WorldWideScience

Sample records for cancer institute budget

  1. Budget institutions and taxation

    DEFF Research Database (Denmark)

    Aaskoven, Lasse

    2018-01-01

    While a number of different studies have explored the effects of budgetary procedures and the centralization of the budget process on government debt, deficits and spending, few of them have explored whether such fiscal institutions matter for public revenue. This article argues that centralizing...... the budget process raises the levels of taxation by limiting the ability of individual government officials to veto tax increases in line with common-pool-problem arguments regarding public finances. Using detailed data on budgetary procedures from 15 EU countries, the empirical analysis shows that greater...... centralization of the budget process increases taxation as a share of GDP and that both the type of budget centralization and level of government fractionalization matter for the size of this effect. The results suggest that further centralizing the budget process limits government debt and deficits...

  2. INSTITUTIONAL SUPPORT OF SECURITY BUDGET OF UKRAINE

    Directory of Open Access Journals (Sweden)

    S. Onishchenko

    2016-06-01

    Full Text Available The institutional framework from positions of different conceptual approaches was examined in the article. The attention was paid the problems of institutional support budget security in Ukraine. The institutionalization of budgetary relations and especially the formation system of institutional support was investigated. The author's approach to the nature of institutional support budget security was suggested. Institutional and legal, institutional and organizational, and staffing budget security were characterized. It is concluded that the process of institutional development budget security characterized by unacceptable levels of institutional strain.

  3. Zero-Base Budgeting:; An Institutional Experience.

    Science.gov (United States)

    Alexander, Donald L.; Anderson, Roger C.

    Zero-base budgeting as it is used at Allegany College is described. Zero-based budgeting is defined as a budgeting and planning approach that requires the examination of every item in a budget request as if the request were being proposed for the first time. Budgets (decision packages) are first made up for decision units (i.e., a course for the…

  4. Participative Budgeting, Budget Evaluation, and Organizational Trust in Post-Secondary Educational Institutions in Canada

    Science.gov (United States)

    Simmons, Cynthia V.

    2012-01-01

    The purpose of this research was to investigate the relationship between a participative budgeting system, the attitudes toward the budget, and levels of organizational trust held by administrators in post-secondary institutions. A 50-item questionnaire was distributed to college and university administrators across Canada. A series of regression…

  5. The institutional logics of local government budget in Indonesia

    Directory of Open Access Journals (Sweden)

    Palupi Ade

    2017-01-01

    Full Text Available This study asks how and why a local government settings budget. It aims to deliver an understanding on how a government entity perceives that budget is important element to manage public expenditures. It uses the S local government in Indonesia as a case study. This study applies Institutional Logics Theory as a theoretical framework in order to analyze data. Data is collected by interviewing seven key persons who directly involves in budgeting process. This research shows that the budgeting process includes determining the purposes of annual budget, setting up planned programs and actvities, determining the amount of revenue that will be collected, allocating resources to expenditures and setting up standar pricing. Some important points in the budgeting process are identified. Those are considering political aspect to determine local tax rate, focusing on competition with other local governments, fulfilling the political promise of local government leader to the constituents, involving community to determine planned program and activities, and allocating resources based on community basic needs. This study concludes that those points develop the institutional logics of politic and managerial in budget setting process.

  6. NCTN Budget

    Science.gov (United States)

    Learn about the budget for the National Clinical Trials Network (NCTN), a National Cancer Institute program that gives funds and other support to cancer research organizations to conduct cancer clinical trials.

  7. Budget institutions and fiscal performance of the Brazilian Federal Government

    Directory of Open Access Journals (Sweden)

    Ana Carolina Giuberti

    2015-05-01

    Full Text Available This article aims to assess the impact of federal budget institutions on the primary deficit of the Brazilian Federal Government from 1985 to 2009, a period marked by important changes in these institutions. Based on the methodology established in the literature on political economy that is linked to the macroeconomic mainstream, three sets of budget indices and their respective sub-indices are constructed, and their behaviour over the period of analysis indicate that the changes made have resulted in institutions that induce greater fiscal discipline. Regarding the effect of these institutions on the fiscal performance, the results allow us to conclude that the institutional changes have contributed to a lower government deficit.

  8. The National Institute of Education and Incremental Budgeting.

    Science.gov (United States)

    Hastings, Anne H.

    1979-01-01

    The National Institute of Education's (NIE) history demonstrates that the relevant criteria for characterizing budgeting as incremental are not the predictability and stability of appropriations but the conditions of complexity, limited information, multiple factors, and imperfect agreement on ends; NIE's appropriations were dominated by political…

  9. The flat‐funding years and the National Cancer Institute: Consequences for cancer research

    OpenAIRE

    Hitt, Emma

    2008-01-01

    The National Cancer Institute (NCI), the principal federal agency for cancer research and training in the US, has contended with a flat budget since 2004, which according to the institute's director is preventing the organisation from keeping pace with the increasing costs of biomedical research. Although the impact of these budget shortfalls are still being debated, Niederhuber believes these so‐called “flat‐funding years” may pave the way for worrying future trends, resulting in a paucity o...

  10. Peralta Cancer Research Institute

    International Nuclear Information System (INIS)

    Anon.

    1979-01-01

    The investigators in the cell biology program at PCRI have pioneered in the development of techniques for culturing human epithelial cells. The cancer diagnosis program has been concerned with researching new techniques for early diagnosis of breast cancer in women. The cancer treatment program has been concerned with applying cell biology and biochemistry advances to improve cancer management

  11. National Cancer Institute

    Science.gov (United States)

    ... programs, and connect with NCI researchers via Twitter chats. Facebook Connect with NCI on its Facebook page to get updates on cancer information, including the latest research, and engage with us on topics of interest to you. View this video on YouTube. On October 18 at 12:00 ...

  12. Why Agencies Budget For Results : Exploring Institutional Explanations for Performance Budgeting: The Case of Forestry and Air Traffic Control

    NARCIS (Netherlands)

    M. de Jong (Maarten)

    2016-01-01

    markdownabstractSummary This PhD research examines institutional explanations for the use of performance information (PI) to learn and improve by government agencies. Despite widespread criticism of and disappointment with New Public Management (NPM) reforms, performance budgeting (PB) is

  13. Institutional shared resources and translational cancer research

    Directory of Open Access Journals (Sweden)

    De Paoli Paolo

    2009-06-01

    Full Text Available Abstract The development and maintenance of adequate shared infrastructures is considered a major goal for academic centers promoting translational research programs. Among infrastructures favoring translational research, centralized facilities characterized by shared, multidisciplinary use of expensive laboratory instrumentation, or by complex computer hardware and software and/or by high professional skills are necessary to maintain or improve institutional scientific competitiveness. The success or failure of a shared resource program also depends on the choice of appropriate institutional policies and requires an effective institutional governance regarding decisions on staffing, existence and composition of advisory committees, policies and of defined mechanisms of reporting, budgeting and financial support of each resource. Shared Resources represent a widely diffused model to sustain cancer research; in fact, web sites from an impressive number of research Institutes and Universities in the U.S. contain pages dedicated to the SR that have been established in each Center, making a complete view of the situation impossible. However, a nation-wide overview of how Cancer Centers develop SR programs is available on the web site for NCI-designated Cancer Centers in the U.S., while in Europe, information is available for individual Cancer centers. This article will briefly summarize the institutional policies, the organizational needs, the characteristics, scientific aims, and future developments of SRs necessary to develop effective translational research programs in oncology. In fact, the physical build-up of SRs per se is not sufficient for the successful translation of biomedical research. Appropriate policies to improve the academic culture in collaboration, the availability of educational programs for translational investigators, the existence of administrative facilitations for translational research and an efficient organization

  14. Institutional shared resources and translational cancer research.

    Science.gov (United States)

    De Paoli, Paolo

    2009-06-29

    The development and maintenance of adequate shared infrastructures is considered a major goal for academic centers promoting translational research programs. Among infrastructures favoring translational research, centralized facilities characterized by shared, multidisciplinary use of expensive laboratory instrumentation, or by complex computer hardware and software and/or by high professional skills are necessary to maintain or improve institutional scientific competitiveness. The success or failure of a shared resource program also depends on the choice of appropriate institutional policies and requires an effective institutional governance regarding decisions on staffing, existence and composition of advisory committees, policies and of defined mechanisms of reporting, budgeting and financial support of each resource. Shared Resources represent a widely diffused model to sustain cancer research; in fact, web sites from an impressive number of research Institutes and Universities in the U.S. contain pages dedicated to the SR that have been established in each Center, making a complete view of the situation impossible. However, a nation-wide overview of how Cancer Centers develop SR programs is available on the web site for NCI-designated Cancer Centers in the U.S., while in Europe, information is available for individual Cancer centers. This article will briefly summarize the institutional policies, the organizational needs, the characteristics, scientific aims, and future developments of SRs necessary to develop effective translational research programs in oncology.In fact, the physical build-up of SRs per se is not sufficient for the successful translation of biomedical research. Appropriate policies to improve the academic culture in collaboration, the availability of educational programs for translational investigators, the existence of administrative facilitations for translational research and an efficient organization supporting clinical trial recruitment

  15. Thyroid cancer: experiences of Cancer Institute, Madras

    International Nuclear Information System (INIS)

    Kannan, R. Ravi; Mahajan, V.; Ganesh, M.S.; Ayyappan, S.; Suresh, V.; Suryasen, S.

    1999-01-01

    It has been long recognized that Thyroid Cancer (TC) envelopes under its umbrella a spectrum of cancers from the relatively indolent well differentiated papillary and follicular cancers to the aggressive and rapidly fatal anaplastic cancers. Medullary cancers fall in between the two extremes. Recently, poor prognostic variants of well-differentiated cancers have been described. There is also a move to define a group of poorly differentiated TC including the insular variants distinguishing them from anaplastic carcinomas. Of the 1168 patients with thyroid nodules seen at the Cancer Institute (WIA), Chennai between 1956 and 1996, 670 cases proved to be malignant either cytologically or histologically. This report is based on the follow-up of these patients which at 10 years was 75%

  16. Budget Impact of Enzalutamide for Chemotherapy-Naïve Metastatic Castration-Resistant Prostate Cancer.

    Science.gov (United States)

    Bui, Cat N; O'Day, Ken; Flanders, Scott; Oestreicher, Nina; Francis, Peter; Posta, Linda; Popelar, Breanna; Tang, Hong; Balk, Mark

    2016-02-01

    Prostate cancer is expected to account for approximately one quarter of all new diagnoses of cancer in American men in 2015. The cost of prostate cancer care is expected to reach $15.1 billion by the year 2020, up from $11.9 billion in 2010. Given the high burden of prostate cancer, health care payers are interested in quantifying the potential budget impact of new therapies. To estimate the budget impact of enzalutamide for the treatment of chemotherapy-naïve metastatic castration-resistant prostate cancer (mCRPC) from a U.S. payer perspective. A model was developed to assess the budget impact of enzalutamide for treatment of chemotherapy-naïve mCRPC patients in a hypothetical 1-million-member U.S. health plan over a 1-year time horizon. Comparators included abiraterone acetate, sipuleucel-T, radium Ra 223 dichloride, and docetaxel. Epidemiologic data, including National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) incidence rates, were used to estimate the number of chemotherapy-naïve mCRPC patients. Dosing, administration, duration of therapy, and adverse event rates were based on package inserts and pivotal studies. Drug costs were obtained from RED BOOK and Centers for Medicare & Medicaid Services (CMS) average sales price pricing files, costs of administration and monitoring from the CMS physician fee schedule, and adverse events from the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project and published literature. Market shares were estimated for each comparator before and after adoption of enzalutamide. The incremental aggregate budget impact, per patient per year (PPPY), per patient per month (PPPM), and per member per month (PMPM), was calculated. One-way sensitivity analyses were performed. In a population of 115 chemotherapy-naïve mCRPC patients, adopting enzalutamide had an annual incremental budget impact of $510,641 ($4,426 PPPY, $369 PPPM, and $0.04 PMPM). Results were most sensitive to

  17. American Institute for Cancer Research

    Science.gov (United States)

    ... Phytochemicals in your food Red and processed meat Sugar and cancer risk Alcohol and cancer risk Physical Activity Are ... Updates: Diabetes Rates are High and Rising, That Links with Cancer Apples and Oranges, What Americans are Eating and ...

  18. 1981 research programme and budget of Hahn-Meitner-Institut fuer Kernforschung Berlin

    International Nuclear Information System (INIS)

    Anon.

    1981-01-01

    Hahn-Meitner-Institut fuer Kernforschung Berlin (HMI) is one of the twelve large research centers of the Federal Republic of Germany; like the other centers, it has to present a combined research programme and budget (programme budget) every year. In these programme budgets, as in the medium-term financial planning in the federal budget, planning for the current year is combined with a medium-term plan for the three next years. For the year 1981, the budget of HMI includes a total expenditure of about DM 85 million, DM 71.2 million of which are direct R + D expenditures. This R + D programme is carried by 396 of the total staff of 705. Research is done in the following fields (approximate figures): Heavy ion physics DM 23.0 million. Radiation- and photochemistry DM 11.4 million. Solid state research DM 20.9 million. Nuclear chemistry DM 8.9 million. Data processing/electronics DM 7.0 million. (orig./UA) [de

  19. The Lust for Efficiency: A Downhome Story or The Implications of Zero-Based Budgeting for Institutions of Higher Education as Seen from the State of Georgia's Experience.

    Science.gov (United States)

    Fincher, Cameron

    Reactions to zero-based budgeting in the State of Georgia as it pertains to institutions of higher education are discussed. Major advantages and disadvantages of zero-based budgeting as reported by budget analysts and selected department heads in state agencies were examined by George Minmier and Roger Hermanson (1976). Zero-based budgeting was…

  20. Budget impact analysis of trastuzumab in early breast cancer: a hospital district perspective.

    Science.gov (United States)

    Purmonen, Timo T; Auvinen, Päivi K; Martikainen, Janne A

    2010-04-01

    Adjuvant trastuzumab is widely used in HER2-positive (HER2+) early breast cancer, and despite its cost-effectiveness, it causes substantial costs for health care. The purpose of the study was to develop a tool for estimating the budget impact of new cancer treatments. With this tool, we were able to estimate the budget impact of adjuvant trastuzumab, as well as the probability of staying within a given budget constraint. The created model-based evaluation tool was used to explore the budget impact of trastuzumab in early breast cancer in a single Finnish hospital district with 250,000 inhabitants. The used model took into account the number of patients, HER2+ prevalence, length and cost of treatment, and the effectiveness of the therapy. Probabilistic sensitivity analysis and alternative case scenarios were performed to ensure the robustness of the results. Introduction of adjuvant trastuzumab caused substantial costs for a relatively small hospital district. In base-case analysis the 4-year net budget impact was 1.3 million euro. The trastuzumab acquisition costs were partially offset by the reduction in costs associated with the treatment of cancer recurrence and metastatic disease. Budget impact analyses provide important information about the overall economic impact of new treatments, and thus offer complementary information to cost-effectiveness analyses. Inclusion of treatment outcomes and probabilistic sensitivity analysis provides more realistic estimates of the net budget impact. The length of trastuzumab treatment has a strong effect on the budget impact.

  1. 75 FR 14172 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2010-03-24

    ... Cancer Institute Special Emphasis Panel, Nucleic Acid Analysis for the Molecular Characterization of... Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer Centers Support; 93.398, Cancer Research... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...

  2. 76 FR 14675 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2011-03-17

    ...-7565, [email protected] . Name of Committee: National Cancer Institute Special Emphasis Panel; Molecular... Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer Centers... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...

  3. 77 FR 19674 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2012-04-02

    ... Institute Special Emphasis Panel; Innovative Molecular Analysis Technologies for Cancer (R21). Date: June 26... Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...

  4. 75 FR 5092 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2010-02-01

    ... . Name of Committee: National Cancer Institute Special Emphasis Panel, Quantitative Cell-Based Imaging....396, Cancer Biology Research; 93.397, Cancer Centers Support; 93.398, Cancer Research Manpower; 93.399... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...

  5. 76 FR 9353 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2011-02-17

    ....gov . Name of Committee: National Cancer Institute Special Emphasis Panel; Molecular Pharmacodynamic... Detection and Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...

  6. 77 FR 33476 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2012-06-06

    ... Cancer Institute Special Emphasis Panel; Biopsy Instruments and Devices That Preserve Molecular Profiles... Detection and Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...

  7. Breast cancer: surgery at the South egypt cancer institute.

    Science.gov (United States)

    Salem, Ahmed A S; Salem, Mohamed Abou Elmagd; Abbass, Hamza

    2010-09-30

    Breast cancer is the most frequent malignant tumor in women worldwide. In Egypt, it is the most common cancer among women, representing 18.9% of total cancer cases (35.1% in women and 2.2% in men) among the Egypt National Cancer Institute's (NCI) series of 10,556 patients during the year 2001, with an age-adjusted rate of 49.6 per 100,000 people. In this study, the data of all breast cancer patients presented to the surgical department of the South Egypt cancer Institute (SECI) hospital during the period from Janurary 2001 to December 2008 were reviewed .We report the progress of the availability of breast cancer management and evaluation of the quality of care delivered to breast cancer patients. The total number of patients with a breast lump presented to the SECI during the study period was 1,463 patients (32 males and 1431 females); 616 patients from the total number were admitted at the surgical department .There was a decline in advanced cases. Since 2001, facilities for all lines of comprehensive management have been made accessible for all patients. We found that better management could lead to earlier presentation, and better overall outcome in breast cancer patients.The incidence is steadily increasing with a tendency for breast cancer to occur in younger age groups and with advanced stages.

  8. 76 FR 26310 - National Cancer Institute; Notice of Meeting

    Science.gov (United States)

    2011-05-06

    ... Group(s); and Budget Presentations. Place: National Institutes of Health, Building 31, 31 Center Drive... entrance onto the NIH campus. All visitor vehicles, including taxicabs, hotel, and airport shuttles will be...

  9. 78 FR 30933 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2013-05-23

    ... Emphasis Panel; Validation and Advanced Development of Emerging Molecular Analysis Technologies for Cancer..., Cancer Detection and Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...

  10. 76 FR 52960 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2011-08-24

    ... Emphasis Panel, Mechanisms of Cell Signaling in Cancer. Date: October 13-14, 2011. Time: 3 to 5 p.m. Agenda..., Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer Centers Support; 93.398... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...

  11. 76 FR 31619 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2011-06-01

    ... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel; SBIR Phase IIB...: To review and evaluate contract proposals. Place: National Institutes of Health, 6116 Executive...

  12. Breast Cancer: Surgery at the South Egypt Cancer Institute

    Directory of Open Access Journals (Sweden)

    Ahmed A.S. Salem

    2010-09-01

    Full Text Available Breast cancer is the most frequent malignant tumor in women worldwide. In Egypt, it is the most common cancer among women, representing 18.9% of total cancer cases (35.1% in women and 2.2% in men among the Egypt National Cancer Institute’s (NCI series of 10,556 patients during the year 2001, with an age-adjusted rate of 49.6 per 100,000 people. In this study, the data of all breast cancer patients presented to the surgical department of the South Egypt cancer Institute (SECI hospital during the period from Janurary 2001 to December 2008 were reviewed .We report the progress of the availability of breast cancer management and evaluation of the quality of care delivered to breast cancer patients. The total number of patients with a breast lump presented to the SECI during the study period was 1,463 patients (32 males and 1431 females; 616 patients from the total number were admitted at the surgical department .There was a decline in advanced cases. Since 2001, facilities for all lines of comprehensive management have been made accessible for all patients. We found that better management could lead to earlier presentation, and better overall outcome in breast cancer patients.The incidence is steadily increasing with a tendency for breast cancer to occur in younger age groups and with advanced stages.

  13. 78 FR 50068 - National Cancer Institute; Notice of Meeting

    Science.gov (United States)

    2013-08-16

    ... Frederick National Laboratory for Cancer Research Strategic Plan; Proposed Organizational Change: Division..., Cancer Construction; 93.393, Cancer Cause and Prevention Research; 93.394, Cancer Detection and Diagnosis... Support; 93.398, Cancer Research Manpower; 93.399, Cancer Control, National Institutes of Health, HHS...

  14. 77 FR 19024 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2012-03-29

    ... Institute Special Emphasis Panel; NCI SPORE in Lymphoma, Leukemia, Brain, Esophageal and Gastrointestinal..., Cancer Cause and Prevention Research; 93.394, Cancer Detection and Diagnosis Research; 93.395, Cancer...

  15. 78 FR 28235 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2013-05-14

    ... Basal- like Breast Cancer. Date: June 13, 2013. Time: 12:00 p.m. to 1:00 p.m. Agenda: To review and... Domestic Assistance Program Nos. 93.392, Cancer Construction; 93.393, Cancer Cause and Prevention Research... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...

  16. 77 FR 5032 - National Cancer Institute; Notice of Meeting

    Science.gov (United States)

    2012-02-01

    ... Initiatives; RFA and RFP Concept Reviews; and Scientific Presentations. Place: National Institutes of Health... Group(s); and Budget Presentations; Reports of Special Initiatives; RFA and RFP Concept Reviews; and Scientific Presentations. Place: National Institutes of Health, Building 31, 31 Center Drive, 6th Floor, Conf...

  17. 77 FR 4052 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2012-01-26

    ... of Committee: National Cancer Institute Special Emphasis Panel, NCI SPORE in Breast, Endometrial, and... Special Emphasis Panel, The Role of Microbial Metabolites in Cancer Prevention and Etiology. Date: March..., Cancer Cause and Prevention Research; 93.394, Cancer Detection and Diagnosis Research; 93.395, Cancer...

  18. 75 FR 20370 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2010-04-19

    ... Special Emphasis Panel, Breast Cancer Biology. Date: May 20, 2010. Time: 8 a.m. to 5 p.m. Agenda: To..., [email protected] . Name of Committee: National Cancer Institute Special Emphasis Panel, Molecular... Biology Research; 93.397, Cancer Centers Support; 93.398, Cancer Research Manpower; 93.399, Cancer Control...

  19. 78 FR 55750 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2013-09-11

    ... Innovative Molecular Analysis Technology Development for Cancer Research (R21). Date: October 24, 2013. Time...: National Cancer Institute Special Emphasis Panel; Integrative Cancer Biology. Date: October 29, 2013. Time... Detection and Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397...

  20. 76 FR 5597 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2011-02-01

    ... Cancer Institute Special Emphasis Panel; Vaccine for Prevention of HIV Infection. Date: February 24, 2011... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... concerning individuals associated with the grant applications and/or contract proposals, the disclosure of...

  1. A budget model to determine the financial health of nursing education programs in academic institutions.

    Science.gov (United States)

    Donnelly, Gloria

    2005-01-01

    In the allocation of resources in academic settings, hierarchies of tradition and status often supersede documented need. Nursing programs sometimes have difficulty in getting what they need to maintain quality programs and to grow. The budget is the crucial tool in documenting nursing program needs and its contributions to the entire academic enterprise. Most nursing programs administrators see only an operating expense budget that may grow or shrink by a rubric that may not fit the reality of the situation. A budget is a quantitative expression of how well a unit is managed. Educational administrators should be paying as much attention to analyzing financial outcomes as they do curricular outcomes. This article describes the development of a model for tracking revenue and expense and a simple rubric for analyzing the relationship between the two. It also discusses how to use financial data to improve the fiscal performance of nursing units and to leverage support during times of growth.

  2. 76 FR 576 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2011-01-05

    ...; Development of Molecular Diagnostics Assay to Detect Basal- like Breast Cancer. Date: February 15, 2011. Time... Institute Special Emphasis Panel; Collaborative Research in Integrative Cancer Biology and the Tumor... Detection and Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397...

  3. 75 FR 3242 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2010-01-20

    ... Special Emphasis Panel, Developing Research Capacity in Africa for the Studies on HIV-Associated... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... commercial property such as patentable material, and personal information concerning individuals associated...

  4. 77 FR 76057 - National Cancer Institute; Notice of Closed Meeting

    Science.gov (United States)

    2012-12-26

    ..., Scientific Review Officer, Resources and Training Review Branch, Division of Extramural Activities, National... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...--Institutional Training and Education Institutional Training and Education Grant. Date: February 25-26, 2013...

  5. Budget Impact Analysis of Biosimilar Trastuzumab for the Treatment of Breast Cancer in Croatia.

    Science.gov (United States)

    Cesarec, August; Likić, Robert

    2017-04-01

    Breast cancer is the most common cancer in women and has considerable impact on healthcare budgets and patients' quality of life. Trastuzumab (Herceptin ® ) is a monoclonal antibody directed against the human epidermal growth factor receptor (HER2) for the treatment of breast cancer. Several trastuzumab biosimilars are currently in development. In 2015, trastuzumab was the drug with the highest financial consumption among all drugs in Croatia. This model estimates the 1-year budget impact of the introduction of biosimilar trastuzumab in Croatia. A budget impact model, based on approvals for trastuzumab treatment in 2015, was developed for the introduction of biosimilars. Two biosimilar scenarios were developed: biosimilar scenario 1, based on all approvals in 2015, and biosimilar scenario 2, based on approvals after February 2015 and the reimbursement of the subcutaneous formulation of trastuzumab in Croatia. Only trastuzumab-naïve patients and drug-acquisition costs were used in the model. Uptake of biosimilar was assumed at 50 %. Scenarios were calculated with price discounts of 15, 25 and 35 %. The robustness of the model was tested by extensive sensitivity analyses. The projected drug cost savings from the introduction of biosimilar trastuzumab range from €0.26 million (scenario 2, 15 % price discount) to €0.69 million (scenario 1, 35 % price discount). If budget savings were reinvested to treat additional patients with trastuzumab, 14 (scenario 2, 15 % price discount) to 47 (scenario 1, 35 % price discount) additional patients could be treated. Sensitivity analyses showed that the incidence of breast cancer had the highest impact on the model, with a 10 % decrease in incidence leading to an 11.3 % decrease in projected savings. The introduction of biosimilar trastuzumab could lead to significant drug cost savings in Croatia.

  6. Roswell Park Cancer Institute/Howard University Prostate Cancer Scholars Program

    Science.gov (United States)

    2017-10-01

    AWARD NUMBER: W81XWH-14-1-0531 TITLE: Roswell Park Cancer Institute/Howard University Prostate Cancer Scholars Program PRINCIPAL INVESTIGATOR...Roswell Park Cancer Institute/Howard University Prostate Cancer 5a. CONTRACT NUMBER W81XWH-14-1-0531 Cancer Scholars Program 5b. GRANT NUMBER 5c...Prostate Cancer Scholars Program is designed to encourage students from under-represented minority groups to enter graduate training and ultimately

  7. 78 FR 8156 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2013-02-05

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute... proposals. Place: Bethesda North Marriott Hotel & Conference Center, Montgomery County Conference Center... Institute, NIH, 6116 Executive Blvd., Suite 703, Room 7072, Bethesda, md 20892-8329, 301-594-1408, Stoicaa2...

  8. An Empirical Study on Key Indicators of Environmental Quality: Green Budgeting - a Catalyst for Sustainable Economy and a Factor for Institutional Change

    Directory of Open Access Journals (Sweden)

    Violeta – Maria Cimpoeru

    2012-06-01

    Full Text Available This paper presents the phenomenon of institutional change through the implementation of sustainable strategies of medium-term budgeting, having as an effect the growth of opportunity to attract proper resources for social and environmental programs. The study analyzes green budget practices and suggests several ways to use them in order to ensure consistency in implementing key elements of sustainable economy. Thus, we conducted an empirical study to explain the decisive factors impact (greenhouse gas emissions and national income on health expenditure and we obtained statistically significant positive relationship, suggesting that green budgeting is an important factor for sustainable economy. The reasons behind the introduction of a sustainable perspective for budgeting in any country are important since they will dictate, to a large extent, the way the medium term budgeting will be institutionalized

  9. Dana-Farber Cancer Institute: Identification of Therapeutic Targets Across Cancer Types | Office of Cancer Genomics

    Science.gov (United States)

    The Dana Farber Cancer Institute CTD2 Center focuses on the use of high-throughput genetic and bioinformatic approaches to identify and credential oncogenes and co-dependencies in cancers. This Center aims to provide the cancer research community with information that will facilitate the prioritization of targets based on both genomic and functional evidence, inform the most appropriate genetic context for downstream mechanistic and validation studies, and enable the translation of this information into therapeutics and diagnostics.

  10. A Qualitative Evaluation of Program Budgeting and Marginal Analysis in a Canadian Pediatric Tertiary Care Institution.

    Science.gov (United States)

    Smith, Neale; Mitton, Craig; Hiltz, Mary-Ann; Campbell, Matthew; Dowling, Laura; Magee, J Fergall; Gujar, Shashi Ashok

    2016-10-01

    Hospitals in Canada are being asked by governments to improve efficiency and do more with fewer resources. Healthcare decision makers are thus driven to find better ways to manage budgets and deliver on their mission. Formal processes of priority setting and resource allocation (PSRA) are one means to this end. This paper reports an evaluation of one such approach, Program Budgeting and Marginal Analysis (PBMA), as applied at a children and women's tertiary care facility in Nova Scotia, Canada. A brief evaluation conducted immediately after the conclusion of the PBMA process was supplemented with a larger retrospective evaluation. The retrospective evaluation included 26 face-to-face individual interviews with senior and middle managers who took part in PBMA. Interview transcripts were analyzed against a template consisting of 19 elements of structure, process, attitudes, and outcomes associated with high performance in PSRA. Respondents had a good experience with the implementation of PBMA, and considered it an improvement over past practice. Success was attributed to effective leadership, and substantial efforts to engage staff members. Understanding of economic and ethical principles of decision making was reportedly increased. Areas for improvement included ensuring that everyone participated in good faith, better communication of final results, and stronger follow-through to determine if anticipated changes and benefits in fact occurred. The evaluation framework employed here proved useful in assessing the quality of this resource allocation exercise. The results are directly useful to local decision makers, and the identified strengths and weaknesses are broadly consistent with those reported in studies of other organizations.

  11. 76 FR 57748 - National Cancer Institute Notice of Closed Meetings

    Science.gov (United States)

    2011-09-16

    ... Logistics Branch, Division of Extramural Activities, National Cancer Institute, 6116 Executive Boulevard... Crystal City, 2799 Jefferson Davis Highway, Arlington, VA 22202. Contact Person: Sergei Radaev, PhD..., Scientific Review Officer, Special Review Logistics Branch, Division of Extramural Activities, National...

  12. Budget impact from the incorporation of positron emission tomography ? computed tomography for staging lung cancers

    OpenAIRE

    Biz, Aline Navega; Caetano, Ros?ngela

    2015-01-01

    OBJECTIVE To estimate the budget impact from the incorporation of positron emission tomography (PET) in mediastinal and distant staging of non-small cell lung cancer.METHODS The estimates were calculated by the epidemiological method for years 2014 to 2018. Nation-wide data were used about the incidence; data on distribution of the disease´s prevalence and on the technologies’ accuracy were from the literature; data regarding involved costs were taken from a micro-costing study and from Brazi...

  13. 77 FR 5029 - National Cancer Institute; Notice of Meeting

    Science.gov (United States)

    2012-02-01

    ... Community; Cancer Drug Shortages: Economic, Regulatory, and Manufacturing Issues; The Role of the Cancer... security, NIH has instituted stringent procedures for entrance onto the NIH campus. All visitor vehicles, including taxicabs, hotel, and airport shuttles will be inspected before being allowed on campus. Visitors...

  14. 75 FR 44274 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2010-07-28

    ... Cancer Institute Special Emphasis Panel, Nanotechnology Imaging and Sensing Platforms for Improved Diagnosis of Cancer. Date: August 31, 2010. Time: 12 p.m. to 1:30 p.m. Agenda: To review and evaluate... 20852 (Telephone Conference Call). Contact Person: Kenneth L. Bielat, PhD, Scientific Review Officer...

  15. 78 FR 64222 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2013-10-28

    ... Conference Call). Contact Person: Robert Bird, Ph.D., Chief, Resources and Training Review Branch, Division....D., Scientific Review Officer, Resources and Training Review Branch, Division of Extramural... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute...

  16. 77 FR 68136 - National Cancer Institute Amended; Notice of Meeting

    Science.gov (United States)

    2012-11-15

    ... Regency Bethesda Hotel, Old Georgetown Room, One Metro Center, Bethesda, MD 20814. The NCAB ad hoc... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute..., Building 31C, Wing C, Conference Room 10, 31 Center Drive, Bethesda, MD 20892 which was published in the...

  17. Hahn-Meitner-Institut Berlin. Programme budget 1995. Planning period 1993 to 1998

    International Nuclear Information System (INIS)

    Moehring, K.; Roberstson, T.

    1995-01-01

    This edition is the first one that has been published after a break of several years. It especially documents the realisation of the ''structure plan HMI 1995, which was agreed on at the end of 1993. In the medium-term this plan wants the institute to focus on the main subjects ''structure and dynamics of condensed material'' and ''solar energy research''. (orig./HP) [de

  18. DEVELOPMENT AND EFFICIENCY OF BUDGET OF PUBLIC INSTITUTIONS BY THE METHOD BASED ON PERFORMANCE

    Directory of Open Access Journals (Sweden)

    Irina-Ștefana, CIBOTARIU

    2014-11-01

    Full Text Available In Romania, public sector performance is a concept on which it has been written very little and rarely applied in practice. The situation is not the same in developed countries economically to where we focus our attention, regarded as models for our country. Internationally, since the early 70s of the last century there were initiated processes of modernization and reorganization of public institutions in different countries. The society required a higher efficiency of the services provided by it, a better use of public services and also an effective bureaucratic model. It can be said that only in this context, government institutions can gain strength, consistency and can become more reliable. Flexibility, decentralization, creativity, self-management and management contract, all used as measurement tools are the basic features of a managerial reforms that focus on results. Determining the results in the public sector and implementing a system of financial and nonfinancial performance measurement requires a clear definition of the objectives and goals of each organization and component institution.

  19. HER2-positive male breast cancer with thyroid cancer: an institutional report and review of literature.

    Science.gov (United States)

    Bardhan, Pooja; Bui, Marilyn M; Minton, Susan; Loftus, Loretta; Carter, W Bradford; Laronga, Christine; Ismail-Khan, Roohi

    2012-01-01

    We report a rare finding of two male breast cancer patients with HER2-positive breast cancer who also developed thyroid cancer. We reviewed 45 male breast cancer patients treated in our institution from 2003 to 2008. Only five male breast cancer patients were HER2-positive. In reviewing the published data, we found no cases of thyroid cancer and concurrent breast cancer in men. However, breast cancer and thyroid cancer have shown close association in women. This finding therefore provokes speculation as to whether we should investigate whether women with HER2-positive breast cancer are at a higher risk for thyroid cancer. Although this observation seems to be clinically prevalent, publications are sparse in clinical research areas linking thyroid cancer to breast cancer.

  20. Budget impact from the incorporation of positron emission tomography - computed tomography for staging lung cancers.

    Science.gov (United States)

    Biz, Aline Navega; Caetano, Rosângela

    2015-01-01

    To estimate the budget impact from the incorporation of positron emission tomography (PET) in mediastinal and distant staging of non-small cell lung cancer. The estimates were calculated by the epidemiological method for years 2014 to 2018. Nation-wide data were used about the incidence; data on distribution of the disease's prevalence and on the technologies' accuracy were from the literature; data regarding involved costs were taken from a micro-costing study and from Brazilian Unified Health System (SUS) database. Two strategies for using PET were analyzed: the offer to all newly-diagnosed patients, and the restricted offer to the ones who had negative results in previous computed tomography (CT) exams. Univariate and extreme scenarios sensitivity analyses were conducted to evaluate the influence from sources of uncertainties in the parameters used. The incorporation of PET-CT in SUS would imply the need for additional resources of 158.1 BRL (98.2 USD) million for the restricted offer and 202.7 BRL (125.9 USD) million for the inclusive offer in five years, with a difference of 44.6 BRL (27.7 USD) million between the two offer strategies within that period. In absolute terms, the total budget impact from its incorporation in SUS, in five years, would be 555 BRL (345 USD) and 600 BRL (372.8 USD) million, respectively. The costs from the PET-CT procedure were the most influential parameter in the results. In the most optimistic scenario, the additional budget impact would be reduced to 86.9 BRL (54 USD) and 103.8 BRL (64.5 USD) million, considering PET-CT for negative CT and PET-CT for all, respectively. The incorporation of PET in the clinical staging of non-small cell lung cancer seems to be financially feasible considering the high budget of the Brazilian Ministry of Health. The potential reduction in the number of unnecessary surgeries may cause the available resources to be more efficiently allocated.

  1. Budget impact from the incorporation of positron emission tomography – computed tomography for staging lung cancers

    Directory of Open Access Journals (Sweden)

    Aline Navega Biz

    2015-01-01

    Full Text Available OBJECTIVE To estimate the budget impact from the incorporation of positron emission tomography (PET in mediastinal and distant staging of non-small cell lung cancer.METHODS The estimates were calculated by the epidemiological method for years 2014 to 2018. Nation-wide data were used about the incidence; data on distribution of the disease´s prevalence and on the technologies’ accuracy were from the literature; data regarding involved costs were taken from a micro-costing study and from Brazilian Unified Health System (SUS database. Two strategies for using PET were analyzed: the offer to all newly-diagnosed patients, and the restricted offer to the ones who had negative results in previous computed tomography (CT exams. Univariate and extreme scenarios sensitivity analyses were conducted to evaluate the influence from sources of uncertainties in the parameters used.RESULTS The incorporation of PET-CT in SUS would imply the need for additional resources of 158.1 BRL (98.2 USD million for the restricted offer and 202.7 BRL (125.9 USD million for the inclusive offer in five years, with a difference of 44.6 BRL (27.7 USD million between the two offer strategies within that period. In absolute terms, the total budget impact from its incorporation in SUS, in five years, would be 555 BRL (345 USD and 600 BRL (372.8 USD million, respectively. The costs from the PET-CT procedure were the most influential parameter in the results. In the most optimistic scenario, the additional budget impact would be reduced to 86.9 BRL (54 USD and 103.8 BRL (64.5 USD million, considering PET-CT for negative CT and PET-CT for all, respectively.CONCLUSIONS The incorporation of PET in the clinical staging of non-small cell lung cancer seems to be financially feasible considering the high budget of the Brazilian Ministry of Health. The potential reduction in the number of unnecessary surgeries may cause the available resources to be more efficiently allocated.

  2. Meeting the Challenge: The National Cancer Institute's Central Institutional Review Board for Multi-Site Research.

    Science.gov (United States)

    Massett, Holly A; Hampp, Sharon L; Goldberg, Jacquelyn L; Mooney, Margaret; Parreco, Linda K; Minasian, Lori; Montello, Mike; Mishkin, Grace E; Davis, Catasha; Abrams, Jeffrey S

    2018-03-10

    The National Institutes of Health (NIH) issued a new policy that requires a single institutional review board (IRB) of record be used for all protocols funded by the NIH that are carried out at more than one site in the United States, effective January 2018. This policy affects several hundred clinical trials opened annually across the NIH. Limited data exist to compare the use of a single IRB to that of multiple local IRBs, so some institutions are resistant to or distrustful of single IRBs. Since 2001, the National Cancer Institute (NCI) has funded a central IRB (CIRB) that provides human patient reviews for its extensive national cancer clinical trials program. This paper presents data to show the adoption, efficiencies gained, and satisfaction of the CIRB among NCI trial networks and reviews key lessons gleaned from 16 years of experience that may be informative for others charged with implementation of the new NIH single-IRB policy.

  3. Budget impact analysis of the fentanyl buccal tablet for treatment of breakthrough cancer pain

    Directory of Open Access Journals (Sweden)

    Darbà J

    2013-12-01

    Full Text Available Josep Darbà,1 Lisette Kaskens,2 Rainel Sánchez-de la Rosa31University of Barcelona, Barcelona, 2BCN Health Economics and Outcomes Research SL, Barcelona, 3Medical and HEOR Department, TEVA Pharmaceutical Industries Ltd, Madrid, SpainBackground: The purpose of this study was to assess the economic impact of the fentanyl buccal tablet for the management of breakthrough cancer pain (BTcP in Spain.Methods: A 4-year budget impact model was developed for the period 2012–2015 for patients with BTcP from the perspective of the Spanish National Health System. BTcP products included in this model were rapid-onset opioids containing fentanyl (buccal, sublingual, or nasal transmucosal. Prevalence data on cancer, BTcP, opioid use, and number of BTcP episodes were obtained from the literature. Input data on health care resources associated with opioid use and opioid-induced side effects were obtained by consulting experts in oncology from different Spanish hospitals. Resources used included drugs, medical and emergency visits, other nonpharmacologic treatments, and treatment of opioid-induced side effects. Unit costs were obtained from the literature, and a 3% discount rate was applied to costs. Based on the unit costs for drugs and health care resources, the annual BTcP treatment costs per patient associated with each fentanyl product were determined to estimate the overall budget impact based on the total treatment population and the percentage of drug utilization associated with each product. One-way sensitivity analyses were conducted to test the robustness of the model.Results: Patients treated with oral opioids for BTcP were estimated at 23,291 in 2012, with an increase up to 23,413 in 2015. The average annual budget savings, with an increase of fentanyl buccal tablets, fentanyl sublingual tablets, and intranasal fentanyl spray, and a decrease in oral transmucosal fentanyl citrate, was estimated at €2.6 million, which represents a 0.5% decrease in

  4. Roswell Park Cancer Institute/ Howard University Prostate Cancer Scholars Program

    Science.gov (United States)

    2016-10-01

    Regulation of Expression of Androgen Receptor in ABCG2+ CWR-R1 Prostate Cancer Cells” 4.) Morenike Olu, K Miller, I Gelman, Dept. Cancer Genetics ... rubric for the Directed Readings course sequence. Training in the use of the web conferencing software will be provided by the Project Director at

  5. 75 FR 48699 - National Cancer Institute; Notice of Closed Meeting

    Science.gov (United States)

    2010-08-11

    ... personal privacy. Name of Committee: National Cancer Institute Initial Review Group, Subcommittee I--Career Development, NCI-I Career Development. Date: September 21, 2010. Time: 8 a.m. to 6 p.m. Agenda: To review and.... Contact Person: Sergei Radaev, PhD, Scientific Review Officer, Resources and Training Review Branch...

  6. 76 FR 1625 - National Cancer Institute; Notice of Closed Meeting

    Science.gov (United States)

    2011-01-11

    ... personal privacy. Name of Committee: National Cancer Institute Initial Review Group; Subcommittee I--Career Development, Career Development. Date: February 22-23, 2011. Time: February 22, 2011, 8 a.m. to 6 p.m. Agenda: To review and evaluate to review and evaluate grant applications. Place: Hilton Alexandria Old Town...

  7. 78 FR 27408 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2013-05-10

    ...., as amended. The contract proposals and the discussions could disclose confidential trade secrets or... with the contract proposals, the disclosure of which would constitute a clearly unwarranted invasion of personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel; SBIR Topic 304...

  8. 75 FR 7489 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2010-02-19

    ...., as amended. The grant applications and/or contract proposals and the discussions could disclose... concerning individuals associated with the grant applications and/or contract proposals, the disclosure [email protected] . Name of Committee: National Cancer Institute Special Emphasis Panel, SBIR Topic 258...

  9. 75 FR 7489 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2010-02-19

    ... review and evaluate grant applications. Place: Legacy Hotel and Meeting Center, 1775 Rockville Pike, Rockville, MD 20852. Contact Person: Lalita D. Palekar, PhD, Scientific Review Officer, Special Review and... Institute Special Emphasis Panel; NCI Cancer Nanotechnology Training (R25) and Career Development Award (K99...

  10. The Regina Elena National Cancer Institute process of accreditation according to the standards of the Organisation of European Cancer Institutes.

    Science.gov (United States)

    Canitano, Stefano; Di Turi, Annunziata; Caolo, Giuseppina; Pignatelli, Adriana C; Papa, Elena; Branca, Marta; Cerimele, Marina; De Maria, Ruggero

    2015-01-01

    The accreditation process is, on the one hand, a tool used to homogenize procedures, rendering comparable and standardized processes of care, and on the other, a methodology employed to develop a culture of quality improvement. Although not yet proven by evidence-based studies that health outcomes improve as a result of an accreditation to excellence, it is undeniable that better control of healthcare processes results in better quality and safety of diagnostic and therapeutic pathways. The Regina Elena National Cancer Institute underwent the accreditation process in accordance with the standards criteria set by the Organisation of European Cancer Institutes (OECI), and it has recently completed the process, acquiring its designation as a Comprehensive Cancer Center (CCC). This was an invaluable opportunity for the Regina Elena Institute to create a more cohesive environment, to widely establish a culture of quality, to implement an institutional information system, and to accelerate the process of patient involvement in strategic decisions. The steps of the process allowed us to evaluate the performance and the organization of the institute and put amendments in place designed to be adopted through 26 improvement actions. These actions regarded several aspects of the institute, including quality culture, information communication technology system, care, clinical trials unit, disease management team, nursing, and patient empowerment and involvement. Each area has a timeline. We chose to present the following 3 improvement actions: clinical trial center, computerized ambulatory medical record, and centrality of patient and humanization of clinical pathway.

  11. Differentiated Thyroid Cancer Multidisciplinary Management at the Colombian National Cancer Institute

    International Nuclear Information System (INIS)

    Garavito, Gloria; Llamas O, Augusto; Cadena, Enrique; De Los Reyes, Amelia

    2009-01-01

    Thyroid cancer is the most common malignant disease of the endocrine system. Two hundred and twenty-one new cases were diagnosed at the National Cancer Institute of Colombia (NCI) in 2006, roughly 4% of all new cancer cases. Weekly multidisciplinary decision-making meetings on thyroid cancer management have been held at the NCI since 1994. This article covers the body of knowledge gathered through 14 years of interdisciplinary collaboration where experience has been combined with the best available evidence.

  12. Spatial analyses identify the geographic source of patients at a National Cancer Institute Comprehensive Cancer Center.

    Science.gov (United States)

    Su, Shu-Chih; Kanarek, Norma; Fox, Michael G; Guseynova, Alla; Crow, Shirley; Piantadosi, Steven

    2010-02-01

    We examined the geographic distribution of patients to better understand the service area of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, a designated National Cancer Institute (NCI) comprehensive cancer center located in an urban center. Like most NCI cancer centers, the Sidney Kimmel Comprehensive Cancer Center serves a population beyond city limits. Urban cancer centers are expected to serve their immediate neighborhoods and to address disparities in access to specialty care. Our purpose was to learn the extent and nature of the cancer center service area. Statistical clustering of patient residence in the continental United States was assessed for all patients and by gender, cancer site, and race using SaTScan. Primary clusters detected for all cases and demographically and tumor-defined subpopulations were centered at Baltimore City and consisted of adjacent counties in Delaware, Pennsylvania, Virginia, West Virginia, New Jersey and New York, and the District of Columbia. Primary clusters varied in size by race, gender, and cancer site. Spatial analysis can provide insights into the populations served by urban cancer centers, assess centers' performance relative to their communities, and aid in developing a cancer center business plan that recognizes strengths, regional utility, and referral patterns. Today, 62 NCI cancer centers serve a quarter of the U.S. population in their immediate communities. From the Baltimore experience, we might project that the population served by these centers is actually more extensive and varies by patient characteristics, cancer site, and probably cancer center services offered.

  13. Creating an effort tracking tool to improve therapeutic cancer clinical trials workload management and budgeting.

    Science.gov (United States)

    James, Pam; Bebee, Patty; Beekman, Linda; Browning, David; Innes, Mathew; Kain, Jeannie; Royce-Westcott, Theresa; Waldinger, Marcy

    2011-11-01

    Quantifying data management and regulatory workload for clinical research is a difficult task that would benefit from a robust tool to assess and allocate effort. As in most clinical research environments, The University of Michigan Comprehensive Cancer Center (UMCCC) Clinical Trials Office (CTO) struggled to effectively allocate data management and regulatory time with frequently inaccurate estimates of how much time was required to complete the specific tasks performed by each role. In a dynamic clinical research environment in which volume and intensity of work ebbs and flows, determining requisite effort to meet study objectives was challenging. In addition, a data-driven understanding of how much staff time was required to complete a clinical trial was desired to ensure accurate trial budget development and effective cost recovery. Accordingly, the UMCCC CTO developed and implemented a Web-based effort-tracking application with the goal of determining the true costs of data management and regulatory staff effort in clinical trials. This tool was developed, implemented, and refined over a 3-year period. This article describes the process improvement and subsequent leveling of workload within data management and regulatory that enhanced the efficiency of UMCCC's clinical trials operation.

  14. Northeast Regional Cancer Institute's Cancer Surveillance and Risk Factor Program

    Energy Technology Data Exchange (ETDEWEB)

    Lesko, Samuel M.

    2007-07-31

    OBJECTIVES The Northeast Regional Cancer Institute is conducting a program of ongoing epidemiologic research to address cancer disparities in northeast Pennsylvania. Of particular concern are disparities in the incidence of, stage at diagnosis, and mortality from colorectal cancer. In northeast Pennsylvania, age-adjusted incidence and mortality rates for colorectal cancer are higher, and a significantly smaller proportion of new colorectal cancer cases are diagnosed with local stage disease than is observed in comparable national data. Further, estimates of the prevalence of colorectal cancer screening in northeast Pennsylvania are lower than the US average. The Northeast Regional Cancer Institute’s research program supports surveillance of common cancers, investigations of cancer risk factors and screening behaviors, and the development of resources to further cancer research in this community. This project has the following specific objectives: I. To conduct cancer surveillance in northeast Pennsylvania. a. To monitor incidence and mortality for all common cancers, and colorectal cancer, in particular, and b. To document changes in the stage at diagnosis of colorectal cancer in this high-risk, underserved community. II. To conduct a population-based study of cancer risk factors and screening behavior in a six county region of northeast Pennsylvania. a. To monitor and document changes in colorectal cancer screening rates, and b. To document the prevalence of cancer risk factors (especially factors that increase the risk of colorectal cancer) and to identify those risk factors that are unusually common in this community. APPROACH Cancer surveillance was conducted using data from the Northeast Regional Cancer Institute’s population-based Regional Cancer Registry, the Pennsylvania Cancer Registry, and NCI’s SEER program. For common cancers, incidence and mortality were examined by county within the region and compared to data for similar populations in the US

  15. Role of the National Cancer Institute in the National Cancer Program on environmental carcinogens

    Energy Technology Data Exchange (ETDEWEB)

    Flamm, W.G.

    1977-01-01

    The following topics are discussed: the need for the National Cancer Institute to coordinate all cancer-related activities at the federal level and the desirability of programming so as to exploit the best opportunities for alleviating the mortality, morbidity, and incidence of cancer in the United States; need for assessing opportunities for prevention of environmental carcinogenesis; creation of the Smoking and Health Program in the NCI; development of cancer atlases from a nationwide survey; and role of the NCI with respect to waterborne carcinogens. (HLW)

  16. Economic evaluation of the breast cancer screening programme in the Basque Country: retrospective cost-effectiveness and budget impact analysis.

    Science.gov (United States)

    Arrospide, Arantzazu; Rue, Montserrat; van Ravesteyn, Nicolien T; Comas, Merce; Soto-Gordoa, Myriam; Sarriugarte, Garbiñe; Mar, Javier

    2016-06-01

    Breast cancer screening in the Basque Country has shown 20 % reduction of the number of BC deaths and an acceptable overdiagnosis level (4 % of screen detected BC). The aim of this study was to evaluate the breast cancer early detection programme in the Basque Country in terms of retrospective cost-effectiveness and budget impact from 1996 to 2011. A discrete event simulation model was built to reproduce the natural history of breast cancer (BC). We estimated for lifetime follow-up the total cost of BC (screening, diagnosis and treatment), as well as quality-adjusted life years (QALY), for women invited to participate in the evaluated programme during the 15-year period in the actual screening scenario and in a hypothetical unscreened scenario. An incremental cost-effectiveness ratio was calculated with the use of aggregated costs. Besides, annual costs were considered for budget impact analysis. Both population level and single-cohort analysis were performed. A probabilistic sensitivity analysis was applied to assess the impact of parameters uncertainty. The actual screening programme involved a cost of 1,127 million euros and provided 6.7 million QALYs over the lifetime of the target population, resulting in a gain of 8,666 QALYs for an additional cost of 36.4 million euros, compared with the unscreened scenario. Thus, the incremental cost-effectiveness ratio was 4,214€/QALY. All the model runs in the probabilistic sensitivity analysis resulted in an incremental cost-effectiveness ratio lower than 10,000€/QALY. The screening programme involved an increase of the annual budget of the Basque Health Service by 5.2 million euros from year 2000 onwards. The BC screening programme in the Basque Country proved to be cost-effective during the evaluated period and determined an affordable budget impact. These results confirm the epidemiological benefits related to the centralised screening system and support the continuation of the programme.

