Time-to-treatment was comparable between groups, while undecided men in the intervention group chose brachytherapy more often than in the control group. Acceptability and usefulness were highly rated. The Personal Patient Profile-Prostate is the first intervention to significantly reduce decisional conflict in a multi-center trial of American men with newly diagnosed localized CaP. Our findings support efficacy of P3P for addressing decision uncertainty and facilitating patient selection of

  10. Academic Cancer Center Phase I Program Development


    Frankel, Arthur E; Flaherty, Keith T; Weiner, George J.; Chen, Robert; Azad, Nilofer S.; Pishvaian, Michael J.; Thompson, John A.; Taylor, Matthew H.; Mahadevan, Daruka; Lockhart, A. Craig; Vaishampayan, Ulka N.; Berlin, Jordan D.; Smith, David C.; Sarantopoulos, John; Riese, Matthew


    Abstract Multiple factors critical to the effectiveness of academic phase I cancer programs were assessed among 16 academic centers in the U.S. Successful cancer centers were defined as having broad phase I and I/II clinical trial portfolios, multiple investigator?initiated studies, and correlative science. The most significant elements were institutional philanthropic support, experienced clinical research managers, robust institutional basic research, institutional administrative efforts to...

  11. Air Risk Information Support Center

    Energy Technology Data Exchange (ETDEWEB)

    Shoaf, C.R.; Guth, D.J. [Environmental Protection Agency, Washington, DC (United States)


    The Air Risk Information Support Center (Air RISC) was initiated in early 1988 by the US Environmental Protection Agency`s (EPA) Office of Health and Environmental Assessment (OHEA) and the Office of Air Quality Planning and Standards (OAQPS) as a technology transfer effort that would focus on providing information to state and local environmental agencies and to EPA Regional Offices in the areas of health, risk, and exposure assessment for toxic air pollutants. Technical information is fostered and disseminated by Air RISCs three primary activities: (1) a {open_quotes}hotline{close_quotes}, (2) quick turn-around technical assistance projects, and (3) general technical guidance projects. 1 ref., 2 figs.

  12. A rapid interview protocol supporting patient-centered quality improvement: hearing the parent's voice in a pediatric cancer unit. (United States)

    Sobo, Elisa J; Billman, Glenn; Lim, Lillian; Murdock, J Wilken; Romero, Elvia; Donoghue, Donna; Roberts, William; Kurtin, Paul S


    The Institute of Medicine's 2001 report on quality delimits six dimensions of optimal care: safety, effectiveness, efficiency, timeliness, patient centeredness, and equity. In fall 2001 parents of pediatric cancer patients were interviewed to determine how well they thought these dimensions were addressed with respect to medication administration. Immediate goals were to identify system weaknesses and devise strategies to prevent future errors. A higher-order goal was to develop and demonstrate a model protocol for rapid-cycle interview assessments. Hematology/oncology directors worked with a research expert to develop a semistructured interview protocol. After training, which included directed reading, oral instruction, and role-playing, a convenience sample of 20 English- and Spanish-speaking parents of inpatients was recruited. Parents were asked to characterize current medication administration practices and to describe problems that they had experienced or witnessed. Rapid content analysis techniques were used to identify issues of importance to the parents. Parents' medication concerns centered on their children's comfort. Parents called for communication improvements, standardization of all nursing procedures and techniques, and a guide or an outline providing a clear understanding of what to expect when and from whom. Viewing these concerns in relation to the Institute of Medicine's quality domains allowed the department to frame an improvement action plan aligned with organizational and national priorities. With good supervision and limited focused training, inexperienced staff can successfully administer semistructured qualitative interviews and help analyze findings for rapid cycle improvement purposes. The protocol can be adapted for use in organizations interested in rapid qualitative assessments of patient and parent preferences.

  13. Children's cancer centers (United States)

    ... workers Mental health experts Therapists Child life workers Teachers Clergy Centers also offer many specific benefits such ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  14. Association Between a Name Change from Palliative to Supportive Care and the Timing of Patient Referrals at a Comprehensive Cancer Center (United States)

    Palla, Shana; Hui, David; Nguyen, Linh; Chacko, Ray; Li, Zhijun; Fadul, Nada; Scott, Cheryl; Thornton, Veatra; Coldman, Brenda; Amin, Yazan; Bruera, Eduardo


    Purpose. Palliative care consultation services are now available in the majority of cancer centers, yet most referrals to palliative care occur late. We previously found that the term “palliative care” was perceived by oncology professionals as a barrier to early patient referral. We aimed to determine whether a service name change to supportive care was associated with earlier referrals. Patients and Methods. Records of 4,701 consecutive patients with a first palliative care consultation before (January 2006 to August 2007) and after (January 2008 to August 2009) the name change were analyzed, including demographics and dates of first registration to hospital, advanced cancer diagnosis, palliative care consultation, and death. One-sample proportions tests, median tests, χ2 tests, and log-rank tests were used to identify group differences. Results. The median age was 59 years, 50% were male, and 90% had solid tumors. After the name change, we found: (a) a 41% greater number of palliative care consultations (1,950 versus 2,751 patients; p palliative care consultation (median, 9.2 months versus 13.2 months; hazard ratio [HR], 0.85; p palliative care consultation (5.2 months versus 6.9 months; HR, 0.82; p palliative care consultation (median 6.2 months versus 4.7 months; HR, 1.21; p care was associated with more inpatient referrals and earlier referrals in the outpatient setting. The outpatient setting facilitates earlier access to supportive/palliative care and should be established in more centers. PMID:21212438

  15. Academic Cancer Center Phase I Program Development. (United States)

    Frankel, Arthur E; Flaherty, Keith T; Weiner, George J; Chen, Robert; Azad, Nilofer S; Pishvaian, Michael J; Thompson, John A; Taylor, Matthew H; Mahadevan, Daruka; Lockhart, A Craig; Vaishampayan, Ulka N; Berlin, Jordan D; Smith, David C; Sarantopoulos, John; Riese, Matthew; Saleh, Mansoor N; Ahn, Chul; Frenkel, Eugene P


    Multiple factors critical to the effectiveness of academic phase I cancer programs were assessed among 16 academic centers in the U.S. Successful cancer centers were defined as having broad phase I and I/II clinical trial portfolios, multiple investigator-initiated studies, and correlative science. The most significant elements were institutional philanthropic support, experienced clinical research managers, robust institutional basic research, institutional administrative efforts to reduce bureaucratic regulatory delays, phase I navigators to inform patients and physicians of new studies, and a large cancer center patient base. New programs may benefit from a separate stand-alone operation, but mature phase I programs work well when many of the activities are transferred to disease-oriented teams. The metrics may be useful as a rubric for new and established academic phase I programs. The Oncologist 2017;22:369-374. © The Authors. The Oncologist published by Wiley Periodicals, Inc. on behalf of AlphaMed Press 2017.

  16. Protein Production Associate | Center for Cancer Research (United States)

    PROGRAM DESCRIPTION The Cancer Research Technology Program (CRTP) develops and implements emerging technology, cancer biology expertise and research capabilities to accomplish NCI research objectives. The CRTP is an outward-facing, multi-disciplinary hub purposed to enable the external cancer research community and provides dedicated support to NCI’s intramural Center for Cancer Research (CCR). The dedicated units provide electron microscopy, protein characterization, protein expression, optical microscopy and genetics. These research efforts are an integral part of CCR at the Frederick National Laboratory for Cancer Research (FNLCR). CRTP scientists also work collaboratively with intramural NCI investigators to provide research technologies and expertise. KEY ROLES/RESPONSIBILITIES The Protein Expression Laboratory (PEL) provides support to the NCI Center for Cancer Research (CCR) by producing high quality protein reagents for a variety of research and development purposes. The PEL creates expression constructs, expresses the encoded recombinant proteins in multiple expression systems, and purifies the recombinant proteins for use in downstream applications. The Protein Production Associate will: Carry out experiments, under the review of a scientist, in the areas of prokaryotic and eukaryotic protein production. Carry out E. coli expression work. Carry out insect cell and mammalian cell culture. Perform microscale protein purification scouting. Perform large-scale purification using FPLC technology. Carry out QC on proteins to ensure high quality reagent production.. Provide timely updates of project progress to supervisor and other staff in both informal and formal reports. Maintain detailed records of all laboratory processes and procedures for quality assurance purposes.

  17. Scientist | Center for Cancer Research (United States)

    PROGRAM DESCRIPTION The Laboratory Animal Sciences Program (LASP) provides exceptional quality animal care and technical support services for animal research performed at the National Cancer Institute at the Frederick National Laboratory for Cancer Research. LASP executes this mission by providing a broad spectrum of state-of-the-art technologies and services that are focused on the design, generation, characterization and application of genetically engineered and biological animal models of human disease, which are aimed at the development of targeted diagnostics and therapies. LASP contributes to advancing human health, developing new treatments, and improving existing treatments for cancer and other diseases while ensuring safe and humane treatment of animals. KEY ROLES/RESPONSIBILITIES The successful candidate for this Scientist I appointment will contribute to scientific, methodological, operational, and logistical oversight of multiple projects that vary in complexity, scope of objectives, number and breadth of participating collaborator organizations, as well as anticipated requirements of budgetary, labor, animal and other resources. This employee will be instrumental in identifying the need, ensuring timely availability, documentation compliance, and assisting in coordinating project efforts with other scientific core facilities, such as the Small Animal Imaging Program, Histopathology Laboratory, and high-throughput genotyping and animal diagnostic facilities, etc. In addition, the Scientist I position is anticipated to initiate, promote, and facilitate project scientific communications among members of Center for Advanced Preclinical Research (CAPR) Preclinical Technology and Optimization (PTO) team at all levels, including periodic scientific data exchanges, interim project status updates, key final deliverables such as project reports, publications, press-releases, and meeting presentations. This employee will also provide support to the PTO team

  18. An Organizational Informatics Analysis of Colorectal, Breast, and Cervical Cancer Screening Clinical Decision Support and Information Systems within Community Health Centers (United States)

    Carney, Timothy Jay


    A study design has been developed that employs a dual modeling approach to identify factors associated with facility-level cancer screening improvement and how this is mediated by the use of clinical decision support. This dual modeling approach combines principles of (1) Health Informatics, (2) Cancer Prevention and Control, (3) Health Services…

  19. Supportive care needs of Iranian cancer patients

    Directory of Open Access Journals (Sweden)

    Azad Rahmani


    Full Text Available Background: A supportive needs assessment is an essential component of any care program. There is no research evidence regarding the supportive care needs of cancer patients in Iran or other Middle Eastern countries. Aims: The aim of this study was to determine the supportive care needs of Iranian cancer patients. Materials and Methods: This descriptive study was conducted in a referral medical center in the northwest of Iran. A total of 274 cancer patients completed the Supportive Care Needs Survey (SCNS-59. Descriptive statistics were used for data analysis. Results: In 18 items of the SCNS, more than 50% of the participants reported that their needs were unmet. Most frequently, unmet needs were related to the health system, information, physical, and daily living domains, and most met needs were related to sexuality, patient care, and support domains. Conclusions: Iranian cancer patients experience many unmet needs and there is an urgent need for establishing additional supportive care services in Iran.

  20. Breast Cancer Center Support Grant (United States)


    ADDRESS: Connecticut Belair Medical Park 3947FerraraDr. Wheaton, MD 20906 TELEPHONE NUMBER: 301-946-6420 8. PHYSICIANS: Martin Wertz, MD Thomas ...Hopkins University Press: 1988. (25) Chamberlain J, Coleman D, Eliman R, Moss S, Thomas B, Price J, et al. Sensitivity and specificity of screening in...lesions. Acta Radiol I997;38(4 Pt l):489-96. (70) Helbich TH, Becherer A, Trattnig S, Leitha T, Kelkar P. Seifert M, et al. Differentiation of

  1. Bioinformatics Analyst | Center for Cancer Research (United States)

    PROGRAM DESCRIPTION The Advanced Biomedical Computing Center (ABCC) is a part of the Data Science and Information Technology Program at Leidos Biomedical Research, Inc. The ABCC provides technology development, scientific consultation, collaboration and training, and high-performance computing support to the NCI and NIH scientists and staff. The Single Cell Analysis Facility (SCAF) is established to utilize a mix of existing and new resources aimed at providing state-of-the-art single-cell technologies to support the cancer research at NCI. KEY ROLES/RESPONSIBILITIES Bioinformatics Analyst Responsible for providing bioinformatics support including project consultation, experimental design, data management and analysis of high throughput sequencing data from next-generation sequencing and single cell technologies Perform single-cell genetic and transcriptional analysis to determine tumor heterogeneity, clonal evolution, immune signatures, and mechanism of resistance Design, develop and maintain robust analysis workflows and software pipelines, as well as custom scripts, to support the analysis of high-throughput sequencing data Provide biological interpretation of analysis results and present analysis results in a clear and concise manner, to scientific audiences Work effectively as a member of a team; coordinate activities among groups located at the Bethesda, Frederick, and Rockville NCI campuses; follow sound scientific practices and maintain effective documentation of activities and analyses This position is in support of the Center for Cancer Research (CCR).

  2. National Support Center: A Service of IBM. (United States)

    Exceptional Parent, 1990


    This article describes (1) IBM's National Support Center for Persons with Disabilities, a clearinghouse of information about adaptive devices, software, and support groups helping disabled persons use IBM computers; (2) special IBM products, including the Screen Reader, SpeechViewer, and PhoneCommunicator; and (3) an IBM-sponsored program whereby…

  3. Senior Clinician | Center for Cancer Research (United States)

    The Center for Cancer Research (CCR), NCI, NIH, HHS is seeking to fill several Senior Clinician positions with outstanding oncologists with research experience and expertise in one of the following areas:  1) genitourinary malignancies, 2) thoracic malignancies; 3) gastrointestinal malignancies; 4) lymphomas; 5) pediatric cancers; or 6) genetic tumor predisposition syndromes. These positions are located at the NIH campus in Bethesda, Maryland. The NIH Clinical Center is the world’s largest research hospital which offers state-of-the-art facilities, collaborative opportunities, and core facilities for advanced technologies.  The Senior Clinician will have available resources including funding for clinical trials, nurse practitioners, research nurses, and patient care coordinators.  In addition, the senior clinician will have access to a robust clinical trials infrastructure including data management, training, protocol support office, regulatory support, information systems and technology, and data safety monitoring.  The CCR’s collaborative culture also offers research staff access to a wide array of intellectual and technological assets, including high-quality technology cores dedicated to pharmacokinetics/pharmacodynamics, protein chemistry, natural products chemistry, biophysics, mass spectrometry, imaging, microscopy, proteomics and genomics, bioinformatics/biostatistics, and flow cytometry.  For an overview of CCR, please visit  For more information contact Lori Holliday at

  4. Utilization of supportive and palliative care services among oncology outpatients at one academic cancer center: determinants of use and barriers to access. (United States)

    Kumar, Pallavi; Casarett, David; Corcoran, Amy; Desai, Krupali; Li, Qing; Chen, Jinbo; Langer, Corey; Mao, Jun J


    Abstract Background: Cancer causes significant symptom burden and diminished quality of life. Despite the expansion of supportive and palliative care services (SPCS), little is known about rates of utilization and barriers to access to these services among oncology outpatients. We performed a cross-sectional survey in three outpatient medical oncology clinics. Patients with a diagnosis of breast, lung, or gastrointestinal (GI) cancer and a Karnofsky score of ≥60 were included. Patients reported their use of SPCS and any perceived barriers. Multivariable logistic regression was used to identify factors associated with SPCS use. Among 313 participants, (50.5%) had not used SPCS since cancer diagnosis. The most common services used were nutrition (26.5%), psychiatric/psychological counseling (29.7%), and physical therapy (15.1%). Pain/palliative care and cancer rehabilitation consultations were used by 8.5% and 4.1% of participants, respectively. In multivariate analysis, graduate education was associated with greater SPCS use (adjusted odds ratio [AOR] 2.14, 95% confidence interval [CI] 1.08-4.26) compared with those with high school or less, whereas having lung cancer was associated with less SPCS use (AOR 0.48, 95% CI 0.24-0.96) when compared with those having breast cancer. The biggest reported barriers to using SPCS were a lack of awareness (22.4%) and lack of physician referral (23%). Approximately half of these patients had not accessed SPCS since cancer diagnosis and cite lack of awareness and physician nonreferral as barriers. Further research is needed to understand patients' needs and beliefs regarding SPCS, and how to integrate SPCS into conventional treatments to improve cancer care.

  5. Facility Head | Center for Cancer Research (United States)

    Facility HeadConfocal Microscopy Core FacilityLaboratory of Cancer Biology and Genetics The Laboratory of Cancer Biology and Genetics (LCBG), Center for Cancer Research (CCR), NCI, NIH, HHS is looking for a motivated and skilled microscopist to fill a Facility Head position to lead its Confocal Microscopy Core Facility. The CCR Microscopy Core provides microscopy equipment and support to approximately 150 active users representing over 20 NCI laboratories. The Core places an emphasis on training independent users, but the staff is available to assist in all phases of experiments. This includes experimental design, data acquisition, and data analysis. The Core provides state-of-the-art microscopic analyses to better understand critical biological structures and cellular processes involved in cancer. The Facility Head will also be expected to participate in the CCR Microscopy Core meetings and to interact extensively with the other microscopy facilities in CCR. Light microscopic techniques and analytic methods currently used in this facility include, but are not limited to: 1) co-localization of fluorescent fusion proteins with organelles; 2) demonstration of membrane ruffling, cytoskeletal organization, focal adhesions and other cell morphology; 3) live time-lapse translocation of fluorescent fusion proteins; 4) fluorescent indicators of oxidative stress in live cells; 5) 4D imaging of cell division; 6) Super-Resolution imaging; 7) tiling; 8) Fluorescent Recovery After Photobleaching (FRAP) and Fluorescent Resonance Energy Transfer (FRET); 9) Fluorescence Correlation Spectroscopy (FCS); 10) Fluorescence Lifetime Imaging (FLIM); and, 11) Second Harmonic Generation imaging (SHG) of whole live tissue/organ. The Facility's equipment includes a Zeiss LSM 710 NLO for two-photon imaging, a Zeiss LSM 780 for higher sensitivity imaging, a Zeiss LSM 780/ELYRA for super-resolution imaging of fixed cells, and the Zeiss LSM 880/Airyscan for super-resolution imaging of live and

  6. [Touching cancer: shiatsu as complementary treatment to support cancer patients]. (United States)

    Argash, Oz; Caspi, Opher


    In recent years there has been an increase in the interest of cancer patients in receiving complementary medicine therapies as supportive measures to cure the disease. In response, medical units that combine conventional and complementary medicine (integrative medicine) have been established in leading cancer centers worldwide. In Israel, a special integrative medicine unit that combines mind-body, Chinese medicine, nutrition, herbs, supplements, and manual therapies (such as shiatsu) before, during and after conventional anti-cancer therapies has been established as an integral part of the Davidoff Comprehensive Cancer Center in 2006. Shiatsu represents a group of manual therapeutic techniques, including acupressure. Shiatsu offers cancer patients a non-pharmacologic method to relieve symptoms and improve quality of life throughout the course of illness. Research indicates that acupressure is relatively effective and safe for common cancer-related symptoms such as nausea, vomiting and insomnia. In our experience, shiatsu is also relatively effective and safe for other common symptoms such as fatigue, muscular pain and body image dissatisfaction. Yet, insufficient evidence exists to delineate the best means by which shiatsu and other manual therapies could or should be integrated into routine cancer care. The purpose of the present paper is to describe what is currently known about this topic in order to support decision-making that is based on facts, rather than on myths and misconceptions. We call for more research that examines the effectiveness and safety of shiatsu and other manual therapies in the care of cancer patients.

  7. Regulatory Submission Coordinator | Center for Cancer Research (United States)

    The Clinical Monitoring Research Program (CMRP) provides administrative support to the National Cancer Institute’s (NCI’s), Center for Cancer Research (CCR), Protocol Support Office (PSO). KEY ROLES/RESPONSIBILITIES Performs regulatory submission/administrative duties for the Protocol Support Office, NCI/CCR Assists with the preparation of documents to include protocols, investigator brochures, consent forms, and submissions to the FDA Maintains revision logs and tracking versions of the documents Provides accurate filing of pertinent regulatory documents Provides administrative support related to document control requirements including filing of master documents, formatting and typing of various document Attends regulatory and administrative meetings for taking and typing of minutes, reports and summaries Communicates with clinical, administrative and management personnel to gather or convey information Edits and prepares material for final review Participates in planning functions Works in conjunction with other administrative staff to accomplish program requirements Acts as liaison coordinating tasks/deadlines between the Clinical Research ARC and the Branch This position is located in Rockville, Maryland.

  8. Engineering Technical Support Center Annual Report Fiscal ... (United States)

    The United States Environmental Protection Agency (EPA or Agency) Office of Research and Development (ORD) created the Engineering Technical Support Center (ETSC) in 1987, one of several technical support centers created as part of the Technical Support Project (TSP). ETSC provides engineering expertise to Agency program and regional offices and remediation teams working at contaminated sites across the country. The ETSC is operated within ORD’s Land Remediation and Pollution Control Division (LRPCD) of the National Risk Management Research Laboratory (NRMRL) in Cincinnati, Ohio. The ETSC’s mission is to provide site-specific scientific and engineering technical support to Remedial Project Managers, On-Scene Coordinators, and other remediation personnel at contaminated sites. This allows local, regional, or national authorities to work more quickly, efficiently, and cost effectively, while also increasing the technical experience of the remediation team. Since its inception, the ETSC has supported countless projects across all EPA Regions in almost all states and territories. This report highlights significant projects the ETSC supported in fiscal year 2015 (FY15). These projects addressed an array of environmental scenarios, such as remote mining contamination, expansive landfill waste, cumulative impacts from multiple contamination sources, and persistent threats from abandoned industrial sites. Constructing and testing new and innovative treatment technol

  9. UNC Cancer Center Director to Lead NCI. (United States)


    President Donald Trump has selected Norman "Ned" Sharpless, MD, director of the University of North Carolina Lineberger Comprehensive Cancer Center, to lead the NCI. The news was met with widespread approval among cancer researchers, who view Sharpless as a strong communicator who can ably represent the needs of the cancer community in the face of proposed funding cuts. ©2017 American Association for Cancer Research.

  10. Fighting liver cancer with combination immunotherapies | Center for Cancer Research (United States)

    A new clinical trial testing the effectiveness of immunotherapy treatment combinations against liver cancer is enrolling patients at the NIH Clinical Center in Bethesda, Maryland. Individually, immunotherapy drugs harness the power of the human immune system to better identify and kill cancer cells. Now, researchers at the NIH’s Center for Cancer Research have begun to find evidence that the drugs may work far more effectively when taken in combination with other therapies and with each other than when taken alone.

  11. Programmer Analyst | Center for Cancer Research (United States)

    PROGRAM DESCRIPTION The Advanced Biomedical Computing Center (ABCC) provides technology development, scientific consultation, collaboration, data analysis and training to the National Cancer Institute (NCI) and National Institutes of Health (NIH) scientists and staff. The Core Infrastructure and Systems Biology (CISB) group in ABCC strives to streamline and provide innovative solutions for the NCI/NIH community to access and use biological information collected across different sources and formats. Integrating diverse data sources to enable disease agnostic access and analysis, variant impact annotation, identifier conversions across species, and merging clinical and research data enables translation from basic to the goal of precision medicine. CISB is looking for an experienced analyst to support the database and application management efforts at the NCI’s Molecular Targets Program (MTP). KEY ROLES/RESPONSIBILITIES Provide data management and analysis support Maintain scientific applications and databases on single-user personal computer through the multi-user, multi-processor large memory mainframe Communicate with the experts in the MTP, gather requirements and provide support Provide training to researchers on a variety of platforms and applications Evaluate and develop methodologies to allow utilization of new software tools and generate the information required by MTP researchers Determine methods and procedures on new assignments Document approaches and mechanisms clearly and comprehensively

  12. Music therapy in a comprehensive cancer center. (United States)

    Richardson, Michael M; Babiak-Vazquez, Adriana E; Frenkel, Moshe A


    The use of music as a therapeutic tool in health and medicine dates back to ancient times. In modern Western medicine, music therapy has been available since the 1950s and is now often incorporated into conventional medicine care. Music therapy is a common modality that is used in hospital settings as part of complementary and integrative medicine programs. It is also a key therapeutic tool used within most integrative medicine programs at large cancer centers in the United States. When used in conjunction with conventional cancer treatments, music therapy has been found to help patients promote a better quality of life; better communicate their fear, sadness, or other feelings; and better manage stress, while alleviating physical pain and discomfort. In this article, we review the literature on the value of integrating music therapy in cancer care and describe the experience of music therapy at a large comprehensive cancer center and the benefits that patients with cancer obtain from this service.

  13. Cancer Virology and HIV Think Tank | Center for Cancer Research (United States)

    Cancer Virology and HIV Think Tank Friday, December 15, 2017 9:30 AM - 3:30 PM Abstract submission deadline: November 29, 2017 Porter Neuroscience Center (Building 35A) Room 620/630 Atrium Space Please mark your calendars for the Cancer Virology and HIV Think Tank Meeting on December 15! This is an annual meeting hosted by the CCR Center of Excellence in HIV/AIDS and Cancer Virology that focuses on the exchange of information about the biology of cancer-associated viruses.

  14. Cancer Biotechnology | Center for Cancer Research (United States)

    Biotechnology advances continue to underscore the need to educate NCI fellows in new methodologies. The Cancer Biotechnology course will be held on the NCI-Frederick campus on January 29, 2016 (Bldg. 549, Main Auditorium) and the course will be repeated on the Bethesda campus on February 9, 2016 (Natcher Balcony C). The latest advances in DNA, protein and image analysis will be presented. Clinical and postdoctoral fellows who want to learn about new biotechnology advances are encouraged to attend this course.

  15. Tenure Track/Tenure Eligible Investigators | Center for Cancer Research (United States)

    The newly established RNA Biology Laboratory at the Center for Cancer Research (CCR), National Cancer Institute (NCI), National Institutes of Health (NIH) in Frederick, Maryland is recruiting Tenure-eligible or Tenure Track Investigators to join the Intramural Research Program’s mission of high impact, high reward science. These positions, which are supported with stable financial resources, are the equivalent of Assistant Professor/Associate Professor/Professor in an academic department. The RNA Biology Laboratory is looking for candidate(s) who will complement our current group of seven dynamic and collaborative principal investigators ( We encourage outstanding scientists investigating any area of RNA Biology to apply. Areas of interest include, but are not limited to, the roles of RNA-binding proteins, noncoding RNAs and nucleotide modifications in cell and organismal function; the ways in which alterations in RNA homeostasis result in diseases such as cancer, and the development of RNA therapeutics. About NCI's Center for Cancer Research The Center for Cancer Research (CCR) is an intramural research component of the National Cancer Institute (NCI). CCR’s enabling infrastructure facilitates clinical studies at the NIH Clinical Center, the world’s largest dedicated clinical research complex; provides extensive opportunities for collaboration; and allows scientists and clinicians to undertake high-impact laboratory- and clinic-based investigations. Investigators are supported by a wide array of intellectual and technological and research resources, including animal facilities and dedicated, high-quality technology cores in areas such as imaging/microscopy, including cryo-electron microscopy; chemistry/purification, mass spectrometry, flow cytometry, SAXS, genomics/DNA sequencing, transgenics and knock out mice, arrays/molecular profiling, and human genetics/bioinformatics. For an overview of CCR, please visit

  16. Final Report - DOE Center for Laser Imaging and Cancer Diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Alfano, Robert R.; Koutcher, Jason A.


    This Final Report summarizes the significant progress made by the researchers, students and staff of the Center for Laser Imaging and Cancer Diagnostics (CLICD) from January 1998 through May 2002. During this period, the Center supported several projects. Most projects were proposed initially, some were added subsequently as their relevance and importance to the DOE mission became evident. DOE support has been leveraged to obtain continuing funding for some projects. Leveraged funds come from various sources, including NIH, Army, NSF and the Air Force. The goal of the Center was to develop laser-based instruments for use in the detection and diagnosis of major diseases, with an emphasis on detection and diagnosis of various cancers. Each of the supported projects is a collaborative effort between physicists and laser scientists and the City College of New York and noted physicians, surgeons, pathologists, and biologists located at medical centers in the Metropolitan area. The participating institutions were: City College of New York Institute for Ultrafast Lasers and Spectroscopy, Hackensack University Medical Center, Lawrence Livermore National Laboratory, Memorial Sloan Kettering Cancer Center, and New York Eye and Ear Institute. Each of the projects funded by the Center is grouped into one of four research categories: a) Disease Detection, b) Non-Disease Applications, c) New Diagnostic Tools, and, d) Education, Training, Outreach and Dissemination. The progress achieved by the multidisciplinary teams was reported in 51 publications and 32 presentations at major national conferences. Also, one U.S. patent was obtained and six U.S. patent applications have been filed for innovations resulting from the projects sponsored by the Center.

  17. Engineering Technical Support Center Annual Report Fiscal Year 2015 (United States)

    The United States Environmental Protection Agency (EPA or Agency) Office of Research and Development (ORD) created the Engineering Technical Support Center (ETSC) in 1987, one of several technical support centers created as part of the Technical Support Project (TSP). ETSC provid...

  18. Logistics Operations Management Center: Maintenance Support Baseline (LOMC-MSB) (United States)

    Kurrus, R.; Stump, F.


    The Logistics Operations Management Center Maintenance Support Baseline is defined. A historical record of systems, applied to and deleted from, designs in support of future management and/or technical analysis is provided. All Flight elements, Ground Support Equipment, Facility Systems and Equipment and Test Support Equipment for which LOMC has responsibilities at Kennedy Space Center and other locations are listed. International Space Station Alpha Program documentation is supplemented. The responsibility of the Space Station Launch Site Support Office is established.

  19. Transplant center support for infectious diseases. (United States)

    Schaenman, Joanna M; Kumar, Deepali; Kotton, Camille N; Danziger-Isakov, Lara; Morris, Michele I


    Transplant Infectious Diseases (TID) is a rapidly growing subspecialty, which has contributed significantly to improving patient outcomes after transplantation. Obtaining institutional support to implement programs that promote excellence in patient care remains a challenge for many non-surgical transplant-related specialties. We surveyed the membership of the American Society of Transplantation Infectious Diseases Community of Practice to assess characteristics of individual transplant programs and delineate current patterns of institutional support of TID, with a goal of facilitating the exchange of innovative funding ideas between transplant programs. Of 53 questionnaires returned, 36 programs reported the existence of a dedicated TID service for adults. Of these, the ratio of dedicated TID providers to the number of solid organ transplant patients transplanted annually ranged from 15:1 to 259:1. A total of 21% of responding programs indicated that they received no support from their institution. Respondents from larger programs were more likely to receive some type of programmatic support. Given that the presence of expert TID input into patient care can improve outcomes through direct patient management and transplant team education, we suggest that continued support of the unbillable time contributed by TID practitioners is a critical part of ensuring excellent outcomes after transplantation. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Strategic performance evaluation in cancer centers. (United States)

    Delgado, Rigoberto I; Langabeer, James R


    Most research in healthcare strategy has focused on formulating or implementing organizational plans and strategies, and little attention has been dedicated to the post-implementation control and evaluation of strategy, which we contend is the most critical aspect of achieving organizational goals. The objective of this study was to identify strategic control approaches used by major cancer centers in the country and to relate these practices to financial performance. Our intent was to expand the theory and practice of healthcare strategy to focused services, such as oncology. We designed a 17-question survey to capture elements of strategy and performance from our study sample, which comprised major cancer hospitals in the United States and shared similar mandates and resource constraints. The results suggest that high-performing cancer centers use more sophisticated analytical approaches, invest greater financial resources in performance analysis, and conduct more frequent performance reviews than do low-performing organizations. Our conclusions point to the need for a more robust approach to strategic assessment. In this article, we offer a number of recommendations for management to achieve strategic plans and goals on the basis of our research. To our knowledge, this study is one of the first to concentrate on the area of strategic control.

  1. Team Lead | Center for Cancer Research (United States)

    We are seeking a highly motivated Sr. Scientist to lead the newly established Single Cell Analysis Facility (SCAF) of the Center for Cancer Research (CCR) at NCI. The SCAF will house state-of-the-art single cell sequencing technologies including 10xGenomics Chromium, BD Genomics Rhapsody, DEPPArray, and other emerging single cell technologies. The successful candidate will be responsible for managing the single cell core activities and will interact with close to 200 laboratories within the CCR to design and carry out single cell experiments for cancer research. In addition to the core activities: - Will be responsible for developing new single cell technologies and making it available for CCR community - Will train/guide staff to carry out wet lab experiment from tissue/cell preparation to NexGen sequencing - Work with dedicated bioinformaticians to perform data qc and analysis - Is expected to author publications in peer reviewed scientific journals

  2. Scientific Management Training | Center for Cancer Research (United States)

    The NCI intramural program is one of the largest centers for cancer research in the world, with approximately 200 principal investigators and 500 postdoctoral fellows. While outstanding scientific research is conducted at NCI, many of the scientists who go on to lead their own laboratories have few management skills. The Scientific Management Training course focuses on personnel and project management. In the “Art of Supervision” section, the emphasis is on the uniqueness of each person and how each staff member should be treated to achieve desired outcomes.

  3. Music therapy in supportive cancer care


    Stanczyk, Malgorzata Monika


    The purpose of this paper is to show some aspects of music therapy application in cancer care and to present the integration of music therapy program into a continuous supportive cancer care for inpatients. A cancer diagnosis is one of the most feared and serious life events that causes stress in individuals and families. Cancer disrupts social, physical and emotional well-being and results in a range of emotions, including anger, fear, sadness, guilt, embarrassment and shame. Music therapy i...

  4. Physician Assistant | Center for Cancer Research (United States)

    counseling within the boundaries of his/her specialty area of education and clinical preparation (pediatrics, adults, urologic, surgical, etc.). Review assigned patient resident reports and carry and answer the resident pager. Provide coverage for the post-call resident’s patients, while working closely with the Inpatient/Fellowship staff.  Support in-patient and out-patient care of subjects enrolled in experimental protocols and clinical trials. Work as a member of a multidisciplinary clinical team to provide comprehensive care to patients in a research environment. Write prescriptions. Explain the care management/discharge plan to all members of the covering team (inpatient NPs, attendings) at signout. This position is located in Bethesda, Maryland in support of the Center for Cancer Research (CCR).

  5. Telemedicine and telesurgery in cancer care: inaugural conference at MD Anderson Cancer Center. (United States)

    Satcher, Robert L; Bogler, Oliver; Hyle, Laurel; Lee, Andrew; Simmons, Angela; Williams, Robert; Hawk, Ernest; Matin, Surena; Brewster, Abenaa M


    Despite the growing incidence of cancer worldwide, there are an insufficient number of primary care physicians, community oncologists, and surgeons to meet the demand for cancer care, especially in rural and other medically underserved areas. Teleoncology, including diagnostics, treatment, and supportive care, has the potential to enhance access to cancer care and to improve clinician education and training. Major cancer centers such as The University of Texas MD Anderson Cancer Center must determine how teleoncology will be used as part of strategic planning for the future. The Telemedicine and Telesurgery in Cancer Care (TTCC) conference was convened to determine technologically based strategies for addressing global access to essential cancer care services. The TTCC conference brought policy makers together with physicians, legal and regulatory experts to define strategies to optimize available resources, including teleoncology, to advance global cancer care. The TTCC conference discourse provided insight into the present state of access to care, expertise, training, technology and other interventions, including teleoncology, currently available through MD Anderson, as well as a vision of what might be achievable in the future, and proposals for moving forward with a comprehensive strategy. © 2014 Wiley Periodicals, Inc.

  6. Center for Global Health announces grants to support portable technologies (United States)

    NCI's Center for Global Health announced grants that will support the development and validation of low-cost, portable technologies. These technologies have the potential to improve early detection, diagnosis, and non-invasive or minimally invasive treatm

  7. Feasibility support for multi-center trials in the Netherlands

    NARCIS (Netherlands)

    Dijk, WA; van der Velde, W; Dassen, WRM; Spruijt, HJ; Baljon, MH


    This paper describes a feasibility support module for multi-center clinical trials in the Netherlands. Ir is a subproject within a large Electronic Patient Record for Cardiology project. The setup is based on the fact that each participating center has its own departmental information system.

  8. TTI Phase 2 Institutional Support: Center for Study of Science ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    TTI Phase 2 Institutional Support: Center for Study of Science, Technology and Policy. This funding will enhance the Center for Study of Science, Technology and Policy's (CSTEP) role as a credible public policy institution in India by strengthening its ability to provide high-quality, influential, and policy-relevant research.

  9. Strategic Plan for Electronic Commerce, Defense Personnel Support Center (United States)


    AD-A274 243 Strategic Plan for Electronic Commerce Defense Personnel Support Center DTIC %!" . FLECTE .: UEC3 0 199 3 -I CUSTOMER SATISFACTION 93 12...220 3 &tiuini nm Best Available Copy Strategic Plan for Electronic Commerce Defense Personnel Support Center NTIS C? ~- j CUSTOMER Avao OrK...Concept of Operations and Projects ........... 6-4 Benefits and Costs of Electronic Commerce in the Medical Directorate

  10. Protocol Coordinator II | Center for Cancer Research (United States)

    Provides programmatic and logistical support for the operations of clinical research for Phase I and Phase II clinical trials Provides deployment of clinical support services for clinical research  Streamlines protocol development timeline Provides data and document collection and compilation for regulatory filing with the FDA and other regulatory authorities Provides technical review and report preparation Provides administrative coordination and general logistical support for regulatory activities Ensures the provision of training for investigators and associate staff to reinforce and enhance a GCP culture Provides quality assurance and quality control oversight Performs regulatory review of clinical protocols, informed consent and other clinical documents  Tracks and facilitates a portfolio of protocols through each process step (IRB, RAC, DSMB, Office of Protocol Services) Assists clinical investigators in preparing clinical research protocols, including writing and formatting protocol documents and consent forms Prepares protocol packages for review and ensures that protocol packages include all the required material and comply with CCR, NCI and NIH policies Collaborates with investigators to resolve any protocol/data issues Coordinates submission of protocols for scientific and ethical review by the Branch scientific review committees, the NCI Institutional Review Board (IRB) and the clinical trial sponsor or the FDA Monitors the review process and maintains detailed, complete and accurate records for each protocol of the approvals at the various stages of the review process, including new protocol submissions, amendments to protocols, and continuing reviews, as well as other submissions such as adverse events Attends and prepares minutes for the Branch Protocol Review Committees For protocols that are performed with other research centers: contacts coordinators at other centers to obtain review committee approvals at these centers,  maintains records of

  11. Flow Cytometry Technician | Center for Cancer Research (United States)

    KEY ROLES/RESPONSIBILITIES The Flow Cytometry Core (Flow Core) of the Cancer & Inflammation Program (CIP) is a service core which supports the research efforts of the CCR by providing expertise in the field of flow cytometry (fluorescence cell sorting) with the goal of gaining a more thorough understanding of the biology of cancer and cancer cells. The Flow Core provides service to 12-15 CIP laboratories and more than 22 non-CIP laboratories. Flow core staff provide technical advice on the experimental design of applications, which include immunological phenotyping, cell function assays, and cell cycle analysis. Work is performed per customer requirements, and no independent research is involved. The Flow Cytometry Technician will be responsible for: Monitor performance of and maintain high dimensional flow cytometer analyzers and cell sorters Operate high dimensional flow cytometer analyzers and cell sorters Monitoring lab supply levels and order lab supplies, perform various record keeping responsibilities Assist in the training of scientific end users on the use of flow cytometry in their research, as well as how to operate and troubleshoot the bench-top analyzer instruments Experience with sterile technique and tissue culture

  12. Development of lung cancer CT screening operating support system (United States)

    Ishigaki, Rikuta; Hanai, Kozou; Suzuki, Masahiro; Kawata, Yoshiki; Niki, Noboru; Eguchi, Kenji; Kakinuma, Ryutaro; Moriyama, Noriyuki


    In Japan, lung cancer death ranks first among men and third among women. Lung cancer death is increasing yearly, thus early detection and treatment are needed. For this reason, CT screening for lung cancer has been introduced. The CT screening services are roughly divided into three sections: office, radiology and diagnosis sections. These operations have been performed through paper-based or a combination of paper-based and an existing electronic health recording system. This paper describes an operating support system for lung cancer CT screening in order to make the screening services efficient. This operating support system is developed on the basis of 1) analysis of operating processes, 2) digitalization of operating information, and 3) visualization of operating information. The utilization of the system is evaluated through an actual application and users' survey questionnaire obtained from CT screening centers.

  13. Perioperative nutrition support in cancer patients. (United States)

    Huhmann, Maureen B; August, David A


    Malnutrition and weight loss negatively affect outcomes in surgical cancer patients. Decades of research have sought to identify the most appropriate use of nutrition support in these patients. National and international guidelines help to direct clinicians' use of nutrition support in surgical patients, but a number of specific issues concerning the use of nutrition support continue to evolve. This review focuses on 5 key issues related to perioperative nutrition support in cancer patients: (1) Which perioperative cancer patients should receive nutrition support? (2) How can the nutrition status and requirements of these patients be optimally assessed? (3) What is the optimal route of administration (parenteral nutrition vs enteral nutrition) and composition of nutrition support in this setting? (4) When should feedings be initiated? (5) What is the role of glycemic control in these patients?

  14. Efficacy of meaning-centered group psychotherapy for cancer survivors : a randomized controlled trial

    NARCIS (Netherlands)

    van der Spek, N; Vos, J; van Uden-Kraan, C F; Breitbart, W.; Cuijpers, P; Holtmaat, K; Witte, B I; Tollenaar, R.A.E.M.; Verdonck-de Leeuw, I M

    BACKGROUND: The aim of this study was to assess the efficacy of meaning-centered group psychotherapy for cancer survivors (MCGP-CS) to improve personal meaning, compared with supportive group psychotherapy (SGP) and care as usual (CAU). METHOD: A total of 170 cancer survivors were randomly assigned

  15. Young Cancer Survivor Connections: A Mixed Methods Investigation of Online Communications, Social Support, and Unmet Needs (United States)


    Society Life with Cancer Light of Life Foundation for Thyroid Cancer Nueva Vida SamFund Sarcoma Alliance Sisters Network Smith Center for and resources for cancer survivors: a systematic literature review. Patient Educ Couns 86:288-96 102. Hormes JM, Lytle LA , Gross CR, Ahmed...176 107. Im EO. 2011. Online support of patients and survivors of cancer. Semin Oncol Nurs 27:229-36 108. Johnson RB, Onwuegbuzie AJ, Turner LA

  16. Quality of life among breast cancer patients undergoing treatment in national cancer centers in Nepal. (United States)

    Manandhar, Sajani; Shrestha, Deepak Sundar; Taechaboonsermsk, Pimsurang; Siri, Sukhontha; Suparp, Jarueyporn


    To study the quality of life and to identify associated factors among breast cancer patients undergoing treatment in national cancer centers in Nepal. One hundred breast cancer patients were selected and interviewed using a structured questionnaire. European Organization of Research and Treatment of Cancer EORTC-QLQ-C30 and EORTC-QLQ-BR23 were used to assess quality of life and modified Medical Outcome Study -Social Support survey(mMOS-SS) was used to assess social support. Only multi-item scales of EORTC C30 and BR23 were analyzed for relationships. Independent sample T-tests and ANOVA were applied to analyze differences in mean scores. The score of global health status/quality of life (GHS/GQoL) was marginally above average (mean=52.8). The worst performed scales in C-30 were emotional and social function while best performed scales were physical and role function. In BR-23, most of the patients fell into the problematic group regarding sexual function and enjoyment. Almost 90% had financial difficulties. Symptom scales did not demonstrate many problems. Older individuals, patients with stage I breast cancer and thosewith good social support were found to have good GHS/GQoL. Of all the influencing factors, social support was established to have strong statistical associations with most of the functional scales: GHS/GQoL (0.003), emotional function (system.

  17. Vacuum and window with rim and center support (United States)

    Mehltretter, J. P.


    Expressions for the bending stresses of a telescope window with a small additionally supported central area are presented. Expressions for maximum bending elongation are taken from the literature, and those for radial and tangential stresses are deduced from the bending moments for given distances from the plate center. Analysis shows that where the central bending excursion is zero, very high stresses equal to those in a window which is not centrally supported occur at the central support. Overall stress can be reduced by choosing the support pressure inside the central area so that radial stress vanishes at the outer boundary of the central support. Along the rim, a hydraulic support system consisting of two concentric O-shaped rings is suggested. For the central support, a frictionless hydraulic piston and an O-ring sealed support plate are advocated.

  18. Protocol Coordinator III | Center for Cancer Research (United States)

    Provides programmatic and logistical support for the operations of clinical research Provides deployment of clinical support services for clinical research Streamlines the protocol development timeline Provides data and documents collection and compilation for regulatory filing with the Food and Drug Administration (FDA) and other regulatory authorities Provides technical review and report preparation Provides administrative coordination and general logistical support for regulatory activities Ensures the provision of training for investigators and associate staff to reinforce and enhance a Good Clinical Practices (GCP) culture Oversees quality assurance and quality control, performs regulatory review of clinical protocols, informed consent and other clinical documents Tracks and facilitates a portfolio of protocols through each process step (Institutional Review Board [IRB], Regulatory Affairs Compliance [RAC], Data Safety Monitoring Board [DSMB], Office of Protocol Services) Assists clinical investigators in preparing clinical research protocols, including writing and formatting consent forms Prepares protocol packages for review and ensures that protocol packages include all required material and complies with CCR, NCI and NIH policies Collaborates with investigators to resolve any protocol/data issues Coordinates submission of protocols for scientific and ethical review by the Branch scientific review committees, the NCI IRB, and the clinical trial sponsor or the FDA Monitors the review process and maintains detailed, complete and accurate approval records for each protocol at the various stages of the review process, including new protocol submissions, amendments to protocols, and continuing reviews, as well as other submissions such as adverse events Attends and prepares minutes for the Branch Protocol Review Committees Contacts coordinators at other centers for protocols that are performed there to obtain review committee approvals at those centers

  19. Music therapy in supportive cancer care. (United States)

    Stanczyk, Malgorzata Monika


    The purpose of this paper is to show some aspects of music therapy application in cancer care and to present the integration of music therapy program into a continuous supportive cancer care for inpatients. A cancer diagnosis is one of the most feared and serious life events that causes stress in individuals and families. Cancer disrupts social, physical and emotional well-being and results in a range of emotions, including anger, fear, sadness, guilt, embarrassment and shame. Music therapy is a part of a complementary medicine program in supportive cancer care which accompanies medical treatment. There are many benefits of music therapy for cancer patients-interactive music therapy techniques (instrumental improvisation, singing) as well as receptive music therapy techniques (listening to recorded or live music, music and imaginary) can be used to improve mood, decrease stress, pain, anxiety level and enhance relaxation. Music therapy is an effective form of supporting cancer care for patients during the treatment process. It may be also basic for planning effective programs of rehabilitation to promote wellness, improve physical and emotional well-being and the quality of life.

  20. Matching of received social support with need for support in adjusting to cancer and cancer survivorship. (United States)

    Merluzzi, Thomas V; Philip, Errol J; Yang, Miao; Heitzmann, Carolyn A


    Optimal matching theory posits that the effects of social support are enhanced when its provision is matched with need for support. We hypothesized that matching received social support with the needs of persons with cancer, and cancer survivors would be related to better psychosocial adjustment than a mismatched condition. In a cross-sectional design, sample 1, consisting of 171 cancer patients, and sample 2, consisting of 118 cancer survivors, completed measures of emotional and instrumental received support, physical debilitation, and psychological distress. The optimal matching theory model was confirmed; those needing support (i.e., greater physical debilitation), who did not receive it, experienced more distress than those who needed support and received it. Patients in treatment benefited from the matching of need and provision for both emotional and instrumental support, whereas survivors only benefited from the matching of emotional support. The results suggest that social support is contextualized by the degree of physical impairment and may be somewhat different for cancer patients in treatment compared with cancer survivors. The transition to cancer survivorship may involve a transformation in the need for as well as the type and amount of received social support. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  1. NCI designated cancer center funding not influenced by organizational structure. (United States)

    Wolfe, Margaret E; Yagoda, Daniel; Thurman, Paul W; Luna, Jorge M; Figg, William Douglas


    National Cancer Institutes (NCI) designated cancer centers use one of three organizational structures. The hypothesis of this study is that there are differences in the amount of annual NCI funding per faculty member based on a cancer center's organizational structure. The study also considers the impact of secondary factors (i.e., the existence of a clinical program, the region and the size of the city in which the cancer center is located) on funding and the number of Howard Hughes Medical Institute (HHMI) investigators at each cancer center. Of the 63 cancer centers, 44 use a matrix structure, 16 have a freestanding structure, and three have a Department of Oncology structure. Kruskal-Wallis tests reveal no statistically significant differences in the amount of funding per faculty member or the number of HHMI investigators between centers with a matrix, freestanding or Department of Oncology structure. Online research and telephone interviews with each cancer center were used to gather information, including: organizational structure, the presence of a clinical program, the number of faculty members, and the number of Howard Hughes Medical Institute investigators. Statistical tests were used to assess the impact which organizational structure has on the amount of funding per faculty member and number of HHMI investigators. While the results seem to suggest that the organizational structure of a given cancer center does not impact the amount of NCI funding or number of HHMI investigators which it attracts, the existence of this relationship is likely masked by the small sample size in this study. Further studies may be appropriate to examine the effect organizational structure has on other measurements which are relevant to cancer centers, such as quality and quantity of research produced.

  2. Experiencing music therapy cancer support. (United States)

    Rykov, Mary H


    I portray health-related research outcomes in an arts-informed representation that disrupts the traditional discursive-scholarly format of journal writing to privilege better the participants' accounts and communicate these experientially. The representation uncovers meaning through alternative ways of communicating and conveys the ineffable quality of music in a manner that may be understood through and beyond words. This expands the convention of health-related research outcomes, including ways of knowing, what can be known and how this can be represented. I elaborate my intentions for this experiential report, discuss theoretical underpinnings of this methodology and describe a music therapy support group model.

  3. Enriching Patient-Centered Medical Homes Through Peer Support. (United States)

    Daaleman, Timothy P; Fisher, Edwin B


    Peer supporters are recognized by various designations-community health workers, promotores de salud, lay health advisers-and are community members who work for pay or as volunteers in association with health care systems or nonprofit community organizations and often share ethnicity, language, and socioeconomic status with the mentees that they serve. Although emerging evidence demonstrates the efficacy of peer support at the community level, the adoption and implementation of this resource into patient-centered medical homes (PCMHs) is still under development. To accelerate that integration, this article addresses three major elements of peer support interventions: the functions and features of peer support, a framework and programmatic strategies for implementation, and fiscal models that would support the sustained viability of peer support programs within PCMHs. Key functions of peer support include assistance in daily management of health-related behaviors, social and emotional support, linkage to clinical care, and longitudinal or ongoing support. An organizational model of innovation implementation provides a useful framework for determining how to implement and evaluate peer support programs in PCMHs. Programmatic strategies that can be useful in developing peer support programs within PCMHs include peer coaching or mentoring, group self-management training, and programs designed around the telephone and information technology. Fiscal models for peer support programs include linkages with hospital or health care systems, service- or community-based nonprofit organizations, and partnerships between health care systems and community groups. Peer support promises to enrich PCMHs by activating patients in their self-care, providing culturally sensitive outreach, and opening the way for partnerships with community-based organizations. © 2015 Annals of Family Medicine, Inc.

  4. Center of Cancer Nanotechnology Excellence for Translational Diagnostics (United States)

    The Center of Cancer Nanotechnology Excellence for Translational Diagnostics, which forms the third cycle CCNE Program at Stanford University, is a consortium that has three highly synchronized Projects and three Cores.

  5. Canadian ATLAS data center to support CERN's LHC

    CERN Multimedia


    "The biggest science experiment in history is currently underway at the world-famous CERN labs in Switzerland, and Canada is poised to play a critical role in its success. Thanks to a $10.5 million investment announced by the Canada Foundation for Innovation (CFI), an ultra-sophisticated computing facility -- the ATLAS Data Center -- will be created to support the ATLAS project at CERN's Large Hadron Collider (LHC)." (1 page)

  6. A Medical Center Network for Optimized Lung Cancer Biospecimen Banking (United States)


    1 Award Number: W81XWH-10-1-0818 TITLE: “A Medical Center Network for Optimized Lung Cancer Biospecimen Banking ” PRINCIPAL INVESTIGATOR: Christopher...To) 20Sep2014 - 19Sep2015 4. TITLE AND SUBTITLE “A Medical Center Network for Optimized Lung Cancer Biospecimen Banking ” 5a. CONTRACT NUMBER 5b...Although new subject enrollments and specimen collection have ceased, the LCBRN is committed to the outcome of this project, which is a bank of

  7. CCR Careers | Center for Cancer Research (United States)

    Be part of our mission to make breakthrough scientific discoveries to find cures and treatments for cancer. Our Principal Investigators lead teams of laboratory scientists, trainees, clinicians, and administrators to unlock scientific knowledge to advance the fight against cancer and HIV/AIDS.

  8. The Dartmouth Center for Cancer Nanotechnology Excellence: magnetic hyperthermia. (United States)

    Baker, Ian; Fiering, Steve N; Griswold, Karl E; Hoopes, P Jack; Kekalo, Katerina; Ndong, Christian; Paulsen, Keith; Petryk, Alicea A; Pogue, Brian; Shubitidze, Fridon; Weaver, John


    The Dartmouth Center for Cancer Nanotechnology Excellence - one of nine funded by the National Cancer Institute as part of the Alliance for Nanotechnology in Cancer - focuses on the use of magnetic nanoparticles for cancer diagnostics and hyperthermia therapy. It brings together a diverse team of engineers and biomedical researchers with expertise in nanomaterials, molecular targeting, advanced biomedical imaging and translational in vivo studies. The goal of successfully treating cancer is being approached by developing nanoparticles, conjugating them with Fabs, hyperthermia treatment, immunotherapy and sensing treatment response.

  9. National Cancer Center Singapore: the way forward. (United States)

    Teo, Melissa; Soo, Khee Chee


    Cancer is the leading cause of death in Singapore, comprising almost 30% of annual deaths. The incidence and prevalence continue to rise, resulting in Singapore having the highest age-standardized rate of cancer in southeast Asia. A review of national health policies in 1992 resulted in the creation of a National Cancer Centre Singapore (NCCS) in 1999. The current NCCS, with its three pillars of clinical service, research and education, manages about 70% of all new cancer cases in the countries public healthcare system. As it outgrows its current outfit and looks to the new NCCS building in 2020, the goal must be for strategic planning to attract and retain the best minds and heart in the field of cancer if it were to continue to be successful in achieving its vision and mission. This article chronicles the NCCS's history and details the foundation of its strategic plans.

  10. Designing Trojan Horses | Center for Cancer Research (United States)

    Waging battle against cancer cells without inflicting damage on normal tissue has long been a goal for cancer treatment. A new type of drug called immunotoxins may help make this goal a reality. Much like the Greeks used a wooden horse to get soldiers inside the gates of Troy, immunotoxins use clever genetic engineering to get a lethal toxin inside cancer cells. Each immunotoxin consists of two components an antibody and a toxin that are fused together. The custom-designed antibody acts as a homing signal, seeking out a specific target present on the surface of cancer cells. When the antibody binds its target, the whole immunotoxin is brought inside the cell. Unwittingly, the cancer cell has exposed itself to a powerful poison, a mistake that will likely condemn it to death.

  11. Specialized programs to support young women with breast cancer. (United States)

    Villarreal-Garza, Cynthia; Martinez-Cannon, Bertha Alejandra; Platas, Alejandra; Ramos-Elias, Pier


    Because of the recognized impact of breast cancer and its treatment on a young woman's life, initiatives are being established worldwide. The main aim of this review was to describe existing specialized programs that support young women with breast cancer (YWBC), advances to date, current challenges and future actions. Current programs for YWBC are now educating professionals, patients, and communities on their specific needs. Also, support groups have helped break isolation and connect YWBC together. Research on biology, treatment, adverse effects, risk factors, genetics, and social aspects on YWBC is now being actively conducted. In low- and middle-income countries, the particular issues of young women are, however, still not systematically addressed, because of scarce funding, lack of awareness of YWBC needs, and deficient provider training. Practice guidelines and algorithms should be disseminated and available for their widespread use to allow standard clinical and supportive care for YWBC even in oncologic centers where no specific programs exist. Also, cancer centers should formally commit to financing, at least partially, dedicated services, and existing programs for YWBC, guaranteeing their continuity. Finally, interinstitutional and international collaborations should be encouraged to facilitate adequately powered research, to avoid repetitive efforts, and to promote knowledge sharing and translation.

  12. Developmental Scientist III | Center for Cancer Research (United States)

    Establishes, implements and maintains standardized processes and assesses performance to make recommendations for improvement Provides support and guidance to the cellular therapy or vector production facilities at the NIH Clinical Center engaged in the manufacture of patient specific therapies Manufactures cellular therapy products for human use Develops and manufactures lentiviral and/or retroviral vectors Prepares technical reports, abstracts, presentations and program correspondence concerning assigned projects through research and analysis of information relevant to government policy, regulations and other relevant data and monitor all assigned programs for compliance Provides project management support with planning and development of project schedules and deliverables, tracking project milestones, managing timelines, preparing status reports and monitoring progress ensuring adherence to deadlines Facilitates communication through all levels of staff by functioning as a liaison between internal departments, senior management, and the customer Serves as a leader/mentor to administrative staff and prepares employee performance evaluations Develops and implements procedures/programs to ensure effective and efficient business and operational processes  Identifies potential bottlenecks in upcoming development processes and works with team members and senior management for resolution Analyzes and tracks initiatives and contracts Coordinates and reviews daily operations and logistics, including purchasing and shipping of miscellaneous equipment, laboratory and office supplies to ensure compliance with appropriate government regulations  Coordinates the administrative, fiscal, contractual, and quality aspects of all projects Ensures that internal budgets, schedules and performance requirements are met Monitors workflow and timelines to ensure production operations are on schedule and adequate raw materials and supplies are available Ensures all activities are in

  13. Signaling, Gene Regulation and Cancer | Center for Cancer Research (United States)

    Although there have been tremendous progress in cancer research and treatment, the mortality caused by this disease is still very high. Cancer is the leading cause of death worldwide and second leading cause of death in the United States of America. Signaling, Gene Regulation and Cancer covers topics including the role of various signaling pathways in development, regulation of cell fate, tumor angiogenesis, duodenal neoplasias, breast, colorectal and prostate cancer, cancer development and progression, microRNA in cancer and epigenetic regulation of cancer.

  14. Study characterizes how DNA-damaging anti-cancer drugs kill cancer cells | Center for Cancer Research (United States)

    Patients whose cancer cells express the SLFN11 protein are more likely to respond to DNA-damaging anti-cancer drugs than those whose cancer cells don’t express SLFN11. In a new study, Center for Cancer Research investigators show how these drugs recruit SLFN11 to block replication and kill cancer cells. Read more…

  15. Nutritional support strategies for malnourished cancer patients. (United States)

    van Bokhorst-de van der Schueren, Marian A E


    A large body of evidence exists, which demonstrates the importance of nutritional support in cancer. The nutritional needs of patients with cancer may differ from those of the healthy population due to hypermetabolism, impaired organ function, increased nutrient losses and therapy-related malnutrition. Patients with cancer often have increased requirements for both macro- and micronutrients due to long periods of undernutrition prior to diagnosis. The aim of nutritional support should be the prevention or reversal of malnutrition, and this should be initiated as early as possible to improve outcomes. Oral supplementation is a simple, non-invasive method of increasing the nutrient intake of those patients who are unable to meet nutritional requirements, despite dietary counselling. Enteral tube feeding is indicated for patients who are unable to meet their nutritional needs by oral intake alone, and has been shown to improve clinical outcomes. Novel approaches in oral supplementation include the use of eicosapentaenoic acid (EPA), a compound under investigation for its role in preventing and treating cancer-associated malnutrition. Individual studies suggest that EPA attenuates cancer-associated wasting and improves immune function. In addition, it has been shown to have anti-tumour effects and improve clinical outcomes. However, results are not consistent for all patient groups and further research is required.

  16. Postdoctoral Fellow | Center for Cancer Research (United States)

    A postdoctoral position is available in the lab of Dr. Steven A. Feldman, Surgery Branch of the National Cancer Institute for a highly-motivated individual to carry out translational research studies aimed at developing and improving novel adoptive T cell therapies for solid cancers. A major focus of the position will utilize gene editing strategies (ZFN and Crispr) to enhance T cell function and/or re-direct T cells by TCR insertion for development of novel personalized cancer therapies based on identifying and targeting immunogenic mutations expressed by a patient’s tumor. 

  17. The HPV Vaccine | Center for Cancer Research (United States)

    Two researchers leveraged CCR’s unique environment of investigator-driven inquiry to pursue studies of two cancer-causing genes that eventually led to the development of a vaccine against two forms of human papillomavirus.