  17. Budget impact model for oncopharmacogenetics from the perspective of mandatory basic health insurance in Switzerland using the example of breast cancer

    Directory of Open Access Journals (Sweden)

    Szucs TD

    2018-04-01

    Full Text Available Thomas D Szucs,1 Kevin P Szillat,2 Eva Blozik3 1University of Basel, Institute of Pharmaceutical Medicine (ECPM, Basel, Switzerland; 2Department of Biology, Institute of Molecular Health Sciences, ETH Zurich, Zürich, Switzerland; 3Department of Health Sciences, Helsana Group, Zürich, Switzerland Abstract: Single-nucleotide polymorphisms (SNPs can severely impact individual drug response and health outcomes in cancer patients. Genetic tests to screen for marker SNPs are available to adjust the drug dose of oncologicals to the patient’s needs. However, it is unclear whether the positive effects outbalance the increased costs or even lead to an overall cost reduction. This very pragmatic analysis used three frequently used oncologicals for the treatment of breast cancer to evaluate whether preemptive pharmacogenetic testing may have a cost-reducing impact on health care spending in the Swiss health care system. Our results indicate that oncopharmacogenetics might help to reduce health care costs (ie, by avoiding adverse drug effects and to increase efficiency of drugs in oncologic patients. Keywords: pharmacogenetics, oncology, budget impact model, Switzerland, health insurance

  18. 75 FR 3243 - National Cancer Institute; Notice of Meeting

    Science.gov (United States)

    2010-01-20

    ...); and Budget Presentations; Reports of Special Initiatives; RFA and RFP Concept Reviews; and Scientific... campus. All visitor vehicles, including taxicabs, hotel, and airport shuttles will be inspected before...

  19. Dana-Farber Cancer Institute: Identification of Therapeutic Targets in KRAS Driven Lung Cancer | Office of Cancer Genomics

    Science.gov (United States)

    The CTD2 Center at Dana Farber Cancer Institute focuses on the use of high-throughput genetic and bioinformatic approaches to identify and credential oncogenes and co-dependencies in cancers. This Center aims to provide the cancer research community with information that will facilitate the prioritization of targets based on both genomic and functional evidence, inform the most appropriate genetic context for downstream mechanistic and validation studies, and enable the translation of this information into therapeutics and diagnostics.

  20. Targeted erlotinib for first-line treatment of advanced non-small cell lung cancer: a budget impact analysis.

    Science.gov (United States)

    Bajaj, Preeti S; Veenstra, David L; Goertz, Hans-Peter; Carlson, Josh J

    2014-08-01

    A recent phase III trial showed that patients with advanced non-small cell lung cancer (NSCLC) whose tumors harbor specific EGFR mutations significantly benefit from first-line treatment with erlotinib compared to chemotherapy. This study sought to estimate the budget impact if coverage for EGFR testing and erlotinib as first-line therapy were provided in a hypothetical 500,000-member managed care plan. The budget impact model was developed from a US health plan perspective to evaluate administration of the EGFR test and treatment with erlotinib for EGFR-positive patients, compared to non-targeted treatment with chemotherapy. The eligible patient population was estimated from age-stratified SEER incidence data. Clinical data were derived from key randomized controlled trials. Costs related to drug, administration, and adverse events were included. Sensitivity analyses were conducted to assess uncertainty. In a plan of 500,000 members, it was estimated there would be 91 newly diagnosed advanced NSCLC patients annually; 11 are expected to be EGFR-positive. Based on the testing and treatment assumptions, it was estimated that 3 patients in Scenario 1 and 6 patients in Scenario 2 receive erlotinib. Overall health plan expenditures would increase by $0.013 per member per month (PMPM). This increase is largely attributable to erlotinib drug costs, in part due to lengthened progression-free survival and treatment periods experienced in erlotinib-treated patients. EGFR testing contributes slightly, whereas adverse event costs mitigate the budget impact. The budget impact did not exceed $0.019 PMPM in sensitivity analyses. Coverage for targeted first-line erlotinib therapy in NSCLC likely results in a small budget impact for US health plans. The estimated impact may vary by plan, or if second-line or maintenance therapy, dose changes/interruptions, or impact on patients' quality-of-life were included.

  1. Demographic pattern of male breast cancer: an institutional based study

    International Nuclear Information System (INIS)

    Tanseem, S.; Khan, M.M.; Khan, M.M.K.

    2011-01-01

    Background: Male breast cancer incidence rises with age with peak in the sixth and seventh decade. It is one of the rare diseases and accounts for less than 1% of all malignancies worldwide. It is usually diagnosed in the late stage with poor prognosis. Objective: The purpose of this study was to know the demographic pattern and tumour characteristic of breast cancer in men reported at Institute of Radiotherapy and Nuclear Medicine (IRNUM), Peshawar. Methods: Retrospective data was collected from the (IRNUM), Peshawar for a period of three years (2006-2008). The evaluation was done from the histopathological reports of mastectomy and biopsy specimens. All male patients in the age group 26 -86 year with breast cancer were included in the study. The age of the patients and tumour characteristics recorded were size, grade, type, skin involvement and stage. Results: Total number of male patients with breast cancer were 31 (2.1%) out of the total patients with breast malignancy during the study period with the mean age of 58.3 years. Tumour size ranged from 2 to 12 Cm. with average of 3.6 Cm. Invasive ductal carcinoma was found in 87% , papillary carcinoma in 6.5%, each of malignant fibrous histocytoma and sarcoma in 3.2% cases. Maximum number of patients was of grade II (41%). Patients in whom stage of the disease was know n were 22 cases with 45.5% had stage III disease and 32% had stage IV disease. Skin involvement was found positive in 8 (25.8%). Conclusion: Due to poor health care system breast cancer is diagnosed in a late stage of the disease and prognosis is poor. (author)

  2. Budget Options

    National Research Council Canada - National Science Library

    2000-01-01

    This volume-part of the Congressional Budget Office's (CBO's) annual report to the House and Senate Committees on the Budget-is intended to help inform policymakers about options for the federal budget...

  3. Population-based geographic access to parent and satellite National Cancer Institute Cancer Center Facilities.

    Science.gov (United States)

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

    2017-09-01

    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

  4. 75 FR 63494 - National Cancer Institute; Notice of Meeting

    Science.gov (United States)

    2010-10-15

    ... Group(s); and Budget Presentations; Reports of Special Initiatives; RFA and RFP Concept Reviews; and... taxicabs, hotel, and airport shuttles will be inspected before being allowed on campus. Visitors will be...

  5. 76 FR 7575 - National Cancer Institute; Notice of Meeting

    Science.gov (United States)

    2011-02-10

    ... Budget Presentations; Reports of Special Initiatives; RFA and RFP Concept Reviews; and Scientific..., hotel, and airport shuttles will be inspected before being allowed on campus. Visitors will be asked to...

  6. 78 FR 5192 - National Cancer Institute; Notice of Meeting

    Science.gov (United States)

    2013-01-24

    ... Review Group(s); and Budget Presentations; Reports of Special Initiatives; RFA and RFP Concept Reviews... entrance onto the NIH campus. All visitor vehicles, including taxicabs, hotel, and airport shuttles will be...

  7. 76 FR 62422 - National Cancer Institute; Notice of Meetings

    Science.gov (United States)

    2011-10-07

    ... Groups; and Budget Presentations; Reports of Special Initiatives; RFA and RFP Concept Reviews; and... taxicabs, hotel, and airport shuttles will be inspected before being allowed on campus. Visitors will be...

  8. 75 FR 26761 - National Cancer Institute; Notice of Meeting

    Science.gov (United States)

    2010-05-12

    ... Group(s); and Budget Presentations; Reports of Special Initiatives; RFA and RFP Concept Reviews; and... campus. All visitor vehicles, including taxicabs, hotel, and airport shuttles will be inspected before...

  9. 78 FR 60887 - National Cancer Institute; Notice of Meeting

    Science.gov (United States)

    2013-10-02

    ...); and Budget Presentations, Reports of Special Initiatives; RFA and RFP Concept Reviews; and Scientific..., including taxicabs, hotel, and airport shuttles will be inspected before being allowed on campus. Visitors...

  10. Budget Impact Analysis of Against Colorectal Cancer In Our Neighborhoods (ACCION): A Successful Community-Based Colorectal Cancer Screening Program for a Medically Underserved Minority Population.

    Science.gov (United States)

    Kim, Bumyang; Lairson, David R; Chung, Tong Han; Kim, Junghyun; Shokar, Navkiran K

    2017-06-01

    Given the uncertain cost of delivering community-based cancer screening programs, we developed a Markov simulation model to project the budget impact of implementing a comprehensive colorectal cancer (CRC) prevention program compared with the status quo. The study modeled the impacts on the costs of clinical services, materials, and staff expenditures for recruitment, education, fecal immunochemical testing (FIT), colonoscopy, follow-up, navigation, and initial treatment. We used data from the Against Colorectal Cancer In Our Neighborhoods comprehensive CRC prevention program implemented in El Paso, Texas, since 2012. We projected the 3-year financial consequences of the presence and absence of the CRC prevention program for a hypothetical population cohort of 10,000 Hispanic medically underserved individuals. The intervention cohort experienced a 23.4% higher test completion rate for CRC prevention, 8 additional CRC diagnoses, and 84 adenomas. The incremental 3-year cost was $1.74 million compared with the status quo. The program cost per person was $261 compared with $86 for the status quo. The costs were sensitive to the proportion of high-risk participants and the frequency of colonoscopy screening and diagnostic procedures. The budget impact mainly derived from colonoscopy-related costs incurred for the high-risk group. The effectiveness of FIT to detect CRC was critically dependent on follow-up after positive FIT. Community cancer prevention programs need reliable estimates of the cost of CRC screening promotion and the added budget impact of screening with colonoscopy. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  11. 78 FR 57400 - National Cancer Institute; Notice of Meeting

    Science.gov (United States)

    2013-09-18

    ... Organizational Engagement; and Proposed Organizational Change: Division of Extramural Activities. Place: National....396, Cancer Biology Research; 93.397, Cancer Centers Support; 93.398, Cancer Research Manpower; 93.399...

  12. 77 FR 70170 - National Cancer Institute; Notice of Closed Meeting

    Science.gov (United States)

    2012-11-23

    ... with the proposed research projects, the disclosure of which would constitute a clearly unwarranted..., Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer Centers Support; 93.398...

  13. 78 FR 41072 - National Cancer Institute; Notice of Closed Meeting

    Science.gov (United States)

    2013-07-09

    ... with the proposed research projects, the disclosure of which would constitute a clearly unwarranted..., Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397, Cancer Centers Support; 93.398...

  14. The national cancer institute (NCI) and cancer biology in a 'post genome world'

    International Nuclear Information System (INIS)

    Klausner, Richard D.

    1996-01-01

    The National Cancer Institute (NCI) exists to reduce the burden of all cancers through research and discovery. Extensive restructuring of the NCI over the past year has been aimed at assuring that the institution functions in all ways to promote opportunities for discovery in the laboratory, in the clinic, and in the community. To do this well requires the difficult and almost paradoxical problem of planning for scientific discovery which, in turn is based on the freedom to pursue the unanticipated. The intellectual and structural landscape of science is changing and it places new challenges, new demands and new opportunities for facilitating discovery. The nature of cancer as a disease of genomic instability and of accumulated genetic change, coupled with a possibility of the development of new technologies for reading, utilizing, interpreting and manipulating the genome of single cells, provides unprecedented opportunities for a new type of high through-put biology that will change the nature of discovery, cancer detection, diagnosis, prognosis, therapeutic decision-making and therapeutic discovery. To capture these new opportunities will require attention to be paid to integrate the development of technology and new scientific discoveries with the ability to apply advances rapidly and efficiently through clinical trials

  15. Disparities in Geographic Accessibility of National Cancer Institute Cancer Centers in the United States.

    Science.gov (United States)

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

    2017-11-11

    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.

  16. Cost-effectiveness and budget impact analysis of a population-based screening program for colorectal cancer.

    Science.gov (United States)

    Pil, L; Fobelets, M; Putman, K; Trybou, J; Annemans, L

    2016-07-01

    Colorectal cancer (CRC) is one of the leading causes of cancer mortality in Belgium. In Flanders (Belgium), a population-based screening program with a biennial immunochemical faecal occult blood test (iFOBT) in women and men aged 56-74 has been organised since 2013. This study assessed the cost-effectiveness and budget impact of the colorectal population-based screening program in Flanders (Belgium). A health economic model was conducted, consisting of a decision tree simulating the screening process and a Markov model, with a time horizon of 20years, simulating natural progression. Predicted mortality and incidence, total costs, and quality-adjusted life-years (QALYs) with and without the screening program were calculated in order to determine the incremental cost-effectiveness ratio of CRC screening. Deterministic and probabilistic sensitivity analyses were conducted, taking into account uncertainty of the model parameters. Mortality and incidence were predicted to decrease over 20years. The colorectal screening program in Flanders is found to be cost-effective with an ICER of 1681/QALY (95% CI -1317 to 6601) in males and €4,484/QALY (95% CI -3254 to 18,163). The probability of being cost-effective given a threshold of €35,000/QALY was 100% and 97.3%, respectively. The budget impact analysis showed the extra cost for the health care payer to be limited. This health economic analysis has shown that despite the possible adverse effects of screening and the extra costs for the health care payer and the patient, the population-based screening program for CRC in Flanders is cost-effective and should therefore be maintained. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  17. Leveraging National Cancer Institute Programmatic Collaboration for Uterine Cervix Cancer Patient Accrual in Puerto Rico

    Directory of Open Access Journals (Sweden)

    Charles A. Kunos

    2018-04-01

    Full Text Available Women in the U.S. Commonwealth of Puerto Rico (PR have a higher age-adjusted incidence rate for uterine cervix cancer than the U.S. mainland as well as substantial access and economic barriers to cancer care. The National Cancer Institute (NCI funds a Minority/Underserved NCI Community Oncology Research Program in PR (PRNCORP as part of a national network of community-based health-care systems to conduct multisite cancer clinical trials in diverse populations. Participation by the PRNCORP in NCI’s uterine cervix cancer clinical trials, however, has remained limited. This study reports on the findings of an NCI site visit in PR to assess barriers impeding site activation and accrual to its sponsored gynecologic cancer clinical trials. Qualitative, semi-structured individual, and group interviews were conducted at six PRNCORP-affiliated locations to ascertain: long-term trial accrual objectives; key stakeholders in PR that address uterine cervix cancer care; key challenges or barriers to activating and to enrolling patients in NCI uterine cervix cancer treatment trials; and resources, policies, or procedures in place or needed on the island to support NCI-sponsored clinical trials. An NCI-sponsored uterine cervix cancer radiation–chemotherapy intervention clinical trial (NCT02466971, already activated on the island, served as a test case to identify relevant patient accrual and site barriers. The site visit identified five key barriers to accrual: (1 lack of central personnel to coordinate referrals for treatment plans, medical tests, and medical imaging across the island’s clinical trial access points; (2 patient insurance coverage; (3 lack of a coordinated brachytherapy schedule at San Juan-centric service providers; (4 limited credentialed radiotherapy machines island-wide; and (5 too few radiology medical physicists tasked to credential trial-specified positron emission tomography scanners island-wide. PR offers a unique opportunity to

  18. Return-to-work intervention for cancer survivors: budget impact and allocation of costs and returns in the Netherlands and six major EU-countries

    NARCIS (Netherlands)

    Mewes, Janne C.; Steuten, Lotte Maria Gertruda; Groeneveld, Iris F.; Boer, Angela G.E.M.; Frings-Dresen, Monique H.W.; IJzerman, Maarten Joost; van Harten, Willem H.

    2015-01-01

    Background Return-to-work (RTW)-interventions support cancer survivors in resuming work, but come at additional healthcare costs. The objective of this study was to assess the budget impact of a RTW-intervention, consisting of counselling sessions with an occupational physician and an

  19. 76 FR 42719 - National Cancer Institute; Notice of Closed Meeting

    Science.gov (United States)

    2011-07-19

    ... with the proposed research projects, the disclosure of which would constitute a clearly unwarranted... and Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397...

  20. 76 FR 10381 - National Cancer Institute; Notice of Closed Meeting

    Science.gov (United States)

    2011-02-24

    ... with the proposed research projects, the disclosure of which would constitute a clearly unwarranted... and Diagnosis Research; 93.395, Cancer Treatment Research; 93.396, Cancer Biology Research; 93.397...

  1. Prevalence of bone marrow necrosis in Egyptian cancer patients referring to the National Cancer Institute

    International Nuclear Information System (INIS)

    Elgamal, B.M.; Rashed, R.A.; Raslan, H.N.

    2011-01-01

    Bone marrow necrosis; Egyptian cancer patients Abstract Background: Bone marrow necrosis is a relatively rare entity which has been associated with a poor prognosis. It is most commonly found in patients with neoplastic disorders and severe infections. Methods: study comprised examination of 5043 bone marrow biopsy specimens performed at the National Cancer Institute, Cairo University, over 7 years period (March 2004-March 2011). It included 5 years retrospective (2867 archived samples) and 2 years prospective (2176 samples). Results: Bone marrow necrosis was diagnosed in fifteen out of 5043 examined specimens with a percentage of 0.3% and ranged from mild to massive according to semiquantitative estimation. Prognosis of all patients was poor with survival not exceeding 6 months from the date of marrow necrosis diagnosis. Conclusion: In Egyptian patients, bone marrow necrosis in association with malignancy is a rare disorder which is accompanied by a poor outcome

  2. Late Budgets

    DEFF Research Database (Denmark)

    Andersen, Asger Lau; Lassen, David Dreyer; Nielsen, Lasse Holbøll Westh

    are negative rather than positive; and when there is divided government. We test the hypotheses of the model using a unique data set of late budgets for US state governments, based on dates of budget approval collected from news reports and a survey of state budget o¢ cers for the period 1988...

  3. Budget impact analysis of everolimus for the treatment of hormone receptor positive, human epidermal growth factor receptor-2 negative (HER2-) advanced breast cancer in the United States.

    Science.gov (United States)

    Xie, Jipan; Diener, Melissa; De, Gourab; Yang, Hongbo; Wu, Eric Q; Namjoshi, Madhav

    2013-01-01

    To estimate the budget impact of everolimus as the first and second treatment option after letrozole or anastrozole (L/A) failure for post-menopausal women with hormone receptor positive (HR+), human epidermal growth factor receptor-2 negative (HER2-) advanced breast cancer (ABC). Pharmacy and medical budget impacts (2011 USD) were estimated over the first year of everolimus use in HR+, HER2- ABC from a US payer perspective. Epidemiology data were used to estimate target population size. Pre-everolimus entry treatment options included exemestane, fulvestrant, and tamoxifen. Pre- and post-everolimus entry market shares were estimated based on market research and assumptions. Drug costs were based on wholesale acquisition cost. Patients were assumed to be on treatment until progression or death. Annual medical costs were calculated as the average of pre- and post-progression medical costs weighted by the time in each period, adjusted for survival. One-way and two-way sensitivity analyses were conducted to assess the model robustness. In a hypothetical 1,000,000 member plan, 72 and 159 patients were expected to be candidates for everolimus treatment as first and second treatment option, respectively, after L/A failure. The total budget impact for the first year post-everolimus entry was $0.044 per member per month [PMPM] (pharmacy budget: $0.058 PMPM; medical budget: -$0.014 PMPM), assuming 10% of the target population would receive everolimus. The total budget impacts for the first and second treatment options after L/A failure were $0.014 PMPM (pharmacy budget: $0.018; medical budget: -$0.004) and $0.030 PMPM (pharmacy budget: $0.040; medical budget: -$0.010), respectively. Results remained robust in sensitivity analyses. Assumptions about some model input parameters were necessary and may impact results. Increased pharmacy costs for HR+, HER2- ABC following everolimus entry are expected to be partially offset by reduced medical service costs. Pharmacy and total

  4. 75 FR 79010 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2010-12-17

    ... Leukemia, and Myeloma. Date: February 2-3, 2011. Time: 8 a.m. to 5 p.m. Agenda: To review and evaluate...; 93.393, Cancer Cause and Prevention Research; 93.394, Cancer Detection and Diagnosis Research; 93.395...

  5. 77 FR 36564 - National Cancer Institute; Notice of Meeting

    Science.gov (United States)

    2012-06-19

    ... Prevention Method: State of the, Science and Evidence. Place: Hilton San Francisco Financial District, 750... applicable, the business or professional affiliation of the interested person. Information is also available... Research; 93.394, Cancer Detection and Diagnosis Research; 93.395, Cancer Treatment Research; 93.396...

  6. 77 FR 64526 - National Cancer Institute; Notice of Meetings

    Science.gov (United States)

    2012-10-22

    ... personnel qualifications and performance, and the competence of individual investigators, the disclosure of... Cancer Advisory Board, Ad hoc Subcommittee on Communications. Open: November 28, 2012, 6:30 p.m. to 8:00 p.m. Agenda: Discussion on Cancer Information and Communications. Place: Hyatt Regency Bethesda, One...

  7. Budget impact analysis of gene expression tests to aid therapy decisions for breast cancer patients in Germany.

    Science.gov (United States)

    Lux, M P; Nabieva, N; Hildebrandt, T; Rebscher, H; Kümmel, S; Blohmer, J-U; Schrauder, M G

    2018-02-01

    Many women with early-stage, hormone receptor-positive breast cancer may not benefit from adjuvant chemotherapy. Gene expression tests can reduce chemotherapy over- and undertreatment by providing prognostic information on the likelihood of recurrence and, with Oncotype DX, predictive information on chemotherapy benefit. These tests are currently not reimbursed by German healthcare payers. An analysis was conducted to evaluate the budget impact of gene expression tests in Germany. Costs of gene expression tests and medical and non-medical costs associated with treatment were assessed from healthcare payer and societal perspectives. Costs were estimated from data collected at a university hospital and were combined with decision impact data for Oncotype DX, MammaPrint, Prosigna and EndoPredict (EPclin). Changes in chemotherapy use and budget impact were evaluated over 1 year for 20,000 women. Chemotherapy was associated with substantial annual costs of EUR 19,003 and EUR 84,412 per therapy from the healthcare payer and societal perspective, respectively. Compared with standard care, only Oncotype DX was associated with cost savings to healthcare payers and society (EUR 5.9 million and EUR 253 million, respectively). Scenario analysis showed that both women at high clinical but low genomic risk and low clinical but high genomic risk were important contributors to costs. Oncotype DX was the only gene expression test that was estimated to reduce costs versus standard care in Germany. The reimbursement of Oncotype DX testing in standard clinical practice in Germany should be considered. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. The Premenopausal Breast Cancer Collaboration: A pooling project of studies participating in the National Cancer Institute Cohort Consortium

    Science.gov (United States)

    Nichols, Hazel B.; Schoemaker, Minouk J.; Wright, Lauren B.; McGowan, Craig; Brook, Mark N.; McClain, Kathleen M.; Jones, Michael E.; Adami, Hans-Olov; Agnoli, Claudia; Baglietto, Laura; Bernstein, Leslie; Bertrand, Kimberly A.; Blot, William J.; Boutron-Ruault, Marie-Christine; Butler, Lesley; Chen, Yu; Doody, Michele M.; Dossus, Laure; Eliassen, A. Heather; Giles, Graham G.; Gram, Inger T.; Hankinson, Susan E.; Hoffman-Bolton, Judy; Kaaks, Rudolf; Key, Timothy J.; Kirsh, Victoria A.; Kitahara, Cari M.; Koh, Woon-Puay; Larsson, Susanna C.; Lund, Eiliv; Ma, Huiyan; Merritt, Melissa A.; Milne, Roger L.; Navarro, Carmen; Overvad, Kim; Ozasa, Kotaro; Palmer, Julie R.; Peeters, Petra H.; Riboli, Elio; Rohan, Thomas E.; Sadakane, Atsuko; Sund, Malin; Tamimi, Rulla M.; Trichopoulou, Antonia; Vatten, Lars; Visvanathan, Kala; Weiderpass, Elisabete; Willett, Walter C.; Wolk, Alicja; Zeleniuch-Jacquotte, Anne; Zheng, Wei; Sandler, Dale P.; Swerdlow, Anthony J.

    2017-01-01

    Breast cancer is a leading cancer diagnosis among premenopausal women around the world. Unlike rates in postmenopausal women, incidence rates of advanced breast cancer have increased in recent decades for premenopausal women. Progress in identifying contributors to breast cancer risk among premenopausal women has been constrained by the limited numbers of premenopausal breast cancer cases in individual studies and resulting low statistical power to subcategorize exposures or to study specific subtypes. The Premenopausal Breast Cancer Collaborative Group was established to facilitate cohort-based analyses of risk factors for premenopausal breast cancer by pooling individual-level data from studies participating in the United States National Cancer Institute Cohort Consortium. This paper describes the Group, including the rationale for its initial aims related to pregnancy, obesity, and physical activity. We also describe the 20 cohort studies with data submitted to the Group by June 2016. The infrastructure developed for this work can be leveraged to support additional investigations. PMID:28600297

  9. American Cancer Society: the world's wealthiest "nonprofit" institution.

    Science.gov (United States)

    Epstein, S S

    1999-01-01

    The American Cancer Society is fixated on damage control--diagnosis and treatment--and basic molecular biology, with indifference or even hostility to cancer prevention. This myopic mindset is compounded by interlocking conflicts of interest with the cancer drug, mammography, and other industries. The "nonprofit" status of the Society is in sharp conflict with its high overhead and expenses, excessive reserves of assets and contributions to political parties. All attempts to reform the Society over the past two decades have failed; a national economic boycott of the Society is long overdue.

  10. THE BUDGETING PROCESS IN ROMANIA

    Directory of Open Access Journals (Sweden)

    TURCIN MARIUS CATALIN

    2015-08-01

    Full Text Available This paper presents the stages of the budgeting process in Romania and the institutions involved in its carry out, having regard to the recent legislative amendments in the field. The study describes the importance of some state institutions in achieving the economic and social policy objectives. According to practice, the institution specializing in drafting the budget bill is the Government, who submits the budget bill annually to the Parliament for adopting the national budget, accompanied by the explanatory statement, annexes and interpretative calculations. The preparatory works are fulfilled by the Ministry of Public Finance and in parallel, by the ministries, authorities, local administrations or other public institutions to prepare their own drafts budget.

  11. Cost-effectiveness and budget impact analyses of a colorectal cancer screening programme in a high adenoma prevalence scenario using MISCAN-Colon microsimulation model.

    Science.gov (United States)

    Arrospide, Arantzazu; Idigoras, Isabel; Mar, Javier; de Koning, Harry; van der Meulen, Miriam; Soto-Gordoa, Myriam; Martinez-Llorente, Jose Miguel; Portillo, Isabel; Arana-Arri, Eunate; Ibarrondo, Oliver; Lansdorp-Vogelaar, Iris

    2018-04-25

    The Basque Colorectal Cancer Screening Programme began in 2009 and the implementation has been complete since 2013. Faecal immunological testing was used for screening in individuals between 50 and 69 years old. Colorectal Cancer in Basque country is characterized by unusual epidemiological features given that Colorectal Cancer incidence is similar to other European countries while adenoma prevalence is higher. The object of our study was to economically evaluate the programme via cost-effectiveness and budget impact analyses with microsimulation models. We applied the Microsimulation Screening Analysis (MISCAN)-Colon model to predict trends in Colorectal Cancer incidence and mortality and to quantify the short- and long-term effects and costs of the Basque Colorectal Cancer Screening Programme. The model was calibrated to the Basque demographics in 2008 and age-specific Colorectal Cancer incidence data in the Basque Cancer Registry from 2005 to 2008 before the screening begun. The model was also calibrated to the high adenoma prevalence observed for the Basque population in a previously published study. The multi-cohort approach used in the model included all the cohorts in the programme during 30 years of implementation, with lifetime follow-up. Unit costs were obtained from the Basque Health Service and both cost-effectiveness analysis and budget impact analysis were carried out. The goodness-of-fit of the model adaptation to observed programme data was evidence of validation. In the cost-effectiveness analysis, the savings from treatment were larger than the added costs due to screening. Thus, the Basque programme was dominant compared to no screening, as life expectancy increased by 29.3 days per person. The savings in the budget analysis appeared 10 years after the complete implementation of the programme. The average annual budget was €73.4 million from year 2023 onwards. This economic evaluation showed a screening intervention with a major health gain

  12. Cancer in human immunodeficiency virus-infected children : A case series from the Children's Cancer Group and the National Cancer Institute

    NARCIS (Netherlands)

    Granovsky, MO; Mueller, BU; Nicholson, HS; Rosenberg, PS; Rabkin, CS

    Purpose: To describe the spectrum of malignancies in human immunodeficiency virus (HIV)-infected children and the clinical outcome of patients with these tumors. Methods: We retrospectively surveyed the Children's Cancer Group (CCG) and the National Cancer institute (NCI) for cases of cancer that

  13. School Programs To Prevent Smoking: The National Cancer Institute Guide to Strategies That Succeed.

    Science.gov (United States)

    Glynn, Thomas J.

    This guide to school-based smoking prevention programs for educators is the product of five years of work to prevent cancer. The National Cancer Institute (NCI) is currently funding 23 coordinated intervention trials directed at youth. Although not all the studies are complete, sufficient results are available to recommend the most effective…

  14. 78 FR 2678 - Proposed Collection; Comment Request (60-Day FRN): The National Cancer Institute (NCI...

    Science.gov (United States)

    2013-01-14

    ... Request (60-Day FRN): The National Cancer Institute (NCI) SmokefreeTXT (Text Message) Program Evaluation..., Behavioral Scientist/ Health Science Administrator, Division of Cancer Control and Population Sciences, 6130... text message smoking cessation intervention designed for young adult smokers ages 18-29. The Smokefree...

  15. The National Cancer Institute's Physical Sciences - Oncology Network

    Science.gov (United States)

    Espey, Michael Graham

    In 2009, the NCI launched the Physical Sciences - Oncology Centers (PS-OC) initiative with 12 Centers (U54) funded through 2014. The current phase of the Program includes U54 funded Centers with the added feature of soliciting new Physical Science - Oncology Projects (PS-OP) U01 grant applications through 2017; see NCI PAR-15-021. The PS-OPs, individually and along with other PS-OPs and the Physical Sciences-Oncology Centers (PS-OCs), comprise the Physical Sciences-Oncology Network (PS-ON). The foundation of the Physical Sciences-Oncology initiative is a high-risk, high-reward program that promotes a `physical sciences perspective' of cancer and fosters the convergence of physical science and cancer research by forming transdisciplinary teams of physical scientists (e.g., physicists, mathematicians, chemists, engineers, computer scientists) and cancer researchers (e.g., cancer biologists, oncologists, pathologists) who work closely together to advance our understanding of cancer. The collaborative PS-ON structure catalyzes transformative science through increased exchange of people, ideas, and approaches. PS-ON resources are leveraged to fund Trans-Network pilot projects to enable synergy and cross-testing of experimental and/or theoretical concepts. This session will include a brief PS-ON overview followed by a strategic discussion with the APS community to exchange perspectives on the progression of trans-disciplinary physical sciences in cancer research.

  16. 77 FR 31627 - National Cancer Institute; Notice of Closed Meeting

    Science.gov (United States)

    2012-05-29

    ... 20892, (301) 496-7628, [email protected] . In the interest of security, NIH has instituted stringent procedures for entrance onto the NIH campus. All visitor vehicles, including taxicabs, hotel, and airport...

  17. 77 FR 31628 - National Cancer Institute; Notice of Closed Meeting

    Science.gov (United States)

    2012-05-29

    ... interest of security, NIH has instituted stringent procedures for entrance onto the NIH campus. All visitor vehicles, including taxicabs, hotel, and airport shuttles will be inspected before being allowed on campus...

  18. 78 FR 53463 - National Cancer Institute; Notice of Meeting

    Science.gov (United States)

    2013-08-29

    ... person. In the interest of security, NIH has instituted stringent procedures for entrance onto the NIH campus. All visitor vehicles, including taxicabs, hotel, and airport shuttles will be inspected before...

  19. 78 FR 313 - National Cancer Institute; Notice of Meeting

    Science.gov (United States)

    2013-01-03

    ... affiliation of the interested person. In the interest of security, NIH has instituted stringent procedures for entrance onto the NIH campus. All visitor vehicles, including taxicabs, hotel, and airport shuttles will be...

  20. 77 FR 64817 - National Cancer Institute; Notice of Meeting

    Science.gov (United States)

    2012-10-23

    ... affiliation of the interested person. In the interest of security, NIH has instituted stringent procedures for entrance onto the NIH campus. All visitor vehicles, including taxicabs, hotel, and airport shuttles will be...

  1. 77 FR 31030 - National Cancer Institute; Notice of Meeting

    Science.gov (United States)

    2012-05-24

    ... person. In the interest of security, NIH has instituted stringent procedures for entrance onto the NIH campus. All visitor vehicles, including taxicabs, hotel, and airport shuttles will be inspected before...

  2. 78 FR 10622 - National Cancer Institute; Notice of Closed Meeting

    Science.gov (United States)

    2013-02-14

    ..., Bethesda, MD 20892, 301-496-7628, [email protected] . In the interest of security, NIH has instituted stringent procedures for entrance onto the NIH campus. All visitor vehicles, including taxicabs, hotel, and airport...

  3. 77 FR 1703 - National Cancer Institute; Notice of Meeting

    Science.gov (United States)

    2012-01-11

    ... professional affiliation of the interested person. In the interest of security, NIH has instituted stringent procedures for entrance onto the NIH campus. All visitor vehicles, including taxicabs, hotel, and airport...

  4. 76 FR 62079 - National Cancer Institute; Notice of Closed Meeting

    Science.gov (United States)

    2011-10-06

    [email protected] . In the interest of security, NIH has instituted stringent procedures for entrance onto the NIH campus. All visitor vehicles, including taxicabs, hotel, and airport shuttles will be inspected...

  5. 77 FR 58851 - National Cancer Institute; Notice of Meeting

    Science.gov (United States)

    2012-09-24

    ... of the interested person. In the interest of security, NIH has instituted stringent procedures for entrance onto the NIH campus. All visitor vehicles, including taxicabs, hotel, and airport shuttles will be...

  6. 78 FR 66034 - National Cancer Institute; Notice of Meeting

    Science.gov (United States)

    2013-11-04

    ... consideration of personnel qualifications and performance and the competence of individual investigators... Cancer Advisory Board; Ad hoc Subcommittee on Communications. Open: December 9, 2013, 7:45 p.m. to 9:15 p.m. Agenda: Discussion on Communications. Place: Hyatt Regency Bethesda, One Bethesda Metro Center...

  7. 76 FR 69744 - National Cancer Institute; Notice of Closed Meeting

    Science.gov (United States)

    2011-11-09

    ... and Therapeutic Agents Enabled by Nanotechnology. Date: November 29, 2011. Time: 8 a.m. to 7 p.m. Agenda: To review and evaluate grant applications. Place: Bethesda North Marriott Hotel & Conference... Review Officer, Special Review and Logistics Branch, Division of Extramural Activities, National Cancer...

  8. System Budgets

    DEFF Research Database (Denmark)

    Jeppesen, Palle

    1996-01-01

    The lecture note is aimed at introducing system budgets for optical communication systems. It treats optical fiber communication systems (six generations), system design, bandwidth effects, other system impairments and optical amplifiers.......The lecture note is aimed at introducing system budgets for optical communication systems. It treats optical fiber communication systems (six generations), system design, bandwidth effects, other system impairments and optical amplifiers....

  9. 77 FR 24969 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2012-04-26

    ... Emphasis Panel; SBIR Topic 255 Development of Anticancer Agents Meeting I. Date: May 14, 2012. Time: 12 p.m. to 3 p.m. Agenda: To review and evaluate contract proposals. Place: National Institutes of Health... Panel; SBIR Topic 255 Development of Anticancer Agents Meeting II. Date: May 15, 2012. Time: 12 p.m. to...

  10. 78 FR 58322 - National Cancer Institute; Amended Notice of Meeting

    Science.gov (United States)

    2013-09-23

    ... Institute Special Emphasis Panel, November 06, 2013, 06:30 p.m. to November 07, 2013, 04:00 p.m., Hilton... August 16, 2013, 78 FR 50065. The meeting notice is amended to change the location from the Hilton...

  11. 77 FR 28613 - National Cancer Institute; Notice of Closed Meetings

    Science.gov (United States)

    2012-05-15

    ... Nanotechnology. Date: July 11-12, 2012. Time: 8:00 a.m. to 12:00 p.m. Agenda: To review and evaluate grant.... to 3:30 p.m. Agenda: To review and evaluate contract proposals. Place: National Institutes of Health... Call). Contact Person: Adriana Stoica, Ph.D., Scientific Review Officer, Special Review and Logistics...

  12. DCS Budget Tracking System

    Data.gov (United States)

    Social Security Administration — DCS Budget Tracking System database contains budget information for the Information Technology budget and the 'Other Objects' budget. This data allows for monitoring...

  13. Laboratory administration--capital budgeting.

    Science.gov (United States)

    Butros, F

    1997-01-01

    The process of capital budgeting varies among different health-care institutions. Understanding the concept of present value of money, incremental cash flow statements, and the basic budgeting techniques will enable the laboratory manager to make the rational and logical decisions that are needed in today's competitive health-care environment.

  14. Implementing Responsibility Centre Budgeting

    Science.gov (United States)

    Vonasek, Joseph

    2011-01-01

    Recently, institutes of higher education (universities) have shown a renewed interest in organisational structures and operating methodologies that generate productivity and innovation; responsibility centre budgeting (RCB) is one such process. This paper describes the underlying principles constituting RCB, its origin and structural elements, and…

  15. Complementary and Alternative Medicine use: Influence of Patients’ Satisfaction with Medical Treatment among Breast Cancer Patients at Uganda Cancer Institute

    Directory of Open Access Journals (Sweden)

    Frank Kiwanuka

    2018-02-01

    Full Text Available Introduction: Use of Complementary and alternative medicine (CAM is high among cancer patients especially breast cancer patients. This study sought to evaluate Complementary and alternative medicine use in breast cancer patients and how its use is influencedby patient’s satisfaction with conventional medical treatment among breast cancer patients attending Uganda Cancer Institute. Patients and Methods: A cross-sectional study design was used in this study. Participants who were diagnosed histologically with breast cancer at Uganda Cancer Institute took part in the study. A questionnaire was developed and used to interview the participants and medical records of the respondents were also reviewed. Results: A total of 235 participants completed the study. The prevalence of CAM use was 77%. CAM therapies used included herbal medicines, prayer for health, vitamins/minerals, native healers, Chinese medicines, massage, yoga, Ayurvedic medicine, Acupuncture, reflexolog, Support group attendance, meditation, Magnetic and Bio-fieldmanipulation. Satisfaction with medical treatment was significantlyassociated with CAM use. Patients who are not satisfiedwith medical treatment were more likely to use CAM. Conclusion: There is a high number of breast cancer patients using CAM, various categories of therapies are being used and patients’ satisfaction with medical treatment triggers off a patients decision to use CAM therapies.

  16. Retrospective study on risk habits among oral cancer patients in Karnataka Cancer Therapy and Research Institute, Hubli, India.

    Science.gov (United States)

    Aruna, D S; Prasad, K V V; Shavi, Girish R; Ariga, Jitendra; Rajesh, G; Krishna, Madhusudan

    2011-01-01

    Retrospective studies on oral cancer patient profiles related to risk habits could provide etiologic clues for prevention in specific geographic areas. To study risk habit characteristics of oral cancer patients. A cross sectional retrospective case record study of oral cancer patients who reported during 1991-2000 to Karnataka Cancer Therapy and Research Institute, Hubli, India was conducted. Data on socio-demography, histopathology, site of cancer and risk habit profiles of the patients were recorded in a predesigned Performa by one calibrated examiner with internal validity checks. The 1,472 oral cancer patients constituted 11% of total cancer patients. Mean age of the patients was 55 years, ranging from 12-88, with a male: female ratio of 2:1. 1,110 (75%) oral cancer patients had risk habits, 55% were habituated for >10 years and 25% were habit free. 751(51%) patients had individual and 359(24%) had combined risk habits. Majority 59% were chewers of betel quid alone (17%)/betel quid with tobacco (42%); smokers were (31%) and alcohol users were (14%) of patients. Chewers of gutkha, khaini were more in 40 years. Risk habituates were highest (87%) in patients with cancer of buccal mucosa, commonly affected site attributed to chewing habit in (51%) of patients. The prevalence of oral cancer was higher among elderly males predominantly with risk habits of betel quid/tobacco chewing and smoking for more than 10 years.

  17. Budget Options

    National Research Council Canada - National Science Library

    2001-01-01

    ... (including the off-budget Social Security trust funds) to $281 billion. That surplus would be the largest in history in nominal dollars and the largest since 1948 as a percentage of gross domestic product (GDP...

  18. Sunitinib treatment in patients with advanced renal cell cancer: the Brazilian National Cancer Institute (INCA) experience.

    Science.gov (United States)

    Coelho, Rafael Corrêa; Reinert, Tomás; Campos, Franz; Peixoto, Fábio Affonso; de Andrade, Carlos Augusto; Castro, Thalita; Herchenhorn, Daniel

    2016-01-01

    The aim of this study was to assess the impact of sunitinib treatment in a non-screened group of patients with metastatic renal cell cancer (mRCC) treated by the Brazilian Unified Health System (SUS) at a single reference institution. Retrospective cohort study, which evaluated patients with mRCC who received sunitinib between May 2010 and December 2013. Fifty-eight patients were eligible. Most patients were male 41 (71%), with a median age of 58 years. Nephrectomy was performed in 41 (71%) patients with a median interval of 16 months between the surgery and initiation of sunitinib. The most prevalent histological subtype was clear cell carcinoma, present in 52 (91.2%) patients. In 50 patients (86%), sunitinib was the first line of systemic treatment. The main adverse effects were fatigue (57%), hypothyroidism (43%), mucositis (33%) and diarrhea (29%). Grade 3 and 4 adverse effects were infrequent: fatigue (12%), hypertension (12%), thrombocytopenia (7%), neutropenia (5%) and hand-foot syndrome (5%). Forty percent of patients achieved a partial response and 35% stable disease, with a disease control rate of 75%. Median progression free survival was 7.6 months and median overall survival was 14.1 months. Sunitinib treatment was active in the majority of patients, especially those with low and intermediate risk by MSKCC score, with manageable toxicity. Survival rates were inferior in this non-screened population with mRCC treated in the SUS. Copyright© by the International Brazilian Journal of Urology.

  19. Sunitinib treatment in patients with advanced renal cell cancer: the Brazilian National Cancer Institute (INCA experience

    Directory of Open Access Journals (Sweden)

    Rafael Corrêa Coelho

    Full Text Available ABSTRACT Purpose: The aim of this study was to assess the impact of sunitinib treatment in a non-screened group of patients with metastatic renal cell cancer (mRCC treated by the Brazilian Unified Health System (SUS at a single reference institution. Material and Methods: Retrospective cohort study, which evaluated patients with mRCC who received sunitinib between May 2010 and December 2013. Results: Fifty-eight patients were eligible. Most patients were male 41 (71%, with a median age of 58 years. Nephrectomy was performed in 41 (71% patients with a median interval of 16 months between the surgery and initiation of sunitinib. The most prevalent histological subtype was clear cell carcinoma, present in 52 (91.2% patients. In 50 patients (86%, sunitinib was the first line of systemic treatment. The main adverse effects were fatigue (57%, hypothyroidism (43%, mucositis (33% and diarrhea (29%. Grade 3 and 4 adverse effects were infrequent: fatigue (12%, hypertension (12%, thrombocytopenia (7%, neutropenia (5% and hand-foot syndrome (5%. Forty percent of patients achieved a partial response and 35% stable disease, with a disease control rate of 75%. Median progression free survival was 7.6 months and median overall survival was 14.1 months. Conclusion: Sunitinib treatment was active in the majority of patients, especially those with low and intermediate risk by MSKCC score, with manageable toxicity. Survival rates were inferior in this non-screened population with mRCC treated in the SUS.

  20. Budget Impact Analysis of Switching to Digital Mammography in a Population-Based Breast Cancer Screening Program: A Discrete Event Simulation Model

    Science.gov (United States)

    Comas, Mercè; Arrospide, Arantzazu; Mar, Javier; Sala, Maria; Vilaprinyó, Ester; Hernández, Cristina; Cots, Francesc; Martínez, Juan; Castells, Xavier

    2014-01-01

    Objective To assess the budgetary impact of switching from screen-film mammography to full-field digital mammography in a population-based breast cancer screening program. Methods A discrete-event simulation model was built to reproduce the breast cancer screening process (biennial mammographic screening of women aged 50 to 69 years) combined with the natural history of breast cancer. The simulation started with 100,000 women and, during a 20-year simulation horizon, new women were dynamically entered according to the aging of the Spanish population. Data on screening were obtained from Spanish breast cancer screening programs. Data on the natural history of breast cancer were based on US data adapted to our population. A budget impact analysis comparing digital with screen-film screening mammography was performed in a sample of 2,000 simulation runs. A sensitivity analysis was performed for crucial screening-related parameters. Distinct scenarios for recall and detection rates were compared. Results Statistically significant savings were found for overall costs, treatment costs and the costs of additional tests in the long term. The overall cost saving was 1,115,857€ (95%CI from 932,147 to 1,299,567) in the 10th year and 2,866,124€ (95%CI from 2,492,610 to 3,239,638) in the 20th year, representing 4.5% and 8.1% of the overall cost associated with screen-film mammography. The sensitivity analysis showed net savings in the long term. Conclusions Switching to digital mammography in a population-based breast cancer screening program saves long-term budget expense, in addition to providing technical advantages. Our results were consistent across distinct scenarios representing the different results obtained in European breast cancer screening programs. PMID:24832200

  1. Outcome and treatment strategy in female lung cancer: a single institution experience

    International Nuclear Information System (INIS)

    Cicenas, S.; Kurtinaitis, J.; Smailyte, G.

    2010-01-01

    Purpose: To assess the survival rate of female lung cancer treated at the Institute of Oncology of the Vilnius University, Lithuania during the period between 1996-2005. Materials and Methods: During the period between 1996-2005, 471 women diagnosed with lung cancer were treated at the Department of Thoracic Surgery and Oncology of the Institute of Oncology, Vilnius University. Data on morphology, stage and treatment was collected from the medical records. All lung cancer cases by histology were classified in two groups: non-small cell lung cancer (includes squamous cell carcinoma, large cell carcinoma, adenocarcinoma and other less common types) and small cell lung cancer. The vital status of the study group was assessed as of December 31, 2007, by passive follow-up, using data from the population registry. It was found that 411 (87.3%) of the patients had died. Survival was estimated according to the Kaplan-Meier method. Results: The median survival of female lung cancer diagnosed during 1996-2005 in Lithuania show to be 8.7 months (8.4 (95% CI 7.2-10.8) months with non-small cell lung cancer and 9.3 (95% CI 6.3-13.0) months with small-cell lung cancer). Survival was more than 20 months in resectable non-small cell lung cancer (stages I, II, IIIA). Non-small cell lung cancer survival in advanced stages was less than 7 months. Small-cell lung cancer patients median survival at limited and extended stages of the disease were 9.5 (95% CI 2.9-18.4) compared to 9.2 (95% CI 6.2-13.7) months. Non-small cell lung cancer patients most frequently were treated by surgery (27.0%), surgery and chemotherapy or radiotherapy (19.6%). Small cell lung cancer patient treatment included chemo and radiotherapy (27.0%), chemotherapy (19.0%), radiotherapy (17.5%), surgery (27.9%). Conclusions: The single center study of female lung cancer diagnosed during 1996-2005 in Lithuania show a significantly better chance of survival in resectable non-small cell lung cancer. Advanced stages of

  2. BEYOND BUDGETING

    Directory of Open Access Journals (Sweden)

    Edo Cvrkalj

    2015-12-01

    Full Text Available Traditional budgeting principles, with strictly defined business goals, have been, since 1998, slowly growing into more sophisticated and organization-adjusted alternative budgeting concepts. One of those alternative concepts is the “Beyond budgeting” model with an implemented performance effects measuring process. In order for the model to be practicable, budget planning and control has to be reoriented to the “bottom up” planning and control approach. In today’s modern business surroundings one has to take both present and future opportunities and threats into consideration, by valorizing them in a budget which would allow a company to realize a whole pallet of advantages over the traditional budgeting principles which are presented later in the article. It is essential to emphasize the importance of successfully implementing the new budgeting principles within an organization. If the implementation has been lacking and done without a higher goal in mind, it is easily possible that the process has been implemented without coordination, planning and control framework within the organization itself. Further in the article we present an overview of managerial techniques and instruments within the “Beyond budgeting” model such as balanced scorecard, rolling forecast, dashboard, KPI and other supporting instruments. Lastly we define seven steps for implementing the “Beyond budgeting” model and offer a comparison of “Beyond budgeting” model against traditional budgeting principles which lists twelve reasons why “Beyond budgeting” is better suited to modern and market-oriented organizations. Each company faces those challenges in their own characteristic way but implementing new dynamic planning models will soon become essential for surviving in the market.

  3. Investments in cancer research awarded to UK institutions and the global burden of cancer 2000–2013: a systematic analysis

    Science.gov (United States)

    Maruthappu, Mahiben; Head, Michael G; Zhou, Charlie D; Gilbert, Barnabas J; El-Harasis, Majd A; Raine, Rosalind; Fitchett, Joseph R; Atun, Rifat

    2017-01-01

    Objectives To systematically categorise cancer research investment awarded to United Kingdom (UK) institutions in the period 2000–2013 and to estimate research investment relative to disease burden as measured by mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs). Design Systematic analysis of all open-access data. Setting and participants Public and philanthropic funding to all UK cancer research institutions, 2000–2013. Main outcome measures Number and financial value of cancer research investments reported in 2013 UK pounds (UK£). Mortality, DALYs and YLDs data were acquired from the Global Burden of Disease Study. A compound metric was adapted to estimate research investment relative to disease burden as measured by mortality, DALYs and YLDs. Results We identified 4299 funded studies with a total research investment of £2.4 billion. The highest fundings by anatomical sites were haematological, breast, prostate, colorectal and ovarian cancers. Relative to disease burden as determined by a compound metric combining mortality, DALYs and YLDs, gender-specific cancers were found to be highest funded—the five sites that received the most funding were prostate, ovarian, breast, mesothelioma and testicular cancer; the least well-funded sites were liver, thyroid, lung, upper gastrointestinal (GI) and bladder. Preclinical science accounted for 66.2% of award numbers and 62.2% of all funding. The top five areas of primary research focus by funding were pathogenesis, drug therapy, diagnostic, screening and monitoring, women's health and immunology. The largest individual funder was the Medical Research Council. In combination, the five lowest funded site-specific cancers relative to disease burden account for 47.9%, 44.3% and 20.4% of worldwide cancer mortality, DALYs and YLDs. Conclusions Research funding for cancer is not allocated according to relative disease burden. These findings are in line with earlier published studies

  4. Political Budget Cycles

    DEFF Research Database (Denmark)

    Aaskoven, Lasse; Lassen, David Dreyer

    2017-01-01

    The political budget cycle—how elections affect government fiscal policy—is one of the most studied subjects in political economy and political science. The key theoretical question is whether incumbent governments can time or structure public finances in ways that improve their chances of reelec......The political budget cycle—how elections affect government fiscal policy—is one of the most studied subjects in political economy and political science. The key theoretical question is whether incumbent governments can time or structure public finances in ways that improve their chances...... on political budget cycles have recently focused on conditions under which such cycles are likely to obtain. Much recent research focuses on subnational settings, allowing comparisons of governments in similar institutional environments, and a consensus on the presences of cycles in public finances...

  5. WORK EXPERIENCE OF THE OPERA TIVE INFORMATION SUPPORT SERVICE FOR SCIENTIFIC RESEARCH A T THE MEDICAL RADIOLOGICAL RESEARCH CENTER NAMED AFTER A.F . TSYB – BRANCH OF THE FEDERAL STATE BUDGET INSTITUTION "NATIONAL MEDICAL RESEARCH RADIOLOGICAL CENTER” OF T

    Directory of Open Access Journals (Sweden)

    N. P. Savina

    2015-01-01

    Full Text Available Abstract:The Operative Information Support Service for Scientific Research of the Medical Radiological Research Center named after A. F. Tsyb — Branch of the FSBI «National Medical Research Radiological Center” of the RF Health Ministry presented a report on providing off-budget support for scientific activities over the period from 1993 to 2014 using domestic and foreign information resources. The dynamics of employee activities in institutional sectors with aim to receive financial support for fundamental and applied scientific research on a competitive and non-competitive basis was given. The analysis of the obtained data indicated that a multi-channeling in off-budget funding was formed. It also showed to some extent a situation at the open market of grants in the field of medical radiology, radiobiology, and radiation epidemiology among leading investors in intellectual products.

  6. Case Study in International Cooperation: Cuba's Molecular Immunology Center and Roswell Park Cancer Institute.

    Science.gov (United States)

    Evans, Rachel; Reid, Mary; Segal, Brahm; Abrams, Scott I; Lee, Kelvin

    2018-04-01

    In 1961, the USA severed diplomatic relations with Cuba, and in 1962 an embargo was imposed on trade and financial relations with that country. It was not until five decades later that the USA and Cuba would reestablish relations. This opened the way for the New York State Trade Mission to Cuba in April 2015, during which Cuba's Molecular Immunology Center and Buffalo, New York's Roswell Park Cancer Institute signed a formal agreement that would set in motion biotechnology research collaboration to address one of the most important causes of death in both countries. Significant research from Cuba led to this groundbreaking collaboration. The purpose of this paper is to discuss the development of this cooperation, from the Molecular Immunology Center's initial investigations, through the opening of a phase I clinical trial at Roswell Park Cancer Institute with therapies developed at the Center. This cooperation was responsible for the first clinical trial for CIMAvax-EGF involving advanced-stage non-small cell lung cancer patients in the USA. A license was also approved by the US Department of the Treasury's Office of Foreign Assets Control authorizing a commercial partnership for development of biotechnology products, combining the cancer research efforts of both institutions. This unusual collaboration between Cuba and the USA-the US economic embargo and travel restrictions not withstanding-opens good prospects for expanded medical research between the two countries. While political and logistical challenges remain, the shared mission and dedication of these Cuban and US scientists points the way towards relationships that can lead to development, testing, approval and use of promising new therapies for cancer patients. KEYWORDS Biotechnology, clinical trials, cancer vaccines, cancer immunotherapy, non-small cell lung cancer, NSCLC, Cuba, USA.

  7. BUDGET AND PUBLIC DEBT

    Directory of Open Access Journals (Sweden)

    Morar Ioan Dan

    2014-12-01

    policy official. Volume and structure of public debt will strike in the future state finances and income citizens who in turn will pay these debts. Regarding payment of public debt in the future, in literature often put morality issue grevarii income of future generations of rulers moment. Another issue addressed in this paper is that of public debt issuance conditions in international financial markets, the international financial institutions or domestic. Substantiating the link between the amount borrowed and realizing their destination in credit is needed to determine the economic and social effects on the budget and on income taxpayers will bear the burden of public debt.

  8. Delivering prostate cancer prevention messages to the public: how the National Cancer Institute (NCI) effectively spread the word about the Prostate Cancer Prevention Trial (PCPT) results.

    Science.gov (United States)

    Croker, Kara Smigel; Ryan, Anne; Morzenti, Thuy; Cave, Lynn; Maze-Gallman, Tamara; Ford, Leslie

    2004-01-01

    The Prostate Cancer Prevention Trial was the first clinical trial to show that a direct intervention (5 mg of finasteride daily for 7 years) could reduce a man's risk of developing prostate cancer. Initial results also suggested that men taking finasteride had an increased risk of developing what appeared to be higher-grade disease (Gleason score 7-10). The National Cancer Institute has a congressional mandate to communicate health information to the public and has established methods to reach the public directly and to reach information intermediaries in the media, professional societies, and advocacy groups. The groundbreaking yet complicated results of the Prostate Cancer Prevention Trial were widely disseminated by National Cancer Institute using the social marketing and public-relations strategies and tactics detailed here. Copyright 2004 Elsevier Inc.

  9. Cost of the Cervical Cancer Screening Program at the Mexican Social Security Institute

    Directory of Open Access Journals (Sweden)

    Víctor Granados-García

    2014-09-01

    Full Text Available Objective. To estimate the annual cost of the National Cervical Cancer Screening Program (CCSP of the Mexican Institute of Social Security (IMSS. Materials and methods. This cost analysis examined regional coverage rates reported by IMSS. We estimated the number of cytology, colposcopy, biopsy and pathology evaluations, as well as the diagnostic test and treatment costs for cervical intraepithelial neoplasia grade II and III (CIN 2/3 and cervical cancer. Diagnostic test costs were estimated using a micro-costing technique. Sensitivity analyses were performed. Results. The cost to perform 2.7 million cytology tests was nearly 38 million dollars, which represents 26.1% of the total program cost (145.4 million. False negatives account for nearly 43% of the program costs. Conclusion. The low sensitivity of the cytology test generates high rates of false negatives, which results in high institutional costs from the treatment of undetected cervical cancer cases.

  10. Genetic polymorphisms of the GNRH1 and GNRHR genes and risk of breast cancer in the National Cancer Institute Breast and Prostate Cancer Cohort Consortium (BPC3

    Directory of Open Access Journals (Sweden)

    Lund Eiliv

    2009-07-01

    Full Text Available Abstract Background Gonadotropin releasing hormone (GNRH1 triggers the release of follicle stimulating hormone and luteinizing hormone from the pituitary. Genetic variants in the gene encoding GNRH1 or its receptor may influence breast cancer risk by modulating production of ovarian steroid hormones. We studied the association between breast cancer risk and polymorphisms in genes that code for GNRH1 and its receptor (GNRHR in the large National Cancer Institute Breast and Prostate Cancer Cohort Consortium (NCI-BPC3. Methods We sequenced exons of GNRH1 and GNRHR in 95 invasive breast cancer cases. Resulting single nucleotide polymorphisms (SNPs were genotyped and used to identify haplotype-tagging SNPs (htSNPS in a panel of 349 healthy women. The htSNPs were genotyped in 5,603 invasive breast cancer cases and 7,480 controls from the Cancer Prevention Study-II (CPS-II, European Prospective Investigation on Cancer and Nutrition (EPIC, Multiethnic Cohort (MEC, Nurses' Health Study (NHS, and Women's Health Study (WHS. Circulating levels of sex steroids (androstenedione, estradiol, estrone and testosterone were also measured in 4713 study subjects. Results Breast cancer risk was not associated with any polymorphism or haplotype in the GNRH1 and GNRHR genes, nor were there any statistically significant interactions with known breast cancer risk factors. Polymorphisms in these two genes were not strongly associated with circulating hormone levels. Conclusion Common variants of the GNRH1 and GNRHR genes are not associated with risk of invasive breast cancer in Caucasians.

  11. Genetic polymorphisms of the GNRH1 and GNRHR genes and risk of breast cancer in the National Cancer Institute Breast and Prostate Cancer Cohort Consortium (BPC3)

    International Nuclear Information System (INIS)

    Canzian, Federico; Calle, Eugenia E; Chanock, Stephen; Clavel-Chapelon, Francoise; Dossus, Laure; Feigelson, Heather Spencer; Haiman, Christopher A; Hankinson, Susan E; Hoover, Robert; Hunter, David J; Isaacs, Claudine; Kaaks, Rudolf; Lenner, Per; Lund, Eiliv; Overvad, Kim; Palli, Domenico; Pearce, Celeste Leigh; Quiros, Jose R; Riboli, Elio; Stram, Daniel O; Thomas, Gilles; Thun, Michael J; Cox, David G; Trichopoulos, Dimitrios; Gils, Carla H van; Ziegler, Regina G; Henderson, Katherine D; Henderson, Brian E; Berg, Christine; Bingham, Sheila; Boeing, Heiner; Buring, Julie

    2009-01-01

    Gonadotropin releasing hormone (GNRH1) triggers the release of follicle stimulating hormone and luteinizing hormone from the pituitary. Genetic variants in the gene encoding GNRH1 or its receptor may influence breast cancer risk by modulating production of ovarian steroid hormones. We studied the association between breast cancer risk and polymorphisms in genes that code for GNRH1 and its receptor (GNRHR) in the large National Cancer Institute Breast and Prostate Cancer Cohort Consortium (NCI-BPC3). We sequenced exons of GNRH1 and GNRHR in 95 invasive breast cancer cases. Resulting single nucleotide polymorphisms (SNPs) were genotyped and used to identify haplotype-tagging SNPs (htSNPS) in a panel of 349 healthy women. The htSNPs were genotyped in 5,603 invasive breast cancer cases and 7,480 controls from the Cancer Prevention Study-II (CPS-II), European Prospective Investigation on Cancer and Nutrition (EPIC), Multiethnic Cohort (MEC), Nurses' Health Study (NHS), and Women's Health Study (WHS). Circulating levels of sex steroids (androstenedione, estradiol, estrone and testosterone) were also measured in 4713 study subjects. Breast cancer risk was not associated with any polymorphism or haplotype in the GNRH1 and GNRHR genes, nor were there any statistically significant interactions with known breast cancer risk factors. Polymorphisms in these two genes were not strongly associated with circulating hormone levels. Common variants of the GNRH1 and GNRHR genes are not associated with risk of invasive breast cancer in Caucasians

  12. A comparative study of breast cancer mass screening using ultrasonography and mammography at a single institution

    International Nuclear Information System (INIS)

    Uemura, Tsuguo; Takahashi, Naohiko; Ueda, Kuniaki

    2011-01-01

    In order to evaluate the effectiveness of ultrasonic screening for breast cancer (US group) in comparison with mammographic screening (MMG group), we analyzed 78,214 breast screening examinees presenting between 2007 and 2008 at our institution. The cancer detection rate in the US group was lower than that in the MMG group. However, the average age in the US group was significantly younger than that in the MMG group, and the rate of annual screening was significantly higher in the former than in the latter. In the US subgroup who underwent annual screening, the recall rate and the cancer detection rate were significantly lower, and the rate of detection of early breast cancers was significantly higher than that in the subgroup who underwent screening biennially or at longer intervals, and there was no significant inter-group difference in the cancer detection rate between women in their 40s and those aged 50 or above who underwent annual screening. The proportion of early breast cancers detected was almost the same in the both groups. In summary, US screening as well as MMG screening seems to be useful for detection of early breast cancer. Although a high recall rate for US screening has been reported previously, annual screening and sufficient quality control based on the guidelines proposed by the Japan Association of Breast and Thyroid Sonology (JABTS) are considered to reduce the recall rate. (author)

  13. A Capsule Look at Zero-Base Budgeting.

    Science.gov (United States)

    Griffin, William A., Jr.

    Weaknesses of the traditional incremental budgeting approach are considered as background to indicate the need for a new system of budgeting in educational institutions, and a step-by-step description of zero-based budgeting (ZBB) is presented. Proposed advantages of ZBB include the following: better staff morale due to a budget that is open and…

  14. Nutritional status of cancer patients admitted for chemotherapy at the National Kidney and Transplant Institute.

    Science.gov (United States)

    Montoya, J E; Domingo, F; Luna, C A; Berroya, R M; Catli, C A; Ginete, J K; Sanchez, O S; Juat, N J; Tiangco, B J; Jamias, J D

    2010-11-01

    Malnutrition is common among cancer patients. This study aimed to determine the overall prevalence of malnutrition among patients undergoing chemotherapy and to determine the predictors of malnutrition among cancer patients. A cross-sectional study was conducted on 88 cancer patients admitted for chemotherapy at the National Kidney and Transplant Institute, Philippines, from October to November 2009. Subjective Global Assessment (SGA), anthropometric data and demographic variables were obtained. Descriptive statistics, ANOVA and logistic regression analysis were performed between the outcome and variables. A total of 88 cancer patients were included in the study. The mean age of the patients was 55.7 +/- 14.8 years. The mean duration of illness was 9.7 +/- 8.7 months and the mean body mass index (BMI) was 22.9 kg/m2. The mean Karnofsky performance status was 79.3. 29.55 percent of the patients had breast cancer as the aetiology of their illness. 38 patients (43.2 percent) had SGA B and four (4.5 percent) had SGA C, giving a total malnutrition prevalence of 47.7 percent. The patients were statistically different with regard to their cancer stage (p is less than 0.001), weight (p is 0.01), BMI (p is 0.004), haemoglobin level (p is 0.001) and performance status by Karnofsky score (p is less than 0.001), as evaluated by ANOVA. Logistic regression analysis showed that cancer stage and Karnofsky performance score were predictors of malnutrition. About 47.7 percent of cancer patients suffer from malnutrition, as classified by SGA. Only cancer stage and Karnofsky performance status scoring were predictive of malnutrition in this select group of patients.

  15. Environmental dose in the Nuclear Medicine Department of the National Institute of Cancer

    International Nuclear Information System (INIS)

    Torres U, C. L.; Avila A, O. L.; Medina V, L. A.; Buenfil B, A. E.; Brandan S, M. E.; Trujillo Z, F. E.; Gamboa de Buen, I.

    2009-01-01

    The dosimeters TLD-100 and TLD-900 were used to know the levels of environmental dose in areas of the Nuclear Medicine Department of the National Institute of Cancer. The dosimeters calibration was carried out in the Metrology Department of the National Institute of Nuclear Research. The radioisotopes used in the studied areas are 131 I, 18 F, 67 Ga, 99m Tc, 111 In, 201 Tl and 137 Cs with gamma energies between 93 and 662 KeV. Dosimeters were placed during five months in the diagnostic, injection, waiting and PET rooms as well as hot room, waste room, enclosed corridors to patient rooms treated with 131 I and 137 Cs and witness dosimeters to know the bottom. The values found vary between 0.3 and 70 major times that those of bottom. The maximum doses were measured in the waste room and in the enclosed corridor to the patient rooms with cervical uterine cancer treated with 137 Cs. (Author)

  16. Investments in cancer research awarded to UK institutions and the global burden of cancer 2000-2013: a systematic analysis.

    Science.gov (United States)

    Maruthappu, Mahiben; Head, Michael G; Zhou, Charlie D; Gilbert, Barnabas J; El-Harasis, Majd A; Raine, Rosalind; Fitchett, Joseph R; Atun, Rifat

    2017-04-20

    To systematically categorise cancer research investment awarded to United Kingdom (UK) institutions in the period 2000-2013 and to estimate research investment relative to disease burden as measured by mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs). Systematic analysis of all open-access data. Public and philanthropic funding to all UK cancer research institutions, 2000-2013. Number and financial value of cancer research investments reported in 2013 UK pounds (UK£). Mortality, DALYs and YLDs data were acquired from the Global Burden of Disease Study. A compound metric was adapted to estimate research investment relative to disease burden as measured by mortality, DALYs and YLDs. We identified 4299 funded studies with a total research investment of £2.4 billion. The highest fundings by anatomical sites were haematological, breast, prostate, colorectal and ovarian cancers. Relative to disease burden as determined by a compound metric combining mortality, DALYs and YLDs, gender-specific cancers were found to be highest funded-the five sites that received the most funding were prostate, ovarian, breast, mesothelioma and testicular cancer; the least well-funded sites were liver, thyroid, lung, upper gastrointestinal (GI) and bladder. Preclinical science accounted for 66.2% of award numbers and 62.2% of all funding. The top five areas of primary research focus by funding were pathogenesis, drug therapy, diagnostic, screening and monitoring, women's health and immunology. The largest individual funder was the Medical Research Council. In combination, the five lowest funded site-specific cancers relative to disease burden account for 47.9%, 44.3% and 20.4% of worldwide cancer mortality, DALYs and YLDs. Research funding for cancer is not allocated according to relative disease burden. These findings are in line with earlier published studies. Funding agencies and industry should openly document their research investments to

  17. Some radiation protection problems in a cancer hospital and associated research institute

    International Nuclear Information System (INIS)

    Trott, N.G.; Anderson, W.; Davis, R.P.; Carden, D.M.

    1980-01-01

    Experience gained at the Royal Marsden Hospital and Institute of Cancer Research has shown that with attention to the design of facilities and procedures and an active personnel monitoring policy, relatively large scale radiation commitments can proceed with individual whole body doses to staff being held well below 15 mSv/annum. In spite of detailed attention to control of radiation work, traumatic radiation incidents may still occur. (H.K.)

  18. Exercise recommendations for childhood cancer survivors exposed to cardiotoxic therapies: an institutional clinical practice initiative.

    Science.gov (United States)

    Okada, Maki; Meeske, Kathleen A; Menteer, Jondavid; Freyer, David R

    2012-01-01

    Childhood cancer survivors who have received treatment with anthracyclines are at risk for developing cardiomyopathy in dose-dependent fashion. Historically, restrictions on certain types of physical activity that were intended to preserve cardiac function have been recommended, based on a mixture of evidence-based and consensus-based recommendations. In the LIFE Cancer Survivorship & Transition Program at Children's Hospital Los Angeles, the authors reevaluated their recommendations for exercise in survivors who were exposed to anthracyclines, with or without irradiation in proximity to the myocardium. The primary goal was to develop consistent, specific, practical, safe, and (where possible) evidence-based recommendations for at-risk survivors in the program. To accomplish this, the authors referred to current exercise guidelines for childhood cancer survivors, consulted recent literature for relevant populations, and obtained input from the program's pediatric cardiology consultant. The resulting risk-based exercise recommendations are designed to complement current published guidelines, maximize safe exercise, and help childhood cancer survivors return to a normal life that emphasizes overall wellness and physical activity. This article describes a single institution's experience in modifying exercise recommendations for at-risk childhood survivors and includes the methods, findings, and current institutional practice recommendations along with sample education materials.

  19. Home - House Budget Committee

    Science.gov (United States)

    Initiatives Hearings Full Menu About Toggle Links Members History Staff Rules & Budget Law News Toggle Links Press Releases Budget Digests HBC Publications Op-Eds Speeches & Statements Budgets Toggle Links FY 2018 Budget FY 2017 Budget FY 2017 Reconciliation FY 2016 Budget FY 2016 Reconciliation FY 2015

  20. Patterns of use of medical cannabis among Israeli cancer patients: a single institution experience.

    Science.gov (United States)

    Waissengrin, Barliz; Urban, Damien; Leshem, Yasmin; Garty, Meital; Wolf, Ido

    2015-02-01

    The use of the cannabis plant (Cannabis sativa L.) for the palliative treatment of cancer patients has been legalized in multiple jurisdictions including Israel. Yet, not much is currently known regarding the efficacy and patterns of use of cannabis in this setting. To analyze the indications for the administration of cannabis among adult Israeli cancer patients and evaluate its efficacy. Efficacy and patterns of use of cannabis were evaluated using physician-completed application forms, medical files, and a detailed questionnaire in adult cancer patients treated at a single institution. Of approximately 17,000 cancer patients seen, 279 (cannabis from an authorized institutional oncologist. The median age of cannabis users was 60 years (range 19-93 years), 160 (57%) were female, and 234 (84%) had metastatic disease. Of 151 (54%) patients alive at six months, 70 (46%) renewed their cannabis permit. Renewal was more common among younger patients and those with metastatic disease. Of 113 patients alive and using cannabis at one month, 69 (61%) responded to the detailed questionnaire. Improvement in pain, general well-being, appetite, and nausea were reported by 70%, 70%, 60%, and 50%, respectively. Side effects were mild and consisted mostly of fatigue and dizziness. Cannabis use is perceived as highly effective by some patients with advanced cancer and its administration can be regulated, even by local authorities. Additional studies are required to evaluate the efficacy of cannabis as part of the palliative treatment of cancer patients. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  1. Survey of Policies and Guidelines on Antioxidant Use for Cancer Prevention, Treatment, and Survivorship in North American Cancer Centers: What Do Institutions Perceive as Evidence?

    Science.gov (United States)

    Hong, Gyeongyeon; White, Jennifer; Zhong, Lihong; Carlson, Linda E

    2015-07-01

    Health care policies and guidelines that are clear and consistent with research evidence are important for maximizing clinical outcomes. To determine whether cancer centers in Canada and the United States had policies and/or guidelines about antioxidant use, and whether policies were aligned with the evidence base, we reviewed current research evidence in the field, and we undertook a survey of the policies and guidelines on antioxidant use at cancer institutions across North America. A survey of policies and guidelines on antioxidant use and the development and communication of the policies and guidelines was conducted by contacting cancer institutions in North America. We also conducted a Website search for each institution to explore any online resources. Policies and guidelines on antioxidant use were collected from 78 cancer institutions. Few cancer institutions had policies (5%) but most provided guidelines (69%). Antioxidants from diet were generally encouraged at cancer institutions, consistent with the current research evidence. In contrast, specific antioxidant supplements were generally not recommended at cancer institutions. Policies and guidelines were developed using evidence-based methods (53%), by consulting another source (35%), or through discussions/conference (26%), and communicated mainly through online resources (65%) or written handouts (42%). For cancer institutions that had no policy or guideline on antioxidants, lack of information and lack of time were the most frequently cited reasons. Policies and guidelines on antioxidants from diet were largely consistent with the research evidence. Policies and guidelines on antioxidant supplements during treatment were generally more restrictive than the research evidence might suggest, perhaps due to the specificity of results and the inability to generalize findings across antioxidants, adding to the complexity of their optimal and safe use. Improved communication of comprehensive research

  2. Cancer incidence and mortality in children in the Mexican Social Security Institute (1996-2013).

    Science.gov (United States)

    Fajardo-Gutiérrez, Arturo; González-Miranda, Guadalupe; Pachuca-Vázquez, Adriana; Allende-López, Aldo; Fajardo-Yamamoto, Liria Mitzuko; Rendón-Macías, Mario Enrique

    2016-04-01

    To identify the cancer incidence and mortality in Mexican Social Security Institute beneficiary (MSSI-B) children during 1996-2013. Both cancer cases (n=4 728) and deaths (n=2 378) were analyzed in MSSI-B children who were registered in five states of the Mexican Republic. The incidence and mortality trends and the incidences (rate x 1 000 000 children / year) of the type of cancer, age, sex, and place of residence were obtained. For both indicators (incidence and mortality), there was a downward trend for the period of 1996-2001 and a stable trend for 2002-2013. This occurred in the overall mortality and incidence trends of the Estado de México and Chiapas and in the leukemia and the acute lymphoid subgroups. The annual overall incidence was 128 cases per 1 000 000 children. Leukemia, lymphomas, and central nervous system tumors were the principal cancer groups. Cancer mortality for the period of 2002-2013 did not diminish. Interinstitutional and/or international research should be designed to improve the care of these children.

  3. Adjuvant chemo radiation in completely resected gastric cancer: experience of the National Cancer Institute of Chile

    International Nuclear Information System (INIS)

    Isa O, Nicolas; Russo N, Moises; Lopez V, Hernan

    2014-01-01

    Background: Gastric cancer is one of the most lethal tumors in the Chilean population. Aim: To report the results of adjuvant chemoradiotherapy in advanced gastric cancer. Material and Methods: Review of medical records of patients with locoregionally advanced gastric cancer, subjected to a curative resection and treated with adjuvant chemoradiotherapy. The treatment was based on he INT 0116/SSWOG protocol, which includes 5-fluorouracil as a single agent. Patients were followed for a median of 58 months. Results: The records of 168 patients (99 men) treated between 2004 nd 2011, were reviewed. Median survival as 41 months. Median lapses between surgery and onset of chemo and radiotherapy were 12 and 17 weeks, respectively. Overall three and five years survival was 53 and 41%, respectively. On multivariate analysis the factors associated with a lower survival were an antral location of the tumor, presence of signet ring cells and more than 5 involved lymph nodes. Conclusions: Three and five years survival of gastric cancer patients subjected to adjuvant chemoradiotherapy was 53 and 41% respectively.These results are similar to those reported elsewhere

  4. Pioneering the Transdisciplinary Team Science Approach: Lessons Learned from National Cancer Institute Grantees.

    Science.gov (United States)

    Vogel, Amanda L; Stipelman, Brooke A; Hall, Kara L; Nebeling, Linda; Stokols, Daniel; Spruijt-Metz, Donna

    2014-01-01

    The National Cancer Institute has been a leader in supporting transdisciplinary (TD) team science. From 2005-2010, the NCI supported Transdisciplinary Research on Energetic and Cancer I (TREC I), a center initiative fostering the TD integration of social, behavioral, and biological sciences to examine the relationships among obesity, nutrition, physical activity and cancer. In the final year of TREC I, we conducted qualitative in-depth-interviews with 31 participating investigators and trainees to learn more about their experiences with TD team science, including challenges, facilitating factors, strategies for success, and impacts. Five main challenges emerged: (1) limited published guidance for how to engage in TD team science, when TREC I was implemented; (2) conceptual and scientific challenges inherent to efforts to achieve TD integration; (3) discipline-based differences in values, terminology, methods, and work styles; (4) project management challenges involved in TD team science; and (5) traditional incentive and reward systems that do not recognize or reward TD team science. Four main facilitating factors and strategies for success emerged: (1) beneficial attitudes and beliefs about TD research and team science; (2) effective team processes; (3) brokering and bridge-building activities by individuals holding particular roles in a research center; and (4) funding initiative characteristics that support TD team science. Broad impacts of participating in TD team science in the context of TREC I included: (1) new positive attitudes about TD research and team science; (2) new boundary-crossing collaborations; (3) scientific advances related to research approaches, findings, and dissemination; (4) institutional culture change and resource creation in support of TD team science; and (5) career advancement. Funding agencies, academic institutions, and scholarly journals can help to foster TD team science through funding opportunities, institutional policies on

  5. 78 FR 44136 - Submission for OMB review; 30-day Comment Request: National Cancer Institute (NCI) Cancer...

    Science.gov (United States)

    2013-07-23

    ... award performance and the effectiveness of the program as a whole. The respondents are the Principal Investigators of the awards, along with their institutional business officials. The awards are administered by... costs to respondents other than their time. The estimated annualized burden hours are 72. Estimated...

  6. NCI QuitPal, an App from the National Cancer Institute | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of Health National Cancer Institute What if the tools you need to quit smoking were as easy ... habits with an easy-to-use calendar Includes motivational reminders that coincide with progress, Sends health milestones ...

  7. Variation in Definitive Therapy for Localized Non-Small Cell Lung Cancer Among National Comprehensive Cancer Network Institutions

    Energy Technology Data Exchange (ETDEWEB)

    Valle, Luca F. [Geisel School of Medicine at Dartmouth College, Dartmouth College, Hanover, New Hampshire (United States); Jagsi, Reshma [Department of Radiation Oncology, University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan (United States); Bobiak, Sarah N.; Zornosa, Carrie [National Comprehensive Cancer Network, Fort Washington, Pennsylvania (United States); D' Amico, Thomas A. [Department of Surgery, Division of Thoracic Surgery, Duke Cancer Institute, Durham, North Carolina (United States); Pisters, Katherine M. [Department of Thoracic/Head and Neck Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Dexter, Elisabeth U. [Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, New York (United States); Niland, Joyce C. [Department of Information Sciences, City of Hope Comprehensive Cancer Center, Duarte, California (United States); Hayman, James A. [Department of Radiation Oncology, University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan (United States); Kapadia, Nirav S., E-mail: Nirav.S.Kapadia@hitchcock.org [Department of Radiation Oncology, Dartmouth-Hitchcock Norris Cotton Cancer Center, Lebanon, New Hampshire (United States); Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire (United States)

    2016-02-01

    Purpose: This study determined practice patterns in the staging and treatment of patients with stage I non-small cell lung cancer (NSCLC) among National Comprehensive Cancer Network (NCCN) member institutions. Secondary aims were to determine trends in the use of definitive therapy, predictors of treatment type, and acute adverse events associated with primary modalities of treatment. Methods and Materials: Data from the National Comprehensive Cancer Network Oncology Outcomes Database from 2007 to 2011 for US patients with stage I NSCLC were used. Main outcome measures included patterns of care, predictors of treatment, acute morbidity, and acute mortality. Results: Seventy-nine percent of patients received surgery, 16% received definitive radiation therapy (RT), and 3% were not treated. Seventy-four percent of the RT patients received stereotactic body RT (SBRT), and the remainder received nonstereotactic RT (NSRT). Among participating NCCN member institutions, the number of surgeries-to-RT course ratios varied between 1.6 and 34.7 (P<.01), and the SBRT-to-NSRT ratio varied between 0 and 13 (P=.01). Significant variations were also observed in staging practices, with brain imaging 0.33 (0.25-0.43) times as likely and mediastinoscopy 31.26 (21.84-44.76) times more likely for surgical patients than for RT patients. Toxicity rates for surgical and for SBRT patients were similar, although the rates were double for NSRT patients. Conclusions: The variations in treatment observed among NCCN institutions reflects the lack of level I evidence directing the use of surgery or SBRT for stage I NSCLC. In this setting, research of patient and physician preferences may help to guide future decision making.

  8. Variation in Definitive Therapy for Localized Non-Small Cell Lung Cancer Among National Comprehensive Cancer Network Institutions

    International Nuclear Information System (INIS)

    Valle, Luca F.; Jagsi, Reshma; Bobiak, Sarah N.; Zornosa, Carrie; D'Amico, Thomas A.; Pisters, Katherine M.; Dexter, Elisabeth U.; Niland, Joyce C.; Hayman, James A.; Kapadia, Nirav S.

    2016-01-01

    Purpose: This study determined practice patterns in the staging and treatment of patients with stage I non-small cell lung cancer (NSCLC) among National Comprehensive Cancer Network (NCCN) member institutions. Secondary aims were to determine trends in the use of definitive therapy, predictors of treatment type, and acute adverse events associated with primary modalities of treatment. Methods and Materials: Data from the National Comprehensive Cancer Network Oncology Outcomes Database from 2007 to 2011 for US patients with stage I NSCLC were used. Main outcome measures included patterns of care, predictors of treatment, acute morbidity, and acute mortality. Results: Seventy-nine percent of patients received surgery, 16% received definitive radiation therapy (RT), and 3% were not treated. Seventy-four percent of the RT patients received stereotactic body RT (SBRT), and the remainder received nonstereotactic RT (NSRT). Among participating NCCN member institutions, the number of surgeries-to-RT course ratios varied between 1.6 and 34.7 (P<.01), and the SBRT-to-NSRT ratio varied between 0 and 13 (P=.01). Significant variations were also observed in staging practices, with brain imaging 0.33 (0.25-0.43) times as likely and mediastinoscopy 31.26 (21.84-44.76) times more likely for surgical patients than for RT patients. Toxicity rates for surgical and for SBRT patients were similar, although the rates were double for NSRT patients. Conclusions: The variations in treatment observed among NCCN institutions reflects the lack of level I evidence directing the use of surgery or SBRT for stage I NSCLC. In this setting, research of patient and physician preferences may help to guide future decision making.

  9. Small molecules, big players: the National Cancer Institute's Initiative for Chemical Genetics.

    Science.gov (United States)

    Tolliday, Nicola; Clemons, Paul A; Ferraiolo, Paul; Koehler, Angela N; Lewis, Timothy A; Li, Xiaohua; Schreiber, Stuart L; Gerhard, Daniela S; Eliasof, Scott

    2006-09-15

    In 2002, the National Cancer Institute created the Initiative for Chemical Genetics (ICG), to enable public research using small molecules to accelerate the discovery of cancer-relevant small-molecule probes. The ICG is a public-access research facility consisting of a tightly integrated team of synthetic and analytical chemists, assay developers, high-throughput screening and automation engineers, computational scientists, and software developers. The ICG seeks to facilitate the cross-fertilization of synthetic chemistry and cancer biology by creating a research environment in which new scientific collaborations are possible. To date, the ICG has interacted with 76 biology laboratories from 39 institutions and more than a dozen organic synthetic chemistry laboratories around the country and in Canada. All chemistry and screening data are deposited into the ChemBank web site (http://chembank.broad.harvard.edu/) and are available to the entire research community within a year of generation. ChemBank is both a data repository and a data analysis environment, facilitating the exploration of chemical and biological information across many different assays and small molecules. This report outlines how the ICG functions, how researchers can take advantage of its screening, chemistry and informatic capabilities, and provides a brief summary of some of the many important research findings.

  10. Institutional clinical trial accrual volume and survival of patients with head and neck cancer.

    Science.gov (United States)

    Wuthrick, Evan J; Zhang, Qiang; Machtay, Mitchell; Rosenthal, David I; Nguyen-Tan, Phuc Felix; Fortin, André; Silverman, Craig L; Raben, Adam; Kim, Harold E; Horwitz, Eric M; Read, Nancy E; Harris, Jonathan; Wu, Qian; Le, Quynh-Thu; Gillison, Maura L

    2015-01-10

    National Comprehensive Cancer Network guidelines recommend patients with head and neck cancer (HNC) receive treatment at centers with expertise, but whether provider experience affects survival is unknown. The effect of institutional experience on overall survival (OS) in patients with stage III or IV HNC was investigated within a randomized trial of the Radiation Therapy Oncology Group (RTOG 0129), which compared cisplatin concurrent with standard versus accelerated fractionation radiotherapy. As a surrogate for experience, institutions were classified as historically low- (HLACs) or high-accruing centers (HHACs) based on accrual to 21 RTOG HNC trials (1997 to 2002). The effect of accrual volume on OS was estimated by Cox proportional hazards models. Median RTOG accrual (1997 to 2002) at HLACs was four versus 65 patients at HHACs. Analysis included 471 patients in RTOG 0129 (2002 to 2005) with known human papillomavirus and smoking status. Patients at HLACs versus HHACs had better performance status (0: 62% v 52%; P = .04) and lower T stage (T4: 26.5% v 35.3%; P = .002) but were otherwise similar. Radiotherapy protocol deviations were higher at HLACs versus HHACs (18% v 6%; P accounting for radiotherapy protocol deviations. Institutional experience substantially influences survival in locally advanced HNC. © 2014 by American Society of Clinical Oncology.

  11. Lumboaortic radiotherapy in patients with cervical cancer. Experience of the National Cancer Institute

    International Nuclear Information System (INIS)

    Santini B, Alejandro; Becerra S, Sergio; Gayan G, Patricio; Carcamo I, Marcela; Bianchi G, Benjamin

    2010-01-01

    Background: Uterine cancer is still a prevalent disease in Chile. Is common to treat patients with tumors in stages IIB and IIIB where the risk of pelvic and paraortic limph node involvement is very high. Its treatment is radio-chemotherapy. Objective: To present a retrospective analysis of patients that suffered cervix-uterine cancer who were treated with radiotherapy including the aortic-lumbar area. Methods: From the revision of patients who were treated of cervix-uterine cancer between the years 1995 and 2007, 39 were treated including aortic-lumbar chains. Evolution and toxicity were analyzed. Two radiotherapy techniques were used. The first one, during the nineties, included two parallel previous and later and opposed fields, and a second technique, currently used, where pelvis and paraortic are radiated at the same time through four lateral (AP-PA) fields. Results: The dosimeter analysis of both techniques shows that there is a higher volume of radiated normal tissue with the two fields techniques, mainly in the small bowel. On the other hand, the toxicity was significantly different being today's technique less toxic and showing low gastrointestinal

  12. Adherence to the cancer prevention recommendations of the World Cancer Research Fund/American Institute for Cancer Research and mortality: a census-linked cohort.

    Science.gov (United States)

    Lohse, Tina; Faeh, David; Bopp, Matthias; Rohrmann, Sabine

    2016-09-01

    Modifiable lifestyle factors linked to cancer offer great potential for prevention. Previous studies suggest an association between adherence to recommendations on healthy lifestyle and cancer mortality. The aim of this study was to examine whether adherence to the cancer prevention recommendations of the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) is associated with reduced all-cause, total cancer, and specific cancer type mortality. We built a lifestyle score that included 3 categories, based on the recommendations of the WCRF/AICR. Applying Cox regression models, we investigated the association with all-cause, total cancer, and specific cancer type mortality; in addition, we included cardiovascular disease (CVD) mortality. We used census- and death registry-linked survey data allowing a mortality follow-up for ≤32 y. Our analysis included 16,722 participants. Information on lifestyle score components and confounders was collected at baseline. Over a mean follow-up of 21.7 y, 3730 deaths were observed (1332 cancer deaths). Comparing best with poorest category of the lifestyle score showed an inverse association with all-cause (HR: 0.82; 95% CI: 0.75, 0.89) and total cancer (men only, HR: 0.69; 95% CI: 0.57, 0.84) mortality. We estimated that ∼13% of premature cancer deaths in men would have been preventable if lifestyle score levels had been high. Inverse associations were observed for lung, upper aerodigestive tract, stomach, and prostate cancer mortality [men and women combined, HR: 0.72; 95% CI: 0.51, 0.99; HR: 0.49; 95% CI: 0.26, 0.92; HR: 0.34; 95% CI: 0.14, 0.83; HR: 0.48; 95% CI: 0.28, 0.82 (men only), respectively]. CVD mortality was not associated with the lifestyle score (men and women combined, HR: 0.96; 95% CI: 0.82, 1.13). Our results support the importance of adhering to recommendations for a healthy lifestyle with regard to all-cause and cancer mortality. To reduce the burden of cancer in the

  13. Plant collecting program in Southeast Asia under the sponsorship of the United States National Cancer Institute (NCI) (1986-1991)

    NARCIS (Netherlands)

    Soejarto, D.D.

    1992-01-01

    Under the funding from the United States National Cancer Institute (NCI)¹, a program was undertaken to collect plant samples in Southeast Asia to be tested for their cancer- and AIDS-arresting properties, for the period of September 1, 1986 through August 31, 1991. The program was implemented with

  14. Brachytherapy or Conformal External Radiotherapy for Prostate Cancer: A Single-Institution Matched-Pair Analysis

    International Nuclear Information System (INIS)

    Pickles, Tom; Keyes, Mira; Morris, W. James

    2010-01-01

    Purpose: In the absence of randomized study data, institutional case series have shown brachytherapy (BT) to produce excellent biochemical control (bNED) in patients with localized prostate cancer compared with alternative curative treatments. This study was designed to overcome some of the limitations of case series studies by using a matched-pair design in patients treated contemporaneously with BT and external beam radiation therapy (EBRT) at a single institution. Methods and Materials: Six hundred one eligible patients treated between 1998 and 2001 were prospectively followed up in our institutional databases and matched on a 1:1 basis for the following known prognostic variables: prostate-specific antigen (PSA) level, Gleason score, T stage, the use and duration of neoadjuvant androgen deprivation therapy, and the percentage of positive tissue core samples. Two hundred seventy-eight perfect matches of patients (139 in each group) with low- and intermediate-risk cancer were further analyzed. bNED (Phoenix definition) was the primary endpoint. Other endpoints were toxicity, PSA kinetics, and the secondary use of androgen deprivation therapy. Results: The 5-year bNED rates were 95% (BT) and 85% (EBRT) (p < 0.001). After 7 years, the BT bNED result was unchanged, but the rate in EBRT patients had fallen to 75%. The median posttreatment PSA nadirs were 0.04 ng/mL (BT) and 0.62 ng/mL (EBRT, p < 0.001), which predicted a higher ongoing treatment failure rate in association with EBRT use than with BT use. Late urinary toxicity and rectal/bowel toxicity were worse in patients treated with BT and EBRT, respectively. Conclusions: BT for both low-risk and selected intermediate-risk cancers achieves exceptional cure rates. Even with dose escalation, it will be difficult for EBRT to match the proven track record of BT seen over the past decade.

  15. Sexual outcomes after partial penectomy for penile cancer: results from a multi-institutional study

    Directory of Open Access Journals (Sweden)

    Salvatore Sansalone

    2017-01-01

    Full Text Available Penile cancer is an uncommon malignancy. Surgical treatment is inevitably mutilating. Considering the strong impact on patients′ sexual life we want to evaluate sexual function and satisfaction after partial penectomy. The patients in this study (n = 25 represented all those who attended our institutions and were diagnosed and treated for penile cancer from October 2011 to November 2013. All patients underwent partial penectomy and followed-up (mean: 14 months; range: 12-25. Sexual presurgical baseline was estimated using the International Index of Erectile Dysfunction 15 (IIEF-15. Sexual outcomes of each patient were estimated considering four standardized and validated questionnaires. We analyzed the means and ranges of IIEF-15 including erectile function (IIEF-1-5 and -15, orgasmic function (IIEF-9 and -10, sexual desire (IIEF-11 and -12, intercourse satisfaction (IIEF-6-8, and overall satisfaction (IIEF-13 and -14. Then, we also used Quality of Erection Questionnaire (QEQ, Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS and Self-Esteem and Relationship (SEAR to evaluate the sexual function and satisfaction of our patients. The final results showed that penile cancer leads to several sexual and psychosexual dysfunctions. Nevertheless, patients who undergo partial penectomy for penile cancer can maintain the sexual outcomes at levels slightly lower to those that existed in the period before surgery.

  16. Gene-environment interactions in cancer epidemiology: a National Cancer Institute Think Tank report.

    Science.gov (United States)

    Hutter, Carolyn M; Mechanic, Leah E; Chatterjee, Nilanjan; Kraft, Peter; Gillanders, Elizabeth M

    2013-11-01

    Cancer risk is determined by a complex interplay of genetic and environmental factors. Genome-wide association studies (GWAS) have identified hundreds of common (minor allele frequency [MAF] > 0.05) and less common (0.01 Think Tank" on January 10-11, 2012. The objective of the Think Tank was to facilitate discussions on (1) the state of the science, (2) the goals of G × E interaction studies in cancer epidemiology, and (3) opportunities for developing novel study designs and analysis tools. This report summarizes the Think Tank discussion, with a focus on contemporary approaches to the analysis of G × E interactions. Selecting the appropriate methods requires first identifying the relevant scientific question and rationale, with an important distinction made between analyses aiming to characterize the joint effects of putative or established genetic and environmental factors and analyses aiming to discover novel risk factors or novel interaction effects. Other discussion items include measurement error, statistical power, significance, and replication. Additional designs, exposure assessments, and analytical approaches need to be considered as we move from the current small number of success stories to a fuller understanding of the interplay of genetic and environmental factors. © 2013 WILEY PERIODICALS, INC.

  17. National institute for Food and Agriculture: novel and changing funding strategies and mechanisms in response to changes in budgets, legislative authorities and scientific culture

    Science.gov (United States)

    Cavallaro, N.; Melnick, R.

    2017-12-01

    Farm Bill legislation establishes different funding mechanisms managed by the National Institute of Food and Agriculture (NIFA), which have changed over the years through reauthorization. Other legislation and executive initiatives, as well as recognition by both funders, funding recipients, private organizations, and non-government organizations have stressed the need for multi-, inter-, and trans-disciplinary research and outreach. This presentation will discuss how changes to NIFA legislative authority as well as changing needs and culture in the government and the scientific research community have led to new mechanisms and strategies for types of funded projects, eligibility for NIFA funding, interagency funding, and iterative changes in direction in research solicitations. For example, limited funding for important topics has prompted a need for interagency collaborations in research funding solicitations and jointly funded projects. New legislative authorities and requirements have led to new modes of collaboration with private industry, NGOs and commodity boards along with international alliances. Unlike most funding agencies, NIFA funds education and extension or outreach projects in addition to research projects. New authorities together with increased recognition of scientific research needed to inform societal challenges has led to new thinking and greater flexibility in funding for long-term research projects and larger regional, multi-institutional and multi-national projects. This, in addition to a shifting culture among researchers and research institutions, has aided in new policies, requirements and initiatives among research institutions and government agencies involving information, data sharing and public access. Examples of new mechanisms and programs and their successes along with their drawbacks will be presented.

  18. Budgeting for School Media Centers.

    Science.gov (United States)

    Drott, M. Carl

    1978-01-01

    Describes various forms of budgets and discusses concepts in budgeting useful to supervisors of school media centers: line item budgets, capital budgets, creating budgets, the budget calendar, innovations, PPBS (Planning, Programing, Budgeting System), zero-based budgeting, cost-benefit analysis, benefits, benefit guidelines, and budgeting for the…

  19. Preliminary results of robotic colorectal surgery at the National Cancer Institute, Cairo University

    International Nuclear Information System (INIS)

    Zaghloul, A.S.; Mahmoud, A.M.

    2016-01-01

    Background: The available literature on minimally invasive colorectal cancer demonstrates that laparoscopic approach is feasible and associated with better short term outcomes than open surgery while maintaining equivalent oncologic safety. Reports have shown that robotic surgery may overcome some of the pitfalls of laparoscopic intervention. Objective of the work: To evaluate early results of robotic colorectal surgery, in a cohort of Egyptian patients, regarding operative time, operative and early post-operative complications, hospital stay and pathological results. Patients and methods: A case series study which was carried out in surgical department at National Cancer Institute, Cairo University. Ten Egyptian cases of colorectal cancer (age ranged from 30 to 67, 5 males and 5 females) were recruited from the period of April 2013 to April 2014. Robotic surgery was performed to all cases. Results: Three patients had low anterior resection, three anterior resection, one total proctectomy, one abdominoperineal resection, one left hemicolectomy and one colostomy. The study reported no mortalities and two morbidities. The mean operative time was 333 min. The conversion to open was done in only one patient. A total mesorectal excision with negative circumferential margin was accomplished in all patients, distal margin was positive in one patient. Mean lymph nodes removed was 10.7. Mean hospital stay was 7.4 days. Conclusion: To the best of our knowledge, this is the first study reporting the outcomes of robotic colorectal cancer intervention in Egyptian patients. Our preliminary results suggest that robotic- assisted surgery for colorectal cancer can be carried out safely and according to oncological principles

  20. Lower Breast Cancer Risk among Women following the World Cancer Research Fund and American Institute for Cancer Research Lifestyle Recommendations: EpiGEICAM Case-Control Study.

    Directory of Open Access Journals (Sweden)

    Adela Castelló

    Full Text Available According to the "World Cancer Research Fund" and the "American Institute of Cancer Research" (WCRF/AICR one in four cancer cases could be prevented through a healthy diet, weight control and physical activity.To explore the association between the WCRF/AICR recommendations and risk of breast cancer.During the period 2006 to 2011 we recruited 973 incident cases of breast cancer and 973 controls from 17 Spanish Regions. We constructed a score based on 9 of the WCRF/AICR recommendations for cancer prevention:: 1Maintain adequate body weight; 2Be physically active; 3Limit the intake of high density foods; 4Eat mostly plant foods; 5Limit the intake of animal foods; 6Limit alcohol intake; 7Limit salt and salt preserved food intake; 8Meet nutritional needs through diet; S1Breastfeed infants exclusively up to 6 months. We explored its association with BC by menopausal status and by intrinsic tumor subtypes (ER+/PR+ & HER2-; HER2+; ER&PR-&HER2- using conditional and multinomial logistic models respectively.Our results point to a linear association between the degree of noncompliance and breast cancer risk. Taking women who met 6 or more recommendations as reference, those meeting less than 3 showed a three-fold excess risk (OR=2.98(CI95%:1.59-5.59, especially for postmenopausal women (OR=3.60(CI95%:1.24;10.47 and ER+/PR+&HER2- (OR=3.60(CI95%:1.84;7.05 and HER2+ (OR=4.23(CI95%:1.66;10.78 tumors. Noncompliance of recommendations regarding the consumption of foods and drinks that promote weight gain in premenopausal women (OR=2.24(CI95%:1.18;4.28; p for interaction=0.014 and triple negative tumors (OR=2.93(CI95%:1.12-7.63; the intake of plant foods in postmenopausal women (OR=2.35(CI95%:1.24;4.44 and triple negative tumors (OR=3.48(CI95%:1.46-8.31; and the alcohol consumption in ER+/PR+&HER2- tumors (OR=1.52 (CI95%:1.06-2.19 showed the strongest associations.Breast cancer prevention might be possible by following the "World Cancer Research Fund" and the

  1. Breast cancer mammographic diagnosis performance in a public health institution: a retrospective cohort study.

    Science.gov (United States)

    Mello, Juliana M R B; Bittelbrunn, Fernando P; Rockenbach, Marcio A B C; May, Guilherme G; Vedolin, Leonardo M; Kruger, Marilia S; Soldatelli, Matheus D; Zwetsch, Guilherme; de Miranda, Gabriel T F; Teixeira, Saone I P; Arruda, Bruna S

    2017-12-01

    To evaluate the quality assurance of mammography results at a reference institution for the diagnosis and treatment of breast cancer in southern Brazil, based on the BIRADS (Breast Imaging Reporting and Data System) 5th edition recommendations for auditing purposes. Retrospective cohort and cross-sectional study with 4502 patients (9668 mammographies)) who underwent at least one or both breast mammographies throughout 2013 at a regional public hospital, linked to a federal public university. The results were followed until 31 December 2014, including true positives (TPs), true negatives (TNs), false positives (FPs), false negatives (FNs), positive predictive values (PPVs), negative predictive value (NPV), sensitivity and specificity, with a confidence interval of 95%. The study showed high quality assurance, particularly regarding sensitivity (90.22%) and specificity (92.31%). The overall positive predictive value (PPV) was 65.35%, and the negative predictive value (NPV) was 98.32%. The abnormal interpretation rate (recall rate) was 12.26%. The results are appropriate when compared to the values proposed by the BIRADS 5th edition. Additionally, the study provided self-reflection considering our radiological practice, which is essential for improvements and collaboration regarding breast cancer detection. It may stimulate better radiological practice performance and continuing education, despite possible infrastructure and facility limitations. • Accurate quality performance rates are possible despite financial and governmental limitations. • Low-income institutions should develop standardised teamwork to improve radiological practice. • Regular mammography audits may help to increase the quality of public health systems.

  2. Creating a "culture of research" in a community hospital: Strategies and tools from the National Cancer Institute Community Cancer Centers Program.

    Science.gov (United States)

    Dimond, Eileen P; 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

    2015-06-01

    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. 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. 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 component yet often challenging to

  3. Automated Budget System -

    Data.gov (United States)

    Department of Transportation — The Automated Budget System (ABS) automates management and planning of the Mike Monroney Aeronautical Center (MMAC) budget by providing enhanced capability to plan,...

  4. Salvage radical prostatectomy for radiation-recurrent prostate cancer: a multi-institutional collaboration.

    Science.gov (United States)

    Chade, Daher C; Shariat, Shahrokh F; Cronin, Angel M; Savage, Caroline J; Karnes, R Jeffrey; Blute, Michael L; Briganti, Alberto; Montorsi, Francesco; van der Poel, Henk G; Van Poppel, Hendrik; Joniau, Steven; Godoy, Guilherme; Hurtado-Coll, Antonio; Gleave, Martin E; Dall'Oglio, Marcos; Srougi, Miguel; Scardino, Peter T; Eastham, James A

    2011-08-01

    Oncologic outcomes in men with radiation-recurrent prostate cancer (PCa) treated with salvage radical prostatectomy (SRP) are poorly defined. To identify predictors of biochemical recurrence (BCR), metastasis, and death following SRP to help select patients who may benefit from SRP. This is a retrospective, international, multi-institutional cohort analysis. There was a median follow-up of 4.4 yr following SRP performed on 404 men with radiation-recurrent PCa from 1985 to 2009 in tertiary centers. Open SRP. BCR after SRP was defined as a serum prostate-specific antigen (PSA) ≥ 0.1 or ≥ 0.2 ng/ml (depending on the institution). Secondary end points included progression to metastasis and cancer-specific death. Median age at SRP was 65 yr of age, and median pre-SRP PSA was 4.5 ng/ml. Following SRP, 195 patients experienced BCR, 64 developed metastases, and 40 died from PCa. At 10 yr after SRP, BCR-free survival, metastasis-free survival, and cancer-specific survival (CSS) probabilities were 37% (95% confidence interval [CI], 31-43), 77% (95% CI, 71-82), and 83% (95% CI, 76-88), respectively. On preoperative multivariable analysis, pre-SRP PSA and Gleason score at postradiation prostate biopsy predicted BCR (p = 0.022; global p 75% of patients 10 yr after surgery. Patients with lower pre-SRP PSA levels and lower postradiation prostate biopsy Gleason score have the highest probability of cure from SRP. Copyright © 2011 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  5. Managing hospital supplies: process reengineering at Gujarat Cancer Research Institute, India.

    Science.gov (United States)

    Ramani, K V

    2006-01-01

    Aims to give an overview of the re-engineering of processes and structures at Gujarat Cancer Research Institute (GCRI), Ahmedabad. A general review of the design, development and implementation of reengineered systems in order to address concerns about the existing systems. Findings GCRI is a comprehensive cancer care center with 550 beds and well equipped with modern diagnostic and treatment facilities. It serves about 200,000 outpatients and 16,000 inpatients annually. The approach to a better management of hospital supplies led to the design, development, and implementation of an IT-based reengineered and integrated purchase and inventory management system. The new system has given GCRI a saving of about 8 percent of its annual costs of purchases, and improved the availability of materials to the user departments. Shows that the savings obtained are used not only for buying more hospital supplies, but also to buy better quality of hospital supplies, and thereby satisfactorily address the GCRI responsibility towards meeting its social obligations for cancer care.

  6. Cost comparison of curative therapies for localized prostate cancer in Japan. A single-institution experience

    International Nuclear Information System (INIS)

    Satoh, Takefumi; Ishiyama, Hiromichi; Matsumoto, Kazumasa

    2009-01-01

    In addition to open surgery, curative therapies for prostate cancer now include endoscopic surgery and radiation therapies. Because of the expansion and subdivision of treatment methods for prostate cancer, the medical fee point schedule in Japan was revised in fiscal year 2006. We examined changes in medical income and expenditure after this revision of the medical fee system. We studied income and expenditure, after institution of the new medical fee schedule, for the five types of therapies for prostate cancer performed at our hospital: two surgical therapies (radical retropubic prostatectomy and laparoscopic prostatectomy) and three radiation therapies (three-dimensional conformal radiation therapy, 192 Ir high-dose-rate brachytherapy, and 125 I low-dose-rate brachytherapy). Low-dose-rate brachytherapy was found to be associated with a profit of 199 yen per patient. Laparoscopic prostatectomy, a highly advanced medical treatment that the fee revision changed from a partially insured to an insured procedure, yielded a profit of 75672 yen per patient. However, high-dose-rate brachytherapy was associated with a loss of 654016 yen per patient. Given the loss in hospital income per patient undergoing high-dose-rate brachytherapy, the medical fee point system for this procedure should be reassessed. (author)

  7. Altered plasma apolipoprotein modifications in patients with pancreatic cancer: protein characterization and multi-institutional validation.