  18. Chromatin Pioneers | Center for Cancer Research (United States)

    Taking advantage of their ability to explore provocative ideas, NCI investigators pioneered the study of chromatin to demonstrate its functional importance and lay the groundwork for understanding its role in cancer and other diseases.

  19. Breast Cancer Translational Research Center of Excellence (United States)


    States Armed Forces. Breast cancer mortality among women អ years accounts for >40% of years of life lost due to this disease. The economic, social and... cancer is a curable disease if it is detected early; as such early detection is related to survivorship, cost of treatment and quality of life for the...certain life style factors as well as comorbidities. For Theme 2 studies, profiling of human biospecimens alone is important but insufficient

  20. Mapping Cancer Cells’ Starting Lines | Center for Cancer Research (United States)

    Many of the defective regulatory pathways that lead to aberrant proliferation in cancer converge on DNA replication. So replication regulatory pathways could be targeted to more specifically kill cancer cells.  Unfortunately such targeting would require knowing where and when DNA replication starts in the cancer genome.  In yeast, the locations of replication initiation sites on chromatin have been extensively mapped, but in human cancer cells only a handful of these sites have been identified.

  1. The Fermi Science Support Center Data Servers and Archive (United States)

    Reustle, Alexander; Fermi Science Support Center


    The Fermi Science Support Center (FSSC) provides the scientific community with access to Fermi data and other products. The Gamma-Ray Burst Monitor (GBM) data is stored at NASA's High Energy Astrophysics Science Archive Research Center (HEASARC) and is accessible through their searchable Browse web interface. The Large Area Telescope (LAT) data is distributed through a custom FSSC interface where users can request all photons detected from a region on the sky over a specified time and energy range. Through its website the FSSC also provides planning and scheduling products, such as long and short term observing timelines, spacecraft position and attitude histories, and exposure maps. We present an overview of the different data products provided by the FSSC, how they can be accessed, and statistics on the archive usage since launch.

  2. Finding Your New Normal: Outcomes of a Wellness-Oriented Psychoeducational Support Group for Cancer Survivors (United States)

    Shannonhouse, Laura; Myers, Jane; Barden, Sejal; Clarke, Philip; Weimann, Rochelle; Forti, Allison; Moore-Painter, Terry; Knutson, Tami; Porter, Michael


    Group interventions have been useful for survivors to overcome the challenges of cancer. This study employed a pre/post, mixed-methods design to explore the influence of an 8-week support group on the holistic wellness of 14 breast cancer survivors. Pairing experiential activities with wellness-centered psychoeducation was viewed positively by…

  3. Stopping Liver Cancer's Rogue COP | Center for Cancer Research (United States)

    Liver cancer is the fourth most common cancer type and the third leading cause of cancer death worldwide. Many liver tumors are actually metastases, tumors seeded in the liver by cancer cells from another organ, but hepatocellular carcinomas (HCCs), the most common liver tumors, are a heterogeneous family of cancers that arise in hepatocytes, the functional cells of the liver. HCCs are often associated with cirrhosis or liver scarring. Because of the variation in tumor phenotypes, the poor understanding of the molecular origins of these tumors, and the increasing number of diagnoses especially in the US, HCC is a major clinical challenge.

  4. Postdoctoral Fellow | Center for Cancer Research (United States)

    Position Type: Centrosome Biology and Microscopy A fully funded postdoctoral position is available immediately in the Centrosome Biology group in the Laboratory of Protein Dynamics and Signaling at the National Cancer Institute. We combine advanced biochemical and cell biology approaches to study centrosome biogenesis and their ultra-structure and function in normal and cancer conditions. Fellows interested in microscopy will benefit from an outstanding training in various modalities of advanced microscopy; multicolor live cell imaging, super-resolution microscopy (SIM, STORM), correlative light/electron microscopy, and laser microsurgery.

  5. Analysis of suffering at work in Family Health Support Centers. (United States)

    Nascimento, Débora Dupas Gonçalves do; Oliveira, Maria Amélia de Campos


    Analyzing the work process in the Family Health Support Center. An exploratory, descriptive case study using a qualitative approach. Focus groups were conducted with 20 workers of a Family Health Support Center, and the empirical material was subjected to content analysis technique and analyzed in light of Work Psychodynamics. The category of suffering is presented herein as arising from the dialectical contradiction between actual work and prescribed work, from resistance to the Family Health Support Center's proposal and a lack of understanding of their role; due to an immediatist and curative culture of the users and the Family Health Strategy; of the profile, overload and identification with work. The dialectical contradiction between expectations from Family Health Strategy teams and the work in the Family Health Support Center compromises its execution and creates suffering for workers. Analisar o processo de trabalho no Núcleo de Apoio à Saúde da Família. Estudo de caso exploratório, descritivo e de abordagem qualitativa. Grupos focais foram realizados com 20 trabalhadores do Núcleo de Apoio à Saúde da Família, o material empírico foi submetido à técnica de análise de conteúdo e analisado à luz da Psicodinâmica do Trabalho. Apresenta-se aqui a categoria sofrimento que neste estudo decorre da contradição dialética entre o trabalho real e o trabalho prescrito, da resistência à proposta do Núcleo de Apoio à Saúde da Família e da falta de compreensão de seu papel; da cultura imediatista e curativa do usuário e da Estratégia Saúde da Família; do perfil, sobrecarga e identificação com o trabalho. A contradição dialética entre expectativas das equipes da Estratégia Saúde da Família e o trabalho no Núcleo de Apoio à Saúde da Família compromete sua efetivação e gera sofrimento aos trabalhadores.

  6. Treatment preference and patient centered prostate cancer care: Design and rationale. (United States)

    Jayadevappa, Ravishankar; Chhatre, Sumedha; Gallo, Joseph J; Wittink, Marsha; Morales, Knashawn H; Bruce Malkowicz, S; Lee, David; Guzzo, Thomas; Caruso, Adele; Van Arsdalen, Keith; Wein, Alan J; Sanford Schwartz, J


    Prostate cancer is a slow progressing cancer that affects millions of men in the US. Due to uncertainties in outcomes and treatment complications, it is important that patients engage in informed decision making to choose the "optimal treatment". Patient centered care that encompasses informed decision-making can improve treatment choice and quality of care. Thus, assessing patient treatment preferences is critical for developing an effective decision support system. The objective of this patient-centered randomized clinical trial was to study the comparative effectiveness of a conjoint analysis intervention compared to usual care in improving subjective and objective outcomes in prostate cancer patients. We identified preferred attributes of alternative prostate cancer treatments that will aid in evaluating attributes of treatment options. In this two-phase study, in Phase 1 we used mixed methods to develop an adaptive conjoint task instrument. The conjoint task required the patients to trade-off attributes associated with treatments by assessing their relative importance. Phase 2 consisted of a randomized controlled trial of men with localized prostate cancer. We analyzed the effect of conjoint task intervention on the association between preferences, treatment and objective and subjective outcomes. Our conjoint task instrument can lead to a values-based patient-centered decision aid tool and help tailor treatment decision making to the values of prostate cancer patients. This will ultimately improve clinical decision making, clinical policy process, enhance patient centered care and improve prostate cancer outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Supporting Human Activities - Exploring Activity-Centered Computing

    DEFF Research Database (Denmark)

    Christensen, Henrik Bærbak; Bardram, Jakob


    In this paper we explore an activity-centered computing paradigm that is aimed at supporting work processes that are radically different from the ones known from office work. Our main inspiration is healthcare work that is characterized by an extreme degree of mobility, many interruptions, ad......-hoc collaboration based on shared material, and organized in terms of well-defined, recurring, work activities. We propose that this kind of work can be supported by a pervasive computing infrastructure together with domain-specific services, both designed from a perspective where work activities are first class...... objects. We also present an exploratory prototype design and first implementation and present some initial results from evaluations in a healthcare environment....

  8. Providing Co-Curricular Support: A Multi-Case Study of Engineering Student Support Centers (United States)

    Lee, Walter C., Jr.


    In response to the student retention and diversity issues that have been persistent in undergraduate engineering education, many colleges have developed Engineering Student Support Centers (ESSCs) such as Minority Engineering Programs (MEPs) and Women in Engineering Programs (WEPs). ESSCs provide underrepresented students with co-curricular…

  9. Patient-centered Medical Home Capability and Clinical Performance in HRSA-supported Health Centers (United States)

    Shi, Leiyu; Lock, Diana C.; Lee, De-Chih; Lebrun-Harris, Lydie A.; Chin, Marshall H.; Chidambaran, Preeta; Nocon, Robert S.; Zhu, Jinsheng; Sripipatana, Alek


    Objectives To evaluate the relationship between Patient-centered Medical Home (PCMH) model adoption in health centers (HCs) and clinical performance measures and to determine if adoption of PCMH characteristics is associated with better clinical performance. Research Design Data came from the Health Resources and Services Administration’s 2009 Uniform Data System and the 2009 Commonwealth Fund National Survey of Federally Qualified Health Centers. Clinical performance measures included 2 process measures (childhood immunization and cervical cancer screening) and 2 outcome measures (hypertension control and diabetes control). Total and subscale PCMH scores were regressed on the clinical performance measures, adjusting for patient, provider, financial, and institutional characteristics. Results The findings showed different directional relationships, with some PCMH domains (care management, test/referral tracking, quality improvement, and external coordination) showing little or no effect on outcome measures of interest, 1 domain (access/communication) associated with improved outcomes, and 1 domain (patient tracking/registry) associated with worse outcomes. Conclusions This study is among the first to examine the association between PCMH transformation and clinical performance in HCs, providing an understanding of the impact of PCMH adoption within safety-net settings. The mixed results highlight the importance of examining relationships between specific PCMH domains and specific clinical quality measures, in addition to analyzing overall PCMH scores which could yield distorted findings. PMID:25793267

  10. A POX on Renal Cancer Cells | Center for Cancer Research (United States)

    Proline oxidase, or POX, is an enzyme responsible for metabolizing the amino acid proline. POX contributes to the regulation of cell death that occurs when cellular systems malfunction, a process called apoptosis. Previous studies have determined that levels of POX are reduced in several types of human cancer. Likewise, many cancer cells become resistant to apoptosis, suggesting a link between POX and cancer cell survival.

  11. Cancer Genetics and Signaling | Center for Cancer Research (United States)

    The Cancer, Genetics, and Signaling (CGS) Group at the National Cancer Institute at Frederick  offers a competitive postdoctoral training and mentoring program focusing on molecular and genetic aspects of cancer. The CGS Fellows Program is designed to attract and train exceptional postdoctoral fellows interested in pursuing independent research career tracks. CGS Fellows participate in a structured mentoring program designed for scientific and career development and transition to independent positions.

  12. Supporting Multiple Programs and Projects at NASA's Kennedy Space Center (United States)

    Stewart, Camiren L.


    With the conclusion of the shuttle program in 2011, the National Aeronautics and Space Administration (NASA) had found itself at a crossroads for finding transportation of United States astronauts and experiments to space. The agency would eventually hand off the taxiing of American astronauts to the International Space Station (ISS) that orbits in Low Earth Orbit (LEO) about 210 miles above the earth under the requirements of the Commercial Crew Program (CCP). By privatizing the round trip journey from Earth to the ISS, the space agency has been given the additional time to focus funding and resources to projects that operate beyond LEO; however, adding even more stress to the agency, the premature cancellation of the program that would succeed the Shuttle Program - The Constellation Program (CxP) -it would inevitably delay the goal to travel beyond LEO for a number of years. Enter the Space Launch System (SLS) and the Orion Multipurpose Crew Vehicle (MPCV). Currently, the SLS is under development at NASA's Marshall Spaceflight Center in Huntsville, Alabama, while the Orion Capsule, built by government contractor Lockheed Martin Corporation, has been assembled and is currently under testing at the Kennedy Space Center (KSC) in Florida. In its current vision, SLS will take Orion and its crew to an asteroid that had been captured in an earlier mission in lunar orbit. Additionally, this vehicle and its configuration is NASA's transportation to Mars. Engineers at the Kennedy Space Center are currently working to test the ground systems that will facilitate the launch of Orion and the SLS within its Ground Services Development and Operations (GSDO) Program. Firing Room 1 in the Launch Control Center (LCC) has been refurbished and outfitted to support the SLS Program. In addition, the Spaceport Command and Control System (SCCS) is the underlying control system for monitoring and launching manned launch vehicles. As NASA finds itself at a junction, so does all of its

  13. CB Registration Form | Center for Cancer Research (United States)

    The registration deadline for the Cancer Biotechnology (CB) class is 1/27/2016. The first 50 registrants for each class offered (Jan. 29 or Feb. 9) will be accepted. Mandatory responses are marked by an asterisk (*). A confirmation e-mail will be sent to the address listed in the "E-mail Address" field upon completion and submission of the form. Questions?

  14. MBCP - Approach - Immunotherapy | Center for Cancer Research (United States)

    Immunotherapy CCR investigators pioneered the use of the tuberculosis vaccine—Bacillus Calmette-Guerin (BCG)—in the treatment of bladder cancer. In cases where the tumor burden is not too high and direct contact can be made with the urothelium surface of the bladder, BCG application appears to elicit an immune response that attacks the tumor as well as the attenuated virus. Ongoing clinical trials focusing on enhancing the patient’s immune system are listed below.

  15. Internet cancer support groups: a feminist analysis. (United States)

    Im, Eun-Ok; Chee, Wonshik; Tsai, Hsiu-Min; Lin, Li-Chen; Cheng, Ching-Yu


    Internet Cancer Support Groups (ICSGs) are an emerging form of support group on Internet specifically for cancer patients. Previous studies have indicated the effectiveness of ICSGs as a research setting or a data-collection method. Yet recent studies have also indicated that ICSGs tend to serve highly educated, high-income White males who tend to be at an early stage of cancer. In this article, a total of 317 general ICSGs and 229 ethnic-specific ICSGs searched through,,,, and are analyzed from a feminist perspective. The written records of group discussions and written memos by the research staff members were also analyzed using content analysis. The idea categories that emerged about these groups include (a) authenticity issues; (b) ethnicity and gender issues; (c) intersubjectivity issues; and (d) potential ethical issues. The findings suggest that (a) researchers adopt multiple recruitment strategies through various Internet sites and/or real settings; (b) researchers raise their own awareness of the potential influences of the health-related resources provided by ICSGs and regularly update their knowledge related to the federal and state standards and/or policies related to ICSGs; and (c) researchers consider adopting a quota-sampling method.

  16. Nurse Practitioner/Physician Assistant | Center for Cancer Research (United States)

    PROGRAM DESCRIPTION Within the Leidos Biomedical Research Inc.’s Clinical Research Directorate, the Clinical Monitoring Research Program (CMRP) provides high-quality comprehensive and strategic operational support to the high-profile domestic and international clinical research initiatives of the National Cancer Institute (NCI), National Institute of Allergy and Infectious Diseases (NIAID), Clinical Center (CC), National Institute of Heart, Lung and Blood Institute (NHLBI), National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Center for Advancing Translational Sciences (NCATS), National Institute of Neurological Disorders and Stroke (NINDS), and the National Institute of Mental Health (NIMH). Since its inception in 2001, CMRP’s ability to provide rapid responses, high-quality solutions, and to recruit and retain experts with a variety of backgrounds to meet the growing research portfolios of NCI, NIAID, CC, NHLBI, NIAMS, NCATS, NINDS, and NIMH has led to the considerable expansion of the program and its repertoire of support services. CMRP’s support services are strategically aligned with the program’s mission to provide comprehensive, dedicated support to assist National Institutes of Health researchers in providing the highest quality of clinical research in compliance with applicable regulations and guidelines, maintaining data integrity, and protecting human subjects. For the scientific advancement of clinical research, CMRP services include comprehensive clinical trials, regulatory, pharmacovigilance, protocol navigation and development, and programmatic and project management support for facilitating the conduct of 400+ Phase I, II, and III domestic and international trials on a yearly basis. These trials investigate the prevention, diagnosis, treatment of, and therapies for cancer, influenza, HIV, and other infectious diseases and viruses such as hepatitis C, tuberculosis, malaria, and Ebola virus; heart, lung, and

  17. A Patient-Centered Perspective on Cancer Survivorship

    Directory of Open Access Journals (Sweden)

    Brad Zebrack


    Full Text Available Survivorship is a complicated notion because people often confuse a process of survivorship with a mythic identity of being a cancer survivor. This confusion may be a distraction to addressing the real-life struggles and challenges experienced by all people diagnosed with cancer. A more expansive perspective of survivorship, one that attends to patients’ physical, psychological, social, spiritual, and existential challenges throughout a continuum of care, would be more in line with what is known empirically about people’s experiences with cancer. In an effort to gain a patient-centered perspective on cancer, and one that emphasizes multiple dimensions of cancer survivorship, the author reports findings from a non-scientific social media poll (via Facebook and personal emails in which survivors and colleagues working in the field of cancer survivorship answered the question: What does cancer survivorship mean to you? The comments are enlightening and useful for guiding the development of a patient-centered, and, thus, more comprehensive, approach to caring for people affected by cancer.

  18. Targeted Infrared Photoimmunotherapy for Cancer | Center for Cancer Research (United States)

    A longstanding goal of cancer therapy is the extensive destruction of cancer cells with minimal collateral damage to normal cells. This goal has been very hard to accomplish. Most existing efficacious treatments inevitably inflict collateral damage on nearby normal cells and tissue.

  19. Prostate Cancer Stem-Like Cells | Center for Cancer Research (United States)

    Prostate cancer is the third leading cause of cancer-related death among men, killing an estimated 27,000 men each year in the United States. Men with advanced prostate cancer often become resistant to conventional therapies. Many researchers speculate that the emergence of resistance is due to the presence of cancer stem cells, which are believed to be a small subpopulation of tumor cells that can self-renew and give rise to more differentiated tumor cells. It is thought that these stem cells survive initial therapies (such as chemotherapy and hormone therapy) and then generate new tumor cells that are resistant to these standard treatments. If prostate cancer stem cells could be identified and characterized, it might be possible to design treatments that prevent resistance.

  20. Designing Colorectal Cancer Screening Decision Support: A Cognitive Engineering Enterprise. (United States)

    Militello, Laura G; Saleem, Jason J; Borders, Morgan R; Sushereba, Christen E; Haverkamp, Donald; Wolf, Steven P; Doebbeling, Bradley N


    Adoption of clinical decision support has been limited. Important barriers include an emphasis on algorithmic approaches to decision support that do not align well with clinical work flow and human decision strategies, and the expense and challenge of developing, implementing, and refining decision support features in existing electronic health records (EHRs). We applied decision-centered design to create a modular software application to support physicians in managing and tracking colorectal cancer screening. Using decision-centered design facilitates a thorough understanding of cognitive support requirements from an end user perspective as a foundation for design. In this project, we used an iterative design process, including ethnographic observation and cognitive task analysis, to move from an initial design concept to a working modular software application called the Screening & Surveillance App. The beta version is tailored to work with the Veterans Health Administration's EHR Computerized Patient Record System (CPRS). Primary care providers using the beta version Screening & Surveillance App more accurately answered questions about patients and found relevant information more quickly compared to those using CPRS alone. Primary care providers also reported reduced mental effort and rated the Screening & Surveillance App positively for usability.


    Yust-Katz, Shlomit; Limon, Dror; Abu-Shkara, Ramez; Siegal, Tali


    Neuro-oncology is a subspecialty attracting physicians from medical disciplines such as neurology, neurosurgery, pediatrics, oncology, and radiotherapy. It deals with diagnosis and management of primary brain tumors, as well as metastatic and non-metastatic neurological manifestations that frequently affect cancer patients including brain metastases, paraneoplastic syndromes and neurological complications of cancer treatment. A neuro-oncology unit was established in Davidoff Cancer Center at Rabin Medical Center. It provides a multidisciplinary team approach for management of brain tumors and services, such as expert outpatient clinics and inpatient consultations for the departments of oncology, hematology, bone marrow transplantation and other departments in the Rabin Medical Center. In addition, expert consultation is frequently provided to other hospitals that treat cancer patients with neurological manifestations. The medical disciplines that closely collaborate for the daily management of neuro-oncology patients include radiotherapy, hematology, oncology, neuro-surgery, neuro-radiology and neuro-pathology. The neuro-oncology center is also involved in clinical and laboratory research conducted in collaboration with researchers in Israel and abroad. The new service contributes substantially to the improved care of cancer patients and to the advance of research topics in the field of neuro-oncology.

  2. Oncofertility Resources at NCI-Designated Comprehensive Cancer Centers


    Clayman, Marla L.; Harper, Maya M.; Quinn, Gwendolyn P.; Reinecke, Joyce; Shah, Shivani


    NCI-designated comprehensive cancer centers (CCCs) set the standard for providing exemplary patient care. Quality cancer care includes discussions about fertility and referrals to fertility specialists for patients at risk for sterility. This study sought to determine what fertility preservation (FP) resources are available in CCCs and how well those are integrated into patient care. Leaders at each CCC received a letter requesting a short telephone interview with individuals who could provid...

  3. Language barriers and patient-centered breast cancer care. (United States)

    Karliner, Leah S; Hwang, E Shelley; Nickleach, Dana; Kaplan, Celia P


    Provision of high quality patient-centered care is fundamental to eliminating healthcare disparities in breast cancer. We investigated physicians' experiences communicating with limited English proficient (LEP) breast cancer patients. Survey of a random sample of California oncologists and surgeons. Of 301 respondents who reported treating LEP patients, 46% were oncologists, 75% male, 68% in private practice, and on average 33% of their patients had breast cancer. Only 40% reported at least sometimes using professional interpretation services. Although 75% felt they were usually able to communicate effectively with LEP patients, more than half reported difficulty discussing treatment options and prognosis, and 56% acknowledged having less-patient-centered treatment discussions with LEP breast cancer patients. In multivariate analysis, use of professional interpreters was associated with 53% lower odds of reporting less-patient-centered treatment discussions (OR 0.47; 95% CI 0.26-0.85). California surgeons and oncologists caring for breast cancer patients report substantial communication challenges when faced with a language barrier. Although use of professional interpreters is associated with more patient-centered communication, there is a low rate of professional interpreter utilization. Future research and policy should focus on increasing access to and reimbursement for professional interpreter services. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  4. Cancer prevention and detection centers: an overview and critique. (United States)

    Humphrey, L J; Lester, P


    Cancer screening is ideally carried out in free standing centers that are located near shopping centers, are quite visible, and have a warm, friendly appearance. This chapter describes the basic elements of such a center, including the use of a mobile mammogram van based at the center. While the precise size, location, and design of a center will vary depending on the specific demographics of an area, these data should facilitate such planning. Programs that can be carried out in this center are described utilizing information from preceding chapters. This chapter enlarges upon their application and then outlines criteria and services. Furthermore, a large section on general or whole-body screening is included. As in other programs, those at risk and the benefits are discussed. While not a high volume, income producer, this program is a requisite component offering great service to the customer.

  5. Advocacy, support and survivorship in prostate cancer. (United States)

    Dunn, J; Casey, C; Sandoe, D; Hyde, M K; Cheron-Sauer, M-C; Lowe, A; Oliffe, J L; Chambers, S K


    Across Australia, prostate cancer support groups (PCSG) have emerged to fill a gap in psychosocial care for men and their families. However, an understanding of the triggers and influencers of the PCSG movement is absent. We interviewed 21 SG leaders (19 PC survivors, two partners), of whom six also attended a focus group, about motivations, experiences, past and future challenges in founding and leading PCSGs. Thematic analysis identified four global themes: illness experience; enacting a supportive response; forming a national collective and challenges. Leaders described men's feelings of isolation and neglect by the health system as the impetus for PCSGs to form and give/receive mutual help. Negotiating health care systems was an early challenge. National affiliation enabled leaders to build a united voice in the health system and establish a group identity and collective voice. Affiliation was supported by a symbiotic relationship with tensions between independence, affiliation and governance. Future challenges were group sustainability and inclusiveness. Study findings describe how a grassroots PCSG movement arose consistent with an embodied health movement perspective. Health care organisations who seek to leverage these community resources need to be cognisant of SG values and purpose if they are to negotiate effective partnerships that maximise mutual benefit. © 2017 The Authors. European Journal of Cancer Care Published by John Wiley & Sons Ltd.

  6. Not slowing down | Center for Cancer Research (United States)

    Nine and-a-half-year-old Travis Carpenter gets a lot of speeding tickets. (He stresses that “and-a-half” part, too). These speeding tickets don’t come from a law enforcement officer but Jesse, one of his nurses at the NIH Clinical Center. Travis uses a power chair that he’s adorned with racing stickers, and his speeding tickets come from him zooming down the Clinical Center’s hallways, dodging the steady traffic of doctors, nurses, patients and families. He loves all things racing, NASCAR and pit crews. Neurofibromatosis type 1 isn’t slowing him down. Read more...

  7. Optimal Design of a Center Support Quadruple Mass Gyroscope (CSQMG). (United States)

    Zhang, Tian; Zhou, Bin; Yin, Peng; Chen, Zhiyong; Zhang, Rong


    This paper reports a more complete description of the design process of the Center Support Quadruple Mass Gyroscope (CSQMG), a gyro expected to provide breakthrough performance for flat structures. The operation of the CSQMG is based on four lumped masses in a circumferential symmetric distribution, oscillating in anti-phase motion, and providing differential signal extraction. With its 4-fold symmetrical axes pattern, the CSQMG achieves a similar operation mode to Hemispherical Resonant Gyroscopes (HRGs). Compared to the conventional flat design, four Y-shaped coupling beams are used in this new pattern in order to adjust mode distribution and enhance the synchronization mechanism of operation modes. For the purpose of obtaining the optimal design of the CSQMG, a kind of applicative optimization flow is developed with a comprehensive derivation of the operation mode coordination, the pseudo mode inhibition, and the lumped mass twisting motion elimination. The experimental characterization of the CSQMG was performed at room temperature, and the center operation frequency is 6.8 kHz after tuning. Experiments show an Allan variance stability 0.12°/h (@100 s) and a white noise level about 0.72°/h/√Hz, which means that the CSQMG possesses great potential to achieve navigation grade performance.

  8. Optimal Design of a Center Support Quadruple Mass Gyroscope (CSQMG

    Directory of Open Access Journals (Sweden)

    Tian Zhang


    Full Text Available This paper reports a more complete description of the design process of the Center Support Quadruple Mass Gyroscope (CSQMG, a gyro expected to provide breakthrough performance for flat structures. The operation of the CSQMG is based on four lumped masses in a circumferential symmetric distribution, oscillating in anti-phase motion, and providing differential signal extraction. With its 4-fold symmetrical axes pattern, the CSQMG achieves a similar operation mode to Hemispherical Resonant Gyroscopes (HRGs. Compared to the conventional flat design, four Y-shaped coupling beams are used in this new pattern in order to adjust mode distribution and enhance the synchronization mechanism of operation modes. For the purpose of obtaining the optimal design of the CSQMG, a kind of applicative optimization flow is developed with a comprehensive derivation of the operation mode coordination, the pseudo mode inhibition, and the lumped mass twisting motion elimination. The experimental characterization of the CSQMG was performed at room temperature, and the center operation frequency is 6.8 kHz after tuning. Experiments show an Allan variance stability 0.12°/h (@100 s and a white noise level about 0.72°/h/√Hz, which means that the CSQMG possesses great potential to achieve navigation grade performance.

  9. Animal Resource Program | Center for Cancer Research (United States)

    CCR Animal Resource Program The CCR Animal Resource Program plans, develops, and coordinates laboratory animal resources for CCR’s research programs. We also provide training, imaging, and technology development in support of moving basic discoveries to the clinic. The ARP Manager:

  10. Postdoctoral Fellow | Center for Cancer Research (United States)

    A postdoctoral fellowship is currently available for productive, highly-motivated, and energetic individuals in the Inflammation and Tumorigenesis Section of Dr. Yinling Hu at the NCI-Frederick campus.  A dynamic research environment and outstanding resources are available for enthusiastic individuals.  Requirements include a Ph.D., M.D., or equivalent degree and experience in Immunology, Molecular Biology, and/or Signaling Research. Candidate must have excellent verbal, written communication and organizational skills, and the ability to handle multiple projects simultaneously. The project will be to investigate mechanisms of IKK/NF-B-involved auto-immunity, infection, innate immunity in mouse models of carcinogenesis/cancer biology, tumor initiating cells, and lymphoid organ development.

  11. Postdoctoral Fellow | Center for Cancer Research (United States)

    The Escorcia Lab within the Molecular Imaging Program (MIP) at the National Cancer Institute (NCI) is seeking a highly motivated postdoctoral candidate with a background in cancer biology and/or radiation biology to lead projects to develop and assess new tumor-selective imaging and therapeutic agents. MIP provides a collaborative environment of experts in (radio)chemistry, biology and physics and offers a unique opportunity to translate successful imaging and therapeutic agents into clinical trials in the NCI. The primary focus of the lab involves developing tumor-selective imaging agents (e.g. PET, SPECT) to inform cytotoxic therapies such as immuno-oncology agents, small molecule chemotherapy, external radiotherapy, or targeted radioimmunotherapy agents, which can be engineered in the lab. In addition, we aim to develop methods to enhance therapeutic efficacy of ionizing radiation, especially targeted nuclide therapies (TNTs), and utilize state of the art dose modeling and detection techniques to ensure therapeutic doses to tumors. Our group is uniquely poised to take advantage of recent approvals of TNTs in humans to expand the repertoire of preclinical agents and translate the most promising ones to the clinic. Our approach is multidisciplinary and spans bioinformatics (e.g. analysis of RNASeq data) to help identify novel imaging and therapeutic targets, genetic engineering (e.g. CRISPR/Cas9) and pharmacologic manipulation to study radiosensitivity, as well as radio- and bioconjugate-chemistry and medical physics to generate/assess our imaging and therapeutic agents. Accordingly, the lab is part of a multidisciplinary team of chemists, physicists, biologists, and physician-scientists who all collaborate to advance the mission of the lab and MIP as a whole, providing an excellent environment for motivated postdoctoral candidates to learn and thrive as scientists.

  12. Quality assessments for cancer centers in the European Union. (United States)

    Wind, Anke; Rajan, Abinaya; van Harten, Wim H


    Cancer centers are pressured to deliver high-quality services that can be measured and improved, which has led to an increase of assessments in many countries. A critical area of quality improvement is to improve patient outcome. An overview of existing assessments can help stakeholders (e.g., healthcare professionals, managers and policy makers) improve the quality of cancer research and care and lead to patient benefits. This paper presents key aspects of assessments undertaken by European cancer centers, such as: are assessments mandatory or voluntary? Do they focus on evaluating research, care or both? And are they international or national? A survey was sent to 33 cancer centers in 28 European Union member states. Participants were asked to score the specifics for each assessment that they listed. Based on the responses from 19 cancer centers from 18 member states, we found 109 assessments. The numbers have steadily increased from 1990's till 2015. Although, a majority of assessments are on patient-care aspects (n = 45), it is unclear how many of those include assessing patient benefits. Only few assessments cover basic research. There is an increasing trend towards mixed assessments (i.e., combining research and patient-care aspects) The need for assessments in cancer centers is increasing. To improve efforts in the quality of research and patient care and to prevent new assessments that "reinvent the wheel", it is advised to start comparative research into the assessments that are likely to bring patient benefits and improve patient outcome. Do assessments provide consistent and reliable information that create added value for all key stakeholders?

  13. What Are Cancer Centers Advertising to the Public? A Content Analysis (United States)

    Vater, Laura B.; Donohue, Julie M.; Arnold, Robert; White, Douglas B; Chu, Edward; Schenker, Yael


    Background Although critics have expressed concerns about cancer center advertising, the content of these advertisements has not been analyzed. Objective To characterize the informational and emotional content of cancer center advertisements. Design Systematic analysis of all cancer center advertisements in top U.S. consumer magazines (N=269) and television networks (N=44) in 2012. Measurements Using a standardized codebook, we assessed (1) types of clinical services promoted; (2) information provided about clinical services, including risks, benefits, and costs; (3) use of emotional advertising appeals; and (4) use of patient testimonials. Two investigators independently coded advertisements using ATLAS.ti. Kappa values ranged from 0.77 to 1.0. Results A total of 102 cancer centers placed 409 unique clinical advertisements in top media markets in 2012. Advertisements promoted treatments (88%) more often than screening (18%) or supportive services (13%; padvertised therapies were described more often than risks (27% vs. 2%; padvertisements mentioned insurance coverage or costs (5%). Emotional appeals were frequent (85%), most often evoking hope for survival (61%), describing cancer treatment as a fight or battle (41%), and evoking fear (30%). Nearly half of advertisements included patient testimonials, usually focused on survival or cure. Testimonials rarely included disclaimers (15%) and never described the results a typical patient might expect. Limitations Internet advertisements were not included. Conclusions Clinical advertisements by cancer centers frequently promote cancer therapy using emotional appeals that evoke hope and fear while rarely providing information about risks, benefits, or costs. Further work is needed to understand how these advertisements influence patient understanding and expectations of benefit from cancer treatments. PMID:24863081

  14. Kundalini yoga as a support therapy for cancer patients


    Kröneck, Mia


    This study was designed to describe cancer patient’s experience of kundalini yoga and its effect on their internal coping resources. The intention of this study is to put forward kundalini yoga as a support therapy for cancer patients for improving their wellbeing during active cancer treatment. This is a descriptive study. An academic literature review was conducted for cancer, cancer treatment, internal coping resources and yoga as therapy topics. Four voluntary female cancer patients (...

  15. Population-based geographic access to parent and satellite National Cancer Institute Cancer Center Facilities. (United States)

    Onega, Tracy; Alford-Teaster, Jennifer; Wang, Fahui


    Satellite facilities of National Cancer Institute (NCI) cancer centers have expanded their regional footprints. This study characterized geographic access to parent and satellite NCI cancer center facilities nationally overall and by sociodemographics. Parent and satellite NCI cancer center facilities, which were geocoded in ArcGIS, were ascertained. Travel times from every census tract in the continental United States and Hawaii to the nearest parent and satellite facilities were calculated. Census-based population attributes were used to characterize measures of geographic access for sociodemographic groups. From the 62 NCI cancer centers providing clinical care in 2014, 76 unique parent locations and 211 satellite locations were mapped. The overall proportion of the population within 60 minutes of a facility was 22% for parent facilities and 32.7% for satellite facilities. When satellites were included for potential access, the proportion of some racial groups for which a satellite was the closest NCI cancer center facility increased notably (Native Americans, 22.6% with parent facilities and 39.7% with satellite facilities; whites, 34.8% with parent facilities and 50.3% with satellite facilities; and Asians, 40.0% with parent facilities and 54.0% with satellite facilities), with less marked increases for Hispanic and black populations. Rural populations of all categories had dramatically low proportions living within 60 minutes of an NCI cancer center facility of any type (1.0%-6.6%). Approximately 14% of the population (n = 43,033,310) lived more than 180 minutes from a parent or satellite facility, and most of these individuals were Native Americans and/or rural residents (37% of Native Americans and 41.7% of isolated rural residents). Racial/ethnic and rural populations showed markedly improved geographic access to NCI cancer center care when satellite facilities were included. Cancer 2017;123:3305-11. © 2017 American Cancer Society. © 2017 American

  16. Survival of adolescents with cancer treated at pediatric versus adult oncology treatment centers in France. (United States)

    Desandes, Emmanuel; Brugieres, Laurence; Laurence, Valérie; Berger, Claire; Kanold, Justyna; Tron, Isabelle; Clavel, Jacqueline; Lacour, Brigitte


    In France, although children aged less than 15 years with cancer are usually referred to pediatric oncology centers, adolescents may be treated at pediatric or adult oncology centers. The objective was to compare survival according to their site of treatment. Using population-based registration, 15- to 19-year-old patients diagnosed with cancer in 2006 or 2007 and living in six French regions (accounting for 41% of the French population) were included. Of the 594 patients included, 33% of the French adolescents were treated at a pediatric oncology center. Compared with those treated at a pediatric center, adolescents treated at an adult center were older, were more likely to have carcinoma and germ-cell tumor, had a longer time to diagnosis, and were less likely to be enrolled in a clinical trial. In addition, the decisions for their management were less likely to be taken in the context of multidisciplinary team meetings. In multivariate analysis, adolescent patients treated at a pediatric center did not have significantly different overall survival (OS) compared with those treated at an adult center (5-year OS: 84.1% [95% confidence interval: 78.6-90.0] versus 87.7% [95% confidence interval: 84.2-91.3]; P = 0.25). The outcomes of French adolescents with cancer have begun to improve, with 81.2% survival in 2006-2007, with no difference between the types of treatment center. However, for this unique group of diseases, survival is not the unique endpoint. In order to ensure good quality of life after cancer, management of those patients requires specific approaches, designed to reduce the late effects of cancer treatment and improve supportive care. © 2016 Wiley Periodicals, Inc.

  17. Centered Differential Waveform Inversion with Minimum Support Regularization

    KAUST Repository

    Kazei, Vladimir


    Time-lapse full-waveform inversion has two major challenges. The first one is the reconstruction of a reference model (baseline model for most of approaches). The second is inversion for the time-lapse changes in the parameters. Common model approach is utilizing the information contained in all available data sets to build a better reference model for time lapse inversion. Differential (Double-difference) waveform inversion allows to reduce the artifacts introduced into estimates of time-lapse parameter changes by imperfect inversion for the baseline-reference model. We propose centered differential waveform inversion (CDWI) which combines these two approaches in order to benefit from both of their features. We apply minimum support regularization commonly used with electromagnetic methods of geophysical exploration. We test the CDWI method on synthetic dataset with random noise and show that, with Minimum support regularization, it provides better resolution of velocity changes than with total variation and Tikhonov regularizations in time-lapse full-waveform inversion.

  18. Quality assessments for cancer centers in the European Union

    NARCIS (Netherlands)

    Wind, Anke; Rajan, A.; van Harten, Willem H.


    Background Cancer centers are pressured to deliver high-quality services that can be measured and improved, which has led to an increase of assessments in many countries. A critical area of quality improvement is to improve patient outcome. An overview of existing assessments can help stakeholders

  19. Patient-Centered Cancer Care Programs in Italy: Benchmarking Global Patient Education Initiatives. (United States)

    Truccolo, Ivana; Cipolat Mis, Chiara; Cervo, Silvia; Dal Maso, Luigino; Bongiovanni, Marilena; Bearz, Alessandra; Sartor, Ivana; Baldo, Paolo; Ferrarin, Emanuela; Fratino, Lucia; Mascarin, Maurizio; Roncadin, Mario; Annunziata, Maria Antonietta; Muzzatti, Barbara; De Paoli, Paolo


    In Italy, educational programs for cancer patients are currently provided by the national government, scientific societies, and patient advocate organizations. Several gaps limit their effectiveness, including the lack of coordinated efforts, poor involvement of patient feedback in the planning of programs, as well as a lack of resources on innovative cancer-related topics. This process is parallel to a strong shift in the attitude of patients towards health in general and taking charge of their own health conditions in particular. The National Cancer Institute in the USA and the Organization of European Cancer Institutes encourage comprehensive cancer centers in providing educational programs conceived to overcome these gaps. The goal of this paper is to identify and describe the key elements necessary to develop a global patient education program and provide recommendations for strategies with practical examples for implementation in the daily activities of cancer institutes. A multidisciplinary committee was established for patient education, including patient representatives as equal partners, to define, implement, verify, and evaluate the fundamental steps for establishing a comprehensive education program. Six essential topics were identified for the program: appropriate communication of cancer epidemiology, clinical trial information, new therapeutic technologies, support in the use of medicines, psycho-oncological interventions, age-personalized approaches, and training programs for healthcare providers. Integration of these topics along with patient feedback is the key to a successful model for educational programs. An integrated educational program can transform a comprehensive cancer center to an institution that provides research and care for and with patients.

  20. Assessing the Development of Multidisciplinary Care: Experience of the National Cancer Institute Community Cancer Centers Program. (United States)

    Friedman, Eliot L; Chawla, Neetu; Morris, Paul T; Castro, Kathleen M; Carrigan, Angela C; Das, Irene Prabhu; Clauser, Steven B


    The National Cancer Institute Community Cancer Centers Program (NCCCP) began in 2007 with a goal of expanding cancer research and delivering quality care in communities. The NCCCP Quality of Care (QoC) Subcommittee was charged with developing and improving the quality of multidisciplinary care. An assessment tool with nine key elements relevant to MDC structure and operations was developed. Fourteen NCCCP sites reported multidisciplinary care assessments for lung, breast, and colorectal cancer in June 2010, June 2011, and June 2012 using an online reporting tool. Each site evaluated their level of maturity (level 1 = no multidisciplinary care, level 5 = highly integrated multidisciplinary care) in nine elements integral to multidisciplinary care. Thematic analysis of open-ended qualitative responses was also conducted. The proportion of sites that reported level 3 or greater on the assessment tool was tabulated at each time point. For all tumor types, sites that reached this level increased in six elements: case planning, clinical trials, integration of care coordination, physician engagement, quality improvement, and treatment team integration. Factors that enabled improvement included increasing organizational support, ensuring appropriate physician participation, increasing patient navigation, increasing participation in national quality initiatives, targeting genetics referrals, engaging primary care providers, and integrating clinical trial staff. Maturation of multidisciplinary care reflected focused work of the NCCCP QoC Subcommittee. Working group efforts in patient navigation, genetics, and physician conditions of participation were evident in improved multidisciplinary care performance for three common malignancies. This work provides a blueprint for health systems that wish to incorporate prospective multidisciplinary care into their cancer programs. Copyright © 2015 by American Society of Clinical Oncology.

  1. Accelerating the delivery of patient-centered, high-quality cancer care. (United States)

    Abrahams, Edward; Foti, Margaret; Kean, Marcia A


    Significant progress has been made in the past 50 years across the field of oncology, and, as a result, the number of cancer survivors in the United States is more than 14.5 million. In fact, the number of cancer survivors continues to grow on an annual basis, which is due in part to improved treatments that help people with cancer live longer, and improvements in early detection that allow doctors to find cancer earlier when the disease is easier to treat. However, in spite of this progress, innovation in cancer research and care is at risk as the rise in health care spending is leading to significant pressure to contain costs. As the oncology community seeks to ensure that innovation in cancer research and care continues, it is imperative that stakeholders focus their attention on the value that the research and care continuum provides. Over the past several years, the Turning the Tide Against Cancer initiative has worked with the cancer community to accelerate the delivery of patient-centered, high-quality cancer research and care, while addressing value and cost. This article highlights policy recommendations that resulted from the convening of an expert working group comprising leaders from across the oncology field. Of the recommendations, the co-conveners have identified several issue areas that merit particular focus in 2015: Support FDA's efforts to modernize its framework for bringing new medicines to patients, through facilitating and implementing innovative approaches to drug development and regulatory review. Ensure that cancer clinical pathways or similar decision-support tools are transparent; developed through a physician-driven process that includes patient input; and meet minimum standards for clinical appropriateness, timeliness, and patient centeredness. Support oncology decision-support tools that are timely, clinically appropriate, and patient centered. Build on existing efforts to convene a multistakeholder committee and develop a report on

  2. Family-centered developmentally supportive care: the Swedish example. (United States)

    Westrup, B


    The prematurely born infant is probably the most vulnerable patient in our hospitals due to the immaturity of all organ systems including the brain. Over recent years, the importance of neurodevelopmentally supportive care has been clarified. In addition, to provide the best possible treatment and environmental conditions for the vital functions of the infant to properly develop, we also must support the psychological processes of bonding and attachment between parents and their newborn infant, which is so crucial for long-term health and development. By integrating scientific findings from natural and behavioral science in multidisciplinary developmentally supportive intervention programs, recommendations for redesigning nurseries and integrating families have developed to meet these challenges. It not only is "baby- and family-friendly" but also has economic benefits and improves the long-term development of the child. The basis of family-centered developmentally supportive care interventions is the recognition that the newborn infant is a human being in his or her own right, and letting the caregivers be guided by the current needs of the individual infant and family. In this context, the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) is unique since it is the only program designed to be implemented from the moment the infant is born. Different strategies can be used to support the nursing and medical teams to help the family become the primary caregivers of their own infants. Sweden has a long tradition of engaging parents in the actual care and of around-the-clock visiting hours. Nurseries have, or are remodeling to have, the facilities enabling parents to live in the units throughout the entire hospital stay. Skin-to-skin contact is widely implemented. In order to ensure that these strategies are in tune with the individual needs of the infant and the families, all major nurseries have trained NIDCAP professionals. Care and

  3. Postdoctoral Fellow | Center for Cancer Research (United States)

    A postdoctoral fellow position is available in the Tissue Morphodynamics Unit, headed by Dr. Kandice Tanner, at the National Cancer Institute. The Tanner lab combines biophysical and cell biological approaches to understand the interplay between cell motility and tissue architecture. We use a combination of imaging modalities, cell biology and animal models. Experience with zebrafish is desired but not mandatory. It is expected that as a member of this lab, one will have an opportunity to be exposed to all these areas. We value a vibrant and collaborative environment where lab members share ideas, reagents and expertise and want to work on fundamental problems in the establishment of metastatic lesions. The successful candidate will interact with a diverse group of scientists with backgrounds in biochemistry, motor biophysics and cell biology. The position offers a generous salary and benefits package as well as the possibility of further career advancement if performance is excellent. 1. Kim J, Staunton J.R., and Tanner K. Independent control of topography for three-dimensional patterning of the ECM microenvironment. (Adv Mater 10.1002/adma.201503950, 2015) 2. Blehm, B.H., Devine, A., Staunton J.R., Tanner, K. In Vivo Tissue has Non-linear Rheological Behavior Distinct from 3D Biomimetic Hydrogels as Determined by AMOTIV Microscopy. (Biomaterials 83:66-78, 2016) 3. Staunton J.R, Vieira, W., Fung Leung, K., Lake R Devine, A, Tanner, K, Mechanical properties of the tumor stromal microenvironment probed ex vivo by in situ-calibrated optical trap-based active microrheology (CAMB 9(3):398-417, 2016) 4. Staunton J.R., Blehm, B.H., Devine, A., Tanner, K. In situ calibration of position detection in an optical trap for active microrheology in viscous materials, (Optics Express, In press 2017)

  4. Identification of a Novel Cancer Biomarker | Center for Cancer Research (United States)

    During cancer development, cells accumulate a variety of mutations which alter their normal components and activities. One potential change is in the carbohydrate or sugar polymers which decorate proteins predominately found on the cell surface. The accessibility of these residues makes them ideal targets for the development of diagnostics or therapeutics.

  5. Complementary and Alternative Medicine Use at a Comprehensive Cancer Center. (United States)

    Luo, Qianlai; Asher, Gary N


    Complementary and alternative medicine (CAM) use is common among cancer patients, but the majority of CAM studies do not specify the time periods in relation to cancer diagnoses. We sought to define CAM use by cancer patients and investigate factors that might influence changes in CAM use in relation to cancer diagnoses. We conducted a cross-sectional survey of adults diagnosed with breast, prostate, lung, or colorectal cancer between 2010 and 2012 at the Lineberger Comprehensive Cancer Center. Questionnaires were sent to 1794 patients. Phone calls were made to nonrespondents. Log binomial/Poisson regressions were used to investigate the association between cancer-related changes in CAM use and conversations about CAM use with oncology providers. We received 603 (33.6 %) completed questionnaires. The mean age (SD) was 64 (11) years; 62% were female; 79% were white; and 98% were non-Hispanic. Respondents reported the following cancer types: breast (47%), prostate (27%), colorectal (14%), lung (11%). Eighty-nine percent reported lifetime CAM use. Eighty-five percent reported CAM use during or after initial cancer treatment, with category-specific use as follows: mind-body medicine 39%, dietary supplements 73%, body-based therapies 30%, and energy medicine 49%. During treatment CAM use decreased for all categories except energy medicine. After treatment CAM use returned to pretreatment levels for most CAMs except chiropractic. Initiation of CAM use after cancer diagnosis was positively associated with a patient having a conversation about CAM use with their oncology provider, mainly driven by patient-initiated conversations. Consistent with previous studies, CAM use was common among our study population. Conversations about CAM use with oncology providers appeared to influence cessation of mind-body medicine use after cancer diagnosis.

  6. Unmet Supportive Care Needs of Iranian Cancer Patients and its Related Factors

    Directory of Open Access Journals (Sweden)

    Faranak Jabbarzadeh Tabrizi


    Full Text Available Introduction: Investigation of supportive care needs of cancer patients is important to implement any supportive care programs. There is no relevant studies investigated supportive care needs of Iranian cancer patients and factors affecting such needs. So, the aims of present study were to determine the unmet supportive care needs of Iranian cancer patients and its predictive factors. Methods: In this descriptive- correlational study 274 cancer patients in one referral medical center in North West of Iran participated. For data collection, demographic and cancer related information checklist and Supportive Care Needs Survey (SCNS was used. Logistic regression was used for data analysis of un-adjusted and adjusted Odds Ratios (ORs for patients needs and analysis of variables of study based on Backward LR procedure SPSS Ver.13. Results: More than fifty percent of participants reported unmet needs in 18 items of SCNS. Most frequent unmet needs were related to health system and information domains and most meet needs were related to sexuality and psychological domains. The result of logistic regression identified predictors of each domain of supportive care needs. The variable such as sex, age and living situation were most important predictors of unmet needs. Conclusion: The results showed that Iranian cancer patients have many supportive care needs in different domains. In general female cancer patients are at risk of more unmet supportive care needs. So, health care professionals should be more sensitive to fulfillment of supportive care needs of female.

  7. Fleet Numerical Meteorology and Oceanography Center support for GODAE (United States)

    Dimitriou, D.; Sharfstein, P.; Ignaszewski, M.; Clancy, M.


    The U.S. Navy's Fleet Numerical Meteorology and Oceanography Center (FNMOC; see, located in Monterey, CA, is the lead activity within the U.S. Department of Defense (DoD) for numerical weather prediction and coupled air-sea modeling. FNMOC fulfills this role through means of a suite of sophisticated global and regional meteorological and oceanographic (METOC) models, extending from the top of the atmosphere to the bottom of the ocean, which is supported by one of the world's most complete real-time METOC databases. Fleet Numerical operates around-the-clock, 365 days per year and distributes METOC products to military and civilian users around the world, both ashore and afloat, through a variety of means, including a rapidly growing and innovative use of Web technology. FNMOC's customers include all branches of the Department of Defense (DoD), other government organizations such as the National Weather Service, private companies such as the Weather Channel, a number of colleges and universities, and the general public. FNMOC acquires and processes over 6 million METOC observations per day—creating one of the world's most comprehensive real-time databases of meteorological and oceanographic observations for assimilation into its models. FNMOC employs three primary models, the Navy Operational Global Atmospheric Prediction System (NOGAPS), the Coupled Ocean/Atmosphere Mesoscale Prediction System (COAMPS), and the WaveWatch III model (WW3), along with a number of specialized models and related applications. NOGAPS is a global weather model, driving nearly all other FNMOC models and applications in some fashion. COAMPS is a high-resolution regional model that has proved to be particularly valuable for forecasting weather and ocean conditions in highly complex coastal areas. WW3 is a state-of-the-art ocean wave model that is employed both globally and regionally in support of a wide variety of naval operations. Specialized models support and

  8. Ambulatory infusional cancer chemotherapy: nursing role in patient management. The Cancer Center of Boston. (United States)

    Moore, C; Strong, D; Childress, J; Fougere, B; Gotthardt, S


    The role of nursing in infusional cancer chemotherapy (ICC) may vary depending on the practice setting. Nurses in free-standing centers and office practices perform many duties that nurses in other facilities may not, because of the lack of many of the supports that benefit hospitals with their multidepartmental and hierarchical structures. Nurses function collaboratively with physicians in the planning and the implementation of patient treatment. Patient-related nursing responsibilities include patient/family education, drug preparation and administration, patient assessment for treatment toxicity, recognition and management of complications related to the catheter or infusion device, and telephone triage. Other duties more removed from patient care might include inventory management, research data collection and management, quality assurance and improvement, compliance with regulatory issues, and a myriad of other responsibilities. The transition of patient care to the outpatient setting has broadened the scope of nursing to include nonpatient care responsibilities due to financial constraints brought about by health care reform, changes in reimbursement patterns, and overhead required to maintain and deliver quality patient care. As a result of nursing responsibilities, it becomes paramount that the aforementioned constructs for program support are in place and that all nurses are consistently trained and have a template to follow for patient treatment and management. Nursing ability to perform patient-related tasks should be proven by formal written and practical competencies repeated annually and as procedural changes are implemented. The paragraphs to follow suggest nursing management of patients receiving ICC using a model developed at The Cancer Center of Boston (TCC).

  9. A multilevel intervention to promote colorectal cancer screening among community health center patients: results of a pilot study

    Directory of Open Access Journals (Sweden)

    Fletcher Robert H


    Full Text Available Abstract Background Colorectal cancer screening rates are low among poor and disadvantaged patients. Patient navigation has been shown to increase breast and cervical cancer screening rates, but few studies have looked at the potential of patient navigation to increase colorectal cancer screening rates. Methods The objective was to determine the feasibility and effectiveness of a patient navigator-based intervention to increase colorectal cancer screening rates in community health centers. Patients at the intervention health center who had not been screened for colorectal cancer and were designated as "appropriate for outreach" by their primary care providers received a letter from their provider about the need to be screened and a brochure about colorectal cancer screening. Patient navigators then called patients to discuss screening and to assist patients in obtaining screening. Patients at a demographically similar control health center received usual care. Results Thirty-one percent of intervention patients were screened at six months, versus nine percent of control patients (p Conclusion A patient navigator-based intervention, in combination with a letter from the patient's primary care provider, was associated with an increased rate of colorectal cancer screening at one health center as compared to a demographically similar control health center. Our study adds to an emerging literature supporting the use of patient navigators to increase colorectal cancer screening in diverse populations served by urban health centers.

  10. A multilevel intervention to promote colorectal cancer screening among community health center patients: results of a pilot study (United States)

    Lasser, Karen E; Murillo, Jennifer; Medlin, Elizabeth; Lisboa, Sandra; Valley-Shah, Lisa; Fletcher, Robert H; Emmons, Karen M; Ayanian, John Z


    Background Colorectal cancer screening rates are low among poor and disadvantaged patients. Patient navigation has been shown to increase breast and cervical cancer screening rates, but few studies have looked at the potential of patient navigation to increase colorectal cancer screening rates. Methods The objective was to determine the feasibility and effectiveness of a patient navigator-based intervention to increase colorectal cancer screening rates in community health centers. Patients at the intervention health center who had not been screened for colorectal cancer and were designated as "appropriate for outreach" by their primary care providers received a letter from their provider about the need to be screened and a brochure about colorectal cancer screening. Patient navigators then called patients to discuss screening and to assist patients in obtaining screening. Patients at a demographically similar control health center received usual care. Results Thirty-one percent of intervention patients were screened at six months, versus nine percent of control patients (p < .001). Conclusion A patient navigator-based intervention, in combination with a letter from the patient's primary care provider, was associated with an increased rate of colorectal cancer screening at one health center as compared to a demographically similar control health center. Our study adds to an emerging literature supporting the use of patient navigators to increase colorectal cancer screening in diverse populations served by urban health centers. PMID:19480698

  11. Lipid Biomarkers Identified for Liver Cancer | Center for Cancer Research (United States)

    Hepatocellular carcinoma (HCC) is an aggressive cancer of the liver with poor prognosis and growing incidence in developed countries. Pathology and genetic profiles of HCC are heterogeneous, suggesting that it can begin growing in different cell types. Although human tumors such as HCC have been profiled in-depth by genomics-based studies, not much is known about their overall metabolite modifications and how these changes can form a network that leads to aggressive disease and poor outcome.

  12. The benefits of cancer screening in kidney transplant recipients: a single-center experience. (United States)

    Kato, Taigo; Kakuta, Yoichi; Abe, Toyofumi; Yamanaka, Kazuaki; Imamura, Ryoichi; Okumi, Masayoshi; Ichimaru, Naotsugu; Takahara, Shiro; Nonomura, Norio


    The frequency of malignancy is increasing in kidney transplant recipients. Posttransplant malignancy (PTM) is a major cause of long-term graft survival inhibition. In this study, we evaluated the frequency and prognosis of PTM at our center and examined the efficacy of cancer screening. Between 1972 and 2013, 750 patients were followed-up at our center. Annual physical examinations and screenings were performed to detect PTM. We investigated the detail of two distinctive cancer groups: screening-detected cancers and symptom-detected cancers. Seventy-seven PTM were identified during the follow-up period. The mean age at the initial PTM detection was 43.6 ± 12.8 years. The mean interval from transplantation to cancer diagnosis was 134.5 ± 11.3 months. Among the 77 patients, posttransplant lymphoproliferative disease (PTLD) was the most common cancer (19.5%, 15/77), followed by renal cell carcinoma (15.6%, 12/77). Of the cancer cases, 46.8% (36/77) were detected via screening. The most frequently screening-detected cancer was renal cell carcinoma of the native kidney and breast cancer (22.2%, 8/36). However, it was difficult to detect PTLD, urothelial carcinoma, and colorectal cancer via screening. Interestingly, Cox proportional regression analyses revealed nonscreened recipients to be a significant prognostic factor for PTM (P kidney transplant recipients. These findings support the provision of long-term appropriate screening for kidney transplant recipients. © 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  13. The Organization of European Cancer Institute Pathobiology Working Group and its support of European biobanking infrastructures for translational cancer research. (United States)

    Riegman, Peter H J; de Jong, Bas W D; Llombart-Bosch, Antonio


    Today's translational cancer research increasingly depends on international multi-center studies. Biobanking infrastructure or comprehensive sample exchange platforms to enable networking of clinical cancer biobanks are instrumental to facilitate communication, uniform sample quality, and rules for exchange. The Organization of European Cancer Institutes (OECI) Pathobiology Working Group supports European biobanking infrastructure by maintaining the OECI-TuBaFrost exchange platform and organizing regular meetings. This platform originated from a European Commission project and is updated with knowledge from ongoing and new biobanking projects. This overview describes how European biobanking projects that have a large impact on clinical biobanking, including EuroBoNeT, SPIDIA, and BBMRI, contribute to the update of the OECI-TuBaFrost exchange platform. Combining the results of these European projects enabled the creation of an open (upon valid registration only) catalogue view of cancer biobanks and their available samples to initiate research projects. In addition, closed environments supporting active projects could be developed together with the latest views on quality, access rules, ethics, and law. With these contributions, the OECI Pathobiology Working Group contributes to and stimulates a professional attitude within biobanks at the European comprehensive cancer centers. Improving the fundamentals of cancer sample exchange in Europe stimulates the performance of large multi-center studies, resulting in experiments with the desired statistical significance outcome. With this approach, future innovation in cancer patient care can be realized faster and more reliably.

  14. End-of-life care at a community cancer center. (United States)

    Cowall, David E; Yu, Bennett W; Heineken, Sandra L; Lewis, Elizabeth N; Chaudhry, Vishal; Daugherty, Joan M


    The evidence-based use of resources for cancer care at end of life (EOL) has the potential to relieve suffering, reduce health care costs, and extend life. Internal benchmarks need to be established within communities to achieve these goals. The purpose for this study was to evaluate data within our community to determine our EOL cancer practices. A random sample of 390 patients was obtained from the 942 cancer deaths in Wicomico County, Maryland, for calendar years 2004 to 2008. General demographic, clinical event, and survival data were obtained from that sample using cancer registry and hospice databases as well as manual medical record reviews. In addition, the intensity of EOL cancer care was assessed using previously proposed indicator benchmarks. The significance of potential relationships between variables was explored using χ(2) analyses. Mean age at death was 70 years; 52% of patients were male; 34% died as a result of lung cancer. Median survival from diagnosis to death was 8.4 months with hospice admission and 5.8 months without hospice (P = .11). Four of eight intensity-of-care indicators (ie, intensive care unit [ICU] admission within last month of life, > one hospitalization within last month of life, hospital death, and hospice referral < 3 days before death) all significantly exceeded the referenced benchmarks. Hospice versus nonhospice admissions were associated (P < .001) with ICU admissions (2% v 13%) and hospital deaths (2% v 54%). These data suggest opportunities to improve community cancer center EOL care.

  15. Cancer Survivorship Care: Person Centered Care in a Multidisciplinary Shared Care Model

    Directory of Open Access Journals (Sweden)

    Jacqueline Loonen


    Full Text Available Survivors of childhood and adult-onset cancer are at lifelong risk for the development of late effects of treatment that can lead to serious morbidity and premature mortality. Regular long-term follow-up aiming for prevention, early detection and intervention of late effects can preserve or improve health. The heterogeneous and often serious character of late effects emphasizes the need for specialized cancer survivorship care clinics. Multidisciplinary cancer survivorship care requires a coordinated and well integrated health care environment for risk based screening and intervention. In addition survivors engagement and adherence to the recommendations are also important elements. We developed an innovative model for integrated care for cancer survivors, the “Personalized Cancer Survivorship Care Model”, that is being used in our clinic. This model comprises 1. Personalized follow-up care according to the principles of Person Centered Care, aiming to empower survivors and to support self management, and 2. Organization according to a multidisciplinary and risk based approach. The concept of person centered care is based on three components: initiating, integrating and safeguarding the partnership with the patient. This model has been developed as a universal model of care that will work for all cancer survivors in different health care systems. It could be used for studies to improve self efficacy and the cost-effectiveness of cancer survivorship care.

  16. Eliminating cancer stem cells: an interview with CCR’s Steven Hou | Center for Cancer Research (United States)

    Steven Hou, Ph.D., senior investigator in the Basic Research Laboratory at the Center for Cancer Research describes his latest research that has uncovered potential ways to eliminate cancer stem cells and may offer hope to patients with reoccurring tumors.  Learn more...

  17. Availability and Integration of Palliative Care at United States Cancer Centers (United States)

    Hui, David; Elsayem, Ahmed; De La Cruz, Maxine; Berger, Ann; Zhukovsky, Donna S.; Palla, Shana; Evans, Avery; Fadul, Nada; Palmer, J. Lynn; Bruera, Eduardo


    Context The current state of palliative care in cancer centers is not known. Objective We conducted a survey to determine the availability and degree of integration of palliative care services, and to compare between National Cancer Institute (NCI) and non-NCI cancer centers in the United States. Design, Setting, and Participants Between June and October 2009, we surveyed both executives and palliative care clinical program leaders, where applicable, of 71 NCI cancer centers and a random sample of 71 non-NCI centers regarding their palliative care services. Executives were also asked about their attitudes toward palliative care. Main Outcome Measure Availability of palliative care services in the cancer center, defined as the presence of at least one palliative care physician. Results We sent 142 and 120 surveys to executives and program leaders, with response rates of 71% and 82%, respectively. NCI cancer centers were significantly more likely to have a palliative care program (50/51 (98%) vs. 39/50 (78%), P=0.002), at least one palliative care physician (46/51 (90%) vs. 28/50 (56%), P=0.04), an inpatient palliative care consultation team (47/51 (92%) vs. 28/50 (56%), Ppalliative care clinic (30/51 (59%) vs. 11/50 (22%), Ppalliative care beds (23/101 (23%)) or an institution-operated hospice (37/101 (36%)). The median reported durations from referral to death were 7 (Q1–Q3 4–16), 7 (Q1–Q3 5–10), and 90 (Q1–Q3 30–120) days for inpatient consultation teams, inpatient units, and outpatient clinics, respectively. Research programs, palliative care fellowships, and mandatory rotations for oncology fellows were uncommon. Executives were supportive of stronger integration and increasing palliative care resources. Conclusion Most cancer centers reported a palliative care program, although the scope of services and the degree of integration varied widely. Further efforts to consolidate existing infrastructure and to integrate palliative care in cancer centers

  18. Wnt Inactivation for Liver Cancer Therapy | Center for Cancer Research (United States)

    Hepatocellular carcinoma (HCC) is the fifth most common and third most deadly type of cancer in the world. The majority of cases occur in Asia and Africa, resulting in most cases being diagnosed only at advanced stages of the disease when drug resistance is high. HCC typically follows damage to the liver such as cirrhosis, making radiation and chemotherapy a more challenging prospect. Surgery is also not a very viable option because less than one in four carcinomas can be completely removed. The limitations in these treatment modalities create the need for alternative therapeutic approaches.

  19. Challenges and Opportunities to Improve Cervical Cancer Screening Rates in US Health Centers through Patient-Centered Medical Home Transformation

    Directory of Open Access Journals (Sweden)

    Olga Moshkovich


    Full Text Available Over the last 50 years, the incidence of cervical cancer has dramatically decreased. However, health disparities in cervical cancer screening (CCS persist for women from racial and ethnic minorities and those residing in rural and poor communities. For more than 45 years, federally funded health centers (HCs have been providing comprehensive, culturally competent, and quality primary health care services to medically underserved communities and vulnerable populations. To enhance the quality of care and to ensure more women served at HCs are screened for cervical cancer, over eight HCs received funding to support patient-centered medical home (PCMH transformation with goals to increase CCS rates. The study conducted a qualitative analysis using Atlas.ti software to describe the barriers and challenges to CCS and PCMH transformation, to identify potential solutions and opportunities, and to examine patterns in barriers and solutions proposed by HCs. Interrater reliability was assessed using Cohen’s Kappa. The findings indicated that HCs more frequently described patient-level barriers to CCS, including demographic, cultural, and health belief/behavior factors. System-level barriers were the next commonly cited, particularly failure to use the full capability of electronic medical records (EMRs and problems coordinating with external labs or providers. Provider-level barriers were least frequently cited.

  20. Cancers in Eastern Libya: first results from Benghazi Medical Center. (United States)

    Bodalal, Zuhir; Azzuz, Raouf; Bendardaf, Riyad


    To study the pattern of cancer incidence and determine the incidence rates in Eastern Libya (for the first time in a decade). A hospital-based registry of cancer patients was formed using records from the primary oncology center in eastern Libya - focusing on those diagnosed in the year 2012. The most common malignancies in men were cancers of the colon (22.3%, n = 90), lung (20.3%, n = 82), prostate (16.1%, n = 65), pancreas (4.2%, n = 17) and liver (4.2%, n = 17). For women, they were found to be cancers of the breast (41.5%, n = 213), colon (16.4%, n = 84), uterus (8%, n = 41), ovary (5.5%, n = 28) and pancreas (3.1%, n = 16). Additionally age-standardized rates (ASR) were determined for Libya. The different cities and towns in eastern Libya were compared for any variation. The city of Beida in particular was found to have a remarkably high incidence of gastric cancer. The different findings were discussed and comparisons were made with past literature as well as the incidence rates for neighbouring countries. The incidence rates given for the eastern region showed differences from previously reported values (i.e., the rate of colon cancer was the highest in North Africa whereas other malignancies occurred less frequently). Potential explanations for the urban-rural difference as well as the difference in incidence rates were put forth. The significance of this study is that it establishes a baseline of cancer incidence which should be the backbone for any future national cancer plan in Libya. Proper surveillance programs need to be in place and healthcare policy should be adjusted to take into account the more prevalent and pressing cancers in society.

  1. Internet Support and Information for Women with Breast Cancer

    National Research Council Canada - National Science Library

    Owen, Jason


    A large body of literature indicates that psychosocial support interventions for cancer patients, which provide specific cognitive-behavioral and coping skills training, are effective in the reduction...

  2. What are cancer centers advertising to the public?: a content analysis. (United States)

    Vater, Laura B; Donohue, Julie M; Arnold, Robert; White, Douglas B; Chu, Edward; Schenker, Yael


    Although critics have expressed concerns about cancer center advertising, analyses of the content of these advertisements are lacking. To characterize the informational and emotional content of direct-to-consumer cancer center advertisements. Content analysis. Top U.S. consumer magazines (n = 269) and television networks (n = 44) in 2012. Types of clinical services promoted; information provided about clinical services, including risks, benefits, costs, and insurance availability; use of emotional advertising appeals; and use of patient testimonials were assessed. Two investigators independently coded advertisements using ATLAS.ti, and κ values ranged from 0.77 to 1.00. A total of 102 cancer centers placed 409 unique clinical advertisements in top media markets in 2012. Advertisements promoted treatments (88%) more often than screening (18%) or supportive services (13%). Benefits of advertised therapies were described more often than risks (27% vs. 2%) but were rarely quantified (2%). Few advertisements mentioned coverage or costs (5%), and none mentioned specific insurance plans. Emotional appeals were frequent (85%), evoking hope for survival (61%), describing cancer treatment as a fight or battle (41%), and inducing fear (30%). Nearly one half of advertisements included patient testimonials, which were usually focused on survival, rarely included disclaimers (15%), and never described the results that a typical patient may expect. Internet advertisements were not included. Clinical advertisements by cancer centers frequently promote cancer therapy with emotional appeals that evoke hope and fear while rarely providing information about risks, benefits, costs, or insurance availability. Further work is needed to understand how these advertisements influence patient understanding and expectations of benefit from cancer treatments. National Institutes of Health.

  3. Center of Excellence for Individuation of Therapy for Breast Cancer (United States)


    Faulds, 1994]. Like other vinca-alkaloids it may interfere with amino acid, cyclic AMP and glutathione metabolism as well as with calmodulin...immunofluorescence. Semin Oncol 16: 5-8 Bunting KD, Lindahl R, Townsend AJ (1994) Oxazaphosphorine-specific resistance in human MCF-7 breast carcinoma cell...SUPPLEMENTARY NOTES 14. ABSTRACT During the most recent period the Center of Excellence continued to collect and process human breast cancer tissues for

  4. [Out-Patient Psychosocial Cancer Counseling Centers and their Clients - Services Provided and Service Utilization by Patients and Patients' Relatives]. (United States)

    Giesler, JürgenM; Weis, Joachim; Schreib, Melanie; Eichhorn, Svenja; Kuhnt, Susanne; Faust, Tanja; Mehnert, Anja; Ernst, Jochen


    Psychosocial cancer counseling centers represent an increasingly important part of comprehensive psychosocial cancer care. Research on the services provided by those centers is sparse, however, as is research on person-, disease-, and treatment-related characteristics of their clients. Therefore, the present study analyzes the services provided by 26 psychosocial cancer counseling centers temporarily being funded by the German Cancer Aid as well as selected characteristics of their clients. Analyses are based on data collected during 2011 by means of a documentation system specifically designed for the purposes of psychosocial cancer counseling. Testing focuses on whether cancer patients and cancer patients' relatives differ with respect to various characteristics and the services used. The results show that psychosocial and benefit counseling represent a major part of counseling services, followed by giving information and employing relaxation techniques. Clients seek counseling primarily in early phases of disease and treatment. Women with breast cancer are over-represented among clients. Analyses also reveal significant differences between cancer patients and patients' relatives. Psychotherapeutic interventions and grief-counseling are more frequent in counseling relatives, whereas benefit counseling is more frequent in working with patients. The results emphasize the relevance of outpatient psychosocial cancer counseling. They may also help support initiatives aiming at establishing psychosocial cancer counseling targeted to the needs of each individual client. © Georg Thieme Verlag KG Stuttgart · New York.

  5. CHDS Supports Fusion Centers Leaders in Child Sex Trafficking Workshop


    Center for Homeland Defense and Security


    Center for Homeland Defense and Security News and Stories, PRESS RELEASES Fusion centers could serve as a central hub in assisting law enforcement fight child sex trafficking. That was one recommendation stemming from a joint meeting of IACP’s Child Sex Trafficking...

  6. Directory of Federally Supported Information Analysis Centers, 1979. Fourth Edition. (United States)


    biomedicine, primatology , and animal behavior. Supervisor: Dr. Alberta B. Ross MISSION: To provide literature-based in- SPONSORS: The Center is...Energy. institutions. YEAR STARTED: 1965. SCOPE: The Center’s bibliographic data base covers primatology , biomedical sciences, STAFt : Full-time: 2

  7. Perceived social support in African American breast cancer patients: Predictors and effects. (United States)

    Thompson, Tess; Pérez, Maria; Kreuter, Matthew; Margenthaler, Julie; Colditz, Graham; Jeffe, Donna B


    Social support plays an important role in quality of life and health outcomes after breast cancer diagnosis and treatment. To examine changes in perceived social support in African American women during the two years following a new breast cancer diagnosis. This secondary analysis uses data collected from 2009 to 2015 from 227 newly diagnosed, African American women with breast cancer (mean age 56 [SD = 10], 59% household income social support (measured by the Medical Outcomes Study Social Support Survey) as well as correlates of baseline levels of social support and predictors of change in individuals' social support. Additional analyses examined whether change in social support over the first year affected depressive symptoms (Center for Epidemiologic Studies Depression Scale) and general health perceptions (RAND SF-36 subscale) at two years. Being married, reporting greater spirituality, and reporting fewer depressive symptoms at baseline were significantly associated with higher initial levels of perceived social support. Women whose social support declined during the first year after diagnosis reported more severe depressive symptoms and worse general health perceptions at two years. Clinicians should periodically assess perceived social support among African American women with breast cancer to help find support resources for those who have low initial social support and for those whose support declines in the first year after diagnosis. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. [Synchronous bilateral breast cancer: experiences in the Mohammed VI Cancer Treatment Center, CHU Ibn Rochd, Casablanca]. (United States)

    Khalil, Ahmadaye Ibrahim; Bendahhou, Karima; Mestaghanmi, Houriya; Saile, Rachid; Benider, Abdellatif


    Synchronous bilateral breast cancers (SBBC) are characterized by extensive clinical and morphological heterogeneity, with an frequency between 1.5 and 3.2%. Women treated for unilateral breast cancer are at higher risk of developing contralateral breast cancer. Screening and advances in breast imaging have improved detection rates of SBBC. Our study aims to analyze the epidemiological, clinical, histological and therapeutic features of bilateral breast cancer. We conducted a cross-sectional study of patients with breast cancer treated at the Mohammed VI Center over a two year period. Statistical analysis of the results was performed using R. software. 31 patients had SBBC, representing 2.4% of breast cancer cases in our Center. The average age was 47.8 ± 8.4 years, 22.6% of patients used oral contraceptives. A family history of breast cancer was observed in 22.6% of cases. The most common histological type was invasive ductal carcinoma (58.1%), SBR grade II and III were common (38.7%). Hormone receptors were positive for progesterone (38.7%) and for estrogen (41.9%). HER2 was overexpressed in 20.0% of cases. 29.0% of patients received hormonal therapy and 3.2% targeted therapies. Our study showed that bilateral breast cancer represents a small percentage of all breast cancers but have specific clinical features that help to differentiate it from unilateral breast cancer.

  9. Studies on retrospective analysis of leading primary cancers and improvement of cancer treatment method in Korea cancer center hospital

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong In; Lee, Kang Hyun; Choi, Soo Yong; Kim, Ki Wha; Kang, Sung Mok


    a. Retrospective studies included cancers of the stomach, breast, bladder, salivary gland, thyroid, esophagus, endometrium and ovary. (1) Study cancers were analyzed about clinical characteristics, prognostic factors influenced on survival time, survival rate, etc. (2) Among 5,305 study patients, 1,405(26.5%) were identified with death, 3,485(65.7%) were alive and 415(7.8%) were not identified. b. Prospective studies included 10 subjects such as bladder cancer, retinoblastoma, malignant patients, gastric cancer, uterine cervix cancer and ovary cancer. We are continuing registering eligible study patients. c. Results for 11 papers were published at the journal. d. We established follow-up system in order to identify the survival for study subjects through National Statistical Office, Government Provincial Office and Cancer Registration System at Korea Cancer Center Hospital. e. At present, we are establishing computerized registration system about case report form for study cancers.

  10. Extending Comprehensive Cancer Center Expertise in Clinical Cancer Genetics and Genomics to Diverse Communities: The power of partnership (United States)

    MacDonald, Deborah J.; Blazer, Kathleen R.; Weitzel, Jeffrey N.


    Rapidly evolving genetic and genomic technologies for genetic cancer risk assessment (GCRA) are revolutionizing our approach to targeted therapy and cancer screening and prevention, heralding the era of personalized medicine. Although many academic medical centers provide GCRA services, most people receive their medical care in the community setting. Yet, few community clinicians have the knowledge or time needed to adequately select, apply and interpret genetic/genomic tests. This article describes alternative approaches to the delivery of GCRA services, profiling the City of Hope Cancer Screening & Prevention Program Network (CSPPN) academic and community-based health center partnership as a model for the delivery of the highest quality evidence-based GCRA services while promoting research participation in the community setting. Growth of the CSPPN was enabled by information technology, with videoconferencing for telemedicine and web conferencing for remote participation in interdisciplinary genetics tumor boards. Grant support facilitated the establishment of an underserved minority outreach clinic in the regional County hospital. Innovative clinician education, technology and collaboration are powerful tools to extend GCRA expertise from a NCI-designated Comprehensive Cancer Center, enabling diffusion of evidenced-base genetic/genomic information and best practice into the community setting. PMID:20495088

  11. Patient-Centered Care in Breast Cancer Genetic Clinics. (United States)

    Brédart, Anne; Anota, Amélie; Dick, Julia; Kuboth, Violetta; Lareyre, Olivier; De Pauw, Antoine; Cano, Alejandra; Stoppa-Lyonnet, Dominique; Schmutzler, Rita; Dolbeault, Sylvie; Kop, Jean-Luc


    With advances in breast cancer (BC) gene panel testing, risk counseling has become increasingly complex, potentially leading to unmet psychosocial needs. We assessed psychosocial needs and correlates in women initiating testing for high genetic BC risk in clinics in France and Germany, and compared these results with data from a literature review. Among the 442 counselees consecutively approached, 212 (83%) in France and 180 (97%) in Germany, mostly BC patients (81% and 92%, respectively), returned the 'Psychosocial Assessment in Hereditary Cancer' questionnaire. Based on the Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) BC risk estimation model, the mean BC lifetime risk estimates were 19% and 18% in France and Germany, respectively. In both countries, the most prevalent needs clustered around the "living with cancer" and "children-related issues" domains. In multivariate analyses, a higher number of psychosocial needs were significantly associated with younger age (b = -0.05), higher anxiety (b = 0.78), and having children (b = 1.51), but not with country, educational level, marital status, depression, or loss of a family member due to hereditary cancer. These results are in line with the literature review data. However, this review identified only seven studies that quantitatively addressed psychosocial needs in the BC genetic counseling setting. Current data lack understandings of how cancer risk counseling affects psychosocial needs, and improves patient-centered care in that setting.

  12. Challenges Implementing Lung Cancer Screening in Federally Qualified Health Centers. (United States)

    Zeliadt, Steven B; Hoffman, Richard M; Birkby, Genevieve; Eberth, Jan M; Brenner, Alison T; Reuland, Daniel S; Flocke, Susan A


    The purpose of this study is to identify issues faced by Federally Qualified Health Centers (FQHCs) in implementing lung cancer screening in low-resource settings. Medical directors of 258 FQHCs serving communities with tobacco use prevalence above the median of all 1,202 FQHCs nationally were sampled to participate in a web-based survey. Data were collected between August and October 2016. Data analysis was completed in June 2017. There were 112 (43%) FQHC medical directors or surrogates who responded to the 2016 survey. Overall, 41% of respondents were aware of a lung cancer screening program within 30 miles of their system's largest clinic. Although 43% reported that some providers in their system offer screening, it was typically at a very low volume (less than ten/month). Although FQHCs are required to collect tobacco use data, only 13% indicated that these data can identify patients eligible for screening. Many FQHCs reported important patient financial barriers for screening, including lack of insurance (72%), preauthorization requirements (58%), and out-of-pocket cost burdens for follow-up procedures (73%). Only 51% indicated having adequate access to specialty providers to manage abnormal findings, and few reported that leadership had either committed resources to lung cancer screening (12%) or prioritized lung cancer screening (12%). FQHCs and other safety-net clinics, which predominantly serve low-socioeconomic populations with high proportions of smokers eligible for lung cancer screening, face significant economic and resource challenges to implementing lung cancer screening. Although these vulnerable patients are at increased risk for lung cancer, reducing patient financial burdens and appropriately managing abnormal findings are critical to ensure that offering screening does not inadvertently lead to harm and increase disparities. Published by Elsevier Inc.

  13. A pilot study into the therapeutic effects of music therapy at a cancer help center. (United States)

    Burns, S J; Harbuz, M S; Hucklebridge, F; Bunt, L


    Since the mid-1980s, music therapy has been a regular feature of the residential program at the internationally renowned Bristol Cancer Help Centre, United Kingdom. Music therapy complements other therapeutic interventions available to residents at the center. To compare the therapeutic effects of listening to music in a relaxed state with the active involvement of music improvisation (the playing of tuned and untuned percussion instruments) in a music therapy group setting and to investigate the potential influence of music therapy on positive emotions and the immune system of cancer patients. A quantitative pre-posttest, psychological/physiological measures, and qualitative focus group design. A cancer help center that offers a fully integrated range of complementary therapies, psychological support, spiritual healing, and nutritional and self-help techniques addressing the physical, mental, emotional, and spiritual needs of cancer patients and their supporters. Twenty-nine cancer patients, aged 21 to 68 years. Group music therapy interventions of listening to recorded/live music in a relaxed state and improvisation. Increased well-being and relaxation and less tension during the listening experience. Increased well-being and energy and less tension during improvisation. Increased levels of salivary immunoglobulin A and decreased levels of cortisol in both experiences. Psychological data showed increased well-being and relaxation as well as altered energy levels in both interventions. Physiological data showed increased salivary immunoglobulin A in the listening experience and a decrease in cortisol levels in both interventions over a 2-day period. Preliminary evidence of a link between positive emotions and the immune system of cancer patients was found. These findings, which link listening to music in a relaxed state and improvisation to alterations in psychological and physiological parameters, may provide a better understanding of the effectiveness of music

  14. Going the Extra Mile: Improved Survival for Pancreatic Cancer Patients Traveling to High-volume Centers. (United States)

    Lidsky, Michael E; Sun, Zhifei; Nussbaum, Daniel P; Adam, Mohamed A; Speicher, Paul J; Blazer, Dan G


    This study compares outcomes following pancreaticoduodenectomy (PD) for patients treated at local, low-volume centers and those traveling to high-volume centers. Although outcomes for PD are superior at high-volume institutions, not all patients live in proximity to major medical centers. Theoretical advantages for undergoing surgery locally exist. The 1998 to 2012 National Cancer Data Base was queried for T1-3N0-1M0 pancreatic adenocarcinoma patients who underwent PD. Travel distances to treatment centers were calculated. Overlaying the upper and lower quartiles of travel distance with institutional volume established short travel/low-volume (ST/LV) and long travel/high-volume (LT/HV) cohorts. Overall survival was evaluated. Of 7086 patients, 773 ST/LV patients traveled ≤6.3 (median 3.2) miles to centers performing ≤3.3 PDs yearly, and 758 LT/HV patients traveled ≥45 (median 97.3) miles to centers performing ≥16 PDs yearly. LT/HV patients had higher stage disease (P travel to a high-volume center remained associated with reduced long-term mortality (hazard ratio 0.75, P travel burden, patients treated at high-volume centers had improved perioperative outcomes, short-term mortality, and overall survival. These data support ongoing efforts to centralize care for patients undergoing PD.

  15. CGH Supports World Cancer Day Every Day (United States)

    We celebrate World Cancer Day every year on February 4th. This year the theme “We can. I can.” invites us to think not only about how we can work with one another to reduce the global burden of cancer, but how we as individuals can make a difference. Every day the staff at CGH work to establish and build upon programs that are aimed at improving the lives of people affected by cancer.

  16. Computer support for cooperative tasks in Mission Operations Centers

    Energy Technology Data Exchange (ETDEWEB)

    Fox, J. [Pacific Northwest Lab., Richland, WA (United States); Moore, M. [National Aeronautics and Space Administration, Greenbelt, MD (United States). Goddard Space Flight Center


    Traditionally, spacecraft management has been performed by fixed teams of operators in Mission Operations Centers. The team cooperatively (1) ensures that payload(s) on spacecraft perform their work and (2) maintains the health and safety of the spacecraft through commanding and monitoring the spacecraft`s subsystems. In the future, the task demands will increase and overload the operators. This paper describes the traditional spacecraft management environment and describes a new concept in which groupware will be used to create a Virtual Mission Operations Center. Groupware tools will be used to better utilize available resources through increased automation and dynamic sharing of personnel among missions.

  17. Assessing Patient-Centered Communication in Cancer Care: Stakeholder Perspectives (United States)

    Mazor, Kathleen M.; Gaglio, Bridget; Nekhlyudov, Larissa; Alexander, Gwen L.; Stark, Azadeh; Hornbrook, Mark C.; Walsh, Kathleen; Boggs, Jennifer; Lemay, Celeste A.; Firneno, Cassandra; Biggins, Colleen; Blosky, Mary Ann; Arora, Neeraj K.


    Purpose: Patient-centered communication is critical to quality cancer care. Effective communication can help patients and family members cope with cancer, make informed decisions, and effectively manage their care; suboptimal communication can contribute to care breakdowns and undermine clinician-patient relationships. The study purpose was to explore stakeholders' views on the feasibility and acceptability of collecting self-reported patient and family perceptions of communication experiences while receiving cancer care. The results were intended to inform the design, development, and implementation of a structured and generalizable patient-level reporting system. Methods: This was a formative, qualitative study that used semistructured interviews with cancer patients, family members, clinicians, and leaders of health care organizations. The constant comparative method was used to identify major themes in the interview transcripts. Results: A total of 106 stakeholders were interviewed. Thematic saturation was achieved. All stakeholders recognized the importance of communication and endorsed efforts to improve communication during cancer care. Patients, clinicians, and leaders expressed concerns about the potential consequences of reports of suboptimal communication experiences, such as damage to the clinician-patient relationship, and the need for effective improvement strategies. Patients and family members would report good communication experiences in order to encourage such practices. Practical and logistic issues were identified. Conclusion: Patient reports of their communication experiences during cancer care could increase understanding of the communication process, stimulate improvements, inform interventions, and provide a basis for evaluating changes in communication practices. This qualitative study provides a foundation for the design and pilot testing of such a patient reporting system. PMID:23943884

  18. Work adjustment of cancer survivors: An organisational support framework

    Directory of Open Access Journals (Sweden)

    Loraine Clur


    Full Text Available Orientation: Medical advancements increase incidents of cancer survivors returning to work. Work adjustment of cancer survivors is essential for job satisfaction and productivity and should be supported and facilitated by the organisation.Research purpose: The purpose of the study was to explore cancer survivors’ return to work experience in order to explicate organisational support needed to facilitate their successful work adjustment.Motivation for the study: Despite the growing awareness of cancer survivorship, the challenges, expectations and management of the return to work process remain under researched.Research approach, design and method: Heidegger’s hermeneutic phenomenology formed the methodological foundation to the study. Purposive sampling was used to select eight participants from an oncology unit and cancer support organisation in the Southern Cape and Little Karoo regions. Participants, diagnosed with various types of cancer, were regarded as cancer survivors as they completed treatment and have returned to work. Data were collected using unstructured interviews and analysed through thematic analysis based on Ricoeur’s hermeneutic phenomenological theory of interpretation.Main findings: Results highlight four themes representing cancer survivors’ needs for organisational support. The support needs are presented in the context of the theory of work adjustment in a hierarchical schema that evolves from a basic need for emotion-focussed support to the need for knowledge and for practical guidance. Support needs culminate in the need for self-actualisation through meaning-making. An organisational support framework is proposed consisting of four integrated functions aimed at addressing the needs that emerged from the data.Practical and managerial implications: The organisational support framework provides guidance to develop an organisational policy and intervention strategy aimed at managing the successful work adjustment

  19. Expectations and reality: perceptions of support among African American breast cancer survivors. (United States)

    Felder, Tisha M; Estrada, Robin Dawson; Quinn, Jada C; Phelps, Kenneth W; Parker, Pearman D; Heiney, Sue P


    The experience of an illness such as breast cancer is not a static event. Just as physiological needs change as a patient transitions through diagnosis, treatment, to long-term survivorship, so too will their needs for social support. We applied a transitions theory framework to explore how African American women with breast cancer conceptualized and experienced support along their breast cancer journey. We recruited 16 African American women with breast cancer from a regional cancer center in South Carolina to complete qualitative, semi-structured interviews. We iteratively examined verbatim transcripts using thematic analysis. Three core themes emerged: 'I guess she was supposed to': When support meets patient expectations; 'I wasn't expecting that and that just made me feel so good': When reality exceeds expectations; and 'Don't try to make an invalid out of me': When support given wasn't what was desired. Survivors shared how their family, friends and clergy met their needs for emotional (e.g. prayer, sharing affirmations about God) and instrumental support (e.g. cooking meals, house cleaning). They emphasized how receiving emotional support from their healthcare providers was a pleasant surprise. However, survivors also described unexpected disappointments when family members offered support that was un-needed or un-desired. Applying transitions theory, we found that social support is a process of bidirectional negotiation where African American women with breast cancer perceive support as helpful and acceptable depending on who offers support, what type of support is offered, and when it is offered. Members of their social support network (e.g. family, friends, providers) should periodically assess the survivor's evolving needs to ensure the social support harmonizes with the needs and expectations of the survivor.

  20. [Quality management in oncology supported by clinical cancer registries]. (United States)

    Klinkhammer-Schalke, Monika; Gerken, Michael; Barlag, Hagen; Tillack, Anett


    Efforts in nationwide quality management for oncology have so far failed to comprehensively document all levels of care. New organizational structures such as population-based clinical cancer registries or certified organ cancer centers were supposed to solve this problem more sufficiently, but they have to be accompanied by valid trans-sectoral documentation and evaluation of clinical data. To measure feasibility and qualitative effectiveness of guideline implementation we approached this problem with a nationwide investigation from 2000 to 2011. The rate of neoadjuvant radio/chemotherapy in stage UICC II/III rectum cancer, cut-off point 80% for separating good from insufficient quality, was used as a quality indicator. The nationwide analysis indicates an increase from 45% to 70%, but only with the implementation strategy of CME. The combination of new structures, evidence-based quality indicators, organ cancer center and clinical cancer registries has shown good feasibility and seems promising. Copyright © 2015. Published by Elsevier GmbH.

  1. Statistical Analysis of Research Data | Center for Cancer Research (United States)

    Recent advances in cancer biology have resulted in the need for increased statistical analysis of research data. The Statistical Analysis of Research Data (SARD) course will be held on April 12-13, 2017 from 9:00 AM – 5:00 PM at the Natcher Conference Center, Balcony A on the Bethesda campus. SARD is designed to provide an overview of the general principles of statistical analysis of research data. The course will be taught by Paul W. Thurman of Columbia University.

  2. Theorizing about social support and health communication in a prostate cancer support group. (United States)

    Arrington, Michael Irvin


    This article inquires into whether and how uncertainty reduction theory and problematic integration theory, two theories relevant to social support as enacted within a chapter of the Man-to-Man prostate cancer support group, inform us of how such groups can assist group members most effectively. Interview data from members of a prostate cancer support group shed light on theoretical assumptions about uncertainty. Although the group applies elements of both theories, prostate cancer survivors likely would benefit from a more comprehensive and flexible treatment of social support theory.

  3. Engineering Technical Support Center Annual Report Fiscal Year 2016 (United States)

    This report highlights significant projects that the ETSC supported in fiscal year 2016. These projects have addressed an array of environmental scenarios, including, but not limited to remote mining contamination, expansive landfill waste, cumulative impacts from multiple contam...

  4. VHA Support Service Center Primary Care Management Module (PCMM) (United States)

    Department of Veterans Affairs — The Primary Care Management Module (PCMM) was developed to assist VA facilities in implementing Primary Care. PCMM supports both Primary Care and non-Primary Care...

  5. Evaluating long-term patient-centered outcomes following prostate cancer treatment: findings from the Michigan Prostate Cancer Survivor study. (United States)

    Darwish-Yassine, May; Berenji, Manijeh; Wing, Diane; Copeland, Glenn; Demers, Raymond Y; Garlinghouse, Carol; Fagerlin, Angela; Newth, Gail E; Northouse, Laurel; Holmes-Rovner, Margaret; Rovner, David; Sims, Jerry; Wei, John T


    Advances in screening and treatment of prostate cancer have dramatically increased the number of survivors in the US population. Yet the effect of screening is controversial, and in some instances may not be beneficial. Previous studies have typically only reported outcomes of treatment and symptoms within a short time frame following treatment. The persistence of such symptoms over time necessitates an improvement of survivor care so that the medical and support needs of these patients are met. This study aims to perform a patient-centered survey of prostate cancer survivors in the Michigan Cancer Registry to identify treatment side effect rates, evaluate survivors' access to preventive care services post-prostate cancer treatment, and assess the informational needs of these survivors regarding their prostate cancer. Linking case files of the Michigan Cancer Registry with records from the National Death Index, we identified prostate cancer patients diagnosed between 1985 and 2004 and alive on 31 December 2005. Participants were selected using a stratified cross-sectional sampling strategy to ensure adequate inclusion of survivors based upon race and ethnicity, urban versus rural location, and number of years since diagnosis of prostate cancer. A total of 2,499 surveys were completed and returned. (1) Physical symptoms--assessing bowel, sexual, urinary, and vitality symptoms by treatment modality. (2) Access to care--identifying whether diagnostic tests for prostate cancer (prostate-specific antigen (PSA) and digital rectal examination) were performed. Determining whether the survivors had knowledge of the "watchful waiting" paradigm for prostate cancer surveillance. (3) Informational needs--assessing whether the informational needs of patients were addressed by providers. Evaluating the significant predictors associated with seeking information about prostate cancer from any other source. Identifying what factors influenced a person to actively seek out

  6. Telephone peer support for women with gynaecological cancer: benefits and challenges for supporters. (United States)

    Pistrang, Nancy; Jay, Zara; Gessler, Sue; Barker, Chris


    Despite the prevalence of one-to-one peer support programmes for people with cancer, little research has examined its impact on the supporters themselves. This qualitative study examined a telephone-delivered one-to-one peer support intervention for women with gynaecological cancer, focussing on supporters' subjective experiences of benefits or costs to themselves and challenges arising in the support process. Semi-structured interviews (N = 24) were conducted with 16 women who provided peer support for 24 patients. Transcripts were analysed thematically using the Framework approach. Participants described significant personal benefits of providing support, including enhanced self-esteem and well-being, and gaining a new perspective and closure on their cancer experience. They experienced no adverse consequences, but several challenges arose, for example, finding a balance between emotional involvement and detachment, and supporting someone with a poor prognosis or high levels of negative emotion. Their accounts indicated resourcefulness in managing the challenges. Providing peer support has a valuable role to play in cancer survivorship; it can facilitate the final stages of moving away from the role of patient and help to promote a more confident post-cancer sense of self. However, readiness to provide support and the availability of backup from health-care professionals appear essential. The findings have implications for the selection, training and supervision of peer supporters. Future studies should routinely measure outcomes for peer supporters. Copyright © 2012 John Wiley & Sons, Ltd.

  7. Factors That Contribute to Community Members' Support of Local Nature Centers (United States)

    Browning, Matthew H. E. M.; Stern, Marc J.; Ardoin, Nicole M.; Heimlich, Joe E.


    Nature centers can serve as valuable community institutions if they are seen as providing important services to the community. Through survey research in communities surrounding 16 nature centers in the United States, we examine the attitudes, behaviors, and beliefs that drive hypothetical support for nature centers from local residents.…

  8. Pain Control: Support for People with Cancer (United States)

    ... do, this booklet includes tips about managing your pain with medicine and other treatments. PDF Kindle ePub This booklet covers: The types and causes of cancer pain How to talk about your pain with your ...

  9. Hypothesis generation using network structures on community health center cancer-screening performance. (United States)

    Carney, Timothy Jay; Morgan, Geoffrey P; Jones, Josette; McDaniel, Anna M; Weaver, Michael T; Weiner, Bryan; Haggstrom, David A


    Nationally sponsored cancer-care quality-improvement efforts have been deployed in community health centers to increase breast, cervical, and colorectal cancer-screening rates among vulnerable populations. Despite several immediate and short-term gains, screening rates remain below national benchmark objectives. Overall improvement has been both difficult to sustain over time in some organizational settings and/or challenging to diffuse to other settings as repeatable best practices. Reasons for this include facility-level changes, which typically occur in dynamic organizational environments that are complex, adaptive, and unpredictable. This study seeks to understand the factors that shape community health center facility-level cancer-screening performance over time. This study applies a computational-modeling approach, combining principles of health-services research, health informatics, network theory, and systems science. To investigate the roles of knowledge acquisition, retention, and sharing within the setting of the community health center and to examine their effects on the relationship between clinical decision support capabilities and improvement in cancer-screening rate improvement, we employed Construct-TM to create simulated community health centers using previously collected point-in-time survey data. Construct-TM is a multi-agent model of network evolution. Because social, knowledge, and belief networks co-evolve, groups and organizations are treated as complex systems to capture the variability of human and organizational factors. In Construct-TM, individuals and groups interact by communicating, learning, and making decisions in a continuous cycle. Data from the survey was used to differentiate high-performing simulated community health centers from low-performing ones based on computer-based decision support usage and self-reported cancer-screening improvement. This virtual experiment revealed that patterns of overall network symmetry, agent

  10. Understanding Preschool Teachers’ Emotional Support as a Function of Center Climate

    Directory of Open Access Journals (Sweden)

    Katherine M. Zinsser


    Full Text Available There is great emphasis recently on improving the quality of early childhood education in the United States. Within quality rating improvement systems, classroom quality is often reported at the center or program levels. Yet little is known about teaching quality at the center level or the influence of center characteristics on teaching quality. Specifically, this study examines the extent to which the quality of emotional support provided by the teacher is associated with characteristics of the center (e.g., prior turnover rates and center director (e.g., education, management practices. Findings from Head Start Family and Child Experiences Survey (FACES 2009 data indicated that emotional support dimensions were differentially predicted by characteristics of the center and the director, including prior teacher turnover rate and director job satisfaction. However, highly regulated indicators of center quality (e.g., student:teacher ratio did not substantially explain emotional support.

  11. 75 FR 11936 - Hewlett Packard; Technical Support Call Center; Boise, ID; Notice of Termination of Investigation (United States)


    ... Employment and Training Administration Hewlett Packard; Technical Support Call Center; Boise, ID; Notice of... was initiated in response to a petition filed on November 16, 2009 on behalf of workers Hewlett Packard, Technical Support Call Center, Boise, Idaho. The petitioner has requested that the petition be...

  12. Adaptive work-centered and human-aware support agents for augmented cognition in tactical environments

    NARCIS (Netherlands)

    Neef, R.M.; Maanen, P.P. van; Petiet, P.; Spoelstra, M.


    We introduce a support system concept that offers both work-centered and human-aware support for operators in tactical command and control environments. The support system augments the cognitive capabilities of the operator by offering instant, personalized task and work support. The operator

  13. Disparities in Geographic Accessibility of National Cancer Institute Cancer Centers in the United States. (United States)

    Xu, Yanqing; Fu, Cong; Onega, Tracy; Shi, Xun; Wang, Fahui


    The National Cancer Institute (NCI) Cancer Centers form the backbone of the cancer care system in the United States since their inception in the early 1970s. Most studies on their geographic accessibility used primitive measures, and did not examine the disparities across urbanicity or demographic groups. This research uses an advanced accessibility method, termed "2-step floating catchment area (2SFCA)" and implemented in Geographic Information Systems (GIS), to capture the degree of geographic access to NCI Cancer Centers by accounting for competition intensity for the services and travel time between residents and the facilities. The results indicate that urban advantage is pronounced as the average accessibility is highest in large central metro areas, declines to large fringe metro, medium metro, small metro, micropolitan and noncore rural areas. Population under the poverty line are disproportionally concentrated in lower accessibility areas. However, on average Non-Hispanic White have the lowest geographic accessibility, followed by Hispanic, Non-Hispanic Black and Asian, and the differences are statistically significant. The "reversed racial disadvantage" in NCI Cancer Center accessibility seems counterintuitive but is consistent with an influential prior study; and it is in contrast to the common observation of co-location of concentration of minority groups and people under the poverty line.

  14. TTI Phase 2 Institutional Support: Center for Study of Science ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    IDRC is investing in local solutions to address climate change-related challenges in India, including heat stress, water management, and climate-related ... IDRC has signed a Memorandum of Understanding (MoU) with the Government of India that enables Canada to continue supporting important research in India.

  15. Supportive and Palliative Care Research | Division of Cancer Prevention (United States)

    Supportive and palliative care research includes studies to prevent or treat the acute and chronic symptoms and morbidities related to cancer and its treatment, and to examine the effects of cancer and its treatment on quality of life and psychosocial issues and treatment strategies at the end of life. Active Projects can range from caregiver issues to geriatrics, physical functioning to cognitive dysfunction. | Examining symptoms and morbidities related to cancer, its treatment, quality of life and end of life.

  16. About Supportive and Palliative Care Research | Division of Cancer Prevention (United States)

    The program supports research in three areas: prevention or treatment of acute or chronic symptoms and morbidities related to cancer, its treatment and caregiving (symptom management research); effects on quality of life from cancer, its treatment and caregiving (quality of life research); and end-of-life psychosocial issues, caregiving and treatment strategies (end-of-life research). |

  17. Choices: An Interactive Decision Support Program for Breast Cancer Treatment

    National Research Council Canada - National Science Library

    Pierce, Penny Fay


    This project is developing a computer-assisted prototype of an individualized decision support system, called Choices, to assist women newly diagnosed with breast cancer in making stressful treatment...

  18. Chemotherapy and You: Support for People with Cancer (United States)

    ... Terms Blogs and Newsletters Health Communications Publications Reports Chemotherapy and You: Support for People With Cancer Chemotherapy ... ePub This booklet covers: Questions and answers about chemotherapy. Answers common questions, such as what chemotherapy is ...

  19. Radiation Therapy and You: Support for People with Cancer (United States)

    ... Terms Blogs and Newsletters Health Communications Publications Reports Radiation Therapy and You: Support for People With Cancer ... Copy This booklet covers: Questions and Answers About Radiation Therapy. Answers common questions, such as what radiation ...

  20. Latina Breast Cancer Patients and Their Informal Support System

    National Research Council Canada - National Science Library

    Hayes-Bautista, David


    The purpose of this research project is to understand the influence of Latino culture in breast cancer treatment, by developing a conceptual model of the informal support system utilized by 60 triads...

  1. Cancer survivors' disclosure of complementary health approaches to physicians: the role of patient-centered communication. (United States)

    Sohl, Stephanie J; Borowski, Laurel A; Kent, Erin E; Smith, Ashley Wilder; Oakley-Girvan, Ingrid; Rothman, Russell L; Arora, Neeraj K


    Cancer survivors' disclosure of complementary health approaches (CHAs) to their follow-up care physicians is necessary to ensure the safe and optimal use of such approaches. Rates of disclosure of CHAs are variable and may be facilitated by patient-centered communication. This cross-sectional study conducted in 2003-2004 examined a population-based sample of leukemia, colorectal, and bladder cancer survivors (n=623) who were 2 to 5 years after their diagnosis. A subset of participants who reported using CHAs (n=196) was analyzed with multivariate logistic regression to examine the association between patients' perceptions of their physician's patient-centered communication (ie, information exchange, affective behavior, knowledge of patients as persons) and patients' disclosure of CHA use to their physician with adjustments for physician, patient, and patient-physician relationship factors. Thirty-one percent of the full sample used CHAs, and 47.6% of CHA users disclosed their use to their physicians. Disclosure was significantly associated with patient-centered communication even with adjustments for hypothesized covariates (odds ratio [OR], 1.37; 95% confidence interval [CI], 1.09-1.71). Perceived physician knowledge of the patient as a person (OR, 1.28; 95% CI, 1.10-1.48) and information exchange (OR, 1.27; 95% CI, 1.02-1.60) were the aspects of patient-centered communication that contributed to this association. The main reason for nondisclosure assessed in the survey was that survivors did not think that it was important to discuss CHAs (67.0%). A majority of physicians encouraged continued use of CHAs when they were disclosed (64.8%). Results support the idea that improving the overall patient centeredness of cancer follow-up care and improving the disclosure of CHA use are potentially synergistic clinical goals. © 2014 American Cancer Society. This article has been contributed to by US Government employees and their work is in the public domain in the USA.

  2. Disseminating end-of-life education to cancer centers: overview of program and of evaluation. (United States)

    Grant, Marcia; Hanson, Jo; Mullan, Patricia; Spolum, Maren; Ferrell, Betty


    Systematic provision of compassionate end-of-life (EOL) care requires strategic training of health professionals. Disseminating EOL Education to Cancer Centers (DELEtCC) targeted education of interdisciplinary institutional teams. Competitively-selected two-person teams participated in a national three-day EOL conference. Nationally recognized faculty created and presented the curriculum. Project faculty supported teams over 18 months as they implemented EOL goals. Conference evaluations were very positive. Independent participant and administrative evaluations reported successful implementation of goals aimed an improving EOL care. DELEtCC disseminated education representing best EOL practices, and participants used this knowledge to create and implement goals aimed at improving EOL care.

  3. Critical Appraisal of Translational Research Models for Suitability in Performance Assessment of Cancer Centers

    NARCIS (Netherlands)

    Rajan, Abinaya; Sullivan, Richard; Bakker, Suzanne; van Harten, Willem H.


    Background. Translational research is a complex cumulative process that takes time. However, the operating environment for cancer centers engaged in translational research is now financially insecure. Centers are challenged to improve results and reduce time from discovery to practice innovations.

  4. Impact of configuration management system of computer center on support of scientific projects throughout their lifecycle (United States)

    Bogdanov, A. V.; Iuzhanin, N. V.; Zolotarev, V. I.; Ezhakova, T. R.


    In this article the problem of scientific projects support throughout their lifecycle in the computer center is considered in every aspect of support. Configuration Management system plays a connecting role in processes related to the provision and support of services of a computer center. In view of strong integration of IT infrastructure components with the use of virtualization, control of infrastructure becomes even more critical to the support of research projects, which means higher requirements for the Configuration Management system. For every aspect of research projects support, the influence of the Configuration Management system is being reviewed and development of the corresponding elements of the system is being described in the present paper.

  5. Developing a Comprehensive Cardio-Oncology Program at a Cancer Institute: The Moffitt Cancer Center Experience (United States)

    Fradley, Michael G.; Brown, Allen C.; Shields, Bernadette; Viganego, Federico; Damrongwatanasuk, Rongras; Patel, Aarti A.; Hartlage, Gregory; Roper, Natalee; Jaunese, Julie; Roy, Larry; Ismail-Khan, Roohi


    Cardio-oncology is a multidisciplinary field focusing on the management and prevention of cardiovascular complications in cancer patients and survivors. While the initial focus of this specialty was on heart failure associated with anthracycline use, novel anticancer agents are increasingly utilized and are associated with many other cardiotoxicities including hypertension, arrhythmias and vascular disease. Since its inception, the field has developed at a rapid pace with the establishment of programs at many major academic institutions and community practices. Given the complexities of this patient population, it is important for providers to possess knowledge of not only cardiovascular disease but also cancer subtypes and their specific therapeutics. Developing a cardio-oncology program at a stand-alone cancer center can present unique opportunities and challenges when compared to those affiliated with other institutions including resource allocation, cardiovascular testing availability and provider education. In this review, we present our experiences establishing the cardio-oncology program at Moffitt Cancer Center and provide guidance to those individuals interested in developing a program at a similar independent cancer institution. PMID:28781723

  6. Developing a Comprehensive Cardio-Oncology Program at a Cancer Institute: The Moffitt Cancer Center Experience. (United States)

    Fradley, Michael G; Brown, Allen C; Shields, Bernadette; Viganego, Federico; Damrongwatanasuk, Rongras; Patel, Aarti A; Hartlage, Gregory; Roper, Natalee; Jaunese, Julie; Roy, Larry; Ismail-Khan, Roohi


    Cardio-oncology is a multidisciplinary field focusing on the management and prevention of cardiovascular complications in cancer patients and survivors. While the initial focus of this specialty was on heart failure associated with anthracycline use, novel anticancer agents are increasingly utilized and are associated with many other cardiotoxicities including hypertension, arrhythmias and vascular disease. Since its inception, the field has developed at a rapid pace with the establishment of programs at many major academic institutions and community practices. Given the complexities of this patient population, it is important for providers to possess knowledge of not only cardiovascular disease but also cancer subtypes and their specific therapeutics. Developing a cardio-oncology program at a stand-alone cancer center can present unique opportunities and challenges when compared to those affiliated with other institutions including resource allocation, cardiovascular testing availability and provider education. In this review, we present our experiences establishing the cardio-oncology program at Moffitt Cancer Center and provide guidance to those individuals interested in developing a program at a similar independent cancer institution.

  7. Senior Laboratory Animal Technician | Center for Cancer Research (United States)

    PROGRAM DESCRIPTION The Laboratory Animal Sciences Program (LASP) provides exceptional quality animal care and technical support services for animal research performed at the National Cancer Institute at the Frederick National Laboratory for Cancer Research. LASP executes this mission by providing a broad spectrum of state-of-the-art technologies and services that are focused on the design, generation, characterization and application of genetically engineered and biological animal models of human disease, which are aimed at the development of targeted diagnostics and therapies. LASP contributes to advancing human health, developing new treatments, and improving existing treatments for cancer and other diseases while ensuring safe and humane treatment of animals. Key Roles/Responsibilities The Senior Laboratory Animal Technician will be responsible for: Daily tasks associated with the care, breeding and treatment of research animals for experimental purposes Management of rodent breeding colonies consisting of multiple, genetically complex strains and associated record keeping and database management Colony management procedures including: tail clipping, animal identification, weaning Data entry consistent with complex colony management Collection of routine diagnostic samples Coordinating shipment of live animals and specimens Performing rodent experimental procedures including basic necropsy and blood collection Observation and recording of physical signs of animal health Knowledge of safe working practices using chemical carcinogen and biological hazards Work schedule may include weekend and holiday hours

  8. Oncofertility resources at NCI-designated comprehensive cancer centers. (United States)

    Clayman, Marla L; Harper, Maya M; Quinn, Gwendolyn P; Reinecke, Joyce; Shah, Shivani


    NCI-designated comprehensive cancer centers (CCCs) set the standard for providing exemplary patient care. Quality cancer care includes discussions about fertility and referrals to fertility specialists for patients at risk for sterility. This study sought to determine what fertility preservation (FP) resources are available in CCCs and how well those are integrated into patient care. Leaders at each CCC received a letter requesting a short telephone interview with individuals who could provide information about the institution's FP resources. A semi-structured interview guide was used and responses were audio-recorded. Data were analyzed using content and thematic analysis. Interviews were conducted with 30 of the 39 CCCs that see adult patients (77%). The remaining institutions included 4 nonresponders, 3 that referred the interviewers to childhood cancer survivorship clinics, 1 that refused, and 1 that could not identify any FP resources. Participants were primarily affiliated with reproductive endocrinology (n=15) or hematology/oncology divisions (n=10). Institutional policies regarding consistent provision of FP information were rare (n=4), although most sites (n=20) either had some services on-site or had referral programs (n=8). However, only 13 had some experimental services, such as ovarian tissue cryopreservation. Respondents reported barriers to provision of FP, including oncologists' identification of patients at risk, low referral rates, and perceptions of patient prognosis. Only 8 (27%) sites had staff with time dedicated to FP. CCCs vary widely in implementing FP-recommended practice to their patients. CCCs are positioned to provide exemplary oncofertility care, but most need to better integrate FP information and referral into practice.

  9. Epidemiology of Bloodstream Infections at a Cancer Center

    Directory of Open Access Journals (Sweden)

    Eduardo Velasco


    Full Text Available CONTEXT: Cancer patients are at unusually high risk for developing bloodstream infections (BSI, which are a major cause of in-hospital morbidity and mortality. OBJECTIVE: To describe the epidemiological characteristics and the etiology of BSI in cancer patients. DESIGN: Descriptive study. SETTING: Terciary Oncology Care Center. PARTICIPANTS: During a 24-month period all hospitalized patients with clinically significant BSI were evaluated in relation to several clinical and demographic factors. RESULTS: The study enrolled 435 episodes of BSI (349 patients. The majority of the episodes occurred among non-neutropenic patients (58.6% and in those younger than 40 years (58.2%. There was a higher occurrence of unimicrobial infections (74.9%, nosocomial episodes (68.3% and of those of undetermined origin (52.8%. Central venous catheters (CVC were present in 63.2% of the episodes. Overall, the commonest isolates from blood in patients with hematology diseases and solid tumors were staphylococci (32% and 34.7%, respectively. There were 70 episodes of fungemia with a predominance of Candida albicans organisms (50.6%. Fungi were identified in 52.5% of persistent BSI and in 91.4% of patients with CVC. Gram-negative bacilli prompted the CVC removal in 45.5% of the episodes. Oxacillin resistance was detected in 26.3% of Staphylococcus aureus isolates and in 61.8% of coagulase-negative Staphylococcus. Vancomycin-resistant enterococci were not observed. Initial empirical antimicrobial therapy was considered appropriate in 60.5% of the cases. CONCLUSION: The identification of the microbiology profile of BSI and the recognition of possible risk factors in high-risk cancer patients may help in planning and conducting more effective infection control and preventive measures, and may also allow further analytical studies for reducing severe infectious complications in such groups of patients.

  10. Social Support for Chamorro Breast Cancer Survivors on Guam. (United States)

    Perez, Lilli Ann; Natividad, Lisalinda; Chung, William; Haddock, Robert L; Wenzel, Lari; Hubbell, F Allan


    The purpose of this study was to assess the types of social support used by Chamorro (indigenous) breast cancer survivors on Guam. We assessed social support use among 25 self-reported Chamorro women with a diagnosis of breast cancer through interviews and construction of genograms and ecomaps -pictorial displays of the women's family relationships, medical history, and their social networks. The mean age of the participants was 54.5 years. The average number of years since the diagnosis of breast cancer was 7.8 years. Respondents indicated that the nuclear family was the most important form of social support (34.2%). Indeed, nuclear family and other types of informal systems were the most common type of social support used by the women (60.2%). Formal support services, clubs, and organizations were reported by 17.9% of participants while spiritual and/or religious resources were reported by 21.9% of them. These Chamorro breast cancer survivors depended largely on family for social support. Support from family, although informal, should be recognized as a pivotal factor in recovery and survivorship. Future directions could incorporate formal and informal mechanisms to utilize this natural support resource.

  11. Social Support for Chamorro Breast Cancer Survivors on Guam (United States)

    Perez, Lilli Ann; Natividad, Lisalinda; Chung, William; Haddock, Robert L.; Wenzel, Lari; Hubbell, F. Allan


    Purpose The purpose of this study was to assess the types of social support used by Chamorro (indigenous) breast cancer survivors on Guam. Methods We assessed social support use among 25 self-reported Chamorro women with a diagnosis of breast cancer through interviews and construction of genograms and ecomaps -pictorial displays of the women's family relationships, medical history, and their social networks. Results The mean age of the participants was 54.5 years. The average number of years since the diagnosis of breast cancer was 7.8 years. Respondents indicated that the nuclear family was the most important form of social support (34.2%). Indeed, nuclear family and other types of informal systems were the most common type of social support used by the women (60.2%). Formal support services, clubs, and organizations were reported by 17.9% of participants while spiritual and/or religious resources were reported by 21.9% of them. Conclusion These Chamorro breast cancer survivors depended largely on family for social support. Support from family, although informal, should be recognized as a pivotal factor in recovery and survivorship. Future directions could incorporate formal and informal mechanisms to utilize this natural support resource. PMID:25866489

  12. Family Support and Colorectal Cancer Screening among Urban African Americans. (United States)

    Brittain, Kelly; Taylor, Jacquelyn Y; Loveland-Cherry, Carol; Northouse, Laurel; Caldwell, Cleopatra H


    Colorectal cancer (CRC) is the third leading cause of cancer death among African Americans. Less than 50% of African Americans have had CRC screening. This study examined the relationships between family support and influence, cultural identity, CRC beliefs, and a screening informed decision among 129 urban African Americans. Family support (p < .01) significantly predicted CRC beliefs and CRC beliefs significantly predicted informed decision (p < .01). Based on study results, practitioners should routinely assess family support and CRC beliefs with African Americans patients. This may improve patient-provider shared decision-making satisfaction and CRC screening adherence among African American patients.

  13. Availability of Information About Lifestyle for Cancer Survivors in England: A Review of Statutory and Charitable Sector Organizations and Cancer Centers. (United States)

    Williams, Kate; Fisher, Abigail; Beeken, Rebecca J; Wardle, Jane


    Health behavior change following a cancer diagnosis has the potential to improve long-term outcomes. However, many patients do not receive professional advice about lifestyle and are therefore increasingly using the Internet to seek further information. The statutory and charitable sectors and cancer centers all play an important role in the provision of information and have been found to be favored by cancer survivors searching for information. However, to date there has been no systematic evaluation of the lifestyle information available online for cancer survivors. The purpose of this review was to identify the lifestyle information provided for cancer survivors by statutory and charitable sector organizations and cancer centers in the United Kingdom. We aimed to identify information on tobacco, physical activity, diet, weight, and alcohol designed for people who have been diagnosed with breast, prostate, or colorectal cancer. The National Health Service (NHS) website was the focus of the search for information provided by the statutory sector. Cancer centers were identified from the Organization of European Cancer Institutes and an Internet search, and charitable sector organizations were identified by searching the Charity Commission database. The three largest generic, breast, prostate, and colorectal cancer charitable organizations were included. A systematic search of the organizations was conducted to identify lifestyle information for cancer survivors. Ten organizations had some lifestyle information for cancer survivors on their websites. The Christie NHS Foundation Trust, Macmillan Cancer Support, and Prostate Cancer UK had the most comprehensive guides, covering physical activity, diet, weight management, smoking, and alcohol. The NHS website did not provide any information but had a link to Cancer Research UK's information about diet. Eight organizations suggested talking to a health professional before making any changes. The majority of

  14. Impersonal, interpersonal, and hyperpersonal social support: cancer and older adults. (United States)

    Robinson, James D; Turner, Jeanine


    Although cancer occurs throughout the life span, many of the most frequently occurring types of cancer increase as we grow older. In fact, only cardiovascular disease accounts for more deaths in adults 65 years of age and older. One of the ways that cancer patients cope or adapt to their illness is through socially supportive communicative interactions and relationships. Cutrona and Russell (1990) argued that social support is multidimensional and suggested that social support is most effective when the support needs of the individual are consistent with the type of social support being offered by the support provider. From the communicative perspective, the notion of optimal matching between the types of social support desired and the type of social support offered is extended to include the type of relationship between the communicants. In addition, it is argued that computer-mediated social support can be superior to face-to-face social support. This article attempts to identify some of the conditions under which this is true.

  15. Decision Aids Can Support Cancer Clinical Trials Decisions: Results of a Randomized Trial. (United States)

    Politi, Mary C; Kuzemchak, Marie D; Kaphingst, Kimberly A; Perkins, Hannah; Liu, Jingxia; Byrne, Margaret M


    Cancer patients often do not make informed decisions regarding clinical trial participation. This study evaluated whether a web-based decision aid (DA) could support trial decisions compared with our cancer center's website. Adults diagnosed with cancer in the past 6 months who had not previously participated in a cancer clinical trial were eligible. Participants were randomized to view the DA or our cancer center's website (enhanced usual care [UC]). Controlling for whether participants had heard of cancer clinical trials and educational attainment, multivariable linear regression examined group on knowledge, self-efficacy for finding trial information, decisional conflict (values clarity and uncertainty), intent to participate, decision readiness, and trial perceptions. Two hundred patients (86%) consented between May 2014 and April 2015. One hundred were randomized to each group. Surveys were completed by 87 in the DA group and 90 in the UC group. DA group participants reported clearer values regarding trial participation than UC group participants reported (least squares [LS] mean = 15.8 vs. 32, p trial participation among cancer patients facing this preference-sensitive choice. Although better informing patients before trial participation could improve retention, more work is needed to examine DA impact on enrollment and retention. This paper describes evidence regarding a decision tool to support patients' decisions about trial participation. By improving knowledge, helping patients clarify preferences for participation, and facilitating conversations about trials, decision aids could lead to decisions about participation that better match patients' preferences, promoting patient-centered care and the ethical conduct of clinical research. ©AlphaMed Press.

  16. PTC test bed upgrades to provide ACSES testing support capabilities at transportation technology center. (United States)


    FRA Task Order 314 upgraded the Positive Train Control (PTC) Test Bed at the Transportation Technology Center to support : testing of PTC systems, components, and related equipment associated with the Advanced Civil Speed Enforcement System : (ACSES)...

  17. Information and psychomotor skills knowledge acquisition: A student-customer-centered and computer-supported approach. (United States)

    Nicholson, Anita; Tobin, Mary


    This presentation will discuss coupling commercial and customized computer-supported teaching aids to provide BSN nursing students with a friendly customer-centered self-study approach to psychomotor skill acquisition.

  18. The Center for Hearing and Speech: Bilingual Support Services through Videoconferencing Technology

    National Research Council Canada - National Science Library

    Douglas, Michael


    .... This manuscript describes a variety of methods that can meet the needs of this ever-growing population by highlighting the dual-language support program at the Center for Hearing and Speech in Houston, Texas...

  19. PARP inhibitors may affect normal cells in patients with a BRCA mutation | Center for Cancer Research (United States)

    PARP inhibition has been approved for treatment of advanced ovarian cancer with BRAC1 and BRAC2 mutations and is being studied in the treatment advanced breast, colorectal, and prostate cancer.  A new study by Center for Cancer Research scientists in the Mouse Cancer Genetics Program and the Laboratory of Genome Integrity, raises concerns that when cancer patients with a BRCA mutation are treated with PARP inhibitors their normal cells may also be affected.  