    Directory of Open Access Journals (Sweden)

    Kazufumi Honda

    Full Text Available BACKGROUND: Among the more common human malignancies, invasive ductal carcinoma of the pancreas has the worst prognosis. The poor outcome seems to be attributable to difficulty in early detection. METHODS: We compared the plasma protein profiles of 112 pancreatic cancer patients with those of 103 sex- and age-matched healthy controls (Cohort 1 using a newly developed matrix-assisted laser desorption/ionization (oMALDI QqTOF (quadrupole time-of-flight mass spectrometry (MS system. RESULTS: We found that hemi-truncated apolipoprotein AII dimer (ApoAII-2; 17252 m/z, unglycosylated apolipoprotein CIII (ApoCIII-0; 8766 m/z, and their summed value were significantly decreased in the pancreatic cancer patients [P = 1.36×10(-21, P = 4.35×10(-14, and P = 1.83×10(-24 (Mann-Whitney U-test; area-under-curve values of 0.877, 0.798, and 0.903, respectively]. The significance was further validated in a total of 1099 plasma/serum samples, consisting of 2 retrospective cohorts [Cohort 2 (n = 103 and Cohort 3 (n = 163] and a prospective cohort [Cohort 4 (n = 833] collected from 8 medical institutions in Japan and Germany. CONCLUSIONS: We have constructed a robust quantitative MS profiling system and used it to validate alterations of modified apolipoproteins in multiple cohorts of patients with pancreatic cancer.

  8. Institutional Clinical Trial Accrual Volume and Survival of Patients With Head and Neck Cancer

    Science.gov (United States)

    Wuthrick, Evan J.; Zhang, Qiang; Machtay, Mitchell; Rosenthal, David I.; Nguyen-Tan, Phuc Felix; Fortin, André; Silverman, Craig L.; Raben, Adam; Kim, Harold E.; Horwitz, Eric M.; Read, Nancy E.; Harris, Jonathan; Wu, Qian; Le, Quynh-Thu; Gillison, Maura L.

    2015-01-01

    Purpose National Comprehensive Cancer Network guidelines recommend patients with head and neck cancer (HNC) receive treatment at centers with expertise, but whether provider experience affects survival is unknown. Patients and Methods The effect of institutional experience on overall survival (OS) in patients with stage III or IV HNC was investigated within a randomized trial of the Radiation Therapy Oncology Group (RTOG 0129), which compared cisplatin concurrent with standard versus accelerated fractionation radiotherapy. As a surrogate for experience, institutions were classified as historically low- (HLACs) or high-accruing centers (HHACs) based on accrual to 21 RTOG HNC trials (1997 to 2002). The effect of accrual volume on OS was estimated by Cox proportional hazards models. Results Median RTOG accrual (1997 to 2002) at HLACs was four versus 65 patients at HHACs. Analysis included 471 patients in RTOG 0129 (2002 to 2005) with known human papillomavirus and smoking status. Patients at HLACs versus HHACs had better performance status (0: 62% v 52%; P = .04) and lower T stage (T4: 26.5% v 35.3%; P = .002) but were otherwise similar. Radiotherapy protocol deviations were higher at HLACs versus HHACs (18% v 6%; P < .001). When compared with HHACs, patients at HLACs had worse OS (5 years: 51.0% v 69.1%; P = .002). Treatment at HLACs was associated with increased death risk of 91% (hazard ratio [HR], 1.91; 95% CI, 1.37 to 2.65) after adjustment for prognostic factors and 72% (HR, 1.72; 95% CI, 1.23 to 2.40) after radiotherapy compliance adjustment. Conclusion OS is worse for patients with HNC treated at HLACs versus HHACs to cooperative group trials after accounting for radiotherapy protocol deviations. Institutional experience substantially influences survival in locally advanced HNC. PMID:25488965

  9. State budget transfers to Health Insurance Funds for universal health coverage: institutional design patterns and challenges of covering those outside the formal sector in Eastern European high-income countries.

    Science.gov (United States)

    Vilcu, Ileana; Mathauer, Inke

    2016-01-15

    Many countries from the European region, which moved from a government financed and provided health system to social health insurance, would have had the risk of moving away from universal health coverage if they had followed a "traditional" approach. The Eastern European high-income countries studied in this paper managed to avoid this potential pitfall by using state budget revenues to explicitly pay health insurance contributions on behalf of certain (vulnerable) population groups who have difficulties to pay these contributions themselves. The institutional design aspects of their government revenue transfer arrangements are analysed, as well as their impact on universal health coverage progress. This regional study is based on literature review and review of databases for the performance assessment. The analytical framework focuses on the following institutional design features: rules on eligibility for contribution exemption, financing and pooling arrangements, and purchasing arrangements and benefit package design. More commonalities than differences can be identified across countries: a broad range of groups eligible for exemption from payment of health insurance contributions, full state contributions on behalf of the exempted groups, mostly mandatory participation, integrated pools for both the exempted and contributors, and relatively comprehensive benefit packages. In terms of performance, all countries have high total population coverage rates, but there are still challenges regarding financial protection and access to and utilization of health care services, especially for low income people. Overall, government revenue transfer arrangements to exempt vulnerable groups from contributions are one option to progress towards universal health coverage.

  10. Private vs. Public Higher Education Budgeting

    Science.gov (United States)

    Beamer, Sarah A.

    2011-01-01

    Private higher education institutions are those entities owned and operated by the private sector, while public institutions are those established, supported, and controlled by a governmental agency, most often a state. Key differences exist between private and public institutions that affect budgeting in critical ways. Such differences include…

  11. Chronological changes in lung cancer surgery in a single Japanese institution

    Directory of Open Access Journals (Sweden)

    Nakamura H

    2017-03-01

    Full Text Available Haruhiko Nakamura, Hiroki Sakai, Hiroyuki Kimura, Tomoyuki Miyazawa, Hideki Marushima, Hisashi Saji Department of Chest Surgery, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan Background: The aim of this study was to evaluate the chronological changes in epidemiological factors and surgical outcomes in patients with lung cancer who underwent surgery in a single Japanese institution.Patients and methods: A clinicopathological database of patients with lung cancer who underwent surgery with curative intent from January 1974 to December 2014 was reviewed. The chronological changes in various factors, including patient’s age, sex, histological type, tumor size, pathological stage (p-stage, surgical method, operative time, intraoperative blood loss, 30-day mortality, and postoperative overall survival (OS, were evaluated.Results: A total of 1,616 patients were included. The numbers of resected patients, females, adenocarcinomas, p-stage IA patients, and age at the time of surgery increased with time, but tumor size decreased (all P<0.0001. Concerning surgical methods, the number of sublobar resections increased, but that of pneumonectomies decreased (P<0.0001. The mean operative time, intraoperative blood loss, and the postoperative 30-day mortality rate decreased (all P<0.0001. When the patients were divided into two groups (1974–2004 and 2005–2014, the 5-year OS rates for all patients and for p-stage IA patients improved from 44% to 79% and from 73% to 89%, respectively (all P<0.0001. The best 5-year OS rate was obtained for sublobar resection (73%, followed by lobectomy (60%, combined resection (22%, and pneumonectomy (21%; P<0.0001.Conclusion: Changes in epidemiological factors, a trend toward less invasive surgery, and a remarkably improved postoperative OS were confirmed, which demonstrated the increasingly important role of surgery in therapeutic strategies for lung cancer. Keywords: lung cancer, surgery, sublobar

  12. Locally advanced cervix cancer: chemotherapy prior to definitive surgery or radiotherapy. A single institutional experience

    International Nuclear Information System (INIS)

    MacLeod, C.; O'Donnell, A.; Tattersall, M.H.N.; Dalrymple, C.; Firth, I.

    2001-01-01

    Primary or neoadjuvant chemotherapy prior to definitive local therapy has potential advantages for locally advanced cervix cancer. It can down stage a cancer and allow definitive local therapy to be technically possible (surgery), or potentially more effective (radiotherapy). It can also eradicate subclinical systemic metastases. This report reviews a single institution's experience of neoadjuvant chemotherapy prior to definitive local therapy for cervix cancer over a 13-year period. One hundred and six patients were treated with this intent. The patients were analysed for their response to chemotherapy, treatment received, survival, relapse and toxicity. The chemotherapy was feasible and the majority of patients had a complete or partial response (58.5%). Eight patients did not proceed to local treatment. Forty-six patients had definitive surgery and 52 had definitive radiotherapy. The 5-year overall survival was 27% and the majority of patients died with disease. The first site of relapse was usually in the pelvis (46.2%). Late complications that required ongoing medical therapy (n = 6) or surgical intervention (n = 2) were recorded in eight patients (7.5%). On univariate analysis stage (P= 0.04), tumour size (P = 0.01), lymph node status (P=0.003), response to chemotherapy (P = 0.045) and treatment (P = 0.003) were all significant predictors of survival. On multivariate analysis, tumour size (P < 0.0001) and nodal status (P = 0.02) were significant predictors of survival. Despite the impressive responses to chemotherapy of advanced cervix cancer, there is evidence from randomized trials that it does not improve or compromise survival prior to radiotherapy. As its role prior to surgery remains unclear, it should not be used in this setting outside a prospective randomized trial. Copyright (2001) Blackwell Science Pty Ltd

  13. Radiogenomics of High-Grade Serous Ovarian Cancer: Multireader Multi-Institutional Study from the Cancer Genome Atlas Ovarian Cancer Imaging Research Group.

    Science.gov (United States)

    Vargas, Hebert Alberto; Huang, Erich P; Lakhman, Yulia; Ippolito, Joseph E; Bhosale, Priya; Mellnick, Vincent; Shinagare, Atul B; Anello, Maria; Kirby, Justin; Fevrier-Sullivan, Brenda; Freymann, John; Jaffe, C Carl; Sala, Evis

    2017-11-01

    Purpose To evaluate interradiologist agreement on assessments of computed tomography (CT) imaging features of high-grade serous ovarian cancer (HGSOC), to assess their associations with time-to-disease progression (TTP) and HGSOC transcriptomic profiles (Classification of Ovarian Cancer [CLOVAR]), and to develop an imaging-based risk score system to predict TTP and CLOVAR profiles. Materials and Methods This study was a multireader, multi-institutional, institutional review board-approved, HIPAA-compliant retrospective analysis of 92 patients with HGSOC (median age, 61 years) with abdominopelvic CT before primary cytoreductive surgery available through the Cancer Imaging Archive. Eight radiologists from the Cancer Genome Atlas Ovarian Cancer Imaging Research Group developed and independently recorded the following CT features: characteristics of primary ovarian mass(es), presence of definable mesenteric implants and infiltration, presence of other implants, presence and distribution of peritoneal spread, presence and size of pleural effusions and ascites, lymphadenopathy, and distant metastases. Interobserver agreement for CT features was assessed, as were univariate and multivariate associations with TTP and CLOVAR mesenchymal profile (worst prognosis). Results Interobserver agreement for some features was strong (eg, α = .78 for pleural effusion and ascites) but was lower for others (eg, α = .08 for intraparenchymal splenic metastases). Presence of peritoneal disease in the right upper quadrant (P = .0003), supradiaphragmatic lymphadenopathy (P = .0004), more peritoneal disease sites (P = .0006), and nonvisualization of a discrete ovarian mass (P = .0037) were associated with shorter TTP. More peritoneal disease sites (P = .0025) and presence of pouch of Douglas implants (P = .0045) were associated with CLOVAR mesenchymal profile. Combinations of imaging features contained predictive signal for TTP (concordance index = 0.658; P = .0006) and CLOVAR profile (mean

  14. [Outpatient management of patients with deep vein thrombosis and cancer: a study of safety, cost and budget impact].

    Science.gov (United States)

    Jara Palomares, Luis; Caballero Eraso, Candela; Elías Hernández, Teresa; Ferrer Galván, Marta; Márquez Peláez, Sergio; Cayuela, Aurelio; Alfaro, María José; Barrot Cortés, Emilia; Otero Candelera, Remedios

    2012-04-07

    This is a safety and cost comparison study with an analysis of budgetary impact of ambulatory management of patients with cancer and deep vein thrombosis (DVT) compared with hospital management. Prospective observational study of patients with known malignancy and diagnosed with DVT from 2003 to 2007. The outcome variables were mortality, relapse and bleeding in one month. We conducted an economic analysis to evaluate the comparative cost of ambulatory patients. Three hundred and seventeen patients, 55 (17%) had cancer. The mean age of patients was 63 ± 11 years. There were 2 hemorrhagic events, 2 recurrences and 6 deaths in one month of follow-up. Of all patients, only 7 (13,7%) required hospitalization. All but one deaths were due to progression of the underlying disease. Economic analysis concluded that outpatient management is 6 times less expensive than hospital management, which would imply a cost reduction of 85%. Specialized outpatient treatment of cancer patients with DVT is safe and could save significant financial resources. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  15. CDO budgeting

    Science.gov (United States)

    Nesladek, Pavel; Wiswesser, Andreas; Sass, Björn; Mauermann, Sebastian

    2008-04-01

    The Critical dimension off-target (CDO) is a key parameter for mask house customer, affecting directly the performance of the mask. The CDO is the difference between the feature size target and the measured feature size. The change of CD during the process is either compensated within the process or by data correction. These compensation methods are commonly called process bias and data bias, respectively. The difference between data bias and process bias in manufacturing results in systematic CDO error, however, this systematic error does not take into account the instability of the process bias. This instability is a result of minor variations - instabilities of manufacturing processes and changes in materials and/or logistics. Using several masks the CDO of the manufacturing line can be estimated. For systematic investigation of the unit process contribution to CDO and analysis of the factors influencing the CDO contributors, a solid understanding of each unit process and huge number of masks is necessary. Rough identification of contributing processes and splitting of the final CDO variation between processes can be done with approx. 50 masks with identical design, material and process. Such amount of data allows us to identify the main contributors and estimate the effect of them by means of Analysis of variance (ANOVA) combined with multivariate analysis. The analysis does not provide information about the root cause of the variation within the particular unit process, however, it provides a good estimate of the impact of the process on the stability of the manufacturing line. Additionally this analysis can be used to identify possible interaction between processes, which cannot be investigated if only single processes are considered. Goal of this work is to evaluate limits for CDO budgeting models given by the precision and the number of measurements as well as partitioning the variation within the manufacturing process. The CDO variation splits according to

  16. Awareness and behavior of oncologists and support measures in medical institutions related to ongoing employment of cancer patients in Japan.

    Science.gov (United States)

    Wada, Koji; Ohtsu, Mayumi; Aizawa, Yoshiharu; Tanaka, Hiroshi; Tagaya, Nobumi; Takahashi, Miyako

    2012-04-01

    Improved outcomes of cancer treatment allow patients to undergo treatment while working. However, support from oncologists and medical institutions is essential for patients to continue working. This study aimed to clarify oncologists' awareness and behavior regarding patients who work during treatment, support in medical institutions and their association. A questionnaire was mailed to all 453 diplomates and faculty of the subspecialty board of medical oncology in the Japanese Society of Medical Oncology and all 1016 surgeons certified by the Japanese Board of Cancer Therapy living in the Kanto area. The questionnaire assessed demographics, oncologist awareness and behavior regarding patient employment and support measures at their medical institutions. Logistic regression analysis was used to examine the association of awareness and behavior of oncologists with support measures at their institutions. A total of 668 individuals participated. The overall response rate was 45.5%. Only 53.6% of respondents advised patients to tell their supervisors about prospects for treatment and ask for understanding. For medical institutions, 28.8% had a nurse-involved counseling program and adjustments in radiation therapy (28.0%) and chemotherapy (41.9%) schedules to accommodate patients' work. There was a significant correlation between awareness and behavior of oncologists and medical institutions' measures to support employed cancer patients. There is room for improvement in awareness and behavior of oncologists and support in medical institutions for cancer patients continuing to work. Oncologists could support working patients by exerting influence on their medical institutions. Conversely, proactive development of support measures by medical institutions could alter the awareness and behavior of oncologists.

  17. Awareness and behavior of oncologists and support measures in medical institutions related to ongoing employment of cancer patients in Japan

    International Nuclear Information System (INIS)

    Wada, Koji; Aizawa, Yoshiharu; Ohtsu, Mayumi; Tanaka, Hiroshi; Tagaya, Nobumi; Takahashi, Miyako

    2012-01-01

    Improved outcomes of cancer treatment allow patients to undergo treatment while working. However, support from oncologists and medical institutions is essential for patients to continue working. This study aimed to clarify oncologists' awareness and behavior regarding patients who work during treatment, support in medical institutions and their association. A questionnaire was mailed to all 453 diplomates and faculty of the subspecialty board of medical oncology in the Japanese Society of Medical Oncology and all 1016 surgeons certified by the Japanese Board of Cancer Therapy living in the Kanto area. The questionnaire assessed demographics, oncologist awareness and behavior regarding patient employment and support measures at their medical institutions. Logistic regression analysis was used to examine the association of awareness and behavior of oncologists with support measures at their institutions. A total of 668 individuals participated. The overall response rate was 45.5%. Only 53.6% of respondents advised patients to tell their supervisors about prospects for treatment and ask for understanding. For medical institutions, 28.8% had a nurse-involved counseling program and adjustments in radiation therapy (28.0%) and chemotherapy (41.9%) schedules to accommodate patients' work. There was a significant correlation between awareness and behavior of oncologists and medical institutions' measures to support employed cancer patients. There is room for improvement in awareness and behavior of oncologists and support in medical institutions for cancer patients continuing to work. Oncologists could support working patients by exerting influence on their medical institutions. Conversely, proactive development of support measures by medical institutions could alter the awareness and behavior of oncologists. (author)

  18. Science, institutional archives and open access: an overview and a pilot survey on the Italian cancer research institutions.

    Science.gov (United States)

    Poltronieri, Elisabetta; Truccolo, Ivana; Di Benedetto, Corrado; Castelli, Mauro; Mazzocut, Mauro; Cognetti, Gaetana

    2010-12-20

    The Open Archive Initiative (OAI) refers to a movement started around the '90 s to guarantee free access to scientific information by removing the barriers to research results, especially those related to the ever increasing journal subscription prices. This new paradigm has reshaped the scholarly communication system and is closely connected to the build up of institutional repositories (IRs) conceived to the benefit of scientists and research bodies as a means to keep possession of their own literary production. The IRs are high-value tools which permit authors to gain visibility by enabling rapid access to scientific material (not only publications) thus increasing impact (citation rate) and permitting a multidimensional assessment of research findings. A survey was conducted in March 2010 to mainly explore the managing system in use for archiving the research finding adopted by the Italian Scientific Institutes for Research, Hospitalization and Health Care (IRCCS) of the oncology area within the Italian National Health Service (Servizio Sanitario Nazionale, SSN). They were asked to respond to a questionnaire intended to collect data about institutional archives, metadata formats and posting of full-text documents. The enquiry concerned also the perceived role of the institutional repository DSpace ISS, built up by the Istituto Superiore di Sanità (ISS) and based on a XML scheme for encoding metadata. Such a repository aims at acting as a unique reference point for the biomedical information produced by the Italian research institutions. An in-depth analysis has also been performed on the collection of information material addressed to patients produced by the institutions surveyed. The survey respondents were 6 out of 9. The results reveal the use of different practices and standard among the institutions concerning: the type of documentation collected, the software adopted, the use and format of metadata and the conditions of accessibility to the IRs. The

  19. California Budget Simulation

    Science.gov (United States)

    Mallinson, Daniel J.

    2018-01-01

    The California Budget Challenge produced by Next10 provides a useful and intuitive tool for instructors to introduce students to public budgeting. Students will reason through a series of budgeting decisions using information provided on the fiscal and practical implications of their choices. The Challenge is updated with each budget cycle, so it…

  20. Plan Your Advertising Budget.

    Science.gov (United States)

    Britt, Steuart-Henderson

    1979-01-01

    Methods for establishing an advertising budget are reviewed. They include methods based on percentage of sales or profits, unit of sales, and objective and task. Also discussed are ways to allocate a promotional budget. The most common breakdowns are: departmental budgets, total budget, calendar periods, media, and sales area. (JMD)

  1. Linking Planning and Budgeting through Business Process Redesign.

    Science.gov (United States)

    Inman, Marianne E.

    In the wake of an extensive strategic planning process that refocused institutional values at Northland College, Wisconsin, the administration undertook linking the budget with the newly articulated plan. Incremental budgeting was no longer feasible, and the new budget would have to reflect streamlining and new ways of functioning. Consequently…

  2. SOME ASPECTS OF STATE BUDGET

    Directory of Open Access Journals (Sweden)

    VEZURE OANA SABINA

    2011-09-01

    Full Text Available In the modern economy, the market, the public purse money materialized in fact all relations that are contained in the sphere of public finances. The state budget is an economic category that is expressed in the form of values, which mobilizes economic relations, is distributed and used the funds of the state. The state budget is a fundamental category of financial sciences. We can address the legal and economic terms. In terms of its legal budget is an act that are set and approved annual revenue and expenditure of the state. Economic activity takes place in each country according to its own mechanism, called the economic mechanism. This is a system of economic management methods for determining management objectives and organizational structures (institutional, superstructure, legal means for driving

  3. The Bone Marrow Transplantation Center of the National Cancer Institute - its resources to assist patients with bone marrow failure

    International Nuclear Information System (INIS)

    Tabak, Daniel

    1997-01-01

    This paper describes the bone marrow transplantation center of the brazilian National Cancer Institute, which is responsible for the cancer control in Brazil. The document also describes the resources available in the Institute for assisting patients presenting bone marrow failures. The Center provides for allogeneic and autologous bone marrow transplants, peripheral stem cell transplants, umbilical cord collections and transplants, and a small experience with unrelated bone marrow transplants. The Center receives patient from all over the country and provides very sophisticated medical care at no direct cost to the patients

  4. The nursing human resource budget: design for success.

    Science.gov (United States)

    Winkler, J B; Cameron, M L; Flarey, D L

    1995-06-01

    As vital as the nursing human resource budget is to the successful achievement of institutional goals, it is very important to present a well-developed budget. Using current automated spreadsheet technology, the nursing human resource budget can be laid out in a format that is easy to understand and easy to present. Using the methods discussed in this article, the nurse executive will be able to perform infinite iterations of the proposed budget with a few simple key strokes, thus allowing for things like zero-based budgeting or addition of programs during the budgeting process or at a later date. Implications for nurse executives are discussed.

  5. Racial Differences in Information Needs During and After Cancer Treatment: a Nationwide, Longitudinal Survey by the University of Rochester Cancer Center National Cancer Institute Community Oncology Research Program.

    Science.gov (United States)

    Asare, Matthew; Peppone, Luke J; Roscoe, Joseph A; Kleckner, Ian R; Mustian, Karen M; Heckler, Charles E; Guido, Joseph J; Sborov, Mark; Bushunow, Peter; Onitilo, Adedayo; Kamen, Charles

    2018-02-01

    Before treatment, cancer patients need information about side effects and prognosis, while after treatment they need information to transition to survivorship. Research documenting these needs is limited, especially among racial and ethnic minorities. This study evaluated cancer patients' needs according to race both before and after treatment. We compared white (n = 904) to black (n = 52) patients receiving treatment at 17 National Cancer Institute Community Oncology Research Program (NCORP) sites on their cancer-related concerns and need for information before and after cancer treatment. Two-sample t test and chi-squared analyses were used to assess group differences. Compared to white patients, black patients reported significantly higher concerns about diet (44.3 vs. 25.4 %,) and exercise (40.4 vs. 19.7 %,) during the course of treatment. Compared to whites, blacks also had significantly higher concern about treatment-related issues (white vs. black mean, 25.52 vs. 31.78), self-image issues (7.03 vs. 8.60), family-related issues (10.44 vs. 12.84), and financial concerns (6.42 vs. 8.90, all p < 0.05). Blacks, compared to whites, also had significantly greater post-treatment information needs regarding follow-up tests (8.17 vs. 9.44), stress management (4.12 vs. 4.89), and handling stigma after cancer treatment (4.21 vs. 4.89) [all p < 0.05]. Pre-treatment concerns and post-treatment information needs differed by race, with black patients reporting greater information needs and concerns. In clinical practice, tailored approaches may work particularly well in addressing the needs and concerns of black patients.

  6. [Nutritional status in patients first hospital admissions service hematology National Cancer Institute].

    Science.gov (United States)

    Baltazar Luna, E; Omaña Guzmán, L I; Ortiz Hernández, L; Ñamendis-Silva, S A; De Nicola Delfin, L

    2013-01-01

    To determine the nutritional status of patients admitted to hospital for the first time the hematology service and who have not received treatment for cancer, to know if the nutritional status assessed by the EGS-GP and serum albumin related mortality of patients A longitudinal, prospective, analytical. EGS-Through GP assessed the nutritional status of patients, we used SPSS 19.0 for data analysis. Evaluaron 119 patients, 52.1% female and 47.9% male. The most common diagnosis was non-Hodgkin lymphoma in 43.7%. According to the EGS-GP 50.4% of patients had some degree of malnutrition or was at risk of suffering of which: 31.1% had moderate and 19.3% had severe malnutrition. The 49.6% of patients had an adequate nutritional status. 30.3% of the patients who died, 37% had severe malnutrition and 50% severe decrease in albumin concentration. The prevalence of malnutrition in hematological patients treated at the National Cancer Institute of Mexico that have not received medical treatment was high. There is an association between nutritional status and mortality in this patient group. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

  7. Chronological changes in lung cancer surgery in a single Japanese institution

    Science.gov (United States)

    Nakamura, Haruhiko; Sakai, Hiroki; Kimura, Hiroyuki; Miyazawa, Tomoyuki; Marushima, Hideki; Saji, Hisashi

    2017-01-01

    Background The aim of this study was to evaluate the chronological changes in epidemiological factors and surgical outcomes in patients with lung cancer who underwent surgery in a single Japanese institution. Patients and methods A clinicopathological database of patients with lung cancer who underwent surgery with curative intent from January 1974 to December 2014 was reviewed. The chronological changes in various factors, including patient’s age, sex, histological type, tumor size, pathological stage (p-stage), surgical method, operative time, intraoperative blood loss, 30-day mortality, and postoperative overall survival (OS), were evaluated. Results A total of 1,616 patients were included. The numbers of resected patients, females, adenocarcinomas, p-stage IA patients, and age at the time of surgery increased with time, but tumor size decreased (all P<0.0001). Concerning surgical methods, the number of sublobar resections increased, but that of pneumonectomies decreased (P<0.0001). The mean operative time, intraoperative blood loss, and the postoperative 30-day mortality rate decreased (all P<0.0001). When the patients were divided into two groups (1974–2004 and 2005–2014), the 5-year OS rates for all patients and for p-stage IA patients improved from 44% to 79% and from 73% to 89%, respectively (all P<0.0001). The best 5-year OS rate was obtained for sublobar resection (73%), followed by lobectomy (60%), combined resection (22%), and pneumonectomy (21%; P<0.0001). Conclusion Changes in epidemiological factors, a trend toward less invasive surgery, and a remarkably improved postoperative OS were confirmed, which demonstrated the increasingly important role of surgery in therapeutic strategies for lung cancer. PMID:28331339

  8. Why providers participate in clinical trials: considering the National Cancer Institute's Community Clinical Oncology Program.

    Science.gov (United States)

    McAlearney, Ann Scheck; Song, Paula H; Reiter, Kristin L

    2012-11-01

    The translation of research evidence into practice is facilitated by clinical trials such as those sponsored by the National Cancer Institute's Community Clinical Oncology Program (CCOP) that help disseminate cancer care innovations to community-based physicians and provider organizations. However, CCOP participation involves unsubsidized costs and organizational challenges that raise concerns about sustained provider participation in clinical trials. This study was designed to improve our understanding of why providers participate in the CCOP in order to inform the decision-making process of administrators, clinicians, organizations, and policy-makers considering CCOP participation. We conducted a multi-site qualitative study of five provider organizations engaged with the CCOP. We interviewed 41 administrative and clinician key informants, asking about what motivated CCOP participation, and what benefits they associated with involvement. We deductively and inductively analyzed verbatim interview transcripts, and explored themes that emerged. Interviewees expressed both "altruistic" and "self-interested" motives for CCOP participation. Altruistic reasons included a desire to increase access to clinical trials and feeling an obligation to patients. Self-interested reasons included the desire to enhance reputation, and a need to integrate disparate cancer care activities. Perceived benefits largely matched expressed motives for CCOP participation, and included internal and external benefits to the organization, and quality of care benefits for both patients and participating physicians. The motives and benefits providers attributed to CCOP participation are consistent with translational research goals, offering evidence that participation can contribute value to providers by expanding access to innovative medical care for patients in need. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Iodine-125 seed brachytherapy for early stage prostate cancer: a single-institution review

    International Nuclear Information System (INIS)

    Zuber, Simon; Weiß, Susan; Baaske, Dieter; Schöpe, Michael; Stevens, Simon; Bodis, Stephan; Zwahlen, Daniel R

    2015-01-01

    We are reporting the five-year biochemical control, toxicity profile and dosimetric parameters using iodine-125 low dose rate brachytherapy (BT) as monotherapy for early stage prostate cancer at a single institution. Between April 2006 and December 2010, 169 men with early stage prostate cancer were treated with BT. Biochemical failure was defined using the Phoenix definition (nadir + 2 ng/mL). Treatment-related morbidities, including urinary, rectal and sexual function, were measured, applying the International Prostate Symptom Score (IPSS), the 7-grade Quality of Life Scale (QoL) and medical status, the International Consultation on Incontinence Modular Questionnaire (ICIQ), the International Index of Erectile Function (IIEF-5) and the Common Terminology Criteria for Adverse Events (CTCAE v4.03). Seed migration and loss, dosimetric parameters and learning effects were also analyzed. Medium follow-up time was 50 months (range, 1–85 months). The five-year biochemical failure rate was 7%. Acute proctitis rates were 19% (grade 1) and 1% (grade 2), respectively. The overall incidence of incontinence was 19% (mild), 16% (moderate) and < 1% (severe). An increase in IPSS ≥ 5 points was detected in 59% of patients, with 38% regaining their baseline. Seed dislocation was found in 24% of patients and correlated with D90 and V100. A learning curve was found for seed migration, D90 and V100. QoL correlated with the general health condition of patient, incontinence symptoms and IPSS. BT for early stage prostate cancer offers excellent five-year biochemical control with low toxicities. QoL aspects are favorable. A learning curve was detected for procedural aspects but its impact on patient relevant endpoints remains inconclusive

  10. FY 1996 Congressional budget request: Budget highlights

    Energy Technology Data Exchange (ETDEWEB)

    1995-02-01

    The FY 1996 budget presentation is organized by the Department`s major business lines. An accompanying chart displays the request for new budget authority. The report compares the budget request for FY 1996 with the appropriated FY 1995 funding levels displayed on a comparable basis. The FY 1996 budget represents the first year of a five year plan in which the Department will reduce its spending by $15.8 billion in budget authority and by $14.1 billion in outlays. FY 1996 is a transition year as the Department embarks on its multiyear effort to do more with less. The Budget Highlights are presented by business line; however, the fifth business line, Economic Productivity, which is described in the Policy Overview section, cuts across multiple organizational missions, funding levels and activities and is therefore included in the discussion of the other four business lines.

  11. Accelerating cancer therapy development: the importance of combination strategies and collaboration. Summary of an Institute of Medicine workshop.

    Science.gov (United States)

    LoRusso, Patricia M; Canetta, Renzo; Wagner, John A; Balogh, Erin P; Nass, Sharyl J; Boerner, Scott A; Hohneker, John

    2012-11-15

    Cancer cells contain multiple genetic changes in cell signaling pathways that drive abnormal cell survival, proliferation, invasion, and metastasis. Unfortunately, patients treated with single agents inhibiting only one of these pathways--even if showing an initial response--often develop resistance with subsequent relapse or progression of their cancer, typically via the activation of an alternative uninhibited pathway. Combination therapies offer the potential for inhibiting multiple targets and pathways simultaneously to more effectively kill cancer cells and prevent or delay the emergence of drug resistance. However, there are many unique challenges to developing combination therapies, including devising and applying appropriate preclinical tests and clinical trial designs, prioritizing which combination therapies to test, avoiding overlapping toxicity of multiple agents, and overcoming legal, cultural, and regulatory barriers that impede collaboration among multiple companies, organizations, and/or institutions. More effective strategies to efficiently develop combination cancer therapies are urgently needed. Thus, the Institute of Medicine's National Cancer Policy Forum recently convened a workshop with the goal of identifying barriers that may be impeding the development of combination investigational cancer therapies, as well as potential solutions to overcome those barriers, improve collaboration, and ultimately accelerate the development of promising combinations of investigational cancer therapies. ©2012 AACR.

  12. Cervical cancer screening: knowledge, attitude and practices among nursing staff in a tertiary level teaching institution of rural India.

    Science.gov (United States)

    Shekhar, Shashank; Sharma, Chanderdeep; Thakur, Sita; Raina, Nidhi

    2013-01-01

    Assessment of the nursing staff knowledge, attitude and practices about cervical cancer screening in a tertiary care teaching institute of rural India. A cross sectional, descriptive, interview- based survey was conducted with a pretested questionnaire among 262 staff nurses of a tertiary care teaching and research institute. In this study 77% respondents knew that Pap smear is used for detection of cervical cancer, but less than half knew that Pap smear can detect even precancerous lesions of cervix. Only 23.4% knew human papilloma virus infection as a risk factor. Only 26.7% of the respondents were judged as having adequate knowledge based on scores allotted for questions evaluating knowledge about cervical cancer and screening. Only 17 (7%) of the staff nurses had themselves been screened by Pap smear, while 85% had never taken a Pap smear of a patient. Adequate knowledge of cervical cancer and screening, higher parity and age >30 years were significantly associated with self screening for cervical cancer. Most nurses held a view that Pap test is a doctor procedure, and nearly 90% of nurses had never referred a patient for Pap testing. The majority of nursing staff in rural India may have inadequate knowledge about cervical cancer screening, and their attitude and practices towards cervical cancer screening could not be termed positive.

  13. STATE BUDGET AND BUDGETARY PROCEDURES IN ROMANIA

    Directory of Open Access Journals (Sweden)

    POPA George Dorel

    2013-12-01

    Full Text Available In Romania, the budget process is governed by the Constitution and the Law of Public Finance no. 500/2002, act that includes the elaboration of the draft budget, approving the state budget, budget execution and budget control. All these activities are carried out in a legal way and administrative- institutional way, presenting features from country to country. The budget shows many traits in common: it is a decision process, because its essence consists in allocating budgetary resources for public goods such as education, health, national defence and so on. On the other hand is an essentially political process because allocation decisions budgetary resources are determined by the political groups, the mechanism of representation and voting, is a complex process with many participants (schools, hospitals, ministries, etc.. The budgetary process is a cyclic process, as it follows a well-defined calendar as a consequence of yearly and advertising budget. In conclusion, the budget process is a set of consecutive stages of development, approval, execution, control and reporting of the state budget, which ends with the approval of its execution account.

  14. Prevalence and Predictors of Neoadjuvant Therapy for Stage IIIA Non-Small Cell Lung Cancer in the National Cancer Database: Importance of Socioeconomic Status and Treating Institution

    Energy Technology Data Exchange (ETDEWEB)

    Sher, David J., E-mail: david_sher@rush.edu [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States); Liptay, Michael J. [Department of Cardiothoracic Surgery, Rush University Medical Center, Chicago, Illinois (United States); Fidler, Mary Jo [Section of Medical Oncology, Rush University Medical Center, Chicago, Illinois (United States)

    2014-06-01

    Purpose: The optimal locoregional therapy for stage IIIA non-small cell lung cancer (NSCLC) is controversial, with definitive chemoradiation therapy (CRT) and neoadjuvant therapy followed by surgery (NT-S) serving as competing strategies. In this study, we used the National Cancer Database to determine the prevalence and predictors of NT in a large, modern cohort of patients. Methods and Materials: Patients with stage IIIA NSCLC treated with CRT or NT-S between 2003 and 2010 at programs accredited by the Commission on Cancer were included. Predictors were categorized as clinical, time/geographic, socioeconomic, and institutional. In accord with the National Cancer Database, institutions were classified as academic/research program and as comprehensive and noncomprehensive community cancer centers. Logistic regression and random effects multilevel logistic regression were performed for univariable and multivariable analyses, respectively. Results: The cohort consisted of 18,581 patients, 3,087 (16.6%) of whom underwent NT-S (10.6% induction CRT, 6% induction chemotherapy). The prevalence of NT-S was constant over time, but there were significant relative 31% and 30% decreases in pneumonectomy and right-sided pneumonectomy, respectively, over time (P trend <.02). In addition to younger age, lower T stage, and favorable comorbidity score, indicators of higher socioeconomic status were strong independent predictors of NT-S, including white race, higher income, and private/managed insurance. The type of institution (academic/research program vs comprehensive or noncomprehensive community cancer centers, odds ratio 1.54 and 2.08, respectively) strongly predicted NT-S, but treatment volume did not. Conclusions: Neoadjuvant therapy followed by surgery was an uncommon treatment approach in Commission on Cancer programs, and the prevalence of postinduction pneumonectomy decreased over time. Higher socioeconomic status and treatment at academic institutions were significant

  15. Prevalence and Predictors of Neoadjuvant Therapy for Stage IIIA Non-Small Cell Lung Cancer in the National Cancer Database: Importance of Socioeconomic Status and Treating Institution

    International Nuclear Information System (INIS)

    Sher, David J.; Liptay, Michael J.; Fidler, Mary Jo

    2014-01-01

    Purpose: The optimal locoregional therapy for stage IIIA non-small cell lung cancer (NSCLC) is controversial, with definitive chemoradiation therapy (CRT) and neoadjuvant therapy followed by surgery (NT-S) serving as competing strategies. In this study, we used the National Cancer Database to determine the prevalence and predictors of NT in a large, modern cohort of patients. Methods and Materials: Patients with stage IIIA NSCLC treated with CRT or NT-S between 2003 and 2010 at programs accredited by the Commission on Cancer were included. Predictors were categorized as clinical, time/geographic, socioeconomic, and institutional. In accord with the National Cancer Database, institutions were classified as academic/research program and as comprehensive and noncomprehensive community cancer centers. Logistic regression and random effects multilevel logistic regression were performed for univariable and multivariable analyses, respectively. Results: The cohort consisted of 18,581 patients, 3,087 (16.6%) of whom underwent NT-S (10.6% induction CRT, 6% induction chemotherapy). The prevalence of NT-S was constant over time, but there were significant relative 31% and 30% decreases in pneumonectomy and right-sided pneumonectomy, respectively, over time (P trend <.02). In addition to younger age, lower T stage, and favorable comorbidity score, indicators of higher socioeconomic status were strong independent predictors of NT-S, including white race, higher income, and private/managed insurance. The type of institution (academic/research program vs comprehensive or noncomprehensive community cancer centers, odds ratio 1.54 and 2.08, respectively) strongly predicted NT-S, but treatment volume did not. Conclusions: Neoadjuvant therapy followed by surgery was an uncommon treatment approach in Commission on Cancer programs, and the prevalence of postinduction pneumonectomy decreased over time. Higher socioeconomic status and treatment at academic institutions were significant

  16. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Centers Advisory Boards & Review Groups Budget & Appropriations Current Year Budget Annual Plan & Budget Proposal Congressional Justification NCI ... using statistics that researchers have collected over many years about people with the same type of cancer. ...

  17. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Reporting & Auditing Grant Transfer Grant Closeout Contracts & Small Business Training Cancer Training at NCI (Intramural) Resources for ... and Review Groups Budget & Appropriations About the Annual Plan & Budget Proposal NCI Congressional Justification NCI Budget Fact ...

  18. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Reporting & Auditing Grant Transfer Grant Closeout Contracts & Small Business Training Cancer Training at NCI (Intramural) Funding for ... and Review Groups Budget & Appropriations About the Annual Plan & Budget Proposal NCI Congressional Justification NCI Budget Fact ...

  19. Tumor induction following intraoperative radiotherapy: Late results of the National Cancer Institute canine trials

    International Nuclear Information System (INIS)

    Barnes, M.; Duray, P.; DeLuca, A.; Anderson, W.; Sindelar, W.; Kinsella, T.

    1990-01-01

    Intraoperative radiotherapy has been employed in human cancer research for over a decade. Since 1979, trials to assess the acute and late toxicity of IORT have been carried out at the National Cancer Institute in an adult dog model in an attempt to establish dose tolerance guidelines for a variety of organs. Of the 170 animals entered on 12 studies with a minimum follow-up of 2 years, 148 dogs received IORT; 22 control animals received only surgery. Animals were sacrificed at designated intervals following IORT, usually at 1, 6, 12, 24, and 60 month intervals. 102 of 148 irradiated dogs were sacrificed less than 24 months; 46 dogs were followed greater than or equal to 24 months after IORT. To date, 34 of the 46 animals have been sacrificed; the 12 remaining animals are to be followed to 5 years. These 12 animals have minimum follow-up of 30 months. In the irradiated group followed for greater than or equal to 24 months, 10 tumors have arisen in 9 animals. One animal developed an incidental spontaneous breast carcinoma outside the IORT port, discovered only at scheduled post-mortem exam. The remaining nine tumors arose within IORT ports. Two tumors were benign neural tumors--a neuroma and a neurofibroma. One animal had a collision tumor comprised of grade I chondrosarcoma adjacent to grade III osteosarcoma arising in lumbar vertebrae. Two other grade III osteosarcomas, one grade III fibrosarcoma, and one grade III malignant fibrous histiocytoma arose in retroperitoneal/paravertebral sites. An embryonal rhabdomyosarcoma (sarcoma botryoides) arose within the irradiated urinary bladder of one animal. No sham irradiated controls nor IORT animals sacrificed less than 24 months have developed any spontaneous or radiation-induced tumors. The time range of diagnoses of tumors was 24-58 months. The IORT dose range associated with tumor development was 20-35 Gy

  20. Evaluation of the cost of cervical cancer at the National Institute of Oncology, Rabat

    Science.gov (United States)

    Cheikh, Amine; El Majjaoui, Sanaa; Ismaili, Nabil; Cheikh, Zakia; Bouajaj, Jamal; Nejjari, Chakib; El Hassani, Amine; Cherrah, Yahya; Benjaafar, Noureddine

    2016-01-01

    Introduction The Cervical Cancer (CC) is one of the heavy and costly diseases for the population and the health system. We want to know through this study, the first in Morocco, the annual cost of the treatment of this disease at the National Institute of Oncology (NIO) in Rabat, we also want to explore the possibility of flat-rate management of this disease in order to standardize medical practices and improve reimbursement by health insurance funds. Methods 550 patients were treated for their cervical cancer in the Rabat's NIO. Data of all of medical and surgical services offered to patients were collected from the NIO registry. The cost of care was assessed using the method of micro-costing. We will focus to the total direct cost of all the services lavished to patients in NIO. Results The global cost was about US$ 1,429,673 with an average estimated at US$ 2,599 ± US$ 839. Radiotherapy accounts for 55% of total costs, followed by brachytherapy (27%) and surgery (7%). This three services plus chemotherapy influence the overall cost of care (p <0.001). Other services (radiology, laboratory tests and consultations) represent only 10%. The overall cost is influenced by the stage of the disease, this cost decreased significantly evolving in the stage of CC (p <0.001). Conclusion The standardization of medical practices is essential to the equity and efficiency in access to care. The flat-rate or lump sum by stage of disease is possible and interesting for standardizing medical practices and improving the services of the health insurance plan. PMID:27347298

  1. Tumor induction following intraoperative radiotherapy: Late results of the National Cancer Institute canine trials

    Energy Technology Data Exchange (ETDEWEB)

    Barnes, M.; Duray, P.; DeLuca, A.; Anderson, W.; Sindelar, W.; Kinsella, T. (Fox Chase Cancer Center, Philadelphia, PA (USA))

    1990-09-01

    Intraoperative radiotherapy has been employed in human cancer research for over a decade. Since 1979, trials to assess the acute and late toxicity of IORT have been carried out at the National Cancer Institute in an adult dog model in an attempt to establish dose tolerance guidelines for a variety of organs. Of the 170 animals entered on 12 studies with a minimum follow-up of 2 years, 148 dogs received IORT; 22 control animals received only surgery. Animals were sacrificed at designated intervals following IORT, usually at 1, 6, 12, 24, and 60 month intervals. 102 of 148 irradiated dogs were sacrificed less than 24 months; 46 dogs were followed greater than or equal to 24 months after IORT. To date, 34 of the 46 animals have been sacrificed; the 12 remaining animals are to be followed to 5 years. These 12 animals have minimum follow-up of 30 months. In the irradiated group followed for greater than or equal to 24 months, 10 tumors have arisen in 9 animals. One animal developed an incidental spontaneous breast carcinoma outside the IORT port, discovered only at scheduled post-mortem exam. The remaining nine tumors arose within IORT ports. Two tumors were benign neural tumors--a neuroma and a neurofibroma. One animal had a collision tumor comprised of grade I chondrosarcoma adjacent to grade III osteosarcoma arising in lumbar vertebrae. Two other grade III osteosarcomas, one grade III fibrosarcoma, and one grade III malignant fibrous histiocytoma arose in retroperitoneal/paravertebral sites. An embryonal rhabdomyosarcoma (sarcoma botryoides) arose within the irradiated urinary bladder of one animal. No sham irradiated controls nor IORT animals sacrificed less than 24 months have developed any spontaneous or radiation-induced tumors. The time range of diagnoses of tumors was 24-58 months. The IORT dose range associated with tumor development was 20-35 Gy.

  2. Demographics of Head and Neck Cancer Patients: A Single Institution Experience

    Science.gov (United States)

    Kitanova, Martina; Dzhenkov, Deyan L; Ghenev, Peter; Sapundzhiev, Nikolay

    2017-01-01

    Introduction Head and neck cancer (HNC) comprises a diverse group of oncological entities, originating from various tissue types and organ localizations, situated in the topographical regions of the head and neck (H&N). This single institution retrospective study was aimed at establishing the HNC patient demographics and categorizing the individual incidence of H&N malignancies, regarding their organ of origin and main histopathological type. Materials and methods All histologically verified cases of HNC from a single tertiary referral center were reviewed in a descriptive retrospective manner. Data sampling period was 47 months. Results Male to female ratio of the registered HNC cases was 3.24:1. The mean age of diagnosis was 63.84 ± 12.65 years, median 65 years. The most common HNC locations include the larynx 30.37% (n = 188), lips and oral cavity 29.08% (n = 180), pharynx 20.03% (n = 124) and salivary glands 10.94% (n = 68), with other locations such as the external nose, nasal cavity and sinuses and auricle and external ear canal harboring a minority of the cases. The main histopathological groups include squamous cell carcinoma 76.74% (n = 475) and adenocarcinoma 6.14% (n = 38), with other malignant entries such as other epithelial malignancies, primary tonsillar, mucosa-associated lymphoid tissue or parenchymal lymphomas, connective tissue neoplasias, neuroendocrine and vascular malignancies diagnosed in a minority of cases. Conclusion Considered to be relatively rare, HNC represents a diverse group of oncological entities with individual and specific demographic characteristics. The reported single institution results appear representative of the national incidence and characteristics of HNC. PMID:28875091

  3. Chemotherapy Regimen in Nonagenarian Cancer Patients: A Bi-Institutional Experience.

    Science.gov (United States)

    Rivoirard, Romain; Chargari, Cyrus; Kullab, Sharif; Trone, Jane-Chloé; Langrand-Escure, Julien; Moriceau, Guillaume; Guy, Jean-Baptiste; Annede, Pierre; Méry, Benoîte; Moncharmont, Coralie; Falk, Alexander Tuan; Vedrine, Lionel; Merrouche, Yacine; Fournel, Pierre; Magné, Nicolas

    2016-01-01

    The elderly population in Western countries is growing and constitutes a public health issue. Concomitantly, age-related diseases such as cancer increase. There are few data on the efficacy, tolerability and toxicity of specific anticancer therapy in the very elderly patients; therefore, their management is not standardized. In this bi-institutional study, we reviewed medical records of patients who received or continued specific anticancer therapy beyond the age of 90 years. Geriatric assessment was not reported for our patients. Twelve patients were enrolled. Their general health condition was good, and half of them were living in elderly institutions. Ten patients had a solid tumor and 2 were treated for hematological malignancies. Most were diagnosed with a locally advanced or metastatic disease, and the goal of treatment was curative for only 1 patient. Six patients received chemotherapy as first-line treatment, 4 patients received targeted therapy and 2 received concomitant chemoradiation. Four patients received a second-line treatment. Despite a significant reduction in treatment posology in half of the patients, 8 acute grade 3/4 toxicities were reported and 2 patients died of treatment-related septic shock. Median duration of first-line treatment was 3.2 months, and progression-free survival ranged from 18 to 311 days. Overall survival ranged from 18 days to 11 years. Aging is a heterogeneous process, and management of elderly patients is a multidisciplinary approach. Geriatric assessment helps to identify older patients with a higher risk of morbidity/mortality and allows to assess the risks and benefits of specific anticancer therapy. The choice of treatment should be based primarily on the expected symptomatic benefit, and treatment should not compromise the quality of life. © 2015 S. Karger AG, Basel.

  4. Beyond Zero Based Budgeting.

    Science.gov (United States)

    Ogden, Daniel M., Jr.

    1978-01-01

    Suggests that the most practical budgeting system for most managers is a formalized combination of incremental and zero-based analysis because little can be learned about most programs from an annual zero-based budget. (Author/IRT)

  5. Fiscal Year 2015 Budget

    Data.gov (United States)

    Montgomery County of Maryland — This dataset includes the Fiscal Year 2015 Council-approved operating budget for Montgomery County. The dataset does not include revenues and detailed agency budget...

  6. Zero-Based Budgeting: The Texas Experience.

    Science.gov (United States)

    Boyd, William L.

    1982-01-01

    Zero-based budgeting was instituted in all Texas state-funded agencies in 1975-76, including colleges. The first two years of using this procedure are reviewed and its applicability to higher education institutions is examined in light of the need to consider educational quality as well as costs. (MSE)

  7. Budgeting and Beyond

    DEFF Research Database (Denmark)

    Rohde, Carsten

    Budgets and budget control has been known since the early 19th century1. However the use of budget control was until the beginning of the 1920ies in US primarily related to governmental units and states and to a minor extent to business units in practice. At that time James McKinsey describes...

  8. Between Bedside and Budget

    NARCIS (Netherlands)

    J.L.T. Blank; E. Eggink

    1998-01-01

    Original title: Tussen bed en budget. The report Between bedside and budget (Tussen bed en budget) describes an extensive empirical study of the efficiency of general and university hospitals in the Netherlands. A policy summary recaps the main findings of the study. Those findings

  9. Library Budget Primer.

    Science.gov (United States)

    Warner, Alice Sizer

    1993-01-01

    Discusses the advantages and disadvantages of six types of budgets commonly used by many different kinds of libraries. The budget types covered are lump-sum; formula; line or line-item; program; performance or function; and zero-based. Accompanying figures demonstrate the differences between four of the budget types. (three references) (KRN)

  10. National Cancer Institute's leadership role in promoting State and Community Tobacco Control research.

    Science.gov (United States)

    Ginexi, Elizabeth M; Vollinger, Robert E

    2016-10-01

    The National Cancer Institute (NCI) has been at the vanguard of funding tobacco control research for decades with major efforts such as the Community Intervention Trial for Smoking Cessation (COMMIT) in 1988 and the American Stop Smoking Intervention Study (ASSIST) in 1991, followed by the Tobacco Research Initiative for State and Community Interventions in 1999. Most recently, in 2011, the NCI launched the State and Community Tobacco Control (SCTC) Research Initiative to address gaps in secondhand smoke policies, tax and pricing policies, mass media countermeasures, community and social norms and tobacco marketing. The initiative supported large scale research projects and time-sensitive ancillary pilot studies in response to expressed needs of state and community partners. This special issue of Tobacco Control showcases exciting findings from the SCTC. In this introductory article, we provide a brief account of NCI's historical commitment to promoting research to inform tobacco control policy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  11. Evaluation of leakage in cobalt-60 unit in National Cancer Institute (NCI) Wad Medani

    International Nuclear Information System (INIS)

    Fadlellah, R. A.

    2013-08-01

    This study has been conducted primarily to evaluate the leakages radiation in cobalt-60 unit in National Cancer Institute Wad Medani, which represent the basic risky factor in this unit for the radio therapists who spend much time during patient set up, also they need to stand near the head of the machine to fix some accessories. The measurements which done using survey meter give normal level of occupational exposure compared with IAEA references except one situation that the radio therapist to be close contact to the head of unit for long time which may increase the received dose, in this situation. The radio therapist either not well trained, or there is insufficient accessories to reduce the time inside the room. Radiotherapy department need a special considerations from the beginning of construction till starting of treatment. It is important to contain separate rooms, for planning to determine treatment area, another one for molding to shape lead blocks to protect normal parts and an optimum designed room for treatment to enable workers to apply basic radiation protection principles. (Author)

  12. Treatment outcomes of female germ cell tumors: The Egyptian National Cancer Institute experience

    International Nuclear Information System (INIS)

    Saber, M.M.; Zeeneldin, A.A.; El Gammal, M.M.; Salem, S.E.; Darweesh, A.D.; Abdelaziz, A.A.; Monir, M.

    2014-01-01

    Introduction: Female germ cell tumors (GCTS) are rare tumors that carry a good prognosis. Aim: To report the experience of the Egyptian National Cancer Institute (ENCI) in managing female GCTs. Methods: This retrospective study included 19 females with ovarian GCTs presenting to the ENCI between 2006 and 2010. Results: The median age was 23 years. Ovaries were the primary site in all patients. Dysgerminoma and teratoma were the predominant pathologies followed by mixed GCT in females. Unilateral ovariectomy or ovarian tumorectomy were the classic surgical procedures with R0 resection being feasible in most cases. Surveillance was adopted in six patients with stage I disease. Chemotherapy was administered in 63% of ovarian GCTs with BEP being the commonest regimen with reasonable tolerability and good response rates. The median OS and EFS were not reached. The projected 5-year OS rate was 93.8%. Both OS and EFS were better in patients responding to chemotherapy than non-responders (p< 0.002). Stage of disease did not significantly affect OS or EFS. Conclusions: Female GCTs rarely affect Egyptian females. They have good prognosis.

  13. Physical properties of a linear accelerator-based stereotactic installed at national cancer institute

    International Nuclear Information System (INIS)

    Attala, E.M.; Deiab, N.A.; Elawady, R.A.

    2005-01-01

    The purpose of this paper is to present the dosimetry and mechanical accuracy of the first dedicated Siemens PRIMUS M6/6ST linear accelerator-based Stereotactic installed in National Cancer Institute for stereotactic radiosurgery and radiotherapy (SRS/SRT). The data were obtained during the installation, acceptance test procedure, and commissioning of the unit. The Primus M6/6ST has a single 6-MV beam with the same beam characteristics as that of the mother unit, the Siemens. The dosimetric data were taken using pin point ion chamber. The cone sizes vary from 12.5 to 40.0 mm diameter. The mechanical stability of the entire system was verified. The variations in isocenter position with table, gantry, and collimator rotation were found to be < 0.5 mm with a compounded accuracy of < or = 1.0 mm. The beam profiles of all cones in the x and y directions were within +/- 0.5 mm and match with the physical size of the cone. The basic dosimetry parameters such as tissue maximum ratio (TMR), off-axis ratio (OAR) and cone factor needed for patient treatment were evaluated. The mechanical and dosimetric characteristics including dose linearity of this unit are presented and found to be suitable for SRS/SRT. The difficulty in absolute dose measurement for small cone is discussed

  14. Possible misdiagnosis of HIV associated lymphoma as tuberculosis among patients attending Uganda Cancer Institute.

    Science.gov (United States)

    Buyego, Paul; Nakiyingi, Lydia; Ddungu, Henry; Walimbwa, Stephen; Nalwanga, Damalie; Reynolds, Steven J; Parkes-Ratanshi, Rosalind

    2017-03-14

    Early diagnosis of HIV associated lymphoma is challenging because the definitive diagnostic procedure of biopsy, requires skills and equipment that are not readily available. As a consequence, diagnosis may be delayed increasing the risk of mortality. We set out to determine the frequency and risk factors associated with the misdiagnosis of HIV associated lymphoma as tuberculosis (TB) among patients attending the Uganda Cancer Institute (UCI). A retrospective cohort study design was used among HIV patients with associated lymphoma patients attending the UCI, Kampala, Uganda between February and March 2015. Eligible patient charts were reviewed for information on TB treatment, socio-demographics, laboratory parameters (Hemoglobin, CD4cells count and lactate dehydrogenase) and clinical presentation using a semi structured data extraction form. A total of 183 charts were reviewed; 106/183 were males (57.9%), the median age was 35 (IQR, 28-45). Fifty six (30.6%) patients had a possible misdiagnosis as TB and their median time on TB treatment was 3.5 (1-5.3) months. In multivariate analysis the presence of chest pain had an odd ratio (OR) of 4.4 (95% CI 1.89-10.58, p HIV associated lymphoma attending UCI are misdiagnosed and treated as TB. Chest pain and stage III and IV of lymphoma were associated with an increased risk of a possible misdiagnosis of lymphoma as TB.

  15. Malignant lymphoma. Prognostic factors and response to treatment of 473 patients at the National Cancer Institute

    International Nuclear Information System (INIS)

    Anderson, T.; DeVita, V.T. Jr.; Simon, R.M.; Berard, C.W.; Canellos, G.P.; Garvin, A.J.; Young, R.C.

    1982-01-01

    Treatment results were reviewed in 473 consecutively staged and treated patients at the National Cancer Institute over a 22-year period from 1953 to 1975. Responses correlated with histologic pattern and stage of disease. Complete responses to radiotherapy were frequent in nodular lymphoma patients. Similar treatment regimens were less effective in diffuse lymphoma patients. Using chemotherapy or combined modality approaches, complete responses were obtained in a high proportion of advanced nodular disease patients. Patients with nodular lymphoma tend to have higher complete response rates and longer survivals than their counterparts with diffuse histologic types. Patients with nodular lymphocytic lymphoma had a better survival than those with mixed or ''histiocytic'' histologic types. Patients with diffuse well differentiated lymphocytic lymphoma survived significantly longer than patients with other diffuse histologic types. Percentage and prominence of nodularity were not of prognostic significance in those patients with combined nodular and diffuse patterns of disease. When compared by histologic type, patient sex did not appear to be an important prognostic factor. The presence of B-symptoms was associated with a poorer survival in patients with nodular disease and in patients with diffuse disease. Over the years of this study, survival appears to have improved in each histologic subtype except diffuse poorly differentiated lymphoma

  16. Institutional (mis)trust in colorectal cancer screening: a qualitative study with Greek, Iranian, Anglo-Australian and Indigenous groups.

    Science.gov (United States)

    Ward, Paul R; Coffey, Cushla; Javanparast, Sara; Wilson, Carlene; Meyer, Samantha B

    2015-12-01

    Colorectal cancer (CRC) has the second highest cancer mortality rate in Australia. The Australian National Bowel Cancer Screening Program (NBCSP) aims to increase early detection of CRC by offering free Faecal Occult Blood Testing (FOBT), although uptake is low for culturally and linguistically diverse (CALD) groups. To present data on trust and mistrust in the NBCSP by population groups with low uptake and thus to highlight areas in need of policy change. A qualitative study was undertaken in South Australia, involving interviews with 94 people from four CALD groups: Greek, Iranian, Anglo-Australian, and Indigenous peoples. Our study highlights the complexities of institutional trust, which involves considerations of trust at interpersonal, local and national levels. In addition, trust and mistrust was found in more abstract systems such as the medical knowledge of doctors to diagnose or treat cancer or the scientific procedures in laboratories to test the FOBTs. The object of institutional (mis)trust differed between cultural groups - Anglo-Australian and Iranian groups indicated a high level of trust in the government, whereas Indigenous participants were much less trusting. The level and nature of trust in the screening process varied between the CALD groups. Addressing program misconceptions, clarifying the FOBT capabilities and involving medical services in collecting and transporting the samples may increase trust in the NBCSP. However, broader and more enduring mistrust in services and institutions may need to be dealt with in order to increase trust and participation. © 2014 John Wiley & Sons Ltd.

  17. Negotiating Creativity on a Small Budget

    DEFF Research Database (Denmark)

    Andersen, Mads Møller

    2018-01-01

    for fiction series, the ambivalent cooperation behind this production exemplifies the low-budget efforts of a traditional public service institution to produce the fiction series that their younger target audience desires. The article uses a narrative-discursive approach to creativity and develops the term...... quite different assumptions about how production conditions can promote creativity, and suggests that a low-budget production can still be labelled as “successful”....

  18. 7 CFR 3402.14 - Budget and budget narrative.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Budget and budget narrative. 3402.14 Section 3402.14... GRADUATE AND POSTGRADUATE FELLOWSHIP GRANTS PROGRAM Preparation of an Application § 3402.14 Budget and budget narrative. Applicants must prepare the Budget, Form CSREES-2004, and a budget narrative...

  19. Diagnostic accuracy of prostate health index to identify aggressive prostate cancer. An Institutional validation study.

    Science.gov (United States)

    Morote, J; Celma, A; Planas, J; Placer, J; Ferrer, R; de Torres, I; Pacciuci, R; Olivan, M

    2016-01-01

    New generations of tumor markers used to detect prostate cancer (PCa) should be able to discriminate men with aggressive PCa of those without PCa or nonaggressive tumors. The objective of this study has been to validate Prostate Health Index (PHI) as a marker of aggressive PCa in one academic institution. PHI was assessed in 357 men scheduled to prostatic biopsy between June of 2013 and July 2014 in one academic institution. Thereafter a subset of 183 men younger than 75 years and total PSA (tPSA) between 3.0 and 10.0 ng/mL, scheduled to it first prostatic biopsy, was retrospectively selected for this study. Twelve cores TRUS guided biopsy, under local anaesthesia, was performed in all cases. Total PSA, free PSA (fPSA), and [-2] proPSA (p2PSA) and prostate volume were determined before the procedure and %fPSA, PSA density (PSAd) and PHI were calculated. Aggressive tumors were considered if any Gleason 4 pattern was found. PHI was compared to %fPSA and PSAd through their ROC curves. Thresholds to detect 90%, 95% of all tumors and 95% and 100% of aggressive tumors were estimated and rates of unnecessary avoided biopsies were calculated and compared. The rate of PCa detection was 37.2% (68) and the rate of aggressive tumors was 24.6% (45). The PHI area under the curve was higher than those of %fPSA and PSAd to detect any PCa (0.749 vs 0.606 and 0.668 respectively) or to detect only aggressive tumors (0.786 vs 0.677 and 0.708 respectively), however, significant differences were not found. The avoided biopsy rates to detect 95% of aggressive tumors were 20.2% for PHI, 14.8% for %fPSA, and 23.5% for PSAd. Even more, to detect all aggressive tumors these rates dropped to 4.9% for PHI, 9.3% for %fPSA, and 7.9% for PSAd. PHI seems a good marker to PCa diagnosis. However, PHI was not superior to %fPSA and PSAd to identify at least 95% of aggressive tumors. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Multi-Institutional Experience of Stereotactic Ablative Radiation Therapy for Stage I Small Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Verma, Vivek [Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska (United States); Simone, Charles B. [Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Allen, Pamela K. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Gajjar, Sameer R. [Baylor College of Medicine, Houston, Texas (United States); Shah, Chirag [Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Zhen, Weining [Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska (United States); Harkenrider, Matthew M. [Department of Radiation Oncology, Loyola University Stritch School of Medicine, Maywood, Illinois (United States); Hallemeier, Christopher L. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Jabbour, Salma K. [Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, New Jersey (United States); Matthiesen, Chance L. [Department of Radiation Oncology, Stephenson Cancer Center, University of Oklahoma, Oklahoma City, Oklahoma (United States); Braunstein, Steve E. [Department of Radiation Oncology, University of California, San Francisco, School of Medicine, San Francisco, California (United States); Lee, Percy [Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California (United States); Dilling, Thomas J. [Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida (United States); Allen, Bryan G. [Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, Iowa (United States); Nichols, Elizabeth M. [Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland (United States); and others

    2017-02-01

    Purpose: For inoperable stage I (T1-T2N0) small cell lung cancer (SCLC), national guidelines recommend chemotherapy with or without conventionally fractionated radiation therapy. The present multi-institutional cohort study investigated the role of stereotactic ablative radiation therapy (SABR) for this population. Methods and Materials: The clinical and treatment characteristics, toxicities, outcomes, and patterns of failure were assessed in patients with histologically confirmed stage T1-T2N0M0 SCLC. Kaplan-Meier analysis was used to evaluate the survival outcomes. Univariate and multivariate analyses identified predictors of outcomes. Results: From 24 institutions, 76 lesions were treated in 74 patients (median follow-up 18 months). The median age and tumor size was 72 years and 2.5 cm, respectively. Chemotherapy and prophylactic cranial irradiation were delivered in 56% and 23% of cases, respectively. The median SABR dose and fractionation was 50 Gy and 5 fractions. The 1- and 3-year local control rate was 97.4% and 96.1%, respectively. The median disease-free survival (DFS) duration was 49.7 months. The DFS rate was 58.3% and 53.2% at 1 and 3 years, respectively. The median, 1-year, and 3-year disease-specific survival was 52.3 months, 84.5%, and 64.4%, respectively. The median, 1-year, and 3-year overall survival (OS) was 17.8 months, 69.9%, and 34.0% respectively. Patients receiving chemotherapy experienced an increased median DFS (61.3 vs 9.0 months; P=.02) and OS (31.4 vs 14.3 months; P=.02). The receipt of chemotherapy independently predicted better outcomes for DFS/OS on multivariate analysis (P=.01). Toxicities were uncommon; 5.2% experienced grade ≥2 pneumonitis. Post-treatment failure was most commonly distant (45.8% of recurrence), followed by nodal (25.0%) and “elsewhere lung” (20.8%). The median time to each was 5 to 7 months. Conclusions: From the findings of the largest report of SABR for stage T1-T2N0 SCLC to date, SABR (≥50

  1. Family history record and hereditary cancer risk perception according to National Cancer Institute criteria in a Spanish medical oncology service: a retrospective study.

    Science.gov (United States)

    Márquez-Rodas, Iván; López-Trabada, Daniel; Rupérez Blanco, Ana Belén; Custodio Cabello, Sara; Peligros Gómez, María Isabel; Orera Clemente, María; Calvo, Felipe A; Martín, Miguel

    2012-01-01

    Identification of patients at risk of hereditary cancer is an essential component of oncology practice, since it enables clinicians to offer early detection and prevention programs. However, the large number of hereditary syndromes makes it difficult to take them all into account in daily practice. Consequently, the National Cancer Institute (NCI) has suggested a series of criteria to guide initial suspicion. It was the aim of this study to assess the perception of the risk of hereditary cancer according to the NCI criteria in our medical oncology service. We retrospectively analyzed the recordings of the family history in new cancer patients seen in our medical oncology service from January to November 2009, only 1 year before the implementation of our multidisciplinary hereditary cancer program. The family history was recorded in only 175/621 (28%) patients. A total of 119 (19%) patients met 1 or more NCI criteria (1 criterion, n = 91; 2 criteria, n = 23; 3 criteria, n = 4; and 4 criteria, n = 1), and only 14 (11.4%) patients were referred to genetic counseling. This study shows that few clinicians record the family history. The perception of the risk of hereditary cancer is low according to the NCI criteria in our medical oncology service. These findings can be explained by the lack of a multidisciplinary hereditary cancer program when the study was performed. Copyright © 2012 S. Karger AG, Basel.

  2. Definitive Radiotherapy for T1–2 Hypopharyngeal Cancer: A Single-Institution Experience

    International Nuclear Information System (INIS)

    Nakajima, Aya; Nishiyama, Kinji; Morimoto, Masahiro; Nakamura, Satoaki; Suzuki, Osamu; Kawaguchi, Yoshifumi; Miyagi, Ken; Fujii, Takashi; Yoshino, Kunitoshi

    2012-01-01

    Purpose: To analyze the outcome in T1–2 hypopharyngeal cancer (HPC) patients treated with definitive radiotherapy (RT). Patients and Methods: A total of 103 patients with T1–2 hypopharyngeal squamous cell carcinoma treated with radical RT between March 2000 and June 2008 at our institution were analyzed. Pre-RT neck dissection (ND) was performed in 26 patients with advanced neck disease. Chemotherapy was used concurrently with RT in 14 patients. Sixty patients were associated with synchronous or metachronous malignancies. The median follow-up for surviving patients was 41 months. Results: The 3-year overall and cause-specific survival rates were 70% and 79%, respectively. The 3-year local control rates were 87% for T1 and 83% for T2 disease. The ultimate local control rate was 89%, including 7 patients in whom salvage was successful. The ultimate local control rate with laryngeal preservation was 82%. Tumors of the medial wall of the pyriform sinus tended to have lower control rates compared with tumors of the lateral or posterior pharyngeal wall. Among patients with N2b–3 disease, the 3-year regional control rates were 74% for patients with pre-RT ND and 40% for patients without ND. The 3-year locoregional control rates were as follows: Stage I, 100%; Stage II, 84%; Stage III, 67%; Stage IVA, 43%; Stage IVB, 67%. Forty-two patients developed disease recurrence, with 29 (70%) patients developing recurrence within the first year. Of the 103 patients, 6 developed late complications higher than or equal to Grade 3. Conclusions: Definitive RT accomplished a satisfactory local control rate and contributed to organ preservation.

  3. Identification of the Mechanisms Underlying Antiestrogen Resistance: Breast Cancer Research Partnership between FIU-UM Braman Family Breast Cancer Institute

    National Research Council Canada - National Science Library

    Roy, Deodutta

    2008-01-01

    This research proposal has two primary objectives which are to (1) increase FIU investigators' research expertise and competitive ability to succeed as independent breast cancer researchers; and (2...

  4. Colon cancer modulation by a diabetic environment: A single institutional experience.

    Science.gov (United States)

    Prieto, Isabel; Del Puerto-Nevado, Laura; Gonzalez, Nieves; Portal-Nuñez, Sergio; Zazo, Sandra; Corton, Marta; Minguez, Pablo; Gomez-Guerrero, Carmen; Arce, Jose Miguel; Sanz, Ana Belen; Mas, Sebastian; Aguilera, Oscar; Alvarez-Llamas, Gloria; Esbrit, Pedro; Ortiz, Alberto; Ayuso, Carmen; Egido, Jesus; Rojo, Federico; Garcia-Foncillas, Jesus

    2017-01-01

    Multiple observational studies suggest an increased risk of colon cancer in patients with diabetes mellitus (DM). This can theoretically be the result of an influence of the diabetic environment on carcinogenesis or the tumor biologic behavior. To gain insight into the influence of a diabetic environment on colon cancer characteristics and outcomes. Retrospective analysis of clinical records in an academic tertiary care hospital with detailed analysis of 81 diabetic patients diagnosed of colon cancer matched with 79 non-diabetic colon cancer patients. The impact of streptozotocin-induced diabetes on the growth of colon cancer xenografts was studied in mice. The incidence of DM in 1,137 patients with colorectal cancer was 16%. The diabetic colon cancer cases and non-diabetic colon cancer controls were well matched for demographic and clinical variables. The ECOG Scale Performance Status was higher (worse) in diabetics (ECOG ≥1, 29.1% of controls vs 46.9% of diabetics, p = 0.02), but no significant differences were observed in tumor grade, adjuvant therapy, tumor site, lymphovascular invasion, stage, recurrence, death or cancer-related death. Moreover, no differences in tumor variables were observed between patients treated or not with metformin. In the xenograft model, tumor growth and histopathological characteristics did not differ between diabetic and nondiabetic animals. Our findings point towards a mild or negligible effect of the diabetes environment on colon cancer behavior, once cancer has already developed.

  5. Understanding the Budget Process

    Directory of Open Access Journals (Sweden)

    Mesut Yalvaç

    2000-03-01

    Full Text Available Many different budgeting techniques can be used in libraries, and some combination of these will be appropriate for almost any individual situation. Li-ne-item, program, performance, formula, variable, and zero-base budgets all have features that may prove beneficial in the preparation of a budget. Budgets also serve a variety of functions, providing for short-term and long-term financial planning as well as for cash management over a period of time. Short-term plans are reflected in the operating budget, while long-term plans are reflected in the capital budget. Since the time when cash is available to an organization does not usually coincide with the time that disbursements must be made, it is also important to carefully plan for the inflow and outflow of funds by means of a cash budget.      During the budget process an organization selects its programs and activities by providing the necessary funding; the library, along with others in the organization, must justify its requests. Because of the cyclical nature of the budget process, it is possible continually to gather information and evaluate alternatives for the next budget period so that the library may achieve its maximum potential for service to its patrons.

  6. Budget reforms in times of austerity

    DEFF Research Database (Denmark)

    Kristiansen, Mads Bøge

    In the literature times of austerity is argued to give rise to centralization of decisions making. A recently published article finds evidence of a centralization cascade in times of austerity. Based on a case study of recent changes of the Danish budget institutions, the aim of this pa-per is to......In the literature times of austerity is argued to give rise to centralization of decisions making. A recently published article finds evidence of a centralization cascade in times of austerity. Based on a case study of recent changes of the Danish budget institutions, the aim of this pa......-per is to explore how such a centralization cascade may look like when zooming into a specific case. Another aim is to explore the consequences of the changes of budget institutions. The paper shows that the fiscal crisis was a window of opportunity for the Ministry of Finance to introduce a budget reform...... finally results in a more detailed control and steering carried out by the managing directors in the agencies. The paper also shows that the changes imply a range of consequences; some are functional others are more dysfunction-al. There seems therefore to be a lot of trade-offs when budget institutions...

  7. Breast cancer amongst Filipino migrants: a review of the literature and ten-year institutional analysis.

    Science.gov (United States)

    Simpson, Jory S; Briggs, Kaleigh; George, Ralph

    2015-06-01

    As one migrates from an area of low to high incidence of breast cancer their personal risk of developing breast cancer increases. This is however not equally distributed across all races and ethnicities. This paper specifically examines Filipino migrants. A literature review was conducted to summarize breast cancer incidence, screening practices and trends in treatment amongst Filipino migrants. In addition, a retrospective cohort study was conducted specifically examining the age in which Filipino women were diagnosed with breast cancer compared to Asian and Caucasian counterparts. Filipino women are diagnosed with breast cancer at a statistically significant younger age (53.2) compared to their Asian (55.1) and Caucasian (58.4) counterparts. In addition, they are at an increased risk of developing more aggressive breast cancer with noteworthy disparities in the care they are receiving. The evidence suggest this group is worthy of special focus when diagnosing and treating breast cancer.

  8. Pharmacogenetics in cancer therapy - 8 years of experience at the Institute for Oncology and Radiology of Serbia.

    Science.gov (United States)

    Cavic, Milena; Krivokuca, Ana; Boljevic, Ivana; Brotto, Ksenija; Jovanovic, Katarina; Tanic, Miljana; Filipovic, Lana; Zec, Manja; Malisic, Emina; Jankovic, Radmila; Radulovic, Sinisa

    2016-01-01

    Pharmacogenetics is a study of possible mechanism by which an individual's response to drugs is genetically determined by variations in their DNA sequence. The aim of pharmacogenetics is to identify the optimal drug and dose for each individual based on their genetic constitution, i.e. to individualize drug treatment. This leads to achieving the maximal therapeutic response for each patient, while reducing adverse side effects of therapy and the cost of treatment. A centralized pharmacogenetics service was formed at the Institute for Oncology and Radiology of Serbia (IORS) with the aim to provide a personalized approach to cancer treatment of Serbian patients. Analyses of KRAS mutations in metastatic colorectal cancer, EGFR mutations in advanced non-small cell lung cancer, CYP2D6 polymorphism in breast cancer, DPD polymorphism in colorectal cancer and MTHFR polymorphism in osteosarcoma have been performed by real time polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism (PCR-RFLP). Mutation testing analyses were successful for 1694 KRAS samples and 1821 EGFR samples, while polymorphism testing was successful for 9 CYP2D6 samples, 65 DPD samples and 35 MTHFR samples. Pharmacogenetic methods presented in this paper provide cancer patients in Serbia the best possible choice of treatment at the moment.

  9. Evaluation of the quality of the mammography study in the radio-diagnostic service of the National Cancer Institute

    International Nuclear Information System (INIS)

    Rubio Laverde, Alba Lucia; Pineros Petersen, Marion; Betancourt Gil, Claudia

    2003-01-01

    The development of mammography quality control programs at radiology services has had an important progress in the last decades, mainly in developed countries. Although breast cancer is one of the leading causes of cancer mortality and incidence in Colombia, quality control programs for mammography screening are just beginning to be considered. This article describes the results of a baseline evaluation aimed at establishing a quality control program at the Radiology Unit of the National Cancer Institute, in Colombia. The mammography equipment, the film processing, and all main physical parameters were checked and compared to international standards. Quality of the image in 301 mammographic X-ray plates was evaluated. In order to implement a good quality control program, the need for acquiring essential instruments, improving physical facilities and starting a continuous training program is imperative

  10. Oral cancer

    Science.gov (United States)

    Cancer - mouth; Mouth cancer; Head and neck cancer; Squamous cell cancer - mouth; Malignant neoplasm - oral ... National Cancer Institute. PDQ lip and oral cavity cancer ... September 25, 2015. www.cancer.gov/types/head-and-neck/hp/lip- ...

  11. A pilot study to assess the level of depression and the coping strategies adopted by cancer patients receiving treatment in Mizoram State Cancer Institute, Aizawl

    Directory of Open Access Journals (Sweden)

    Gitumoni Konwar

    2015-01-01

    Full Text Available Background: Cancer, the second most common cause of death, has become a major health problem. Depression is the most common psychological problem encountered in patients with cancer. The coping skills adopted may affect the mental health of patients. Therefore, this research is undertaken to assess the level of depression and coping strategy adopted by the patients diagnosed with cancer. Materials and methods: A descriptive study to assess the level of depression and coping strategy adopted by cancer patients receiving treatment in Mizoram State Cancer Institute, Aizawl was carried out from April to May 2014 with 30 convenient samples. Depression was assessed by using Hospital Anxiety and Depression Scale (HADS developed by Zigmond and Snaith in 1983. Coping strategy adopted by patients were assessed by revised version of the Ways of Coping Checklist developed by Folkman and Lazarus in 1985. Results: Findings of the study showed that depression was universal to all the cancer patients. Majority of cancer patients (66.5% had moderate depression while 13.26% of the cancer patients had severe depression, and only 6.7% of them reported to have low depression. The most effective coping strategy adopted was reappraisal, followed by distancing. There is significant correlation between depression and reappraisal (r=-0.538, p<0.002, and also with depression and acceptance (r=-0.415, p<0.022 strategies. Conclusion: As depression is universal to all cancer patients, use of appropriate coping strategy is very essential to improve their quality of life. The recognition of coping strategies by health team may enable appropriate information and interventions to be provided at optimal times for each individual.

  12. Biomarkers for Early Detection of Clinically Relevant Prostate Cancer: A Multi-Institutional Validation Trial

    Science.gov (United States)

    2015-10-01

    provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently ...biomarker platforms in our multi-center, prospectively accrued prostate cancer active surveillance cohort – the Canary Prostate Active Surveillance...prostate cancers currently diagnosed are low risk tumors for which there is substantial evidence that the cancer will not cause harm if left untreated

  13. Comparison of Serum Selenium Levels in Breast Cancer Patients and Healthy People at a Cancer Institute in 2004

    Directory of Open Access Journals (Sweden)

    M Maleki

    2007-01-01

    Full Text Available Introduction: Breast Cancer is one of the most important fatal cancers in women. The mean age of breast cancer in Iran is 48.8 years which is very lower than other countries. Selenium can play an important role in reduction of cancer in several ways, for example selenium increases immunity response and protects cells from oxidation of free radicals and also decreases carcinogenic metabolites. Breast cancer is one of the most important cancers in our country because its incidence is very high and the mean age of patients is very low. Different studies have shown the benefits of selenium in prevention of cancer and since many years selenium has been used as a dietary supplement in advanced countries. Several studies regarding relationship between selenium levels and breast cancer have been done in different countries. We therefore planned a study to evaluate serum selenium levels in breast cancer patients and compare them with a healthy control group. Methods: We selected 45 patients younger than 48 years old and 33 patients older than 48 years old who had not yet received any therapy (surgery, chemotherapy, etc for their cancer as a case group and 46 healthy people who were matched with the patients as a control group and included 23 persons younger and 23 persons older than 48 years old. From each participant, 5cc blood was derived and in several stages, serum selenium levels were evaluated using atomic absorption technology. Data about type of cancer, stage, grade, IHC and cigarette smoking were also collected. Results: The mean Se level was 161.20 μg/l (SD=46.27 μg/l in the patients and 189.13 μg/l (SD=48.75 μg/l in the control group that was statistically significant (P48 years old was 155.39 μg/l (SD=46.68 μg/l that was lower than the control groups. Difference in serum selenium levels between patients and controls in the older group was significant (P=0.007, but in the younger group, it was not statistically significant (P=0

  14. Understanding the Budget Process

    OpenAIRE

    Mesut Yalvaç

    2000-01-01

    Many different budgeting techniques can be used in libraries, and some combination of these will be appropriate for almost any individual situation. Li-ne-item, program, performance, formula, variable, and zero-base budgets all have features that may prove beneficial in the preparation of a budget. Budgets also serve a variety of functions, providing for short-term and long-term financial planning as well as for cash management over a period of time. Short-term plans are reflected in the oper...

  15. Screening mammography. A missed clinical opportunity? Results of the NCI [National Cancer Institute] Breast Cancer Screening Consortium and national health interview survey studies

    International Nuclear Information System (INIS)

    Anon.

    1990-01-01

    Data from seven studies sponsored by the National Cancer Institute (NCI) were used to determine current rates of breast cancer screening and to identify the characteristics of and reasons for women not being screened. All seven studies were population-based surveys of women aged 50 to 74 years without breast cancer. While over 90% of non-Hispanic white respondents had regular sources of medical care, 46% to 76% had a clinical breast examination within the previous year, and only 25% to 41% had a mammogram. Less educated and poorer women had fewer mammograms. The two most common reasons women gave for never having had a mammogram were that they did not known they needed it and that their physician had not recommended it. Many physicians may have overlooked the opportunity to recommend mammography for older women when performing a clinical breast examination and to educate their patients about the benefit of screening mammography

  16. Epidemiology and management of breast carcinoma in Egyptian males: Experience of a single Cancer Institute

    International Nuclear Information System (INIS)

    Elshafiey, M.M.; Elsebai, H.I.; Attia, A.A.; Zeeneldin, A.A.; Moneer, M.; Mohamed, D.B.; Gouda, I.

    2011-01-01

    To assess the epidemiological and clinico-pathological features, surgical and reconstructive techniques, adjuvant treatments and clinical outcome of breast carcinoma in males (BCM) at the Egyptian National Cancer Institute (NCI). Patients and methods: Thirty-two males with breast carcinoma presented to NCI between January 2000 and December 2002. They were evaluated by complete history, physical examination, laboratory and radiological investigations. Results: Median age was 59 years. Left sided and retroareolar breast lumps were the commonest presentations. Grade 11 tumors positive for hormone receptors were very common. Stage I, II, 111 and IV disease were encountered in 6.2%, 34.4%, 34.4% and 25.0% of patients, respectively. Curative surgery was done in 22 patients; they received adjuvant hormonal therapy, chemotherapy and radiotherapy in 22,16 and 10 patients, respectively. Eight metastatic patients were treated with palliative measures. Surgery was done in 25 patients; the most common procedure was modified radical mastectomy (40.6%). Primary closure was feasible in 17 patients (68%), local flaps were needed in 4 cases (16%), while myocutaneous flap was done in 3 cases (12%). The commonest complication was development of seroma (9 cases). The overall survival (OS) at 5 years was 65.4%. The disease free survival (DPS) at 5 years was 53.9%. Stage and curative surgery significantly affected OS, while type of surgery was the only variable significantly affecting DPS. Conclusion: Male breast carcinoma occurs at older ages than females, usually in advanced stage. This necessitates directing attention of males and awareness on the prevalence and risk factors for this disease.needed in 4 cases (16%), while myocutaneous flap was done in 3 cases (12%). The commonest complication was development of seroma (9 cases). The overall survival (OS) at 5 years was 65.4%. The disease free survival (DPS) at 5 years was 53.9%. Stage and curative surgery significantly affected OS

  17. Retrospective assessment of occupational asbestos exposure among 220 patients with respiratory cancer hospitalized at Vilnius University Institute of Oncology

    International Nuclear Information System (INIS)

    Petrauskaite Everatt, R.; Jankauskas, R.; Tossavainen, A.; Cicenas, S.; Smolianskiene, G.

    2005-01-01

    No cases of lung cancer or mesothelioma have ever been diagnosed or compensated as asbestos-related in Lithuania. This paper attempts to estimate the proportion of those occupationally exposed to asbestos among respiratory cancer patients. Occupational exposure to asbestos was assessed retrospectively for 218 lung cancer and 2 mesothelioma patients admitted to Institute of Oncology, Vilnius University. The evaluation was based on personal interview data using an internationally established questionnaire. Cumulative exposure to asbestos at work was evaluated in fibre-years. A cumulative asbestos exposure of ≥25 fibre-years was found for 7 patients (3.2%), in further 135 (61.2%) a cumulative exposure from 0.01 to 24.99 fibre-years was assessed. The most common occupations among heavily (≥25 fibre-years) exposed patients were smith, welder or insulator in foundries, construction, shipyard as well as asbestos cement and glass industry. Preliminary findings indicate that a fraction (3.2%) of the respiratory cancer cases could be attributed to occupational exposure to asbestos. Since 1560 or more cases of lung cancer are registered every year in Lithuania, about 50 cases per year could be predicted to be asbestos-related. (author)

  18. Biomarkers for Early Detection of Clinically Relevant Prostate Cancer: A Multi-Institutional Validation Trial

    Science.gov (United States)

    2017-10-01

    25 4 1. INTRODUCTION Although prostate - specific antigen (PSA) testing and the resulting treatment of...details of this work are described in the attached paper titled “Refined analysis of prostate specific antigen kinetics to predict prostate cancer...Wagner; Daniel W. Lin,; and Yingye Zheng. “Refined analysis of prostate specific antigen kinetics to predict prostate cancer active surveillance outcomes

  19. Adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations and breast cancer risk in the Cancer de Màma (CAMA) study.

    Science.gov (United States)

    Fanidi, Anouar; Ferrari, Pietro; Biessy, Carine; Ortega, Carolina; Angeles-Llerenas, Angélica; Torres-Mejia, Gabriella; Romieu, Isabelle

    2015-12-01

    We investigated the association between adherence to the recommendations of the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) and breast cancer (BC) risk in the Cancer de Màma (CAMA) study in a Mexican population. Population-based case-control study. Incident BC cases (n 1000) and controls (n 1074) matched on age, region and health-care system were recruited. In-person interviews were conducted to assess BC risk factors and habitual diet was assessed with an FFQ. Conformity to the WCRF/AICR recommendations was evaluated through a score incorporating seven WCRF/AICR components (body fatness, physical activity, foods and drinks that promote weight gain, plant foods, animal foods, alcoholic drinks and breast-feeding), with high scores indicating adherence to the WCRF/AICR recommendations. No statistically significant associations between WCRF/AICR score and risk of BC were observed. After excluding BMI from the WCRF/AICR score, the top quartile was associated with a decreased BC risk overall, with ORQ4-Q1=0.68 (95% CI 0.49, 0.92, P trend=0.03), and among postmenopausal women, with ORQ4-Q1=0.60 (95% CI 0.39, 0.94, P trend=0.03). Inverse associations were observed between BMI and risk of BC overall and among premenopausal women, with OR=0.57 (95% CI 0.42, 0.76, P trend <0.01) and 0.48 (95% CI 0.31, 0.73, P trend<0.01), respectively. Physical activity level was inversely associated with BC risk. The WCRF/AICR index was not related with BC risk in the CAMA study. A combination of six components excluding BMI showed strong protective associations, particularly in postmenopausal women. Further prospective studies are required to clarify the role of adherence to WCRF/AICR recommendations, particularly with respect to BMI, in the Mexican population.

  20. Budgeting in an Academic Library: A Lively Lunch Discussion

    OpenAIRE

    Wikoff, Karin

    2017-01-01

    Are you always seeking to improve budgeting in your academic library? Are you fascinated by the challenge of predicting costs for subscriptions? I went on an "Academic Library Budgeting Roadshow," and had discussions with peers at seven other institutions. In this session, I will present a summary of my findings, then pose the same questions to the group. We'll discuss everything from the budget process and timeline, to allocating funds, to predicting subscription costs, to what you do if you...

  1. The Utility of Expert Diagnosis in Surgical Neuropathology: Analysis of Consultations Reviewed at 5 National Comprehensive Cancer Network Institutions.

    Science.gov (United States)

    Bruner, Janet M; Louis, David N; McLendon, Roger; Rosenblum, Marc K; Archambault, W Tad; Most, Susan; Tihan, Tarik

    2017-03-01

    The aim of this study was to characterize the type and degree of discrepancies between non-expert and expert diagnoses of CNS tumors to identify the value of consultations in surgical neuropathology. Neuropathology experts from 5 National Comprehensive Cancer Network (NCCN) member institutions participated in the review of 1281 consultations selected based on inclusion criteria. The consultation cases were re-reviewed at the NCCN headquarters to determine concordance with the original diagnoses. Among all consultations, 249 (19.4%) were submitted for expert diagnoses without final diagnoses from the submitting institution. Within the remaining 1032 patients, the serious/major discrepancy rate was 4.8%, and less serious and minor discrepancies were seen in 19.4% of the cases. The discrepancy rate was higher among patients who were referred to NCCN institutions for consultation compared to those who were referred for treatment only. The discrepancy rates, patient demographics, type of consultations and submitting institutions varied among participating NCCN institutions. Expert consultations identified a subset of cases with significant diagnostic discrepancies, and constituted the initial diagnoses in some cases. These data indicate that expert consultations in glial tumors and all types of pediatric CNS tumors can improve accurate diagnosis and enable appropriate management. © 2017 American Association of Neuropathologists, Inc. All rights reserved.

  2. Budgeting Approaches in Community Colleges

    Science.gov (United States)

    Palmer, James C.

    2014-01-01

    Several budgeting approaches have been initiated as alternatives to the traditional, incremental process. These include formula budgeting; zero-base budgeting; planning, programming, and budgeting systems; and responsibility center budgeting. Each is premised on assumptions about how organizations might best make resource allocation decisions.…

  3. CEA budget in 1982

    Energy Technology Data Exchange (ETDEWEB)

    1981-12-01

    In 1982, the amount of the CEA budget will be 13.4 billions French Francs. The main characteristics are the priority for employment and investments. In this budget programs are adapted to fit R and D to the government policy: innovation, industrial valorization and fundamental research especially thermonuclear fusion and in the electronuclear field to safety, reprocessing and radioactive waste management.

  4. Budgeting in Nonprofit Organizations.

    Science.gov (United States)

    Kelly, Lauren

    1985-01-01

    This description of the role of budgets in nonprofit organizations uses libraries as an example. Four types of budgets--legislative, management, cash, and capital--are critiqued in terms of cost effectiveness, implementation, and facilitation of organizational control and objectives. (CLB)

  5. Colorado Children's Budget 2010

    Science.gov (United States)

    Colorado Children's Campaign, 2010

    2010-01-01

    The "Children's Budget 2010" is intended to be a resource guide for policymakers and advocates who are interested in better understanding how Colorado funds children's programs and services. It attempts to clarify often confusing budget information and describe where the state's investment trends are and where those trends will lead the…

  6. Colorado Children's Budget 2013

    Science.gov (United States)

    Buck, Beverly; Baker, Robin

    2013-01-01

    The "Colorado Children's Budget" presents and analyzes investments and spending trends during the past five state fiscal years on services that benefit children. The "Children's Budget" focuses mainly on state investment and spending, with some analysis of federal investments and spending to provide broader context of state…

  7. The Agency's budget

    International Nuclear Information System (INIS)

    1964-01-01

    A total Agency Budget of $10 406 000 for 1965 was approved by the General Conference at its session of September 1964; the Budget for the year 1964 amounted to $9 812 000. The consolidated Budget figures are shown in the table at the end of this article. The Budget falls into two parts - the Regular Budget and the Operational Budget. The Regular Budget provides for the ordinary administrative expenses of the Agency, and for expert panels, special missions, symposia and conferences, distribution of information, and scientific and technical services. In conformity with the Agency's Statute, these expenses are met by contributions made according to Voluntary contributions are paid initially into a General Fund established for this purpose, and money for operations is transferred to the respective Operating Funds as appropriate, and as approved by the Board of Governors. The scale of assessments for 1965 is based on the United Nations scale for 1964. The assessments are estimated to yield $7 713 000 - an increase of 6.8 per cent; however, more than three quarters of this increase will be offset by credits which Member States will receive as a result of a cash surplus brought forward. The Operational Budget is financed by voluntary contributions and is divided into two parts - Operating Fund I, devoted to certain laboratory and research projects, and Operating Fund II, for technical assistance, training and research contracts.

  8. Preparing the operating budget.

    Science.gov (United States)

    Williams, R B

    1983-12-01

    The process of preparing a hospital pharmacy budget is presented. The desired characteristics of a budget and the process by which it is developed and approved are described. Fixed, flexible, and zero-based budget types are explained, as are the major components of a well-developed budget: expense, workload, productivity, revenue, and capital equipment and other expenditures. Specific methods for projecting expenses and revenues, based on historical data, are presented along with a discussion of variables that must be considered in order to achieve an accurate and useful budget. The current shift in emphasis away from revenue capture toward critical analysis of pharmacy costs underscores the importance of budgetary analysis for hospital pharmacy managers.

  9. Critical appraisal of the suitability of translational research models for performance assessment of cancer institutions

    NARCIS (Netherlands)

    Rajan, A.; Sullivan, R.; Bakker, S.; van Harten, Willem H.

    2012-01-01

    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.

  10. Biomarkers for Early Detection of Clinically Relevant Prostate Cancer. A Multi-Institutional Validation Trial

    Science.gov (United States)

    2016-10-01

    aim 2: Evaluate a panel of four-kallikrein plasma-based markers to determine the presence of or progression to clinically relevant prostate cancer...and sent to Genomic Health, Inc. for processing. Task 3: Analysis of scientific Aim 2: Evaluate a panel of four-kallikrein plasma-based markers to...site: FHCRC) PCA3 and the TMPRSS2:ERG fusion are prostate cancer-specific biomarkers that hold promise for stratifying risk in the setting of AS

  11. Colon cancer modulation by a diabetic environment: A single institutional experience

    OpenAIRE

    Prieto, Isabel; del Puerto-Nevado, Laura; Gonzalez, Nieves; Portal-Nu?ez, Sergio; Zazo, Sandra; Corton, Marta; Minguez, Pablo; Gomez-Guerrero, Carmen; Arce, Jose Miguel; Sanz, Ana Belen; Mas, Sebastian; Aguilera, Oscar; Alvarez-Llamas, Gloria; Esbrit, Pedro; Ortiz, Alberto

    2017-01-01

    Background Multiple observational studies suggest an increased risk of colon cancer in patients with diabetes mellitus (DM). This can theoretically be the result of an influence of the diabetic environment on carcinogenesis or the tumor biologic behavior. Aim To gain insight into the influence of a diabetic environment on colon cancer characteristics and outcomes. Material and methods Retrospective analysis of clinical records in an academic tertiary care hospital with detailed analysis of 81...

  12. The Role of Rationality in University Budgeting.

    Science.gov (United States)

    Chaffee, Ellen Earle

    1983-01-01

    Although empirical accounts of organizational decision making often show that the process is not a rational one, a study of budgeting at Stanford University during the 1970s, while not conclusive or comprehensive, supported the claim that the institution's process was rational and provided a procedure for testing a decision-making model. (MSE)

  13. Connecting the Dots: A Comparative Global Multi-Institutional Study of Prohibitive Factors Affecting Cancer Pain Management.

    Science.gov (United States)

    Amoatey Odonkor, Charles; Addison, William; Smith, Sean; Osei-Bonsu, Ernest; Tang, Teresa; Erdek, Michael

    2017-02-01

    The goal of this study was to elucidate the attitudes, beliefs, and barriers interfering with cancer pain management, the degree of barrier interference with trainees’ care of patients, and the relationships among prohibitive factors to pain management for physicians in a low–middle-income countries (LMICs) vs high-income countries (HICs). A multi-institutional cross-sectional survey of physicians in specialties with a focus in pain management training was performed. All surveys were completed anonymously from July 1, 2015, to November 30, 2015. One hundred and twenty physicians participated in the survey. Surveys were based on prior questionnaires published in the literature. Descriptive statistics were calculated, and chi-square (ℵ2) analysis, Fisher’s exact test, and Spearman rank correlation analyses were performed. Compared with their peers in HICs, physicians in LMICs reported less experience with cancer pain management despite seeing more cancer patients with advanced disease (41% vs 15.2%, p pain (84% vs 76%) and lack of training and expertise (87% vs 78%) were significantly more prohibitive for physicians in LMICs than those in HICs; p pain management among trainee physicians in low- vs high-resource environments. Understanding these differences may spur further collaboration in the design of contextually relevant solutions, which could potentially help improve the adequacy of cancer pain management

  14. One-Step Nucleic Acid Amplification in Breast Cancer Sentinel Lymph Node: A Single Institutional Experience and a Short Review

    OpenAIRE

    Brambilla, Tatiana; Fiamengo, Barbara; Tinterri, Corrado; Testori, Alberto; Grassi, Massimo Maria; Sciarra, Amedeo; Abbate, Tommaso; Gatzemeier, Wolfgang; Roncalli, Massimo; Di Tommaso, Luca

    2015-01-01

    Sentinel lymph node (SLN) examination is a standard in breast cancer patients, with several methods employed along its 20 years history, the last one represented by one-step nucleic acid amplification (OSNA). The latter is a intra-operative molecular assay searching for CK19 mRNA as a surrogate of metastatic cells. Our 3 years experience with OSNA (1122 patients) showed results overlapping those recorded in the same institution with a morphological evaluation (930 patients) of SLN. In detail,...

  15. Breast cancer in women aging 35 years old and younger: The Egyptian National Cancer Institute (NCI) experience.

    Science.gov (United States)

    Darwish, A D; Helal, A M; Aly El-Din, N H; Solaiman, L L; Amin, A

    2017-02-01

    The aim is to identify the epidemiological and clinicopathological features associated with young breast cancer (BC) patients and to discuss factors affecting tumor recurrence and DFS. A retrospective analysis was conducted based on medical records from young females patients aged ≤35 years with pathologically confirmed primary breast cancer treated during 2008-2010 at NCI. Cases with non invasive cancer and non carcinoma histology are excluded. Of the 5408 cases diagnosed with breast cancer, 554 were young. Four hundred & fifty eight patients representing 9.2% were within our inclusion criteria. Almost half of the patients (45.9%) presented with stage III. Axillary nodes involvement was in 63.9%, 83.3% were grade 2. More than one quarter of tumors was hormone receptors negative (28.8%) & Her2 was over-expressed in 30%. Mastectomy was offered in 72% while conservative breast surgery in 26%, 69.2% received chemotherapy either adjuvant, neoadjuvant or both, 82.5% received adjuvant radiotherapy, 68.6% received hormonal therapy. Metastatic disease developed in 51.3%, with 31% having more than one site of metastases. After a median follow up period of 66 months, the median DFS of patients was 60 months. The median DFS was significantly shorter among patients with positive lymph nodes (P Breast cancer in young women is aggressive from the time of diagnosis. Our results provide baseline data of young BC in the Middle East & North Africa region; thus, contributing to future epidemiological and hospital-based researches. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Awareness on cytology procedure in oral cancer detection among undergraduates: An institutional study.

    Science.gov (United States)

    Ramesh, Gayathri; Pathak, Rajeev; Pathak, Sunita; Raj, Amrita; Kumar, Amit; Katiyar, Anuradha

    2017-11-01

    The screening and the early detection of the premalignant and malignant lesions are the only means for controlling the oral cancer which is known to be one of the leading causes for mortality worldwide. Oral exfoliative cytology though not a substitute for biopsy can be a powerful tool for its early detection. Dental Surgeons can play a great role in this direction. The present study was undertaken to assess the self-reported knowledge and attitude regarding the early detection of oral cancer and exfoliative cytology among the undergraduates of Rama Dental College, Kanpur. A pretested questionnaire based cross sectional study consisting of twenty four questions was conducted among hundred randomly selected students from third year, final year and intern's batch. According to 73% of students biopsy was the special test done in oral cancer detection and only 59% had heard regarding oral cytology technique. Formalin was the fixative known for cytology smears among 61%. Significance of toluidine blue staining was not known by 62%. Seventy seven percent of students were not aware about classes of cytology reporting. Eighty six percent of students felt that the adequacy of training in cytology was lagging. This survey identified an existing gap in the knowledge among the dental students regarding cytology as a diagnostic aid in oral cancer detection. This emphasizes the need to provide training for undergraduates at clinical level on regular basis and also through CDE and oral can-cer detection workshops.

  17. Decreased early mortality associated with the treatment of acute myeloid leukemia at National Cancer Institute-designated cancer centers in California.

    Science.gov (United States)

    Ho, Gwendolyn; Wun, Ted; Muffly, Lori; Li, Qian; Brunson, Ann; Rosenberg, Aaron S; Jonas, Brian A; Keegan, Theresa H M

    2018-05-01

    To the authors' knowledge, few population-based studies to date have evaluated the association between location of care, complications with induction therapy, and early mortality in patients with acute myeloid leukemia (AML). Using linked data from the California Cancer Registry and Patient Discharge Dataset (1999-2014), the authors identified adult (aged ≥18 years) patients with AML who received inpatient treatment within 30 days of diagnosis. A propensity score was created for treatment at a National Cancer Institute-designated cancer center (NCI-CC). Inverse probability-weighted, multivariable logistic regression models were used to determine associations between location of care, complications, and early mortality (death ≤60 days from diagnosis). Of the 7007 patients with AML, 1762 (25%) were treated at an NCI-CC. Patients with AML who were treated at NCI-CCs were more likely to be aged ≤65 years, live in higher socioeconomic status neighborhoods, have fewer comorbidities, and have public health insurance. Patients treated at NCI-CCs had higher rates of renal failure (23% vs 20%; P = .010) and lower rates of respiratory failure (11% vs 14%; P = .003) and cardiac arrest (1% vs 2%; P = .014). After adjustment for baseline characteristics, treatment at an NCI-CC was associated with lower early mortality (odds ratio, 0.46; 95% confidence interval, 0.38-0.57). The impact of complications on early mortality did not differ by location of care except for higher early mortality noted among patients with respiratory failure treated at non-NCI-CCs. The initial treatment of adult patients with AML at NCI-CCs is associated with a 53% reduction in the odds of early mortality compared with treatment at non-NCI-CCs. Lower early mortality may result from differences in hospital or provider experience and supportive care. Cancer 2018;124:1938-45. © 2018 American Cancer Society. © 2018 American Cancer Society.

  18. Medical care costs incurred by patients with smoking-related non-small cell lung cancer treated at the National Cancer Institute of Mexico.

    Science.gov (United States)

    Arrieta, Oscar; Quintana-Carrillo, Roger Humberto; Ahumada-Curiel, Gabriel; Corona-Cruz, Jose Francisco; Correa-Acevedo, Elma; Zinser-Sierra, Juan; de la Mata-Moya, Dolores; Mohar-Betancourt, Alejandro; Morales-Oyarvide, Vicente; Reynales-Shigematsu, Luz Myriam

    2014-01-01

    Smoking is a public health problem in Mexico and worldwide; its economic impact on developing countries has not been well documented. The aim of this study was to assess the direct medical costs attributable to smoking incurred by lung cancer patients treated at the National Cancer Institute of Mexico (INCan). The study was conducted at INCan in 2009. We carried out a cost of illness (COI) methodology, using data derived from an expert panel consensus and from medical chart review. A panel of experts developed a diagnostic-therapeutic guide that combined the hospital patient pathways and the infrastructure, human resources, technology, and services provided by the medical units at INCan. Cost estimates in Mexican pesos were adjusted by inflation and converted into US Dollars using the 2013 FIX exchange rate for foreign transactions (1 USD = 13.06 Mexican pesos). A 297 incident cases diagnosed with any type of lung cancer were analyzed. According to clinical stage, the costs per patient were 13,456; 35,648; 106,186; and 144,555 USD, for lung cancer stages I, II, III, and IV respectively. The weighted average annual cost/patient was and 139,801 USD and the average annual cost/patient that was attributable to smoking was 92,269 USD. This cost was independent of the clinical stage, with stage IV representing 96% of the annual cost. The total annual cost of smoking-related lung cancer at INCan was 19,969,781 USD. The medical care costs of lung cancer attributable to smoking represent a high cost both for INCan and the Mexican health sector. These costs could be reduced if all provisions established in the Framework Convention of Tobacco Control of the World Health Organization were implemented in Mexico.

  19. Verification of uncertainty budgets

    DEFF Research Database (Denmark)

    Heydorn, Kaj; Madsen, B.S.

    2005-01-01

    , and therefore it is essential that the applicability of the overall uncertainty budget to actual measurement results be verified on the basis of current experimental data. This should be carried out by replicate analysis of samples taken in accordance with the definition of the measurand, but representing...... the full range of matrices and concentrations for which the budget is assumed to be valid. In this way the assumptions made in the uncertainty budget can be experimentally verified, both as regards sources of variability that are assumed negligible, and dominant uncertainty components. Agreement between...

  20. FY 1997 congressional budget request: Budget highlights

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-03-01

    This is an overview of the 1997 budget request for the US DOE. The topics of the overview include a policy overview, the budget by business line, business lines by organization, crosswalk from business line to appropriation, summary by appropriation, energy supply research and development, uranium supply and enrichment activities, uranium enrichment decontamination and decommissioning fund, general science and research, weapons activities, defense environmental restoration and waste management, defense nuclear waste disposal, departmental administration, Office of the Inspector General, power marketing administrations, Federal Energy Regulatory commission, nuclear waste disposal fund, fossil energy research and development, naval petroleum and oil shale reserves, energy conservation, economic regulation, strategic petroleum reserve, energy information administration, clean coal technology and a Department of Energy Field Facilities map.