  20. Incidental pulmonary embolism in cancer patients: clinical characteristics and outcome – a comprehensive cancer center experience

    Directory of Open Access Journals (Sweden)

    Abdel-Razeq H


    Full Text Available Hikmat N Abdel-Razeq1, Asem H Mansour2, Yousef M Ismael11Department of Internal Medicine, 2Department of Radiology, King Hussein Cancer Center, Amman, JordanBackground and objectives: Cancer patients undergo routine imaging studies much more than others. The widespread use of the recently introduced multi-detector CT scanners has resulted in an increasing number of incidentally diagnosed pulmonary embolism (PE in asymptomatic cancer patients. The significance and clinical outcome of such incidental PE is described.Methods: Both radiology department and hospital databases were searched for all cancer patients with a diagnosis of incidental PE. CT scans were performed using a 64-slice scanner with a 5.0 mm slice thickness.Results: During the study period, 34 patients with incidental PE were identified. The mean age (±SD was 57.7 (±12.4 years. All patients had active cancer, gastric, lung, colorectal, and lymphomas being the most frequent. Most patients had advanced-stage disease at the time of PE diagnosis; 26 (77% patients had stage IV, whereas only 3 patients had stages I or II disease. Twenty-seven (79% patients had their PE while undergoing active treatment with chemotherapy (68% or radiotherapy (12%; none, however, were on hormonal therapy. Most (74% patients had their PE diagnosed without history of recent hospital admission. Except for 5 (15%, all other patients were anticoagulated. With follow-up, 2 patients developed recurrent PE, 2 others had clinical and echocardiographic evidence of pulmonary hypertension, and 9 (26% died suddenly within 30 days of the diagnosis of incidental PE; 2 of these where among the 5 patients who were not anticoagulated.Conclusion: Incidental PE in cancer patients is increasingly encountered. Similar to symptomatic PE, many were diagnosed in patients with advanced stage disease and while undergoing active anti-cancer therapy. A significant percentage of patients had recurrent emboli, pulmonary hypertension

  1. Management and performance features of cancer centers in Europe: A fuzzy-set analysis

    NARCIS (Netherlands)

    Wind, Anke; Lobo, Mariana Fernandes; van Dijk, Joris; Lepage-Nefkens, Isabelle; Laranja-Pontes, Jose; da Conceicao Goncalves, Vitor; van Harten, Willem H.; Rocha-Goncalves, Francisco Nuno


    The specific aim of this study is to identify the performance features of cancer centers in the European Union by using a fuzzy-set qualitative comparative analysis (fsQCA). The fsQCA method represents cases (cancer centers) as a combination of explanatory and outcome conditions. This study uses

  2. Perceived social support and its impact on depression and health-related quality of life: a comparison between cancer patients and general population. (United States)

    Yoo, Hyosang; Shin, Dong Wook; Jeong, Ansuk; Kim, So Young; Yang, Hyung-Kook; Kim, Jun Suk; Lee, Ji Eun; Oh, Jae Hwan; Park, Eun-Cheol; Park, Keeho; Park, Jong-Hyock


    It is well known that cancer patients' perception of social support is associated with their depressive symptoms and health-related quality of life. However, there have been little studies that compared the variates of cancer patients with the general population. We sought to compare differences in the level of perceived social support and the impact of perceived social support on depressive symptoms and health-related quality of life between cancer survivors and the general population. Data were collected from 1818 cancer patients treated at the National Cancer Center and regional cancer centers in South Korea. The control group of the general population was composed of 2000 individuals without cancer from community. Cancer patients reported significantly higher level of perceived social support than the general population, while they reported lower health-related quality of life and were more susceptible to depression. The positive associations of higher perceived social support with lower depressive symptoms, as well as with higher health-related quality of life, were stronger among cancer patients than among the general population. The interaction effect suggests that the impact of social support would be stronger among cancer patients than the general public. Thus, it would be beneficial to pay attention to providing social support to cancer patients, particularly to those who are more vulnerable. Furthermore, investigation of the most effective and efficient methods to deliver social support interventions would be worthwhile.

  3. Evidence-based nutritional support of the elderly cancer patient. (United States)

    Bozzetti, Federico


    The papers included in this section represent the effort of the Task Force on Nutrition of the International Society of Geriatric Oncology to synthetize the evidence-based concepts on nutritional support of the elderly cancer patients. In the attempt of presenting a comprehensive overview of the topic, the panel included experts from different specialties: basic researchers, nutritionists, geriatricians, nurses, dieticians, gastroenterologists, oncologists. Cancer in elderly people is a growing problem. Not only in almost every country, the proportion of people aged over 60 years is growing faster than any other age group, but cancer per se is also a disease of old adult-elderly people, hence the oncologists face an increasing number of these patients both now and in the next years. The are several studies on nutrition of elderly subjects and many other on nutrition of cancer patients but relatively few specifically devoted to the nutritional support of the elderly cancer patients. However, the awareness that elderly subjects account for a high proportion of the mixed cancer patients population, in some way legitimates us to extend some conclusions of the literature also to the elderly cancer patients. Although the topics of this Experts' Consensus have been written by specialists in different areas of nutrition, the final message is addressed to the oncologists. Not only they should be more directly involved in the simplest steps of the nutritional care (recognition of the potential existence of a "nutritional risk" which can compromise the planned oncologic program, use of some oral supplements, etc.) but, as the true experts of the natural history of their cancer patient, they should also coordinate the process of the nutritional support, integrating this approach in the overall multidisciplinary cancer care. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. What do cancer support groups provide which other supportive relationships do not? The experience of peer support groups for people with cancer. (United States)

    Ussher, Jane; Kirsten, Laura; Butow, Phyllis; Sandoval, Mirjana


    This qualitative study examined the questions of what cancer support groups provide that other supportive relationships do not, and what the self perceived consequences are of support group attendance. Nine representative Australian cancer peer support groups, consisting of a total of 93 interviewees, 75 women, and 18 men, with a mean age of 62, took part in participant observation and focus group interviews, with the data analysed using positioning theory. Support groups were positioned by participants as providing a unique sense of community, unconditional acceptance, and information about cancer and its treatment, in contrast to the isolation, rejection, and lack of knowledge about cancer frequently experienced outside the group. Groups were also positioned as occasionally emotionally challenging, in contrast to the experience of normalising support from family and friends. Increased empowerment and agency were positioned as the most significant consequences of group support, consisting of increased confidence and a sense of control in relation to self, living with cancer, and interactions with others, in particular the medical profession. The support group was also positioned as facilitating positive relationships with family and friends because of relieving their burden of care, by providing a safe space for the expression of emotion. No difference was found between professionally led and peer led support groups, suggesting that it is not the professional background of the leader which is of importance, but whether the group provides a supportive environment, mutuality, and a sense of belonging, and whether it meets the perceived needs of those attending. It is suggested that future research should examine the construction and experience of social support in those who drop out of, or who do not attend, cancer support groups, in order to provide further insight into the contrast between social support within groups and support in other contexts.

  5. Development of a Community-Based Palliative Care Model for Advance Cancer Patients in Public Health Centers in Busan, Korea. (United States)

    Kim, Sook-Nam; Choi, Soon-Ock; Shin, Seong Hoon; Ryu, Ji-Sun; Baik, Jeong-Won


    A feasible palliative care model for advance cancer patients is needed in Korea with its rapidly aging population and corresponding increase in cancer prevalence. This study describes the process involved in the development of a community-based palliative care (CBPC) model implemented originally in a Busan pilot project. The model development included steps I and II of the pilot project, identification of the service types, a survey exploring the community demand for palliative care, construction of an operational infrastructure, and the establishment of a service delivery system. Public health centers (including Busan regional cancer centers, palliative care centers, and social welfare centers) served as the regional hubs in the development of a palliative care model. The palliative care project included the provision of palliative care, establishment of a support system for the operations, improvement of personnel capacity, development of an educational and promotional program, and the establishment of an assessment system to improve quality. The operational infrastructure included a service management team, provision teams, and a support team. The Busan Metropolitan City CBPC model was based on the principles of palliative care as well as the characteristics of public health centers that implemented the community health projects. The potential use of the Busan CBPC model in Korea should be explored further through service evaluations.

  6. The development and implementation of a volunteer lay navigation competency framework at an outpatient cancer center. (United States)

    Lorhan, Shaun; Wright, Michelle; Hodgson, Sally; van der Westhuizen, Michael


    To describe the development and delivery of a competency framework designed to guide the recruitment, training, and competency screening of volunteer lay navigators at an outpatient cancer centre in Victoria, BC. Volunteers that passed a screening interview underwent 22 h of training focusing on the scope of the navigator's role, communication skills, and cancer center processes and resources. Volunteers that passed a post-training interview, by demonstrating a basic level of competency in three domains (Self as Navigator, Communication, and Knowledge/Information), were invited to participate as volunteer lay navigators in a three-step intervention with newly diagnosed lung cancer patients at the British Columbia Cancer Agency-Vancouver Island Centre. Of the 27 volunteers who attended a screening interview, 20 were invited to participate in training. From the subset of 20, 13 of these participants achieved competency scores high enough to qualify them to practice as volunteer lay navigators. By incorporating the lessons we have learned from this study, we believe that the lay navigation competency framework serves as a useful model for selecting, training, and supporting competent navigators.

  7. Center of Excellence for Individualization of Therapy for Breast Cancer (United States)


    5-FU resistance in metastatic breast cancer. San Antonio Breast Cancer Symposium . 2006. Ref Type: Abstract Collado,M., Gil,J., Efeyan,A., Guerra ...cancer - a new therapeutic opportunity. Nat. Rev. Cancer 5, 505-515. Miller,L.D., Smeds,J., George,J., Vega ,V.B., Vergara,L., Ploner,A., Pawitan,Y., Hall

  8. Social Media Use for Cancer Education at a Community-Based Cancer Center in South Korea. (United States)

    Heo, Jaesung; Chun, Mison; Lee, Hyun Woo; Woo, Jeong-Hee


    The main purpose of this study was to evaluate the effectiveness of the education system using social media. Eight educational video clips were developed instructing the viewer on cancer-related issues such as prevention, treatment, and survivorship. Each video was made with participation of medical professors and posted on a YouTube channel. A mobile phone application was produced containing a scheduler function, introduction of a community cancer center program, and cancer information. A medical blog was established to provide stationary materials such as images and articles. Descriptive analysis was done by Google analytics. From May of 2014 to June of 2016, 15,247 total views were recorded on the YouTube channel, and the average view duration was about 3 min. The most popular video was about chemotherapy treatment; 5409 (36%) people watched this video, and 3615 (23.5%) people viewed a video on balanced dietary habits. As well as South Korea, 1,113 (7%) views were confirmed in the United States and 175 (1%) in Japan. The equipment used to watch the contents were mobile phones (59%), laptops (33%), and tablets (6%). Five hundred people installed the smartphone application from March of 2015 to July of 2016. Three hundred eighty-three medical contents were posted on the blog since March of 2015. Cancer education is necessary to address the education needs of patients with cancer and their caregivers. Education based on social media could be an effective method that reaches beyond geographical boundaries.

  9. Racial Differences in Perceptions of Social Support in Consumer-Centered Services (United States)

    Woodward, Amanda Toler; Mowbray, Carol T.; Holter, Mark C.; Bybee, Deborah


    The purpose of this study was to explore potential racial differences in the experience of support offered by consumer-centered services for adults with serious mental illness. The study used hierarchical linear modeling to examine the level of support consumers report receiving from programs and the extent to which program-level characteristics…

  10. Availability of Outpatient Clinical Nutrition Services for Patients With Cancer Undergoing Treatment at Comprehensive Cancer Centers. (United States)

    Platek, Mary E; Johnson, Jordan; Woolf, Kathleen; Makarem, Nour; Ompad, Danielle C


    The mission of US Comprehensive Cancer Centers (CCC) is to reduce cancer morbidity and mortality. The type of clinical nutrition services available to outpatients seeking treatment at CCCs is unknown. The purpose of this cross-sectional study was to determine the prevalence and types of outpatient clinical nutrition services available at CCCs. A list of the National Cancer Institute (NCI) -designated CCCs was compiled. A telephone survey that queried clinical nutrition services available to outpatients undergoing treatment was developed. The survey was conducted with clinical nutrition personnel during usual working hours between April and October 2012. Of the 40 CCCs, 32 (80%) completed the survey. Thirty CCCs offered referral- or consult-based services with a clinical nutrition professional such as a registered dietitian (RD). Other services included nutrition classes (56%), nutrition pamphlets (94%), and counseling by non-nutrition health care providers (81%). Twenty-three of the centers monitored patients regularly, but less than half followed a clinical nutrition protocol such as those established by the Academy of Nutrition and Dietetics. Referral-based services were provided for cancers with a high prevalence of malnutrition, such as head and neck and GI, with most monitoring patients regularly but less than half using evidence-based protocols. CCCs rely on referral-based clinical nutrition service, which are not consistently a part of multidisciplinary care. An in-depth comparison of clinical nutrition services among other approaches to cancer care, including a comparison of clinical outcomes among these different approaches, is needed. Copyright © 2015 by American Society of Clinical Oncology.

  11. Correlates of social support in young adults with advanced cancer. (United States)

    Trevino, K M; Fasciano, K; Block, S; Prigerson, H G


    This study examined the relationship between perceived social support, quality of life (QoL), and grief in young adults with advanced cancer. Seventy-one young adults (20-40 years) with advanced cancer were administered measures of social support, QoL, and grief. Regression analyses examined the relationship between social support and QoL and grief. Higher levels of total social support were associated with better psychological and existential QoL and less severe grief. Availability of someone to talk to about problems was also associated with better psychological and existential QoL and less severe grief. Tangible support was associated with better psychological and existential QoL. Availability of someone to engage in activities with was only associated with better existential QoL. These results suggest that enhancing social support may improve psychological well-being in this population. In addition, specific types of social support may be particularly relevant to the psychological well-being of young adults with advanced cancer.

  12. Support for coping after diagnosis of gynaecologic cancer

    DEFF Research Database (Denmark)

    Adellund, Kamila; Frandsen, Helle Nørtved; Juhl, Inger Rudbeck

    their existence is threatened and their ability to cope weakened. The main question of this investigation was: How can the nurse in a multidisciplinary team support patients and relatives to master the first few days where cancer is suspected? We aimed to: Fase 1:          Explore the needs of support...... of the project are expected in late August 2009. The results relate to the needs for support for patients and relatives in the early phase of diagnosing.   Implications for practice: Our results may lead to a nursing practice with increased support and involvement of relatives and patients during the early...

  13. Treatment outcomes in stage IIIA non-small-cell lung cancer in a community cancer center. (United States)

    Hanson, Shaun; Persad, Kamleish; Qiao, Xian; Guarino, Michael; Petrelli, Nicholas


    Treatment outcomes for non-small-cell lung cancer (NSCLC) patients diagnosed at stage IIIA have been analyzed in many studies, which generally involve patients younger and healthier than the average patient with this disease. To analyze demographics and treatment outcomes in patients with stage IIIA NSCLC at a community cancer center. We reviewed charts of 226 patients diagnosed with stage IIIA NSCLC from January 2003 to December 2008 treated at our community cancer center. Results Median overall survival for all patients and sequentially and concurrently treated chemoradiation patients were 18 months, and 18 months, and 20 months, respectively. Median overall survival for women and men was 24 months and 16 months, respectively. Median overall survival for all patients and sequentially and concurrently treated chemoradiation patients were 18 months, and 18 months, and 20 months, respectively. Median overall survival for women and men was 24 months and 16 months, respectively. Study design was retrospective and some medical records were not available. However, this population is likely representative of patients treated in similar settings. In our population, advanced age and male gender were associated with lower median survival. Responses to concurrent and sequential chemoradiation seemed to differ based on age group, which may be useful as a prognostic guideline for similar populations. ©2015 Frontline Medical Communications.

  14. 75 FR 41522 - Hewlett Packard, Technical Support Call Center, Including On-Site Leased Workers From Manpower... (United States)


    ... Employment and Training Administration Hewlett Packard, Technical Support Call Center, Including On-Site... workers of Hewlett Packard, Technical Support Call Center, including on-site leased workers from Manpower..., Idaho location of Hewlett Packard, Technical Support Call Center. The Department has determined that...

  15. Existential support needs following cancer treatment with curative intent


    Lagerdahl, Anna; Moynihan, Manus; Stollery, Brian


    Aims Research in recent years reveals that people can experience a range of existential difficulties following the end of cancer treatment. However, few studies have examined how to best support people with these needs. The aim of this study is to explore what support may be required to help people manage their existential concerns following the end of treatment. It is the second part of a study that examined the existential concerns of the same participants (Lagerdahl, Moynihan and Stollery ...

  16. User-centered design to improve clinical decision support in primary care. (United States)

    Brunner, Julian; Chuang, Emmeline; Goldzweig, Caroline; Cain, Cindy L; Sugar, Catherine; Yano, Elizabeth M


    A growing literature has demonstrated the ability of user-centered design to make clinical decision support systems more effective and easier to use. However, studies of user-centered design have rarely examined more than a handful of sites at a time, and have frequently neglected the implementation climate and organizational resources that influence clinical decision support. The inclusion of such factors was identified by a systematic review as "the most important improvement that can be made in health IT evaluations." (1) Identify the prevalence of four user-centered design practices at United States Veterans Affairs (VA) primary care clinics and assess the perceived utility of clinical decision support at those clinics; (2) Evaluate the association between those user-centered design practices and the perceived utility of clinical decision support. We analyzed clinic-level survey data collected in 2006-2007 from 170 VA primary care clinics. We examined four user-centered design practices: 1) pilot testing, 2) provider satisfaction assessment, 3) formal usability assessment, and 4) analysis of impact on performance improvement. We used a regression model to evaluate the association between user-centered design practices and the perceived utility of clinical decision support, while accounting for other important factors at those clinics, including implementation climate, available resources, and structural characteristics. We also examined associations separately at community-based clinics and at hospital-based clinics. User-centered design practices for clinical decision support varied across clinics: 74% conducted pilot testing, 62% conducted provider satisfaction assessment, 36% conducted a formal usability assessment, and 79% conducted an analysis of impact on performance improvement. Overall perceived utility of clinical decision support was high, with a mean rating of 4.17 (±.67) out of 5 on a composite measure. "Analysis of impact on performance

  17. Role of Theories in the Design of Web-Based Person-Centered Support: A Critical Analysis. (United States)

    Ranerup, Agneta; Sparud-Lundin, Carina; Koinberg, Ingalill; Skärsäter, Ingela; Jenholt-Nolbris, Margaretha; Berg, Marie


    Objective. The aim of this study was to provide a critical understanding of the role of theories and their compatibility with a person-centered approach in the design and evaluation of web-based support for the management of chronic illness. Methods. Exploration of web-based support research projects focusing on four cases: (1) preschool children aged 4-6 with bladder dysfunction and urogenital malformation; (2) young adults aged 16-25 living with mental illness; (3) women with type 1 diabetes who are pregnant or in early motherhood; and (4) women who have undergone surgery for breast cancer. Data comprised interviews with research leaders and documented plans. Analysis was performed by means of a cross-case methodology. Results. The used theories concerned design, learning, health and well-being, or transition. All web support products had been developed using a participatory design (PD). Fundamental to the technology design and evaluation of outcomes were theories focusing on learning and on health and well-being. All theories were compatible with a person-centered approach. However, a notable exception was the relatively collective character of PD and Communities of Practice. Conclusion. Our results illustrate multifaceted ways for theories to be used in the design and evaluation of web-based support.

  18. Outcomes of stage II endometrial cancer: The UPMC Hillman Cancer Center experience. (United States)

    Chen, Katherine S; Berhane, Hebist; Gill, Beant S; Olawaiye, Alexander; Sukumvanich, Paniti; Kelley, Joseph L; Boisen, Michelle M; Courtney-Brooks, Madeleine; Comerci, John T; Edwards, Robert; Berger, Jessica; Beriwal, Sushil


    Previous studies of stage II endometrial cancer have included cancers with cervical glandular involvement, a factor no longer associated with risk of recurrence. In order to better assess relapse patterns and the impact of adjuvant therapy, a retrospective analysis was conducted for patients with modern stage II endometrial cancer, defined as cervical stromal invasion. Patients diagnosed with surgically staged FIGO stage II endometrial cancer at the UPMC Hillman Cancer Center from 1990-2013 were reviewed. Factors associated with rates of locoregional control (LRC), distant metastasis (DM), disease-free survival (DFS), and overall survival (OS) were analyzed using the log rank test. 110 patients with FIGO stage II disease were identified. Most (84.5%) received EBRT±BT, with 13.6% receiving BT alone. With a median follow-up of 64.6months, the 5-year actuarial rates of LRC, DM, DFS, and OS were 94.9%, 85.1%, 67.9%, and 75.0%, respectively. With 5 locoregional failures, the only factor predictive of LRC was pelvic lymph node dissection. Characteristics associated with DM included age, LVSI, depth of myometrial invasion, and receipt of chemotherapy. Factors predictive of both DFS and OS were age, grade, adverse histology, LVSI, depth of myometrial invasion, and receipt of chemotherapy. This represents the largest single-institution study for modern stage II endometrial cancer, confirming high rates of pelvic disease control after surgery and adjuvant therapy. With most patients receiving adjuvant radiotherapy, the predominant mode of failure, albeit low in absolute number, remains distant metastases. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. [National respiration center support patients with tracheostomy tubes. Outpatient clinic for respiratory support in the home]. (United States)

    Geisewall, Klara; Håkansson, Stefan; Oddby, Eva; Ek, Mats E; Jakobsson, Jan G


    It is now 60 years since the polio epidemic in Copenhagen and the first use of prolonged invasive positive pressure ventilation. After this pioneer work positive pressure ventilation rapidly became well established. Intubation/tracheostomy and mechanical ventilation are now standard in Intensive Care Units. In the late 1970 Gillis Andersson was the first in Sweden to discharge patients home with invasive mechanical ventilator support. His pioneer work included the development of a dedicated practical and technical support organization at National Respiration Centre at Danderyds Hospital. This unit developed skills in patient customized tracheostomy tube construction and home invasive ventilation supportive care. Tracheostomy tubes and home ventilators have since then developed rapidly. Some patients still need customized tracheostomy tubes, which the NRC supplies. The production is certified by the Swedish Medicinal Product Agency. Today invasive home ventilation is standard care. Invasive mechanical home ventilation when instituted as a life-saving therapy in, for example, progressive ALS patients is complex and resource-intensive. New aspects such as training and education in order to secure quality of care in the home environment is one of many challenges. When commencing invasive ventilation in patients with progressive neurological disease ethical considerations must also be acknowledged, e.g. aspects such as patients' perhaps changing wishes during the course of illness regarding cessation of life support.

  20. Creating a “culture of research” in a community hospital: Strategies and tools from the National Cancer Institute Community Cancer Centers Program (United States)

    St. Germain, Diane; Nacpil, Lianne M; Zaren, Howard A; Swanson, Sandra M; Minnick, Christopher; Carrigan, Angela; Denicoff, Andrea M; Igo, Kathleen E; Acoba, Jared D; Gonzalez, Maria M; McCaskill-Stevens, Worta


    Background The value of community-based cancer research has long been recognized. In addition to the National Cancer Institute’s Community Clinical and Minority-Based Oncology Programs established in 1983, and 1991 respectively, the National Cancer Institute established the National Cancer Institute Community Cancer Centers Program in 2007 with an aim of enhancing access to high-quality cancer care and clinical research in the community setting where most cancer patients receive their treatment. This article discusses strategies utilized by the National Cancer Institute Community Cancer Centers Program to build research capacity and create a more entrenched culture of research at the community hospitals participating in the program over a 7-year period. Methods To facilitate development of a research culture at the community hospitals, the National Cancer Institute Community Cancer Centers Program required leadership or chief executive officer engagement; utilized a collaborative learning structure where best practices, successes, and challenges could be shared; promoted site-to-site mentoring to foster faster learning within and between sites; required research program assessments that spanned clinical trial portfolio, accrual barriers, and outreach; increased identification and use of metrics; and, finally, encouraged research team engagement across hospital departments (navigation, multidisciplinary care, pathology, and disparities) to replace the traditionally siloed approach to clinical trials. Limitations The health-care environment is rapidly changing while complexity in research increases. Successful research efforts are impacted by numerous factors (e.g. institutional review board reviews, physician interest, and trial availability). The National Cancer Institute Community Cancer Centers Program sites, as program participants, had access to the required resources and support to develop and implement the strategies described. Metrics are an important

  1. Renal Cancer Biomarkers | NCI Technology Transfer Center | TTC (United States)

    The National Cancer Institute's Laboratory of Proteomics and Analytical Technologies is seeking statements of capability or interest from parties interested in collaborative research to further develop, evaluate, or commercialize diagnostic, therapeutic and prognostic cancer biomarkers from clinical specimens.

  2. Impact of pharmacist interventions on cost avoidance in an ambulatory cancer center. (United States)

    Randolph, Laura A; Walker, Cheri K; Nguyen, Ann T; Zachariah, Subi R


    Objective To provide a foundation to justify the presence of a full-time clinical pharmacist in the ambulatory cancer center in addition to an existing centralized pharmacist through cost avoidance calculation and patient and staff satisfaction surveys. Methods The prospective, pilot study took place in an ambulatory cancer center over four weeks in 2014. Cost avoidance values were assigned to interventions performed by a pharmacy resident, who was present in the ambulatory cancer center during clinic hours, along with a centralized oncology pharmacist routinely working with the cancer center. Anonymous patient and staff satisfaction surveys based on a 5-point Likert scale were distributed to assess the perceived benefit of a pharmacist located in the ambulatory cancer center. Results Data collection took place over approximately one month. After evaluation of 962 interventions from both pharmacists, the estimated cost avoidance was US$282,741 per pharmacist per year, yielding a net benefit of US$138,441. The most common interventions made by the resident included chemotherapy regimen review (n = 290, 69%) and patient counseling (n = 102, 24%), while the majority of the centralized pharmacist's interventions was chemotherapy regimen review (n = 525, 97%). Results from the anonymous patient and staff surveys revealed an overall positive perception of the pharmacy resident while in the ambulatory cancer center. Conclusion A full-time clinical pharmacist in an ambulatory cancer center is both financially beneficial and positively perceived by patients and staff.

  3. Brain metastases in patients diagnosed with a solid primary cancer during childhood: experience from a single referral cancer center. (United States)

    Suki, Dima; Khoury Abdulla, Rami; Ding, Minming; Khatua, Soumen; Sawaya, Raymond


    Metastasis to the brain is frequent in adult cancer patients but rare among children. Advances in primary tumor treatment and the associated prolonged survival are said to have increased the frequency of brain metastasis in children. The authors present a series of cases of brain metastases in children diagnosed with a solid primary cancer, evaluate brain metastasis trends, and describe tumor type, patterns of occurrence, and prognosis. Patients with brain metastases whose primary cancer was diagnosed during childhood were identified in the 1990-2012 Tumor Registry at The University of Texas M.D. Anderson Cancer Center. A review of their hospital records provided demographic data, history, and clinical data, including primary cancer sites, number and location of brain metastases, sites of extracranial metastases, treatments, and outcomes. Fifty-four pediatric patients (1.4%) had a brain metastasis from a solid primary tumor. Sarcomas were the most common (54%), followed by melanoma (15%). The patients' median ages at diagnosis of the primary cancer and the brain metastasis were 11.37 years and 15.03 years, respectively. The primary cancer was localized at diagnosis in 48% of patients and disseminated regionally in only 14%. The primary tumor and brain metastasis presented synchronously in 15% of patients, and other extracranial metastases were present when the primary cancer was diagnosed. The remaining patients were diagnosed with brain metastasis after initiation of primary cancer treatment, with a median presentation interval of 17 months after primary cancer diagnosis (range 2-77 months). At the time of diagnosis, the brain metastasis was the first site of systemic metastasis in only 4 (8%) of the 51 patients for whom data were available. Up to 70% of patients had lung metastases when brain metastases were found. Symptoms led to the brain metastasis diagnosis in 65% of cases. Brain metastases were single in 60% of cases and multiple in 35%; 6% had only

  4. Tailoring cancer education and support programs for low-income, primarily African American cancer survivors. (United States)

    Martin, Michelle Y; Pollack, Lori A; Evans, Mary B; Smith, Judith Lee; Kratt, Polly; Prayor-Patterson, Heather; Watson, Christopher D; Dignan, Mark; Cheney, Lydia C; Pisu, Maria; Liwo, Amandiy; Hullett, Sandral


    to identify the information and stress-management topics of most interest to low-income, predominantly African American cancer survivors. descriptive, cross sectional. outpatient oncology clinic in a public hospital in Birmingham, Alabama. 25 patients with cancer; 12 were men, 22 were African Americans, and 16 had a 12th-grade education or less. patients ranked potential topics to be included in an educational curriculum. quantitative rankings of information and stress-management priorities. learning about cancer, understanding cancer treatments, relieving cancer pain, and keeping well in mind and body were the most highly ranked topics among those offered within the American Cancer Society's I Can Cope curriculum, which also included supportive topics such as mobilizing social support. The preferred stress-management topics were humor therapy, music therapy, meditation, and relaxation; lower-ranked topics included pet therapy and art as therapy. cancer survivors appear most interested in topics specific to their illness and treatment versus supportive topics. Stress management also received high rankings. nurses have a key role in providing patient education and support. Tailoring education programs may better target specific needs and improve the quality of cancer care of underserved patients.

  5. Male sexuality after cancer treatment - needs for information and support : testicular cancer compared to malignant lymphoma

    NARCIS (Netherlands)

    Jonker-Pool, G.; Hoekstra, H.J.; van Imhoff, G.W.; Sonneveld, D.J.A.; Sleijfer, D.T.; van Driel, M.F.; Koops, H.S.; van de Wiel, H.B.M.

    Testicular cancer (TC) as well as malignant lymphoma (NIL), both have nowadays an excellent prognosis. However, both types of cancer may be diagnosed at young adulthood and patients may experience sexual concerns. In this article the need for information and support concerning sexuality will be

  6. The "specter" of cancer: exploring secondary trauma for health professionals providing cancer support and counseling. (United States)

    Breen, Lauren J; O'Connor, Moira; Hewitt, Lauren Y; Lobb, Elizabeth A


    Health professionals are vulnerable to occupational stress and tend to report high levels of secondary trauma and burnout; this is especially so for those working in "high-death" contexts such as cancer support and palliative care. In this study, 38 health professionals (psychologists, social workers, pastoral carers/chaplains, nurses, group facilitators, and a medical practitioner) who provide grief support and counseling in cancer and palliative care each participated in a semistructured interview. Qualitatively, a grounded theory analysis revealed four themes: (a) the role of health professionals in supporting people who are experiencing grief and loss issues in the context of cancer, (b) ways of working with patients with cancer and their families, (c) the unique qualities of cancer-related loss and grief experiences, and (d) the emotional demands of the work and associated self-care. The provision of psychological services in the context of cancer is colored by the specter of cancer, an unseen yet real phenomenon that contributes to secondary trauma and burnout. The participants' reported secondary trauma has serious repercussions for their well-being and may compromise the care they provide. The findings have implications for the retention and well-being of personnel who provide psychosocial care in cancer and the quality and delivery of services for people with cancer and their families. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  7. [Cancer plans apply to surgical treatment of prostate cancer: A geographically isolated center balance]. (United States)

    Mondet, F; Alimi, J-C; Boyer, C


    Since 2003, fight against cancer was structured by 3 national cancer programs (CP). The objective of this study is to evaluate the application of these measures in the case of surgical prostate cancer (PCa) treatment in a geographically isolated center. Monocentric retrospective study carried in a 100-bed clinic located 2hours away from a Cancer Regional Reference Center. Between August 2009 and December 2014, 251 consecutive patients were treated by total laparoscopic prostatectomy (TLP). Fifty-seven patients (22.7 %) received a secondary treatment after TLP. The study focused on the delay between prostate biopsies and PTL, the traceability of AD elements, the return of active patients, inclusion in clinical trials (GETUG 17, GETUG 20 and GETUG 22). Data were collected in September 2016. The follow-up defined by the time between the date of the last visit and the prostate biopsy allows a median follow-up of 43.1 months (2.4-80.5). All elements of the CAP are totally gathered on 45 % of the patients (113/251). Thirty-four (13.5 %) patients were active at the time of the intervention. Thirty-one (91.2 %) will return to an identical activity after a median work stoppage of 1.7 month (0.25-6). Fourteen percent (35/251) of the patients are eligible to a clinical trial. Seventeen percent (6/35) of them were proposed to one of a trial after multidisciplinary meeting and 5.7 % (2/35) are eventually included in one trial. CP define a course of high quality care. A better transparency of the founding of the enforceable measures and a better consideration for the local specificities should facilitate their application. The TLP treat the PCa with the reasonable objective of a return to an identical professional activity. The multidisciplinary meeting does not guarantee the participation to clinical trial, which depends mainly on distance from the Cancer Regional Reference Center and the vigilance of the Urologist. 4. Copyright © 2017 Elsevier Masson SAS. All rights

  8. Coordinating Center: Molecular and Cellular Findings of Screen-Detected Lesions | Division of Cancer Prevention (United States)

    DESCRIPTION (provided by applicant): The Molecular and Cellular Characterization of Screen?Detected Lesions ? Coordinating Center and Data Management Group will provide support for the participating studies responding to RFA CA14?10. The coordinating center supports three main domains: network coordination, statistical support and computational analysis and protocol development and database support. Support for communication is provided through an interactive web portal, management of conference calls, and meeting support. |



    A. V. Masloboev


    The paper deals with engineering problems and application perspectives of virtual cognitive centers as intelligent systems for information support of interagency activities in the field of complex security management of regional development. A research prototype of virtual cognitive center for regional security management in crisis situations, implemented as hybrid cloud service based on IaaS architectural framework with the usage of multi-agent and web-service technologies has been developed...

  10. Nutritional support practices in hematopoietic stem cell transplantation centers: A nationwide comparison. (United States)

    Baumgartner, Annic; Bargetzi, Mario; Bargetzi, Annika; Zueger, Noemi; Medinger, Micheal; Passweg, Jakob; Schanz, Urs; Samaras, Panagiotis; Chalandon, Yves; Pichard, Claude; Limonta, Alessandro; Wannesson, Luciano; Pabst, Thomas; Duchosal, Michel A; Hess, Urs; Stanga, Zeno; Mueller, Beat; Schuetz, Philipp


    In 2009, international nutritional societies published practice guidelines on screening and nutritional support for patients undergoing stem cell transplantation. Little is known about how these guidelines are implemented in clinical practice. We performed a nationwide survey with the aim of understanding current practice patterns, differences between clinical practice, and international recommendations as well as barriers to the use of nutritional therapy. We performed a qualitative survey including all centers across Switzerland offering allogeneic (n = 3) or autologous (n = 7) stem cell transplantation. We focused on in-house protocols pertaining to malnutrition screening, indications for nutritional support, types of nutritional therapy available and provided, and recommendations regarding neutropenic diets. All centers offering allogeneic, and most of the centers offering autologous transplantation, had a malnutrition screening tool, mainly the nutritional risk score (NRS 2002) method. Only one center does not provide nutritional support. There is wide variation regarding start and stop of nutritional therapy as well as route of delivery, with five centers recommending parenteral nutrition and five centers recommending enteral nutrition as a first step. Although all centers offering allogeneic transplantation, and approximately every other autologous transplant center, used a neutropenic diet, specific recommendations regarding the type of food and food handling showed significant variation. This Swiss survey found wide variation in the use of nutritional therapy in patients undergoing stem cell transplantation, with low adherence overall to current practice guidelines. Understanding and reducing barriers to guideline implementation in clinical practice may improve clinical outcomes. Close collaboration of centers will facilitate future research needed to improve current practice and ensure high quality of treatment. Copyright © 2016 Elsevier Inc. All

  11. Cancer Research Center Indiana University School of Medicine

    Energy Technology Data Exchange (ETDEWEB)


    The Department of Energy (DOE) proposes to authorize the Indiana School of Medicine to proceed with the detailed design, construction and equipping of the proposed Cancer Research Center (CRC). A grant was executed with the University on April 21, 1992. A four-story building with basement would be constructed on the proposed site over a 24-month period. The proposed project would bring together, in one building, three existing hematology/oncology basic research programs, with improved cost-effectiveness through the sharing of common resources. The proposed site is currently covered with asphaltic pavement and is used as a campus parking lot. The surrounding area is developed campus, characterized by buildings, walkways, with minimal lawns and plantings. The proposed site has no history of prior structures and no evidence of potential sources of prior contamination of the soil. Environmental impacts of construction would be limited to minor increases in traffic, and the typical noises associated with standard building construction. The proposed CRC project operation would involve the use radionuclides and various hazardous materials in conducting clinical studies. Storage, removal and disposal of hazardous wastes would be managed under existing University programs that comply with federal and state requirements. Radiological safety programs would be governed by Nuclear Regulatory Commission (NRC) license and applicable Environmental Protection Agency (EPA) regulations. There are no other NEPA reviews currently active which are in relationship to this proposed site. The proposed project is part of a Medical Campus master plan and is consistent with applicable local zoning and land use requirements.

  12. Surgical leadership and standardization of multidisciplinary breast cancer care: the evolution of the National Accreditation Program for Breast Centers. (United States)

    Bensenhaver, Jessica; Winchester, David P


    Evidence has shown that multidisciplinary specialist team evaluation and management for cancer results in better patient outcomes. For breast cancer, breast centers are where this evaluation and management occurs. The National Accreditation Program for Breast Centers has helped standardize multidisciplinary breast cancer care by defining services and standards required of accredited breast centers. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. The Gemini Science User Support Department: A community-centered approach to user support (United States)

    Chené, André-Nicolas; Thomas-Osip, Joanna


    The Gemini Science User Support Department (SUSD) was formed a little more than a year ago to create a collaborative community of users and staff and to consolidate existing post-observing support throughout the observatory for more efficient use of resources as well as better visibility amongst our user community. This poster is an opportunity to exchange ideas about how Gemini can improve your experience while working with the Observatory and present details about new avenues of post-observing support coming soon. We encourage your feedback at any time.Shortly after its creation, the SUSD conducted a complete revision of the communication cycle between Gemini and its community of researchers. The cycle was then revisited from the perspective of an astronomer interested in using Gemini for their research. This exercise led to a series of proposed changes that are currently under development, and the implementation of a sub-selection is expected in 2016, including the following. (1) Email notifications: Gemini users will receive new forms of email communications that are more instructive and tailored to their program. The objective is to direct the users more efficiently toward the useful links and documentation all along the lifecycle of the program, from phaseII to after the data are completely reduced. (2) HelpDesk system: The HelpDesk will become more user-friendly and transparent. (3) Webpages: The organization of the Gemini webpages will be redesigned to optimize navigation; especially for anything regarding more critical periods likes phaseIs and phaseIIs. (4) Data Reduction User Forum: Following recommendations from Gemini users, new capabilities were added to the forum, like email notifications, and a voting system, in order to make it more practical. This forum's objective is to bring the Gemini community together to exchange their ideas, thoughts, questions and solutions about data reduction, a sort of Reddit, StackOverflow or Slashdot for Gemini data.

  14. Effectiveness and cost-effectiveness of meaning-centered group psychotherapy in cancer survivors: protocol of a randomized controlled trial. (United States)

    van der Spek, Nadia; Vos, Joël; van Uden-Kraan, Cornelia F; Breitbart, William; Cuijpers, Pim; Knipscheer-Kuipers, Kitty; Willemsen, Vincent; Tollenaar, Rob A E M; van Asperen, Christi J; Verdonck-de Leeuw, Irma M


    Meaning-focused coping may be at the core of adequate adjustment to life after cancer. Cancer survivors who experience their life as meaningful are better adjusted, have better quality of life and psychological functioning. Meaning-Centered Group Psychotherapy for Cancer Survivors (MCGP-CS) was designed to help patients to sustain or enhance a sense of meaning and purpose in their lives. The aim of the proposed study is to evaluate the effectiveness and cost-effectiveness of MCGP-CS. Survivors diagnosed with cancer in the last 5 years and treated with curative intent, are recruited via several hospitals in the Netherlands. After screening, 168 survivors are randomly assigned to one of the three study arms: 1. Meaning-Centered Group Psychotherapy (MCGP-CS) 2. Supportive group psychotherapy (SGP) 3. Care as usual (CAU). Baseline assessment takes place before randomisation, with follow up assessments post-intervention and at 3, 6 and 12 months follow-up. Primary outcome is meaning making (PMP, PTGI, SPWB). Secondary outcome measures address quality of life (EORTC-30), anxiety and depression (HADS), hopelessness (BHS), optimism (LOT-R), adjustment to cancer (MAC), and costs (TIC-P, EQ-5D, PRODISQ). Meaning-focused coping is key to adjustment to life after cancer, however, there is a lack of evidence based psychological interventions in this area. Many cancer survivors experience feelings of loneliness and alienation, and have a need for peer support, therefore a group method in particular, can be beneficial for sustaining or enhancing a sense of meaning. If this MCGP-CS is effective for cancer survivors, it can be implemented in the practice of psycho-oncology care. Netherlands Trial Register, NTR3571.

  15. Liver disease stage determines whether the immune response stifles or stimulates tumor growth | Center for Cancer Research (United States)

    Researchers at the Center for Cancer Research and colleagues from three cancer research centers in Germany have discovered a mechanism whereby precancerous liver cells, found in individuals with chronic liver disease, can prevent neighboring cells from becoming cancerous but can also speed the growth of cells that have already become cancerous.  Learn more...

  16. Improving coordination of care centers for the elderly through IT support

    DEFF Research Database (Denmark)

    Johansen, Andreas Kaas; Lauridsen, Frederik Vahr Bjarnø; Manea, Vlad


    appointments, and general discomfort. In this poster we report on preliminary findings from a project aimed at creating improved IT support for coordination of care for the elderly in a Danish municipality. We propose that in order to successfully support heterogeneous collaboration, our system must address......In Denmark, care of elderly people involves numerous and relatively autonomous care providers, including care centers, activity centers, physiotherapists, doctors, and other specialists. However, due to a poor coordination of activities, many elderly experience a lack of continuity of care, missed...

  17. Quality of laparoscopic radical hysterectomy in developing countries: a comparison of surgical and oncologic outcomes between a comprehensive cancer center in the United States and a cancer center in Colombia. (United States)

    Pareja, Rene; Nick, Alpa M; Schmeler, Kathleen M; Frumovitz, Michael; Soliman, Pamela T; Buitrago, Carlos A; Borrero, Mauricio; Angel, Gonzalo; Reis, Ricardo Dos; Ramirez, Pedro T


    To help determine whether global collaborations for prospective gynecologic surgery trials should include hospitals in developing countries, we compared surgical and oncologic outcomes of patients undergoing laparoscopic radical hysterectomy at a large comprehensive cancer center in the United States and a cancer center in Colombia. Records of the first 50 consecutive patients who underwent laparoscopic radical hysterectomy at The University of Texas MD Anderson Cancer Center in Houston (between April 2004 and July 2007) and the first 50 consecutive patients who underwent the same procedure at the Instituto de Cancerología-Clínica las Américas in Medellín (between December 2008 and October 2010) were retrospectively reviewed. Surgical and oncologic outcomes were compared between the 2 groups. There was no significant difference in median patient age (US 41.9 years [range 23-73] vs. Colombia 44.5 years [range 24-75], P=0.09). Patients in Colombia had a lower median body mass index than patients in the US (24.4 kg/m(2) vs. 28.7 kg/m(2), P=0.002). Compared to patients treated in Colombia, patients who underwent surgery in the US had a greater median estimated blood loss (200 mL vs. 79 mL, P<0.001), longer median operative time (328.5 min vs. 235 min, P<0.001), and longer postoperative hospital stay (2 days vs. 1 day, P<0.001). Surgical and oncologic outcomes of laparoscopic radical hysterectomy were not worse at a cancer center in a developing country than at a large comprehensive cancer center in the United States. These results support consideration of developing countries for inclusion in collaborations for prospective surgical studies. Copyright © 2011 Elsevier B.V. All rights reserved.

  18. [Nutritional assessment and perioperative nutritional support in gastric cancer patients]. (United States)

    Seo, Kyung Won; Yoon, Ki Young


    Weight loss and malnutrition are common in cancer patients. Although weight loss is predominantly due to loss of fat mass, the morbidity risk is given by the decrease in muscle mass. The assessment of nutritional status is essential for a diagnosis of nutritional compromise and required for the multidisciplinary approach. Subjective global assessment (SGA) is made by the patients nutritional symptoms and weight loss. The objective assessment, a significant weight loss (>10%) for 6 months is considered an indicator of nutritional deficiency. The mean body index, body fat mass and body protein mass are decreased as cancer stage increases. The biochemical data of albumin, cholesterol, triglyceride, Zn, transferrin, total lymphocyte count are decreased in advanced cancer stage. Daily energy intake, cabohyderate and Vit B1 intake is decreased according to cancer stage. The patients are divided into three groups according to SGA. The three groups showed a significant difference in body weight, 1 month weight loss%, 6 month weight loss%, body mass index, mid arm circumference, albumin, energy intake, as well as carbohyderate intake protein and energy malnutrition. Nutritional assessment is of great importance because undernutrition has been shown to be associated with increase in stomach cancer associated morbidity and mortality. The authors concluded that nutritional assessment should be done in cancer patients preoperatively, and with adequate nutritional support, the morbidity and mortality would be decreased.

  19. Study shows aspirin reduces the risk and recurrence of prostate cancer in African-American men | Center for Cancer Research (United States)

    African-American men who take a daily dose of aspirin experience a significantly lower risk of developing advanced prostate cancer – the aggressive and deadly form of the disease – than African-American men who do not regularly use aspirin, according to a study from the Center for Cancer Research (CCR) Laboratory of Human Carcinogenesis. Learn more...

  20. Online support groups for women with breast cancer. (United States)

    McCaughan, Eilis; Parahoo, Kader; Hueter, Irene; Northouse, Laurel; Bradbury, Ian


    Survival rates for women with a diagnosis of breast cancer continue to improve. However, some women may experience physical, psychological and emotional effects post diagnosis, throughout treatment and beyond. Support groups can provide opportunities for people to share their experiences and learn from others. As the number of online support groups increases, more and more women with breast cancer will likely access them. To assess effects of online support groups on the emotional distress, uncertainty, anxiety, depression and quality of life (QoL) of women with breast cancer. We searched for trials in the Cochrane Breast Cancer Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 4), MEDLINE, Embase and PsycINFO on 2 May 2016, and we handsearched journals and reference lists. We also searched the World Health Organization's International Clinical Trials Registry Platform (WHO ICTRP) search portal and on 2 May 2016. We included randomised controlled trials (RCTs) assessing effects of online support groups on women with a diagnosis of breast cancer and women who have completed breast cancer treatment. We included studies comparing online support groups with a usual care group, and studies comparing two or more types of online support groups (without a usual care group). Two review authors independently extracted data and assessed risk of bias. We presented outcome data using mean differences (MDs) and standardised mean differences (SMDs) along with 95% confidence intervals (CIs), and we used the fixed-effect model when appropriate. We assessed the quality of the body of evidence using the GRADE approach. We included six studies (492 women) that assessed online support groups for women with breast cancer. Online support groups in these six trials lasted from six to 30 weeks. Women participated in these groups between 1.5 and 2.5 hours per week, and investigators conducted all studies in the USA

  1. Meharry-Johns Hopkins Center for Prostate Cancer Research (United States)


    SUPPLEMENTARY NOTES 14. ABSTRACT This project seeks to add to research knowledge that impacts racial disparities in prostate cancer by examining how...project seeks to add to available research on racial disparities in prostate cancer by examining health patterns among sons of fathers with the disease...Institute (NCI) state cancer profiles , the mortality rate is almost three times that of CA men (73.9 per 100,000 AA / 25.6 per 100,000 C). Genetic and

  2. Women and prostate cancer support groups: the gender connect? (United States)

    Bottorff, Joan L; Oliffe, John L; Halpin, Michael; Phillips, Melanie; McLean, Graham; Mroz, Lawrence


    There are more than 100 prostate cancer support groups (PCSGs) in Canada, most of which meet on a monthly basis-yet little attention has been paid to the role of women at these groups. As part of an ongoing ethnographic study of PCSGs, we examined women's motivations for attending the groups, their ways of functioning in PCSGs and the benefits they accrued. Participant observations conducted at 13 British Columbian-based PCSGs and individual interview data from 20 women who regularly attended PCSG meetings were analyzed. Although the groups did not overtly limit women's attendance, the women's decisions to attend and their participation at group meetings were subject to much self-reflection, uncertainty and tension. Motivations to access a PCSG included a desire to support their partners, develop understandings about the illness and disease, and to manage their own experience of prostate cancer. Our analyses revealed that women assume three roles in PCSGs: social facilitator, background supporter and cancer co-survivor. The women reported many interrelated benefits as a result of attending, including information, hope and reassurance, and connecting with other women in similar circumstances. The results from this study reveal how traditional feminine ideals, such as nurturing and caring for the men in their lives, facilitating social connections and the desire to share emotional experiences guided the behaviors. Based on the study findings, we suggest that efforts to support women's involvement in PCSGs are critical to enhancing the effectiveness of the groups for both men and women.

  3. Prevalence of renal insufficiency in elderly cancer patients in a tertiary cancer center. (United States)

    Pontes, Lucíola de Barros; Antunes, Yuri Philippe Pimentel Vieira; Bugano, Diogo Diniz Gomes; Karnakis, Theodora; Giglio, Auro Del; Kaliks, Rafael Aliosha


    To estimate the prevalence of abnormal glomerular filtration rate in elderly patients with solid tumors. A retrospective study with patients aged >65 years diagnosed with solid tumors between January 2007 and December 2011 in a cancer center. The following data were collected: sex, age, serum creatinine at the time of diagnosis and type of tumor. Renal function was calculated using abbreviated Modification of Diet in Renal Disease (MDRD) formulae and then staged in accordance with the clinical practice guidelines published by the Working Group of the National Kidney Foundation. A total of 666 patients were included and 60% were male. The median age was 74.2 years (range: 65 to 99 years). The most prevalent diagnosis in the study population were colorectal (24%), prostate (20%), breast (16%) and lung cancer (16%). The prevalence of elevated serum creatinine (>1.0mg/dL) was 30%. However, when patients were assessed using abbreviated MDRD formulae, 66% had abnormal renal function, stratified as follows: 45% with stage 2, 18% with stage 3, 3% with stage 4 and 0.3% with stage 5. To the best of our knowledge, this was the first study to estimate the frequency of renal insufficiency in elderly cancer patients in Brazil. The prevalence of abnormal renal function among our cohort was high. As suspected, the absolute creatinine level does underestimate renal function impairment and should not be used as predictor of chemotherapy metabolism, excretion and consequent toxicity.

  4. Sociodemographic parameters of Esophageal Cancer in northwest India: A regional cancer center experience of 10 years

    Directory of Open Access Journals (Sweden)

    Akhil Kapoor


    Full Text Available Background: Despite various advances in the treatment of Esophageal Cancer (EC, being one of the least responsive tumors to cancer therapy, the overall prognosis remains poor. Therefore, it is significant to understand various sociodemographic factors associated with EC to find out various schemes for primary prevention of the disease. Materials and Methods: This is a retrospective analysis of medical records of the EC patients registered in the regional cancer center of northwest India from January 2003 to December 2012. The site of the disease and the histology were also recorded in addition to the various sociodemographic parameters. Results: Out of 55,742 patients registered in our hospital; 3,667 were diagnosed to have EC. Male:female ratio was 1.15:1. The mean age was 54.6 ± 11.74 years; 66.15% of the patients were illiterate and 48.6% belonged to the low socioeconomic status. Smoking and alcohol consumption were identified as risk factors in 48 and 25.6% of the patients, respectively. Conclusions: The etiology in majority of the patients is linked to tobacco and alcohol, thus, modification of life style with limiting the use of addictions may be an effective strategy in the prevention of this dreaded and mostly incurable disease.

  5. Interactive breast cancer segmentation based on relevance feedback: from user-centered design to evaluation (United States)

    Gouze, A.; Kieffer, S.; Van Brussel, C.; Moncarey, R.; Grivegnée, A.; Macq, B.


    Computer systems play an important role in medical imaging industry since radiologists depend on it for visualization, interpretation, communication and archiving. In particular, computer-aided diagnosis (CAD) systems help in lesion detection tasks. This paper presents the design and the development of an interactive segmentation tool for breast cancer screening and diagnosis. The tool conception is based upon a user-centered approach in order to ensure that the application is of real benefit to radiologists. The analysis of user expectations, workflow and decision-making practices give rise to the need for an interactive reporting system based on the BIRADS, that would not only include the numerical features extracted from the segmentation of the findings in a structured manner, but also support human relevance feedback as well. This way, the numerical results from segmentation can be either validated by end-users or enhanced thanks to domain-experts subjective interpretation. Such a domain-expert centered system requires the segmentation to be sufficiently accurate and locally adapted, and the features to be carefully selected in order to best suit user's knowledge and to be of use in enhancing segmentation. Improving segmentation accuracy with relevance feedback and providing radiologists with a user-friendly interface to support image analysis are the contributions of this work. The preliminary result is first the tool conception, and second the improvement of the segmentation precision.

  6. Mayo Clinic Cancer Center experience of metastatic extramammary Paget disease 1998-2012

    Directory of Open Access Journals (Sweden)

    Leslie Padrnos


    Full Text Available Extramammary Paget disease (EMPD is a rare cutaneous malignancy. The most common presentation of EMPD is the vulva followed by perianal involvement. Most cases are localized to the dermis with treatment focused on surgery, topical treatment or radiotherapy. Recurrence is frequent despite therapies utilized. Metastatic extramammary Paget disease is uncommon and, as such, standard treatment guidelines do not exist. This study sought to evaluate the treatment regimens and outcomes of patients treated at a Mayo Clinic Center from 1998-2012. Cancer registry inquiry revealed 261 patients with report advanced Paget disease during these years. Ten cases of metastatic EPMD were identified with sufficient documentation for review. This review reveals support for utilizing localized radiation therapy for bulky disease sequentially with systemic chemotherapy consisting of carboplatin and paclitaxel or irinotecan. Further studies are necessary to define the optimal treatment regimen.

  7. [Psychosocial Situation and Patient Satisfaction among Clients of Cancer Counselling Centers in Saxony]. (United States)

    Götze, Heide; Röder, Heiko; Frenschkowski, Sandra; Mehnert, Anja


    Outpatient psychosocial counselling (OPC) centers for those affected by cancer fulfill 2 main purposes: (a) to offer low-threshold psychological, social and legal counselling, and (b) to refer clients to other services. Here we report findings from a user-based assessment of OPC in the state of Saxony, Germany. This study was funded in part by the Saxon State Ministry of Social Affairs and Consumer Protection. We used a paper-based questionnaire to survey 213 clients of OPC in Saxony at 2 points (t1: up to one week after first contact, t2: 4 months after t1). All participants were cancer patients. The survey assessed utilization of services, depressive symptoms (PHQ-9), anxiety (GAD-7), quality of life (SF-8) as well as clients' satisfaction with the counselling service (ZUF-8). The majority of clients (81%) were referred to the OPC from a hospital or rehabilitation center. 46% of patients only had one contact. 78% of counselling sessions treated matters of social law. Patients suffered from 13 problems on average, the most common being fatigue and exhaustion, worries, anxiety, uncertainty about the future, and pain. Half the patients (49%) reported moderate to severe anxiety and 68% showed elevated levels of depressive symptoms. Psychosocial distress did not change significantly over time (GAD-7: p=0.580, PHQ-9: p=0.101). Patients' quality of life was low overall (cut-off<50). At t2, quality of life had particularly increased in physical aspects, but overall quality of life remained lower than in the general population (all subscales: p<0.05). We identified younger age and lower income as risk factors for higher psychosocial distress and lower quality of life. Patients were very satisfied with the counselling they received, 9% reported to be dissatisfied. Our results show that psychosocial distress remains high over a longer period of time at least for some patients. This illustrates the persisting need for long-term support regarding physical, mental and social

  8. Using the Multicultural Family Support Centers and Adjustment among Interethnic and Interracial Families in South Korea (United States)

    Chung, Grace H.; Yoo, Joan P.


    The present study proposes a model of using the Multicultural Family Support Centers and adjustment among foreign brides and their interethnic and interracial families in South Korea based on the narratives of 10 foreign brides married to Korean men and 11 service providers who directly interact with these women and their families. The results…

  9. 78 FR 37228 - Cooperative Agreement To Support the Western Center for Food Safety (United States)


    ... Safety AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug... Western Center for Food Safety (WCFS). FDA regards the continued support of WCFS as crucial to receiving invaluable insight into the food safety issues that it is directed to address through various provisions of...

  10. Family Members' Views on Seeking Placement in State-Supported Living Centers in Texas (United States)

    Colvin, Alex D.; Larke, Patricia J.


    This study investigated the factors that influence family members' decisions to seek placement for relatives with intellectual and/or developmental disabilities (ID/DD) into state-supported living centers in Texas. The sample included 51 family caregivers between the ages of 26 and 95. Using descriptive statistics, correlation, and inferential…

  11. State of the Art Student Support Services in an IEP Learning Center (United States)

    Hanson, Jessica; Maxwell, Jeffrey; Mulder, Monika


    Intensive English language programs (IEPs) at American universities have the task of recruiting, retaining, and preparing international students for mainstream classes. In order to achieve these tasks, many programs have explored using supplemental instruction (SI) in the form of learning centers (LCs) to support their students. In this study, we…

  12. 78 FR 42084 - Electronic Study Data Submission; Data Standard Support; Availability of the Center for Drug... (United States)


    ... HUMAN SERVICES Food and Drug Administration Electronic Study Data Submission; Data Standard Support... Drug Administration, HHS. ACTION: Notice. SUMMARY: The Center for Drug Evaluation and Research (CDER) of the Food and Drug Administration (FDA) is announcing the availability of the CDER Data Standards...

  13. Providing Open-Access Know How for Directors of Quantitative and Mathematics Support Centers

    Directory of Open Access Journals (Sweden)

    Michael Schuckers


    Full Text Available The purpose of this editorial is to introduce the quantitative literacy community to the newly published A Handbook for Directors of Quantitative and Mathematics Centers. QMaSCs (pronounced “Q-masks” can be broadly defined as centers that have supporting students in quantitative fields of study as part of their mission. Some focus only on calculus or mathematics; others concentrate on numeracy or quantitative literacy, and some do all of that. A QMaSC may be embedded in a mathematics department, or part of a learning commons, or a stand-alone center. There are hundreds of these centers in the U.S. The new handbook, which is the outgrowth of a 2013 NSF-sponsored, national workshop attended by 23 QMaSC directors from all quarters of the U.S., is available open access on the USF Scholar Commons and in hard copy from This editorial by the handbook’s editors provides background and overview of the 20 detailed chapters on center leadership and management; community interactions; staffing, hiring and training; center assessment; and starting a center; and then a collection of ten case studies from research universities, four-year state colleges, liberal arts colleges, and a community college. The editorial ends by pointing out the need and potential benefits of a professional organization for QMaSC directors.

  14. Social Support for Siblings of Children with Cancer (United States)


    collect data included the Brown IDS Self-Concept Reference Test , Family Relations Test , Roberts Apperception Test and 17 the Family Environment Scale. The... Apperception Test (TAT). Scores from the Piers-Harris and Family Relations Test were analyzed using t tests for separate samples and chi-square tests ...DATES COVtIRED May 1993 THESIS/D_ 4. TITLE AND SUBTITLE 5. FUNDING NUMBERS Social Support for Siblings of Children with Cancer 6. AUTHOR(S) John

  15. How should we design supportive cancer care? The patient's perspective. (United States)

    Casarett, David; Fishman, Jessica; O'Dwyer, Peter J; Barg, Frances K; Naylor, Mary; Asch, David A


    Hospice services are designed to meet the needs of patients near the end of life. Although so-called open-access hospice programs and bridge programs are beginning to offer these services to patients who are still receiving treatment, it is not known whether they best meet patients' needs. Three hundred adult patients receiving treatment for cancer completed interviews in which each patient's value or ability for supportive care services were calculated from the choices that they made among combinations of those services. Preferences for five traditional hospice services and six alternative supportive care services were measured, and patients were followed up for 6 months or until death. Patients' utilities for alternative services were higher than those for traditional hospice services (0.53 v 0.39; sign-rank test P 2; n = 54; 0.65 v 0.48; P < .001) and among those who were in the last 6 months of life (0.68 v 0.56; sign-rank test P = .003). Even patients who were willing to forgo cancer treatment (n = 38; 13%) preferred alternative services (3.1 v 1.8; P < .001). Patients who are receiving active treatment for cancer, and even those who are willing to stop treatment, express a clear preference for alternative supportive care services over traditional hospice services. Supportive care programs for patients with advanced cancer should reconsider the services that they offer and might seek to include novel services in addition to, or perhaps instead of, traditional hospice services.