  1. Whom to treat? Factors associated with chemotherapy recommendations and outcomes among patients with NHL at the Uganda Cancer Institute.

    Directory of Open Access Journals (Sweden)

    Manoj Menon

    Full Text Available Cancer treatment options in sub-Saharan Africa are scarce despite an increasing burden of disease. Identification of those cancer patients who would benefit most from the limited resources available would allow broader and more effective therapy.We conducted a retrospective analysis of patients over the age of 18 at the time of a pathologic diagnosis of NHL between 2003 and 2010 who were residents of Kyandondo County (Uganda and presented to the Uganda Cancer Institute for care.A total of 128 patients were included in this analysis. Chemotherapy was recommended to 117 (91.4% of the patients; the odds of recommending chemotherapy decreased for each additional month of reported symptoms prior to diagnosis. Of the 117 patients to whom chemotherapy was recommended, 111 (86.7% patients received at least 1 cycle of chemotherapy; HIV infected patients, as well as those with a lower hemoglobin and advanced disease at the time of diagnosis were significantly less likely to complete therapy. Among the patients who initiated chemotherapy, twenty patients died prior to treatment completion (including nine who died within 30 days. Hemoglobin level at the time of presentation was the only variable associated with early mortality in the adjusted model.In resource-poor areas, it is essential to align health care expenditures with interventions likely to provide benefit to affected populations. Targeting cancer therapy to those with a favorable chance of responding will not only save limited resources, but will also prevent harm in those patients unlikely to realize an effect of cancer-directed therapy.

  2. Budget Automation System

    Data.gov (United States)

    U.S. Environmental Protection Agency — BAS is the central Agency system used to integrate strategic planning, annual planning, budgeting and financial management. BAS contains resource (dollars and FTE),...

  3. Water Budget Tool

    Science.gov (United States)

    If you're designing a new landscape or rethinking your current one, the WaterSense Water Budget Tool will tell you if you have designed a landscape that will use an appropriate amount of water for your climate.

  4. Global Carbon Budget 2017

    NARCIS (Netherlands)

    Le Quere, Corinne; Andrew, Robbie M.; Friedlingstein, Pierre; Sitch, Stephen; Pongratz, Julia; Manning, Andrew C.; Korsbakken, Jan Ivar; Peters, Glen P.; Canadell, Josep G.; Jackson, Robert B.; Boden, Thomas A.; Tans, Pieter P.; Andrews, Oliver D.; Arora, Vivek K.; Bakker, Dorothee C. E.; Barbero, Leticia; Becker, Meike; Betts, Richard A.; Bopp, Laurent; Chevallier, Frederic; Chini, Louise P.; Ciais, Philippe; Cosca, Catherine E.; Cross, Jessica; Currie, Kim; Gasser, Thomas; Harris, Ian; Hauck, Judith; Haverd, Vanessa; Houghton, Richard A.; Hunt, Christopher W.; Hurtt, George; Ilyina, Tatiana; Jain, Atul K.; Kato, Etsushi; Kautz, Markus; Keeling, Ralph F.; Goldewijk, Kees Klein; Koertzinger, Arne; Landschuetzer, Peter; Lefevre, Nathalie; Lenton, Andrew; Lienert, Sebastian; Lima, Ivan; Lombardozzi, Danica; Metzl, Nicolas; Millero, Frank; Monteiro, Pedro M. S.; Munro, David R.; Nabel, Julia E. M. S.; Nakaoka, Shin-ichiro; Nojiri, Yukihiro; Padin, X. Antonio; Peregon, Anna; Pfeil, Benjamin; Pierrot, Denis; Poulter, Benjamin; Rehder, Gregor; Reimer, Janet; Roedenbeck, Christian; Schwinger, Jorg; Seferian, Roland; Skjelvan, Ingunn; Stocker, Benjamin D.; Tian, Hanqin; Tilbrook, Bronte; Tubiello, Francesco N.; van der Laan-Luijkx, Ingrid T.; van der Werf, Guido R.; van Heuven, Steven; Viovy, Nicolas; Vuichard, Nicolas; Walker, Anthony P.; Watson, Andrew J.; Wiltshire, Andrew J.; Zaehle, Soenke; Zhu, Dan

    2018-01-01

    Accurate assessment of anthropogenic carbon dioxide (CO2) emissions and their redistribution among the atmosphere, ocean, and terrestrial biosphere - the "global carbon budget" - is important to better understand the global carbon cycle, support the development of climate policies, and project

  5. Jackson Revenue Budget

    Data.gov (United States)

    City of Jackson, Mississippi — This dataset shows the City of Jackson's FY2017 revenue budget, revenue collected to date, and the balance remaining to be collected. The data can be broken down by...

  6. Budget and Actuals

    Data.gov (United States)

    Town of Chapel Hill, North Carolina — This dataset contains the Town's Year-to-Date Budget and Actuals for Fiscal Years 2016, 2017, and 2018. Fiscal years run from July 1 to June 30. The data comes from...

  7. Meningiomas after cranial radiotherapy for childhood cancer: a single institution experience.

    Science.gov (United States)

    Felicetti, Francesco; Fortunati, Nicoletta; Garbossa, Diego; Biasin, Eleonora; Rudà, Roberta; Daniele, Dino; Arvat, Emanuela; Corrias, Andrea; Fagioli, Franca; Brignardello, Enrico

    2015-07-01

    Childhood cancer survivors (CCS) treated with cranial radiation therapy (CRT) are at risk of developing meningiomas. The aim of this study was to evaluate the cumulative incidence of meningiomas in a cohort of CCS who previously underwent CRT. We considered all CCS who received CRT and were followed up at the "Transition Unit for Childhood Cancer Survivors" in Turin. Even though asymptomatic, they had at least one brain computed tomography or magnetic resonance imaging performed at a minimum interval of 10 years after treatment for pediatric cancer. We identified 90 patients (median follow-up 24.6 years). Fifteen patients developed meningioma (median time from pediatric cancer, 22.5 years). In four patients, it was suspected on the basis of neurological symptoms (i.e., headache or seizures), whereas all other cases, including five giant meningiomas, were discovered in otherwise asymptomatic patients. Multiple meningiomas were discovered in four CCS. Ten patients underwent surgical resection. An atypical meningioma (grade II WHO) was reported in four patients. One patient with multiple meningiomas died for a rapid growth of the intracranial lesions. A second neoplasm (SN) other than meningioma was diagnosed in five out of the 15 patients with meningioma and in ten out of the 75 CCS without meningioma. Cox multivariate analysis showed that the occurrence of meningioma was associated with the development of other SNs, whereas age, sex, or CRT dose had no influence. CCS at risk of the development of meningioma deserve close clinical follow-up, especially those affected by other SNs.

  8. Under Secretary of Defense (Comptroller) > Budget Materials > Budget1998

    Science.gov (United States)

    functionalStatements OUSD(C) History FMR Budget Materials Budget Execution Financial Management Improving Financial Performance Reports Regulations banner DoD Budget Request 2019 | 2018 | 2017 |2016 | 2015 | 2014 | 2013 | 2012 President's Budget request for the Department of Defense sustains the President's commitment to invest in

  9. A New Approach in Public Budgeting: Citizens' Budget

    Science.gov (United States)

    Bilge, Semih

    2015-01-01

    Change and transformation in the understanding and definition of citizenship has led to the emergence of citizen-oriented public service approach. This approach also raised a new term and concept in the field of public budgeting because of the transformation in the processes of public budgeting: citizens' budget. The citizens' budget which seeks…

  10. The Budget as a Management Tool: Zero Base Budgeting, Panacea ...

    African Journals Online (AJOL)

    Nigeria has been experiencing difficulties in Budget implementation. The objective of this article is to present alternative forms of budgeting and after exposition on them, to recommend one that could mitigate budget implementation problem for Nigeria. Two types of budgeting addressed are incremental and zero-base.

  11. European Union Budget Politics

    DEFF Research Database (Denmark)

    Citi, Manuele

    2015-01-01

    The marginal involvement of the European Union (EU) in redistributive policies and its limited fiscal resources have led to a notable lack of attention by EU scholars towards the EU budget and its dynamics. Yet the nature of the budgetary data and their high usability for statistical analysis make...... to form winning coalitions in the Council, the ideological positioning of the co-legislators and the inclusion of the cohesion countries have played a significant role in driving budget change....

  12. The Budget Impact of Including Necitumumab on the Formulary for First-Line Treatment of Metastatic Squamous Non-Small Cell Lung Cancer: U.S. Commercial Payer and Medicare Perspectives.

    Science.gov (United States)

    Bly, Christopher A; Molife, Cliff; Brown, Jacqueline; Tawney, Mahesh K; Carter, Gebra Cuyun; Cinfio, Frank N; Klein, Robert W

    2018-06-01

    Necitumumab (Neci) was the first biologic approved by the FDA for use in combination with gemcitabine and cisplatin (Neci + GCis) in first-line treatment of metastatic squamous non-small cell lung cancer (msqNSCLC). The potential financial impact on a health plan of adding Neci + GCis to drug formularies may be important to value-based decision makers in the United States, given ever-tightening budget constraints. To estimate the budget impact of introducing Neci + GCis for first-line treatment of msqNSCLC from U.S. commercial and Medicare payer perspectives. The budget impact model estimates the costs of msqNSCLC before and after adoption of Neci + GCis in hypothetical U.S. commercial and Medicare health plans over a 3-year time horizon. The eligible patient population was estimated from U.S. epidemiology statistics. Clinical data were obtained from randomized clinical trials, U.S. prescribing information, and clinical guidelines. Market share projections were based on market research data. Cost data were obtained from online sources and published literature. The incremental aggregate annual health plan, per-patient-per-year (PPPY), and per-member-per-month (PMPM) costs were estimated in 2015 U.S. dollars. One-way sensitivity analyses were conducted to assess the effect of model parameters on results. In a hypothetical 1,000,000-member commercial health plan with an estimated population of 30 msqNSCLC patients receiving first-line chemotherapy, the introduction of Neci + GCis at an initial market share of approximately 5% had an overall year 1 incremental budget impact of $88,394 ($3,177 PPPY, $0.007 PMPM), representing a 2.9% cost increase and reaching $304,079 ($10,397 PPPY, $0.025 PMPM) or a 7.4% cost increase at a market share of 14.7% in year 3. This increase in total costs was largely attributable to Neci drug costs and, in part, due to longer survival and treatment duration for patients treated with Neci+GCis. Overall, treatment costs increased by $81

  13. The Budget Policy in the Context of Economic Transformations

    Directory of Open Access Journals (Sweden)

    Pasichnik Vladimir A.

    2017-12-01

    Full Text Available The article is aimed at disclosing the essence and role of budget policy in the system of socio-economic development of country, defining the institutional approach in the process of its formation and implementation, based on changes in the public environment. The socio-economic development of society at this stage requires the use of budgetary policy as an effective instrument for the State regulation of economic and social relations. It is important to determine the priorities of the budget policy, including the medium-term perspective, based on the basic principles of the socio-economic development of country, improvement of the State regulation in the sphere of generation of budget income, the planning and usage of budget expenditures, the inter-budget relations, which will increase the efficiency of functioning of the economic and budget system as a whole.

  14. Risk-reducing Salpingo-Oophorectomy in Women at Higher Risk of Ovarian and Breast Cancer: A Single Institution Prospective Series.

    Science.gov (United States)

    Ricciardi, Enzo; Tomao, Federica; Aletti, Giovanni; Bazzurini, Luca; Bocciolone, Luca; Boveri, Sara; Landoni, Fabio; Lapresa, Maria Teresa; Maruccio, Matteo; Parma, Gabriella; Peccatori, Fedro; Petrella, Maria Cristina; Zanagnolo, Vanna; Colombo, Nicoletta; Maggioni, Angelo

    2017-09-01

    Occult cancers' reported rates vary from 2-12% and serous tubal intraepithelial carcinomas (STICs) have been identified in 3-12% of the prophylactically removed tubes of women carrying a BRCA mutation. The aim of this study was to evaluate the incidence of tubal minor epithelial atypia (STIL), STIC, and occult invasive cancer and to evaluate the cancer-specific mortality in a prospective series of women at higher risk of ovarian and breast cancer undergoing risk-reducing salpingo-oophorectomy (RRSO) n a tertiary cancer center. A series of RRSO specimens (including endometrial biopsy) from women carrying a BRCA mutation, BRCA-unknown and BRCA-negative were collected between January 1998 and April 2016 at the Division of Gynecology at the European Institute of Oncology. Inclusion criteria were: asymptomatic women who had a negative gynecologic screening within 3 months prior to RRSO. Exclusion criteria were: women with ovarian/tubal cancer prior to RRSO. A total of 411 women underwent RRSO. Median age at RRSO was 47.0 years (range=32-70 years); 75.2% had a history of breast cancer. Fifteen women were diagnosed with an occult cancer (7 STIC, 4 invasive cancers, 2 breast cancers metastatic to the adnexa, 2 endometrial cancer) (3.6%). Sixteen showed a STIL (3.9%). When excluding cases with preoperative positive markers, the occult invasive cancer rate drops to 1.5%. Our study, covering an 18-year period, shows a substantial low risk of occult cancer among a high-risk population of women undergoing RRSO. Our data still support the indication for RRSO in higher-risk patients. An endometrial biopsy should also be routinely obtained as it raises the chances of detecting occult endometrial cancers that may be otherwise missed. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  15. Evaluation of intratumoral HER-2 heterogeneity by fluorescence in situ hybridization in invasive breast cancer: a single institution study.

    Science.gov (United States)

    Lee, Sarah; Jung, Woohee; Hong, Soon-Won; Koo, Ja Seung

    2011-08-01

    This study aimed to determine the incidence and characteristics of HER-2 gene heterogeneity in invasive breast cancer in a single institution. Included were 971 cases of primary invasive breast cancer diagnosed between 2008 and 2010. Fluorescence in situ hybridization (FISH) image files were retrospectively reviewed and HER-2 gene heterogeneity was defined as more than 5% but less than 50% of analyzed invasive tumor cells with a HER-2/Chr17 ratio higher than 2.2, according to the College of American Pathologists guidelines. HER-2 gene heterogeneity was identified in 24 (2.5%) cases. The mean proportion of invasive tumor cells with a HER-2/chromosome 17 ratio higher than 2.2 was 11.6% (range: 5%-25%). Of 24 cases, HER-2 gene status was not amplified in 8, showed borderline amplification in 2, and amplification in 14. All HER-2 amplification cases were low-grade. In conclusion, HER-2 gene heterogeneity of invasive breast cancer is identified in routine FISH examination. This may affect the results of HER-2 gene amplification status in FISH studies.

  16. Overview of the National Cancer Institute's activities related to exposure of the public to fallout from the Nevada Test Site

    International Nuclear Information System (INIS)

    Wachholz, B.W.

    1990-01-01

    The Department of Health and Human Services (DHHS) was directed by Congress to assess the risk of thyroid cancer from 131I associated with fallout from the atmospheric testing of nuclear weapons at the Nevada Test Site. The National Cancer Institute (NCI) was requested by DHHS to address Public Law 97-414, Section 7 (a), which directs DHHS to (1) conduct scientific research and prepare analyses necessary to develop valid and credible assessments of the risks of thyroid cancer that are associated with thyroid doses of Iodine 131; (2)...develop...methods to estimate the thyroid doses of Iodine 131 that are received by individuals from nuclear bomb fallout; (and) (3)...develop...assessments of the exposure to Iodine 131 that the American people received from the Nevada atmospheric nuclear bomb tests. In addition, the University of Utah, under contract with the NCI, is carrying out a study to determine if the incidence of thyroid disease and leukemia among identified populations in Utah may be related to exposure from fallout originating at the Nevada Test Site

  17. Place of death of pediatric cancer patients in a single institute during 7 years.

    Science.gov (United States)

    Yanai, Tomoko; Hirase, Satoshi; Matsunoshita, Natsuki; Yamamoto, Nobuyuki; Ninchoji, Takeshi; Kubokawa, Ikuko; Mori, Takeshi; Hayakawa, Akira; Takeshima, Yasuhiro; Iijima, Kazumoto; Matsuo, Masafumi

    2012-06-27

    Place of death is an important issue at the end-of-life. It is poorly understood in pediatric cancer patients in Japan. This study aimed to clarify place of death of children with cancer as well as variables associated with place of death. Study population was pediatric cancer patients who died in the Department of Pediatrics at Kobe University Hospital during the last 7 years. The medical records were retrospectively reviewed regardless of cause of death to derive data relating to patients' characteristics and disease. 18 patients were included. Median age at death was 12.2 years old. 6 patients including 5 children in complete remission had hematological disease and 12 patients suffered from solid tumors. 4 patients (22.2%) died at home, whereas 14 patients (77.8%) died in the hospital including 6 ICU deaths. No one died in hospices. Preference of patients was unavailable due to the lack of inquiry. Factors influencing place of death (home, ICU, non-ICU) were disease (hematological disease vs. solid tumor, p=0.010, brain tumor vs. non-brain tumor, p=0.023), disease status (complete remission vs. non-complete remission, p=0.0014) and preference of families (p=0.029). Among 6 families who expressed preference, no disparity was observed between actual and preferred place of death. This is the first English publication of place of death of pediatric cancer patients in Japan. The low percentage of home death, factors influencing place of death and the lack of disparity between actual and preferred place of death were indicated. Further studies are required to better understand place of death.

  18. Biomarkers for Early Detection of Clinically Relevant Prostate Cancer: A Multi-Institutional Validation Trial

    Science.gov (United States)

    2017-10-01

    size, diagnostic Gleason (3+3 or 3+4), BMI ( obese , overweight or normal), race (Caucasian, African American or other), ethnicity (Hispanic versus...results were presented at the 2016 Meeting of the American Urological Association (AUA) and have been published in European Urology (v72, pp448-454.) A...prostate cancer in men in the Canary Prostate Active Surveillance Study (PASS).” Annual Meeting of the American Urological Association; 2016 May 6-10, San

  19. Platinum-Based Therapy in Adenosquamous Pancreatic Cancer: Experience at Two Institutions

    OpenAIRE

    Andre Luiz De Souza; Muhammad Wasif Saif

    2014-01-01

    Adenosquamous carcinoma of the pancreas is a rare type of pancreatic cancer. Although its molecular biology profile hasbeen shown to be similar to pancreatic ductal adenocarcinoma tumors, it has different prognostic features. There is noconsensus or guidelines to treat this tumor differently from pancreatic adenocarcinoma, but therapies based on gemcitabineand platinum chemotherapeutics such as cisplatin and oxaliplatin have been used based on results of a few case reports. Wediscuss the Abst...

  20. CPRIT/Johnson Space Center, September, 2011 (Cancer Prevention and Research Institute of Texas)

    Science.gov (United States)

    Davis, Jeffrey; Lane, Helen; Baker, Tracey; Cucinotta, Francis; Wu, Honglu

    2011-01-01

    JSC researchers study carcinogenesis, cancer prevention and treatment along with epidemiological (primarily retrospective and longitudinal) studies, modeling, and interactions with the environment such as radiation, nutritional, and endocrine changes related to space flight along with behaviors such as smoking. Cancer research is a major focus for human space flight due to the exposure to space radiation which consists of particles of varying charges and energies, and secondary neutrons. The JSC laboratories collaborate with investigators from the U.S. as well as our European and Japanese partners. We use accelerator facilities at the Brookhaven National Laboratory, Loma Linda University and Los Alamos National Laboratory that generate high energy charged particles and neutrons to simulate cosmic radiation and solar particle events. The research using cultured cells and animals concentrates on damage and repair from the level of DNA to organ tissues, due to exposure to simulated space radiation exposure, that contribute to the induction of leukemia and solid tumors in most major tissues such as lung, colon, liver and breast. The goal of the research is to develop a mathematical model that can predict cancer morbidity and mortality risks with sufficient accuracy for a given space mission.

  1. Cervical Lymph Node Metastases From Unknown Primary Cancer: A Single-Institution Experience With Intensity-Modulated Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Villeneuve, Hugo, E-mail: hugo.villeneuve@umontreal.ca [Department of Radiation Oncology, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Despres, Philippe; Fortin, Bernard; Filion, Edith; Donath, David [Department of Radiation Oncology, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Soulieres, Denis [Department of Medical Oncology, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Guertin, Louis; Ayad, Tarek; Christopoulos, Apostolos [Department of Head and Neck Surgery, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Nguyen-Tan, Phuc Felix [Department of Radiation Oncology, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada)

    2012-04-01

    Purpose: To determine the effectiveness and rate of complications of intensity-modulated radiotherapy (IMRT) in the treatment of cervical lymph node metastases from unknown primary cancer. Methods and Materials: Between February 2005 and November 2008, 25 patients with an unknown primary cancer underwent IMRT, with a median radiation dose of 70 Gy. The bilateral neck and ipsilateral putative pharyngeal mucosa were included in the target volume. All patients had squamous cell carcinoma, except for 1 patient who had adenosquamous differentiation. They were all treated with curative intent. Of the 25 included patients, 20 were men and 5 were women, with a median age of 54 years. Of these patients, 3 had Stage III, 18 had Stage IVa, and 4 had Stage IVb. Of the 25 patients, 18 (72%) received platinum-based chemotherapy in a combined-modality setting. Neck dissection was reserved for residual disease after definitive IMRT. Overall survival, disease-free survival, and locoregional control were calculated using the Kaplan-Meier method. Results: With a median follow-up of 38 months, the overall survival, disease-free survival, and locoregional control rates were all 100% at 3 years. No occurrence of primary cancer was observed during the follow-up period. The reported rates of xerostomia reduced with the interval from the completion of treatment. Nine patients (36%) reported Grade 2 or greater xerostomia at 6 months, and only 2 (8%) of them reported the same grade of salivary function toxicity after 24 months of follow-up. Conclusion: In our institution, IMRT for unknown primary cancer has provided good overall and disease-free survival in all the patients with an acceptable rate of complications. IMRT allowed us to address the bilateral neck and ipsilateral putative pharyngeal mucosa with minimal late salivary function toxicity. The use of concurrent chemotherapy and IMRT for more advanced disease led to good clinical results with reasonable toxicities.

  2. Challenges Facing Early Phase Trials Sponsored by the National Cancer Institute: An Analysis of Corrective Action Plans to Improve Accrual.

    Science.gov (United States)

    Massett, Holly A; Mishkin, Grace; Rubinstein, Larry; Ivy, S Percy; Denicoff, Andrea; Godwin, Elizabeth; DiPiazza, Kate; Bolognese, Jennifer; Zwiebel, James A; Abrams, Jeffrey S

    2016-11-15

    Accruing patients in a timely manner represents a significant challenge to early phase cancer clinical trials. The NCI Cancer Therapy Evaluation Program analyzed 19 months of corrective action plans (CAP) received for slow-accruing phase I and II trials to identify slow accrual reasons, evaluate whether proposed corrective actions matched these reasons, and assess the CAP impact on trial accrual, duration, and likelihood of meeting primary scientific objectives. Of the 135 CAPs analyzed, 69 were for phase I trials and 66 for phase II trials. Primary reasons cited for slow accrual were safety/toxicity (phase I: 48%), design/protocol concerns (phase I: 42%, phase II: 33%), and eligibility criteria (phase I: 41%, phase II: 35%). The most commonly proposed corrective actions were adding institutions (phase I: 43%, phase II: 85%) and amending the trial to change eligibility or design (phase I: 55%, phase II: 44%). Only 40% of CAPs provided proposed corrective actions that matched the reasons given for slow accrual. Seventy percent of trials were closed to accrual at time of analysis (phase I = 48; phase II = 46). Of these, 67% of phase I and 70% of phase II trials met their primary objectives, but they were active three times longer than projected. Among closed trials, 24% had an accrual rate increase associated with a greater likelihood of meeting their primary scientific objectives. Ultimately, trials receiving CAPs saw improved accrual rates. Future trials may benefit from implementing CAPs early in trial life cycles, but it may be more beneficial to invest in earlier accrual planning. Clin Cancer Res; 22(22); 5408-16. ©2016 AACRSee related commentary by Mileham and Kim, p. 5397. ©2016 American Association for Cancer Research.

  3. HDR and LDR Brachytherapy in the Treatment of Lip Cancer: the Experience of the Catalan Institute of Oncology.

    Science.gov (United States)

    Ayerra, Arrate Querejeta; Mena, Estefanía Palacios; Fabregas, Joan Pera; Miguelez, Cristina Gutiérrez; Guedea, Ferran

    2010-03-01

    Lip cancer can be treated by surgery, external radiotherapy, and/or brachytherapy (BT). In recent years, BT has become increasingly favored for this type of cancer. The aim of the present study was to analyze local control and survival of patients treated at our institution between July 1989 and June 2008. We performed a retrospective study of 121 patients (109 males and 12 females) who underwent lip cancer brachytherapy from July 1989 to June 2008. Median age was 67 years and median follow-up was 31.8 months (range 20-188 months). Out of 121 patients, 100 (82.6%) were treated with low dose rate (LDR) BT while the remaining 21 patients (17.4%) received high dose rate (HDR) BT. The most common cell type was squamous cell carcinoma (115 cases; 95%) and most tumors were located on the lower lip (107 patients; 88.4%). Most cases were either stage T1 (62 patients; 51.2%), or T2 (44 cases; 36.4%). After 15 years of follow-up, overall survival was 89.5%, cause-specific survival 97.8%, and disease-free survival 86.6%. Local, regional, and distant control at 15 years were 90%, 92%, and 98.8%, respectively. Grade 3 mucosal toxicity was observed in 23% of patients treated with LDR compared to 33% of HDR patients, and grade 4 mucosal toxicity in 9% versus 0% in the HDR group. Our findings confirm that brachytherapy is an effective treatment for lip cancer. The results from our series are in line with those published elsewhere. Based on our limited data, HDR appears to be equally as good as LDR, although this needs to be confirmed by further studies.

  4. Estrogen receptor and progesterone receptor status of breast cancer patients of eastern India: A multi-institutional study.

    Science.gov (United States)

    Chatterjee, Koushik; Bhaumik, Gautam; Chattopadhyay, Bhargab

    2018-01-01

    There is a paucity of any significant data on the estrogen receptor (ER) and progesterone receptor (PR) status of breast cancer patients from the eastern part of India. This study aims to document the ER and PR status of breast cancer patients in the eastern Indian population, as catered by two premier tertiary care hospitals in Kolkata. All breast cancer patients registered between January 1, 2013 and December 31, 2015, in the Departments of Oncology, of IPGMER and SSKM Hospitals and R. G. Kar Medical College and Hospital, Kolkata, who had at least undergone a core biopsy or surgery, were analyzed retrospectively for documentation of their ER and PR status, using the 2010 American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) interpretation guidelines. Over a period of 3 years, a total of 927 patients were included for the study. A total of 825 (89%) patients had their ER and PR data available for evaluation. ER and PR positive was seen in 312 (37.82%) patients, ER and PR negative in 399 (48.36%) patients, ER positive and PR negative in 71 (8.6%) patients, and ER negative and PR positive results was found in 43 (5.21%) patients. This is the first multi-institutional documentation of ER and PR status from eastern India, having a modest number of patients and one of the earliest documentations using the latest ASCO/CAP interpretation guidelines. These findings resemble the data from the south and also reiterate the fact that majority of the Indian breast cancer patients are still ER and PR negative in spite of the changes in the interpretation guidelines.

  5. 1985 nuclear budget requests up 12 %

    International Nuclear Information System (INIS)

    Anon.

    1984-01-01

    The estimates of government agencies for the fiscal 1985 nuclear-related budget were presented to the Ministry of Finance, which amount to 343.76 billion yen (up 12.1 %). The budgetary requests by the Science and Technology Agency are 179.24 billion yen in the general account and 90.21 billion yen in the special account for power resource development, and the budgetary requests by the Ministry of International Trade and Industry are 1.03 billion yen and 70.08 billion yen, respectively. The budget demands by the STA, which supervises Power Reactors and Nuclear Fuel Development Corporation, Japan Atomic Energy Research Institute, etc. are for the continuation of current projects, including the beginning of the construction of the prototype FBR Monju and the neutral beam injector for the fusion device JT-60. The budget demands by MITI are similarly for the safety measures and verification tests for nuclear power generation. (Mori, K.)

  6. Chemo-radiotherapy plus hyperthermia in locally advanced cervical cancer: preliminary results of an institutional phase II study

    International Nuclear Information System (INIS)

    Gabbani, M.; Marciai, N.; Maluta, S.; Griso, C.; Merlin, F.; Cassandrini, P.; Giudici, S.; Franchi, M.; Zanini, L.

    2005-01-01

    Full text: Radiotherapy given concurrently with a cisplatin-based regimen has shown a benefit in patients with locally advanced cervical cancer so becoming the new standard treatment according to EBM criteria. Addition of hyperthermia to radiotherapy has also been proved to yield an advantage in survival and local control in pts affected by recurrent and local advanced cervical cancer in the Dutch Phase III trial so that the Consensus Forum of Kadota (Osaha June 2004) included cervical cancer among tumors treatable with hyperthermia. In our institutional multidisciplinary team a pilot study has been designed in order to evaluate feasibility, outcome and toxicity of tri-modality treatment in pts with locally advanced cervical cancer in our daily practice. Since January 2003 to now eight patients affected by cervical cancer with stage IB2 through IVA N0-N+ pelvic or paraaortic were entered the study. Six patients were treated at initial diagnosis and two patients after chemotherapy which had achieved stable disease. Treatment regimen consisted in 5 courses of weekly chemotherapy (cisplatin 40 mg/mq) with concurrent external radiotherapy to a total dose of 64-66 Gy on CTV1 and 45 Gy on para-aortic nodes plus boost in pts with enlarged nodes identified by imaging. Five weekly sessions of hyperthermia were performed by using BSD 2000 system and sigma 60 applicator. No significant toxicity occurred and all of the patients completed tri-modality treatment in accordance with the study protocol. Seven pts experienced a complete clinical remission and one patient a partial remission as defined by clinical and imaging examinations. After four months from the end of the treatment a patient with Stage IIB bulky tumor plus one pelvic positive node who was in complete remission (Clinical examination, MRI and TAC-PET three months from the end of the treatment were negative for evidence of disease) developed a bleeding recto-vaginal fistula plus central pelvic necrosis for which an

  7. Local recurrence after surgery for non-small cell lung cancer: a recursive partitioning analysis of multi-institutional data.

    Science.gov (United States)

    Kelsey, Chris R; Higgins, Kristin A; Peterson, Bercedis L; Chino, Junzo P; Marks, Lawrence B; D'Amico, Thomas A; Varlotto, John M

    2013-10-01

    To define subgroups at high risk of local recurrence (LR) after surgery for non-small cell lung cancer using a recursive partitioning analysis (RPA). This Institutional Review Board-approved study included patients who underwent upfront surgery for I-IIIA non-small cell lung cancer at Duke Cancer Institute (primary set) or at other participating institutions (validation set). The 2 data sets were analyzed separately and identically. Disease recurrence at the surgical margin, ipsilateral hilum, and/or mediastinum was considered an LR. Recursive partitioning was used to build regression trees for the prediction of local recurrence-free survival (LRFS) from standard clinical and pathological factors. LRFS distributions were estimated with the Kaplan-Meier method. The 1411 patients in the primary set had a 5-year LRFS rate of 77% (95% confidence interval [CI], 0.74-0.81), and the 889 patients in the validation set had a 5-year LRFS rate of 76% (95% CI, 0.72-0.80). The RPA of the primary data set identified 3 terminal nodes based on stage and histology. These nodes and their 5-year LRFS rates were as follows: (1) stage I/adenocarcinoma, 87% (95% CI, 0.83-0.90); (2) stage I/squamous or large cell, 72% (95% CI, 0.65-0.79); and (3) stage II-IIIA, 62% (95% CI, 0.55-0.69). The validation RPA identified 3 terminal nodes based on lymphovascular invasion (LVI) and stage: (1) no LVI/stage IA, 82% (95% CI, 0.76-0.88); (2) no LVI/stage IB-IIIA, 73% (95% CI, 0.69-0.80); and (3) LVI, 58% (95% CI, 0.47-0.69). The risk of LR was similar in the primary and validation patient data sets. There was discordance between the 2 data sets regarding the clinical factors that best segregate patients into risk groups. Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  8. Audiovisual biofeedback breathing guidance for lung cancer patients receiving radiotherapy: a multi-institutional phase II randomised clinical trial.

    Science.gov (United States)

    Pollock, Sean; O'Brien, Ricky; Makhija, Kuldeep; Hegi-Johnson, Fiona; Ludbrook, Jane; Rezo, Angela; Tse, Regina; Eade, Thomas; Yeghiaian-Alvandi, Roland; Gebski, Val; Keall, Paul J

    2015-07-18

    There is a clear link between irregular breathing and errors in medical imaging and radiation treatment. The audiovisual biofeedback system is an advanced form of respiratory guidance that has previously demonstrated to facilitate regular patient breathing. The clinical benefits of audiovisual biofeedback will be investigated in an upcoming multi-institutional, randomised, and stratified clinical trial recruiting a total of 75 lung cancer patients undergoing radiation therapy. To comprehensively perform a clinical evaluation of the audiovisual biofeedback system, a multi-institutional study will be performed. Our methodological framework will be based on the widely used Technology Acceptance Model, which gives qualitative scales for two specific variables, perceived usefulness and perceived ease of use, which are fundamental determinants for user acceptance. A total of 75 lung cancer patients will be recruited across seven radiation oncology departments across Australia. Patients will be randomised in a 2:1 ratio, with 2/3 of the patients being recruited into the intervention arm and 1/3 in the control arm. 2:1 randomisation is appropriate as within the interventional arm there is a screening procedure where only patients whose breathing is more regular with audiovisual biofeedback will continue to use this system for their imaging and treatment procedures. Patients within the intervention arm whose free breathing is more regular than audiovisual biofeedback in the screen procedure will remain in the intervention arm of the study but their imaging and treatment procedures will be performed without audiovisual biofeedback. Patients will also be stratified by treating institution and for treatment intent (palliative vs. radical) to ensure similar balance in the arms across the sites. Patients and hospital staff operating the audiovisual biofeedback system will complete questionnaires to assess their experience with audiovisual biofeedback. The objectives of this

  9. Audiovisual biofeedback breathing guidance for lung cancer patients receiving radiotherapy: a multi-institutional phase II randomised clinical trial

    International Nuclear Information System (INIS)

    Pollock, Sean; O’Brien, Ricky; Makhija, Kuldeep; Hegi-Johnson, Fiona; Ludbrook, Jane; Rezo, Angela; Tse, Regina; Eade, Thomas; Yeghiaian-Alvandi, Roland; Gebski, Val; Keall, Paul J

    2015-01-01

    There is a clear link between irregular breathing and errors in medical imaging and radiation treatment. The audiovisual biofeedback system is an advanced form of respiratory guidance that has previously demonstrated to facilitate regular patient breathing. The clinical benefits of audiovisual biofeedback will be investigated in an upcoming multi-institutional, randomised, and stratified clinical trial recruiting a total of 75 lung cancer patients undergoing radiation therapy. To comprehensively perform a clinical evaluation of the audiovisual biofeedback system, a multi-institutional study will be performed. Our methodological framework will be based on the widely used Technology Acceptance Model, which gives qualitative scales for two specific variables, perceived usefulness and perceived ease of use, which are fundamental determinants for user acceptance. A total of 75 lung cancer patients will be recruited across seven radiation oncology departments across Australia. Patients will be randomised in a 2:1 ratio, with 2/3 of the patients being recruited into the intervention arm and 1/3 in the control arm. 2:1 randomisation is appropriate as within the interventional arm there is a screening procedure where only patients whose breathing is more regular with audiovisual biofeedback will continue to use this system for their imaging and treatment procedures. Patients within the intervention arm whose free breathing is more regular than audiovisual biofeedback in the screen procedure will remain in the intervention arm of the study but their imaging and treatment procedures will be performed without audiovisual biofeedback. Patients will also be stratified by treating institution and for treatment intent (palliative vs. radical) to ensure similar balance in the arms across the sites. Patients and hospital staff operating the audiovisual biofeedback system will complete questionnaires to assess their experience with audiovisual biofeedback. The objectives of this

  10. Differences in CT features of peritoneal carcinomatosis, sarcomatosis, and lymphomatosis: Retrospective analysis of 122 cases at a tertiary cancer institution

    International Nuclear Information System (INIS)

    O'Neill, A.C.; Shinagare, A.B.; Rosenthal, M.H.; Tirumani, S.H.; Jagannathan, J.P.; Ramaiya, N.H.

    2014-01-01

    Aims: To study the differences in the imaging features of spread from the three cancer cell lines, namely epithelial, sarcomatoid, and lymphoid, resulting in peritoneal carcinomatosis, peritoneal sarcomatosis, and peritoneal lymphomatosis, respectively. Materials and methods: In this institutional review board-approved Health Insurance Portability and Accountability Act (HIPAA)-compliant retrospective study, an electronic radiology database was searched to identify patients with peritoneal tumour spread who underwent CT imaging at Dana-Farber Cancer Institute, a tertiary cancer institution, between January 2011 and December 2012. Out of 1214 patients with possible peritoneal tumour spread on the radiology reports, 122 patients were included with histopathologically confirmed peritoneal disease (50 randomly selected patients with peritoneal carcinomatosis and sarcomatosis each, and all 22 patients with lymphomatosis). Two blinded, fellowship-trained radiologists in consensus reviewed the CT images in random order and recorded the imaging findings of peritoneal tumour spread. The statistical analysis was performed in two steps: the first comparing incidence of various features in each group and the second step was a pairwise analysis between each cohort. Results: Peritoneal carcinomatosis more frequently had ascites, peritoneal thickening, and omental cake (all p ≤ 0.001). Measurable nodules were less common in peritoneal carcinomatosis (p < 0.001), and when present, were ill-defined and had an irregular outline (p ≤ 0.002). Peritoneal sarcomatosis more often had discrete nodules that were well defined and had a smooth outline and less frequently had ascites, peritoneal thickening, omental caking, serosal implants, and lymphadenopathy (all p ≤ 0.005). Peritoneal lymphomatosis frequently involved the omentum and mesentery, and often had associated lymphadenopathy and splenomegaly (all p ≤ 0.002). Conclusion: Peritoneal carcinomatosis, sarcomatosis

  11. Dose escalation by hypo fractionation in localized prostate cancer - a large single institution experience

    International Nuclear Information System (INIS)

    Mahadevan, A.; Klein, E.; Kupelian, P.

    2003-01-01

    To report the outcomes of high dose radiation therapy using Intensity Modulated Radiation Therapy (IMRT) with hypo fractionation in localized prostate cancer at the Cleveland Clinic Foundation. A total of 278 patients with localized prostate cancer were treated with IMRT between 1998 and 2001. All cases had available pretreatment PSA (iPSA) and biopsy Gleason scores (bGS), no nodal metastasis, a minimum 2 year follow-up, and >5 follow-up PSA levels. The frequency by T-stage was: T1-T2A in 86%, T2B-T2C in 9%, and T3 in 5%. The median iPSA was 8.35. The frequency by bGS was: =7 in 45%. The age range for the patients was from 48 to 85 years (median 68 years). The median follow-up was 33 months (range: 24-49 months). The median doses delivered were 83Gy (delivered at 2.5Gy per fraction to 70 Gy; this being equivalent to 83 Gy at standard fractionation of 1.8 Gy using an alpha/beta of 2). The ASTRO definition for biochemical failure was used. Toxicity was assessed using Radiation Therapy Oncology Group (RTOG) criteria. The 3-year biochemical relapse free survival (bRFS) for the entire cohort at three years was 91%. Any (grade 1 or higher) acute genito-urinary (GU) side effects were seen in 79% of patients. Grade 2 or higher acute GU toxicity was seen in 18% of patients. Any (grade 1 or higher) acute gastro-intestinal (GI) side effects were seen in 65% of patients. Grade 2 or higher acute GI toxicity was seen in 11% of patients. Any (grade 1 or higher) late GU side effects were seen in 3% of patients. Grade 2 or higher late GU toxicity was seen in 1.5% of patients. Any (grade 1 or higher) late GI side effects were seen in 13% of patients. Grade 2 or higher late GI toxicity was seen in 5% of patients. Higher doses of radiation delivered by IMRT resulted in excellent bRFS outcomes in patients with localized prostate cancer receiving external beam radiation therapy. IMRT can be effectively used to safely increase dose delivery without compromising on quality of life

  12. A Pragmatic Evaluation of the National Cancer Institute Physician Data Query (PDQ)®-Based Brief Counseling on Cancer-Related Fatigue among Patients Undergoing Radiation Therapy

    Science.gov (United States)

    Bauml, Joshua; Xie, Sharon X; Penn, Courtney; Desai, Krupali; Dong, Kimberly W; Bruner, Deborah Watkins; Vapiwala, Neha; Mao, Jun James

    2018-01-01

    Purpose Cancer-Related Fatigue (CRF) negatively affects quality of life among cancer patients. This study seeks to evaluate the outcome and patient receptiveness of a brief counseling program based on National Cancer Institute (NCI) PDQ® information to manage CRF when integrated into Radiation Therapy (RT). Methods We conducted a prospective cohort study among patients undergoing non-palliative RT. Patients with stage I–III tumors and with Karnofsky score 60 or better were given a ten-minute behavioral counseling session during the first two weeks of RT. The Brief Fatigue Inventory (BFI) was administered at baseline/end of RT. Results Of 93 patients enrolled, 89% found the counseling useful and practical. By the end of RT, 59% reported increased exercise, 41.6% sought nutrition counseling, 72.7% prioritized daily activities, 74.4% took daytime naps, and 70.5% talked with other cancer patients. Regarding counseling, patients who had received chemotherapy prior to RT had no change in fatigue (−0.2), those who received RT alone had mild increase in fatigue (0.7, p=0.02), and those who received concurrent chemotherapy experienced a substantial increase in fatigue (3.0 to 5.2, p=0.05). Higher baseline fatigue and receipt of chemotherapy were predictive of worsened fatigue in a multivariate model (both p<0.01). Conclusion Our data suggests that brief behavioral counseling based on NCI guidelines is well accepted by patients showing an uptake in many activities to cope with CRF. Those who receive concurrent chemotherapy and with higher baseline fatigue are at risk for worsening fatigue despite of guideline-based therapy. PMID:29479490

  13. Multidisciplinary Service Utilization Pattern by Advanced Head and Neck Cancer Patients: A Single Institution Study

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    Jacqueline C. Junn

    2012-01-01

    Full Text Available Purpose. To analyze the patterns and associations of adjunctive service visits by head and neck cancer patients receiving primary, concurrent chemoradiation therapy. Methods. Retrospective chart review of patients receiving adjunctive support during a uniform chemoradiation regimen for stages III-IV head and neck squamous cell carcinoma. Univariate and multivariate models for each outcome were obtained from simple and multivariate linear regression analyses. Results. Fifty-two consecutive patients were assessed. Female gender, single marital status, and nonprivate insurance were factors associated with an increased number of social work visits. In a multivariate analysis, female gender and marital status were related to increased social work services. Female gender and stage IV disease were significant for increased nursing visits. In a multivariate analysis for nursing visits, living greater than 20 miles between home and hospital was a negative predictive factor. Conclusion. Treatment of advanced stage head and neck cancer with concurrent chemoradiation warrants a multidisciplinary approach. Female gender, single marital status, and stage IV disease were correlated with increased utilization of social work and nursing services. Distance over 20 miles from the center was a negative factor. This information may help guide the treatment team to allocate resources for the comprehensive care of patients.

  14. Biomedical information @ the speed of light: implementing desktop access to publishers' resources at the Paterson Institute for Cancer Research.

    Science.gov (United States)

    Glover, S W

    2001-06-01

    Shortly after midnight every Thursday morning, a list server in Massachusetts delivers an electronic table of contents message to the Kostoris Medical Library at the Paterson Institute for Cancer Research in Manchester, UK. The messageins details of the latest edition of the New England Journal of Medicine, complete with hyperlinks to the full text of the content online. Publishers' electronic current awareness services have been integrated into the dissemination process of the Library service to enhance the speed of communication and access to full text content. As a means of promoting electronic journal use, a system of e-mail delivery coupled with fast Internet access has allowed a migration from paper-based current awareness alerting to a seamless online product.

  15. Present state of studies on FFAG accelerator for radiotherapy of cancer in National Institute of Radiological Sciences

    International Nuclear Information System (INIS)

    Misu, Toshiyuki

    2003-01-01

    From 2001, developmental contract studies with Ministry of Education, Culture, Sports, Science and Technology for a compact accelerator for heavy ion radiotherapy of cancer started in National Institute of Radiological Sciences (NIRS) with use of fixed field alternating gradient (FFAG) accelerator, which had been developed in High Energy Accelerator Research Organization (KEK). This paper describes the present state of those studies. Described are FFAG accelerator design for repeated acceleration for 200 Hz or more toward the carbon ion at 400 MeV/u with the range of 25 cm in water, FFAG optical systems for these purposes by linear analyses, and the present situation of the design. Technological problems yielded and future study plan are also commented. (N.I.)

  16. Evolution of accesses to information on breast cancer and screening on the Brazilian National Cancer Institute website: an exploratory study.

    Science.gov (United States)

    Vasconcellos-Silva, Paulo Roberto; Sormunen, Taina; Craftman, Åsa Gransjön

    2018-04-01

    Delays in diagnosis due to low Breast Cancer awareness are widespread in Brazil maybe owing to ineffective strategies to raise attention on early diagnosis. As a proxy of collective interest in BC screanning (BCS) we studied the monthly accesses to BC and BCS webpages in INCA's website along 48 months. A log analyzer built a time serie (2006-2009) of BC and BCS monthly means, which oscilations were studied by analysis of variance (ANOVA). We found significant increasing accesses to BC and transient "attention peaks". Enlargement in BC/BCS differences along all period were caused by increasing accesses to BC and decreasing/minor/stable oscillations to SBC pages. These results are consistent with previous reports on increasing interest to BC contrasting with indifference on BCS. In the context of an exploratory study, we discussed some aspects: weakness of a "prevention culture"; lack of confidence in health system and screening programs; "celebrity effect" in the context of media framing; collective perception of risks heightened by perception of social vulnerability. Findings suggest that culture-tailored communication strategies would be necessary to inform Brazilian people about BCS. Future research is needed to study social perceptions and constructions on BC topics.

  17. Evolution of accesses to information on breast cancer and screening on the Brazilian National Cancer Institute website: an exploratory study

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Vasconcellos-Silva

    Full Text Available Abstract Delays in diagnosis due to low Breast Cancer awareness are widespread in Brazil maybe owing to ineffective strategies to raise attention on early diagnosis. As a proxy of collective interest in BC screanning (BCS we studied the monthly accesses to BC and BCS webpages in INCA's website along 48 months. A log analyzer built a time serie (2006-2009 of BC and BCS monthly means, which oscilations were studied by analysis of variance (ANOVA. We found significant increasing accesses to BC and transient “attention peaks”. Enlargement in BC/BCS differences along all period were caused by increasing accesses to BC and decreasing/minor/stable oscillations to SBC pages. These results are consistent with previous reports on increasing interest to BC contrasting with indifference on BCS. In the context of an exploratory study, we discussed some aspects: weakness of a “prevention culture”; lack of confidence in health system and screening programs; “celebrity effect” in the context of media framing; collective perception of risks heightened by perception of social vulnerability. Findings suggest that culture-tailored communication strategies would be necessary to inform Brazilian people about BCS. Future research is needed to study social perceptions and constructions on BC topics.

  18. [Evaluation of breast cancer treatment at a tertiary-level institution with Popular Health Insurance in Mexico].

    Science.gov (United States)

    Arce-Salinas, Claudia; Lara-Medina, Fernando Ulises; Alvarado-Miranda, Alberto; Castañeda-Soto, Noel; Bargalló-Rocha, Enrique; Ramírez-Ugalde, María Teresa; Pérez-Sánchez, Víctor; Rivera, Lesbia; Gambo-Vignole, Carlos; Santamaría-Galicia, Julieta; Nieves-Casas, Rosa Isela; Morán-Muñoz, Héctor; Mohar-Betancourt, Alejandro

    2012-01-01

    In our country breast cancer represents a major health problem. Only 45% of all population has access to health services, the consequence is delay in diagnosis and treatment. In Mexico, 66% of all new cases of breast cancer are diagnosed in locally advanced stages. From May 2007 the Health System Protection Against Catastrophic Expenses, called Seguro Popular (SP), breast cancer was included in covering the treatment of this neoplasm in any patient without access to social security. To evaluate the results and impact of SP in the adjuvant and neoadjuvant treatment of a group of patients diagnosed with breast cancer at an institution of national reference. We analyzed a group of 259 patients in stages (I-IIIC). The clinical stages I and II (55 patients) were treated with adjuvant chemotherapy FAC -T (fluorouracil 500 mg/m2, adriamycin 50 mg/m2 and cyclophosphamide 500 mg/m2 (FAC) followed by 12 weeks of paclitaxel 80 mg/m2 +/- trastuzumab loading dose of 4 mg/kg followed by 2 mg/kg); 204 patients in locally advanced stages (IIB-IIIC) received FAC-T +/- trastuzumab followed by surgery. Adjuvant treatment consisted of endocrine therapy for hormone-sensitive patients and radiotherapy 50 cGy according to international standards. The age at diagnosis was 47 years (range 23-68). 80% of them were locally advanced stages (IIB-IIIC) and were treated in a neoadjuvant setting, 20% was in early stages, treated with surgery and adjuvant chemotherapy The disease-free survival and overall survival at 30 months was 85.7 and 90% respectively. Overall pathologic complete response was obtained in 15% of cases. In the subgroup analysis showed that 41% of patients HER2 (+), 29% of triple-negative patients and 9% of hormone-sensitive tumors achieved complete pathological response (p = 0.0001). This is the first analysis of efficacy of adjuvant and neoadjuvant treatment in breast cancer since the introduction of popular secure non-entitled population. It is clear that treatment efficacy

  19. Intraoperative radiation therapy in gynecologic cancer: update of the experience at a single institution

    International Nuclear Information System (INIS)

    Garton, Graciela R.; Gunderson, Leonard L.; Webb, Maurice J.; Wilson, Timothy O.; Cha, Stephen S.; Podratz, Karl C.

    1997-01-01

    Purpose: To update the Mayo Clinic experience with intraoperative radiation therapy (IORT) in patients with gynecologic cancer. Methods and Materials: Between January 1983 and June 1991, 39 patients with recurrent or locally advanced gynecologic malignancies received intraoperative radiation therapy with electrons. The anatomical area treated was pelvis (side walls or presacrum) or periaortic nodes or a combination of both. In addition to intraoperative radiation therapy, 28 patients received external beam irradiation (median dose, 45 Gy; range, 0.9 to 65.7 Gy), and 13 received chemotherapy preoperatively. At the time of intraoperative radiation therapy and after maximum debulking operation, 23 patients had microscopic residual disease and 16 had gross residual disease up to 5 cm in thickness. Median follow-up for surviving patients was 43.4 months (range, 27.1 to 125.4 months). Results: The 5-year actuarial local control with or without central control was 67.4%, and the control within the IORT field (central control) was 81%. The risk of distant metastases at 5 years was 52% (82% in patients with gross residual disease and 33% in patients with only microscopic disease postoperatively). Actuarial 5-year overall survival and disease-free survival was 31.5 and 40.5%, respectively. Patients with microscopic disease had 5-year disease-free and overall survival of 55 and 50%, respectively. Grade 3 toxicity was directly associated with IORT in six patients (15%). Conclusion: Patients with local, regionally recurrent gynecologic cancer may benefit from maximal surgical debulking and IORT with or without external beam irradiation, especially those with microscopic residual disease

  20. The costs of breast cancer in a Mexican public health institution

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    Jacobo Alejandro Gómez-Rico

    2008-11-01

    Full Text Available Jacobo Alejandro Gómez-Rico1, Marina Altagracia-Martínez1, Jaime Kravzov-Jinich1, Rosario Cárdenas-Elizalde1, Consuelo Rubio-Poo21Universidad Autónoma Metropolitano–Xochimilco (UAM-X, Departments: Biological Systems and Healthcare, Biological and Health Sciences Division (DCBS; 2Universidad Nacional Autónoma de México (UNAM, Faculty of Professional Studies-Zaragoza (FES-ZaragozaAbstract: Breast cancer (BC is the second leading cause of death as a result of neoplasia in Mexico. This study aimed to identify the direct and indirect costs of treating female outpatients diagnosed with BC at a Mexican public hospital. A cross-sectional, observational, analytical study was conducted. A total of 506 medical records were analyzed and 102 were included in the cost analysis. The micro-costing process was used to estimate treatment costs. A 17-item questionnaire was used to obtain information on direct and indirect costs. Of the 102 women with BC included in the study, 92.2% (94 were at Stage II, and only 7.8% at Stage I. Total direct costs over six months for the 82 women who had modified radical mastectomy (MRM surgury were US$733,821.15. Total direct costs for the 15 patients with conservative surgery (CS were US$138,190.39. We found that the total economic burden in the study population was much higher for patients with MRM than for patients with CS.Keywords: breast cancer, Mexican women, direct and indirect costs

  1. An Institutional Retrospective Analysis of 93 Patients with Brain Metastases from Breast Cancer: Treatment Outcomes, Diagnosis-Specific Prognostic Factors

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    Delphine Antoni

    2012-12-01

    Full Text Available To evaluate the prognostic factors and indexes of a series of 93 patients with breast cancer and brain metastases (BM in a single institution. Treatment outcomes were evaluated according to the major prognostic indexes (RPA, BSBM, GPA scores and breast cancer subtypes. Independent prognostic factors for overall survival (OS were identified. The median OS values according to GPA 0–1, 1.5–2, 2.5–3 and 3.5–4, were 4.5, 9.5, 14.2 and 19.1 months, respectively (p < 0.0001 and according to genetic subtypes, they were 5, 14.2, 16.5 and 17.1 months for basal-like, luminal A and B and HER, respectively (p = 0.04. Using multivariate analysis, we established a new grading system using the six factors that were identified as indicators of longer survival: age under 60 (p = 0.001, high KPS (p = 0.007, primary tumor control (p = 0.05, low number of extracranial metastases and BM (p = 0.01 and 0.0002, respectively and triple negative subtype (p = 0.002. Three groups with significantly different median survival times were identified: 4.1, 9.5 and 26.3 months, respectively (p < 0.0001. Our new grading system shows that prognostic indexes could be improved by using more levels of classification and confirms the strength of biological prognostic factors.