  16. A person-centered intervention targeting the psychosocial needs of gynecological cancer survivors

    DEFF Research Database (Denmark)

    Olesen, Mette Linnet; Duun-Henriksen, Anne Katrine; Hansson, Eva Helena


    PURPOSE: We investigated the effect of a person-centered intervention consisting of two to four nurse-led conversations using guided self-determination tailored to gynecologic cancer (GSD-GYN-C) on gynecological cancer survivors' quality of life (QOL), impact of cancer, distress, anxiety......, depression, self-esteem, and self-reported ability to monitor and respond to symptoms of recurrence. METHODS: We randomly assigned 165 gynecological cancer survivors to usual care (UC) plus GSD-GYN-C or UC alone. Self-reported QOL-cancer survivor (QOL-CS) total score and subscale scores on physical...... and control groups after baseline adjustment. CONCLUSION: We observed higher physical well-being 9 months after randomization in the GSD-GYN-C group, as compared to women receiving usual care. IMPLICATIONS FOR CANCER SURVIVORS: The results suggest that the person-centered intervention GSD-GYN-C may improve...

  17. The role of support in wrestling with cancer

    Directory of Open Access Journals (Sweden)

    Marzena Kamińska


    Full Text Available The support provided to patients with cancer is an important determinant of their sense of security and quality of life at all stages of diagnosis, treatment, rehabilitation, remission or progression of the disease. The support is complex; its nature and scope depend on the current needs of the people who receive it. The subjective dimension of the support given to oncology patients offer sample opportunities to address the psychological impact, overcoming stress, a pathy and feelings of lesser self-esteem and use less ness. The level of support very often determines the level of optimistic attitude to life of patients and influences their motivation to fight with the disease.

  18. Chromosomal Translocations: Chicken or Egg? | Center for Cancer Research (United States)

    Many tumor cells have abnormal chromosomes. Some of these abnormalities are caused by chromosomal translocations, which occur when two chromosomes break and incorrectly rejoin, resulting in an exchange of genetic material. Translocations can activate oncogenes, silence tumor suppressor genes, or result in the creation of completely new fusion gene products. While there is little doubt that chromosomal translocations can contribute to cancer, there is an active "chicken and the egg" discussion about the role translocations and other chromosomal abnormalities play—do they actually cause cancer or merely occur because of other changes within the cancer cell.  

  19. Medullary Thyroid Carcinoma Program | Center for Cancer Research (United States)

    Medullary Thyroid Carcinoma Program Multiple endocrine neoplasia (MEN) types 2A and 2B are rare genetic diseases, which lead to the development of medullary thyroid cancer, usually in childhood. Surgery is the only standard treatment.

  20. Understanding Papillary Renal Cell Carcinoma | Center for Cancer Research (United States)

    Renal cell carcinoma (RCC), the most common form of kidney cancer in adults, is not a single disease but rather a collection of different tumor types driven by distinct genetic changes that arise within the same tissue.

  1. Language-based communication strategies that support person-centered communication with persons with dementia. (United States)

    Savundranayagam, Marie Y; Moore-Nielsen, Kelsey


    There are many recommended language-based strategies for effective communication with persons with dementia. What is unknown is whether effective language-based strategies are also person centered. Accordingly, the objective of this study was to examine whether language-based strategies for effective communication with persons with dementia overlapped with the following indicators of person-centered communication: recognition, negotiation, facilitation, and validation. Conversations (N = 46) between staff-resident dyads were audio-recorded during routine care tasks over 12 weeks. Staff utterances were coded twice, using language-based and person-centered categories. There were 21 language-based categories and 4 person-centered categories. There were 5,800 utterances transcribed: 2,409 without indicators, 1,699 coded as language or person centered, and 1,692 overlapping utterances. For recognition, 26% of utterances were greetings, 21% were affirmations, 13% were questions (yes/no and open-ended), and 15% involved rephrasing. Questions (yes/no, choice, and open-ended) comprised 74% of utterances that were coded as negotiation. A similar pattern was observed for utterances coded as facilitation where 51% of utterances coded as facilitation were yes/no questions, open-ended questions, and choice questions. However, 21% of facilitative utterances were affirmations and 13% involved rephrasing. Finally, 89% of utterances coded as validation were affirmations. The findings identify specific language-based strategies that support person-centered communication. However, between 1 and 4, out of a possible 21 language-based strategies, overlapped with at least 10% of utterances coded as each person-centered indicator. This finding suggests that staff need training to use more diverse language strategies that support personhood of residents with dementia.

  2. Providing Open-Access Know How for Directors of Quantitative and Mathematics Support Centers


    Michael Schuckers; Mary B. O'Neill; Grace Coulombe


    The purpose of this editorial is to introduce the quantitative literacy community to the newly published A Handbook for Directors of Quantitative and Mathematics Centers. QMaSCs (pronounced “Q-masks”) can be broadly defined as centers that have supporting students in quantitative fields of study as part of their mission. Some focus only on calculus or mathematics; others concentrate on numeracy or quantitative literacy, and some do all of that. A QMaSC may be embedded in a mathematics departm...

  3. Prevalence and correlates of postdiagnosis initiation of complementary and alternative medicine among patients at a comprehensive cancer center. (United States)

    Perlman, Adam; Lontok, Oliver; Huhmann, Maureen; Parrott, J Scott; Simmons, Leigh Ann; Patrick-Miller, Linda


    Patients with cancer increasingly use complementary and alternative medicine (CAM) in conjunction with conventional oncology treatments. Previous studies have not investigated postdiagnosis initiation of CAM therapies or independent correlates of use of individual CAM modalities. The purpose of this study was to determine the prevalence and correlates of individual CAM modalities initiated after cancer diagnosis. A cross-sectional survey was conducted of a random sample of adults with a cancer diagnosis (N = 1,228) seeking care at a National Cancer Institute-designated comprehensive cancer center within a 12-month period. The majority of patients were female (64.7%), white (86.9%), and married (72.8%).Three-quarters (75.2%) used at least one CAM modality, and 57.6% of those using CAM initiated use after cancer diagnosis. For all CAM therapies combined, women were 1.7 times more likely than men to initiate any CAM therapy after cancer diagnosis. However, when CAM modalities were differentiated by type, men and women were equally likely to initiate all therapies except for psychotherapy and mind-body approaches. Postdiagnosis initiation of every CAM modality, except mind-body therapies, differed by cancer type. A significant proportion of patients initiated CAM use after diagnosis. However, specific type of CAM initiated varied by demographics and cancer type, suggesting there is not a "typology" of CAM user. Optimal comprehensive cancer treatment, palliation, and survivorship care will require patient and provider education regarding CAM use by modality type; improved provider-patient communication regarding potential benefits, limitations, and risks; and institutional policies to support integrated conventional and CAM treatment.

  4. Vaginal Radical Trachelectomy for early stage cervical cancer. Results of the Danish National Single Center Strategy

    DEFF Research Database (Denmark)

    Hauerberg, L; Høgdall, C; Loft, A


    OBJECTIVE: To present and evaluate an unselected national single center strategy with fertility preserving trachelectomy in cervical cancer. In 2003 nationwide single-center referral of women for trachelectomies was agreed upon between all Danish departments performing cervical cancer surgery...... a total of 77 pregnancies. Of the 72 women 40 were referred to fertility treatment. First and second trimester miscarriage rates were 21.6% and 2.7%, respectively. A total of 53 children were born of which 41 were delivered after gestational week 34. CONCLUSION: This unselected national single center...

  5. Symptomatic improvement reported after receiving Reiki at a cancer infusion center. (United States)

    Marcus, Dawn A; Blazek-O'Neill, Betsy; Kopar, Jennifer L


    To evaluate patient-perceived benefits from receiving Reiki at a cancer infusion center. During a 6-month period, adults at a university hospital receiving Reiki through volunteer services were invited to complete a survey asking about perceived changes after Reiki. Changes in pain, mood, distress, sleep, and appetite were rated on a 5-point scale from no benefit to great benefit. Surveys were distributed after completing treatment and were returned in postage-paid envelops. A total of 145 surveys were completed (34.5% response rate), with 47 participants seen in the cancer infusion center and 98 in other areas of the hospital. Reiki was rated as a positive experience by 94% at the cancer center and 93% of others, with 92% at the cancer center and 86% of others interested in receiving additional Reiki sessions. Symptomatic improvement was similar for people at the cancer center and others, respectively, with much to great improvement for 89% and 86% for relaxation, 75% and 75% for anxiety/worry, 81% and 78% for improved mood, 43% and 35% for improved sleep, 45% and 49% for reduced pain, 38% and 43% for reduced isolation/loneliness, 75% and 63% for improved attitude, and 30% and 30% for improved appetite. Response was unaffected by previous exposure to Reiki, massage, or other touch therapy. Reiki results in a broad range of symptomatic benefits, including improvements in common cancer-related symptoms.

  6. Patient-centered cancer treatment planning: improving the quality of oncology care. Summary of an Institute of Medicine workshop. (United States)

    Balogh, Erin P; Ganz, Patricia A; Murphy, Sharon B; Nass, Sharyl J; Ferrell, Betty R; Stovall, Ellen


    The Institute of Medicine's National Cancer Policy Forum recently convened a workshop on patient-centered cancer treatment planning, with the aim of raising awareness about this important but often overlooked aspect of cancer treatment. A primary goal of patient-centered treatment planning is to engage patients and their families in meaningful, thorough interactions with their health care providers to develop an accurate, well-conceived treatment plan, using all available medical information appropriately while also considering the medical, social, and cultural needs and desires of the patient and family. A cancer treatment plan can be shared among the patient, family, and care team in order to facilitate care coordination and provide a roadmap to help patients navigate the path of cancer treatment. There are numerous obstacles to achieving patient-centered cancer treatment planning in practice. Some of these challenges stem from the patient and include patients' lack of assertiveness, health literacy, and numeracy, and their emotional state and concurrent illnesses. Others are a result of physician limitations, such as a lack of time to explain complex information and a lack of tools to facilitate treatment planning, as well as insensitivity to patients' informational, cultural, and emotional needs. Potential solutions to address these obstacles include better training of health care providers and patients in optimal communication and shared decision making, and greater use of support services and tools such as patient navigation and electronic health records. Other options include greater use of quality metrics and reimbursement for the time it takes to develop, discuss, and document a treatment plan.

  7. Pain centers professionals' beliefs on non-cancer chronic pain

    National Research Council Canada - National Science Library

    Dayse Maioli Garcia; Cibele Andrucioli de Mattos-Pimenta


    ...%) pain centers in the city of S.Paulo. The Survey of Chronic Pain Attitudes-Professionals was employed to evaluate pain professionals' beliefs toward emotions, control, disability, solicitude, cure and harm...

  8. Tumor Biology and Immunology | Center for Cancer Research (United States)

    Tumor Biology and Immunology The Comparative Brain Tumor Consortium is collaborating with National Center for Advanced Translational Sciences to complete whole exome sequencing on canine meningioma samples. Results will be published and made publicly available.

  9. University of Nebraska Medical Center | Division of Cancer Prevention (United States)

    Principal investigator: Michael (Tony) A. Hollingsworth, PhD Institution: Research Unit - University of Nebraska Medical Center Title of the PCDC Project This page is under construction. Please check back at a later date. |

  10. Aggressive Treatment of Patients with Metastatic Colorectal Cancer Increases Survival: A Scandinavian Single-Center Experience

    Directory of Open Access Journals (Sweden)

    Kristoffer Watten Brudvik


    Full Text Available Background. We examined overall and disease-free survivals in a cohort of patients subjected to resection of liver metastasis from colorectal cancer (CRLM in a 10-year period when new treatment strategies were implemented. Methods. Data from 239 consecutive patients selected for liver resection of CRLM during the period from 2002 to 2011 at a single center were used to estimate overall and disease-free survival. The results were assessed against new treatment strategies and established risk factors. Results. The 5-year cumulative overall and disease-free survivals were 46 and 24%. The overall survival was the same after reresection, independently of the number of prior resections and irrespectively of the location of the recurrent disease. The time intervals between each recurrence were similar (11 ± 1 months. Patients with high tumor load given neoadjuvant chemotherapy had comparable survival to those with less extensive disease without neoadjuvant chemotherapy. Positive resection margin or resectable extrahepatic disease did not affect overall survival. Conclusion. Our data support that one still, and perhaps to an even greater extent, should seek an aggressive therapeutic strategy to achieve resectable status for recurrent hepatic and extrahepatic metastases. The data should be viewed in the context of recent advances in the understanding of cancer biology and the metastatic process.

  11. Meaning-centered group psychotherapy for patients with advanced cancer: a pilot randomized controlled trial. (United States)

    Breitbart, William; Rosenfeld, Barry; Gibson, Christopher; Pessin, Hayley; Poppito, Shannon; Nelson, Christian; Tomarken, Alexis; Timm, Anne Kosinski; Berg, Amy; Jacobson, Colleen; Sorger, Brooke; Abbey, Jennifer; Olden, Megan


    An increasingly important concern for clinicians who care for patients at the end of life is their spiritual well-being and sense of meaning and purpose in life. In response to the need for short-term interventions to address spiritual well-being, we developed Meaning Centered Group Psychotherapy (MCGP) to help patients with advanced cancer sustain or enhance a sense of meaning, peace and purpose in their lives, even as they approach the end of life. Patients with advanced (stage III or IV) solid tumor cancers (N=90) were randomly assigned to either MCGP or a supportive group psychotherapy (SGP). Patients were assessed before and after completing the 8-week intervention, and again 2 months after completion. Outcome assessment included measures of spiritual well-being, meaning, hopelessness, desire for death, optimism/pessimism, anxiety, depression and overall quality of life. MCGP resulted in significantly greater improvements in spiritual well-being and a sense of meaning. Treatment gains were even more substantial (based on effect size estimates) at the second follow-up assessment. Improvements in anxiety and desire for death were also significant (and increased over time). There was no significant improvement on any of these variables for patients participating in SGP. MCGP appears to be a potentially beneficial intervention for patients' emotional and spiritual suffering at the end of life. Further research, with larger samples, is clearly needed to better understand the potential benefits of this novel intervention. (c) 2009 John Wiley & Sons, Ltd.

  12. Analysis of Maryland cancer patient participation in National Cancer Institute-supported cancer treatment clinical trials. (United States)

    Baquet, Claudia R; Ellison, Gary L; Mishra, Shiraz I


    We examined the relationship of sociodemographic factors, urban/rural residence, and county-level socioeconomic factors on accrual of Maryland patients with cancer to National Cancer Institute (NCI)-sponsored cancer treatment clinical trials. Data were analyzed for the period 1999 to 2002 for 2240 Maryland patients with cancer accrued onto NCI-sponsored treatment trials. The extent to which Maryland patients with cancer and patients residing in lower socioeconomic and/or rural areas were accrued to cancer trials and were representative of all patients with cancer in Maryland was determined. Data were obtained from several sources, including NCI's Cancer Therapy Evaluation Program for Maryland patients with cancer in Cooperative Group therapeutic trials, Maryland Cancer Registry data on cancer incidence, and United States Census and the Department of Agriculture. For Maryland patients with cancer accrued onto NCI-sponsored treatment trials between 1999 and 2002, subgroups accrued at a higher rate included pediatric and adolescent age groups, white patients, female patients (for sex-specific tumors), patients with private health insurance, and patients residing in the Maryland National Capitol region. Moreover, between 1999 and 2002, there was an estimated annual decline (8.9% per year; P Maryland patients with cancer onto NCI-sponsored treatment trials based on patient age, race/ethnicity, geography of residence, and county-level socioeconomic factors. Findings provide the basis for development of innovative tailored and targeted educational efforts to improve trial accrual, particularly for the underserved.


    Directory of Open Access Journals (Sweden)

    A. V. Masloboev


    Full Text Available The paper deals with engineering problems and application perspectives of virtual cognitive centers as intelligent systems for information support of interagency activities in the field of complex security management of regional development. A research prototype of virtual cognitive center for regional security management in crisis situations, implemented as hybrid cloud service based on IaaS architectural framework with the usage of multi-agent and web-service technologies has been developed. Virtual cognitive center is a training simulator software system and is intended for solving on the basis of distributed simulation such problems as: strategic planning and forecasting of risk-sustainable development of regional socioeconomic systems, agents of management interaction specification synthesis for regional components security in different crisis situations within the planning stage of joint anti-crisis actions.

  14. Multidisciplinary Optimization of Oral Chemotherapy Delivery at the University of Wisconsin Carbone Cancer Center. (United States)

    Mulkerin, Daniel L; Bergsbaken, Jason J; Fischer, Jessica A; Mulkerin, Mary J; Bohler, Aaron M; Mably, Mary S


    Use of oral chemotherapy is expanding and offers advantages while posing unique safety challenges. ASCO and the Oncology Nursing Society jointly published safety standards for administering chemotherapy that offer a framework for improving oral chemotherapy practice at the University of Wisconsin Carbone Cancer Center. With the goal of improving safety, quality, and uniformity within our oral chemotherapy practice, we conducted a gap analysis comparing our practice against ASCO/Oncology Nursing Society guidelines. Areas for improvement were addressed by multidisciplinary workgroups that focused on education, workflows, and information technology. Recommendations and process changes included defining chemotherapy, standardizing patient and caregiver education, mandating the use of comprehensive electronic order sets, and standardizing documentation for dose modification. Revised processes allow pharmacists to review all orders for oral chemotherapy, and they support monitoring adherence and toxicity by using a library of scripted materials. Between August 2015 and January 2016, revised processes were implemented across the University of Wisconsin Carbone Cancer Center clinics. The following are key performance indicators: 92.5% of oral chemotherapy orders (n = 1,216) were initiated within comprehensive electronic order sets (N = 1,315), 89.2% compliance with informed consent was achieved, 14.7% of orders (n = 193) required an average of 4.4 minutes review time by the pharmacist, and 100% compliance with first-cycle monitoring of adherence and toxicity was achieved. We closed significant gaps between institutional practice and published standards for our oral chemotherapy practice and experienced steady improvement and sustainable performance in key metrics. We created an electronic definition of oral chemotherapies that allowed us to leverage our electronic health records. We believe our tools are broadly applicable.

  15. 78 FR 22794 - World Trade Center Health Program; Certification of Breast Cancer in WTC Responders and Survivors... (United States)


    ... disruption, as a 9/11 exposure, could be associated with breast cancer.\\3\\ For that reason, the Administrator... HUMAN SERVICES 42 CFR Part 88 World Trade Center Health Program; Certification of Breast Cancer in WTC... Federal Register adding certain types of cancer to the List of World Trade Center (WTC)-Related Health...

  16. Health promotion and illness demotion at prostate cancer support groups. (United States)

    Oliffe, John L; Gerbrandt, Julieta S; Bottorff, Joan L; Hislop, T Gregory


    Although health promotion programs can positively influence health practices, men typically react to symptoms, rather than maintain their health, and are more likely to deny than discuss illness-related issues. Prostate cancer support groups (PCSGs) provide an intriguing exception to these practices, in that men routinely discuss ordinarily private illness experiences and engage with self-health. This article draws on individual interview data from 52 men, and participant observations conducted at the meetings of 15 groups in British Columbia, Canada to provide insights to how groups simultaneously facilitate health promotion and illness demotion. The study findings reveal how an environment conducive to men's talk was established to normalize prostate cancer and promote the individual and collective health of group members. From a gendered perspective, men both disrupted and embodied dominant ideals of masculinity in how they engaged with their health at PCSGs.

  17. Recombination Origin of Retrovirus XMRV | Center for Cancer Research (United States)

    Xenotropic murine leukemia virus–related virus (XMRV) was first reported in samples from a human prostate tumor in 2006, and, at that time, claims were made that XMRV infection rates ranged from 6 to 27 percent of human prostate cancers.  Later research reported XMRV in the blood of 67 percent of people with chronic fatigue syndrome (CFS). When follow-up studies failed to detect XMRV in multiple sets of specimens from people with prostate cancer or CFS and healthy controls, the original reports came under closer scrutiny.

  18. Supportive Care: Integration of Patient-Centered Kidney Care to Manage Symptoms and Geriatric Syndromes (United States)

    Jassal, Sarbjit Vanita


    Dialysis care is often associated with poor outcomes including low quality of life (QOL). To improve patient-reported outcomes, incorporation of the patient’s needs and perspective into the medical care they receive is essential. This article provides a framework to help clinicians integrate symptom assessment and other measures such as QOL and frailty scores into a clinical approach to the contemporary supportive care of patients with advanced CKD. This approach involves (1) defining our understanding of kidney supportive care, patient-centered dialysis, and palliative dialysis; (2) understanding and recognizing common symptoms associated with advanced CKD; (3) discussing the concepts of physical function, frailty, and QOL and their role in CKD; and (4) identifying the structural and process barriers that may arise when patient-centered dialysis is being introduced into clinical practice. PMID:27510454

  19. Pioneering Quality Assessment in European Cancer Centers: A Data Analysis of the Organization for European Cancer Institutes Accreditation and Designation Program

    NARCIS (Netherlands)

    Saghatchian, Mahasti; Thonon, Frederique; Boomsma, Femke; Hummel, Henk; Koot, Bert; Harrison, Chris; Rajan, Abinaya; de Valeriola, Dominique; Otter, Renee; Pontes, Jose Laranja; Lombardo, Claudio; McGrath, Eoin; Ringborg, Ulrik; Tursz, Thomas; van Harten, Willem H.


    Purpose: In order to improve the quality of care in Cancer Centers (CC) and designate Comprehensive Cancer Centers (CCCs), the Organization for European Cancer Institutes (OECI) launched an Accreditation and Designation (A&D) program. The program facilitates the collection of defined data and the

  20. A Survey of User-Centered System Design for Supporting Online Collaborative Writing

    Directory of Open Access Journals (Sweden)

    Nani Sri Handayani


    Full Text Available Collaborative Writing (CW is a new emerging issue in education that must be addressed interdisciplinary. Nowadays there are a lot soft ware that can be use to support and enhance the collaboration in group writing. This paper presents the discussion about the recent user centre system design for supporting collaborative writing. Based on the taxonomy and collaborative writing and the problems appear in collaborative writing, we will proposed the required design of the User-Centered System Design (UCSD for CW software. The last part of this paper will be dedicated to examine the recent available CW soft wares based on the required designed proposed

  1. Crop Production for Advanced Life Support Systems - Observations From the Kennedy Space Center Breadboard Project (United States)

    Wheeler, R. M.; Sager, J. C.; Prince, R. P.; Knott, W. M.; Mackowiak, C. L.; Stutte, G. W.; Yorio, N. C.; Ruffe, L. M.; Peterson, B. V.; Goins, G. D.


    The use of plants for bioregenerative life support for space missions was first studied by the US Air Force in the 1950s and 1960s. Extensive testing was also conducted from the 1960s through the 1980s by Russian researchers located at the Institute of Biophysics in Krasnoyarsk, Siberia, and the Institute for Biomedical Problems in Moscow. NASA initiated bioregenerative research in the 1960s (e.g., Hydrogenomonas) but this research did not include testing with plants until about 1980, with the start of the Controlled Ecological Life Support System (CELSS) Program. The NASA CELSS research was carried out at universities, private corporations, and NASA field centers, including Kennedy Space Center (KSC). The project at KSC began in 1985 and was called the CELSS Breadboard Project to indicate the capability for plugging in and testing various life support technologies; this name has since been dropped but bioregenerative testing at KSC has continued to the present under the NASA s Advanced Life Support (ALS) Program. A primary objective of the KSC testing was to conduct pre-integration tests with plants (crops) in a large, atmospherically closed test chamber called the Biomass Production Chamber (BPC). Test protocols for the BPC were based on observations and growing procedures developed by university investigators, as well as procedures developed in plant growth chamber studies at KSC. Growth chamber studies to support BPC testing focused on plant responses to different carbon dioxide (CO2) concentrations, different spectral qualities from various electric lamps, and nutrient film hydroponic culture techniques.

  2. Moderators of the effects of meaning-centered group psychotherapy in cancer survivors on personal meaning, psychological well-being, and distress

    NARCIS (Netherlands)

    Holtmaat, Karen; van der Spek, Nadia; Witte, Birgit I; Breitbart, William; Cuijpers, Pim; Verdonck-de Leeuw, Irma M


    PURPOSE: There is evidence to support that meaning-centered group psychotherapy for cancer survivors (MCGP-CS) is an effective intervention for improving personal meaning and psychological well-being, as well as reducing psychological distress. In order to investigate which subpopulations MCGP-CS

  3. Kennedy Space Center: Constellation Program Electrical Ground Support Equipment Research and Development (United States)

    McCoy, Keegan


    The Kennedy Space Center (KSC) is NASA's spaceport, launching rockets into space and leading important human spaceflight research. This spring semester, I worked at KSC on Constellation Program electrical ground support equipment through NASA's Undergraduate Student Research Program (USRP). This report includes a discussion of NASA, KSC, and my individual research project. An analysis of Penn State's preparation of me for an internship and my overall impressions of the Penn State and NASA internship experience conclude the report.

  4. Activities and experience of the Federal Resource Center for Organizing Comprehensive Support for Children with ASD

    Directory of Open Access Journals (Sweden)

    Khaustov A.V.


    Full Text Available This article presents basic activities and experience of the Federal Resource Center for Organizing Comprehensive Sup¬port for Children with ASD of Moscow state university of psychology & education, amassed during 22 years of practice. Some statistic data on the center’s activity are displayed. Emphasis is done on multidirectional work and developing ways of interdepartmental and networking interaction for the sake of founding a system of complex support for autistic children in Russian Federation.

  5. Facing spousal cancer during child-rearing years: The short-term effects of the Cancer-PEPSONE programme-a single-center randomized controlled trial. (United States)

    Senneseth, Mette; Dyregrov, Atle; Laberg, Jon; Matthiesen, Stig B; Pereira, Mariana; Hauken, May A


    To measure the short-term effects of the Cancer-PEPSONE programme (CPP) on the partners' received and perceived social support, psychological distress, and quality of life (QOL), as well as explore the role of received social support as a mediator of the intervention effects. Open single-center randomized controlled trial, trial number 15982171(ISRCTN). Eligible participants were the partners of cancer patients who were concomitantly caring for minors (the well parents). The sample consisted of 35 participants randomly allocated to receive either intervention (n = 17) or support as usual (n = 18). At the 3-month follow-up (approximately 1 month after intervention), 24 continued to participate (intervention n = 13, control n = 11). The intervention group selected supporters to participate in CPP (N = 130). Data were obtained using validated questionnaire. The multivariate analysis of covariance revealed significant intervention effects (P = .03, η2p  = 0.42), with main effects on received and perceived social support. A mediational analysis suggested that CPP may have indirect effects on QOL through received social support. Even though the long-term effects are yet to be studied, CPP seems to increase social support for the well parents' short term, which in turn may improve their QOL. Given the study's low sample size, further replications in larger samples are required. Copyright © 2016 John Wiley & Sons, Ltd.

  6. Perceived Stress in Online Prostate Cancer Community Participants: Examining Relationships with Stigmatization, Social Support Network Preference, and Social Support Seeking. (United States)

    Rising, Camella J; Bol, Nadine; Burke-Garcia, Amelia; Rains, Stephen; Wright, Kevin B


    Men with prostate cancer often need social support to help them cope with illness-related physiological and psychosocial challenges. Whether those needs are met depends on receiving support optimally matched to their needs. This study examined relationships between perceived stress, prostate cancer-related stigma, weak-tie support preference, and online community use for social support in a survey of online prostate cancer community participants (n = 149). Findings revealed a positive relationship between stigma and perceived stress. This relationship, however, was moderated by weak-tie support preference and online community use for social support. Specifically, stigma was positively related to perceived stress when weak-tie support was preferred. Analyses also showed a positive relationship between stigma and perceived stress in those who used their online community for advice or emotional support. Health communication scholars should work collaboratively with diagnosed men, clinicians, and online community administrators to develop online interventions that optimally match social support needs.

  7. The International Experience of the State Support for Creating the Transport and Logistics Centers

    Directory of Open Access Journals (Sweden)

    Zharska Iryna O.


    Full Text Available The article is aimed at analysis and synthesis of the international experience as to the State support for creating the transport and logistics centers (TLCs. The causes for emergence of the first TLCs in Europe (60-80-ies of XX century were considered. Values of the LPI index for the countries occupying the first 40 positions of the ranking as of 2014 and of 2016 have been provided, and the major changes during this time have been analyzed. The ranking position of Ukraine is displayed separately. Features of the logistics infrastructure of nine countries with a high value of the LPI index have been considered, degree of the State involvement in the formation of the TLC network has been analyzed. It has been substantiated that creation of the transport and logistics centers allows to reduce the logistics costs of individual producers and contributes to enhancing the efficiency of operation of the national economy in general by attracting investments in the infrastructure development, increasing the number of jobs and tax revenues. The basic motifs that determine the interest of the State authorities in providing support for creating the transportation and logistics centers have been defined. Prospect for further research in this direction will be determining the efficiency of using the different models of the State support for creation and development of TLCs

  8. The Art of Interpreting Epigenetic Activity | Center for Cancer Research (United States)

    Even though all the cells of the human body share a common genomic blueprint, epigenetic activity such as DNA methylation, introduces molecular diversity that results in functionally and biologically different cellular constituents. In cancers, this ability of epigenetic activity to introduce molecular diversity is emerging as a powerful classifier of biological aggressiveness.

  9. Finding the Right Care | Center for Cancer Research (United States)

    Trained as a registered nurse and with a doctoral degree in public health, Jane D. is no stranger to the U.S. health care system. But, when she found herself facing a diagnosis of anal cancer in 2013, she felt adrift.

  10. COP - Pet Owners - Open Clinical Trials | Center for Cancer Research (United States)

    Current Open Clinical Trials If you are interested in learning more about the eligibility requirements for any of open studies listed below, please contact the nearest participating University or Christina Mazcko. To search studies being conducted by other groups please visit Vet Cancer Trials. This will allow you to search by location and tumor type.

  11. Ganging Up on Brain Metastases | Center for Cancer Research (United States)

    When primary tumors metastasize to the brain, the prognosis for patients is poor. The currently accepted treatment is whole-brain radiation therapy, and the median survival time is several months. Since these types of tumors form in 10 to 30 percent of adult cancer patients, improvements in treatment methods are a necessity.  

  12. NCI RNA Biology 2017 symposium recap | Center for Cancer Research (United States)

    The recent discovery of new classes of RNAs and the demonstration that alterations in RNA metabolism underlie numerous human cancers have resulted in enormous interest among CCR investigators in RNA biology. In order to share the latest research in this exciting field, the CCR Initiative in RNA Biology held its second international symposium April 23-24, 2017, in Natcher Auditorium. Learn more...

  13. An academic medical center model for community colorectal cancer screening: the Centers for Disease Control and Prevention demonstration program experience. (United States)

    Lane, Dorothy S; Cavanagh, Mary F; Messina, Catherine R; Anderson, Joseph C


    During 2005-2009, the Centers for Disease Control and Prevention funded five colorectal cancer (CRC) screening demonstration projects around the United States; only one was based in an academic medical center (AMC) rather than a health department. The Suffolk County Preventive Endoscopy Project (Project SCOPE) was a collaborative effort between Stony Brook University Medical Center (SBUMC) and the Suffolk County Department of Health Services. Project SCOPE's objective was to increase CRC screening among Suffolk County residents at least 50 years old who had inadequate or no insurance coverage for CRC screening. The demonstration application drew on the screening, diagnostic, and treatment resources of the AMC and the indigent populations using its outpatient clinics. Patients at 10 county health centers were a primary target for (previously inaccessible) colonoscopy screening. The project's organizational center was SBUMC's preventive medicine department, which was linked to SBUMC's large gastroenterology practice. The specific staffing, financial, and training issues faced by this project provide insights for others who are similarly interested in community engagement. During 40 months of screening, 800 indigent, culturally diverse patients were recruited, and they underwent colonoscopy. Challenges encountered included unreachable referred patients (425 patients; 28% of referrals) and medical ineligibility (e.g., symptomatic comorbid conditions). Pending legislation providing federal funding for a national program offers other AMCs the opportunity to adopt a model such as that proven feasible during Project SCOPE. The lessons learned may have broader application for fostering collaborative AMC partnerships and for enhancing recruitment and retention of participants through outreach.

  14. Breast cancer survivors' preferences for technology-supported exercise interventions. (United States)

    Phillips, Siobhan M; Conroy, David E; Keadle, Sarah Kozey; Pellegrini, Christine A; Lloyd, Gillian R; Penedo, Frank J; Spring, Bonnie


    The purpose of this study was to explore breast cancer survivors' interest in and preferences for technology-supported exercise interventions. Post-treatment survivors [n = 279; M age = 60.7 (SD = 9.7)] completed a battery of online questionnaires in August 2015. Descriptive statistics were calculated for all data. Logistic regression analyses were conducted to examine relationships between survivors' interest in a technology-supported exercise interventions and demographic, disease, and behavioral factors. These same factors were examined in relation to perceived effectiveness of such interventions using multiple regression analyses. About half (53.4%) of survivors self-reported meeting public health recommendations for physical activity. Fewer than half reported using an exercise or diet mobile app (41.2%) or owning an activity tracker (40.5%). The majority were interested in receiving remotely delivered exercise counseling (84.6%), participating in a remotely delivered exercise intervention (79.5%), and using an exercise app or website (68%). Survivors reported that the most helpful technology-supported intervention components would be an activity tracker (89.5%), personalized feedback (81.2%), and feedback on how exercise is influencing mood, fatigue, etc. (73.6%). Components rated as least helpful were social networking integration (31.2%), group competitions (33.9%), and ability to see others' progress (35.1%). Preferences for technology-supported exercise interventions varied among breast cancer survivors. Nonetheless, data indicate that technology-supported interventions may be feasible and acceptable. Engaging stakeholders may be important in developing and testing potential intervention components.

  15. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Childhood Cancers Late Effects of Childhood Cancer Treatment Pediatric Supportive Care Unusual Cancers of Childhood Treatment Childhood ... long she has to live. For Doctors, a Patient-Centered Approach View this video on YouTube. Anthony ...

  16. [Importance of psychological support for families of children with cancer]. (United States)

    Kisić, Tatjana; Konstantinidis, Nada; Kolarović, Jovanka; Kaćanski, Natasa


    A family of a child with cancer needs continuous help and support from medical and other professionals, relatives, friends and community at the moment of making diagnosis and during the treatment. The goal of this study was to find out the most frequent sources of individual or community based psychological support, reported by parents of children suffering from malignant diseases. We focused on the help received at the moment of making diagnosis and within the first and second year of treatment. We analyzed data obtained by a questionnaire specially designed for parents of children suffering from different malignancies. The poll was conducted from April 2007 till October 2009 at the Hematology/Oncology Department of Children's Hospital of Novi Sad and it included 72 parents of both sexes, whose children were treated at our Department in the period from 2007 to 2009. The children were of different age. The parents selected the following forms of support as the most important: support given by the emotional partner and other family members (together with sick and healthy child), communication with and accessibility of hospital stuff (physicians at the first place, but also psychologists, nurses, other parents, support groups...). They also expressed their need for contacting friends, relatives and other close people. The selected forms of support are extremely important for the patients (regardless of age) and for their family. All forms of organized and professionally conducted psycho-social support of patients and their family result in higher quality of psychological survival during the treatment and further rehabilitation of patients after rejoining their primary social environment. Family is the primary and the most important social surrounding within which disease both happens and is resolved. Adequate support can help family to overcome such crises, thus leading to the positive outcome.

  17. Enteral nutrition support of head and neck cancer patients. (United States)

    Raykher, Aleksandra; Russo, Lianne; Schattner, Mark; Schwartz, Lauren; Scott, Burma; Shike, Moshe


    Patients with head and neck cancer are at high risk for malnutrition due to dysphagia from the tumor and treatment. Despite difficulty with oral intake, these patients usually have a normal stomach and lower gastrointestinal tract. Enteral nutrition support via percutaneous endoscopic gastrostomy (PEG) administered in the home by the patient helps to prevent weight loss, dehydration, nutrient deficiencies, treatment interruptions, and hospitalizations. It also improves quality of life. Successful management of these patients requires orderly care and follow-up by a multidisciplinary nutrition team.

  18. The breast cancer and the environment research centers: transdisciplinary research on the role of the environment in breast cancer etiology. (United States)

    Hiatt, Robert A; Haslam, Sandra Z; Osuch, Janet


    We introduce and describe the Breast Cancer and the Environment Research Centers (BCERC), a research network with a transdisciplinary approach to elucidating the role of environmental factors in pubertal development as a window on breast cancer etiology. We describe the organization of four national centers integrated into the BCERC network. Investigators use a common conceptual framework based on multiple levels of biologic, behavioral, and social organization across the life span. The approach connects basic biologic studies with rodent models and tissue culture systems, a coordinated multicenter epidemiologic cohort study of prepubertal girls, and the integration of community members of breast cancer advocates as key members of the research team to comprise the network. Relevant literature is reviewed that describes current knowledge across levels of organization. Individual research questions and hypotheses in BCERC are driven by gaps in our knowledge that are presented at genetic, metabolic, cellular, individual, and environmental (physical and social) levels. As data collection on the cohort, animal experiments, and analyses proceed, results will be synthesized through a transdisciplinary approach. Center investigators are addressing a large number of specific research questions related to early pubertal onset, which is an established risk factor for breast cancer. BCERC research findings aimed at the primary prevention of breast cancer will be disseminated to the scientific community and to the public by breast cancer advocates, who have been integral members of the research process from its inception.

  19. Caregiver social support quality when interacting with cancer survivors: advancing the dual-process model of supportive communication. (United States)

    Harvey-Knowles, Jacquelyn; Faw, Meara H


    Cancer caregivers often experience significant challenges in their motivation and ability to comfort cancer survivors, particularly in a spousal or romantic context. Spousal cancer caregivers have been known to report even greater levels of burden and distress than cancer sufferers, yet still take on the role of acting as an informal caregiver so they can attend to their partner's needs. The current study tested whether a theoretical model of supportive outcomes-the dual-process model of supportive communication-explained variations in cancer caregivers' motivation and ability to create high-quality support messages. The study also tested whether participant engagement with reflective journaling on supportive acts was associated with increased motivation or ability to generate high-quality support messages. Based upon the dual-process model, we posited that, following supportive journaling tasks, caregivers of spouses currently managing a cancer experience would report greater motivation but also greater difficulty in generating high-quality support messages, while individuals caring for a patient in remission would report lower motivation but greater ability to create high-quality support messages. Findings provided support for these assertions and suggested that reflective journaling tasks might be a useful tool for improving remission caregivers' ability to provide high-quality social support to survivors. Corresponding theoretical and applied implications are discussed.

  20. Integrating complementary medicine in supportive cancer care models across four continents. (United States)

    Ben-Arye, Eran; Schiff, Elad; Zollman, Catherine; Heusser, Peter; Mountford, Pablo; Frenkel, Moshe; Bar-Sela, Gil; Lavie, Ofer


    The need to integrate complementary medicine (CM) consultation in supportive care of patients with cancer is acknowledged by oncologists owing to the ongoing research on CM efficacy and awareness of its potential risks. In this article, we aim to provide oncologists with models for CM integration within supportive care. Descriptive analysis of key elements which facilitate CM integration is presented by physicians leading six integrative cancer care programs across four continents. Perspectives of integration are supplemented by a literature review, quantitative data on the clinical activity in each center, and qualitative narrative-based citations of seven oncology patients and healthcare providers. It is recommended that CM consultation be provided by physicians with extensive CM training. The following key elements were identified as essential for integrative program design within oncological supportive care: (1) Location of the integrative physician (IP) room within the oncology department area, (2) Required oncologist referral to CM consultation, (3) Allocated time to IP-oncologist communication, (4) Research-based integrative practice, (5) Inclusion of paid professional CM practitioners, (6) Institutional cost covered service. Integration of CM consultation within oncological supportive care needs to take in account six key elements that ensure high-quality evidence-based concomitant integrative practice.

  1. Fasting glucose and risk of colorectal cancer in the Korean Multi-center Cancer Cohort. (United States)

    Park, Hyeree; Cho, Sooyoung; Woo, Hyeongtaek; Park, Sue K; Shin, Hai-Rim; Chang, Soung-Hoon; Yoo, Keun-Young; Shin, Aesun


    Previous cohort studies have demonstrated a positive association between diabetes mellitus (DM) and colorectal cancer (CRC). However, there are few comparisons between DM groups categorized by fasting glucose level. This study examined associations between diabetes as defined by fasting glucose level and self-reported history of DM and CRC risk among Korean adults. Data from the Korean Multi-center Cancer Cohort between 1993 and 2005 were analyzed. The study population comprised 14,570 participants aged 20 years or older. Participants were followed until December 31, 2012 (median follow-up: 11.9 years). Among participants with high fasting glucose (≥126mg/dL), the risk of developing CRC was significantly higher (HR: 1.51 [1.02-2.25]) than among participants with low fasting glucose (fasting glucose and history of DM were considered together, the risk of CRC among participants with both high fasting glucose and history of DM was 54% (HR: 1.54 [0.97-2.43]), and the risk of CRC among participants with high fasting glucose and no history of DM was 50% (HR: 1.50 [0.73-3.05]). When the first 5 years of follow-up were excluded, among participants with high fasting glucose, the risk of developing CRC was significantly higher (HR: 1.61 [1.02-2.56]) than among participants with low fasting glucose. Risk of CRC was also significantly higher among participants with high fasting glucose and no history of DM (HR: 1.69 [1.01-2.84]). High fasting glucose and self-reported history of DM were associated with increased risk of CRC in this Korean population.

  2. Inhibiting the Epidermal Growth Factor Receptor | Center for Cancer Research (United States)

    The Epidermal Growth Factor Receptor (EGFR) is a widely distributed cell surface receptor that responds to several extracellular signaling molecules through an intracellular tyrosine kinase, which phosphorylates target enzymes to trigger a downstream molecular cascade. Since the discovery that EGFR mutations and amplifications are critical in a number of cancers, efforts have been under way to develop and use targeted EGFR inhibitors. These efforts have met with some spectacular successes, but many patients have not responded as expected, have subsequently developed drug-resistant tumors, or have suffered serious side effects from the therapies to date. CCR Investigators are studying EGFR from multiple vantage points with the goal of developing even better strategies to defeat EGFR-related cancers.

  3. Unlocking the black box: supporting practices to become patient-centered medical homes. (United States)

    Coleman, Katie; Phillips, Kathryn E; Van Borkulo, Nicole; Daniel, Donna M; Johnson, Karin E; Wagner, Edward H; Sugarman, Jonathan R


    Despite widespread interest in supporting primary care transformation, few evidence-based strategies for technical assistance exist. The Safety Net Medical Home Initiative (SNMHI) sought to develop a replicable and sustainable model for Patient-centered Medical Home practice transformation. This paper describes the multimodal technical assistance approach used by the SNMHI and the participating practices' assessment of its value and helpfulness in supporting their transformation. Components of the technical assistance framework included: (1) individual site-level coaching provided by local medical home facilitators and supplemented by expert consultation; (2) regional and national learning communities of participating practices that included in-person meetings and field trips; (3) data monitoring and feedback including longitudinal feedback on medical home implementation as measured by the Patient-centered Medical Home-A; (4) written implementation guides, tools, and webinars relating to each of the 8 Change Concepts for Practice Transformation; and (5) small grant funds to support infrastructure and staff development. Overall, practices found the technical assistance helpful and most valued in-person, peer-to-peer-learning opportunities. Practices receiving technical assistance from membership organizations with which they belonged before the SNMHI scored higher on measures of medical home implementation than practices working with organizations with whom they had no prior relationship. There is an important role for both local and national organizations to provide nonduplicative, mutually reinforcing support for primary care transformation. How (in-person, between-peers) and by whom technical assistance is provided may be important to consider.

  4. Supporting Informed Decision Making in Prevention of Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Constantino MARTINS


    Full Text Available Identifying and making the correct decision on the best health treatment or screening test option can become a difficult task. Therefore is important that the patients get all types of information appropriate to manage their health. Decision aids can be very useful when there is more than one reasonable option about a treatment or uncertain associated with screening tests. The decision aids tools help people to understand their clinical condition, through the description of the different options available. The purpose of this paper is to present the project “Supporting Informed Decision Making In Prevention of Prostate Cancer” (SIDEMP. This project is focused on the creation of a Web-based decision platform specifically directed to screening prostate cancer, that will support the patient in the process of making an informed decision

  5. Genetic Factors in Breast Cancer: Center for Interdisciplinary Biobehavioral Research (United States)


    argues a similar point by suggesting that institutional racism encoun- tered by those growing up Black in the U.S. has served to provide...confidential’’); (3) stigma related to testing (e.g., ‘‘If I were found to carry a gene mutation for cancer, it would cause others to view me negatively...related pros (a = .84); negative emotional reaction (a = .69); confidentiality concerns (a = .70); stigma related to testing (a = .73); family related

  6. Modern Soft Tissue Pathology | Center for Cancer Research (United States)

    This book comprehensively covers modern soft tissue pathology and includes both tumors and non-neoplastic entities. Soft tissues make up a large bulk of the human body, and they are susceptible to a wide range of diseases. Many soft-tissue tumors are biologically very aggressive, and the chance of them metastasizing to vital organs is quite high. In recent years, the outlook for soft-tissue cancers has brightened dramatically due to the increased accuracy of the pathologist's tools.

  7. NCI Symposium on Chromosome Biology to bring together internationally renowned experts in the fields of chromosome structure and function | Center for Cancer Research (United States)

    The Center for Cancer Research’s Center of Excellence in Chromosome Biology is hosting the “Nuclear Structure, Genome Integrity and Cancer Symposium“ on November 30 - December 1, 2016 at the Natcher Conference Center, Bethesda, Maryland. Learn more ...

  8. Nutrition support in surgical patients with colorectal cancer. (United States)

    Chen, Yang; Liu, Bao-Lin; Shang, Bin; Chen, Ai-Shan; Liu, Shi-Qing; Sun, Wei; Yin, Hong-Zhuan; Yin, Jian-Qiao; Su, Qi


    To review the application of nutrition support in patients after surgery for colorectal cancer, and to propose appropriate nutrition strategies. A total of 202 consecutive surgical patients admitted to our hospital with a diagnosis of colon cancer or rectal cancer from January 2010 to July 2010, meeting the requirements of Nutrition Risk Screening 2002, were enrolled in our study. Laboratory tests were performed to analyze the nutrition status of each patient, and the clinical outcome variables, including postoperative complications, hospital stay, cost of hospitalization and postoperative outcome, were analyzed. The "non-risk" patients who did not receive postoperative nutrition support had a higher rate of postoperative complications than patients who received postoperative nutrition support (2.40 ± 1.51 vs. 1.23 ± 0.60, P = 0.000), and had a longer postoperative hospital stay (23.00 ± 15.84 d vs. 15.27 ± 5.89 d, P = 0.009). There was higher cost of hospitalization for patients who received preoperative total parenteral nutrition (TPN) than for patients who did not receive preoperative TPN (62 713.50 ± 5070.66 RMB Yuan vs. 43178.00 ± 3596.68 RMB Yuan, P = 0.014). Applying postoperative enteral nutrition significantly shortened postoperative fasting time (5.16 ± 1.21 d vs. 6.40 ± 1.84 d, P = 0.001) and postoperative hospital stay (11.92 ± 4.34 d vs. 15.77 ± 6.03 d, P = 0.002). The patients who received postoperative TPN for no less than 7 d had increased serum glucose levels (7.59 ± 3.57 mmol/L vs. 6.48 ± 1.32 mmol/L, P = 0.006) and cost of hospitalization (47 724.14 ± 16 945.17 Yuan vs. 38 598.73 ± 8349.79 Yuan, P = 0.000). The patients who received postoperative omega-3 fatty acids had a higher rate of postoperative complications than the patients who did not (1.33 ± 0.64 vs. 1.13 ± 0.49, P = 0.041). High level of serum glucose was associated with a high risk of postoperative complications of infection. Appropriate and moderate nutritional

  9. Neuro-Oncology Branch Appointment - what happens at the clinical center | Center for Cancer Research (United States)

    What Happens When I Get To The Clinical Center at NIH? 1. Visit the Admissions Department Registering is the first step to being evaluated by the Brain Tumor Clinic. Visit Admissions to get registered as a patient. They will ask you for your contact information and provide you with a patient identification number. 2. Proceed to the NOB Clinic Proceed to the Brain Tumor Clinic on the 13th floor.

  10. Computer aided decision support system for cervical cancer classification (United States)

    Rahmadwati, Rahmadwati; Naghdy, Golshah; Ros, Montserrat; Todd, Catherine


    Conventional analysis of a cervical histology image, such a pap smear or a biopsy sample, is performed by an expert pathologist manually. This involves inspecting the sample for cellular level abnormalities and determining the spread of the abnormalities. Cancer is graded based on the spread of the abnormal cells. This is a tedious, subjective and time-consuming process with considerable variations in diagnosis between the experts. This paper presents a computer aided decision support system (CADSS) tool to help the pathologists in their examination of the cervical cancer biopsies. The main aim of the proposed CADSS system is to identify abnormalities and quantify cancer grading in a systematic and repeatable manner. The paper proposes three different methods which presents and compares the results using 475 images of cervical biopsies which include normal, three stages of pre cancer, and malignant cases. This paper will explore various components of an effective CADSS; image acquisition, pre-processing, segmentation, feature extraction, classification, grading and disease identification. Cervical histological images are captured using a digital microscope. The images are captured in sufficient resolution to retain enough information for effective classification. Histology images of cervical biopsies consist of three major sections; background, stroma and squamous epithelium. Most diagnostic information are contained within the epithelium region. This paper will present two levels of segmentations; global (macro) and local (micro). At the global level the squamous epithelium is separated from the background and stroma. At the local or cellular level, the nuclei and cytoplasm are segmented for further analysis. Image features that influence the pathologists' decision during the analysis and classification of a cervical biopsy are the nuclei's shape and spread; the ratio of the areas of nuclei and cytoplasm as well as the texture and spread of the abnormalities

  11. A coping and communication support intervention tailored to older patients diagnosed with late-stage cancer

    Directory of Open Access Journals (Sweden)

    Julia Hannum Rose


    Full Text Available Julia Hannum Rose1,2,3, Rosanne Radziewicz4, Karen F Bowman5, Elizabeth E O’Toole11Case Western Reserve University School of Medicine, Cleveland, OH, USA; 2Louis Stokes Cleveland VAMC-GRECC, Cleveland, OH, USA; 3Center for Health Care Research and Policy, Case at MetroHealth Medical Center, Cleveland, OH, USA; 4Department of Nursing, MetroHealth Medical Center, Cleveland, OH, USA; 5Department of Sociology, Case Western Reserve University, Cleveland, OH, USAAbstract: As our society ages, increasing numbers of older Americans will be diagnosed and eventually will die of cancer. To date, psycho-oncology interventions for advanced cancer patients have been more successful in reaching younger adult age groups and generally have not been designed to respond to the unique needs and preferences of older patients. Theories and research on successful aging (Baltes and Baltes 1990; Baltes 1997, health information processing style (Miller 1995; Miller et al 2001 and non-directive client-centered therapy (Rogers 1951, 1967, have guided the development of a coping and communication support (CCS intervention. Key components of this age-sensitive and tailored intervention are described, including problem domains addressed, intervention strategies used and the role of the CCS practitioner. Age group comparisons in frequency of contact, problems raised and intervention strategies used during the first six weeks of follow up indicate that older patients were similar to middle-aged patients in their level of engagement, problems faced and intervention strategies used. Middle-aged patients were more likely to have problems communicating with family members at intervention start up and practical problems as well in follow up contacts. This is the first intervention study specifically designed to be age sensitive and to examine age differences in engagement from the early treatment phase for late-stage cancer through end of life. This tailored intervention is

  12. The moderating role of social support on depression and anxiety for gastric cancer patients and their family caregivers.

    Directory of Open Access Journals (Sweden)

    Ansuk Jeong

    Full Text Available There is a consensus that cancer care should go beyond physical care as cancer patients and their family caregivers experience psychological burden, financial difficulty, as well as social relation issues. The current study aimed to investigate the moderating impact of social support on depression and anxiety of cancer patients and their family caregivers.Gastric cancer patients and their family caregivers who visited a university medical center in Seoul were approached for participation in the study. Fifty-two pairs of adult patients and caregivers participated in the study. Along with demographic information and the physical condition of the patients, such as pre-operation cancer stage and the type of gastrectomy, social support, depression, and anxiety were measured for patients and caregivers, respectively.In the first round of analysis, patients' depression was associated with age, while patients' anxiety was related to income. On the other hand, caregivers' depression was not associated with patients' health and living arrangement. In the second round of analysis to examine the moderating effect of social support, patients' income and social support were related to depression and anxiety, but the interaction of income and social support was only observed for anxiety. For caregivers, no interaction effects were found. Social support decreased the negative effects of low income status on the patients.While the income of the families with cancer cannot be adjusted in the short-term, their experience of social support can be managed by a proper support system. Diverse implications in medical settings are discussed.

  13. Early diagnosis and treatment of breast cancer in Japanese kidney transplant recipients: a single center experience


    Kato, Taigo; Kakuta, Yoichi; Yamanaka, Kazuaki; Okumi, Masayoshi; Abe, Toyofumi; Imamura, Ryoichi; Ichimaru, Naotsugu; Takahara, Shiro; Nonomura, Norio


    Background The incidence of malignancies in kidney transplant recipients is increasing. Breast cancer is a common malignancy after kidney transplantation and can be more aggressive in kidney transplant recipients than in the general population. In this study, we evaluated the incidence and prognosis of breast cancer in kidney transplant recipients. Findings Between 1993 and 2013, 750 kidney transplant patients were followed-up at our center. Since 1999, annual physical examination, mammograph...

  14. Visual screening of oral cavity cancer in a male population: Experience from a medical center


    Chang, I-How; Jiang, Rong-San; Wong, Yong-Kie; Wu, Shang-Heng; Chen, Fun-Jou; Liu, Shih-An


    Background: We aimed to evaluate the effectiveness of an oral cavity cancer visual screening program conducted in a tertiary academic medical center. We also wanted to determine which group of participants was at greater risk of contracting oral cavity cancer. Methods: Participants were first asked to relate their personal habits during the past 6 months. Visual screening of the oral cavity was then performed under adequate lighting and with proper instruments. Results: From March 2005 ...

  15. Person centered prediction of survival in population based screening program by an intelligent clinical decision support system. (United States)

    Safdari, Reza; Maserat, Elham; Asadzadeh Aghdaei, Hamid; Javan Amoli, Amir Hossein; Mohaghegh Shalmani, Hamid


    To survey person centered survival rate in population based screening program by an intelligent clinical decision support system. Colorectal cancer is the most common malignancy and major cause of morbidity and mortality throughout the world. Colorectal cancer is the sixth leading cause of cancer death in Iran. In this survey, we used cosine similarity as data mining technique and intelligent system for estimating survival of at risk groups in the screening plan. In the first step, we determined minimum data set (MDS). MDS was approved by experts and reviewing literatures. In the second step, MDS were coded by python language and matched with cosine similarity formula. Finally, survival rate by percent was illustrated in the user interface of national intelligent system. The national intelligent system was designed in PyCharm environment. Main data elements of intelligent system consist demographic information, age, referral type, risk group, recommendation and survival rate. Minimum data set related to survival comprise of clinical status, past medical history and socio-demographic information. Information of the covered population as a comprehensive database was connected to intelligent system and survival rate estimated for each patient. Mean range of survival of HNPCC patients and FAP patients were respectively 77.7% and 75.1%. Also, the mean range of the survival rate and other calculations have changed with the entry of new patients in the CRC registry by real-time. National intelligent system monitors the entire of risk group and reports survival rates by electronic guidelines and data mining technique and also operates according to the clinical process. This web base software has a critical role in the estimation survival rate in order to health care planning.

  16. eHealth to support cancer survivors: development, implementation and evaluation of an interactive portal

    NARCIS (Netherlands)

    Kuijpers, W.


    Many cancer survivors suffer from physical and psychosocial problems due to cancer itself and cancer treatment. Patient empowerment and eHealth offer opportunities to support cancer survivors. This thesis describes the development, implementation and evaluation of MijnAVL, an eHealth application.

  17. Supportive and Palliative Care Research Funding Opportunities | Division of Cancer Prevention (United States)

    The Division of Cancer Prevention (DCP) conducts and supports research to determine a person's risk of cancer and to find ways to reduce the risk. This knowledge is critical to making progress against cancer because risk varies over the lifespan as genetic and epigenetic changes can transform healthy tissue into invasive cancer.

  18. Supportive and Palliative Care Research Clinical Trials | Division of Cancer Prevention (United States)

    The Division of Cancer Prevention (DCP) conducts and supports research to determine a person's risk of cancer and to find ways to reduce the risk. This knowledge is critical to making progress against cancer because risk varies over the lifespan as genetic and epigenetic changes can transform healthy tissue into invasive cancer.

  19. Completed Supportive and Palliative Care Research Grants | Division of Cancer Prevention (United States)

    The Division of Cancer Prevention (DCP) conducts and supports research to determine a person's risk of cancer and to find ways to reduce the risk. This knowledge is critical to making progress against cancer because risk varies over the lifespan as genetic and epigenetic changes can transform healthy tissue into invasive cancer.

  20. Active Supportive and Palliative Care Research Grants | Division of Cancer Prevention (United States)

    The Division of Cancer Prevention (DCP) conducts and supports research to determine a person's risk of cancer and to find ways to reduce the risk. This knowledge is critical to making progress against cancer because risk varies over the lifespan as genetic and epigenetic changes can transform healthy tissue into invasive cancer.

  1. Service of Remembrance: a comprehensive cancer center's response to bereaved family members. (United States)

    Knight, Louise; Cooper, Rhonda S; Hypki, Cinder


    Comprehensive cancer centers that offer an array of clinical trials and treatment options often experience significant patient mortality rates. Bereavement resources may not be routinely incorporated into the service delivery model in these specialty hospitals. In response, an interdisciplinary team at one cancer center proposed, planned, and implemented an annual Service of Remembrance. The incorporation of music, poetry, and visual arts was important in designing a program that would provide a meaningful, spiritual experience. A community artist who designed an interactive memorial art piece played a pivotal role. This article outlines the process of institutional culture change and describes future challenges in the implementation of this type of bereavement service.

  2. Toward patient-centered, personalized and personal decision support and knowledge management: a survey. (United States)

    Leong, T-Y


    This paper summarizes the recent trends and highlights the challenges and opportunities in decision support and knowledge management for patient-centered, personalized, and personal health care. The discussions are based on a broad survey of related references, focusing on the most recent publications. Major advances are examined in the areas of i) shared decision making paradigms, ii) continuity of care infrastructures and architectures, iii) human factors and system design approaches, iv) knowledge management innovations, and v) practical deployment and change considerations. Many important initiatives, projects, and plans with promising results have been identified. The common themes focus on supporting the individual patients who are playing an increasing central role in their own care decision processes. New collaborative decision making paradigms and information infrastructures are required to ensure effective continuity of care. Human factors and usability are crucial for the successful development and deployment of the relevant systems, tools, and aids. Advances in personalized medicine can be achieved through integrating genomic, phenotypic and other biological, individual, and population level information, and gaining useful insights from building and analyzing biological and other models at multiple levels of abstraction. Therefore, new Information and Communication Technologies and evaluation approaches are needed to effectively manage the scale and complexity of biomedical and health information, and adapt to the changing nature of clinical decision support. Recent research in decision support and knowledge management combines heterogeneous information and personal data to provide cost-effective, calibrated, personalized support in shared decision making at the point of care. Current and emerging efforts concentrate on developing or extending conventional paradigms, techniques, systems, and architectures for the new predictive, preemptive, and

  3. Mutant HABP2 Causes Non-Medullary Thyroid Cancer | Center for Cancer Research (United States)

    The thyroid is a butterfly-shaped gland that lies at the base of the throat in front of the windpipe. A member of the endocrine system, the thyroid secretes hormones to regulate heart rate, blood pressure, temperature, and metabolism. Cancer of the thyroid is the most common endocrine cancer and the eighth most common cancer in the U.S. An estimated 63,450 Americans will be diagnosed with thyroid cancer this year. The vast majority is of follicular cell origin, and the remaining cancer originates from parafollicular cells, so called medullary thyroid cancer.

  4. The Carolina Center of Cancer Nanotechnology Excellence: past accomplishments and future perspectives. (United States)

    Juliano, Rudy L; Sunnarborg, Susan; DeSimone, Joseph; Haroon, Zishan


    The Carolina Center of Cancer Nanotechnology Excellence (C-CCNE) is funded by the National Cancer Institute and is based at the University of North Carolina. The C-CCNE features interactions between physical and biological scientists in a series of projects and cores that work together to quickly harness innovations in nanotechnology for the early diagnosis and treatment of cancer. Two key focus areas of the C-CCNE are, first, the selective delivery of drugs and imaging agents utilizing advanced nanoparticle technology, and second, novel approaches to imaging and radiotherapy utilizing carbon nanotube-based x-ray sources.