  2. Imaging yield from 133 consecutive patients with prostate cancer and low trigger PSA from a single institution

    International Nuclear Information System (INIS)

    Shinagare, A.B.; Keraliya, A.; Somarouthu, B.; Tirumani, S.H.; Ramaiya, N.H.; Kantoff, P.W.

    2016-01-01

    Aim: To investigate the yield of imaging in patients with relapsed prostate cancer (PC) with a low trigger prostate-specific antigen (PSA). Materials and methods: This institutional review board (IRB)-approved, Health Insurance Portability and Accountability Act (HIPAA)-compliant retrospective study included all 133 patients (mean age 68 years; range 45–88; median 69 months since original diagnosis; interquartile range [IQR]: 32–139) with hormone-sensitive PC (HSPC, n=28) or castration-resistant PC (CRPC, n=105) and trigger PSA 0.05 for all). Fifty-seven of the 133 (43%) patients had findings seen only at CT, of which 37 had new extra-osseous findings. Only 2/133 (2%) had findings at bone scintigraphy not seen at CT, both in areas not covered on CT. Conclusion: Imaging frequently demonstrated new metastatic and non-metastatic findings in patients with a low trigger PSA. CT is valuable in these patients because extra-osseous findings not visible at bone scintigraphy are frequently seen. - Highlights: • New and existing metastases common in prostate cancer with low trigger PSA. • Previous reports of threshold PSA levels may not apply in follow-up setting. • No difference in metastatic pattern between hormone sensitive and resistant disease. • CT showed extra-osseous findings not seen on bone scan in 44% patients. • Bone scan rarely showed findings not visible on concurrent CT.

  3. Genetics Home Reference: lung cancer

    Science.gov (United States)

    ... Share: Email Facebook Twitter Home Health Conditions Lung cancer Lung cancer Printable PDF Open All Close All Enable Javascript ... cancer, childhood Additional NIH Resources (3 links) National Cancer Institute: Lung Cancer Overview National Cancer Institute: Lung Cancer Prevention ...

  4. Skin Sparing Mastectomy and Immediate Breast Reconstruction (SSMIR for early breast cancer: Eight years single institution experience

    Directory of Open Access Journals (Sweden)

    Bobin Jean

    2008-04-01

    Full Text Available Abstract Background Skin Sparing Mastectomy (SSM and immediate breast reconstruction has become increasingly popular as an effective treatment for patients with breast carcinoma. The aim of this study was to evaluate the clinical outcome of skin sparing mastectomy in early breast cancer at a single population-based institution. Methods Records of ninety-five consecutive patients with operable breast cancer who had skin-sparing mastectomy and immediate breast reconstructions between 1995 and 2003 were reviewed. Patient and tumor characteristic, type of reconstruction, postoperative complications, aesthetic results and incidence of recurrence were analyzed. Results Mean age of the patients was 51.6(range 33–72 years. The AJCC pathologic stages were 0 (n = 51, 53.7%, I (n = 20, 21.1%, and II (n = 2, 2.1%. Twenty of the patients had recurrent disease (21.1%. The immediate breast reconstructions were performed with autologus tissue including latissimus dorsi musculocutaneous flap in 63 (66.3% patients and transverse rectus abdominis myocutaneous (TRAM flap in 4 (4.2% patients. Implants were used in 28 (29.4% patients. The average hospital stay was 7.7 days. Flap complication occurred in seven (10.4% patients resulting in four (6% re-operations and there were no delay in accomplishing postoperative adjuvant therapy. At a median follow-up of 69 months (range 48 to 144, local recurrence was seen in one patient (1.1% and systemic recurrence was seen in two patients (2.1%. Conclusion Skin sparing mastectomy and immediate breast reconstruction for early breast cancer is associated with low morbidity and low rate of local recurrence.

  5. MUC1 Expression by Immunohistochemistry Is Associated with Adverse Pathologic Features in Prostate Cancer: A Multi-Institutional Study.

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    Okyaz Eminaga

    Full Text Available The uncertainties inherent in clinical measures of prostate cancer (CaP aggressiveness endorse the investigation of clinically validated tissue biomarkers. MUC1 expression has been previously reported to independently predict aggressive localized prostate cancer. We used a large cohort to validate whether MUC1 protein levels measured by immunohistochemistry (IHC predict aggressive cancer, recurrence and survival outcomes after radical prostatectomy independent of clinical and pathological parameters.MUC1 IHC was performed on a multi-institutional tissue microarray (TMA resource including 1,326 men with a median follow-up of 5 years. Associations with clinical and pathological parameters were tested by the Chi-square test and the Wilcoxon rank sum test. Relationships with outcome were assessed with univariable and multivariable Cox proportional hazard models and the Log-rank test.The presence of MUC1 expression was significantly associated with extracapsular extension and higher Gleason score, but not with seminal vesicle invasion, age, positive surgical margins or pre-operative serum PSA levels. In univariable analyses, positive MUC1 staining was significantly associated with a worse recurrence free survival (RFS (HR: 1.24, CI 1.03-1.49, P = 0.02, although not with disease specific survival (DSS, P>0.5. On multivariable analyses, the presence of positive surgical margins, extracapsular extension, seminal vesicle invasion, as well as higher pre-operative PSA and increasing Gleason score were independently associated with RFS, while MUC1 expression was not. Positive MUC1 expression was not independently associated with disease specific survival (DSS, but was weakly associated with overall survival (OS.In our large, rigorously designed validation cohort, MUC1 protein expression was associated with adverse pathological features, although it was not an independent predictor of outcome after radical prostatectomy.

  6. What is the radiotherapy quality control program (PQRT) of the National Cancer Institute - Rio de Janeiro/Brazil?

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    Campos de Araujo, A.M.; Viegas, C.C.B.; Salomon de Souza, R. [Instituto Nacional de Cancer, Praca Cruz Vermelha No. 23, Centro 20230-130, Rio de Janeiro (Brazil)]. e-mail: amcampos@inca.gov.br; tld@inca.gov.br; salomon@inca.gov.br

    2004-07-01

    The National Cancer Institute (INCA) Quality Program in Radiotherapy (PQRT) started in 1999 as a 3 years pilot program with only 33 participant institutions. Due to its positive results, it has been integrated to the permanent INCA programs and its activities extended to all the radiotherapy services where patients from the National Health System (SUS) are treated. They are about 150 services (90% of all the available Brazilian radiotherapy services). The PQRT activities objective is to allow that radiotherapeutic treatments can be carried out just like planned, according to international quality and safety standards. The PQRT main activities are: on-site quality control audits, postal TLD audits in reference and non-reference conditions, training and development of research projects. The on-site quality control audits have already evaluated 75 teletherapy units (37 Co-60 and 38 linear accelerators), performing dosimetric, electrical, mechanical and safety tests. The Postal TLD audits used, till 2002, for the 33 participants, the International Atomic Energy Agency (IAEA) system for reference conditions. Five audits have been performed with this simple system. Since 2003, the PQRT postal TLD audit program is using its own system, developed for reference and non-reference conditions. This new system has been already applied to 58 beams (18 Co-60 and 40 linacs). In total, in reference conditions, PQRT has performed 400 audits in reference conditions (190 Co-60 and 210 linacs). Eighteen courses attended to the participants, covering their main practical problems. In parallel, some research studies have been carried out.

  7. What is the radiotherapy quality control program (PQRT) of the National Cancer Institute - Rio de Janeiro/Brazil?

    International Nuclear Information System (INIS)

    Campos de Araujo, A.M.; Viegas, C.C.B.; Salomon de Souza, R.

    2004-01-01

    The National Cancer Institute (INCA) Quality Program in Radiotherapy (PQRT) started in 1999 as a 3 years pilot program with only 33 participant institutions. Due to its positive results, it has been integrated to the permanent INCA programs and its activities extended to all the radiotherapy services where patients from the National Health System (SUS) are treated. They are about 150 services (90% of all the available Brazilian radiotherapy services). The PQRT activities objective is to allow that radiotherapeutic treatments can be carried out just like planned, according to international quality and safety standards. The PQRT main activities are: on-site quality control audits, postal TLD audits in reference and non-reference conditions, training and development of research projects. The on-site quality control audits have already evaluated 75 teletherapy units (37 Co-60 and 38 linear accelerators), performing dosimetric, electrical, mechanical and safety tests. The Postal TLD audits used, till 2002, for the 33 participants, the International Atomic Energy Agency (IAEA) system for reference conditions. Five audits have been performed with this simple system. Since 2003, the PQRT postal TLD audit program is using its own system, developed for reference and non-reference conditions. This new system has been already applied to 58 beams (18 Co-60 and 40 linacs). In total, in reference conditions, PQRT has performed 400 audits in reference conditions (190 Co-60 and 210 linacs). Eighteen courses attended to the participants, covering their main practical problems. In parallel, some research studies have been carried out

  8. Multi-institutional Comparison of Intensity Modulated Radiation Therapy (IMRT) Planning Strategies and Planning Results for Nasopharyngeal Cancer

    Science.gov (United States)

    Park, Sung Ho; Park, Suk Won; Oh, Do Hoon; Choi, Youngmin; Kim, Jeung Kee; Ahn, Yong Chan; Park, Won; Suh, Hyun Sook; Lee, Rena; Bae, Hoonsik

    2009-01-01

    The intensity-modulated radiation therapy (IMRT) planning strategies for nasopharyngeal cancer among Korean radiation oncology facilities were investigated. Five institutions with IMRT planning capacity using the same planning system were invited to participate in this study. The institutions were requested to produce the best plan possible for 2 cases that would deliver 70 Gy to the planning target volume of gross tumor (PTV1), 59.4 Gy to the PTV2, and 51.5 Gy to the PTV3 in which elective irradiation was required. The advised fractionation number was 33. The planning parameters, resultant dose distributions, and biological indices were compared. We found 2-3-fold variations in the volume of treatment targets. Similar degree of variation was found in the delineation of normal tissue. The physician-related factors in IMRT planning had more influence on the plan quality. The inhomogeneity index of PTV dose ranged from 4 to 49% in Case 1, and from 5 to 46% in Case 2. Variation in tumor control probabilities for the primary lesion and involved LNs was less marked. Normal tissue complication probabilities for parotid glands and skin showed marked variation. Results from this study suggest that greater efforts in providing training and continuing education in terms of IMRT planning parameters usually set by physician are necessary for the successful implementation of IMRT. PMID:19399266

  9. How one institution overcame the challenges to start an MRI-based brachytherapy program for cervical cancer

    Directory of Open Access Journals (Sweden)

    Matthew M. Harkenrider

    2017-03-01

    Full Text Available Purpose : Adaptive magnetic resonance imaging (MRI-based brachytherapy results in improved local control and decreased high-grade toxicities compared to historical controls. Incorporating MRI into the workflow of a department can be a major challenge when initiating an MRI-based brachytherapy program. This project aims to describe the goals, challenges, and solutions when initiating an MRI-based cervical cancer brachytherapy program at our institution. Material and methods : We describe the 6-month multi-disciplinary planning phase to initiate an MRI-based brachytherapy program. We describe the specific challenges that were encountered prior to treating our first patient. Results : We describe the solutions that were realized and executed to solve the challenges that we faced to establish our MRI-based brachytherapy program. We emphasize detailed coordination of care, planning, and communication to make the workflow feasible. We detail the imaging and radiation physics solutions to safely deliver MRI-based brachytherapy. The focus of these efforts is always on the delivery of optimal, state of the art patient care and treatment delivery within the context of our available institutional resources. Conclusions : Previous publications have supported a transition to MRI-based brachytherapy, and this can be safely and efficiently accomplished as described in this manuscript.

  10. Leiomyosarcoma of the head and neck: A 17-year single institution experience and review of the National Cancer Data Base.

    Science.gov (United States)

    Workman, Alan D; Farquhar, Douglas R; Brody, Robert M; Parasher, Arjun K; Carey, Ryan M; Purkey, Michael T; Nagda, Danish A; Brooks, John S; Hartner, Lee P; Brant, Jason A; Newman, Jason G

    2018-04-01

    Leiomyosarcoma is a rare neoplasm of the head and neck. The purpose of this study was to present our single-institution case series of head and neck leiomyosarcoma and a review of cases in the National Cancer Data Base (NCDB). Patients with head and neck leiomyosarcoma at the University of Pennsylvania and in the NCDB were identified. Demographic characteristics, tumor factors, treatment paradigms, and outcomes were evaluated for prognostic significance. Nine patients with head and neck leiomyosarcoma from the institution were identified; a majority had high-grade disease and cutaneous leiomyosarcoma, with a 5-year survival rate of 50%. Two hundred fifty-nine patients with leiomyosarcoma were found in the NCDB; macroscopic positive margins and high-grade disease were associated with poor prognosis (P < .01), and positive surgical margins were related to adjuvant radiation (P < .001). Head and neck leiomyosarcoma presents at a high grade and is preferentially treated with surgery. Several demographic and tumor-specific factors are associated with outcomes and prognosis. © 2017 Wiley Periodicals, Inc.

  11. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Cancer Moonshot Genomic Data Commons National Clinical Trials Network RAS Initiative Progress Annual Report to the Nation ... NCI Directors NCI Organization Advisory Boards and Review Groups Budget & Appropriations About the Annual Plan & Budget Proposal ...

  12. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Plan & Budget Proposal Congressional Justification NCI Budget Fact Book Legislative Activities Hearings & Testimonies Current Congress Legislative History Committees of Interest Legislative Resources Recent Public Laws Careers Visitor Information Search Search Home About Cancer ...

  13. Proposal of cancer therapy system without rotating gantry

    International Nuclear Information System (INIS)

    Kodaira, Masanobu

    2002-01-01

    Beam therapy is one of useful methods for cancer therapy. Many results in National Institute of Radiological Sciences (NIRS) show many abilities of beam therapy for cancer therapy. In Japan, several beam therapy facilities are constructed or under construction. If its construction budget becomes to be smaller, beam therapy may be used as the general cancer therapy. But in the present beam therapy facilities, the budget of its construction is very large. One of the reasons of big budget is the construction of the big buildings equipped with thick shielding walls. Most of space of the facilities with thick shielding walls is devoted to the treatment equipments such as rotating gantries and beam transport lines. This proposal is that using oblique beam line and rotating treatment bed, multi-portal irradiation is realized without rotating gantry. At the same time, we designed adequate beam lines to minimize the total facilities. (author)

  14. Testicular cancer

    Science.gov (United States)

    ... Germ cell tumor; Seminoma testicular cancer; Nonseminoma testicular cancer; Testicular neoplasm ... Philadelphia, PA: Elsevier Saunders; 2014:chap 86. National Cancer Institute. PDQ testicular cancer treatment. Updated February 17, 2016. www.cancer. ...

  15. Public Budget Database - Budget Authority and offsetting receipts 1976-Current

    Data.gov (United States)

    Executive Office of the President — This file contains historical budget authority and offsetting receipts for 1976 through the current budget year, as well as four years of projections. It can be used...

  16. Estimation of the excess lifetime cancer risk from radon exposure in some buildings of Kufa Technical Institute, Iraq

    Directory of Open Access Journals (Sweden)

    Ali Abid Abojassim

    2017-12-01

    Full Text Available A number of international health organizations consider the exposure to residential radon as the second main cause of lung cancer after cigarette smoking. It was found that there is no database on radon concentrations for the Kufa Technical Institute buildings in the literature. This therefore triggers a special need for radon measurement in some Kufa Technical Institute buildings. This study aims to investigate the indoor radon levels inside the Kufa Technical Institute buildings for the first time using different radon measurement methods such as active (RAD-7 and passive (LR-115 Type II methods. Seventy eight of Solid-State Nuclear Track Detectors (SSNTDs LR-115 Type II were distributed at four buildings within the study area. The LR-115 Type II detectors were exposed in the study area for three months period. In parallel to the latter, seventy two active measurements were conducted using RAD-7 in the same buildings for correlation investigation purposes between the two kinds of measurements (i.e. passive and active.The results demonstrate that the radon concentrations were generally low, ranging from 38.4 to 77.2 Bq/m3, with a mean value of 50 Bq/m3. The mean of the equilibrium equivalent radon concentration and annual effective dose were assessed to be 19.9 Bq/m3 and 1.2 mS/y, respectively; the excess lifetime lung cancer risk was approximately 11.6 per million personal. A high correlation was found between the methods of measurements (i.e. LR-115 Type II and RAD-7, R2 = 0.99 which is significant at P < 0.001. The results of this work revealed that the Radon concentration was below the action level set by the United States Environmental Protection Agency of 148 Bq/m3. This therefore indicates that no radiological health hazard exists. However, the relatively high concentrations in some classrooms can be addressed by the natural ventilation or the classrooms being supplied with suction fans.

  17. Morbidity analysis in minimally invasive esophagectomy for oesophageal cancer versus conventional over the last 10 years, a single institution experience

    Directory of Open Access Journals (Sweden)

    Misbah Khan

    2017-01-01

    Full Text Available Background: There has been an increasing inclination towards minimally invasive esophagectomies (MIEs at our institute recently for resectable oesophageal cancer. Objectives: The purpose of the present study is to report peri-operative and long-term procedure specific outcomes of the two groups and analyse their changing pattern at our institute. Methods: All adult patients with a diagnosis of oesophageal cancer managed at our institute from 2005 to 2015 were included in this retrospective study. Patients' demographic and clinical characteristics were recorded through our hospital information system. The cohort of esophagectomies was allocated into two groups, conventional open esophagectomy (OE or total laparoscopic MIE; hybrid esophagectomies were taken as a separate group. The short-term outcome measures are an operative time in minutes, length of hospital and Intensive Care Unit (ICU stay in days, post-operative complications and 30 days in-hospital mortality. Complications are graded according to the Clavien-Dindo classification system. Long-term outcomes are long-term procedure related complications over a minimum follow-up of 1 year. Trends were analysed by visually inspecting the graphic plots for mean number of events in each group each year. Results: Our results showed no difference in mortality, length of hospital and ICU stays and incidence of major complications between three groups on uni- and multi-variate analysis (P > 0.05. The operative time was significantly longer in MIE group (odds ratio [OR]: 1.66, confidence interval [CI]: 2.4–11.5. The incidence of long-term complication was low for MIE (OR: 1.0, CI: 133–1.017. However, all post-operative surgical outcomes trended to improve in both groups over the course of this study and stayed better for MIE group except for the operative time. Conclusion: MIE has overall comparable surgical outcomes to its conventional counterpart. Furthermore, the peri-operative outcomes tend to

  18. AGF program budget 1991

    International Nuclear Information System (INIS)

    1991-01-01

    The present program budget of the Arbeitsgemeinschaft Grossforschungseinrichtungen (AGF) (Cooperative of Major Research Establishments) describes its research and development objectives and the progress of work in the major research establishments involved and states the medium-term annual financial and personnel effort. (orig.) [de

  19. Budget Pressures Churn Workforce

    Science.gov (United States)

    Cavanagh, Sean

    2011-01-01

    When the budget-cutting ended this year in one rural North Texas school district, the people-moving began. Forced to chop its total staff to 55 employees from 64, the Perrin-Whitt Consolidated Independent school system went the route of many districts across the country: It made the majority of its reductions by encouraging early retirements and…

  20. AGF program budget 1992

    International Nuclear Information System (INIS)

    1992-01-01

    The program budget of the Arbeitsgemeinschaft Grossforschungseinrichtungen (AGF) (Cooperative of Major Research Establishments) describes its research and development objectives and the progress of work in the major research establishments involved and states the medium-term annual financial and personnel effort. (orig.)

  1. Budgeting Academic Space

    Science.gov (United States)

    Harris, Watson

    2011-01-01

    There are many articles about space management, including those that discuss space calculations, metrics, and categories. Fewer articles discuss the space budgeting processes used by administrators to allocate space. The author attempts to fill this void by discussing her administrative experiences with Middle Tennessee State University's (MTSU)…

  2. Integrated Budget Office Toolbox

    Science.gov (United States)

    Rushing, Douglas A.; Blakeley, Chris; Chapman, Gerry; Robertson, Bill; Horton, Allison; Besser, Thomas; McCarthy, Debbie

    2010-01-01

    The Integrated Budget Office Toolbox (IBOT) combines budgeting, resource allocation, organizational funding, and reporting features in an automated, integrated tool that provides data from a single source for Johnson Space Center (JSC) personnel. Using a common interface, concurrent users can utilize the data without compromising its integrity. IBOT tracks planning changes and updates throughout the year using both phasing and POP-related (program-operating-plan-related) budget information for the current year, and up to six years out. Separating lump-sum funds received from HQ (Headquarters) into separate labor, travel, procurement, Center G&A (general & administrative), and servicepool categories, IBOT creates a script that significantly reduces manual input time. IBOT also manages the movement of travel and procurement funds down to the organizational level and, using its integrated funds management feature, helps better track funding at lower levels. Third-party software is used to create integrated reports in IBOT that can be generated for plans, actuals, funds received, and other combinations of data that are currently maintained in the centralized format. Based on Microsoft SQL, IBOT incorporates generic budget processes, is transportable, and is economical to deploy and support.

  3. Reforming the EU Budget

    DEFF Research Database (Denmark)

    Citi, Manuele

    The marginal involvement of the EU in redistributive policies and its limited fiscal resources have led to a lack of attention to the EU budget and its determinants. In this paper I analyse an original dataset containing yearly data on the main macrocategories of expenditure and how they have...

  4. Zero-Based Budgeting.

    Science.gov (United States)

    Wichowski, Chester

    1979-01-01

    The zero-based budgeting approach is designed to achieve the greatest benefit with the fewest undesirable consequences. Seven basic steps make up the zero-based decision-making process: (1) identifying program goals, (2) classifying goals, (3) identifying resources, (4) reviewing consequences, (5) developing decision packages, (6) implementing a…

  5. Budgeting and Finance

    NARCIS (Netherlands)

    F.K.M. van Nispen tot Pannerden (Frans)

    2012-01-01

    textabstractThe Call for a Budgetary Theory: The appeal of Valdimer Key for a budgetary theory marks the interest in public budgeting in modern history. He clearly referred to a normative theory, raising the question: ‘on what basis shall it be decided to allocate X dollars to activity A instead of

  6. Kinetic energy budget details

    Indian Academy of Sciences (India)

    Abstract. This paper presents the detailed turbulent kinetic energy budget and higher order statistics of flow behind a surface-mounted rib with and without superimposed acoustic excitation. Pattern recognition technique is used to determine the large-scale structure magnitude. It is observed that most of the turbulence ...

  7. A Better Budget Rule

    Science.gov (United States)

    Dothan, Michael; Thompson, Fred

    2009-01-01

    Debt limits, interest coverage ratios, one-off balanced budget requirements, pay-as-you-go rules, and tax and expenditure limits are among the most important fiscal rules for constraining intertemporal transfers. There is considerable evidence that the least costly and most effective of such rules are those that focus directly on the rate of…

  8. Global Carbon Budget 2016

    NARCIS (Netherlands)

    Le Quéré, Corinne; Andrew, Robbie M.; Canadell, Josep G.; Sitch, Stephen; Ivar Korsbakken, Jan; Peters, Glen P.; Manning, Andrew C.; Boden, Thomas A.; Tans, Pieter P.; Houghton, Richard A.; Keeling, Ralph F.; Alin, Simone; Andrews, Oliver D.; Anthoni, Peter; Barbero, Leticia; Bopp, Laurent; Chevallier, Frédéric; Chini, Louise P.; Ciais, Philippe; Currie, Kim; Delire, Christine; Doney, Scott C.; Friedlingstein, Pierre; Gkritzalis, Thanos; Harris, Ian A; Hauck, Judith; Haverd, Vanessa; Hoppema, Mario; Klein Goldewijk, Kees; Jain, Atul K.; Kato, Etsushi; Körtzinger, Arne; Landschützer, Peter; Lefèvre, Nathalie; Lenton, Andrew; Lienert, Sebastian; Lombardozzi, Danica; Melton, Joe R.; Metzl, Nicolas; Millero, Frank; Monteiro, Pedro M S; Munro, David R.; Nabel, Julia E M S; Nakaoka, Shin Ichiro; O'Brien, Kevin; Olsen, Are; Omar, Abdirahman M.; Ono, Tsuneo; Pierrot, Denis; Poulter, Benjamin; Rödenbeck, Christian; Salisbury, Joe; Schuster, Ute; Schwinger, Jörg; Séférian, Roland; Skjelvan, Ingunn; Stocker, Benjamin D.; Sutton, Adrienne J.; Takahashi, Taro; Tian, Hanqin; Tilbrook, Bronte; Van Der Laan-Luijkx, Ingrid T.; Van Der Werf, Guido R.; Viovy, Nicolas; Walker, Anthony P.; Wiltshire, Andrew J.; Zaehle, Sönke

    2016-01-01

    Accurate assessment of anthropogenic carbon dioxide (CO2) emissions and their redistribution among the atmosphere, ocean, and terrestrial biosphere-the "global carbon budget"-is important to better understand the global carbon cycle, support the development of climate policies, and project future

  9. Sabotage in Capital Budgeting

    DEFF Research Database (Denmark)

    Brunner, Markus; Ostermaier, Andreas

    2018-01-01

    for honesty inhibits sabotage. Moreover, honesty suppresses negative reciprocity and thus reduces sabotage not only directly but also indirectly. Our findings warn firms to consider the sabotage of investments as a hidden cost of control in budgeting. They show that honesty has a spill-over effect...

  10. Why budget accountability fails? The elusive links between parliaments and audit agencies in the oversight of the budget

    Directory of Open Access Journals (Sweden)

    CARLOS SANTISO

    2015-09-01

    Full Text Available ABSTRACTParliaments and audit agencies have critical and complementary roles in the oversight of the budget and the enforcement of government accountability. Yet, the nexus between parliaments and audit agencies is one of the weakest links in the accountability chain, generating an accountability gap in the budget process. This articles analyses the interactions between parliaments and audit agencies in the oversight of government finances during the latter stages of the budget process. Using proxies to evaluate the quality of those linkages, such as the follow-up to audit findings and the discharge of government, it shows important dysfunctions in the interactions between parliaments and audit agencies due to a combination of technical capacity constraints and political economy disincentives. It suggests that the effective functioning of the system of checks and balances in public budgeting critically hinges on the agility of the linkages between accountability institutions. As such, the failure of budget accountability is due to systemic dysfunctions in the systems of accountability, rather than the failure of an individual accountability institution acting in isolation. In addition, the effectiveness of the horizontal accountability architecture depends on the political economy incentives shaping the budget process, which are generated by the interactions between the choice of institutional design and budget rules, with the degree of political competition and electoral rules.

  11. Pazopanib in metastatic renal cancer: a “real-world” experience at National Cancer Institute “Fondazione G. Pascale”

    Directory of Open Access Journals (Sweden)

    Sabrina Chiara Cecere

    2016-08-01

    Full Text Available Pazopanib is an oral angiogenesis inhibitor, currently approved for treatment of metastatic renal cell carcinoma (mRCC and soft tissue sarcoma. The present study analyzed the outcomes of pazopanib in first-line treatment of mRCC, in a single Italian cancer center. In the light of the retrospective, observational nature and the unselected population, our experience can be defined a real-world study. The medical records of 38 mRCC patients treated with front-line pazopanib were retrospectively reviewed and analyzed. The progression free survival (PFS and the overall survival (OS were the primary endpoints, while secondary objectives included Objective Response Rate (ORR, Disease Control Rate (DCR, and treatment tolerability. Pazopanib achieved a median PFS (mPFS of 12.7 months (95% CI, 6.9-18.5 months. The median OS (mOS was 26.2 months (95% CI, 12.6-39.9 months; the observed ORR and DCR were 30.3% and 72.7%, respectively, with a median duration of response of 11 weeks. mPFS appeared not to be influenced by number of co-morbidities (3, gender, Fuhrman grade and age. Conversely, the ORR and the DCR positively affect the mPFS (HR=0.05 [95% CI, 0.05-055], p=0.01; HR=0.10 [95% CI, 0.02-0.43], p=0.002 respectively. A worse outcome was associated with a lower mPFS in patients with liver metastases (p= 0.2 and with a high tumor burden (number of metastatic sites 6 (p= 0.08. Worst OS was observed in patients age >70 years old (HR=6.91 [95% CI, 1.49-31.91], p=0.01. The treatment was well tolerated: no grade 4 adverse events, nor discontinuation due to toxicities was reported. Grade 3 hypertension affected positively the OS reaching the statistical significance (HR=0.22 [95% CI, 0.05-0.8], p=0.03 and thyroid dysfunction (hypo and hyperthyroidism seems to correlate with better outcome in terms of a longer mPFS (HR=0.12 [95% CI, 0.02-0.78], p=0.02. Our results are consistent with those reported in prospective phase III trials and the published retrospective

  12. Efficacy of doxorubicin after progression on carboplatin and paclitaxel in advanced or recurrent endometrial cancer: a retrospective analysis of patients treated at the Brazilian National Cancer Institute (INCA).

    Science.gov (United States)

    Moreira, Emeline; Paulino, Eduardo; Ingles Garces, Álvaro Henrique; Fontes Dias, Mariane S; Saramago, Marcos; de Moraes Lino da Silva, Flora; Thuler, Luiz Claudio Santos; de Melo, Andréia Cristina

    2018-01-31

    The treatment of endometrial cancer (EC) is challenging. There is no standard of care for patients who progressed after carboplatin and paclitaxel (CT) and all available drugs show a small response and poor long-term survival in this scenario. The objective of this study was to evaluate the efficacy and toxicity profile of palliative doxorubicin after progression to CT therapy in advanced or recurrent EC. A retrospective review of the Brazilian National Cancer Institute database between 2009 and 2013 was performed, and all patients with recurrent and advanced EC treated with palliative doxorubicin after progression on CT were included. Progression-free survival (PFS), overall survival (OS), objective response rates as well as toxicity were evaluated. A total of 33 patients were enrolled, with a median age of 65.7 years. Objective responses were documented in 12.1% (3.0% of complete responses and 9.1% of partial responses). The median PFS was 4.4 months, and the median OS was 8.1 months for patients exposed to doxorubicin. The most common adverse event was anemia observed in 60.6% of patients. This retrospective study suggests that doxorubicin has a modest activity in patients with advanced or recurrent EC after treatment with CT.

  13. Prophylactic cranial irradiation in small cell lung cancer: a single institution experience.

    Science.gov (United States)

    Naidoo, J; Kehoe, M; Sasiadek, W; Hacking, D; Calvert, P

    2014-03-01

    Prophylactic cranial irradiation (PCI) is used to prevent the development of brain metastases in small cell lung carcinoma. PCI confers an overall survival (OS) benefit in both limited and extensive stage disease. We analyze the incidence of symptomatic brain metastases, progression-free survival (PFS) and OS in a cohort of patients who received PCI, in a 5-year period. A retrospective review of all patients who had received PCI between 2006 and 2011 at the Whitfield Clinic was completed. Patient- and disease-related characteristics, the number of patients who developed brain metastases, PFS and OS data were collected. 24 patients were identified. 14 (58.3 %) patients were male, 10 (41.7 %) were female, with a mean age of 62.5 years (range 31-78). All patients were smokers. 12 (50 %) patients had limited stage small cell lung cancer (SCLC), 12 (50 %) had extensive stage disease. 2 (8.2 %) patients developed brain metastases post PCI (p = 0.478.) The median PFS for limited stage SCLC was 13 months (range 3-20) and 10 months (range 5-18) for extensive stage SCLC. Median OS was 15 months (range 4-29) in limited stage SCLC, and 11 months (range 5-29) in extensive stage SCLC. Our study demonstrated a low incidence of symptomatic brain metastases and favourable median PFS and OS in the patients that received PCI, when compared to published phase III data.

  14. A Proposed Architecture for Implementing a Knowledge Management System in the Brazilian National Cancer Institute

    Directory of Open Access Journals (Sweden)

    José Geraldo Pereira Barbosa

    2009-07-01

    Full Text Available Because their services are based decisively on the collection, analysis and exchange of clinical information or knowledge, within and across organizational boundaries, knowledge management has exceptional application and importance to health care organizations. This article proposes a conceptual framework for a knowledge management system, which is expected to support both hospitals and the oncology network in Brazil. Under this holistic single-case study, triangulation of multiple sources of data collection was used by means of archival records, documents and participant observation, as two of the authors were serving as INCA staff members, thus gaining access to the event and its documentation and being able to perceive reality from an insider point of view. The benefits derived from the present status of the ongoing implementation, so far, are: (i speediness of cancer diagnosis and enhanced quality of both diagnosis and data used in epidemiological studies; (ii reduction in treatment costs; (iii relief of INCA’S labor shortage; (iii improved management performance; (iv better use of installed capacity; (v easiness of massive (explicit knowledge transference among the members of the network; and (vi increase in organizational capacity of knowledge retention (institutionalization of procedures.

  15. Security and privacy requirements for a multi-institutional cancer research data grid: an interview-based study.

    Science.gov (United States)

    Manion, Frank J; Robbins, Robert J; Weems, William A; Crowley, Rebecca S

    2009-06-15

    Data protection is important for all information systems that deal with human-subjects data. Grid-based systems--such as the cancer Biomedical Informatics Grid (caBIG)--seek to develop new mechanisms to facilitate real-time federation of cancer-relevant data sources, including sources protected under a variety of regulatory laws, such as HIPAA and 21CFR11. These systems embody new models for data sharing, and hence pose new challenges to the regulatory community, and to those who would develop or adopt them. These challenges must be understood by both systems developers and system adopters. In this paper, we describe our work collecting policy statements, expectations, and requirements from regulatory decision makers at academic cancer centers in the United States. We use these statements to examine fundamental assumptions regarding data sharing using data federations and grid computing. An interview-based study of key stakeholders from a sample of US cancer centers. Interviews were structured, and used an instrument that was developed for the purpose of this study. The instrument included a set of problem scenarios--difficult policy situations that were derived during a full-day discussion of potentially problematic issues by a set of project participants with diverse expertise. Each problem scenario included a set of open-ended questions that were designed to elucidate stakeholder opinions and concerns. Interviews were transcribed verbatim and used for both qualitative and quantitative analysis. For quantitative analysis, data was aggregated at the individual or institutional unit of analysis, depending on the specific interview question. Thirty-one (31) individuals at six cancer centers were contacted to participate. Twenty-four out of thirty-one (24/31) individuals responded to our request- yielding a total response rate of 77%. Respondents included IRB directors and policy-makers, privacy and security officers, directors of offices of research, information

  16. Security and privacy requirements for a multi-institutional cancer research data grid: an interview-based study

    Directory of Open Access Journals (Sweden)

    Weems William A

    2009-06-01

    Full Text Available Abstract Background Data protection is important for all information systems that deal with human-subjects data. Grid-based systems – such as the cancer Biomedical Informatics Grid (caBIG – seek to develop new mechanisms to facilitate real-time federation of cancer-relevant data sources, including sources protected under a variety of regulatory laws, such as HIPAA and 21CFR11. These systems embody new models for data sharing, and hence pose new challenges to the regulatory community, and to those who would develop or adopt them. These challenges must be understood by both systems developers and system adopters. In this paper, we describe our work collecting policy statements, expectations, and requirements from regulatory decision makers at academic cancer centers in the United States. We use these statements to examine fundamental assumptions regarding data sharing using data federations and grid computing. Methods An interview-based study of key stakeholders from a sample of US cancer centers. Interviews were structured, and used an instrument that was developed for the purpose of this study. The instrument included a set of problem scenarios – difficult policy situations that were derived during a full-day discussion of potentially problematic issues by a set of project participants with diverse expertise. Each problem scenario included a set of open-ended questions that were designed to elucidate stakeholder opinions and concerns. Interviews were transcribed verbatim and used for both qualitative and quantitative analysis. For quantitative analysis, data was aggregated at the individual or institutional unit of analysis, depending on the specific interview question. Results Thirty-one (31 individuals at six cancer centers were contacted to participate. Twenty-four out of thirty-one (24/31 individuals responded to our request- yielding a total response rate of 77%. Respondents included IRB directors and policy-makers, privacy and

  17. Security and privacy requirements for a multi-institutional cancer research data grid: an interview-based study

    Science.gov (United States)

    2009-01-01

    Background Data protection is important for all information systems that deal with human-subjects data. Grid-based systems – such as the cancer Biomedical Informatics Grid (caBIG) – seek to develop new mechanisms to facilitate real-time federation of cancer-relevant data sources, including sources protected under a variety of regulatory laws, such as HIPAA and 21CFR11. These systems embody new models for data sharing, and hence pose new challenges to the regulatory community, and to those who would develop or adopt them. These challenges must be understood by both systems developers and system adopters. In this paper, we describe our work collecting policy statements, expectations, and requirements from regulatory decision makers at academic cancer centers in the United States. We use these statements to examine fundamental assumptions regarding data sharing using data federations and grid computing. Methods An interview-based study of key stakeholders from a sample of US cancer centers. Interviews were structured, and used an instrument that was developed for the purpose of this study. The instrument included a set of problem scenarios – difficult policy situations that were derived during a full-day discussion of potentially problematic issues by a set of project participants with diverse expertise. Each problem scenario included a set of open-ended questions that were designed to elucidate stakeholder opinions and concerns. Interviews were transcribed verbatim and used for both qualitative and quantitative analysis. For quantitative analysis, data was aggregated at the individual or institutional unit of analysis, depending on the specific interview question. Results Thirty-one (31) individuals at six cancer centers were contacted to participate. Twenty-four out of thirty-one (24/31) individuals responded to our request- yielding a total response rate of 77%. Respondents included IRB directors and policy-makers, privacy and security officers, directors of

  18. Temporal and Other Exposure Aspects of Residential Magnetic Fields Measurement in Relation to Acute Lymphoblastic Leukaemia in Children: The National Cancer Institute Children's Cancer Group Study (invited paper)

    International Nuclear Information System (INIS)

    Baris, D.; Linet, M.; Auvinen, A.; Kaune, W.T.; Wacholder, S.; Kleinerman, R.; Hatch, E.; Robison, L.; Niwa, S.; Haines, C.; Tarone, R.E.

    1999-01-01

    Case-control studies have used a variety of measurements to evaluate the relationship of children's exposure to magnetic fields (50 or 60 Hz) with childhood leukaemia and other childhood cancers. In the absence of knowledge about which exposure metrics may be biologically meaningful, studies during the past 10 years have often used time-weighted average (TWA) summaries of home measurements. Recently, other exposure metrics have been suggested, usually based on theoretical considerations or limited laboratory data. In this paper, the rationale and associated preliminary studies undertaken are described as well as feasibility and validity issues governing the choice of the primary magnetic field exposure assessment methods and summary metric used to estimate children's exposure in the National Cancer Institute/Children's Cancer Group (NCI/CCG) case-control study. Also provided are definitions and discussion of the strengths and weaknesses of the various exposure metrics used in exploratory analyses of the NCI/CCG measurement data. Exposure metrics evaluated include measures of central tendency (mean, median, 30th to 70th percentiles), peak exposures (90th and higher percentiles, peak values of the 24 h measurements), and measurements of short-term temporal variability (rate of change). This report describes correlations of the various metrics with the time-weighted average for the 24 h period (TWA-24-h). Most of the metrics were found to be positively and highly correlated with TWA-24-h, but lower correlations of TWA-24-h with peak exposure and with rate of change were observed. To examine further the relation between TWA and alternative metrics, similar exploratory analysis should be considered for existing data sets and for forthcoming measurement investigations of residential magnetic fields and childhood leukaemia. (author)

  19. Pazopanib in Metastatic Renal Cancer: A “Real-World” Experience at National Cancer Institute “Fondazione G. Pascale”

    Science.gov (United States)

    Cecere, Sabrina C.; Rossetti, Sabrina; Cavaliere, Carla; Della Pepa, Chiara; Di Napoli, Marilena; Crispo, Anna; Iovane, Gelsomina; Piscitelli, Raffaele; Sorrentino, Domenico; Ciliberto, Gennaro; Maiolino, Piera; Muto, Paolo; Perdonà, Sisto; Berretta, Massimiliano; Pignata, Sandro; Facchini, Gaetano; D'Aniello, Carmine

    2016-01-01

    Pazopanib is an oral angiogenesis inhibitor, currently approved for treatment of metastatic renal cell carcinoma (mRCC) and soft tissue sarcoma. The present study analyzed the outcomes of pazopanib in first-line treatment of mRCC, in a single Italian cancer center. In the light of the retrospective, observational nature and the unselected population, our experience can be defined a “real-world” study. The medical records of 38 mRCC patients treated with front-line pazopanib were retrospectively reviewed and analyzed. The progression free survival (PFS) and the overall survival (OS) were the primary endpoints, while secondary objectives included objective response rate (ORR), disease control rate (DCR), and treatment tolerability. Pazopanib achieved a median PFS (mPFS) of 12.7 months (95% CI, 6.9–18.5 months). The median OS (mOS) was 26.2 months (95% CI, 12.6–39.9 months); the observed ORR and DCR were 30.3 and 72.7%, respectively, with a median duration of response of 11 weeks. mPFS appeared not to be influenced by number of co-morbidities (< 3 vs. ≥3), gender, Fuhrman grade and age. Conversely, the ORR and the DCR positively affect the mPFS (HR = 0.05 [95% CI, 0.05–0.55], p = 0.01; HR = 0.10 [95% CI, 0.02–0.43], p = 0.002, respectively). A worse outcome was associated with a lower mPFS in patients with liver metastases (p = 0.2) and with a high tumor burden (number of metastatic sites < 6 vs. ≥6) (p = 0.08). Worst OS was observed in patients aged ≥70 years old (HR = 6.91 [95% CI, 1.49–31.91], p = 0.01). The treatment was well-tolerated: no grade 4 adverse events, nor discontinuation due to toxicities was reported. Grade 3 hypertension affected positively the OS reaching the statistical significance (HR = 0.22 [95% CI, 0.05–0.8], p = 0.03). Thyroid dysfunction (hypo and hyperthyroidism) seems to correlate with better outcome in terms of a longer mPFS (HR = 0.12 [95% CI, 0.02–0.78], p = 0.02). Our results are consistent with those reported in

  20. Capacity for Cancer Care Delivery Research in National Cancer Institute Community Oncology Research Program Community Practices: Availability of Radiology and Primary Care Research Partners.

    Science.gov (United States)

    Carlos, Ruth C; Sicks, JoRean D; Chang, George J; Lyss, Alan P; Stewart, Teresa L; Sung, Lillian; Weaver, Kathryn E

    2017-12-01

    Cancer care spans the spectrum from screening and diagnosis through therapy and into survivorship. Delivering appropriate care requires patient transitions across multiple specialties, such as primary care, radiology, and oncology. From the program's inception, the National Cancer Institute Community Oncology Research Program (NCORP) sites were tasked with conducting cancer care delivery research (CCDR) that evaluates structural, organizational, and social factors, including care transitions that determine patient outcomes. The aim of this study is to describe the capacity of the NCORP to conduct multidisciplinary CCDR that includes radiology and primary care practices. The NCORP includes 34 community and 12 minority and underserved community sites. The Landscape Capacity Assessment was conducted in 2015 across these 46 sites, composed of the 401 components and subcomponents designated to conduct CCDR. Each respondent had the opportunity to designate an operational practice group, defined as a group of components and subcomponents with common care practices and resources. The primary outcomes were the proportion of adult oncology practice groups with affiliated radiology and primary care practices. The secondary outcomes were the proportion of those affiliated radiology and primary care groups that participate in research. Eighty-seven percent of components and subcomponents responded to at least some portion of the assessment, representing 230 practice groups. Analyzing the 201 adult oncology practice groups, 85% had affiliated radiologists, 69% of whom participate in research. Seventy-nine percent had affiliated primary care practitioners, 31% of whom participate in research. Institutional size, multidisciplinary group practice, and ownership by large regional or multistate health systems was associated with research participation by affiliated radiology and primary care groups. Research participation by these affiliated specialists was not significantly

  1. Radiation therapy outcomes in muscle invasive urinary bladder cancer: A single institution experience.

    Science.gov (United States)

    Tiwana, M S; Ni, L H; Saini, S; Verma, S K; Doddamani, D; Jain, N; Biswas, M; Gupta, Meenu; Gupta, Madhur; Saini, M; Chauhan, N

    2016-01-01

    To audit the survival outcomes and loco-regional control in muscle invasive urinary bladder cancer patients treated with external beam radiation therapy (RT). From November 2008 through December 2011, 50 consecutively diagnosed muscle invasive urinary bladder carcinoma (T2-4a N0-2, M0) patients were included in this retrospective study. All these patients received external beam RT to a median dose of 60 Gy (range 30-66 Gy), and were not suitable for radical surgery due to patients' preference or medical comorbidities. A stepwise procedure using proportional hazard regression was used to identify prognostic factors with respect to survival. Completion trans-urethral resection of bladder tumor was done in 38 (76%) patients of the cohort and 47 (94%) had transitional cell carcinoma on histopathology. Clinical stage T2 was diagnosed in 40 (80%) patients. The median follow-up for the entire cohort was 14 ± 8.9 months (range 1-36 months). In conclusion, 24 patients (48%) were free of disease, 5 patients (10%) had residual disease, and 13 patients (26%) had died of disease. Two-year and 3 year overall survival of intact bladder for the entire cohort was 58% and 43.6%, respectively. Cox regression modeling strongly suggested clinical stage (P = 0.01) and RT dose (P = 0.001) as being predictors for overall survival. RT shows reliable outcomes and excellent compliance in this advanced disease. Prescribing a higher RT dose could potentially correlate to better intact bladder control rates while maintaining good quality of life in selected patients.

  2. Expanding public-private collaborations to enhance cancer drug development: a report of the Institute of Medicine's workshop series, "Implementing a National Cancer Clinical Trials System for the 21st Century".

    Science.gov (United States)

    Bertagnolli, Monica M; Canetta, Renzo; Nass, Sharyl J

    2014-11-01

    Since their inception in the 1950s, the National Cancer Institute-funded cancer cooperative groups have been important contributors to cancer clinical and translational research. In 2010, a committee appointed by the Institute of Medicine (IOM) of the National Academy of Sciences completed a consensus review on the status of the U.S. publicly funded cancer clinical trials system. This report identified a need to reinvigorate the cooperative groups and provided recommendations for improving their effectiveness. Follow-up workshops to monitor progress were conducted by the IOM's National Cancer Policy Forum and the American Society of Clinical Oncology (ASCO) in 2011 and 2013. One of the key recommendations of the IOM report was a call for greater collaboration among stakeholders in cancer research. In particular, more active engagement and better alignment of incentives among the cooperative groups, the National Cancer Institute, the U.S. Food and Drug Administration, and the biopharmaceutical industry were identified as essential to achieving the promise of oncology drug development. This review, based on presentations and discussion during the IOM-ASCO workshops, outlines the progress and remaining challenges of these collaborations. ©AlphaMed Press.

  3. Expanding Public-Private Collaborations to Enhance Cancer Drug Development: A Report of the Institute of Medicine’s Workshop Series, “Implementing a National Cancer Clinical Trials System for the 21st Century”

    Science.gov (United States)

    Canetta, Renzo; Nass, Sharyl J.

    2014-01-01

    Since their inception in the 1950s, the National Cancer Institute-funded cancer cooperative groups have been important contributors to cancer clinical and translational research. In 2010, a committee appointed by the Institute of Medicine (IOM) of the National Academy of Sciences completed a consensus review on the status of the U.S. publicly funded cancer clinical trials system. This report identified a need to reinvigorate the cooperative groups and provided recommendations for improving their effectiveness. Follow-up workshops to monitor progress were conducted by the IOM’s National Cancer Policy Forum and the American Society of Clinical Oncology (ASCO) in 2011 and 2013. One of the key recommendations of the IOM report was a call for greater collaboration among stakeholders in cancer research. In particular, more active engagement and better alignment of incentives among the cooperative groups, the National Cancer Institute, the U.S. Food and Drug Administration, and the biopharmaceutical industry were identified as essential to achieving the promise of oncology drug development. This review, based on presentations and discussion during the IOM-ASCO workshops, outlines the progress and remaining challenges of these collaborations. PMID:25326161

  4. ExCEL in Social Work: Excellence in Cancer Education & Leadership: An Oncology Social Work Response to the 2008 Institute of Medicine Report.

    Science.gov (United States)

    Otis-Green, Shirley; Jones, Barbara; Zebrack, Brad; Kilburn, Lisa; Altilio, Terry A; Ferrell, Betty

    2015-09-01

    ExCEL in Social Work: Excellence in Cancer Education & Leadership was a multi-year National Cancer Institute (NCI)-funded grant for the development and implementation of an innovative educational program for oncology social workers. The program's curriculum focused upon six core competencies of psychosocial-spiritual support necessary to meet the standard of care recommended by the 2008 Institute of Medicine (IOM) Report: Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. The curriculum was delivered through a collaborative partnership between the City of Hope National Medical Center and the two leading professional organizations devoted exclusively to representing oncology social workers--the Association of Oncology Social Work and the Association of Pediatric Oncology Social Workers. Initial findings support the feasibility and acceptability of this tailored leadership skills-building program for participating oncology social workers.