  5. Supporting a Physical Self-Access Center with a Virtual Presence

    Directory of Open Access Journals (Sweden)

    Troy Rubesch


    Full Text Available This article describes the motivation and reasoning behind an ongoing project to create an online presence of a Self-Access Center (SAC. The project involves the selection and integration of a number of technologies which work to together to supplement the physical SAC. The authors argue that such projects have value both for the institutions which host them, and also for the learners they serve, such as support of individualized and independent learning, promotion of the SAC, and hosting and archiving resources. Establishing an online presence allows learners much greater freedom in when, where, what, and how they study.

  6. Vaccines 2.0 | Center for Cancer Research (United States)

    In 1974, Jay A. Berzofsky, M.D., Ph.D., now Chief of CCR’s Vaccine Branch, came to NIH to study protein folding. His curious mind and collaborative spirit quickly led him into the intertwined fields of immunology and vaccine development. With close to 500 publications to his name, Berzofsky has pioneered the characterization of B- and T-cell epitopes and their modification to make vaccines directed against cancer and chronic infectious diseases. He has also characterized and taken advantage of the cellular and molecular regulators of immune responses in order to enhance tumor immunity and vaccine efficacy. In the last several years, he has translated many of these strategies into promising clinical trials. From the microcosm of his laboratory, he brings the same spirit of cross-fertilizing, bench-to-bedside research to leading the Vaccine Branch as a whole.

  7. Lymphedema after gynecological cancer treatment : prevalence, correlates, and supportive care needs

    National Research Council Canada - National Science Library

    Beesley, Vanessa; Janda, Monika; Eakin, Elizabeth; Obermair, Andreas; Battistutta, Diana


    Few studies have evaluated lymphedema after gynecological cancer treatment. The aim of this research was to establish prevalence, correlates, and supportive care needs of gynecological cancer survivors who develop lymphedema...

  8. MIF Drives Pancreatic Cancer Aggressiveness by Downregulating NR3C2 | Center for Cancer Research (United States)

    Pancreatic cancer, while relatively rare, is an aggressive disease ranked as the fourth leading cause of cancer-related death in the US. Because most patients are diagnosed at an advanced stage and their tumors resist available treatments, novel therapeutic targets are urgently needed. Macrophage Migration Inhibitory Factor (MIF) is a proinflammatory cytokine that is elevated in pancreatic ductal adenocarcinoma (PDAC), the most common form of pancreatic cancer, and may provide a molecular link between inflammation and cancer, though the mechanism is unknown.

  9. Sibling Supporters' Experiences of Giving Support to Siblings Who Have a Brother or a Sister With Cancer. (United States)

    Nolbris, Margaretha Jenholt; Nilsson, Stefan

    Siblings of a child with a life-threatening disease, such as cancer, have a right to measures that promote their health and welfare. Siblings may find it hard to understand what is happening to the sick child with cancer and why he or she reacts as he or she does. The aim of the study was to explore sibling supporters' thoughts about the experiences they had in providing support for siblings with a brother or a sister with a life-threatening disease such as cancer. All the 12 sibling supporters currently working in Sweden participated in a qualitative, descriptive study from which 5 categories emerged, showing that the sibling supporters supported siblings from diagnosis until possible death. They enabled siblings who were in the same situation to meet each other and arranged activities suited to their ages, as well as offering an encouraging environment. To help the siblings, the sibling supporters found it necessary to interact with both the parents and the ward staff. The sibling supporters felt that their support was important and necessary in helping siblings promote their own health both when the sick child was alive and also after his or her death. The experience of the sibling supporters was that they listened to the siblings' stories and met them when they were in their crisis. The study confirms that sibling supporters should be a part of the health care team that treat and support the family when a child has cancer.

  10. Cloud Computing Applications in Support of Earth Science Activities at Marshall Space Flight Center (United States)

    Molthan, Andrew L.; Limaye, Ashutosh S.; Srikishen, Jayanthi


    Currently, the NASA Nebula Cloud Computing Platform is available to Agency personnel in a pre-release status as the system undergoes a formal operational readiness review. Over the past year, two projects within the Earth Science Office at NASA Marshall Space Flight Center have been investigating the performance and value of Nebula s "Infrastructure as a Service", or "IaaS" concept and applying cloud computing concepts to advance their respective mission goals. The Short-term Prediction Research and Transition (SPoRT) Center focuses on the transition of unique NASA satellite observations and weather forecasting capabilities for use within the operational forecasting community through partnerships with NOAA s National Weather Service (NWS). SPoRT has evaluated the performance of the Weather Research and Forecasting (WRF) model on virtual machines deployed within Nebula and used Nebula instances to simulate local forecasts in support of regional forecast studies of interest to select NWS forecast offices. In addition to weather forecasting applications, rapidly deployable Nebula virtual machines have supported the processing of high resolution NASA satellite imagery to support disaster assessment following the historic severe weather and tornado outbreak of April 27, 2011. Other modeling and satellite analysis activities are underway in support of NASA s SERVIR program, which integrates satellite observations, ground-based data and forecast models to monitor environmental change and improve disaster response in Central America, the Caribbean, Africa, and the Himalayas. Leveraging SPoRT s experience, SERVIR is working to establish a real-time weather forecasting model for Central America. Other modeling efforts include hydrologic forecasts for Kenya, driven by NASA satellite observations and reanalysis data sets provided by the broader meteorological community. Forecast modeling efforts are supplemented by short-term forecasts of convective initiation, determined by

  11. Alaska Center for Unmanned Aircraft Systems Integration (ACUASI): Operational Support and Geoscience Research (United States)

    Webley, P. W.; Cahill, C. F.; Rogers, M.; Hatfield, M. C.


    Unmanned Aircraft Systems (UAS) have enormous potential for use in geoscience research and supporting operational needs from natural hazard assessment to the mitigation of critical infrastructure failure. They provide a new tool for universities, local, state, federal, and military organizations to collect new measurements not readily available from other sensors. We will present on the UAS capabilities and research of the Alaska Center for Unmanned Aircraft Systems Integration (ACUASI, Our UAS range from the Responder with its dual visible/infrared payload that can provide simultaneous data to our new SeaHunter UAS with 90 lb. payload and multiple hour flight time. ACUASI, as a designated US Federal Aviation Administration (FAA) test center, works closely with the FAA on integrating UAS into the national airspace. ACUASI covers all aspects of working with UAS from pilot training, airspace navigation, flight operations, and remote sensing analysis to payload design and integration engineers and policy experts. ACUASI's recent missions range from supporting the mapping of sea ice cover for safe passage of Alaskans across the hazardous winter ice to demonstrating how UAS can be used to provide support during oil spill response. Additionally, we will present on how ACUASI has worked with local authorities in Alaska to integrate UAS into search and rescue operations and with NASA and the FAA on their UAS Transport Management (UTM) project to fly UAS within the manned airspace. ACUASI is also working on developing new capabilities to sample volcanic plumes and clouds, map forest fire impacts and burn areas, and develop a new citizen network for monitoring snow extent and depth during Northern Hemisphere winters. We will demonstrate how UAS can be integrated in operational support systems and at the same time be used in geoscience research projects to provide high precision, accurate, and reliable observations.

  12. Storytelling as part of cancer rehabilitation to support cancer patients and their relatives. (United States)

    la Cour, Karen; Ledderer, Loni; Hansen, Helle Ploug


    Previous research on psychosocial support for cancer-related concerns has primarily focused on either patients or their relatives, although limited research is available on how patients and their relatives can be supported together. The aim of this article is to explore the use of storytelling as a part of a residential cancer rehabilitation intervention for patients together with their relatives, with a specific focus on their management of cancer-related concerns. Ten pairs participated in the intervention and data were generated through ethnographic fieldwork, including participant observations, informal conversations and follow-up interviews conducted one month after completing the intervention. Analysis was performed drawing on narrative theory combined with social practice theory. The results demonstrate that the use of storytelling and metaphors intertwined with other course activities, such as dancing and arts & crafts, provided the patients and their relatives with strategies to manage cancer-related concerns, which they were later able to apply in their everyday lives. The study results may be useful to other professionals in clinical practice for rehabilitation purposes for addressing issues of fear and worry.

  13. A Clinical Decision Support System for Breast Cancer Patients (United States)

    Fernandes, Ana S.; Alves, Pedro; Jarman, Ian H.; Etchells, Terence A.; Fonseca, José M.; Lisboa, Paulo J. G.

    This paper proposes a Web clinical decision support system for clinical oncologists and for breast cancer patients making prognostic assessments, using the particular characteristics of the individual patient. This system comprises three different prognostic modelling methodologies: the clinically widely used Nottingham prognostic index (NPI); the Cox regression modelling and a partial logistic artificial neural network with automatic relevance determination (PLANN-ARD). All three models yield a different prognostic index that can be analysed together in order to obtain a more accurate prognostic assessment of the patient. Missing data is incorporated in the mentioned models, a common issue in medical data that was overcome using multiple imputation techniques. Risk group assignments are also provided through a methodology based on regression trees, where Boolean rules can be obtained expressed with patient characteristics.

  14. Transcription factor FOXA2-centered transcriptional regulation network in non-small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Sang-Min; An, Joo-Hee; Kim, Chul-Hong; Kim, Jung-Woong, E-mail:; Choi, Kyung-Hee, E-mail:


    Lung cancer is the leading cause of cancer-mediated death. Although various therapeutic approaches are used for lung cancer treatment, these mainly target the tumor suppressor p53 transcription factor, which is involved in apoptosis and cell cycle arrest. However, p53-targeted therapies have limited application in lung cancer, since p53 is found to be mutated in more than half of lung cancers. In this study, we propose tumor suppressor FOXA2 as an alternative target protein for therapies against lung cancer and reveal a possible FOXA2-centered transcriptional regulation network by identifying new target genes and binding partners of FOXA2 by using various screening techniques. The genes encoding Glu/Asp-rich carboxy-terminal domain 2 (CITED2), nuclear receptor subfamily 0, group B, member 2 (NR0B2), cell adhesion molecule 1 (CADM1) and BCL2-associated X protein (BAX) were identified as putative target genes of FOXA2. Additionally, the proteins including highly similar to heat shock protein HSP 90-beta (HSP90A), heat shock 70 kDa protein 1A variant (HSPA1A), histone deacetylase 1 (HDAC1) and HDAC3 were identified as novel interacting partners of FOXA2. Moreover, we showed that FOXA2-dependent promoter activation of BAX and p21 genes is significantly reduced via physical interactions between the identified binding partners and FOXA2. These results provide opportunities to understand the FOXA2-centered transcriptional regulation network and novel therapeutic targets to modulate this network in p53-deficient lung cancer. - Highlights: • Identification of new target genes of FOXA2. • Identifications of novel interaction proteins of FOXA2. • Construction of FOXA2-centered transcriptional regulatory network in non-small cell lung cancer.

  15. Introduction of the non-technical skills for surgeons (NOTSS) system in a Japanese cancer center. (United States)

    Tsuburaya, Akira; Soma, Takahiro; Yoshikawa, Takaki; Cho, Haruhiko; Miki, Tamotsu; Uramatsu, Masashi; Fujisawa, Yoshikazu; Youngson, George; Yule, Steven


    Non-technical skills rating systems, which are designed to support surgical performance, have been introduced worldwide, but not officially in Japan. We performed a pilot study to evaluate the "non-technical skills for surgeons" (NOTSS) rating system in a major Japanese cancer center. Upper gastrointestinal surgeons were selected as trainers or trainees. The trainers attended a master-class on NOTSS, which included simulated demo-videos, to promote consistency across the assessments. The trainers thereafter commenced observing the trainees and whole teams, utilizing the NOTSS and "observational teamwork assessment for surgery" (OTAS) rating systems, before and after their education. Four trainers and six trainees were involved in this study. Test scores for understanding human factors and the NOTSS system were 5.89 ± 1.69 and 8.00 ± 1.32 before and after the e-learning, respectively (mean ± SD, p = 0.010). The OTAS scores for the whole team improved significantly after the trainees' education in five out of nine stages (p < 0.05). There were no differences in the NOTSS scores before and after education, with a small improvement in the total scores for the "teamwork and communication" and "leadership" categories. These findings demonstrate that implementing the NOTSS system is feasible in Japan. Education of both surgical trainers and trainees would contribute to better team performance.

  16. Psycho-Oncology Structure and Profiles of European Centers Treating Patients With Gynecological Cancer

    NARCIS (Netherlands)

    Hasenburg, Annette; Amant, Frederic; Aerts, Leen; Pascal, Astrid; Achimas-Cadariu, Patriciu; Kesic, Vesna


    Objective: Psycho-oncological counseling should be an integrated part of modern cancer therapy. The aim of this study was to assess the structures and interests of psychooncology services within European Society of Gynecological Oncology (ESGO) centers. Methods: In 2010, a survey, which consisted of

  17. In Memoriam: Amar J.S. Klar, Ph.D. | Center for Cancer Research (United States)

    In Memoriam: Amar J.S. Klar, Ph.D. The Center for Cancer Research mourns the recent death of colleague and friend Amar J.S. Klar, Ph.D.  Dr. Klar was a much-liked and respected member of the NCI community as part of the Gene Regulation and Chromosome Biology Laboratory since 1988.

  18. Peer support preferences among African-American breast cancer survivors and caregivers. (United States)

    Haynes-Maslow, Lindsey; Allicock, Marlyn; Johnson, La-Shell


    Breast cancer mortality rates continue to improve due to advances in cancer control and treatment. However, gains in breast cancer survival rates vary by race. Psychosocial support systems can lead to improved health outcomes among cancer survivors. This study was a part of a larger study exploring the challenges that both African-American cancer survivors and caregivers face across the cancer continuum. The objective of this paper was to explore African-American breast cancer survivors' and caregivers' preferences regarding characteristics and qualities of Peer Connect guides to inform the development of a peer support program. Forty-one African-American cancer survivors and caregivers participated in five focus groups lasting approximately 90 min. Participants were asked about what qualities or characteristics they would prefer in a peer support guide to make them feel comfortable talking with them. Focus group transcripts were analyzed using thematic content analysis, an iterative coding process. Themes were identified based on the research team's integrated and unified final codes. Twenty-two cancer survivors, 19 caregivers, and 3 individuals who were both survivors and caregivers participated in the focus groups. Participants discussed five preferences for peer support guides: (1) competency, (2) gender, (3) age, (4) cancer role status, and (5) relationship to participant. This study highlights cancer survivors' and caregivers' perceptions of characteristics needed for peer support providers that in turn can influence whether and how they participate in cancer support programs.

  19. NASA Glenn Research Center Support of the Advanced Stirling Radioisotope Generator Project (United States)

    Wilson, Scott D.; Wong, Wayne A.


    A high-efficiency radioisotope power system was being developed for long-duration NASA space science missions. The U.S. Department of Energy (DOE) managed a flight contract with Lockheed Martin Space Systems Company to build Advanced Stirling Radioisotope Generators (ASRGs), with support from NASA Glenn Research Center. DOE initiated termination of that contract in late 2013, primarily due to budget constraints. Sunpower, Inc., held two parallel contracts to produce Advanced Stirling Convertors (ASCs), one with Lockheed Martin to produce ASC-F flight units, and one with Glenn for the production of ASC-E3 engineering unit "pathfinders" that are built to the flight design. In support of those contracts, Glenn provided testing, materials expertise, Government-furnished equipment, inspection capabilities, and related data products to Lockheed Martin and Sunpower. The technical support included material evaluations, component tests, convertor characterization, and technology transfer. Material evaluations and component tests were performed on various ASC components in order to assess potential life-limiting mechanisms and provide data for reliability models. Convertor level tests were conducted to characterize performance under operating conditions that are representative of various mission conditions. Despite termination of the ASRG flight development contract, NASA continues to recognize the importance of high-efficiency ASC power conversion for Radioisotope Power Systems (RPS) and continues investment in the technology, including the continuation of the ASC-E3 contract. This paper describes key Government support for the ASRG project and future tests to be used to provide data for ongoing reliability assessments.

  20. Second Primary Tumors associated with Breast Cancer: Kuwait Cancer Control Center Experience. (United States)

    Fayaz, Salah; Demian, Gerges Attia; Eissa, Heba El-Sayed; Abuzalouf, Sadeq


    To review the clinico-epidemiologic characteristics of patients who presented with two or more primary cancers, one of which was breast cancer (BC) and to develop a follow-up program for the high risk patients. Patients who were diagnosed with BC and one or more non breast cancer (NBC) were retrospectively reviewed. Medical files were retrieved and epidemiological as well as clinical data were analyzed. Sixty-two patients were retrieved. BC was the first primary in 26 patients while it was the second in 36 patients. Two were males and 60 were females. The median age was 48 years and the median follow-up was 11.5 years. The median interval between the 1st and 2nd primary was 6 years. The most commonly associated NBCs were colon and thyroid cancers, each accounts for 24% of cases followed by endometrial cancer, 18%; Hodgkin's disease, 6.5%; renal and ovarian neoplasm and NHL, 5% each. Others included prostate, lung, cervical and gastric cancers, soft tissue sarcoma and osteosarcoma. Thyroid cancer was more common as first cancer while endometrial cancer was more as second cancer. All patients who developed BC following Hodgkin's disease had received chest irradiation. Seven patients developed 3rd primary (4 lung cancers, 2 NHL, and 1 AML). Patients who were diagnosed with BC should be screened for colon and endometrial cancer. Similarly, patients received chest irradiation at young age, and those diagnosed with thyroid or colon cancer should be screened for BC. Protocol of surveillance needs to be defined. Genetic counseling should be offered to individuals who have experienced multiple primary cancers particularly those with family history and young age of onset.

  1. Filtered selection coupled with support vector machines generate a functionally relevant prediction model for colorectal cancer

    Directory of Open Access Journals (Sweden)

    Gabere MN


    Full Text Available Musa Nur Gabere,1 Mohamed Aly Hussein,1 Mohammad Azhar Aziz2 1Department of Bioinformatics, King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 2Colorectal Cancer Research Program, Department of Medical Genomics, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia Purpose: There has been considerable interest in using whole-genome expression profiles for the classification of colorectal cancer (CRC. The selection of important features is a crucial step before training a classifier.Methods: In this study, we built a model that uses support vector machine (SVM to classify cancer and normal samples using Affymetrix exon microarray data obtained from 90 samples of 48 patients diagnosed with CRC. From the 22,011 genes, we selected the 20, 30, 50, 100, 200, 300, and 500 genes most relevant to CRC using the minimum-redundancy–maximum-relevance (mRMR technique. With these gene sets, an SVM model was designed using four different kernel types (linear, polynomial, radial basis function [RBF], and sigmoid.Results: The best model, which used 30 genes and RBF kernel, outperformed other combinations; it had an accuracy of 84% for both ten fold and leave-one-out cross validations in discriminating the cancer samples from the normal samples. With this 30 genes set from mRMR, six classifiers were trained using random forest (RF, Bayes net (BN, multilayer perceptron (MLP, naïve Bayes (NB, reduced error pruning tree (REPT, and SVM. Two hybrids, mRMR + SVM and mRMR + BN, were the best models when tested on other datasets, and they achieved a prediction accuracy of 95.27% and 91.99%, respectively, compared to other mRMR hybrid models (mRMR + RF, mRMR + NB, mRMR + REPT, and mRMR + MLP. Ingenuity pathway analysis was used to analyze the functions of the 30 genes selected for this model and their potential association with CRC: CDH3, CEACAM7, CLDN1, IL8, IL6R, MMP1

  2. Immigrant Workers Centers in Eastern Massachusetts, USA: Fostering Services, Support, Advocacy, and Community Organizing

    Directory of Open Access Journals (Sweden)

    Humberto Reynoso-Vallejo


    Full Text Available Immigrant Workers Centers (IWCs are community-based organizations that have been developed in the United States to promote and protect workers’ rights through support, services, advocacy, and organizing initiatives. The purpose of this research study was to examine how IWCs in the Eastern part of the state of Massachusetts are structured along twelve dimensions of organizational development and community organizing. Qualitative research methods were used to identify shared themes within the six IWCs and three immigrant support organizations, as well as their organizational responses to the current anti-immigrant environment. IWCs constituted a convenience sample which enabled the researchers to gather data utilizing a case study methodology. In-depth semi-structured interviews were conducted between the months of July and September of 2009 to answer the following research questions: 1What are the shared themes for the development of Immigrant Workers Centers?, and 2 How do Immigrant Workers Centers respond to current anti-immigrant sentiment, intolerant immigration policies, and increased exploitation in this troubled economy? Shared themes among the IWCs include prioritizing community organizing for workers’ rights and collective empowerment. Sub-modalities such as education, training and leadership development area common feature. While some individual support is provided, and in some cases, programming, it always is offered within a context that emphasizes the need for collective action to overcome injustice. Issues addressed include health/safety, sexual harassment, discrimination, and various problems associated with wages (underpayment, missed payments, collecting back wages, and lack of overtime pay. IWCs respond to antiimmigrant policies and practices by supporting larger efforts for immigration reformat the municipal, state, and federal levels. Coalitions of IWCS and their allies attempt to make state wide and federal policy changes

  3. Social Support and Women Living With Breast Cancer in the South of Thailand. (United States)

    Suwankhong, Dusanee; Liamputtong, Pranee


    To discuss social support among women with breast cancer in rural communities in southern Thailand. Qualitative research that allowed researchers to understand the lived experiences of women living with breast cancer and social support. In-depth interviewing and drawing methods were adopted with 20 women with breast cancer. Thematic analysis was employed to analyze the data. Most women with breast cancer received three types of social support: emotional support, tangible support, and informational support. Most support came from family members and relatives. Religion was also a form of social support for women. Many women, however, received insufficient social support from healthcare providers. This reduced their capacity to manage their illness, thus impacting their well-being. Various forms of support are essential for women with breast cancer so that they can better cope with their condition. Nurses and other health professionals are an important source of social support for women with breast cancer. Through having an understanding of and being sensitive to these women's experiences, culture, and challenges, nurses and healthcare professionals can provide more individualized support and care to women during a vulnerable period of their life. We contend that the cultural perspectives of patients are crucial in nursing science. Nurses need to appreciate the importance of culture for the support of patients with breast cancer. © 2015 Sigma Theta Tau International.

  4. Who are the support persons of haematological cancer survivors and how is their performance perceived? (United States)

    Hall, Alix; Lynagh, Marita; Carey, Mariko; Sanson-Fisher, Rob; Mansfield, Elise


    To explore: (1) how haematological cancer survivors and their support persons perceive the overall performance of the support person; (2) disagreement between survivor and support person ratings; and (3) characteristics associated with support persons rating their performance poorly. This is a substudy of a larger project of Australian haematological cancer survivors and their support persons. For this substudy, haematological cancer survivors were recruited from 4 Australian population-based cancer registries and asked to pass on a questionnaire package to their support persons. Survivors who passed on a questionnaire package to their support person were asked to answer questions about the support person and how they perceived the support person's performance. Similarly, support persons answered questions on their own performance as a support person. A total of 924 haematological cancer survivors and 821 support persons were eligible for this study. Most survivors rated their support person as performing very well (84%) while less than half (48%) of support persons rated their own performance as very well. There was significant disagreement between survivor and their support person (dyad) ratings of the support person's performance. Support persons with above normal levels of depression (vs those with normal levels) had significantly higher odds of rating their own performance as "not well/somewhat well." Health care providers should consider providing additional education and skills-based interventions to support persons who experience increased symptoms of depression. Copyright © 2017 John Wiley & Sons, Ltd.

  5. Second-Opinion Review of Breast Imaging at a Cancer Center: Is It Worthwhile? (United States)

    Coffey, Kristen; D'Alessio, Donna; Keating, Delia M; Morris, Elizabeth A


    Second-opinion review of breast imaging studies can be a time-consuming and labor-intensive process. The purpose of this investigation was to determine whether reinterpretation of studies obtained at institutions outside a cancer center influences clinical management, specifically by revealing additional cancer and preventing unnecessary biopsy. A review was conducted of breast imaging studies of 200 patients who underwent ultrasound and MRI at community facilities and had the images submitted for second opinions at a cancer center between January and April 2014. Each case was evaluated for concordance between the original report and the second-opinion interpretation. Second-opinion review resulting in the recommendation and performance of new biopsies was further subdivided into benign, high-risk, and malignant categories based on the histopathologic results obtained at the cancer center. Second-opinion review of the 200 cases showed a change in interpretation in 55 cases (28%; 95% CI, 21-34%). Overall, 26 recommendations (13%; 95% CI, 9-18%) led to a major change in management. Twenty new biopsies were performed, yielding 10 malignancies (5%; 95% CI, 2-9%) and four high-risk lesions (2%; 95% CI, 1-5%). Surgical management was changed to mastectomy for 6 of 10 patients (60%) with new sites of biopsy-proven malignancy. Eight biopsies were averted (4%; 95% CI, 2-8%) on the basis of benign interpretation of the imaging findings, and no disease was found at 1-year follow-up evaluation. Reinterpretation of studies obtained outside a cancer center resulted in a change in interpretation in more than one-fourth of submitted studies. Additional cancer was detected in 5% of patients, and biopsy was averted for 4%. The practice of second-opinion review influences clinical management and adds value to patient care.

  6. 78 FR 50068 - National Cancer Institute; Notice of Meeting (United States)


    ... Center Drive, Room 7W-102, Bethesda, MD 20892, (240) 276-6341. Any interested person may file written..., Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer Centers Support; 93.398...

  7. PROACT: Iterative Design of a Patient-Centered Visualization for Effective Prostate Cancer Health Risk Communication. (United States)

    Hakone, Anzu; Harrison, Lane; Ottley, Alvitta; Winters, Nathan; Gutheil, Caitlin; Han, Paul K J; Chang, Remco


    Prostate cancer is the most common cancer among men in the US, and yet most cases represent localized cancer for which the optimal treatment is unclear. Accumulating evidence suggests that the available treatment options, including surgery and conservative treatment, result in a similar prognosis for most men with localized prostate cancer. However, approximately 90% of patients choose surgery over conservative treatment, despite the risk of severe side effects like erectile dysfunction and incontinence. Recent medical research suggests that a key reason is the lack of patient-centered tools that can effectively communicate personalized risk information and enable them to make better health decisions. In this paper, we report the iterative design process and results of developing the PROgnosis Assessment for Conservative Treatment (PROACT) tool, a personalized health risk communication tool for localized prostate cancer patients. PROACT utilizes two published clinical prediction models to communicate the patients' personalized risk estimates and compare treatment options. In collaboration with the Maine Medical Center, we conducted two rounds of evaluations with prostate cancer survivors and urologists to identify the design elements and narrative structure that effectively facilitate patient comprehension under emotional distress. Our results indicate that visualization can be an effective means to communicate complex risk information to patients with low numeracy and visual literacy. However, the visualizations need to be carefully chosen to balance readability with ease of comprehension. In addition, due to patients' charged emotional state, an intuitive narrative structure that considers the patients' information need is critical to aid the patients' comprehension of their risk information.

  8. Improving cancer pain control with NCCN guideline-based analgesic administration: a patient-centered outcome. (United States)

    Janjan, Nora


    Improving the control of cancer-related pain (CRP) is a clinical and ethical imperative. Clinical research has documented improved treatment tolerance and survival rates among patients with cancer who have effective pain control. Barriers to CRP control include inadequate patient and physician education. Meta-analyses of patient education studies correlate improvements in CRP control with improved communications with health care providers and the implementation of strategies that assist with adherence to medication schedules. These strategies build patient confidence, allowing better self-management of pain and reduced psychological consequences. For physicians, ample educational resources exist in CRP management. However, in both the inpatient and outpatient settings, compliance with NCCN Clinical Practice Guidelines in Oncology for Adult Cancer Pain continues to be less than 70%, and more than one-third of patients continue to receive inadequate doses of analgesics. Patient-centered outcomes have become an integral end point in health policy, and the nation's medical training, research, and delivery systems are transforming to a value-based accreditation and reimbursement system. Pain control is a significant patient-centered outcome in cancer care, because pain adversely impacts function and affects all domains of quality of life. Agreement is clear on the value of health care interventions that relieve suffering from cancer pain and restore personal dignity. Copyright © 2014 by the National Comprehensive Cancer Network.

  9. Early diagnosis and treatment of breast cancer in Japanese kidney transplant recipients: a single center experience. (United States)

    Kato, Taigo; Kakuta, Yoichi; Yamanaka, Kazuaki; Okumi, Masayoshi; Abe, Toyofumi; Imamura, Ryoichi; Ichimaru, Naotsugu; Takahara, Shiro; Nonomura, Norio


    The incidence of malignancies in kidney transplant recipients is increasing. Breast cancer is a common malignancy after kidney transplantation and can be more aggressive in kidney transplant recipients than in the general population. In this study, we evaluated the incidence and prognosis of breast cancer in kidney transplant recipients. Between 1993 and 2013, 750 kidney transplant patients were followed-up at our center. Since 1999, annual physical examination, mammography, and breast ultrasonography have been performed for such patients. Diagnostic studies, including core needle or mammotome biopsy, were performed for suspected malignancies. Patients with malignant neoplasm were administered the appropriate treatment and followed-up to assess tumor response and symptoms. Nine patients were diagnosed with breast cancer during the follow-up period. The mean age at the initial detection of the breast cancer was 47.7 ± 8.4 years. The mean interval from transplantation to diagnosis was 148.7 ± 37.1 months. Of the 9 patients, 8 were detected through the screening test; 7 were treated with breast conservative surgery and 1 was treated with modified radical mastectomy. The cancer stages were 0 (n = 2), I (n = 6), and II (n = 1). The incidence of breast cancer tended to be unchanged with time between transplantation and diagnosis, inconsistent with the increase in the duration of immunosuppression. Annual screening tests are crucial in the early diagnosis of breast cancer. Early treatment of breast cancer can result in an excellent prognosis in kidney transplant recipients.

  10. Nutritional support of the elderly cancer patient: the role of the nurse. (United States)

    Hopkinson, Jane B


    Cancer in the geriatric population is a growing problem. Malnutrition is common in cancer. A number of factors increase the risk for malnutrition in older people with cancer, including chronic comorbid conditions and normal physiological changes of aging. Nurses have an important role in the nutritional support of older cancer patients. To contribute to the improvement of nutritional support of these patients, nurses need appropriate training to be able to identify risk for malnutrition and offer a range of interventions tailored to individual need. Factors to consider in tailoring interventions include disease status, cancer site, cancer treatment, comorbidity, physiological age, method of facilitating dietary change, and family support. This article identifies ways in which nurses can contribute to the nutritional support of older cancer patients and thus help mitigate the effects of malnutrition. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Obesity-Linked Mouse Models of Liver Cancer | Center for Cancer Research (United States)

    Jimmy Stauffer, Ph.D., and colleagues working with Robert  Wiltrout, Ph.D., in CCR’s Cancer and Inflammation Program, along with collaborators in the Laboratory of Human Carcinogenesis, have developed a novel mouse model that demonstrates how fat-producing phenotypes can influence the development of hepatic cancer.   The team recently reported their findings in Cancer Research.

  12. BMI1 and H-RAS Cooperate to Drive Breast Cancer Metastasis | Center for Cancer Research (United States)

    There have been significant improvements in the diagnosis of breast cancer at early stages of the disease. However, even when patients are identified early, there is a 30 percent chance of recurrence after apparently successful treatment of the initial tumor. The major cause of death for breast cancer patients is metastasis of the tumor to other organs but, unfortunately, the mechanisms of metastatic progression and cancer recurrence are poorly understood.

  13. Novel Antibody Targets Glypican-3 in Liver Cancer | Center for Cancer Research (United States)

    New treatments for patients with liver cancer, the third most common cause of cancer-related death, are desperately needed. Hepatocellular carcinoma (HCC) is the most common type of liver cancer, and HCC tumors are particularly insensitive to chemotherapy. Surgery is the standard treatment for HCCs caught early, but only about a third of cases are identified at this stage. Antibody therapy offers a potential alternative for treating later-stage tumors.

  14. Depression, social support, and clinical outcomes following lung transplantation: a single-center cohort study. (United States)

    Smith, Patrick J; Snyder, Laurie D; Palmer, Scott M; Hoffman, Benson M; Stonerock, Gregory L; Ingle, Krista K; Saulino, Caroline K; Blumenthal, James A


    Depressive symptoms are common among lung transplant candidates and have been associated with poorer clinical outcomes in some studies. Previous studies have been plagued by methodologic problems, including small sample sizes, few clinical events, and uncontrolled confounders, particularly perioperative complications. In addition, few studies have examined social support as a potential protective factor. We therefore examined the association between pretransplant depressive symptoms, social support, and mortality in a large sample of lung transplant recipients. As a secondary aim, we also examined the associations between psychosocial factors, perioperative outcomes [indexed by hospital length of stay (LOS)], and mortality. We hypothesized that depression would be associated with longer LOS and that the association between depression, social support, and mortality would be moderated by LOS. Participants included lung transplant recipients, transplanted at Duke University Medical Center from January 2009 to December 2014. Depressive symptoms were evaluated using the Beck Depression Inventory (BDI-II) and social support using the Perceived Social Support Scale (PSSS). Medical risk factors included forced vital capacity (FVC), partial pressure of carbon dioxide (PCO2 ), donor age, acute rejection, and transplant type. Functional status was assessed using six-minute walk distance (6MWD). We also controlled for demographic factors, including age, gender, and native disease. Transplant hospitalization LOS was examined as a marker of perioperative clinical outcomes. Participants included 273 lung recipients (174 restrictive, 67 obstructive, 26 cystic fibrosis, and six "other"). Pretransplant depressive symptoms were common, with 56 participants (21%) exhibiting clinically elevated levels (BDI-II ≥ 14). Greater depressive symptoms were associated with longer LOS [adjusted b = 0.20 (2 days per 7-point higher BDI-II score), P support (P support were associated with greater

  15. Physician Assistant/Nurse Practitioner | Center for Cancer Research (United States)

    clinical liaison to area hospices and/or home care agencies as needed or as appropriate Acts as a clinical liaison between inpatient and outpatient nurses in order to provide continuity of care to the hospitalized patient Maintains documented evidence of weekly case review with the collaborating physician Attends and participates in multidisciplinary meetings Practices within boundaries established by the Nurse Practice Act, State of Maryland and Medical Board of the Clinical Center Liaises with Leidos Biomed and various NCI staff to initiate and complete tasks relating to medicine and clinical protocols, and all activities related to nursing Performs clinical data recording and medical chart entries Dictates admission and discharge summaries 

  16. Current status of operations in community general support centers and the correlation of personal traits, work environment and occupational stress

    National Research Council Canada - National Science Library

    Yamaguchi, Yoshie


    The purpose of this study was to identify the current status of operations at community general support centers which provide coordination for elderly care and the correlation of personal traits, work...

  17. Supportive care needs after gynecologic cancer: where does sexual health fit in? (United States)

    McCallum, Megan; Jolicoeur, Lynne; Lefebvre, Monique; Babchishin, Lyzon K; Robert-Chauret, Stéphanie; Le, Tien; Lebel, Sophie


    Descriptive, cross-sectional study. Follow-up clinic of a gynecologic oncology program in a regional cancer center. 113 women treated for gynecologic cancer. Data were collected using standardized instruments and analyzed through descriptive and correlation statistics. Supportive care needs, sexual health needs, vaginal changes, desire for help, and socio-demographic and medical factors. Forty percent of the sample was worried about the status of their sex life and many wished to meet one-on-one with a health professional or to receive written information. Younger age, premenopausal status at diagnosis, and lower sexual satisfaction and more vaginal changes after treatment were associated with greater sexual health needs and desire for help. Several sexual health needs were among the highest reported supportive care needs. Certain subgroups may report higher needs and desire for help; this domain merits additional research. Needs were extremely diverse, reflecting the use of an individual approach to screening for and meeting survivor needs. Personal perceptions of the implications and meaning of sexual health and vaginal changes create the subjective experience of a need. Discussions of the women's perceptions of their needs and their views of healthy sexuality will help develop effective treatment plans.

  18. Insertion of occupational therapists in the support centers for family health of Fortaleza

    Directory of Open Access Journals (Sweden)

    Fernanda Reis


    Full Text Available Today, Family Health Support Centers (FHSC characterize new environment for the activity of occupational therapists in Primary Health Care. Aiming to understand this new insertion we carried out a descriptive study of qualitative nature. Through a focus group, we obtained data on the subject from 13 occupation therapists that have worked in FHSCs in the municipality of Fortaleza, Ceará state, Brazil. The material obtained was categorized by thematic analysis and interpreted based on collective health and occupation therapy frameworks. The results and discussion converged to the categories of (1 Insertion of occupational therapists in the FHSNs studied, and (2 Working conditions: a place characterized by fragilities and overcoming. Our findings point to the need to establish a common agenda between FHSN professionals and Family Health Strategy teams; difficulties in establishing bonds between the supporters and the supported in the work process; working precariousness and material shortage. The encounter of such professionals potentiated reflections about the working processes and the exchange of experiences, raising awareness to new perspectives for occupational therapy in Primary Health Care and to the need to make these professionals’ performances in this specific context more public.

  19. Evaluation of stage acoustics in Seoul Arts Center Concert Hall by measuring stage support. (United States)

    Jeon, Jin Yong; Barron, Michael


    Stage acoustics is an important characteristic for concert halls, both for the acoustic quality on stage and for the audience. However, relatively little research has been conducted into the question. This study was based on the investigation of an actual concert hall stage, that of the Seoul Arts Center Concert Hall in Korea. The stage acoustics was evaluated in the actual hall, and with two models: a 1:25 scale model and a computer model. The study was based on the stage support parameter ST1 proposed by Gade as a measure of support for individual performers [Acustica 65, 193-203 (1989)]. The variation of support was measured on the empty stage of the actual hall and in the two models. The effect of musicians on stage, the effect of moving the orchestra, the effect of ceiling height and of stage-wall profile were also investigated. Conclusions are drawn both relating to the Seoul Concert Hall stage and stages in general.

  20. Bariatric Surgery and Liver Cancer in a Consortium of Academic Medical Centers. (United States)

    Yang, Baiyu; Yang, Hannah P; Ward, Kristy K; Sahasrabuddhe, Vikrant V; McGlynn, Katherine A


    Obesity is implicated as an important factor in the rising incidence of liver cancer in the USA. Bariatric surgery is increasingly used for treating morbid obesity and comorbidities. Using administrative data from UHC, a consortium of academic medical centers in the USA, we compared the prevalence of liver cancer among admissions with and without a history of bariatric surgery within a 3-year period. Admissions with a history of bariatric surgery had a 61 % lower prevalence of liver cancer compared to those without a history of bariatric surgery (prevalence ratio 0.39, 95 % confidence interval 0.35-0.44), and these inverse associations persisted within strata of sex, race, and ethnicity. This hospital administrative record-based analysis suggests that bariatric surgery could play a role in liver cancer prevention.

  1. Effectiveness and cost-effectiveness of meaning-centered group psychotherapy in cancer survivors: protocol of a randomized controlled trial.

    NARCIS (Netherlands)

    van der Spek, N.; Vos, J.; van Uden-Kraan, C.F.; Breitbart, W.; Cuijpers, P.; Knipscheer-Kuipers, K.; Willemsen, V.W.B.; Tollenaar, R.A.; van Asperen, C.J.; de Leeuw, I.M.


    Background: Meaning-focused coping may be at the core of adequate adjustment to life after cancer. Cancer survivors who experience their life as meaningful are better adjusted, have better quality of life and psychological functioning. Meaning-Centered Group Psychotherapy for Cancer Survivors

  2. Health beliefs related to breast cancer screening behaviours in women who applied to cancer early detection center

    Directory of Open Access Journals (Sweden)

    Melek Serpil Talas


    Full Text Available Background: Breast cancer is one of the most common malignancies affecting women in Turkey. The early detection methods for breast cancer have been associated with health belief variables. Objectives: The purpose of this study was to determine women's health beliefs related to breast cancer screening behaviours. Methods: This study was designed as descriptive and cross-sectional survey and was performed on 344 women who applied the Nigde Cancer Early Diagnosis, Screening and Education Center between May and October 2009. The data were collected using a questionnaire which consists of socio-demographic characteristics and breast cancer risk factors and Health Belief Model Scale. Data analysis was performed using frequency and Mann-Whitney U Test. All values of p0.05. According to study results, the rate of regular BSE performance rate for women was found low. Therefore, KETEM was planned to the training programs related to breast cancer screening methods. [TAF Prev Med Bull 2015; 14(3.000: 265-271

  3. Late effects of treatment in survivors of childhood cancer from a tertiary cancer center in South India

    Directory of Open Access Journals (Sweden)

    Rejiv Rajendranath


    Full Text Available Background: Improved survival after childhood cancer is attributed to intensive, aggressive therapy, adverse sequelae of which can manifest months to years after completion of treatment. There is little information about the late adverse effects of both childhood cancer and its therapy in survivors in India. Aim: To determine the long-term sequelae associated with therapy in childhood cancer survivors attending a tertiary cancer center in India. Materials and Methods: We studied 155 consecutive survivors of childhood cancer who were ≤14 years at the time of diagnosis and had completed 3 years of follow-up. The study included a complete history and clinical examination, with specific investigations to detect organ toxicity. Quality of life (QOL was assessed from responses to a standardized questionnaire. Neurocognitive assessment was carried out in 20 survivors with an adaptation of the revised Wechsler adult intelligence scale for adults and the Malins intelligence scale for children. Results: The late effects included impaired fertility in 38 patients (24.5%, impaired growth pattern in 7 (4.5%, endocrine dysfunction in 7 (4.5% and second malignancy in 2 (1.2%. Three of the 20 patients assessed had severe neurocognitive impairment. A high QOL was reported by 60% of survivors and an "average" QOL by 38%. Conclusion: Our study showed that most survivors had a good QOL and our results will help clinicians to better monitor childhood cancer survivors in countries with limited resources.

  4. Complementary and Alternative Medicine Use in Individuals Presenting for Care at a Comprehensive Cancer Center. (United States)

    Judson, Patricia L; Abdallah, Reem; Xiong, Yin; Ebbert, Judith; Lancaster, Johnathan M


    To define the use of complementary and alternative medicine (CAM) in individuals presenting for care at a comprehensive cancer center. A total of 17 639 individuals presenting to an NCI-designated Comprehensive Cancer Center (and consortium sites) completed a questionnaire regarding CAM use. Data were analyzed using the univariate χ2 test to assess CAM use associated with a number of variables, including cancer status, age, gender, marital status, ethnicity, race, employment, and education level. Eighty-seven percent of individuals who completed the CAM survey acknowledged CAM therapy use within the previous 12 months. Of the 5 broad categories of CAM, the most commonly used were biologically based approaches (14 759/17 639 [83.67%]), mind-body interventions (4624/17 485 [26.45%]), manipulative and body-based therapies (3957/17 537 [22.56%]), alternative medical systems (429/15 952 [2.69%]), and energy therapies (270/15 872 [1.7%]). CAM use was more prevalent among women, non-Hispanics, Caucasians, patients 60 to 69 years of age, and those who are married, have a higher level of education, and are employed ( P cancer center. Our analysis revealed that a very high percentage of patients utilize CAM. Because many of these CAM interventions are not studied in oncology patients, additional research on safety, efficacy, and mechanisms of action are essential. Furthermore, it is important that oncologists understand CAM modalities and counsel their patients about their use.

  5. Latina Breast Cancer Patients and Their Informal Support System

    National Research Council Canada - National Science Library

    Hayes-Bautista, David


    ... consisting of Latina cancer patients, their spouses/significant others and family/friends. Participants are drawn from the Breast Cancer Treatment fund, which provides payment for services for uninsured women. Findings...

  6. Nutrition support in surgical patients with colorectal cancer

    National Research Council Canada - National Science Library

    Yang Chen Bao-Lin Liu Bin Shang Ai-Shan Chen Shi-Qing Liu Wei Sun Hong-Zhuan Yin Jian-Qiao Yin Qi su


    ...: A total of 202 consecutive surgical patients admitted to our hospital with a diagnosis of colon cancer or rectal cancer from January 2010 to July 2010, meeting the requirements of Nutrition Risk...

  7. Perceived stress in online prostate cancer community participants: Examining relationships with stigmatization, social support network preference, and social support seeking

    NARCIS (Netherlands)

    Rising, C.J.; Bol, N.; Burke-Garcia, A.; Rains, S.; Wright, K.B.


    Men with prostate cancer often need social support to help them cope with illness-related physiological and psychosocial challenges. Whether those needs are met depends on receiving support optimally matched to their needs. This study examined relationships between perceived stress, prostate

  8. Personality predicts perceived availability of social support and satisfaction with social support in women with early stage breast cancer

    NARCIS (Netherlands)

    den Oudsten, Brenda L.; van Heck, Guus L.; van der Steeg, Alida F. W.; Roukema, Jan A.; de Vries, Jolanda


    This study examines the relationships between personality, on the one hand, and perceived availability of social support (PASS) and satisfaction with received social support (SRSS), on the other hand, in women with early stage breast cancer (BC). In addition, this study examined whether a stressful

  9. Partner support and distress in women with breast cancer : The role of patients' awareness of support and level of mastery

    NARCIS (Netherlands)

    Hinnen, Chris; Ranchor, Adelita V.; Baas, Pieter C.; Sanderman, Robbert; Hagedoorn, Mariet


    The aim of the present study was to investigate the associations between partners' ways of providing support (both active engagement and protective buffering) and distress in women with breast cancer as a function of patients' awareness of the support received and their sense of mastery. These

  10. Improvement of European Translational Cancer Research - Collaboration between comprehensive cancer centers

    NARCIS (Netherlands)

    Ringborg, Ulrik; de Valeriola, Dominique; van Harten, Willem H.; Llombart Bosch, Antonio; Lombardo, Claudio; Nilsson, Kenneth; Philip, Thierry; Pierotti, Marco A.; Riegman, Peter; Saghatchian, Mahasti; Storme, Guy; Tursz, Thomas; Verellen, Dirk


    Even though the increasing incidence of cancer is mainly a consequence of a population with a longer life span, part of this augmentation is related to the increasing prevalence of patients living with a chronic cancer disease. To fight the problem, improved preventive strategies are mandatory in

  11. Lessons Learned in over Two Decades of GPS/GNSS Data Center Support (United States)

    Boler, F. M.; Estey, L. H.; Meertens, C. M.; Maggert, D.


    The UNAVCO Data Center in Boulder, Colorado, curates, archives, and distributes geodesy data and products, mainly GPS/GNSS data from 3,000 permanent stations and 10,000 campaign sites around the globe. Although now having core support from NSF and NASA, the archive began around 1992 as a grass-roots effort of a few UNAVCO staff and community members to preserve data going back to 1986. Open access to this data is generally desired, but the Data Center in fact operates under an evolving suite of data access policies ranging from open access to nondisclosure for special cases. Key to processing this data is having the correct equipment metadata; reliably obtaining this metadata continues to be a challenge, in spite of modern cyberinfrastructure and tools, mostly due to human errors or lack of consistent operator training. New metadata problems surface when trying to design and publish modern Digital Object Identifiers for data sets where PIs, funding sources, and historical project names now need to be corrected and verified for data sets going back almost three decades. Originally, the data was GPS-only based on three signals on two carrier frequencies. Modern GNSS covers GPS modernization (three more signals and one additional carrier) as well as open signals and carriers of additional systems such as GLONASS, Galileo, BeiDou, and QZSS, requiring ongoing adaptive strategies to assess the quality of modern datasets. Also, new scientific uses of these data benefit from higher data rates than was needed for early tectonic applications. In addition, there has been a migration from episodic campaign sites (hence sparse data) to continuously operating stations (hence dense data) over the last two decades. All of these factors make it difficult to realistically plan even simple data center functions such as on-line storage capacity.

  12. Unmet Supportive Care Needs in U.S. Dialysis Centers and Lack of Knowledge of Available Resources to Address Them. (United States)

    Culp, Stacey; Lupu, Dale; Arenella, Cheryl; Armistead, Nancy; Moss, Alvin H


    Because of high symptom burden, numerous comorbidities, and shortened life expectancy, dialysis patients are increasingly recognized as appropriate candidates for early and continuous supportive care. The objectives of this study were to describe dialysis professionals' perceptions of the adequacy of supportive care in dialysis centers, barriers to providing it, suggestions for improving it, and familiarity with the existing evidence-based resources for supportive care of dialysis patients. The Coalition for Supportive Care of Kidney Patients conducted an online survey of dialysis professionals and administrators solicited through the 18 End-Stage Renal Disease Networks and the Renal Physicians Association. Only 4.5% of 487 respondents believed their dialysis centers were presently providing high-quality supportive care. They identified bereavement support, spiritual support, and end-of-life care discussions as the top three unmet needs. They reported that lack of a predictive algorithm for prognosis was the top barrier, and "guidelines to help with decision-making in seriously ill patients" was the top priority to improve supportive care. A majority of respondents were unaware that an evidence-based validated prognostic model and a clinical practice guideline to help with decision-making were already available. Dialysis professionals report significant unmet supportive care needs and barriers in their centers with only a small minority rating themselves as competently providing supportive care. There is an urgent need for education of dialysis professionals about available supportive care resources to provide quality supportive care to dialysis patients. Copyright © 2016. Published by Elsevier Inc.

  13. Critical Appraisal of Translational Research Models for Suitability in Performance Assessment of Cancer Centers (United States)

    Rajan, Abinaya; Sullivan, Richard; Bakker, Suzanne


    Background. Translational research is a complex cumulative process that takes time. However, the operating environment for cancer centers engaged in translational research is now financially insecure. Centers are challenged to improve results and reduce time from discovery to practice innovations. Performance assessment can identify improvement areas that will help reduce translational delays. Currently, no standard method exists to identify models for use in performance assessment. This study aimed to critically appraise translational research models for suitability in performance assessment of cancer centers. Methods. We conducted a systematic review to identify models and developed a set of criteria based on scientometrics, complex adaptive systems, research and development processes, and strategic evaluation. Models were assessed for linkage between research and care components, new knowledge, systems integration, performance assessment, and review of other models. Results. Twelve models were identified; six described phases/components for translational research in different blocks (T models) and six described the process of translational research (process models). Both models view translational research as an accumulation of new knowledge. However, process models more clearly address systems integration, link research and care components, and were developed for evaluating and improving the performance of translational research. T models are more likely to review other models. Conclusion. Process models seem to be more suitable for performance assessment of cancer centers than T models. The most suitable process models (the Process Marker Model and Lean and Six Sigma applications) must be thoroughly tested in practice. PMID:23263926

  14. Partners in recovery: social support and accountability in a consumer-run mental health center. (United States)

    Lewis, Sara E; Hopper, Kim; Healion, Ellen


    Consumer-run mental health programs that include advocacy, peer counseling, and mentoring are somewhat commonplace in community mental health services, yet fully peer-operated mental health centers remain novel in the public mental health landscape. This ethnographic study of a consumer-run mental health center had two major aims: to learn what is distinctive about consumer-run services-for example, how they might strengthen personal capacity for social integration-and to explore how the development of these capacities might promote recovery. Data collection for this modified ethnographic study consisted of ten months of participant observation, coupled with semistructured interviews (N=25), a focus group (N=22), and dramatic skits (N=17), to identify and define the distinctive features of the program, both structurally and from the point of view of participants. Inquiry was framed theoretically by the capabilities approach. Participants in this consumer-run mental health program experienced themselves as accountable for and to their peers in what amounts to a shared project of recovery. As part of a capacity-building approach in consumer-run services, programs should aim to not only provide social support for participants but also foster a culture in which service users are accountable for their peers. Such reciprocity may help to strengthen socialization skills, which could better prepare consumers for participation in the community at large.

  15. Heparin-induced thrombocytopenia among patients of a comprehensive cancer center

    Directory of Open Access Journals (Sweden)

    Weixin Wu


    Full Text Available Most clinical studies of heparin-induced thrombocytopenia have not included cancer patients who have high risk of thromboembolism, frequent exposure to heparin, and many potential causes of thrombocytopenia other than heparin-induced thrombocytopenia. To estimate the incidence and prevalence of heparin-induced thrombocytopenia in cancer patients, we identified cases based on diagnostic codes, anti-heparin antibody testing, and clinical characteristics (4T score at a comprehensive cancer center between 1 October 2008 and 31 December 2011. We estimated that the prevalence of heparin-induced thrombocytopenia to be 0.02% among all cancer patients and 0.24% among cancer patients exposed to heparin. The annual incidence of heparin-induced thrombocytopenia was 0.57 cases per 1000 cancer patients exposed to heparin. Of the 40 cancer patients with the International Classification of Diseases (Ninth Revision; ICD-9 code for heparin-induced thrombocytopenia, positive anti-heparin antibody, and 4T score ≥4, 5 (12.5% died of related thromboembolic or hemorrhagic complications. In a multivariate logistic regression model, male gender was a significant (p = 0.035 factor, and non-hematological malignancy was a significant (p = 0.017 factor associated with anti-heparin antibody positivity. Future studies may further examine the risk factors associated with heparin-induced thrombocytopenia in larger cohorts.

  16. Cloud Computing Applications in Support of Earth Science Activities at Marshall Space Flight Center (United States)

    Molthan, A.; Limaye, A. S.


    Currently, the NASA Nebula Cloud Computing Platform is available to Agency personnel in a pre-release status as the system undergoes a formal operational readiness review. Over the past year, two projects within the Earth Science Office at NASA Marshall Space Flight Center have been investigating the performance and value of Nebula's "Infrastructure as a Service", or "IaaS" concept and applying cloud computing concepts to advance their respective mission goals. The Short-term Prediction Research and Transition (SPoRT) Center focuses on the transition of unique NASA satellite observations and weather forecasting capabilities for use within the operational forecasting community through partnerships with NOAA's National Weather Service (NWS). SPoRT has evaluated the performance of the Weather Research and Forecasting (WRF) model on virtual machines deployed within Nebula and used Nebula instances to simulate local forecasts in support of regional forecast studies of interest to select NWS forecast offices. In addition to weather forecasting applications, rapidly deployable Nebula virtual machines have supported the processing of high resolution NASA satellite imagery to support disaster assessment following the historic severe weather and tornado outbreak of April 27, 2011. Other modeling and satellite analysis activities are underway in support of NASA's SERVIR program, which integrates satellite observations, ground-based data and forecast models to monitor environmental change and improve disaster response in Central America, the Caribbean, Africa, and the Himalayas. Leveraging SPoRT's experience, SERVIR is working to establish a real-time weather forecasting model for Central America. Other modeling efforts include hydrologic forecasts for Kenya, driven by NASA satellite observations and reanalysis data sets provided by the broader meteorological community. Forecast modeling efforts are supplemented by short-term forecasts of convective initiation, determined by

  17. Cancer pain management at a tertiary care cancer center in India--a retrospective analysis of 3,238 patients. (United States)

    Bhatnagar, Sushma; Mishra, Seema; Srikanti, Madhurima; Gupta, Deepak


    Effective pain control is essential for the management of patients with cancer. About 70-80 percent of patients with cancer present in an advanced stage of disease. Patients with advanced cancer frequently experience intractable pain, with diverse symptoms that can make daily living impossible and affect the quality of life. This article reports the management of 3,238 patients with cancer pain over a period of five years. Nearly 89.6 percent patients had good pain relief with Visual Analogue Scale score less than 3. These promising results were achieved by careful patient assessment, close liaison with clinicians from other specialties, and using a variety of analgesic regimen including oral analgesics, anesthetic procedures, psychological interventions, and supportive care. However, the main stay of treatment was oral analgesics, following the principles of World Health Organization ladder, with continuing follow-up.

  18. Supportive care organisation in France: an in depth study by the French speaking association for supportive care in cancer (AFSOS). (United States)

    Scotté, F; Hervé, C; Oudard, S; Bugat, M E; Bugat, R; Farsi, F; Namer, M; Tourani, J M; Tournigand, C; Yazbek, G; Richard, S; Krakowski, I


    Supportive care in cancer (SCC) was further enhanced in the Second National Cancer Act decreed in December 2009. The aim of our study was to assess current SCC efficacy. The French speaking association for supportive care in cancer (AFSOS) conducted an observational study to evaluate practices, organisations and information given to patients. A specific 32 point questionnaire was sent to 1621 French physicians (MDs) caring for cancer patients. Three different organisations were evaluated: the individual MDs, the transversal team and its particular structure specialised in global patient care specifically developed at comprehensive cancer centres - CCC. During their disease, 68% of patients received SCC, which was more available during the palliative period (90%) than at the diagnosis (44%). Our results found that 71% of cancer departments had a specific interdisciplinary cross-team to provide SCC, particularly in CCC (62%; p=0.01) while 37% had specific inpatient units. A specific organisation dedicated to home care was greater in CCC than in public or private centres (69%, 45%, 20% respectively; p=0.01). Adverse event information was performed more by an oncologist than other specialists (p=0.01). Our results suggest that the specific SCC organisation could be a useful management tool to improve supportive care for cancer patients. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Distress from changes in physical appearance and support through information provision in male cancer patients. (United States)

    Nozawa, Keiko; Tomita, Makiko; Takahashi, Eriko; Toma, Shoko; Arai, Yasuaki; Takahashi, Miyako


    This study aims to reveal the present situation of changes in physical appearance induced by treatment, the effects of these changes on social activities, and support from medical staff in male cancer patients. A questionnaire survey was administered to 949 male patients (response rate: 90.1%) visiting the National Cancer Center Hospital in Tokyo over 3 days in January 2015. The final respondents were 823 patients (mean age: 65.3, standard deviation (SD) = 12.32). Fifty-two percent of the sample, and 79.4% of patients aged under 65 were employed. A total of 84.9% experienced changes in physical appearance, and the highest mean scores of psychological were observed for stoma (3.1) and skin eczema (2.9). A total of 66.4% reported no difference in daily life even after their physical appearance changed. However, patients younger than 65 years old who were employed experienced high social difficulties (12.5%). Many wanted to stop going to work and experienced severe distress in their social lives; 74.1% reported it is important to have the same physical appearance at work as before treatment. The majority of patients obtained information from doctors (35.2%) and consulted with their wife or partner (66.2%) regarding their appearance changes, and 5.7% did not have anyone to consult with. This study clarified important aspects for supporting male cancer patients: timing, content, target audience and steps of information provision. Appropriate information provision from medical staff prior to treatment can be useful in preparing patients for physical appearance changes and decreasing the severity of symptoms.

  20. Effect of Internet peer-support groups on psychosocial adjustment to cancer

    DEFF Research Database (Denmark)

    Høybye, Mette Terp; Dalton, S O; Deltour, I


    BACKGROUND: We conducted a randomised study to investigate whether providing a self-guided Internet support group to cancer patients affected mood disturbance and adjustment to cancer. METHODS: Baseline and 1-, 6- and 12-month assessments were conducted from 2004 to 2006 at a national rehabilitat......BACKGROUND: We conducted a randomised study to investigate whether providing a self-guided Internet support group to cancer patients affected mood disturbance and adjustment to cancer. METHODS: Baseline and 1-, 6- and 12-month assessments were conducted from 2004 to 2006 at a national...... by participation in an Internet support group. Outcome measures included self-reported mood disturbance, adjustment to cancer and self-rated health. Differences in scores were compared between the control group and the intervention group. RESULTS: The effect of the intervention on mood disturbance and adjustment...... of Internet-based support groups in cancer patients still needs to confirm long-lasting psychological effects....

  1. Co-creation of an ICT-supported cancer rehabilitation application for resected lung cancer survivors: design and evaluation. (United States)

    Timmerman, Josien G; Tönis, Thijs M; Dekker-van Weering, Marit G H; Stuiver, Martijn M; Wouters, Michel W J M; van Harten, Wim H; Hermens, Hermie J; Vollenbroek-Hutten, Miriam M R


    Lung cancer (LC) patients experience high symptom burden and significant decline of physical fitness and quality of life following lung resection. Good quality of survivorship care post-surgery is essential to optimize recovery and prevent unscheduled healthcare use. The use of Information and Communication Technology (ICT) can improve post-surgery care, as it enables frequent monitoring of health status in daily life, provides timely and personalized feedback to patients and professionals, and improves accessibility to rehabilitation programs. Despite its promises, implementation of telehealthcare applications is challenging, often hampered by non-acceptance of the developed service by its end-users. A promising approach is to involve the end-users early and continuously during the developmental process through a so-called user-centred design approach. The aim of this article is to report on this process of co-creation and evaluation of a multimodal ICT-supported cancer rehabilitation program with and for lung cancer patients treated with lung resection and their healthcare professionals (HCPs). A user-centered design approach was used. Through semi-structured interviews (n = 10 LC patients and 6 HCPs), focus groups (n = 5 HCPs), and scenarios (n = 5 HCPs), user needs and requirements were elicited. Semi-structured interviews and the System Usability Scale (SUS) were used to evaluate usability of the telehealthcare application with 7 LC patients and 10 HCPs. The developed application consists of: 1) self-monitoring of symptoms and physical activity using on-body sensors and a smartphone, and 2) a web based physical exercise program. 71 % of LC patients and 78 % of HCPs were willing to use the application as part of lung cancer treatment. Accessibility of data via electronic patient records was essential for HCPs. LC patients regarded a positive attitude of the HCP towards the application essential. Overall, the usability (SUS median score = 70


    Directory of Open Access Journals (Sweden)

    Kelly Ranyelle Alves Araujo


    Full Text Available To support and expand the care attention and the health management in primary care, in particular the Family Health Strategy, it was created the Family Health Support Centers (NASF. The NASF accounts with several professionals, including occupational therapists, who develop different activities, including health promotion, holistic care and psychosocial rehabilitation. The aim of this article is to discuss from practical experience in a NASF in the metropolitan region of Brasilia how students and practitioners of occupational therapy falls within that service, identifying the main limitations and the work that advances the health care setting. Results: The students and occupational therapist service sought to develop an integrated and intersectoral. Actions were part of the home visits, group approaches with different community groups, active search for users and partnerships in the community. Thus, the work is still very limited assistance and connected to the matricial point of view, as recommended. We conclude that, despite the NASF be a new field of labor for occupational therapists, the actions of social inclusion, empowerment and citizenship developed can encourage healthy habits, but practices need to be revised to follow the proposal of this device.

  3. Supporting Clinical Cognition: A Human-Centered Approach to a Novel ICU Information Visualization Dashboard. (United States)

    Faiola, Anthony; Srinivas, Preethi; Duke, Jon


    Advances in intensive care unit bedside displays/interfaces and electronic medical record (EMR) technology have not adequately addressed the topic of visual clarity of patient data/information to further reduce cognitive load during clinical decision-making. We responded to these challenges with a human-centered approach to designing and testing a decision-support tool: MIVA 2.0 (Medical Information Visualization Assistant, v.2). Envisioned as an EMR visualization dashboard to support rapid analysis of real-time clinical data-trends, our primary goal originated from a clinical requirement to reduce cognitive overload. In the study, a convenience sample of 12 participants were recruited, in which quantitative and qualitative measures were used to compare MIVA 2.0 with ICU paper medical-charts, using time-on-task, post-test questionnaires, and interviews. Findings demonstrated a significant difference in speed and accuracy with the use of MIVA 2.0. Qualitative outcomes concurred, with participants acknowledging the potential impact of MIVA 2.0 for reducing cognitive load and enabling more accurate and quicker decision-making.

  4. Loneliness, depression, and social support of patients with cancer and their caregivers. (United States)

    Şahin, Zümrüt Akgün; Tan, Mehtap


    Loneliness is a significant psychosocial concern for patients with cancer, and depression may be an antecedent to loneliness. To date, no studies have directly addressed the relationship of loneliness, depression, and social support among Turkish patients with cancer and their caregivers. The emotional responses that result from a cancer diagnosis vary and may include anxiety, anger, frustration, or depression. Because of the unexpected demands and emotions thrust on them, the caregivers of patients with cancer may be just as likely to experience loneliness or depression following a cancer diagnosis. As a result, this study sought to examine that relationship among a sample of 60 patients with cancer and 60 caregivers.

  5. Selective CD4+ T Cell Loss Promotes Liver Cancer Development | Center for Cancer Research (United States)

    Hepatocellular carcinoma (HCC), the second leading cause of cancer deaths worldwide, commonly develops in patients with underlying chronic liver disease, such as hepatitis B or C virus infection or non-alcoholic fatty liver disease (NAFLD).

  6. Inflammation and Cancer: Two Pieces of the Same Puzzle? | Center for Cancer Research (United States)

    Chronic inflammation, in Crohn’s disease for example, is a known risk factor for malignant transformation, however the role inflammation plays in cancer initiation is poorly understood. STAT2, an important protein that regulates gene activation, is known to be stimulated by immune factors that inhibit cell growth. STAT2 also has reduced expression in the immune cells of patients with Crohn’s disease, which suggested to Ana Gamero, Ph.D., a former NCI Scholar of the Laboratory of Experimental Immunology, CCR, and now Assistant Professor at Temple University in collaboration with Nancy Colburn, Ph.D. of the Laboratory of Cancer Prevention and her colleagues, that STAT2 may be a key protein in regulating inflammation-induced cancer progression. The results of their studies were recently published in a Cancer Prevention Research article.

  7. PS1-30: Identification of Distress in the Breast Cancer Patient in a Rural Community Cancer Center (United States)

    Ziemba, Steven


    Background/Aims Community cancer centers are faced with the task of providing multidisciplinary care to their patients in an environment that is challenged for resources, time and reimbursement. Among other patient care factors, psychosocial care has become one such area of concern. The ability to rapidly identify a patient with psychosocial issues can help facilitate providing that care in an expedient and cost-effective manner. The purpose of the study was to develop a profile of a breast cancer patient exhibiting distress. Methods The study followed a cross-sectional, correlational design. Patients with breast cancer of any stage in the early phase of their treatment and who had completed the Distress Thermometer (DT) assessment as part of their routine care were consented for additional data collection. The study was conducted at a community cancer center in rural Georgia, and a total of 85 patients participated. Results The study identified 42% (36 of 85) of participants with mild distress, 31% (26 of 85) with moderate distress, and 27% (23 of 85) with severe distress. Approximately 42% (36 of 85) self-identified as African-American, and all were non-Hispanic, which mirrors the regional population where the study was conducted. All participants were female with an average age of 61. Those with a severe DT score indicated their top five sources of distress as Worry, Sadness, Nervousness, Fears and Treatment Decisions. This contrasts with those with a Mild DT score, who indicated Sleep, Treatment Decisions, Nervousness, Fatigue and Finances as sources of distress. The common factor of Treatment Decisions between these groups demonstrates that a greater ratio of patients with a severe DT score was receiving chemotherapy and/or radiation than those with mild DT score. Not surprisingly, those with a mild DT score were more likely to have an earlier stage cancer, although the difference was not statistically significant. Conclusions Participants demonstrated factors

  8. The Effects of Yoga, Massage, and Reiki on Patient Well-Being at a Cancer Resource Center. (United States)

    Rosenbaum, Mark S; Velde, Jane


    Cancer resource centers offer patients a variety of therapeutic services. However, patients with cancer and cancer healthcare practitioners may not fully understand the specific objectives and benefits of each service. This research offers guidance to cancer healthcare practitioners on how they can best direct patients to partake in specific integrative therapies, depending on their expressed needs. This article investigates the effects of yoga, massage, and Reiki services administered in a cancer resource center on patients' sense of personal well-being. The results show how program directors at a cancer resource center can customize therapies to meet the needs of patients' well-being. The experimental design measured whether engaging in yoga, massage, or Reiki services affects the self-perceived well-being of 150 patients at a cancer resource center at two times. All three services helped decrease stress and anxiety, improve mood, and enhance cancer center patrons' perceived overall health and quality of life in a similar manner. Reiki reduced the pain of patients with cancer to a greater extent than either massage or yoga.

  9. Social support for breast cancer management among Portuguese-speaking immigrant women. (United States)

    Guruge, Sepali; Maheu, Christine; Zanchetta, Margareth Santos; Fernandez, Francyelle; Baku, Lorena


    Breast cancer is one of the most commonly diagnosed types of cancer among women in Canada. Much health sciences research has examined this topic. The importance of formal and informal social support in managing breast cancer has received particular attention, but research with immigrant women has been limited. This article presents the findings of an applied ethnographic study conducted in Toronto, Canada, with 12 Portuguese-speaking women from Brazil, Portugal, and Angola about their need for, access to, and use of social support in the management of breast cancer. The key findings pertain to cancer-related fears and stigma that restrict access to and use of informal social support, barriers to obtaining formal social support, and women's resilience in the context of limited informal and formal social support. Implications for healthcare providers are presented at micro, meso, and macro levels.

  10. Demographic characteristics, call details and psychosocial support needs of the family/friends of someone diagnosed with cancer who access Australian Cancer Council telephone information and support services. (United States)

    Heckel, Leila; Fennell, Kate M; Mohebbi, Mohammadreza; Byrnes, Monica; Livingston, Patricia M


    Community-based cancer organizations provide telephone-based information and support services to assist people diagnosed with cancer and their family/friends. We investigated the demographic characteristics and psychosocial support needs of family/friends who contacted Australian Cancer Council 13 11 20 information and support helplines. Data collected on 42,892 family/friends who contacted a 13 11 20 service across Australia from January 2010 to December 2012 were analyzed. Chi-square analysis was used to examine associations between caller groups and reasons for calling, logistic regression to examine age and gender interaction effects. The majority of calls received were from women (81%) of middle- (40%) and high-socio-economic backgrounds (41%), aged 40-59 years (46%); 52% phoned for information on cancer diagnosis (including early detection, risk factors), 22% on treatment/disease management, and 26% phoned seeking psychological/emotional support. Information on a diagnosis was significantly more often the reason older males called, compared to female callers of any age. Overall, 32% found out about the service through Cancer Council resources or events, 20% from the media, 18% from the internet; 11% from health professionals. Family/friends of persons diagnosed with cancer have specific information and support needs. This study identifies groups of family/friends to whom the promotion of this service could be targeted. Within Australia and internationally, clinicians and oncology nurses as well as allied health professionals can provide an important role in increasing access to cancer telephone support services to ensure the needs of the family and friends of people affected by cancer are being met. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Barriers to Integration of Traditional and Complementary Medicine in Supportive Cancer Care of Arab Patients in Northern Israel

    Directory of Open Access Journals (Sweden)

    Eran Ben-Arye


    Full Text Available In 2008, an Integrative Oncology Program (IOP, aiming to improve patients’ quality of life during chemotherapy and advanced cancer, was launched within the Clalit Health Organization's oncology service at the Lin Medical Center, Haifa, Israel. The IOP clinical activity is documented using a research-based registry protocol. In this study, we present an analysis of the registry protocol of 15 Arab patients with cancer who were referred to the IOP. Analysis of patients’ reported outcomes using the Edmonton Symptom Assessment Scale suggests that integrative medicine care improves fatigue (=0.024, nausea (=0.043, depression (=0.012, anxiety (=0.044, appetite (=0.012, and general well-being (=0.031. Barriers to integration of traditional and complementary medicine in supportive care of Arab patients are discussed followed by six practical recommendations aimed at improving accessibility of patients to integrative supportive care, as well as compliance with treatments.

  12. A cancer center's approach to engaging African American men about cancer: the men's fellowship breakfast, Southeastern Michigan, 2008-2014. (United States)

    Langford, Aisha T; Griffith, Derek M; Beasley, Derrick D; Braxton, Effat Id-Deen


    Despite disproportionate rates of cancer morbidity and mortality among African American men, few community-based efforts have been developed and sustained to educate African American men about cancer. The University of Michigan Comprehensive Cancer Center implemented a series of breakfasts to improve cancer awareness, screening, and education among African American men. This article describes the rationale for and history of the community intervention. The 21 breakfasts were held from 2008 through mid-2014 in Ypsilanti and Ann Arbor, Michigan. Ypsilanti ranks below Michigan and the nation on most socioeconomic indicators, although most residents are high school graduates (88% in Ypsilanti and 96.5% in Ann Arbor). African American men in Ypsilanti have higher death rates for diseases associated with poor diet and inadequate physical activity compared with Ypsilanti whites and general populations in Michigan and the nation. We conducted a multicomponent qualitative process evaluation including staff meetings, conversations with participants, and focus groups. We collected 425 post-event surveys to evaluate the breakfasts quantitatively. Participants were African American (85%), were aged 51 to 70 years (54%), had health insurance (89%), and had some college education (38%). Fifty-three percent of participants reported interest in the breakfast topics including nutrition; 46%, prostate cancer; 34%, colorectal cancer, and 32%, pain management; 62% reported willingness to participate in a clinical trial. African American men are interested in learning about health and are willing to attend a health-focused breakfast series. The Men's Fellowship Breakfast is a promising strategy for bringing men together to discuss cancer screening and risk reduction.

  13. The impact of the hospital work environment on social support from physicians in breast cancer care. (United States)

    Ansmann, Lena; Wirtz, Markus; Kowalski, Christoph; Pfaff, Holger; Visser, Adriaan; Ernstmann, Nicole


    Research on determinants of a good patient-physician interaction mainly disregards systemic factors, such as the work environment in healthcare. This study aims to identify stressors and resources within the work environment of hospital physicians that enable or hinder the physicians' provision of social support to patients. Four data sources on 35 German breast cancer center hospitals were matched: structured hospital quality reports and surveys of 348 physicians, 108 persons in hospital leadership, and 1844 patients. Associations between hospital structures, physicians' social resources as well as job demands and control and patients' perceived support from physicians have been studied in multilevel models. Patients feel better supported by their physicians in hospitals with high social capital, a high percentage of permanently employed physicians, and less physically strained physicians. The results highlight the importance of the work environment for a good patient-physician interaction. They can be used to develop interventions for redesigning the hospital work environment, which in turn may improve physician satisfaction, well-being, and performance and consequently the quality of care. Health policy and hospital management could create conditions conducive to better patient-physician interaction by strengthening the social capital and by increasing job security for physicians. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. 76 FR 576 - National Cancer Institute; Notice of Closed Meetings (United States)


    ... Emphasis Panel; SPORE in Mesothelioma, Lung, Breast and Ovarian Cancers. Date: February 2-3, 2011. Time: 8....395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer Centers Support; 93...

  15. Internet Support and Information for Women with Breast Cancer

    National Research Council Canada - National Science Library

    Owen, Jason


    Traditional methods of providing psychosocial interventions for cancer patients are associated with positive patient outcomes but have limited overall impact attributable to low participation rates...

  16. Internet Support and Information for Women with Breast Cancer

    National Research Council Canada - National Science Library

    Owen, Jason


    Traditional methods of providing psychosocial interventions for cancer patients are associated with positive patient outcomes but have limited overall impact attributable to low participation rates...

  17. The frequency, cost, and clinical outcomes of hypernatremia in patients hospitalized to a comprehensive cancer center. (United States)

    Salahudeen, Abdulla K; Doshi, Simit M; Shah, Pankaj


    To study the frequency of hypernatremia in hospitalized cancer patients and its impact on clinical outcomes and healthcare cost. Cross-sectional analysis of data obtained from patients admitted to the University of Texas M. D. Anderson Cancer Center over a 3-month period in 2006. The clinical outcomes and hospital costs were compared among hypernatremics, eunatremics, and hyponatremics (serum sodium values include >147, 135-147, and hypernatremia (90 %) acquired during hospital stay. The multivariate hazard ratio (HR) for mortality in hypernatremic was 5-fold higher than eunatremic (HR for 90 days-5.09 (95 % CI, 3.32-7.81); p hypernatremia was far less frequent than hyponatremia in the hospitalized cancer patients, most hypernatremia were acquired in the hospital and had substantially higher mortality, hospital stay, and hospital bills than eunatremic or even hyponatremic patients. Studies are warranted to determine whether avoidance of hypernatremia or its prompt and sustained correction improves clinical outcomes.

  18. Effects of Using Child Personas in the Development of a Digital Peer Support Service for Childhood Cancer Survivors. (United States)

    Wärnestål, Pontus; Svedberg, Petra; Lindberg, Susanne; Nygren, Jens M


    Peer support services have the potential to support children who survive cancer by handling the physical, mental, and social challenges associated with survival and return to everyday life. Involving the children themselves in the design process allows for adapting services to authentic user behaviors and goals. As there are several challenges that put critical requirements on a user-centered design process, we developed a design method based on personas adapted to the particular needs of children that promotes health and handles a sensitive design context. The purpose of this study was to evaluate the effects of using child personas in the development of a digital peer support service for childhood cancer survivors. The user group's needs and behaviors were characterized based on cohort data and literature, focus group interviews with childhood cancer survivors (n=15, 8-12 years), stakeholder interviews with health care professionals and parents (n=13), user interviews, and observations. Data were interpreted and explained together with childhood cancer survivors (n=5) in three explorative design workshops and a validation workshop with children (n=7). We present findings and insights on how to codesign child personas in the context of developing digital peer support services with childhood cancer survivors. The work resulted in three primary personas that model the behaviors, attitudes, and goals of three user archetypes tailored for developing health-promoting services in this particular use context. Additionally, we also report on the effects of using these personas in the design of a digital peer support service called Give Me a Break. By applying our progressive steps of data collection and analysis, we arrive at authentic child-personas that were successfully used to design and develop health-promoting services for children in vulnerable life stages. The child-personas serve as effective collaboration and communication aids for both internal and external

  19. A patient-centered methodology that improves the accuracy of prognostic predictions in cancer.

    Directory of Open Access Journals (Sweden)

    Mohammed Kashani-Sabet

    Full Text Available Individualized approaches to prognosis are crucial to effective management of cancer patients. We developed a methodology to assign individualized 5-year disease-specific death probabilities to 1,222 patients with melanoma and to 1,225 patients with breast cancer. For each cancer, three risk subgroups were identified by stratifying patients according to initial stage, and prediction probabilities were generated based on the factors most closely related to 5-year disease-specific death. Separate subgroup probabilities were merged to form a single composite index, and its predictive efficacy was assessed by several measures, including the area (AUC under its receiver operating characteristic (ROC curve. The patient-centered methodology achieved an AUC of 0.867 in the prediction of 5-year disease-specific death, compared with 0.787 using the AJCC staging classification alone. When applied to breast cancer patients, it achieved an AUC of 0.907, compared with 0.802 using the AJCC staging classification alone. A prognostic algorithm produced from a randomly selected training subsample of 800 melanoma patients preserved 92.5% of its prognostic efficacy (as measured by AUC when the same algorithm was applied to a validation subsample containing the remaining patients. Finally, the tailored prognostic approach enhanced the identification of high-risk candidates for adjuvant therapy in melanoma. These results describe a novel patient-centered prognostic methodology with improved predictive efficacy when compared with AJCC stage alone in two distinct malignancies drawn from two separate populations.

  20. A Work Sampling Assessment of the Nursing Delivery of Palliative Care in Ambulatory Cancer Centers. (United States)

    Davison, Jennifer; Schenker, Yael; Donovan, Heidi; Rosenzweig, Margaret


    Most cancer care occurs within infusion rooms at ambulatory cancer centers, which are staffed by RNs administering chemotherapies and other cancer care medications. Many patients receiving these therapies have basic palliative care needs that could be addressed by the RNs. However, the extent to which these RNs spend their time on basic, or "primary," palliative care is unknown. The aim of this project was to conduct a work sampling assessment of infusion room RNs' work activities and provision of primary palliative care. A single observer conducted direct observation work sampling at three academic cancer center infusion rooms. Nursing tasks were recorded via freehand text and later assigned an appropriate task code. Observed infusion room RNs spent about 1% of their time on direct care palliative care tasks, primarily symptom assessment. The remainder of their time was divided among direct (28%) and indirect (56%) nonpalliative care activities, unit-related activities (7%), and personal time (9%). Infusion room RNs spent less than a third of their time on administering direct patient care and very minimal time on performing palliative care activities.

  1. Review of streptococcal bloodstream infections at a comprehensive cancer care center, 2000-2011. (United States)

    Shelburne, Samuel A; Tarrand, Jeffrey; Rolston, Kenneth V


    To determine the comparative rates, clinical characteristics, and outcomes of invasive infections due to specific streptococcal types in patients with cancer. Review of electronic medical records of patients with non-viridans group streptococcal bloodstream infection (BSI) at the MD Anderson Cancer Center from 2000 to 2011. 550 streptococcal BSI were identified. The largest number of cases were caused by Streptococcus pneumoniae (251), group B Streptococcus (147), and gamma-hemolytic streptococci (55). Risk factors for developing a severe streptococcal infection included older age, being neutropenic at onset of BSI, and having a respiratory source of infection. Between 2000-2001 and 2010-2011, the rates of S. pneumoniae BSI and penicillin non-susceptibility decreased by 55% and 100%. In contrast the rate of group B streptococcal (GBS) BSI increased 34% over the same time period. GBS accounted for >80% of the recurrent infections following streptococcal BSI. Patients with breast cancer and those with soft-tissue/bone BSI sources were at increased risk for recurrent GBS infection but had lower rates of severe GBS disease. From 2000 to 2011, our comprehensive cancer center observed a significant decrease in the rates of S. pneumoniae BSI and a significant increase in the rates of GBS BSI. Copyright © 2012 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  2. The healing and spiritual properties of music therapy at a cancer care center. (United States)

    McClean, Stuart; Bunt, Leslie; Daykin, Norma


    This article explores the theme of spirituality, health, and well-being, in relation to an emerging body of research on the impact of music therapy in cancer care. The focus of this article is a music therapy service established as part of a residential 5-day retreat program at a cancer care center. The aim of the study was to explore the experiences of patients with cancer with one-off group music therapy at a cancer care center. Central emphasis is given to exploring a range of themes relating to the healing and spiritual properties of music therapy group work. This is a qualitative study, following a modified grounded-theory approach. Twenty-three (23) in-depth tape-recorded telephone interviews were conducted with people who had taken part in the music therapy sessions. The results focus on those findings relevant to notions of spirituality and healing, drawing on four overarching spirituality themes of transcendence, connectedness, search for meaning, and faith and hope. The authors consider the applicability of broader schemas that attempt to define and explore the role and significance of spirituality.

  3. Along the Cancer Continuum: Integrating Therapeutic Support and Bereavement Groups for Children and Teens of Terminally Ill Cancer Patients (United States)

    Werner-Lin, Allison; Biank, Nancee M.


    Family life is altered irrevocably when a young parent is diagnosed with or dies from cancer. This article tracks the genesis and transformation of a comprehensive psychoeducational support and bereavement program for children, adolescents, and parents affected by cancer. From the inception of the program, families with parents in active treatment…

  4. Adolescent and young adult oncology patients: Disparities in access to specialized cancer centers. (United States)

    Alvarez, Elysia; Keegan, Theresa; Johnston, Emily E; Haile, Robert; Sanders, Lee; Saynina, Olga; Chamberlain, Lisa J


    Adolescents and young adults (AYAs) ages 15 to 39 years with cancer continue to experience disparate survival outcomes compared with their younger and older counterparts. This may be caused in part by differential access to specialized cancer centers (SCCs), because treatment at SCCs has been associated with improved overall survival. The authors examined social and clinical factors associated with AYA use of SCCs (defined as Children's Oncology Group-designated or National Cancer Institute-designated centers). A retrospective, population-based analysis was performed on all hospital admissions of AYA oncology patients in California during 1991 through 2014 (n = 127,250) using the Office of Statewide Health Planning and Development database. Multivariable logistic regression analyses examined the contribution of social and clinical factors on always receiving care from an SCC (vs sometimes or never). Results are presented as adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Over the past 20 years, the percentage of patients always receiving inpatient care at an SCC increased over time (from 27% in 1991 to 43% in 2014). In multivariable regression analyses, AYA patients were less likely to always receive care from an SCC if they had public insurance (OR, 0.64; 95% CI, 0.62-0.66), were uninsured (OR, 0.51; 95% CI, 0.46-0.56), were Hispanic (OR, 0.88; 95% CI, 0.85-0.91), lived > 5 miles from an SCC, or had a diagnosis other than leukemia and central nervous system tumors. Receiving care at an SCC was influenced by insurance, race/ethnicity, geography, and tumor type. Identifying the barriers associated with decreased SCC use is an important first step toward improving outcomes in AYA oncology patients. Cancer 2017;123:2516-23. © 2017 American Cancer Society. © 2017 American Cancer Society.

  5. The Application Of The Support System Decision Stadium Of Breast Cancer Using Fuzzy Logic Based Android

    Directory of Open Access Journals (Sweden)

    Rico Adrial


    Full Text Available Breast cancer treatable while still stadium early. The first step in the treatment of disease breast cancer is detection by true that symptoms appearing on the body patient is really cancer cells. Stadium cancer is the result of diagnostic by physicians so that ease in understanding for patients . On this research used fuzzy logic as a method that helps in making the support system of decision in determining stadium breast cancer. today much android applications are made  in the provision of information in the field of health. By combining knowledge in the health sector , fuzzy logic and android is expected to become an application latest supporters of intelligible decision by many people on the health sector. The support system decision stadium disease breast cancer using fuzzy logic android based was designed . We can conclude that the application apply calculation based on fuzzy logic method sugeno and has been tested by calculation on matlab and manually.

  6. Genetic Variation Linked to Lung Cancer Survival in White Smokers | Center for Cancer Research (United States)

    CCR investigators have discovered evidence that links lung cancer survival with genetic variations (called single nucleotide polymorphisms) in the MBL2 gene, a key player in innate immunity. The variations in the gene, which codes for a protein called the mannose-binding lectin, occur in its promoter region, where the RNA polymerase molecule binds to start transcription, and in the first exon that is responsible for the correct structure of MBL. The findings appear in the September 19, 2007, issue of the Journal of the National Cancer Institute.

  7. Adoptive T-cell Therapy Promising for Metastatic Cervical Cancer | Center for Cancer Research (United States)

    Over 4,000 women in the U.S. die from cervical cancer each year. Nearly all cases of the disease are caused by infection with human papilloma viruses (HPVs), particularly strains 16 and 18. Cervical cancer can be prevented with vaccination against HPVs before the initiation of sexual activity and can be detected early with regular screening via the Pap test and/or HPV DNA testing. If the disease progresses to a metastatic state, however, it is generally incurable and difficult to treat with chemotherapy.

  8. Decision support system development at the Upper Midwest Environmental Sciences Center (United States)

    Fox, Timothy J.; Nelson, J. C.; Rohweder, Jason J.


    A Decision Support System (DSS) can be defined in many ways. The working definition used by the U.S. Geological Survey Upper Midwest Environmental Sciences Center (UMESC) is, “A spatially based computer application or data that assists a researcher or manager in making decisions.” This is quite a broad definition—and it needs to be, because the possibilities for types of DSSs are limited only by the user group and the developer’s imagination. There is no one DSS; the types of DSSs are as diverse as the problems they help solve. This diversity requires that DSSs be built in a variety of ways, using the most appropriate methods and tools for the individual application. The skills of potential DSS users vary widely as well, further necessitating multiple approaches to DSS development. Some small, highly trained user groups may want a powerful modeling tool with extensive functionality at the expense of ease of use. Other user groups less familiar with geographic information system (GIS) and spatial data may want an easy-to-use application for a nontechnical audience. UMESC has been developing DSSs for almost 20 years. Our DSS developers offer our partners a wide variety of technical skills and development options, ranging from the most simple Web page or small application to complex modeling application development.

  9. Integrating Palliative Care Into Comprehensive Cancer Centers: Consensus-Based Development of Best Practice Recommendations (United States)

    Stiel, Stephanie; Simon, Steffen T.; Schmitz, Andrea; van Oorschot, Birgitt; Stachura, Peter; Ostgathe, Christoph


    Background. International associations admit that specialized palliative care (SPC) is an obvious component of excellent cancer care. Nevertheless, gaps in integration at the international level have been identified. Recommendations for integrating SPC in clinical care, research, and education are needed, which are subject of the present study. Materials and Methods. A Delphi study, with three written Delphi rounds, including a face-to-face-meeting with a multiprofessional expert panel (n = 52) working in SPC in 15 German Comprehensive Cancer Centers (CCCs) funded by the German Cancer Aid was initiated. Initial recommendations are built on evidence-based literature. Consensus was defined in advance with ≥80% agreement based on the question of whether each recommendation was unambiguously formulated, relevant, and realizable for a CCC. Results. A total of 38 experts (73.1%) from 15 CCCs performed all three Delphi rounds. Consensus was achieved for 29 of 30 recommendations. High agreement related to having an organizationally and spatially independent palliative care unit (≥6 beds), a mobile multiprofessional SPC team, and cooperation with community-based SPC. Until round 3, an ongoing discussion was registered on hospice volunteers, a chair of palliative care, education in SPC among staff in emergency departments, and integration of SPC in decision-making processes such as tumor boards or consultation hours. Integration of SPC in decision-making processes was not consented by a low-rated feasibility (76.3%) due to staff shortage. Conclusion. Recommendations should be considered when developing standards for cancer center of excellence in Germany. Definition and implementation of indicators of integration of SPC in CCCs and evaluation of its effectiveness are current and future challenges. Implications for Practice: General and specialized palliative care (SPC) is an integral part of comprehensive cancer care. However, significant diversity concerning the design

  10. [Relationship of social support and meaning of life to suicidal thoughts in cancer patients]. (United States)

    Kim, Yeon Jung; Lee, Kwang Ja


    This study was done to explore the relationship of social support and meaning of life to suicidal thoughts among patients with cancer. Data were collected by questionnaires from 138 patients who had been in cancer treatment at medical clinics and 8 patients who were members of an internet cancer association. The data were collected between August and November 2009 and analyzed using SPSS 12.0. Of the participants, 47.3% reported having had suicidal thoughts and 16.4% had attempted suicide since the diagnosis of cancer. The study participants received most support from family members, but 73.3% reported experiencing an existential vacuum. The suicide attempt group had significantly higher scores according to gender, age, level of education, diagnosis, treatment modality, level of activity, caregiver and social support compare to the suicide thought group. Suicidal thoughts were negatively related to social support and meaning of life was positively associated with social support. Support from family and friends and diagnosis explained 50.0% of variance for suicidal thoughts with 36.0% of variance being explained by family support. Nurses should be able to identify risk factors for suicide in cancer patients. Prevention and intervention efforts need to be directed toward improving social support, family support in particular, and assisting patients finding meaning in life after a diagnosis of cancer.

  11. Thrombospondin 1 Wages a Double Hit Against Cancer | Center for Cancer Research (United States)

    Cancer is the result of a complex series of molecular steps that promote uncontrolled growth and erode the body’s ability to fight the resulting tumor. Generating a more complete picture of these molecular events should help identify strategies to prevent and treat the disease.

  12. Oncologists' perspectives on concurrent palliative care in a National Cancer Institute-designated comprehensive cancer center. (United States)

    Bakitas, Marie; Lyons, Kathleen Doyle; Hegel, Mark T; Ahles, Tim


    The purpose of this study was to understand oncology clinicians' perspectives about the care of advanced cancer patients following the completion of the ENABLE II (Educate, Nurture, Advise, Before Life Ends) randomized clinical trial (RCT) of a concurrent oncology palliative care model. This was a qualitative interview study of 35 oncology clinicians about their approach to patients with advanced cancer and the effect of the ENABLE II RCT. Oncologists believed that integrating palliative care at the time of an advanced cancer diagnosis enhanced patient care and complemented their practice. Self-assessment of their practice with advanced cancer patients comprised four themes: (1) treating the whole patient, (2) focusing on quality versus quantity of life, (3) “some patients just want to fight,” and (4) helping with transitions; timing is everything. Five themes comprised oncologists' views on the complementary role of palliative care: (1) “refer early and often,” (2) referral challenges: “Palliative” equals “hospice”; “Heme patients are different,” (3) palliative care as consultants or co-managers, (4) palliative care “shares the load,” and (5) ENABLE II facilitated palliative care integration. Oncologists described the RCT as holistic and complementary, and as a significant factor in adopting concurrent care as a standard of care.

  13. Perceptions of complementary medicine integration in supportive cancer care of Arabs and Jews in Israel: a cross-cultural study. (United States)

    Ben-Arye, Eran; Schiff, Elad; Silbermann, Michael; Agbarya, Abed; Bar-Sela, Gil


    There is a dearth of studies on how cultural background influences patients' attitudes and choices regarding complementary and traditional medicine (CTM) integration. To explore Arab and Jewish patients' perspectives regarding CTM use and its possible integration within conventional cancer care. This was a cross-cultural study. We developed a 27-item questionnaire that evaluates patients' perceptions regarding CTM integration in supportive cancer care. The questionnaire was administered to a convenience sample of patients receiving cancer care in community and hospital oncology centers. Of the 770 respondents (response rate 88%), 324 defined their religion as Muslim, Christian, or Druze (henceforth, regarded as Arabs) and 446 were Jews. Respondents in the two groups differed significantly in terms of age, gender, marital status, number of children, education, religiosity, and prevalence of cancer types (excluding breast cancer). Although Arab respondents reported less use of CTM for cancer-related outcomes (39.6% vs. 52.1%; P = 0.001), they expressed greater support than Jewish respondents for optional CTM consultation if provided within conventional oncology care (P < 0.0001). Respondents in both groups stated that their primary expectation from the oncologist concerning CTM was to participate in formulating a CTM treatment plan to be provided within the oncology department. Compared with Arab respondents, Jews expected CTM consultations to focus on improving daily functioning and coping, reducing chemotherapy side effects, and providing spiritual support. Although quality of life-related expectations are more pronounced among Jewish respondents, both groups share the expectation from their health care providers to be actively involved in construction of a tailored integrative CTM treatment plan. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  14. [Nutritional risk factors in patients with head and neck cancer in oncology care center Michoacan state]. (United States)

    García Rojas Vázquez, L E; Trujano-Ramos, L A; Pérez-Rivera, E


    The head and neck cancer in Michoacán, Mexico, ranks as the third most common cancer and accounts for 12% of deaths. The increase in malnutrition in a patient with this disease has been associated with increased mortality. We studied prospectively 30 patients of both sexes, aged 18 years with head and neck cancer in the Cancer Care Center of Michoacan. In the evaluation period since August 2010 to August 2011. Formats were used VGS-Oncology (Subjective Global Assessment), NRS 2002 (Nutritional risk screen) and Guss (Gugging Swallowing Screen), through which nutritional risk was determined, and established the swallowing capacity of the study population. In our study, 53.3% of the population had moderate malnutrition according to the VGS Oncology, 33% weight loss record. The NRS 2002 show that 43.3% is at risk of malnutrition. The degree of dysphagia is shown more often in older patients, cancer type and stage of illness. Nutritional risk scales relate directly proportional to tumor location and stage, as well, there are other different oncological factors involved in the patient's nutritional deterioration. Therefore it is of vital importance to have a nutritionist as part of the multidisciplinary team, to detect the nutritional risk and to be able to handle it in an opportune way. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

  15. On-Site Fertility Preservation Services for Adolescents and Young Adults in a Comprehensive Cancer Center. (United States)

    Peavey, Mary; Arian, Sara; Gibbons, William; Lu, Karen; Gershenson, David; Woodard, Terri


    Adolescents and young adults (AYAs) receiving cancer treatments that may impair fertility should receive counseling about risk of infertility and options for fertility preservation (FP) before treatment and/or during survivorship. Our objective was to define the AYA patient population referred to an on-site fertility consultation service within a comprehensive cancer center and determine factors associated with patients proceeding with FP treatment. We conducted a retrospective chart review of AYA women who completed a consultation at the MD Anderson Fertility Preservation and Family Building Service during the first year of service. Records of 154 referred AYA patients were reviewed for age, ethnicity, cancer type gravidity and parity, survivorship status, and decision to pursue FP treatment. Patients (mean age 29.7) were Caucasian (55%), Hispanic (23%), and African American (10%). The majority of women (67%) were seen for FP before cancer treatment and the remaining sought options for family building while in survivorship. The most common cancer types were hematologic (29%), breast (25%), and gynecologic (23%). Patients referred to an on-site fertility consultation service were medically and ethnically diverse. Interest in fertility counseling and treatment was apparent in both survivorship pre- and postcancer treatment. Although the referral group was ethnically diverse, Caucasian women were most likely to pursue FP treatment compared to women of other ethnicities.

  16. [Urethral stricture rate after prostate cancer radiotherapy : Five-year data of a certified prostate cancer center]. (United States)

    Kranz, J; Maurer, G; Maurer, U; Deserno, O; Schulte, S; Steffens, J


    A urethral stricture is a scar of the urethral epithelium which can cause obstructive voiding dysfunction with consequential damage of the upper urinary tract. Almost 45% of all strictures are iatrogenic; they develop in 2-9% of patients after radical prostatectomy, but can also occur after prostate cancer radiotherapy. This study provides 5‑year data of a certified prostate cancer center (PKZ) in terms of urethral strictures. Between 01/2008 and 12/2012 a total of 519 men were irradiated for prostate cancer (LDR and HDR brachytherapy as well as external beam radiation). The entire cohort was followed-up prospectively according to a standardized protocol (by type of irradiation). Short segment urethral strictures were treated by urethrotomy, recurrent and long segment stenosis with buccal mucosa urethroplasty. A total of 18 of 519 (3.4%) patients developed a urethral stricture post-therapeutically, which recurred in 66% of cases after the first operative treatment. The largest risk for developing a urethral stricture is attributed to the HDR brachytherapy (8.9%). Urethral strictures after prostate cancer radiotherapy should be diagnosed and treated in time for long-term preservation of renal function. The rate of radiogenic urethral strictures (3.4%) is equivalent to those after radical prostatectomy. Due to a high rate of recurrences, urethrotomy has a limited importance after irradiation.

  17. Indicators of malnutrition in children with cancer: A study of 690 patients from a tertiary care cancer center. (United States)

    Srivastava, R; Pushpam, D; Dhawan, D; Bakhshi, S


    Large data pertaining to indicators of malnutrition in children with cancer is lacking from India. In view of this, we prospectively analyzed consecutive de novo childhood patients with cancer presenting at a tertiary care center. Height and weight of each child (n = 690) were compared with World Health Organization child growth standards-2006 for that particular age and sex to get weight-for-age, height-for-age, and weight-for-height indices and below 2SD of the reference median on these indices were considered as underweight, stunted, and wasted, respectively. Body mass index (BMI) for age was also analyzed for thinness and obesity. Prevalence of malnutrition based on Z-score for weight-for-age, height-for-age, weight-for-height, and BMI-for-age was 30%, 31%, 35%, and 41%, respectively. Weight-for-age (underweight) was significantly associated (P = 0.018) with solid tumors. Height-for-age, weight-for-age, and BMI-for-age were significantly associated (P = 0.007, P = 0.016, and P ≤ 0.001, respectively) with rural community. Malnutrition was observed in approximately one-third of children with cancer. Malnutrition is associated with solid tumors and those coming from rural community. Wasting has a higher prevalence in children with cancer in <5 years of age group.

  18. 2014 Korean Liver Cancer Study Group-National Cancer Center Korea practice guideline for the management of hepatocellular carcinoma. (United States)


    The guideline for the management of hepatocellular carcinoma (HCC) was first developed in 2003 and revised in 2009 by the Korean Liver Cancer Study Group and the National Cancer Center, Korea. Since then, many studies on HCC have been carried out in Korea and other countries. In particular, a substantial body of knowledge has been accumulated on diagnosis, staging, and treatment specific to Asian characteristics, especially Koreans, prompting the proposal of new strategies. Accordingly, the new guideline presented herein was developed on the basis of recent evidence and expert opinions. The primary targets of this guideline are patients with suspicious or newly diagnosed HCC. This guideline provides recommendations for the initial treatment of patients with newly diagnosed HCC.

  19. Barriers to colorectal cancer screening in community health centers: A qualitative study

    Directory of Open Access Journals (Sweden)

    Fletcher Robert H


    Full Text Available Abstract Background Colorectal cancer screening rates are low among disadvantaged patients; few studies have explored barriers to screening in community health centers. The purpose of this study was to describe barriers to/facilitators of colorectal cancer screening among diverse patients served by community health centers. Methods We identified twenty-three outpatients who were eligible for colorectal cancer screening and their 10 primary care physicians. Using in-depth semi-structured interviews, we asked patients to describe factors influencing their screening decisions. For each unscreened patient, we asked his or her physician to describe barriers to screening. We conducted patient interviews in English (n = 8, Spanish (n = 2, Portuguese (n = 5, Portuguese Creole (n = 1, and Haitian Creole (n = 7. We audiotaped and transcribed the interviews, and then identified major themes in the interviews. Results Four themes emerged: 1 Unscreened patients cited lack of trust in doctors as a barrier to screening whereas few physicians identified this barrier; 2 Unscreened patients identified lack of symptoms as the reason they had not been screened; 3 A doctor's recommendation, or lack thereof, significantly influenced patients' decisions to be screened; 4 Patients, but not their physicians, cited fatalistic views about cancer as a barrier. Conversely, physicians identified competing priorities, such as psychosocial stressors or comorbid medical illness, as barriers to screening. In this culturally diverse group of patients seen at community health centers, similar barriers to screening were reported by patients of different backgrounds, but physicians perceived other factors as more important. Conclusion Further study of these barriers is warranted.

  20. Design and operation of the emergency support center, CAE; Diseno y explotacion del centro de apoyo en emergencias, CAE

    Energy Technology Data Exchange (ETDEWEB)

    Caro, R. J.; Lopez Trillo, E.


    The enhancements developed in Spain in the area of Emergency Management, as consequence of the accident at the Fukushima Dai-Ichi NPP in 2011, included the definition of new emergency response centers; Alternative Center for Emergency Management (CAGE) on each NPP and the Emergency Support Center (CAE), shared by all NPPs. This article summarizes the main features and operation activities undertaken since the establishment of the new CAE, centralized, external to the NPPs shared by all Spanish plants and managed by Tecnatom. (Author)

  1. Chemotherapy versus support cancer treatment in advanced gastric cancer: a meta-analysis

    Directory of Open Access Journals (Sweden)

    L. Casaretto


    Full Text Available The aim of the present study was to compare the efficacy of chemotherapy and support treatment in patients with advanced non-resectable gastric cancer in a systematic review and meta-analysis of randomized clinical trials that included a comparison of chemotherapy and support care treatment in patients diagnosed with gastric adenocarcinoma, regardless of their age, gender or place of treatment. The search strategy was based on the criteria of the Cochrane Base, using the following key words: 1 randomized clinical trials and antineoplastic combined therapy or gastrointestinal neoplasm, 2 stomach neoplasm and drug therapy, 3 clinical trial and multi-modality therapy, 4 stomach neoplasm and drug therapy or quality of life, 5 double-blind method or clinical trial. The search was carried out using the Cochrane, Medline and Lilacs databases. Five studies fulfilled the inclusion criteria, for a total of 390 participants, 208 (53% receiving chemotherapy, 182 (47% receiving support care treatment and 6 losses (1.6%. The 1-year survival rate was 8% for support care and 20% for chemotherapy (RR = 2.14, 95% CI = 1.00-4.57, P = 0.05; 30% of the patients in the chemotherapy group and 12% in the support care group attained a 6-month symptom-free period (RR = 2.33, 95% CI = 1.41-3.87, P < 0.01. Quality of life evaluated after 4 months was significantly better for the chemotherapy patients (34%; RR = 2.07, 95% CI = 1.31-3.28, P < 0.01 with tumor mass reduction (RR = 3.32, 95% CI = 0.77-14.24, P = 0.1. Chemotherapy increased the 1-year survival rate of the patients and provided a longer symptom-free period of 6 months and an improvement in quality of life.

  2. Effects of supported metallocene catalyst active center multiplicity on antioxidant-stabilized ethylene homo- and copolymers

    KAUST Repository

    Atiqullah, Muhammad


    © 2014 Akadémiai Kiadó, Budapest, Hungary. A silica-supported bis(n-butylcyclopentadienyl) zirconium dichloride [( n BuCp)2ZrCl2] catalyst was synthesized. This was used to prepare an ethylene homopolymer and an ethylene-1-hexene copolymer. The active center multiplicity of this catalyst was modeled by deconvoluting the copolymer molecular mass distribution and chemical composition distribution. Five different active site types were predicted, which matched the successive self-nucleation and annealing temperature peaks. The thermo-oxidative melt stability, with and without Irganox 1010 and Irgafos 168, of the above polyethylenes was investigated using nonisothermal differential scanning calorimetric (DSC) experiments at 150 °C. This is a temperature that ensures complete melting of the samples and avoids the diffusivity of oxygen to interfere into polyethylene crystallinity and its thermo-oxidative melt degradation. The oxidation parameters such as onset oxidation temperature, induction period, protection factor, and S-factor were determined by combining theoretical modeling with the DSC experiments. Subsequently, these findings were discussed considering catalyst active center multiplicity and polymer microstructure, particularly average ethylene sequence length. Several insightful results, which have not been reported earlier in the literature, were obtained. The antioxidant effect, for each polymer, varied as (Irganox + Irgafos) ≈ Irganox > Irgafos > Neat polymer. The as-synthesized homopolymer turned out to be almost twice as stable as the corresponding copolymer. The antioxidant(s) in the copolymer showed higher antioxidant effectiveness (AEX) than those in the homopolymer. Irganox exhibited more AEX than Irgafos. To the best of our knowledge, such findings have not been reported earlier in the literature. However, mixed with Irganox or Irgafos, their melt oxidation stability was comparable. The homopolymer, as per the calculated S-factor, showed Irganox

  3. Coping with cancer -- finding the support you need (United States)

    ... Security if you have advanced cancer. Counseling Services Counseling can help you cope with difficult feelings like anger, fear, ... they can pay Some medical schools offer free counseling Where to get Help Here is a list of groups for people ...

  4. Childhood cancer treatment optimization: In rhabdomyosarcoma and supportive care

    NARCIS (Netherlands)

    Schoot, R.A.


    This thesis covers two subjects investigating optimization of cancer cure: prevention and treatment of central venous catheter related complications and improvement of local treatment in head and neck rhabdomyosarcoma survivors. Central venous catheters are indispensable in the modern day treatment

  5. Managing symptoms during cancer treatments: evaluating the implementation of evidence-informed remote support protocols

    Directory of Open Access Journals (Sweden)

    Stacey Dawn


    Full Text Available Abstract Background Management of cancer treatment-related symptoms is an important safety issue given that symptoms can become life-threatening and often occur when patients are at home. With funding from the Canadian Partnership Against Cancer, a pan-Canadian steering committee was established with representation from eight provinces to develop symptom protocols using a rigorous methodology (CAN-IMPLEMENT©. Each protocol is based on a systematic review of the literature to identify relevant clinical practice guidelines. Protocols were validated by cancer nurses from across Canada. The aim of this study is to build an effective and sustainable approach for implementing evidence-informed protocols for nurses to use when providing remote symptom assessment, triage, and guidance in self-management for patients experiencing symptoms while undergoing cancer treatments. Methods A prospective mixed-methods study design will be used. Guided by the Knowledge to Action Framework, the study will involve (a establishing an advisory knowledge user team in each of three targeted settings; (b assessing factors influencing nurses’ use of protocols using interviews/focus groups and a standardized survey instrument; (c adapting protocols for local use, ensuring fidelity of the content; (d selecting intervention strategies to overcome known barriers and implementing the protocols; (e conducting think-aloud usability testing; (f evaluating protocol use and outcomes by conducting an audit of 100 randomly selected charts at each of the three settings; and (g assessing satisfaction with remote support using symptom protocols and change in nurses’ barriers to use using survey instruments. The primary outcome is sustained use of the protocols, defined as use in 75% of the calls. Descriptive analysis will be conducted for the barriers, use of protocols, and chart audit outcomes. Content analysis will be conducted on interviews/focus groups and usability testing

  6. Social Media: Support for Survivors and Young Adults With Cancer. (United States)

    Walton, AnnMarie L; Albrecht, Tara A; Lux, Lauren; Judge Santacroce, Sheila


    Social media use is ubiquitous among young adults. Young adults with cancer must make important decisions about where, what, and how to share information on social media. Oncology nurses are in a unique position to start conversations about the risks and benefits of social media use. This column aims to review a variety of social media platforms that may be used by young adults with cancer and provide guidance to nurses on initiating open dialogue with young adults about social media usage. 

  7. Rad51 supports triple negative breast cancer metastasis (United States)

    Wiegmans, Adrian P; Al-Ejeh, Fares; Chee, Nicole; Yap, Pei-Yi; Gorski, Julia J; Silva, Leonard Da; Bolderson, Emma; Chenevix-Trench, Georgia; Anderson, Robin; Simpson, Peter T; Lakhani, Sunil R; Khanna, Kum Kum


    In contrast to extensive studies on familial breast cancer, it is currently unclear whether defects in DNA double strand break (DSB) repair genes play a role in sporadic breast cancer development and progression. We performed analysis of immunohistochemistry in an independent cohort of 235 were sporadic breast tumours. This analysis suggested that RAD51 expression is increased during breast cancer progression and metastasis and an oncogenic role for RAD51 when deregulated. Subsequent knockdown of RAD51 repressed cancer cell migration in vitro and reduced primary tumor growth in a syngeneic mouse model in vivo. Loss of RAD51 also inhibited associated metastasis not only in syngeneic mice but human xenografts and changed the metastatic gene expression profile of cancer cells, consistent with inhibition of distant metastasis. This demonstrates for the first time a new function of RAD51 that may underlie the proclivity of patients with RAD51 overexpression to develop distant metastasis. RAD51 is a potential biomarker and attractive drug target for metastatic triple negative breast cancer, with the capability to extend the survival of patients, which is less than 6 months. PMID:24811120

  8. The Effects of a Culturally Tailored, Patient-Centered Psychosocial Intervention in South Korean Cancer Survivors. (United States)

    Kim, Dohun; Chang, Sun Ju; Lee, Hyun Ok; Lee, Seung Hee


    This study aimed to develop a culturally tailored, patient-centered psychosocial intervention program and to investigate the effects of the program on health-related quality of life, sleep disturbance, and depression in cancer survivors. This was a one-group pretest and posttest design. A total of 19 cancer survivors participated in the program. The program was designed to have an 8-week duration with one class per week. Every class was composed of a 90-min education session and a 90-min exercise. Among the health-related quality of life subscales, the scores of global health status/quality of life, physical functioning, and emotional functioning at posttest were statistically increased than those at pretest. Fatigue scores significantly decreased, whereas no changes were observed in sleep disturbance or depression scores. The findings of this study suggested that a culturally tailored, patient-centered psychosocial intervention could be applied in clinical settings to improve health-related quality of life in cancer survivors.

  9. An integrated methodology for process improvement and delivery system visualization at a multidisciplinary cancer center. (United States)

    Singprasong, Rachanee; Eldabi, Tillal


    Multidisciplinary cancer centers require an integrated, collaborative, and stream-lined workflow in order to provide high quality of patient care. Due to the complex nature of cancer care and continuing changes to treatment techniques and technologies, it is a constant struggle for centers to obtain a systemic and holistic view of treatment workflow for improving the delivery systems. Project management techniques, Responsibility matrix and a swim-lane activity diagram representing sequence of activities can be combined for data collection, presentation, and evaluation of the patient care. This paper presents this integrated methodology using multidisciplinary meetings and walking the route approach for data collection, integrated responsibility matrix and swim-lane activity diagram with activity time for data representation and 5-why and gap analysis approach for data analysis. This enables collection of right detail of information in a shorter time frame by identifying process flaws and deficiencies while being independent of the nature of the patient's disease or treatment techniques. A case study of a multidisciplinary regional cancer centre is used to illustrate effectiveness of the proposed methodology and demonstrates that the methodology is simple to understand, allowing for minimal training of staff and rapid implementation. © 2011 National Association for Healthcare Quality.

  10. Psychological adaptation and social support of parents of pediatric cancer patients : A prospective longitudinal study

    NARCIS (Netherlands)

    Hoekstra-Weebers, JEHM; Jaspers, JPC; Kamps, WA; Klip, EC

    Objective: To investigate levels of support and the concurrent and prospective effects of support on the psychological functioning of parents of children with cancer in a prospective longitudinal study. Methods: Parents' (n = 128) self-perceived level of psychological distress, quantity of support,

  11. Wonders & Worries: evaluation of a child centered psychosocial intervention for families who have a parent/primary caregiver with cancer. (United States)

    Phillips, Farya; Prezio, Elizabeth A


    Scant evidence exists to guide interventions for children who have a parent with cancer. This study evaluated the outcomes of a community based psychosocial intervention targeted to children dealing with parental or primary caregiver cancer. This curriculum provided an age-appropriate understanding of the illness, facilitated the expression of feelings, identified individual coping skills to help ease feelings related to parent's cancer, and enhanced the family's ability to communicate about the disease. Families whose children participated in the six-week curriculum-based intervention completed a questionnaire that included demographic information, a five-item assessment of changes in parenting abilities, and a nine-item assessment of changes in children's behavioral issues. The prevalence of each reported item was determined through a secondary analyses of cross-sectional data derived from a multi-year sample of these survey results. A sample of 156 families responded to the survey between 2009 and 2014. A majority of families described improvement in all five areas of parenting abilities assessed including communication skills and confidence in parenting. Amelioration of multiple children's issues was reported including improved communication skills (87%), reduced anxiety (84%), increased feeling of security at home (90%), and improved school performance (73%). The results reported here suggest that this child centered psychosocial intervention promoted positive adaptation by actively supporting families and children while a parent/primary caregiver coped with a cancer diagnosis. Future research is planned utilizing a randomized controlled study design to formally evaluate the effectiveness and preventative impact of this manualized six-week curriculum. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  12. Experimental drug STA-8666 causes complete tumor regression in animal models of pediatric sarcomas | Center for Cancer Research (United States)

    New studies from scientists in the NCI Center for Cancer Research’s (CCR) Pediatric Oncology Branch suggest that an experimental drug called STA-8666 could be an effective treatment for the childhood cancers Ewing sarcoma and rhabdomyosarcoma. In mouse models of these diseases, STA-8666 eliminated tumors and prolonged survival beyond that of animals treated with a related drug, irinotecan. Read more…

  13. Social support in patients' and husbands' adjustment to breast cancer. (United States)

    Northouse, L L


    Data were obtained from 50 mastectomy patients and their husbands at 3 days and 30 days postsurgery to determine the nature of the relationship between social support and the adjustment of mastectomy patients and their husbands over time. Psychosocial adjustment was related to both patients' and husbands' levels of social support. Patients and husbands who reported higher levels of social support reported fewer adjustment difficulties at both 3 days and 30 days postsurgery. Patients and husbands differed significantly in the levels of support they perceived over time; husbands perceived less support from friends, nurses, and physicians. This study underscores the importance of assessing the support resources of both patients and husbands over time.

  14. Optimal scheduling of logistical support for medical resources order and shipment in community health service centers

    Directory of Open Access Journals (Sweden)

    Ming Liu


    Full Text Available Purpose: This paper aims to propose an optimal scheduling for medical resources order and shipment in community health service centers (CHSCs.Design/methodology/approach: This paper presents two logistical support models for scheduling medical resources in CHSCs. The first model is a deterministic planning model (DM, which systematically considers the demands for various kinds of medical resources, the lead time of supplier, the storage capacity and other constraints, as well as the integrated shipment planning in the dimensions of time and space. The problem is a multi-commodities flow problem and is formulated as a mixed 0-1 integer programming model. Considering the demand for medical resources is always stochastic in practice, the second model is constructed as a stochastic programming model (SM. A solution procedure is developed to solve the proposed two models and a simulation-based evaluation method is proposed to compare the performances of the proposed models. Findings andFindings: The main contributions of this paper includes the following two aspects: (1 While most research on medical resources optimization studies a static problem taking no consideration of the time evolution and especially the dynamic demand for such resources, the proposed models in our paper integrate time-space network technique, which can find the optimal scheduling of logistical support for medical resources order and shipment in CHSCs effectively. (2 The logistics plans in response to the deterministic demand and the time-varying demand are constructed as 0-1 mixed integer programming model and stochastic integer programming model, respectively. The optimal solutions not only minimize the operation cost of the logistics system, but also can improve the order and shipment operation in practice.Originality/value: Currently, medical resources in CHSCs are purchased by telephone or e-mail. The important parameters in decision making, i.e. order/shipment frequency

  15. Health Information Technology Challenges to Support Patient-Centered Care Coordination. (United States)

    Séroussi, B; Jaulent, M-C; Lehmann, C U


    To provide an editorial introduction to the 2015 IMIA Yearbook of Medical Informatics. We provide a brief overview of the 2015 special topic "Patient-Centered Care Coordination", discuss the addition of two new sections to the Yearbook, Natural Language Processing and Public Health & Epidemiology Informatics, and present our editorial plans for the upcoming celebration of the 25th anniversary of the Yearbook. Care delivery currently occurs through the processing of complex clinical pathways designed for increasingly multi-morbid patients by various practitioners in different settings. To avoid the consequences of the fragmentation of services, care should be organized to coordinate all providers, giving them the opportunity to share the same holistic view of the patient's condition, and to be informed of the planned clinical pathway that establishes the roles and interventions of each one. The adoption and use of electronic health records (EHRs) is a solution to address health information sharing and care coordination challenges. However, while EHRs are necessary, they are not sufficient to achieve care coordination, creating information availability does not mean the information will be accessed. This edition of the Yearbook acknowledges the fact that health information technology (HIT), and EHRs in particular, are not yet fully addressing the challenges in care coordination. Emerging trends, tools, and applications of HIT to support care coordination are presented through the keynote paper, survey papers, and working group contributions. In 2015, the IMIA Yearbook has been extended to emphasize two fields of biomedical informatics through new sections. Next year, the 25th anniversary of the Yearbook will be celebrated in grand style! A special issue with a touch of reflection, a bit of rediscovery, and some "science-fiction" will be published in addition to the usual edition.

  16. Evaluation of support groups for women with breast cancer: importance of the navigator role

    Directory of Open Access Journals (Sweden)

    Till James E


    Full Text Available Abstract Background At least some forms of breast cancer are increasingly being viewed as a chronic illness, where an emphasis is placed on meeting the various ongoing needs of people living with cancer, their families and other members of their social support networks. This commentary outlines some approaches to the evaluation of cancer-related support groups, with a particular emphasis on those designed to provide long-distance support, via the internet, for women with breast cancer. Discussion The literature on evaluations of community-based cancer support groups indicates that they offer a number of benefits, and that it is more reasonable to expect an impact of such interventions on psychosocial functioning and/or health-related quality of life than on survival. The literature on both face-to-face and online social support groups suggests that they offer many advantages, although evaluation of the latter delivery mechanism presents some ethical issues that need to be addressed. Many popular online support groups are peer-moderated, rather than professionally-moderated. In an evaluation of online support groups, different models of the role of the "navigator" need to be taken into account. Some conceptual models are outlined for the evaluation of the "navigator role" in meeting the informational, decisional and educational needs of women with breast cancer. The Breast-Cancer Mailing List, an example of an unmoderated internet-based peer-support group, is considered within the context of a Shared or Tacit Model of the navigator role. Conclusion Application of the concept of a "navigator role" to support groups in general, and to unmoderated online ones in particular, has received little or no attention in the research literature. The navigator role should be taken into account in research on this increasingly important aspect of cancer communication.

  17. Optical diagnosis of colon and cervical cancer by support vector machine (United States)

    Mukhopadhyay, Sabyasachi; Kurmi, Indrajit; Dey, Rajib; Das, Nandan K.; Pradhan, Sanjay; Pradhan, Asima; Ghosh, Nirmalya; Panigrahi, Prasanta K.; Mohanty, Samarendra


    A probabilistic robust diagnostic algorithm is very much essential for successful cancer diagnosis by optical spectroscopy. We report here support vector machine (SVM) classification to better discriminate the colon and cervical cancer tissues from normal tissues based on elastic scattering spectroscopy. The efficacy of SVM based classification with different kernel has been tested on multifractal parameters like Hurst exponent, singularity spectrum width in order to classify the cancer tissues.

  18. Educational Needs of Oncology Practitioners in a Regional Cancer Center in the Middle East-Improving the Content of Smoking Cessation Training Programs. (United States)

    Obeidat, N A; Hawari, F I; Amarin, R; Altamimi, B Aburajab; Ghonimat, I M


    Little is known with regard to perceptions and information needs of oncology practitioners in the Middle East as they pertain to smoking cessation (SC) support for cancer patients. We sought to assess these in a regional cancer center. A survey was distributed to oncology practitioners (physicians, nurses, pharmacists, and physio- and respiratory therapists) at King Hussein Cancer Center (Amman, Jordan) for self-completion. The survey included SC-related measures of perceptions, knowledge, and practices. Descriptive statistics and cross tabulations were performed to identify misperceptions and knowledge gaps that could be corrected through continuing education. Findings revealed, among 254 practitioners surveyed, low referral rates to the SC clinic. Negative perceptions about cancer patients who smoke existed (e.g., patients needing smoking to control anxiety; patients' willpower sufficient for quitting; patients not wanting to quit and not needing more information). Substantial knowledge gaps were prevalent with regard to the detrimental outcomes associated with continued tobacco use after a cancer diagnosis and with regard to approved SC medication choices. Our results are useful in identifying topics that need to be highlighted during training and educational efforts in the region and also reinforce the need to avail such efforts in order to improve SC-related knowledge and perceptions.

  19. Unmet Supportive Care Needs among Breast Cancer Survivors of Community-Based Support Group in Kuching, Sarawak

    Directory of Open Access Journals (Sweden)

    Emmanuel Joseph Fong


    Full Text Available Background. Recognizing the needs of cancer survivors is one of the important aspects in healthcare delivery. This study aimed to determine the prevalence of unmet supportive care needs and its associated factors among the breast cancer survivors of community-based support group in Kuching, Sarawak. Materials and Methods. This was a cross-sectional study using Supportive Care Needs Survey (SCNS-SF34. All the members of community-based breast cancer support groups in Kuching were invited. A total of 101 respondents were face-to-face interviewed after the consent was obtained. Data was entered and analyzed using SPSS version 20. Results. The respondents endorsed health system and information domain with the highest mean score (2.48; 95% CI: 2.32–2.64. Top 10 items with “moderate to high” level unmet needs had a prevalence of 14.9% to 34.7% of respondents indicating need. Significantly higher level of unmet needs was associated with survivors who were younger (less than 60 years old, had higher education attainment, were unemployed, had survival duration of up to 5 years, and were undergoing active treatment. Conclusion. Systematic delivery of health information which is targeted, culturally sensitive, and linguistically appropriate for addressing younger age, education level, employment status, length of survivorship, and treatment stage should be considered not only at hospital-based setting but also at the community-based support groups.

  20. A Frontline Decision Support System for Georgia Career Centers. Staff Working Paper. (United States)

    Eberts, Randall W.; OLeary, Christopher J.

    The Workforce Investment Act requires local areas receiving funding to establish one-stop centers where employment service providers in a local labor market are assembled in one location. Challenges facing center staff are the expected large volume of customers resulting from relaxed program eligibility rules and limited resources for assessment…

  1. Identifying Molecular Culprits of Cervical Cancer Progression | Center for Cancer Research (United States)

    Human papillomavirus (HPV) DNA is found in 99.7% of invasive cervical carcinomas, providing strong evidence that the virus is a causative agent in the development of this disease. However, most women who become infected with HPV do not develop invasive cervical lesions, indicating that additional exogenous or genetic factors may determine whether HPV preclinical lesions will progress to cancer. Identification of these factors would be facilitated by a deeper understanding of the cellular and molecular changes that accompany progression to malignancy. In addition, knowledge of which women are at greatest risk for disease progression would be a significant clinical advancement in the management of patients with premalignant cervical lesions.

  2. Child Maltreatment and Breast Cancer Survivors: Social Support Makes a Difference for Quality of Life, Fatigue, and Cancer Stress (United States)

    Fagundes, Christopher P.; Lindgren, Monica E.; Shapiro, Charles L.; Kiecolt-Glaser, Janice K.


    Purpose To identify how child maltreatment is associated with quality of life (QOL) among breast cancer survivors. Patients and Methods One hundred and thirty two women who had completed treatment for stage 0-IIIA breast cancer within the past two years (except for tamoxifen/aromatase inhibitors) and were at least two months post surgery, radiation, or chemotherapy completed questionnaires including the Childhood Trauma Questionnaire, the Impact of Events Scale, the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF), and the Fact-B breast cancer quality of life questionnaire. Results Women who were abused or neglected as children reported more cancer-related psychological distress, more fatigue, and poorer physical, emotional, functional, and breast cancer specific well-being after treatment. These relations were partially explained by the fact that breast cancer survivors reported receiving less support as adults. Conclusion The findings suggest that child maltreatment is an important predictor of QOL among breast cancer survivors. One reason why this association exists is because those who are maltreated as children report less support as adults. A better understanding of how child maltreatment contributes to breast cancer survivor QOL will help in tailoring and therefore enhancing the efficacy of interventions aimed at improving QOL. PMID:21752636

  3. Child maltreatment and breast cancer survivors: social support makes a difference for quality of life, fatigue and cancer stress. (United States)

    Fagundes, Christopher P; Lindgren, Monica E; Shapiro, Charles L; Kiecolt-Glaser, Janice K


    To identify how child maltreatment is associated with quality of life (QOL) among breast cancer survivors. One hundred and thirty two women who had completed treatment for stage 0-IIIA breast cancer within the past 2 years (except for tamoxifen/aromatase inhibitors) and were at least 2 months post surgery, radiation, or chemotherapy completed questionnaires including the Childhood Trauma Questionnaire, the Impact of Events Scale, the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF) and the Fact-B breast cancer quality of life questionnaire. Women who were abused or neglected as children reported more cancer-related psychological distress, more fatigue and poorer physical, emotional, functional and breast cancer-specific well-being after treatment. These relations were partially explained by the fact that breast cancer survivors reported receiving less support as adults. The findings suggest that child maltreatment is an important predictor of QOL among breast cancer survivors. One reason why this association exists is because those who are maltreated as children report less support as adults. A better understanding of how child maltreatment contributes to breast cancer survivor QOL will help in tailoring and, therefore, enhancing the efficacy of interventions aimed at improving QOL. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. The Race Gap in Support Group Participation by Breast Cancer Survivors: Real or Artifact? (United States)

    Michalec, Barret; Van Willigen, Marieke; Wilson, Kenneth; Schreier, Ann; Williams, Susan


    Addressing methodological weaknesses of previous research, this study assesses whether African American women are, in fact, less likely to participate in breast cancer support groups than are White women. Of the breast cancer survivors, 958 (26% African Americans, 73% Caucasian) completed interviews concerning demographic characteristics, other…

  5. Supportive nursing care around breast cancer surgery : An evaluation of the 1997 status in The Netherlands

    NARCIS (Netherlands)

    Thijs-Boer, FM; de Kruif, ATC; van de Wiel, HBM

    This study aimed to assess nurses' involvement in the supportive care of patients with recently diagnosed breast cancer in Dutch hospitals. A questionnaire used to evaluate various aspects of nursing care for breast cancer patients was sent to the surgical nursing teams in all 120 Dutch hospitals

  6. The general practitioner’s informative and supportive role in Danish cancer treatment

    DEFF Research Database (Denmark)

    Jensen, Henry; Vinter, Mette Marianne; Lehmann Knudsen, Janne

    ’s pathway progresses, the GP’s role is often limited as the majority of cancer patients do not contact their GP during treatment. It has been suggested that GPs could play a more comprehensive role in the initial cancer trajectory. Aim To investigate Danish cancer patients’ evaluation of their GP......Introduction The cancer patient’s pathway is complex and involves a large number of healthcare professionals across different healthcare sectors. For most patients, the general practitioner (GP) is the first point of contact with the healthcare system when symptoms arise. However, as the patient......’s informative and supportive role in the cancer pathway. Methods We conducted a nationwide population-based survey of Danish cancer patients’ perception of quality of care across the different healthcare sectors. A population of 8,607 patients registered with a first-time cancer diagnosis from May to August...

  7. A qualitative study of women's experiences of healthcare, treatment and support for metastatic breast cancer. (United States)

    Lewis, Sophie; Yee, Jasmine; Kilbreath, Sharon; Willis, Karen


    The purpose of this qualitative research was to identify the healthcare, information and support needs of women living with metastatic breast cancer. Semi-structured qualitative interviews were conducted with 18 women. Women were asked about their experiences of living with metastatic breast cancer and their information and support needs. Women valued relationships with their healthcare professionals, particularly their oncologists. They wanted more attention paid to side-effects of ongoing treatments, which had a negative impact on their health. While oncologists were a primary source of information, women also drew on other sources. There were mixed findings about the value of support groups, with women preferring to seek alternative sources of social support. A diagnosis of metastatic breast cancer brings heightened reliance on healthcare professionals to respond to women's needs in a way that is different to that required with a diagnosis of early breast cancer. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Autophagy Supports Breast Cancer Stem Cell Maintenance by Regulating IL6 Secretion

    National Research Council Canada - National Science Library

    Maycotte, Paola; Jones, Kenneth L; Goodall, Megan L; Thorburn, Jacqueline; Thorburn, Andrew


    .... The autophagy is thought to be a critical process for cancer stem cell (CSC) or tumor-initiating cell maintenance but the mechanisms by which autophagy supports survival of CSCs remain poorly understood...

  9. The OCHIN community information network: bringing together community health centers, information technology, and data to support a patient-centered medical village. (United States)

    Devoe, Jennifer E; Sears, Abigail


    Creating integrated, comprehensive care practices requires access to data and informatics expertise. Information technology (IT) resources are not readily available to individual practices. One model of shared IT resources and learning is a "patient-centered medical village." We describe the OCHIN Community Health Information Network as an example of this model; community practices have come together collectively to form an organization that leverages shared IT expertise, resources, and data, providing members with the means to fully capitalize on new technologies that support improved care. This collaborative facilitates the identification of "problem sheds" through surveillance of network-wide data, enables shared learning regarding best practices, and provides a "community laboratory" for practice-based research. As an example of a community of solution, OCHIN uses health IT and data-sharing innovations to enhance partnerships between public health leaders, clinicians in community health centers, informatics experts, and policy makers. OCHIN community partners benefit from the shared IT resource (eg, a linked electronic health record, centralized data warehouse, informatics, and improvement expertise). This patient-centered medical village provides (1) the collective mechanism to build community-tailored IT solutions, (2) "neighbors" to share data and improvement strategies, and (3) infrastructure to support innovations based on electronic health records across communities, using experimental approaches.

  10. Patterns of treatment for early stage breast cancers at the M. D. Anderson Cancer Center from 1997 to 2004. (United States)

    Shen, Yu; Dong, Wenli; Feig, Barry W; Ravdin, Peter; Theriault, Richard L; Giordano, Sharon H


    The objectives of this study were to examine the patterns of use for adjuvant therapy and the changes in surgical practice for patients with early stage breast cancer and to describe how recent large clinical trial results impacted the patterns of care at The University of Texas M. D. Anderson Cancer Center (MDACC). The study included 5486 women who were diagnosed with stage I through IIIA breast cancer between 1997 and 2004 and received their treatment at MDACC. A chi-square trend test and multivariate logistic regression model were used to assess changes in treatment patterns over time. Among lymph node-positive patients, the use of anthracycline plus taxane chemotherapy increased from 17% in 1997 to 81% in 2004 (P 1997 and 2000. For postmenopausal patients who received endocrine therapy, the use of tamoxifen was replaced increasingly by the use of aromatase inhibitors (from 100% on tamoxifen in 1997 to 14% in 2004; P 1997 to 2004 (from 1.8% to 69.7%, respectively, among patients who underwent mastectomy; and from 18.1% to 87.1%, respectively, among patients who underwent breast-conserving surgery; P < .001). The results from this study suggested that key findings from adjuvant therapy and surgical procedures from large clinical trials often prompt immediate changes in the patient care practices of research hospitals like MDACC.

  11. Locoregional Prostate Cancer Treatment Pattern Variation in Independent Cancer Centers: Policy Effect, Patient Preference, or Physician Incentive?

    Directory of Open Access Journals (Sweden)

    Andrew S. Camarata


    Full Text Available Surveillance, Epidemiologic, and End Results (SEER registry data abstracted from a priority 2 or higher reporting source from 2006 to 2008 were used to compare treatment patterns in 45–64-year old men diagnosed with locoregional prostate cancer (LRPC across states with or without radiation therapy-directed certificate of need (CON laws and across independent cancer centers (ICCs compared to large multi-specialty groups (LMSGs. Adjusted treatment percentages for the five most common LRPC treatments (surgery, external beam radiation therapy (EBRT, combination brachytherapy with EBRT, brachytherapy, and observation were compared using cross-sectional logistic regression between CON-unregulated and -regulated states and between LMSGs and ICCs. LRPC EBRT rates were no different across CON regions, but are increased in ICCs compared to LMSGs (37.00% vs. 13.23%, P < 0.001. Variation in LRPC treatment patterns by reporting source merits further scrutiny under the Affordable Care Act of 2010, considering the intent of incentivized accountable care organizations (ACOs established by the Patient Protection and Affordable Care Act of 2010 (PPACA and the implications of early descriptions of these new healthcare provider organizations on prostate cancer treatment patterns.

  12. Preliminary results of SIB-IMRT in head and neck cancers: Report from a regional cancer center in northern India

    Directory of Open Access Journals (Sweden)

    Chakraborty Santam


    Full Text Available Background : Intensity-modulated radiotherapy using simultaneous integrated boost (SIB-IMRT is an attractive method for the treatment of head and neck cancers with sparing of the salivary function. Aims : To assess the feasibility, toxicity, and tumor control using SIB-IMRT in locally advanced head and neck cancers in the Indian setting. Settings and Design : The study was conducted in a regional cancer center in northern India. A review of the treatment result of the first 20 patients is presented. Methods and Materials : SIB-IMRT was planned for 20 patients-14 patients were treated with the SIB-72 schedule delivering a dose of 72 Gy, 66 Gy, and 57 Gy to the PTV GTV , PTV CTV1 , and PTV CTV2 in 33 fractions. Six patients were treated with the SIB-66 schedule delivering 66 Gy, 60 Gy, and 54 Gy to the above-mentioned volumes in 30 fractions. Patients were monitored for toxicity using the CTCAE v 3.0 criteria. Descriptive analysis of toxicity and actuarial estimates of the loco-regional control and survival are presented. Results : Grade III mucositis was seen in 65% patients. None of the patients had Grade III dermatitis. The projected 2-year overall survival was 95%. Conclusion : SIB-IMRT schedules evaluated were found to be safe and effective and are being subjected to further prospective studies.

  13. Prognostic factors after pulmonary metastasectomy of colorectal cancers: a single-center experience. (United States)

    Fournel, Ludovic; Maria, Stefania; Seminel, Marie; Nesci, Jessica; Mansuet-Lupo, Audrey; Guinet, Claude; Magdeleinat, Pierre; Bobbio, Antonio; Regnard, Jean-François; Alifano, Marco


    Surgical resection has been widely admitted as the treatment of choice for pulmonary metastases of colorectal cancer (CRC). Nevertheless, this practice is not supported by high level of evidence and patients' eligibility remains controversial. Aim of this study was to evaluate long terms results and factors influencing survival after lung metastasectomy of CRC. A single-center retrospective analysis of patients with pathologically proven colorectal metastasis, operated from 2004 to 2013, was performed. Patients were treated with a multidisciplinary approach and selected for surgery if complete resection was considered feasible. Three hundred and six patients were considered for analysis. Mean number of lesions at CT scan was 2.6±2.3. Ratios of each largest resection type at first side surgery were: segmentectomy 20.6%, lobectomy 12.9%, bilobectomy 1.2%, pneumonectomy 1.2% and sub-lobar resection 64.1%, respectively. No in-hospital death occurred. At pathology, mean number of resected metastasis was 2.6±2.3, ranging from 1 to 12. Resection was complete in 92.5% of patients. Nodal involvement was proven in 40 (12.9%) patients. The initially planned complete resection could not be achieved in 23 (7.5%) cases. Mean follow-up was 3.06±2.36 years. Kaplan-Meier analysis revealed that recurrence-free survival (RFS) was 76.3% [95% confidence interval (95% CI), 71-80.7%], 38.9% (95% CI, 33-44.7%), 28.3% (95% CI, 22.5-34.4%) and 22.7% (95% CI, 16.5-29.5%) at 1, 3, 5 and 7 years, respectively. Overall survival (OS) estimates were 77.8% (95% CI, 72.7-82.7%), 59.0% (95% CI, 51.2-66.4%), and 56.9% (95% CI, 48.4-65.0%) at 3, 5 and 7 years, respectively. Multivariate analysis, including pT parameter of the primary tumor, number of lesions, one-sided versus bilateral lung disease, and body mass index (BMI) (all significant at univariate analysis), showed that bilateral disease (P<0.001) and pT4 primary (P=0.005) were independent pejorative predictors of OS, whereas BMI ≥25 was

  14. 78 FR 61386 - Hewlett Packard Company, AMS Call Center-Conway, CSS-Americas Support (AMSS) Division, Personal... (United States)


    ... Employment and Training Administration Hewlett Packard Company, AMS Call Center-Conway, CSS-Americas Support (AMSS) Division, Personal Systems Business Unit, Conway, Arkansas; Hewlett Packard Company, TS AMS GD FS... December 21, 2012 by a state workforce official on behalf of workers of Hewlett Packard Company, AMS Call...

  15. A Family-Centered Positive Behavior Support Approach to the Amelioration of Food Refusal Behavior: An Empirical Case Study (United States)

    Binnendyk, Lauren; Lucyshyn, Joseph M.


    The purpose of this study was to evaluate the effectiveness of a family-centered positive behavior support approach to the amelioration of food refusal behavior in a child with autism. The study was conducted with the child and his family in their home. It employed an empirical case study design with one meal routine: snack time. Following…

  16. Controls Over Navy Military Payroll Disbursed in Support of Operations in Southwest Asia at San Diego-Area Disbursing Centers (United States)


    Support Center are coordinating with the Navy Standard Integrated Personnel System Project Management Office to develop the ability to readily... Management Office , Defense Finance and Accounting Service Cleveland, Navy Personnel Command Millington, and the National Archive and Records...working with the Office of the Secretary of the Navy (Financial Management and Comptroller), Navy 8 Standard Integrated Personnel System Project

  17. Intelligence and High Intensity Drug Trafficking Areas (HIDTA’s): A Critical Evaluation of the HIDTA Investigative Support Center (ISC) (United States)


    The purpose of this thesis is to evaluate critically the ongoing reform of the High Intensity Drug Trafficking Area (HIDTA) Investigative Support...or Fusion Center for information sharing between agencies investigating crimes relating to drug trafficking , terrorism, and money laundering.

  18. Impact of cancer support groups on childhood cancer treatment and abandonment in a private pediatric oncology centre

    Directory of Open Access Journals (Sweden)

    Arathi Srinivasan


    Full Text Available Aims: To analyze the impact of two cancer support groups in the treatment and abandonment of childhood cancer. Materials and Methods: This is a retrospective review of children with cancer funded and non-funded who were treated at Kanchi Kamakoti CHILDS Trust Hospital from 2010 to 2013. A total of 100 patients were funded, 57 by Ray of Light Foundation and 43 by Pediatric Lymphoma Project and 70 non-funded. Results: The total current survival of 80%, including those who have completed treatment and those currently undergoing treatment, is comparable in both the groups. Abandonment of treatment after initiating therapy was not seen in the financially supported group whereas abandonment of treatment after initiation was seen in one child in the non-funded group. Conclusions: Besides intensive treatment with good supportive care, financial support also has an important impact on compliance and abandonment in all socioeconomic strata of society. Financial support from private cancer support groups also has its impact beyond the patient and family, in reducing the burden on government institutions by non-governmental funding in private sector. Improvement in the delivery of pediatric oncology care in developing countries could be done by financial support from the private sector.

  19. Primary Caregivers' Support for Female Family Members With Breast or Gynecologic Cancer. (United States)

    Han, Jung-Hee; Han, Song-Hee; Lee, Myo-Suk; Kwon, Hye-Jin; Choe, Kwisoon


    Female patients with cancer depend on loved ones; thus, family support is pivotal to assist patients in successfully adjusting to life with treatment routines. Our study explored the experiences of primary caregivers who provide care and support for female family members with cancer. This study used a qualitative phenomenological research approach. Interviews and journaling about the caregiving experience were conducted with the family members of female cancer patients-6 spouses, 11 daughters, 1 son, and 1 younger sister. Data analysis involved Giorgi's 3-step phenomenological analysis method. The central theme of the primary caregivers' supportive care for their female family member with cancer was "being with" her. This was composed of the following themes: "being there for her via efforts," "living through feelings of guilt and anxiety," and "lessons learned from cancer in the family." This study reveals an integrated picture of family caregivers' supportive caring experiences. By providing both positive and negative aspects of the caregiving experience, the findings in this study will provide a theoretical foundation to develop more successful support programs for family caregivers of female patients with cancer. Family-oriented education programs need to be developed to include both the family and the patient in the long journey of cancer. The family caregivers' feelings of guilt regarding the cause of the illness and feelings of anxiety about the uncertainty of the illness should be assessed and managed during the course of the patients' treatment and care.

  20. Psychological distress, coping and social support in the diagnostic and preoperative phase of breast cancer


    Drageset, Sigrunn


    Aims: The main aim of this thesis was to describe the psychological distress, coping and social support among women in the diagnostic and preoperative phase of breast cancer using quantitative and qualitative approaches in sequence. This included descriptions of relationships between demographic variables, social support, anxiety, coping and defence strategies among women with suspected breast cancer, as well as in-depth descriptions of the women’s experiences after having rece...

  1. Nutritional support among cancer patients enrolled in palliative home care services


    Orrevall, Ylva


    Nutritional problems are common in palliative cancer care. Little is known about nutritional problems and nutritional support in home care. AIMS: The primary aim of this thesis was to investigate experiences of nutritional problems and home nutritional support, with a special focus on home parenteral nutrition (HPN), from the perspectives of cancer patients and their family members. Further aims were to investigate the prevalence of nutritional risk and use of nutritional su...

  2. The Cost analysis of cervical cancer screening services provided by Damavand health center in 2013

    Directory of Open Access Journals (Sweden)

    Arezoo Chouhdari


    Full Text Available Background: Today, the health sector in many countries is facing with severe resource constraints; hence it is absolutely necessary that cost-benefit and cost-effectiveness assessment have a major role in design of health services. The purpose of this study was to evaluate the cost-benefit and effectiveness of cervical cancer screening service (Pap smear test done by the health centers in Damavand County in 2013.  Methods: This is a descriptive study with cross-sectional method. All data was extracted from existing documents in Damavand health network.Cost of service screening for doing Pap smear test (manpower costs of performing the service, the cost of transferring samples, water, electricity, telephone and gas was estimated in all health centers then results, were compared with the incomes of this service.  Results: Screening program coverage was 22.3%, 6.9% and 6.05% in 2011, 2012 and 2013 respectively. All costs and incomes of units performing Pap smear screening test were calculated. Entire costs and incomes of this service during 2013 were respectively 303,009,000 and 11,640,000 RLS equal $12,227 and $496.73. Therefore, the cost-benefit ratio of this screening test was approximately 0.040.  Conclusion: The costs of units performing cervical cancer screening test in Damavand Health Center were much more than this benefit and because of a none-positive Pap smear test in spite of high cost, performing this test in Damavand health centers was not cost effective.

  3. Cancer patient-centered home care: a new model for health care in oncology

    Directory of Open Access Journals (Sweden)

    Tralongo P


    Full Text Available Paolo Tralongo1, Francesco Ferraù2, Nicolò Borsellino3, Francesco Verderame4, Michele Caruso5, Dario Giuffrida6, Alfredo Butera7, Vittorio Gebbia81Medical Oncology Unit, Azienda Sanitaria Provinciale, Siracusa; 2Medical Oncology Unit, Ospedale San Vincenzo, Taormina; 3Medical Oncology Unit, Ospedale Buccheri La Ferla, Palermo; 4Medical Oncology Unit, Ospedale Giovanni Paolo II, Sciacca; 5Medical Oncology Unit, Istituto Humanitas, Catania; 6Medical Oncology Unit, Istituto Oncologico del Mediterraneo, Catania; 7Medical Oncology Unit, Ospedale San Giovanni di Dio, Agrigento; 8Medical Oncology Unit, Dipartimento Oncologico, La Maddalena, Università degli Studi, Palermo, ItalyAbstract: Patient-centered home care is a new model of assistance, which may be integrated with more traditional hospital-centered care especially in selected groups of informed and trained patients. Patient-centered care is based on patients' needs rather than on prognosis, and takes into account the emotional and psychosocial aspects of the disease. This model may be applied to elderly patients, who present comorbid diseases, but it also fits with the needs of younger fit patients. A specialized multidisciplinary team coordinated by experienced medical oncologists and including pharmacists, psychologists, nurses, and social assistance providers should carry out home care. Other professional figures may be required depending on patients' needs. Every effort should be made to achieve optimal coordination between the health professionals and the reference hospital and to employ shared evidence-based guidelines, which in turn guarantee safety and efficacy. Comprehensive care has to be easily accessible and requires a high level of education and knowledge of the disease for both the patients and their caregivers. Patient-centered home care represents an important tool to improve quality of life and help cancer patients while also being cost effective.Keywords: cancer, home care

  4. Computer decision support system for the stomach cancer diagnosis (United States)

    Polyakov, E. V.; Sukhova, O. G.; Korenevskaya, P. Y.; Ovcharova, V. S.; Kudryavtseva, I. O.; Vlasova, S. V.; Grebennikova, O. P.; Burov, D. A.; Yemelyanova, G. S.; Selchuk, V. Y.


    The paper considers the creation of the computer knowledge base containing the data of histological, cytologic, and clinical researches. The system is focused on improvement of diagnostics quality of stomach cancer - one of the most frequent death causes among oncologic patients.

  5. Support requirements for caregivers of patients with palliative cancer

    NARCIS (Netherlands)

    Jansma, F.F.; Schure, L.M.; Meyboom-de Jong, B.

    Health policy is shifting from professional to informal care. Studies have shown that informal caregivers provide an average of 55% of the needed care. The aim of this study was to get insight in the needs of the caregivers of patients with palliative cancer and how to address those needs with a

  6. Living with prostate cancer: randomised controlled trial of a multimodal supportive care intervention for men with prostate cancer

    Directory of Open Access Journals (Sweden)

    Lepore Stephen


    Full Text Available Abstract Background Prostate cancer is the most common male cancer in developed countries and diagnosis and treatment carries with it substantial morbidity and related unmet supportive care needs. These difficulties may be amplified by physical inactivity and obesity. We propose to apply a multimodal intervention approach that targets both unmet supportive care needs and physical activity. Methods/design A two arm randomised controlled trial will compare usual care to a multimodal supportive care intervention "Living with Prostate Cancer" that will combine self-management with tele-based group peer support. A series of previously validated and reliable self-report measures will be administered to men at four time points: baseline/recruitment (when men are approximately 3-6 months post-diagnosis and at 3, 6, and 12 months after recruitment and intervention commencement. Social constraints, social support, self-efficacy, group cohesion and therapeutic alliance will be included as potential moderators/mediators of intervention effect. Primary outcomes are unmet supportive care needs and physical activity levels. Secondary outcomes are domain-specific and health-related quality of life (QoL; psychological distress; benefit finding; body mass index and waist circumference. Disease variables (e.g. cancer grade, stage will be assessed through medical and cancer registry records. An economic evaluation will be conducted alongside the randomised trial. Discussion This study will address a critical but as yet unanswered research question: to identify a population-based way to reduce unmet supportive care needs; promote regular physical activity; and improve disease-specific and health-related QoL for prostate cancer survivors. The study will also determine the cost-effectiveness of the intervention. Trial Registration ACTRN12611000392965

  7. Psycho-oncological support for breast cancer patients: A brief overview of breast cancer services certification schemes and national health policies in Europe


    Neamţiu, L.; Deandrea, S.; Pylkkänen, L.; Freeman, C; López Alcalde, J.; Bramesfeld, A.; Saz-Parkinson, Z.; Ulutürk, A.; Lerda, D.


    Psycho-oncology addresses the psychological, social, behavioural, and ethical aspects of cancer. Identification and proper management of the patients' psychosocial needs, as well as the needs of their caregivers and family are essential for a person-centred concept of breast cancer care. The aim of this overview is to describe how psychosocial support in breast cancer is incorporated in cancer-related policy documents, such as national cancer plans and breast cancer care certifica...

  8. The effectiveness of support groups in Asian breast cancer patients: An integrative review

    Directory of Open Access Journals (Sweden)

    Fang-Yu Chou


    Full Text Available Cancer support group has been studied as an intervention to improve patient psychosocial well-being. The effectiveness of support groups among Asian breast cancer (BC patients has been unclear and received limited attention to the evidence of its effectiveness. The social-cognitive processing theory underlies the principles of support groups and advocates that a positive, supportive social environment can improve cognitive processing. The purpose of this paper is to present an integrative review of research evidence on the effectiveness of cancer support groups with Asian BC patients. Empirical studies related to support group among Asian and Asian American BC patients published between 1982 and April 2014 are reviewed. There are 15 studies selected (12 from the Asian-Pacific region and 3 from Western countries. The review includes 1 qualitative study, 3 descriptive studies, 1 mixed method design, and 10 experimental or quasi-experimental studies. The support group intervention activities include psycho-educational program such as health education, problem-solving, and stress management. These studies support the effectiveness of support group in alleviating psychological distress and supporting quality of life of Asian BC women. Overall, there is limited research on the use and effectiveness of support groups with Asians cancer patients in Asia and in Western countries. Without accounting for Asian immigrants overseas, the Asian population is expected to grow from 4.3 to 5.3 billion by 2050. As cancer patients become more diverse due to global emigration, more rigorous studies examining the effectiveness of psychosocial intervention among transcultural cancer patients are needed.

  9. The Effectiveness of Support Groups in Asian Breast Cancer Patients: An Integrative Review. (United States)

    Chou, Fang-Yu; Lee-Lin, Frances; Kuang, Lily Y


    Cancer support group has been studied as an intervention to improve patient psychosocial well-being. The effectiveness of support groups among Asian breast cancer (BC) patients has been unclear and received limited attention to the evidence of its effectiveness. The social-cognitive processing theory underlies the principles of support groups and advocates that a positive, supportive social environment can improve cognitive processing. The purpose of this paper is to present an integrative review of research evidence on the effectiveness of cancer support groups with Asian BC patients. Empirical studies related to support group among Asian and Asian American BC patients published between 1982 and April 2014 are reviewed. There are 15 studies selected (12 from the Asian-Pacific region and 3 from Western countries). The review includes 1 qualitative study, 3 descriptive studies, 1 mixed method design, and 10 experimental or quasi-experimental studies. The support group intervention activities include psycho-educational program such as health education, problem-solving, and stress management. These studies support the effectiveness of support group in alleviating psychological distress and supporting quality of life of Asian BC women. Overall, there is limited research on the use and effectiveness of support groups with Asians cancer patients in Asia and in Western countries. Without accounting for Asian immigrants overseas, the Asian population is expected to grow from 4.3 to 5.3 billion by 2050. As cancer patients become more diverse due to global emigration, more rigorous studies examining the effectiveness of psychosocial intervention among transcultural cancer patients are needed.

  10. Social and psychological determinants of levels of engagement with an online breast cancer support group: posters, lurkers, and nonusers. (United States)

    Han, Jeong Yeob; Kim, Jung-Hyun; Yoon, Hye Jin; Shim, Minsun; McTavish, Fiona M; Gustafson, David H


    Despite the benefits and growing availability of online cancer support groups, many breast cancer patients still do not actively participate in them. To better understand cancer patients' online information- and support-seeking behaviors, this study explores how various social and psychological characteristics predict different levels of engagement with an online breast cancer support group: posters, lurkers, and nonusers. The study sample included 231 recently diagnosed breast cancer patients. Data included baseline survey scores of demographic, disease-related, and psychosocial factors and automatically collected discussion group use data over the 4-month intervention. Patterns of engagement with the cancer support group differed according to the patients' characteristics, suggesting that (a) cancer patients have very different orientations to and engagement with an online support group, and (b) deficits in social and psychological resources may not be barriers to participation in a cancer support group, but rather motivators to interact with other patients. The authors discuss the theoretical and practical implications of their findings.

  11. Work Centered Support System Design: Using Frames to Reduce Work Complexity

    National Research Council Canada - National Science Library

    Eggleston, Robert G; Whitaker, Randall D


    .... Based on our experience implementing the design of three WCSSs we have distilled a set of three form-based design principles that help insure a work-centered perspective is expressed in the interface...

  12. Air, Climate and Energy (ACE) Centers: Supporting Air Quality and Climate Solutions (United States)

    EPA through its Science to Achieve Results (STAR) program, is providing $30 million in funding for three university-based research centers to investigate regional differences in air pollution and the effects of global climate change.

  13. The efficacy of student-centered instruction in supporting science learning. (United States)

    Granger, E M; Bevis, T H; Saka, Y; Southerland, S A; Sampson, V; Tate, R L


    Transforming science learning through student-centered instruction that engages students in a variety of scientific practices is central to national science-teaching reform efforts. Our study employed a large-scale, randomized-cluster experimental design to compare the effects of student-centered and teacher-centered approaches on elementary school students' understanding of space-science concepts. Data included measures of student characteristics and learning and teacher characteristics and fidelity to the instructional approach. Results reveal that learning outcomes were higher for students enrolled in classrooms engaging in scientific practices through a student-centered approach; two moderators were identified. A statistical search for potential causal mechanisms for the observed outcomes uncovered two potential mediators: students' understanding of models and evidence and the self-efficacy of teachers.

  14. Analysis of Maryland Cancer Patient Participation in NCI Supported Cancer Treatment Clinical Trials (United States)

    Baquet, Claudia R.; Ellison, Gary L.; Mishra, Shiraz I.


    Purpose We examined the relationship of sociodemographic factors, urban/rural residence, and countylevel socioeconomic factors on accrual of Maryland patients with cancer to National Cancer Institute (NCI)-sponsored cancer treatment clinical trials. Patients and Methods Data were analyzed for the period 1999 to 2002 for 2,240 Maryland patients with cancer accrued onto NCI-sponsored treatment trials. The extent to which Maryland patients with cancer and patients residing in lower socioeconomic and/or rural areas were accrued to cancer trials and were representative of all patients with cancer in Maryland was determined. Data were obtained from several sources, including NCI’s Cancer Therapy Evaluation Program for Maryland patients with cancer in Cooperative Group therapeutic trials, Maryland Cancer Registry data on cancer incidence, and United States Census and the Department of Agriculture. Results For Maryland patients with cancer accrued onto NCI-sponsored treatment trials between 1999 and 2002, subgroups accrued at a higher rate included pediatric and adolescent age groups, white patients, female patients (for sex-specific tumors), patients with private health insurance, and patients residing in the Maryland National Capitol region. Moreover, between 1999 and 2002, there was an estimated annual decline (8.9% per year; P Maryland patients with cancer onto NCI-sponsored treatment trials based on patient age, race/ethnicity, geography of residence, and county-level socioeconomic factors. Findings provide the basis for development of innovative tailored and targeted educational efforts to improve trial accrual, particularly for the underserved. PMID:19711497

  15. Center for Corporate Climate Leadership Building Internal Support in Supply Chain Management (United States)

    Organizations build support for addressing GHG emissions by developing key allies in business units, leveraging one business unit to drive change across the organization, and securing executive support while communicating resource needs.

  16. Current activities and future directions of comprehensive hepatitis control measures in Japan: The supportive role of the Hepatitis Information Center in building a solid foundation. (United States)

    Oza, Noriko; Isoda, Hiroshi; Ono, Toshiki; Kanto, Tatsuya


    In Japan, hepatitis B or C virus infection has been a major health issue. For the prevention of liver-related deaths, multifaceted strategies have been taken against hepatitis virus. In fiscal year (FY) 2002, nationwide screening for hepatitis was started as a part of health examinations provided by municipal governments. From FY2007, the hepatitis treatment network has been strengthened by the nationwide establishment of regional government-based hepatitis treatment systems, comprising linked regional core centers, specialized institutions for hepatitis treatment, primary care physicians, and regional governments. Special subsidy program for patients with viral hepatitis was started at FY2008. The range of coverage has been expanding from patients treated with interferon to those on nucleotide analogs or interferon-free therapies, including drug prices and examination expenses. The Basic Act on Hepatitis Measures was established in 2009. The Basic Guidelines for Promotion of Control Measures for hepatitis was issued in 2011, comprising nine principles in order to promote measures for hepatitis B and C. The Hepatitis Information Center was established in 2008. Its mission is to provide up-to-date hepatitis-related information, supporting collaboration between regional core centers, and training medical personnel. The revision of the above-mentioned Basic Guidelines in 2016 set the target as the reduction of patients progressing to cirrhosis and/or liver cancer. Achieving this goal definitely requires active collaboration among the national and local governments, regional core centers, and the Hepatitis Information Center, and participation by medical personnel, patients, and people with awareness. © 2017 The Authors Hepatology Research published by John Wiley & Sons Australia, Ltd on behalf of Japan Society of Hepatology.

  17. Decision-support networks of women newly diagnosed with breast cancer. (United States)

    Wallner, Lauren P; Li, Yun; McLeod, M Chandler; Hamilton, Ann S; Ward, Kevin C; Veenstra, Christine M; An, Lawrence C; Janz, Nancy K; Katz, Steven J; Hawley, Sarah T


    Little is known about the size and characteristics of the decision-support networks of women newly diagnosed with breast cancer and whether their involvement improves breast cancer treatment decisions. A population-based sample of patients newly diagnosed with breast cancer in 2014 and 2015, as reported to the Georgia and Los Angeles Surveillance, Epidemiology, and End Results registries, were surveyed approximately 7 months after diagnosis (N = 2502; response rate, 68%). Network size was estimated by asking women to list up to 3 of the most important decision-support persons (DSPs) who helped them with locoregional therapy decisions. Decision deliberation was measured using 4 items assessing the degree to which patients thought through the decision, with higher scores reflecting more deliberative breast cancer treatment decisions. The size of the network (range, 0-3 or more) was compared across patient-level characteristics, and adjusted mean deliberation scores were estimated across levels of network size using multivariable linear regression. Of the 2502 women included in this analysis, 51% reported having 3 or more DSPs, 20% reported 2, 18% reported 1, and 11% reported not having any DSPs. Married/partnered women, those younger than 45 years, and black women all were more likely to report larger network sizes (all P support networks were associated with more deliberative surgical treatment decisions (P breast cancer should acknowledge and engage informal DSPs. Cancer 2017;123:3895-903. © 2017 American Cancer Society. © 2017 American Cancer Society.

  18. Social support, self-care, and quality of life in cancer patients receiving radiotherapy in Thailand

    Energy Technology Data Exchange (ETDEWEB)

    Hanucharurnkul, S.


    The purpose of the study was two-fold: (1) to examine the relationships among self-care, social support, and quality of life in adult cancer patients receiving radiotherapy while the selected basic conditioning factors of age, marital and socio-economic status, living arrangement, stage and site of cancer were statistically controlled; and (2) to test a theoretical model which postulated that (a) quality of life was predicted jointly by the selected basic conditioning factors, social support and self-care, and (b) self-care was predicted jointly by the selected basic conditioning factors and social support. A convenience sample of 112 adult cervical and head/neck cancer patients receiving radiotherapy was obtained from radiotherapy outpatient clinic in three hospitals located in Bangkok, Thailand. Results of the study indicated positive relationships among self-care, social support, and quality of life. Socio-economic status, site of cancer, and self-care were significant predictors for reported quality of life. Social support appeared to be a significant predictor of quality of life indirectly through self-care. Socio-economic status and social support were also significant predictors of self-care, whereas, stage and site of cancer seemed to predict self-care indirectly through social support.

  19. Pattern Analysis and Decision Support for Cancer through Clinico-Genomic Profiles (United States)

    Exarchos, Themis P.; Giannakeas, Nikolaos; Goletsis, Yorgos; Papaloukas, Costas; Fotiadis, Dimitrios I.

    Advances in genome technology are playing a growing role in medicine and healthcare. With the development of new technologies and opportunities for large-scale analysis of the genome, genomic data have a clear impact on medicine. Cancer prognostics and therapeutics are among the first major test cases for genomic medicine, given that all types of cancer are related with genomic instability. In this paper we present a novel system for pattern analysis and decision support in cancer. The system integrates clinical data from electronic health records and genomic data. Pattern analysis and data mining methods are applied to these integrated data and the discovered knowledge is used for cancer decision support. Through this integration, conclusions can be drawn for early diagnosis, staging and cancer treatment.

  20. The role of social support, family identification, and family constraints in predicting posttraumatic stress after cancer. (United States)

    Swartzman, Samantha; Sani, Fabio; Munro, Alastair J


    We compared social support with other potential psychosocial predictors of posttraumatic stress after cancer. These included family identification, or a sense of belonging to and commonality with family members, and family constraints, or the extent to which family members are closed, judgmental, or unreceptive in conversations about cancer. We also tested the hypothesis that family constraints mediate the relationship between family identification and cancer-related posttraumatic stress. We used a cross-sectional design. Surveys were collected from 205 colorectal cancer survivors in Tayside, Scotland. Both family identification and family constraints were stronger independent predictors of posttraumatic stress than social support. In multivariate analyses, social support was not a significant independent predictor of posttraumatic stress. In addition, there was a significant indirect effect of family identification on posttraumatic stress through family constraints. Numerous studies demonstrate a link between social support and posttraumatic stress. However, experiences within the family may be more important in predicting posttraumatic stress after cancer. Furthermore, a sense of belonging to and commonality with the family may reduce the extent to which cancer survivors experience constraints on conversations about cancer; this may, in turn, reduce posttraumatic stress. Copyright © 2016 John Wiley & Sons, Ltd.

  1. Integration of complementary and alternative medicine into cancer-specific supportive care programs in Australia: A scoping study. (United States)

    Lim, Eunjin; Vardy, Janette L; Oh, Byeongsang; Dhillon, Haryana M


    The main aim of this research was to describe the availability and integration of supportive care programs (SCPs), particularly complementary and alternative medicine (CAM) services, for adults in Australian oncology treatment centers. We systematically searched 124 Australian hospitals listed as having an oncology department out of a total of 1157 hospitals listed in the Australian Hospitals and Aged Care Databases (2014), and assessed their website and relevant leaflets. Direct contact was made with a relevant staff member in each hospital. Data were collected regarding the range of SCP and CAM services available. Of the 124 hospitals, 89 (72%) provide nonspecific guidance to SCP or a staff member (e.g. social worker or care coordinator) who directs patients, advising them about SCP; 35 hospitals (28%) provide active referral to SCP, of which 24 of 35 (69%) include CAM in their service, with individual variation in how it is incorporated. Only 11 (46%) of these 24 CAM incorporated oncology centers in Australia provided systematically integrated CAM programs. The majority of Australian oncology departments do not have CAM incorporated into their services. In those that do, less than half had systemically integrated CAM. The types of CAM available, how they are accessed and how they are integrated varied across hospitals. Further research is required to understand how to successfully and systematically integrate cancer-specific supportive care such as CAM into Australian cancer services. © 2016 John Wiley & Sons Australia, Ltd.

  2. [Social counseling in outpatient cancer counseling centers : Offers and use by advice-seekers]. (United States)

    Ernst, Jochen; Mehnert, Anja; Weis, Joachim; Faust, Tanja; Giesler, Jürgen M; Roick, Julia


    Outpatient psychosocial cancer care has gained importance in recent years and psychosocial counselling services (PCS) offer a broad spectrum of counselling interventions. Yet there is no published research on PCS legal counselling services. This study investigated the range of issues addressed by legal counselling and their relationship with characteristics of advice seekers and counsellors. We analyzed the records of 21 PCS funded by the German Cancer Aid (DKH) including 5203 advice seekers (80 % patients, 20 % others including friends and family; age ∅ 54 years; 24 % male) in 20,947 counselling sessions. We calculated descriptive statistics and binary logistic regression analyses (legal counselling: yes/no). Fifty-five percent of counselling seekers received legal counselling and 28 % approached the PCS exclusively for legal counselling. The proportion of people seeking legal advice ranged from 15 to 87 % between counselling centers. The most common topics during legal counselling were medical rehabilitation programs (57 %) and disability law (43 %). Counselling occurred in a single session in 68 % of cases and was mostly sought by older and unemployed persons with a recent diagnosis. Legal counselling made up 18 % of counselling time. Legal advice was mostly given by social workers (71 %). Legal counselling is a major part of psychosocial care services. Our results reveal large differences between counselling centers. Further research on quality of care and efficacy of legal counseling is needed.

  3. Development of a mobile application of Breast Cancer e-Support program for women with breast cancer undergoing chemotherapy. (United States)

    Zhu, Jiemin; Ebert, Lyn; Xue, Zhimin; Shen, Qu; Chan, Sally Wai-Chi


    Women with breast cancer undergoing chemotherapy experience a variety of physical and psychosocial symptoms, which have negative effect on women's quality of life and psychological well-being. Although M-health technologies provides innovative and easily accessible option to provide psychosocial support, mobile phone based interventions remain limited for these women in China. To develop a new mobile application to offer information as well as social and emotional support to women with breast cancer undergoing chemotherapy to promote their self-efficacy and social support, thus improving symptom management strategies. Basing on previous theoretical framework which incorporated Bandura's self-efficacy theory and the social exchange theory, a new mobile application, called Breast Cancer e-Support Program (BCS) was designed, with the content and functionality being validated by the expert panel and women with breast cancer. BCS App program has four modules: 1) Learning forum; 2) Discussion forum; 3) Ask-the-Expert forum; and 4) Personal Stories forum. BCS program can be applied on both android mobile phones and iPhones to reach more women. This is the first of its kind developed in China for women with breast cancer undergoing chemotherapy. A randomized controlled trial is undertaking to test the effectiveness of BCS program.

  4. Bone marrow macrophages support prostate cancer growth in bone. (United States)

    Soki, Fabiana N; Cho, Sun Wook; Kim, Yeo Won; Jones, Jacqueline D; Park, Serk In; Koh, Amy J; Entezami, Payam; Daignault-Newton, Stephanie; Pienta, Kenneth J; Roca, Hernan; McCauley, Laurie K


    Resident macrophages in bone play important roles in bone remodeling, repair, and hematopoietic stem cell maintenance, yet their role in skeletal metastasis remains under investigated. The purpose of this study was to determine the role of macrophages in prostate cancer skeletal metastasis, using two in vivo mouse models of conditional macrophage depletion. RM-1 syngeneic tumor growth was analyzed in an inducible macrophage (CSF-1 receptor positive cells) ablation model (MAFIA mice). There was a significant reduction in tumor growth in the tibiae of macrophage-ablated mice, compared with control non-ablated mice. Similar results were observed when macrophage ablation was performed using liposome-encapsulated clodronate and human PC-3 prostate cancer cells where tumor-bearing long bones had increased numbers of tumor associated-macrophages. Although tumors were consistently smaller in macrophage-depleted mice, paradoxical results of macrophage depletion on bone were observed. Histomorphometric and micro-CT analyses demonstrated that clodronate-treated mice had increased bone volume, while MAFIA mice had reduced bone volume. These results suggest that the effect of macrophage depletion on tumor growth was independent of its effect on bone responses and that macrophages in bone may be more important to tumor growth than the bone itself. In conclusion, resident macrophages play a pivotal role in prostate cancer growth in bone.

  5. Incidence of antiemetic-induced akathisia in patients at a comprehensive cancer center. (United States)

    Rashid, A; Baile, W; Olubajo, T; De La Garza, R


    Akathisia is a common and severely disabling medication-induced movement disorder. The condition is often missed, and patients suffer for a long time until diagnosed and managed properly. It is important to bring awareness to the clinicians for early detection and management of akathisia. We reviewed a 4-year record of patients seen at a comprehensive cancer center for anxiety and restlessness. Patients diagnosed with akathisia and the medications causing akathisia were identified. Management of akathisia is discussed. The results showed that 4.7% of patients developed akathisia while taking antiemetic agents to control chemotherapy-induced nausea/vomiting. Early detection and management of akathisia resulted in quick recovery and reduced patients' suffering. Akathisia is an unpleasant feeling of motor restlessness with anxiety. Clinicians need to have a full understanding to identify the subtle difference between functional anxiety and akathisia. Key Points Akathisia is a severely disabling medication-induced mood disorder seen in cancer patients due to antiemetic drugs prescribed to control chemotherapy-induced nausea and vomiting. We sought to determine the incidence of akathisia in a comprehensive cancer center. A retrospective chart review was conducted of 592 patients seen by the Department of Psychiatry for anxiety during a 4-year period. We found that 4.7% of patients developed akathisia while taking antiemetic drugs. Clinician's awareness and patient education are needed to identify early signs/symptoms of akathisia, and proper management will reduce patients' suffering, caregiver burden, and cost of emergency room visits. Copyright © 2017 John Wiley & Sons, Ltd.

  6. Minimally invasive esophagectomy for cancer: Single center experience after 44 consecutive cases

    Directory of Open Access Journals (Sweden)

    Bjelović Miloš


    Full Text Available Introduction. At the Department of Minimally Invasive Upper Digestive Surgery of the Hospital for Digestive Surgery in Belgrade, hybrid minimally invasive esophagectomy (hMIE has been a standard of care for patients with resectable esophageal cancer since 2009. As a next and final step in the change management, from January 2015 we utilized total minimally invasive esophagectomy (tMIE as a standard of care. Objective. The aim of the study was to report initial experiences in hMIE (laparoscopic approach for cancer and analyze surgical technique, major morbidity and 30-day mortality. Methods. A retrospective cohort study included 44 patients who underwent elective hMIE for esophageal cancer at the Department for Minimally Invasive Upper Digestive Surgery, Hospital for Digestive Surgery, Clinical Center of Serbia in Belgrade from April 2009 to December 2014. Results. There were 16 (36% middle thoracic esophagus tumors and 28 (64% tumors of distal thoracic esophagus. Mean duration of the operation was 319 minutes (approximately five hours and 20 minutes. The average blood loss was 173.6 ml. A total of 12 (27% of patients had postoperative complications and mean intensive care unit stay was 2.8 days. Mean hospital stay after surgery was 16 days. The average number of harvested lymph nodes during surgery was 31.9. The overall 30-day mortality rate within 30 days after surgery was 2%. Conclusion. As long as MIE is an oncological equivalent to open esophagectomy (OE, better relation between cost savings and potentially increased effectiveness will make MIE the preferred approach in high-volume esophageal centers that are experienced in minimally invasive procedures.

  7. Sharing post-AML consolidation supportive therapy with local centers reduces patient travel burden without compromising outcomes. (United States)

    Hershenfeld, Samantha A; Maki, Kimberly; Rothfels, Lana; Murray, Cindy S; Nixon, Shannon; Schimmer, Aaron D; Doherty, Mary C


    Acute myeloid leukemia (AML) is frequently treated with induction and consolidation chemotherapy. Consolidation chemotherapy can be delivered on an ambulatory basis, requiring some patients to travel long distances for treatment at specialized centers. We developed a shared care model where patients receive consolidation chemotherapy at a quaternary center, but post-consolidation supportive care at local hospitals. To evaluate the impact of our model on patient travel and outcomes we conducted a retrospective analysis of AML and acute promyelocytic leukemia patients receiving consolidation over four years at our quaternary center. 73 patients received post-consolidation care locally, and 344 at the quaternary center. Gender, age and cytogenetic risk did not significantly differ between groups. Shared care patients saved mean round trip distance of 146.5km±99.6 and time of 96.7min±63.4 compared to travelling to quaternary center. There was no significant difference in overall survival between groups, and no increased hazard of death for shared care patients. 30, 60, and 90day survival from start of consolidation was 98.6%, 97.2%, and 95.9% for shared care and 98.8%, 97.1%, and 95.3% for quaternary center patients. Thus, a model utilizing regional partnerships for AML post-consolidation care reduces travel burden while maintaining safety. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Economic Constraints – the Growing Challenge for Western Breast Cancer Centers (United States)

    Seidel, Rene P.; Lux, Michael P.; Hoellthaler, Josef; Beckmann, Matthias W.; Voigt, Wieland


    Summary Breast cancer care in Western countries has reached a considerable level of quality and standardization, which has contributed to the decline in breast cancer mortality. Certified Breast Cancer Centers (BCC) represent an important element of this development. Related to changes in reimbursement and growing costs, BCC face economic constraints which ultimately could endanger the achievements of the past. Thus, BCC have to optimize their care strategies from an economic perspective, particularly by increasing efficiency but also by adapting their service portfolio. This could result in competitive advantages and additional revenue by increasing case numbers and extra charges to patients. Furthermore, an intensification of collaboration with the outpatient sector resulting in an integrated and managed ‘trans-sectoral’ care approach which could allow to shift unprofitable procedures to the outpatient sector – in the sense of a win-win situation for both sectors and without loss of care quality – seems reasonable. Structured and specialized consulting approaches can further be a lever to fulfill economic requirements in order to avoid cuts in medical care quality for the sake of a balanced budget. In this review, economic constraints of BCC with a focus on the German healthcare system and potential approaches to ameliorate these financial burdens are being discussed. PMID:24715842

  9. Prospective multi-center trial utilizing electronic brachytherapy for the treatment of endometrial cancer

    Directory of Open Access Journals (Sweden)

    Thropay John P


    Full Text Available Abstract Background A modified form of high dose rate (HDR brachytherapy has been developed called Axxent Electronic Brachytherapy (EBT. EBT uses a kilovolt X-ray source and does not require treatment in a shielded vault or a HDR afterloader unit. A multi-center clinical study was carried out to evaluate the success of treatment delivery, safety and toxicity of EBT in patients with endometrial cancer. Methods A total of 15 patients with stage I or II endometrial cancer were enrolled at 5 sites. Patients were treated with vaginal EBT alone or in combination with external beam radiation. Results The prescribed doses of EBT were successfully delivered in all 15 patients. From the first fraction through 3 months follow-up, there were 4 CTC Grade 1 adverse events and 2 CTC Grade II adverse events reported that were EBT related. The mild events reported were dysuria, vaginal dryness, mucosal atrophy, and rectal bleeding. The moderate treatment related adverse events included dysuria, and vaginal pain. No Grade III or IV adverse events were reported. The EBT system performed well and was associated with limited acute toxicities. Conclusions EBT shows acute results similar to HDR brachytherapy. Additional research is needed to further assess the clinical efficacy and safety of EBT in the treatment of endometrial cancer.

  10. The Role of Re-resection for Breast Cancer Liver Metastases-a Single Center Experience. (United States)

    BacalbaȘa, Nicolae; Balescu, Irina; Dima, Simona; Popescu, Irinel


    The aim of the present study was to evaluate the effectiveness and safety of hepatic re-resection for breast cancer liver metastases. Between January 2004 and December 2014 seven patients were submitted to liver re-resection for breast cancer liver metastases at our Center. The main inclusion criteria were presence of isolated liver metastases and absence of systemic recurrent disease Results: The median age at the time of breast surgery was 51 years (range=39-69 years). The first liver resection was performed after a median period of 34.7 months and consisted of minor hepatectomies in six and major hepatectomy in one patient. The second liver resection was performed after a median interval of 22 months from the first liver resection and consisted of major resection in one case and minor resection in the other six cases. Postoperative complications occurred in a single case after the first liver surgery and in two cases after the second hepatic resection, all cases being successfully managed conservatively. Overall postoperative mortality was 0. The median overall survival after the second liver resection was 28 months. Re-resection for breast cancer liver metastases can be safely performed and may bring survival benefit. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  11. Person-centered Web support to women with type 1 diabetes in pregnancy and early motherhood--the development process. (United States)

    Berg, Marie; Adolfsson, Annsofie; Ranerup, Agneta; Sparud-Lundin, Carina


    Pregnancy and early motherhood are extraordinarily demanding periods for women with type 1 diabetes, who therefore need optimal support. This article describes the process of developing person-centered Web-based support for women with type 1 diabetes during the period of pregnancy through early motherhood. Important aspects of person-centeredness are a broader scope of medicine, viewing the patient as a person, shared decision-making to accomplish a therapeutic alliance, and the role of documentation. A participatory design was used in the development process to capture the target group's knowledge, experiences, and needs, and a systematic process map for Web-based support was used to describe the process. Content and layout in the Web support were developed collaboratively by project managers, advisory and scientific reference groups, technical producers, and representatives for the target group. Based on needs assessment and evidence synthesis, three main components of complementary Web-based support were identified: (1) specific information about pregnancy, childbirth, and early motherhood in relation to type 1 diabetes; (2) a self-care diary, including a device for documenting and evaluating blood glucose levels, insulin doses, food intake, physical activities, and overall well-being; and (3) a forum for communication between women with type 1 diabetes in the childbearing period. Using a perspective of person-centered care, a participatory design and the process map were fruitful for developing person-centered Web support for self-care and self-learning. The developed Web support product will be evaluated in a randomized controlled trial and further developed based on this result.

  12. [Current status of operations in community general support centers and the correlation of personal traits, work environment and occupational stress]. (United States)

    Yamaguchi, Yoshie


    The purpose of this study was to identify the current status of operations at community general support centers which provide coordination for elderly care and the correlation of personal traits, work environment and the occupational stress of the staff. Subjects of the study were 251 staff members of community general support centers. The current status of operations at the community general support centers and the personal traits, work environment, effort-remuneration imbalance model (ERI) and general health questionnaire (GHQ) were surveyed. The initial analysis involved a comparison by a chi-square test on: The effort-remuneration ratio (E/R ratio) of personal traits and work environment, risk of over-commitment (OC), and GHQ score. To explore the correlation between the E/R ratio of the three GHQ groups (low, middle and high score groups) and the OC value, one-way analysis of variance was performed. Out of the four basic functions of the community general support centers, 22.0% of the respondents noted that "establishment of a regional, comprehensive/multi-tiered service network" was functioning, and 50.4% of respondents noted that "comprehensive and continuous care management" was functioning. The average effort score was 15.5 +/- 5.3, approximately double the average value of preceding studies. Significant differences found in GHQ scores were related to working hours (pworking hours of 50 h or more" (OR: 10.38, 95% CI: 2.52-42.70), "Unstable employment" (OR: 2.75, 95% CI: 1.22-6.21) and "Anxiety related to task content" (OR: 17.04, 95% CI: 3.57-81.24). Items observed to have significant correlation with OC value risk factors were: "Weekly working hours of 50 h or more" (OR: 8.04, 95% CI: 1.99-32.41) and "Anxiety related to task content" (OR: 4.60, 95% CI: 2.04-10.37). We conclude that the basic functions of the community general support centers are not presently very functional. The stress levels of the community general support center staff are high and

  13. Dyadic interdependence of psychosocial outcomes among haematological cancer survivors and their support persons. (United States)

    Paul, Christine; Hall, Alix; Oldmeadow, Christopher; Lynagh, Marita; Campbell, Sharon; Bradstock, Ken; Williamson, Anna; Carey, Mariko; Sanson-Fisher, Rob


    This study aimed to explore the dyadic relationships between unmet need, depression, and anxiety in people diagnosed with haematological cancer and their support persons. Adult survivors (18 years+) who had been diagnosed with a haematological cancer were recruited to a cross-sectional mailed survey via five state cancer registries in Australia. Participating survivors invited a support person to also complete a survey. Structural equation modelling was used to explore the relationships among survivor and support person self-reported depression, anxiety, and unmet needs. Of the 4299 eligible haematological cancer survivors contacted by the registries, 1511 (35%) returned a completed survey as did 1004 support persons. There were 787 dyads with complete data. After adjusting for age, gender, rurality, cancer type, and whether the support person was a relative, positive correlations were found between survivor and support person scores for depression (p = 0.0029) and unmet needs (p support person depression (p = 0.0036). Support person unmet needs were significantly related to a higher depression score for survivors (p = 0.0067). Greater support person unmet needs were significantly related to a higher anxiety score for survivors (p = 0.0083). Survivor unmet needs did not have a significant relationship to support person anxiety (p = 0.78). Unmet needs may mediate the interdependence of psychosocial experiences for survivors and support persons, although a longitudinal study is required to confirm causality. Addressing unmet needs may be a potential target for improving outcomes for both groups.

  14. Emotional coping differences among breast cancer patients from an online support group: A longitudinal study

    NARCIS (Netherlands)

    Batenburg, A.E.; Das, H.H.J.


    Background: Previous research on the effects of online peer support on psychological well-being of patients with cancer showed mixed findings. There is a need for longitudinal studies explaining if and when online peer-led support groups are beneficial. How patients cope with emotions that come

  15. Using Technologies to Support the Social and Academic Engagement of Young People with Cancer (United States)

    Donovan, Owen M.


    Situated in the larger questions of how to support the educational engagement and positive psychosocial development of young people with cancer, the purpose of this exploratory study was to address gaps in the literature and build understanding of how young people use digital and Internet-connected technologies in ways that support their social…

  16. The Association of Social Support and Education with Breast and Cervical Cancer Screening (United States)

    Documet, Patricia; Bear, Todd M.; Flatt, Jason D.; Macia, Laura; Trauth, Jeanette; Ricci, Edmund M.


    Background: Disparities in breast and cervical cancer screening by socioeconomic status persist in the United States. It has been suggested that social support may facilitate screening, especially among women of low socioeconomic status. However, at present, it is unclear whether social support enables mammogram and Pap test compliance. Purpose:…

  17. A Closer Look at Social Support as a Moderator of Stress in Breast Cancer. (United States)

    Roberts, Cleora S.; And Others


    Explored effects of perceived social support from friends, family, and spouses on psychological adjustment of 135 newly diagnosed breast cancer patients. Initial data analyses revealed moderate correlations between greater psychological distress and lower levels of social support. When personality variable of social desirability was controlled…

  18. A Threshold Model of Social Support, Adjustment, and Distress after Breast Cancer Treatment (United States)

    Mallinckrodt, Brent; Armer, Jane M.; Heppner, P. Paul


    This study examined a threshold model that proposes that social support exhibits a curvilinear association with adjustment and distress, such that support in excess of a critical threshold level has decreasing incremental benefits. Women diagnosed with a first occurrence of breast cancer (N = 154) completed survey measures of perceived support…

  19. 78 FR 53763 - Proposed Collection; 60-day Comment Request Cancer Trials Support Unit (CTSU) (NCI) (United States)


    ... Support Unit (CTSU) (NCI) SUMMARY: In compliance with the requirement of Section 3506(c)(2)(A) of the... Rockville, MD 20850 or call non-toll-free number 240-276-6080 or Email your request, including your address...: Cancer Trials Support Unit (CTSU) (NCI), 0925- 0624, Expiration Date 12/31/2013, REVISION, National...

  20. Supportive Care Needs for Women With Gynecological Cancer and Their Relatives During the Prediagnostic Period

    DEFF Research Database (Denmark)

    Holt, Kamila Adellund; Hansen, Helle Ploug; Mogensen, Ole


    The prediagnostic process for gynecological cancer has become quite rapid. It gives the woman limited time to handle new information about her illness and make decisions. The existing support initiatives in Denmark focus on aftercare rather than on needs for support in the prediagnostic period....