  5. ExCEL in Social Work: Excellence in Cancer Education & Leadership An Oncology Social Work Response to the 2008 Institute of Medicine Report

    Science.gov (United States)

    Otis-Green, Shirley; Jones, Barbara; Zebrack, Brad; Kilburn, Lisa; Altilio, Terry A.; Ferrell, Betty

    2014-01-01

    ExCEL in Social Work : Excellence in Cancer Education & Leadership was a multi-year National Cancer Institute (NCI)-funded grant for the development and implementation of an innovative educational program for oncology social workers. The program’s curriculum focused upon six core competencies of psychosocial-spiritual support necessary to meet the standard of care recommended by the 2008 Institute of Medicine (IOM) Report: Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. The curriculum was delivered through a collaborative partnership between the City of Hope National Medical Center and the two leading professional organizations devoted exclusively to representing oncology social workers - the Association of Oncology Social Work and the Association of Pediatric Oncology Social Workers. Initial findings support the feasibility and acceptability of this tailored leadership skills-building program for participating oncology social workers. PMID:25146345

  6. Clinical results of stereotactic body radiotherapy for Stage I small-cell lung cancer. A single institutional experience

    International Nuclear Information System (INIS)

    Shioyama, Yoshiyuki; Nakamura, Katsumasa; Sasaki, Tomonari; Ohga, Saiji; Yoshitake, Tadamasa; Nonoshita, Takeshi; Asai, Kaori; Terashima, Koutarou; Matsumoto, Keiji; Hirata, Hideki; Honda, Hiroshi

    2013-01-01

    The purpose of this study was to evaluate the treatment outcomes of stereotactic body radiotherapy (SBRT) for Stage I small-cell lung cancer (SCLC). From April 2003 to September 2009, a total of eight patients with Stage I SCLC were treated with SBRT in our institution. In all patients, the lung tumors were proven as SCLC pathologically. The patients' ages were 58-84 years (median: 74). The T-stage of the primary tumor was T1a in two, T1b in two and T2a in four patients. Six of the patients were inoperable because of poor cardiac and/or pulmonary function, and two patients refused surgery. SBRT was given using 7-8 non-coplanar beams with 48 Gy in four fractions. Six of the eight patients received 3-4 cycles of chemotherapy using carboplatin (CBDCA) + etoposide (VP-16) or cisplatin (CDDP) + irinotecan (CPT-11). The follow-up period for all patients was 6-60 months (median: 32). Six patients were still alive without any recurrence. One patient died from this disease and one died from another disease. The overall and disease-specific survival rate at three years was 72% and 86%, respectively. There were no patients with local progression of the lesion targeted by SBRT. Only one patient had nodal recurrence in the mediastinum at 12 months after treatment. The progression-free survival rate was 71%. No Grade 2 or higher SBRT-related toxicities were observed. SBRT plus chemotherapy could be an alternative to surgery with chemotherapy for inoperable patients with Stage I small-cell lung cancer. However, further investigation is needed using a large series of patients. (author)

  7. Proton Beam Reirradiation for Recurrent Head and Neck Cancer: Multi-institutional Report on Feasibility and Early Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Romesser, Paul B. [Memorial Sloan Kettering Cancer Center, Radiation Oncology, New York, New York (United States); Cahlon, Oren [Memorial Sloan Kettering Cancer Center, Radiation Oncology, New York, New York (United States); ProCure Proton Therapy Center, Somerset, New Jersey (United States); Scher, Eli D. [Memorial Sloan Kettering Cancer Center, Radiation Oncology, New York, New York (United States); Hug, Eugen B.; Sine, Kevin [ProCure Proton Therapy Center, Somerset, New Jersey (United States); DeSelm, Carl [Memorial Sloan Kettering Cancer Center, Radiation Oncology, New York, New York (United States); Fox, Jana L. [Montefiore Medical Center, Radiation Oncology, Bronx, New York (United States); Mah, Dennis [ProCure Proton Therapy Center, Somerset, New Jersey (United States); Garg, Madhur K. [Montefiore Medical Center, Radiation Oncology, Bronx, New York (United States); Han-Chih Chang, John [Northwestern Medicine Chicago Proton Center, Warrenville, Illinois (United States); Lee, Nancy Y., E-mail: leen2@mskcc.org [Memorial Sloan Kettering Cancer Center, Radiation Oncology, New York, New York (United States)

    2016-05-01

    Purpose: Reirradiation therapy (re-RT) is the only potentially curative treatment option for patients with locally recurrent head and neck cancer (HNC). Given the significant morbidity with head and neck re-RT, interest in proton beam radiation therapy (PBRT) has increased. We report the first multi-institutional clinical experience using curative-intent PBRT for re-RT in recurrent HNC. Methods and Materials: A retrospective analysis of ongoing prospective data registries from 2 hybrid community practice and academic proton centers was conducted. Patients with recurrent HNC who underwent at least 1 prior course of definitive-intent external beam radiation therapy (RT) were included. Acute and late toxicities were assessed with the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0 and the Radiation Therapy Oncology Group late radiation morbidity scoring system, respectively. The cumulative incidence of locoregional failure was calculated with death as a competing risk. The actuarial 12-month freedom–from–distant metastasis and overall survival rates were calculated with the Kaplan-Meier method. Results: Ninety-two consecutive patients were treated with curative-intent re-RT with PBRT between 2011 and 2014. Median follow-up among surviving patients was 13.3 months and among all patients was 10.4 months. The median time between last RT and PBRT was 34.4 months. There were 76 patients with 1 prior RT course and 16 with 2 or more courses. The median PBRT dose was 60.6 Gy (relative biological effectiveness, [RBE]). Eighty-five percent of patients underwent prior HNC RT for an oropharynx primary, and 39% underwent salvage surgery before re-RT. The cumulative incidence of locoregional failure at 12 months, with death as a competing risk, was 25.1%. The actuarial 12-month freedom–from–distant metastasis and overall survival rates were 84.0% and 65.2%, respectively. Acute toxicities of grade 3 or greater included mucositis (9

  8. Proton Beam Reirradiation for Recurrent Head and Neck Cancer: Multi-institutional Report on Feasibility and Early Outcomes

    International Nuclear Information System (INIS)

    Romesser, Paul B.; Cahlon, Oren; Scher, Eli D.; Hug, Eugen B.; Sine, Kevin; DeSelm, Carl; Fox, Jana L.; Mah, Dennis; Garg, Madhur K.; Han-Chih Chang, John; Lee, Nancy Y.

    2016-01-01

    Purpose: Reirradiation therapy (re-RT) is the only potentially curative treatment option for patients with locally recurrent head and neck cancer (HNC). Given the significant morbidity with head and neck re-RT, interest in proton beam radiation therapy (PBRT) has increased. We report the first multi-institutional clinical experience using curative-intent PBRT for re-RT in recurrent HNC. Methods and Materials: A retrospective analysis of ongoing prospective data registries from 2 hybrid community practice and academic proton centers was conducted. Patients with recurrent HNC who underwent at least 1 prior course of definitive-intent external beam radiation therapy (RT) were included. Acute and late toxicities were assessed with the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0 and the Radiation Therapy Oncology Group late radiation morbidity scoring system, respectively. The cumulative incidence of locoregional failure was calculated with death as a competing risk. The actuarial 12-month freedom–from–distant metastasis and overall survival rates were calculated with the Kaplan-Meier method. Results: Ninety-two consecutive patients were treated with curative-intent re-RT with PBRT between 2011 and 2014. Median follow-up among surviving patients was 13.3 months and among all patients was 10.4 months. The median time between last RT and PBRT was 34.4 months. There were 76 patients with 1 prior RT course and 16 with 2 or more courses. The median PBRT dose was 60.6 Gy (relative biological effectiveness, [RBE]). Eighty-five percent of patients underwent prior HNC RT for an oropharynx primary, and 39% underwent salvage surgery before re-RT. The cumulative incidence of locoregional failure at 12 months, with death as a competing risk, was 25.1%. The actuarial 12-month freedom–from–distant metastasis and overall survival rates were 84.0% and 65.2%, respectively. Acute toxicities of grade 3 or greater included mucositis (9

  9. Next-generation sequencing in NSCLC and melanoma patients: a cost and budget impact analysis

    Science.gov (United States)

    van Amerongen, Rosa A; Retèl, Valesca P; Coupé, Veerle MH; Nederlof, Petra M; Vogel, Maartje J; van Harten, Wim H

    2016-01-01

    Next-generation sequencing (NGS) has reached the molecular diagnostic laboratories. Although the NGS technology aims to improve the effectiveness of therapies by selecting the most promising therapy, concerns are that NGS testing is expensive and that the ‘benefits’ are not yet in relation to these costs. In this study, we give an estimation of the costs and an institutional and national budget impact of various types of NGS tests in non-small-cell lung cancer (NSCLC) and melanoma patients within The Netherlands. First, an activity-based costing (ABC) analysis has been conducted on the costs of two examples of NGS panels (small- and medium-targeted gene panel (TGP)) based on data of The Netherlands Cancer Institute (NKI). Second, we performed a budget impact analysis (BIA) to estimate the current (2015) and future (2020) budget impact of NGS on molecular diagnostics for NSCLC and melanoma patients in The Netherlands. Literature, expert opinions, and a data set of patients within the NKI (n = 172) have been included in the BIA. Based on our analysis, we expect that the NGS test cost concerns will be limited. In the current situation, NGS can indeed result in higher diagnostic test costs, which is mainly related to required additional tests besides the small TGP. However, in the future, we expect that the use of whole-genome sequencing (WGS) will increase, for which it is expected that additional tests can be (partly) avoided. Although the current clinical benefits are expected to be limited, the research potentials of NGS are already an important advantage. PMID:27899957

  10. Bounded Rationality and Budgeting

    OpenAIRE

    Ibrahim, Mukdad

    2016-01-01

    This article discusses the theory of bounded rationality which had been introduced by Herbert Simon in the 1950s. Simon introduced the notion of bounded rationality stating that while decision-makers strive for rationality, they are limited by the effect of the environment, their information process capacity and by the constraints on their information storage and retrieval capabilities. Moreover, this article tries to specifically blend this notion into budgeting, using the foundations of inc...

  11. Programme budget 1981

    International Nuclear Information System (INIS)

    1980-01-01

    There are 11 main fields of KfK R + D activities which are connected with one or more of the research goals of a) assurance of nuclear fuel supply, b) nuclear waste management, c) safety of nuclear facilities, d) basic research and research on new technologies. The scientific and technical tasks connected with these goals in 1981 and on a medium-term basis as well as the financial requirements are presented in the programme budget. (orig.) [de

  12. The Incredible Shrinking Budget

    Science.gov (United States)

    T.H.E. Journal, 2013

    2013-01-01

    If district technology leaders had a nickel for every time they heard the phrase "the new normal," they'd have all the money they need to run their IT departments. In an effort to help readers think about their budgets in creative and practical ways, "T.H.E. Journal" and the Consortium for School Networking (CoSN) recently convened a panel of CTOs…

  13. High-dose therapy and autologous transplantation for lymphoma: the Peter MacCallum Cancer institute experience

    International Nuclear Information System (INIS)

    Dowling, A.J.; Prince, H.M.; Wolf, M.; Januszewicz, H.; Seymour, J.F.; Gates, P.; Wirth, A.; Juneja, S.; Smith, J.G.

    2001-01-01

    High-dose therapy (HDT) with autologous bone marrow or blood cell transplantation for the treatment of lymphoma commenced at Peter MacCallum Cancer Institute in 1986. To examine the patient characteristics and outcomes of patients with non-Hodgkin's lymphoma (NHL) and Hodgkin's disease (HD) treated with HDT and autologous transplantation at our Institute in the first 10 years of the service (1986-95). A retrospective analysis was performed examining patient characteristics, prior chemotherapy regimens, pretransplant disease status, HDT regimen, source of stem cells, time for haematopoietic recovery, complications of transplantation, response rates, overall survival (OS) and progression-free survival (PFS). Sixty-seven patients with NHL were treated with an estimated 5-year OS rate of 44% (95% confidence interval (CI) 32-56%) and PFS rate of 34% (95% CI 21-44%). Factors independently predictive of an unfavourable PFS on multivariate analyses were presence of constitutional symptoms at transplant (P < 0.002) and chemotherapy-resistant disease at transplant (P= 0.02). Twenty-three patients with HD were treated with a 5-year predicted OS rate of 74% (95% CI 56-92%) and PFS rate of 57% (95% CI 36-77%).There was no difference in PFS for HD patients who relapsed either within 12 months of completion of front-line therapy or after this time (P =0.5). The transplant-related mortality for the entire cohort was 17%, with a progressive decrease over time. HDT with autologous transplantation achieves durable PFS and OS in patients with lymphoma. Improved patient selection, therapy modifications according to prognostic factors and ongoing improvements in supportive care should improve outcomes further

  14. Budget Impact Analysis of Afatinib for First-Line Treatment of Patients with Metastatic Non-Small Cell Lung Cancer with Epidermal Growth Factor Receptor Exon 19 Deletions or Exon 21 Substitution Mutations in a U.S. Health Plan.

    Science.gov (United States)

    Graham, Jonathan; Earnshaw, Stephanie; Burslem, Kate; Lim, Jonathan

    2018-06-01

    Afatinib is 1 of 3 tyrosine kinase inhibitors approved in the United States for the first-line treatment of patients with metastatic non-small cell lung cancer (NSCLC) whose tumors have epidermal growth factor receptor (EGFR) exon 19 deletions (del19) or exon 21 (L858R) substitution mutations. In clinical trials, afatinib has demonstrated improvement in progression-free survival versus standard chemotherapy and gefitinib. To analyze the impact of increases in afatinib treatment share on the cost and health outcomes in a commercial health plan in the United States. A decision model was developed to evaluate the budget impact of increases in afatinib share for the first-line treatment of patients with metastatic NSCLC with EGFR del19 or L858R substitution mutations over a 5-year time horizon. The model compared the total annual costs for a health plan with 1 million covered lives in a scenario in which afatinib share increased 5 percentage points annually to one in which all treatment shares remained constant over time. The number of patients eligible for treatment was estimated using published incidence data. Therapies included in the model were afatinib, erlotinib, gefitinib, and the chemotherapy doublet, pemetrexed in combination with cisplatin. The mean time spent by patients in progression-free and progressive disease states was based on survival data from clinical trials and a network meta-analysis. Therapy-related costs included monthly drug acquisition and administration costs and costs of managing adverse reactions. Disease management costs were also assessed in the model. Scenario analyses were performed to assess alternative scenarios of afatinib treatment share. Additionally, a one-way sensitivity analysis was performed to test the robustness of the model, given parameter uncertainty. Using the base-case parameter assumptions and a 5-percentage-point annual increase in afatinib treatment share, we estimated the total budget increases in years 1 through 5

  15. One-Step Nucleic Acid Amplification in Breast Cancer Sentinel Lymph Node: A Single Institutional Experience and a Short Review.

    Science.gov (United States)

    Brambilla, Tatiana; Fiamengo, Barbara; Tinterri, Corrado; Testori, Alberto; Grassi, Massimo Maria; Sciarra, Amedeo; Abbate, Tommaso; Gatzemeier, Wolfgang; Roncalli, Massimo; Di Tommaso, Luca

    2015-01-01

    Sentinel lymph node (SLN) examination is a standard in breast cancer patients, with several methods employed along its 20 years history, the last one represented by one-step nucleic acid amplification (OSNA). The latter is a intra-operative molecular assay searching for CK19 mRNA as a surrogate of metastatic cells. Our 3 years experience with OSNA (1122 patients) showed results overlapping those recorded in the same institution with a morphological evaluation (930 patients) of SLN. In detail, the data of OSNA were almost identical to those observed with standard post-operative procedure in terms of patients with positive SLN (30%) and micrometastatic/macrometastatic involvement of SLN (respectively, 38-45 and 62-55%). By contrast, when OSNA was compared to the standard intraoperatory procedure, it was superior in terms of accuracy, prompting the use of this molecular assay as a very valid, and reproducible for intra-operative evaluation of SLN. Further possibilities prompting the use of OSNA range from adhesion to quality control programs, saving of medical time, ability to predict, during surgery, additional nodal metastasis, and molecular bio-banking.

  16. Clinical characteristics and treatment outcomes of patients with colorectal cancer who develop brain metastasis: a single institution experience.

    Science.gov (United States)

    Fountzilas, Christos; Chang, Katherine; Hernandez, Brian; Michalek, Joel; Crownover, Richard; Floyd, John; Mahalingam, Devalingam

    2017-02-01

    The development of brain metastasis (BM) in patients with colorectal cancer (CRC) is a rare and late event. We sought to investigate the clinical characteristics, disease course and safety using biologic agents in our patients with CRC who develop brain metastases. A retrospective review of patients with CRC with brain metastases treated at our institution from 01/2005-01/2015 was performed. Survival analysis was performed using the Kaplan-Meier method. Forty patients were included in the analysis. Median age was 55.5 years, 67.5% were males, and 28% had a KRAS mutation. Twenty-four percent were treatment-naive at the time of BM diagnosis. Patients had a median of two brain lesions. Sixty-five percent of the patients were treated with radiotherapy alone, 22.5% had both surgical resection and brain radiotherapy. Median overall survival was 3.2 months after development of BM. Overall survival was longer in patients who received combined modality local therapy compared to patients treated with surgical resection or radiotherapy alone. Patients who received systemic treatment incorporating biologics following development of BM had a median overall survival of 18.6 months. Overall, the administration of biologic agents was safe and well tolerated. In summary, BM is an uncommon and late event in the natural history of metastatic CRC. The ability to deliver combined-modality local brain therapy as well as availability of more systemic therapy options appear to lead to improved outcomes.

  17. Monitoring of people and workers exposure to the electric, magnetic and electromagnetic fields in an Italian national cancer Institute

    Directory of Open Access Journals (Sweden)

    Palomba Raffaele

    2008-07-01

    Full Text Available Abstract Background The paper reports the electric, magnetic and electromagnetic fields (emf measurements carried out in the Regina Elena National Cancer Institute (NCI. Several devices, used in diagnostics and in medical cures, can represent sources of emf for the workers and for the public subjected to the treatments. The aim is to evaluate their exposition, in order to assess the compliance with the law. Methods The investigations have been carried out in the departments of: intensive care, physiotherapy, MR presstherapy and in the surgical rooms. The measurements have been performed using broad band probes in the frequency ranges 5 Hz÷30 kHz and 100 kHz-3 GHz. Results The variability of the magnetic induction (B(μT levels is between 0,05 μT and 80 μT. The statistical distribution shows that most of the measurements are in the range 0,05 Conclusion The measurement of the emf levels in the NCI is recommended because of the presence of the oncological patients; their long stay near the equipments and their day-long exposure represent additional risk factors for which a prudent avoidance strategy have to de adopted.

  18. ONE STEP NUCLEIC ACID AMPLIFICATION IN BREAST CANCER SENTINEL LYMPH NODE.A SINGLE INSTITUTIONAL EXPERIENCE AND A SHORT REVIEW.

    Directory of Open Access Journals (Sweden)

    Tatiana eBrambilla

    2015-06-01

    Full Text Available Sentinel lymph node (SLN examination is a standard in breast cancer patients, with several methods employed along its 20-years history, the last one represented by OSNA. The latter is a intra-operative molecular assay searching for CK19 mRNA as a surrogate of metastatic cells. Our 3-years experience with OSNA (1122 patients showed results overlapping those recorded in the same Institution with a morphological evaluation (930 patients of SLN. In detail the data of OSNA were almost identical to those observed with standard post-operative procedure in terms of patients with positive SLN (30% and micrometastatic/macrometastatic involvement of SLN (respectively 38-45% and 62-55%. By contrast when OSNA was compared to the standard intra-operatory procedure it was superior in terms of accuracy, prompting the use of this molecular assay as a very valid and reproducible for intra-operative evaluation of SLN.Further possibilities prompting the use of OSNA range from adhesion to quality control programs, saving of medical time, ability to predict, during surgery, additional nodal metatastis and molecular bio-banking.

  19. Uterine Cancer: Cancer of the Uterus

    Science.gov (United States)

    ... Subscribe To receive Publications email updates Submit Uterine cancer Cancer of the uterus (uterine cancer) is cancer ... Institute . Expand all | Collapse all What is uterine cancer? Cancer is a disease in which certain body ...

  20. Global carbon budget 2013

    International Nuclear Information System (INIS)

    Le Quere, C.; Moriarty, R.; Jones, S.D.; Boden, T.A.; Peters, G.P.; Andrew, R.M.; Andres, R.J.; Ciais, P.; Bopp, L.; Maignan, F.; Viovy, N.

    2014-01-01

    Accurate assessment of anthropogenic carbon dioxide (CO 2 ) emissions and their redistribution among the atmosphere, ocean, and terrestrial biosphere is important to better understand the global carbon cycle, support the development of climate policies, and project future climate change. Here we describe data sets and a methodology to quantify all major components of the global carbon budget, including their uncertainties, based on the combination of a range of data, algorithms, statistics and model estimates and their interpretation by a broad scientific community. We discuss changes compared to previous estimates, consistency within and among components, alongside methodology and data limitations. CO 2 emissions from fossil-fuel combustion and cement production (EFF) are based on energy statistics, while emissions from land-use change (ELUC), mainly deforestation, are based on combined evidence from land-cover change data, fire activity associated with deforestation, and models. The global atmospheric CO 2 concentration is measured directly and its rate of growth (GATM) is computed from the annual changes in concentration. The mean ocean CO 2 sink (SOCEAN) is based on observations from the 1990's, while the annual anomalies and trends are estimated with ocean models. The variability in SOCEAN is evaluated for the first time in this budget with data products based on surveys of ocean CO 2 measurements. The global residual terrestrial CO 2 sink (SLAND) is estimated by the difference of the other terms of the global carbon budget and compared to results of independent dynamic global vegetation models forced by observed climate, CO 2 and land cover change (some including nitrogen-carbon interactions). All uncertainties are reported as ±1, reflecting the current capacity to characterise the annual estimates of each component of the global carbon budget. For the last decade available (2003-2012), EFF was 8.6±0.4 GtC yr -1 , ELUC 0.9±0.5 GtC yr -1 , GATM 4.3±0

  1. Marketing with limited budget

    OpenAIRE

    Smirnova, Daria

    2017-01-01

    The purpose of this research-based thesis was to get an idea how managers of two small resembling hotels of a specific region deal with marketing process with a limited budget. In addition, the aim of the thesis was to examine if hotel managers who were interviewed perceive marketing only in the way of ‘promotion’ rather than marketing research, marketing mix and marketing environment theories. It was also found out if hotel managers of those hotels consider marketing as a key to successful h...

  2. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Events Scientific Meetings & Lectures Conferences Advisory Board Meetings Social Media Cancer Currents ... Organization Advisory Boards and Review Groups Budget & Appropriations About ...

  3. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... History of NCI Contributing to Cancer Research Senior Leadership Director Deputy Director Previous Directors NCI Organization Divisions, Offices & Centers Advisory Boards & Review Groups Budget & ...

  4. Age-dependent Characteristics in Women with Breast Cancer: Mastectomy and Reconstructive Trends at an Urban Academic Institution.

    Science.gov (United States)

    Rodby, Katherine A; Robinson, Emilie; Danielson, Kirstie K; Quinn, Karina P; Antony, Anuja K

    2016-03-01

    Breast reconstruction is an important aspect of treatment after breast cancer. Postmastectomy reconstruction bears a significant impact on a woman's postsurgical confidence, sexuality, and overall well-being. Previous studies have inferred that women under age 40 years have unique characteristics that distinguish them from an older cohort. Identifying age-dependent trends will assist with counseling women on mastectomy and reconstruction. To identify age-dependent trends, 100 consecutive women were sampled from a prospectively maintained breast reconstruction database at an urban academic institution from June 2010 through June 2013. Women were placed into two cohorts mastectomy, reconstructive and symmetry procedures were evaluated. Statistical analysis was performed using SAS software. In 100 patients of the sample study cohort, 151 reconstructions were performed. Increasing age was associated with one or more comorbidities [odds ratio (OR) = 1.07, P = 0.005], whereas younger age was associated with metastatic disease (OR = 0.88, P = 0.006), chemotherapy (OR = 0.94, P = 0.01), and radiation (OR = 0.94, P = 0.006); split cohorts demonstrated similar trends (P Mastectomy and reconstructive characteristics associated with younger age included bilateral mastectomy (OR = 0.94, P = 0.004), tissue expander (versus autologous flap) (OR = 0.94, P = 0.009), extra high implant type (OR = 0.94, P = 0.049), whereas increasing use of autologous flaps and contralateral mastopexy symmetry procedures (OR = 1.09, P = 0.02) were associated with an aging cohort. Increasing age was not associated with an increasing likelihood of complications (P = 0.75). Age-related factors play a role in the treatment of patients with breast cancer. Younger women typically present with more aggressive features requiring oncologic treatment including chemotherapy and radiation. Mastectomy and reconstructive choices also demonstrate age-dependent characteristics. Women in younger age groups are more

  5. Value of a gene signature assay in patients with early breast cancer and intermediate risk: a single institution retrospective study.

    Science.gov (United States)

    Bonneterre, Jacques; Prat, Aleix; Galván, Patricia; Morel, Pascale; Giard, Sylvia

    2016-05-01

    Purpose In daily clinical practice, the indication for adjuvant chemotherapy (CT) is relatively easy to make in patients with early hormone-receptor-positive (HR+) breast cancer with either very poor or very good clinicopathological prognostic variables. However, this decision is much more difficult in patients with intermediate clinicopathological prognostic variables. Here, we evaluate the value of a gene-expression profile identified by the Prosigna gene signature assay in guiding treatment decision-making in patients with these intermediate features. Methods A consecutive cohort of 577 HR + breast cancer patients surgically treated in a single institution between January 2012 and December 2012 was evaluated. From this population, pre- and post-menopausal patients with intermediate prognosis clinicopathological variables were identified and indication of adjuvant CT in these patients was recorded. The gene signature assay was performed retrospectively in this intermediate risk group. Descriptive statistics are presented. Results Among 96 intermediate-risk patients, 64 postmenopausal patients underwent gene signature testing. Subtype distribution was as follows: Luminal A (N = 33; 51.6%), Luminal B (N = 31; 48.4%). Risk of recurrence (ROR) distribution was as follows: ROR-low (n = 16; 25%); ROR-intermediate (N = 26; 40.6%); and ROR-high (N = 22; 34.4%). CT was subsequently administered in 18.7%, 53.8% and 59.0% of the ROR-low, ROR-intermediate and ROR-high groups, respectively. With the use of the gene signature assay, 59.4% of the intermediate cases were re-classified to either ROR-low or ROR-high risk categories. In the ROR-intermediate group, 11/26 patients (42.3%) had Luminal A and 15/26 (57.7%) had Luminal B. Due to follow-up time constraints, no patient outcome results were evaluated. Conclusion The gene signature assay provides clinically useful information and improved treatment decision-making in patients with intermediate risk based on

  6. Environmental budget and policy goal

    Energy Technology Data Exchange (ETDEWEB)

    Noh, Sang Hwan [Korea Environment Institute, Seoul (Korea)

    1998-12-01

    The assigned budget for environmental sector is quite insufficient to meet enormous environmental demand. Under this circumstance, there is only one way to solve environmental problems efficiently, i.e. to use a given budget efficiently. Therefore, the study on efficient utilization of a given environmental invested finance is needed by customizing a diagnosis of present condition on the operation of environmental budget and environmental investment analysis. In this respect, an entire national budget of 1999 and environmental budget were analyzed in this study. By analyzing economic efficiency of sewage disposal program, integrated septic tank system, VOC regulation, incinerator construction program, food waste disposal program, and recycling program, an efficient budget policy was presented. 19 refs., 18 figs., 169 tabs.

  7. Baseline budgeting for continuous improvement.

    Science.gov (United States)

    Kilty, G L

    1999-05-01

    This article is designed to introduce the techniques used to convert traditionally maintained department budgets to baseline budgets. This entails identifying key activities, evaluating for value-added, and implementing continuous improvement opportunities. Baseline Budgeting for Continuous Improvement was created as a result of a newly named company president's request to implement zero-based budgeting. The president was frustrated with the mind-set of the organization, namely, "Next year's budget should be 10 to 15 percent more than this year's spending." Zero-based budgeting was not the answer, but combining the principles of activity-based costing and the Just-in-Time philosophy of eliminating waste and continuous improvement did provide a solution to the problem.

  8. Cervical Cancer

    Science.gov (United States)

    ... I find more information about cervical and other gynecologic cancers? Centers for Disease Control and Prevention: 800-CDC-INFO or www. cdc. gov/ cancer/ gynecologic National Cancer Institute: 800-4-CANCER or www. ...

  9. Ovarian Cancer

    Science.gov (United States)

    ... I find more information about ovarian and other gynecologic cancers? Centers for Disease Control and Prevention: 800-CDC-INFO or www. cdc. gov/ cancer/ gynecologic National Cancer Institute: 800-4-CANCER or www. ...

  10. Global Carbon Budget 2017

    Science.gov (United States)

    Le Quéré, Corinne; Andrew, Robbie M.; Friedlingstein, Pierre; Sitch, Stephen; Pongratz, Julia; Manning, Andrew C.; Korsbakken, Jan Ivar; Peters, Glen P.; Canadell, Josep G.; Jackson, Robert B.; Boden, Thomas A.; Tans, Pieter P.; Andrews, Oliver D.; Arora, Vivek K.; Bakker, Dorothee C. E.; Barbero, Leticia; Becker, Meike; Betts, Richard A.; Bopp, Laurent; Chevallier, Frédéric; Chini, Louise P.; Ciais, Philippe; Cosca, Catherine E.; Cross, Jessica; Currie, Kim; Gasser, Thomas; Harris, Ian; Hauck, Judith; Haverd, Vanessa; Houghton, Richard A.; Hunt, Christopher W.; Hurtt, George; Ilyina, Tatiana; Jain, Atul K.; Kato, Etsushi; Kautz, Markus; Keeling, Ralph F.; Klein Goldewijk, Kees; Körtzinger, Arne; Landschützer, Peter; Lefèvre, Nathalie; Lenton, Andrew; Lienert, Sebastian; Lima, Ivan; Lombardozzi, Danica; Metzl, Nicolas; Millero, Frank; Monteiro, Pedro M. S.; Munro, David R.; Nabel, Julia E. M. S.; Nakaoka, Shin-ichiro; Nojiri, Yukihiro; Padin, X. Antonio; Peregon, Anna; Pfeil, Benjamin; Pierrot, Denis; Poulter, Benjamin; Rehder, Gregor; Reimer, Janet; Rödenbeck, Christian; Schwinger, Jörg; Séférian, Roland; Skjelvan, Ingunn; Stocker, Benjamin D.; Tian, Hanqin; Tilbrook, Bronte; Tubiello, Francesco N.; van der Laan-Luijkx, Ingrid T.; van der Werf, Guido R.; van Heuven, Steven; Viovy, Nicolas; Vuichard, Nicolas; Walker, Anthony P.; Watson, Andrew J.; Wiltshire, Andrew J.; Zaehle, Sönke; Zhu, Dan

    2018-03-01

    Accurate assessment of anthropogenic carbon dioxide (CO2) emissions and their redistribution among the atmosphere, ocean, and terrestrial biosphere - the global carbon budget - is important to better understand the global carbon cycle, support the development of climate policies, and project future climate change. Here we describe data sets and methodology to quantify the five major components of the global carbon budget and their uncertainties. CO2 emissions from fossil fuels and industry (EFF) are based on energy statistics and cement production data, respectively, while emissions from land-use change (ELUC), mainly deforestation, are based on land-cover change data and bookkeeping models. The global atmospheric CO2 concentration is measured directly and its rate of growth (GATM) is computed from the annual changes in concentration. The ocean CO2 sink (SOCEAN) and terrestrial CO2 sink (SLAND) are estimated with global process models constrained by observations. The resulting carbon budget imbalance (BIM), the difference between the estimated total emissions and the estimated changes in the atmosphere, ocean, and terrestrial biosphere, is a measure of imperfect data and understanding of the contemporary carbon cycle. All uncertainties are reported as ±1σ. For the last decade available (2007-2016), EFF was 9.4 ± 0.5 GtC yr-1, ELUC 1.3 ± 0.7 GtC yr-1, GATM 4.7 ± 0.1 GtC yr-1, SOCEAN 2.4 ± 0.5 GtC yr-1, and SLAND 3.0 ± 0.8 GtC yr-1, with a budget imbalance BIM of 0.6 GtC yr-1 indicating overestimated emissions and/or underestimated sinks. For year 2016 alone, the growth in EFF was approximately zero and emissions remained at 9.9 ± 0.5 GtC yr-1. Also for 2016, ELUC was 1.3 ± 0.7 GtC yr-1, GATM was 6.1 ± 0.2 GtC yr-1, SOCEAN was 2.6 ± 0.5 GtC yr-1, and SLAND was 2.7 ± 1.0 GtC yr-1, with a small BIM of -0.3 GtC. GATM continued to be higher in 2016 compared to the past decade (2007-2016), reflecting in part the high fossil emissions and the small SLAND

  11. Global Carbon Budget 2017

    Directory of Open Access Journals (Sweden)

    C. Le Quéré

    2018-03-01

    Full Text Available Accurate assessment of anthropogenic carbon dioxide (CO2 emissions and their redistribution among the atmosphere, ocean, and terrestrial biosphere – the global carbon budget – is important to better understand the global carbon cycle, support the development of climate policies, and project future climate change. Here we describe data sets and methodology to quantify the five major components of the global carbon budget and their uncertainties. CO2 emissions from fossil fuels and industry (EFF are based on energy statistics and cement production data, respectively, while emissions from land-use change (ELUC, mainly deforestation, are based on land-cover change data and bookkeeping models. The global atmospheric CO2 concentration is measured directly and its rate of growth (GATM is computed from the annual changes in concentration. The ocean CO2 sink (SOCEAN and terrestrial CO2 sink (SLAND are estimated with global process models constrained by observations. The resulting carbon budget imbalance (BIM, the difference between the estimated total emissions and the estimated changes in the atmosphere, ocean, and terrestrial biosphere, is a measure of imperfect data and understanding of the contemporary carbon cycle. All uncertainties are reported as ±1σ. For the last decade available (2007–2016, EFF was 9.4 ± 0.5 GtC yr−1, ELUC 1.3 ± 0.7 GtC yr−1, GATM 4.7 ± 0.1 GtC yr−1, SOCEAN 2.4 ± 0.5 GtC yr−1, and SLAND 3.0 ± 0.8 GtC yr−1, with a budget imbalance BIM of 0.6 GtC yr−1 indicating overestimated emissions and/or underestimated sinks. For year 2016 alone, the growth in EFF was approximately zero and emissions remained at 9.9 ± 0.5 GtC yr−1. Also for 2016, ELUC was 1.3 ± 0.7 GtC yr−1, GATM was 6.1 ± 0.2 GtC yr−1, SOCEAN was 2.6 ± 0.5 GtC yr−1, and SLAND was 2.7 ± 1.0 GtC yr−1, with a small BIM of −0.3 GtC. GATM continued to be

  12. Program budget 1979

    International Nuclear Information System (INIS)

    1978-01-01

    This HMI report explains the tasks and activities of the Institute and gives an account of the main research activities in the fields of heavy ion physics, radiation chemistry and photochemistry, solids, nuclear chemistry, data processing and electronics. In addition, a survey is given of the Institute's infrastructure and the financial situation. (HK) [de

  13. BUDGET PLANNING IN FINANCIAL MANAGEMENT

    OpenAIRE

    Nataliya Melnichuk

    2015-01-01

    The purpose of the paper is to determine the nature, targets, functions, principles and methods of budget planning and development of classifications due to its types. The essence of budget planning presented by various authors, is own interpretation (the process of developing a plan of formation, distribution and redistribution of financial funds according to budget system units during the reporting period based on budgetary purposes and targets defined by socio-economic development strategy...

  14. Budget 2002: business taxation measures

    OpenAIRE

    Blow, L.; Hawkins, M.; Klemm, A.; McCrae, J.; Simpson, H.

    2002-01-01

    Following the 2002 Budget, this Briefing Note examines some of the Chancellor's changes to business taxation. A number of Budget measures, including the research and development tax credit for large companies and the exemption of capital gains on the sale of subsidiaries, are welcome and should improve the efficiency of the UK's tax system. All of these measures were subject to extensive prior consultation. A number of other measures were not foreshadowed in the Pre-Budget Report. Three of th...

  15. Collection assessment and acquisitions budgets

    CERN Document Server

    Lee, Sul H

    2013-01-01

    This invaluable new book contains timely information about the assessment of academic library collections and the relationship of collection assessment to acquisition budgets. The rising cost of information significantly influences academic libraries'abilities to acquire the necessary materials for students and faculty, and public libraries'abilities to acquire material for their clientele. Collection Assessment and Acquisitions Budgets examines different aspects of the relationship between the assessment of academic library collections and the management of library acquisition budgets. Librar

  16. Brachytherapy for T1-T2 floor-of-the-mouth cancers: the Gustave-Roussy Institute experience

    International Nuclear Information System (INIS)

    Marsiglia, Hugo; Haie-Meder, Christine; Sasso, Giuseppe; Mamelle, Gerard; Gerbaulet, Alain

    2002-01-01

    Purpose: In a retrospective analysis, we evaluated the Gustave-Roussy Institute's experience of locoregional control, survival, and complications of low-dose rate brachytherapy for carcinoma of the floor of the mouth. Methods and Materials: Between 1970 and 1985, 160 patients with previously untreated carcinoma of the floor of the mouth received interstitial brachytherapy as definitive treatment. Of the 160 patients, 79 (49%) had T1 and 81 (51%) had T2 lesions, and 127 (79%) had N0 and 33 (21%) had N1; 84% of tumors arose from the anterior floor of the mouth. Brachytherapy was performed with 192 Ir wires, according to the Paris system rules, followed by neck dissection (T2 or N1) or follow-up (T1N0). Results: With a follow-up period of 9-19 years, the observed survival rates were 89% at 2 years and 76% at 5 years, and the local control rates were 93% in T1 and 88% in T2 tumors. A low rate of distant metastases was noticed (5%); 31% of patients developed a second primary cancer. Severe mucosal necrosis was observed in <10% of patients. Any grade of bone necrosis was seen in 18% of cases (only 2.5% had G3 necrosis). This complication occurred more frequently in patients with poor dental status and in those treated without dental protection during implantation (p <0.001). Conclusion: Radical brachytherapy offers excellent local control (89%) and an acceptable rate of complications (<10% severe necrosis) that may be significantly decreased with dental care and the use of protective devices. The high incidence of second malignancies remains a major concern in these patients

  17. Using health care audit to improve quality of clinical records: the preliminary experience of an Italian Cancer Institute.

    Science.gov (United States)

    Cadeddu, Chiara; Specchia, Maria Lucia; Cacciatore, Pasquale; Marchini, Raffaele; Ricciardi, Walter; Cavuto, Costanza

    2017-01-01

    Audit and feedback are recognized as part of a strategy for improving performance and supporting quality and safety in European health care systems. These considerations led the Clinical Management Staff of the "Regina Elena" Italian Cancer Institute to start a project of self-assessment of the quality of clinical records and organizational appropriateness through a retrospective review. The evaluation about appropriateness and congruity concerned both clinical records of 2013 and of 2015. At the end of the assessment of clinical records of each Care Unit, results were shared with medical staff in scheduled audit meetings. One hundred and thirteen clinical records (19%) did not meet congruity criteria, while 74 (12.6%) resulted as inappropriate. Considering the economic esteem calculated from the difference between Diagnosis Related Groups (DRG) primarily identified as main diagnosis and main surgical intervention or procedure and those modified during the Local Health Unit (LHU) assessment, 2 surgical Care Units produced a high negative difference in terms of economic value with a consequent drop of hospital discharge form (named in Italian "scheda di dimissione ospedaliera", SDO) remuneration, 7 Care Units produced about the same medium difference with almost no change as SDO remuneration, and 2 Care Units had a positive difference with a profit in terms of SDO remuneration. Concerning the quality assessment of clinical records of 2015, the most critical areas were related to medical documents and hospital discharge form compilation. Our experience showed the effectiveness of clinical audit in assessing the quality of filling in medical records and the appropriateness of hospital admissions and the acceptability of this tool by clinicians.

  18. The current status of treatment for oropharyngeal cancer in Japan. A multi-institutional retrospective observation study

    International Nuclear Information System (INIS)

    Homma, Akihiro; Hayashi, Ryuichi; Kawabata, Kazuyoshi

    2013-01-01

    The purpose of this study was to assess the current status of the treatment for oropharyngeal cancer (OPC) in Japan to assist the planning of clinical trials in the future. The data for 523 patients with previously untreated OPC were obtained from 12 institutions from April 2005 to N/larch 2007. Of the 523 patients, 471 patients with squamous cell carcinoma and with curative intent were included in an analysis of the treatment and its results. Of the 471 patients with OPC treated with curative intent, 186 patients (39.5%) were treated with surgery, 118 (25.1%) with radiotherapy (RT) alone and 167 (355%) with CRT. Surgery was indicated for 60.4% of the patients with stage I, 47.8% in stage II, 29.4% in stage III, and 36.44% in stage IV. CRT was indicated for 8.3% in stage II, but the percentage increased with higher stage. The percentage of RT was around 30% among stage I-III, but in stage IV, 21.3% of the patients were indicated for RT. The median follow-up period was 4 years and 5 months. The 2-year and 5-year overall survival rates for the 471 patients were 85% and 69.9%, respectively. The 5-year overall survival rates for patients treated initially with surgery, RT and CRT were 73%, 69.1% and 65.6%, respectively. The 5-year overall survival rates for patients with stage I, II, III, IVA, and IVB were 78.9%. 87.3%, 69.7%, 66.6%, and 47.7%, respectively. Although this study was retrospective, we could understand the tendency of treatment choice according to various factors and treatment results. The information will be useful for planning clinical trials in the future. (author)

  19. Primary non-Hodgkin's lymphomas of the breast: 23 years of experience at the Colombian national cancer institute

    International Nuclear Information System (INIS)

    Rodriguez, Myriam; Grajales, Marco; Londono, Sonia; Ortiz, Natascha

    2004-01-01

    Primary non- Hodgkin's lymphomas of the breast (PNHLB) are an infrequent malignancy. In a review of the literature, in which six Latin American journals are included, approximately 450 cases have been reported during the past two decades. in this paper we present the experience of the national cancer institute of Colombia during the last 23 years. Objective: to carry out a retrospective analysis of the characteristics, natural history, prognostic factors, and outcome of patients with PNHLB at the NCI of Colombia. Methods: the medical histories of patients diagnosed with PNHLB between 1980 and 2003 were reviewed; likewise, the clinical characteristics, treatment protocols, and final outcomes were analyzed. Results: 25 patients were identified as PNHLB. The average follow-up was 57 months. The medium age was 58, ranging from 26 to 83. 84% had diffused large cell lymphoma. The Karnofsky index was over 80 in 92% of the patients. 72% received chop chemotherapy. Two patients received a combination without doxorubicin. 68% received combined chemo- and radiation therapy. Two patients refused therapy. Two patients died before receiving any type of treatment. CNS compromise was observed in 20% of patients during the evolution of their disease. The youngest patient, whose case deserves special comment, obtained a second complete remission with simple mastectomy, after having relapsed after conventional chemotherapy, radiotherapy, and autologous bone marrow transplant. No significant prognostic variables were found using the univariate analysis. Conclusions: a high rate of complete remission can be achieved by using combined treatment in patients with PNHLB. The medium overall survival was not reached after 71 months of follow-up. The most frequent relapse site was the CNS

  20. Management Head and Neck Ewing's Sarcoma Family of tumors: Experience of the National Cancer Institute, Cairo University

    International Nuclear Information System (INIS)

    Abdel Rahman, M.; El-Baradie, T.; Bahaa, Sh.; Shalan, M.; El-Baradie, M.

    2010-01-01

    Ewing's sarcoma accounts for 4-6% of primary malignant bone tumors and it affects the head and neck in only 1-4% of cases. The purpose of this study was to review the NCI experience with Ewing's sarcoma of the head and neck in children. Patients and Methods: A retrospective analysis of patient files with head and neck Ewing's sarcoma treated at the National Cancer Institute, Cairo University, Egypt, during the period from 1997 to 2008 was done. Files were reviewed and data for patients, tumor and treatment profile were extracted. Results: Twenty patients out of 280 with Ewing's sarcoma were identified during an 11 -year period. Patients had a median age of 11.5 years (range 5 months - 22 years) with a male to female ratio of 1:1. The most common tumor site was in the mandible (9/20, 45%) followed by a neck mass (4/20, 20%) and a clavicular mass (3/20, 15%). Six patients (30%) were metastatic at presentation. Most of the patients (19/20, 95%) received chemotherapy. Local therapy was in the form of radical radiotherapy for 8 patients (40%), 2 patients (10%) had surgery alone, while five patients (25%) had surgical resection and postoperative radiotherapy. Overall survival ranged from 1 to 128 months, with a median of 36 months. At the end of the study, 9 patients (45%) were alive in CR, 6 (30%) were lost to FU in disease progression, while 5 patients died from disease progression. Conclusion: Ewing's sarcoma of the head and neck is a disease of a rare incidence with debate about the optimum local therapy. Small non-metastatic tumors with good response to chemotherapy have abetter outcome.

  1. Cost and Outcome of Treatment of Adults with Acute Myeloid Leukemia at the National Cancer Institute-Egypt

    International Nuclear Information System (INIS)

    El-Zawahry, H.M.; Zeeneldin, A.A.; Samra, M.A.; El-Gammal, M.M.; Mattar, M.M.

    2007-01-01

    Despite important advances in the therapy of acute myeloid leukemia (AML), the majority of patients die of their disease, unless bone marrow transplantation (BMT) is done. Infection and hemorrhage are still the major causes of mortality in AML patients. Progress in therapy and supportive care has led to gradual improvement in the overall results, but further improvements are still needed. Patients and Methods: The aim of this study is to identify the outcome and costs of adult AML patients treated with conventional chemotherapy (CCT) at the National Cancer Institute (NCI), Cairo University during the time period from April 1999 to January 2002. Clinical, laboratory characteristics were all recorded. Data regarding different types of therapies given for these patients including response, outcome and costs were also collected. Results: The median age of 82 identified AML patients was 34 years. The complete remission (CR) rate after induction with CCT was 52% (42/82 patients) with a median CR duration of 9 months. Twenty-eight percent of patients who achieved CR subsequently relapsed. By January 2003, fifty-eight patients were dead (70.7%). Infections were the major mortality cause, followed by disease progression then bleeding (65%, 28% and 7% respectively). The median treatment cost per patient was 33158 Egyptian Pounds (LE). It was higher for patients who achieved CR compared to those who relapsed and/or died. Drugs contributed by 78 % to the total treatment cost, while hospitalization, investigations and blood-component therapy contributed by 6%, 7% and 8% respectively. Conclusions: Outcome of patients with AML treated at NCI- Cairo University can be enhanced by improvement of supportive therapy; mainly infection control and expanding BMT programs to accommodate all eligible patients

  2. Dose budget for exposure control

    International Nuclear Information System (INIS)

    Nair, P.S.

    1999-01-01

    Dose budget is an important management tool to effectively control the collective dose incurred in a nuclear facility. The budget represents a set of yardsticks or guidelines for use in controlling the internal activities, involving radiation exposure in the organisation. The management, through budget can evaluate the radiation protection performance at every level of the organisation where a number of independent functional groups work on routine and non-routine jobs. The discrepancy between the plan and the actual performance is high lighted through the budgets. The organisation may have to change the course of its operation in a particular area or revise its plan with due focus on appropriate protective measures. (author)

  3. Prostate cancer (PCa) risk variants and risk of fatal PCa in the National Cancer Institute Breast and Prostate Cancer Cohort Consortium.

    Science.gov (United States)

    Shui, Irene M; Lindström, Sara; Kibel, Adam S; Berndt, Sonja I; Campa, Daniele; Gerke, Travis; Penney, Kathryn L; Albanes, Demetrius; Berg, Christine; Bueno-de-Mesquita, H Bas; Chanock, Stephen; Crawford, E David; Diver, W Ryan; Gapstur, Susan M; Gaziano, J Michael; Giles, Graham G; Henderson, Brian; Hoover, Robert; Johansson, Mattias; Le Marchand, Loic; Ma, Jing; Navarro, Carmen; Overvad, Kim; Schumacher, Fredrick R; Severi, Gianluca; Siddiq, Afshan; Stampfer, Meir; Stevens, Victoria L; Travis, Ruth C; Trichopoulos, Dimitrios; Vineis, Paolo; Mucci, Lorelei A; Yeager, Meredith; Giovannucci, Edward; Kraft, Peter

    2014-06-01

    Screening and diagnosis of prostate cancer (PCa) is hampered by an inability to predict who has the potential to develop fatal disease and who has indolent cancer. Studies have identified multiple genetic risk loci for PCa incidence, but it is unknown whether they could be used as biomarkers for PCa-specific mortality (PCSM). To examine the association of 47 established PCa risk single-nucleotide polymorphisms (SNPs) with PCSM. We included 10 487 men who had PCa and 11 024 controls, with a median follow-up of 8.3 yr, during which 1053 PCa deaths occurred. The main outcome was PCSM. The risk allele was defined as the allele associated with an increased risk for PCa in the literature. We used Cox proportional hazards regression to calculate the hazard ratios of each SNP with time to progression to PCSM after diagnosis. We also used logistic regression to calculate odds ratios for each risk SNP, comparing fatal PCa cases to controls. Among the cases, we found that 8 of the 47 SNPs were significantly associated (pPCa, but most did not differentiate between fatal and nonfatal PCa. Rs11672691 and rs10993994 were associated with both fatal and nonfatal PCa, while rs6465657, rs7127900, rs2735839, and rs13385191 were associated with nonfatal PCa only. Eight established risk loci were associated with progression to PCSM after diagnosis. Twenty-two SNPs were associated with fatal PCa incidence, but most did not differentiate between fatal and nonfatal PCa. The relatively small magnitudes of the associations do not translate well into risk prediction, but these findings merit further follow-up, because they may yield important clues about the complex biology of fatal PCa. In this report, we assessed whether established PCa risk variants could predict PCSM. We found eight risk variants associated with PCSM: One predicted an increased risk of PCSM, while seven were associated with decreased risk. Larger studies that focus on fatal PCa are needed to identify more markers that

  4. Operational budgeting using fuzzy goal programming

    OpenAIRE

    Saeed Mohammadi; Kamran Feizi; Ali Khatami Firouz Abadi

    2013-01-01

    Having an efficient budget normally has different advantages such as measuring the performance of various organizations, setting appropriate targets and promoting managers based on their achievements. However, any budgeting planning requires prediction of different cost components. There are various methods for budgeting planning such as incremental budgeting, program budgeting, zero based budgeting and performance budgeting. In this paper, we present a fuzzy goal programming to estimate oper...

  5. Nuclear budget up 9.6% for fiscal 1981

    International Nuclear Information System (INIS)

    1981-01-01

    After reviewing the overall governmental budgets for fiscal 1981 including energy budget, the nuclear budget for the Science and Technology Agency and the Ministry of International Trade and Industry is described. The 1981 nuclear budget amounts to 178,013 million yen in general account, 4.2% increase over the previous year; and 93,237 million yen, increase of 17.3%, in the special account for power source development. The total is 271,250 million yen. For the STA, budgetary allocations were made for researches on nuclear power safety, a multi-purpose high temperature gas-cooled reactor and nuclear fusion in Japan Atomic Energy Research Institute, developments of FBR and ATR and nuclear fuel cycle in Power Reactor and Nuclear Fuel Development Corporation, and so on. For the MITI, allocations were made for nuclear plant safety, nuclear fuel cycle, and others. (Mori, K.)

  6. Gender inequality in Russia: the perspective of participatory gender budgeting.

    Science.gov (United States)

    Zakirova, Venera

    2014-11-01

    Gender-based discrimination is found in all economies in the world. Women's unpaid work accounts for about half of the world GDP, yet women remain under-valued and under-represented in national policies worldwide. The question of gender budgeting and citizens' participation in budgeting and governance processes has gained attention in recent years, but Russia is far from implementing these. Instead, blindness to gender issues dominates in national strategies and budgets. This paper explores these issues and looks in-depth at them in the decentralisation process in Bashkortostan, a central Russian republic. Civil society institutions whose role is to strengthen the links between government, civil society and the community in Bashkortostan, such as Public Chambers and Municipalities, lack the capacity to introduce participatory gender budgeting. As a result, no systematic participatory planning, let alone planning that is gender-sensitive, has taken place there. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  7. Radiomic features for prostate cancer detection on MRI differ between the transition and peripheral zones: Preliminary findings from a multi-institutional study.

    Science.gov (United States)

    Ginsburg, Shoshana B; Algohary, Ahmad; Pahwa, Shivani; Gulani, Vikas; Ponsky, Lee; Aronen, Hannu J; Boström, Peter J; Böhm, Maret; Haynes, Anne-Maree; Brenner, Phillip; Delprado, Warick; Thompson, James; Pulbrock, Marley; Taimen, Pekka; Villani, Robert; Stricker, Phillip; Rastinehad, Ardeshir R; Jambor, Ivan; Madabhushi, Anant

    2017-07-01

    To evaluate in a multi-institutional study whether radiomic features useful for prostate cancer (PCa) detection from 3 Tesla (T) multi-parametric MRI (mpMRI) in the transition zone (TZ) differ from those in the peripheral zone (PZ). 3T mpMRI, including T2-weighted (T2w), apparent diffusion coefficient (ADC) maps, and dynamic contrast-enhanced MRI (DCE-MRI), were retrospectively obtained from 80 patients at three institutions. This study was approved by the institutional review board of each participating institution. First-order statistical, co-occurrence, and wavelet features were extracted from T2w MRI and ADC maps, and contrast kinetic features were extracted from DCE-MRI. Feature selection was performed to identify 10 features for PCa detection in the TZ and PZ, respectively. Two logistic regression classifiers used these features to detect PCa and were evaluated by area under the receiver-operating characteristic curve (AUC). Classifier performance was compared with a zone-ignorant classifier. Radiomic features that were identified as useful for PCa detection differed between TZ and PZ. When classification was performed on a per-voxel basis, a PZ-specific classifier detected PZ tumors on an independent test set with significantly higher accuracy (AUC = 0.61-0.71) than a zone-ignorant classifier trained to detect cancer throughout the entire prostate (P  0.14) were obtained for all institutions. A zone-aware classifier significantly improves the accuracy of cancer detection in the PZ. 3 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:184-193. © 2016 International Society for Magnetic Resonance in Medicine.

  8. Budgeting Time to Teach about the School Budget

    Science.gov (United States)

    Weiss, Dale

    2011-01-01

    As a teacher in the Milwaukee Public Schools (MPS) for the past 16 years, the author has grown used to dismal budget cut news arriving each February. Although cuts are always frustrating and their results burdensome, the school has been able to "hang on" reasonably well. This year, however, the budget cuts were extreme. In this article,…

  9. BUDGET PLANNING IN FINANCIAL MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Nataliya Melnichuk

    2015-11-01

    Full Text Available The purpose of the paper is to determine the nature, targets, functions, principles and methods of budget planning and development of classifications due to its types. The essence of budget planning presented by various authors, is own interpretation (the process of developing a plan of formation, distribution and redistribution of financial funds according to budget system units during the reporting period based on budgetary purposes and targets defined by socio-economic development strategy is proposed. Methodology. The following methods such as cognition, induction, deduction, analysis and synthesis have been used in the process of survey. Results of the survey proves that budget planning plays an essential role in the financial management. On condition business environment changing even the best management system can become obsolete. The immediate reaction to the new trends in the financial system as a whole, in the industry is possible with budget planning as well. It also allows to make appropriate adjustments to the plans. Adjustment of long-term, medium-term and short-term plans makes it possible, without changing goals, to change ways of their achievement and thus to raise the level of efficiency of budget funds formation and use. It is necessary to revise the whole system plans, including their mission and goals in the case of global changes in the external and internal environment. Practical implications. The proposed approach to the classification of budget planning types allows to cope with the shortcomings of modern planning in the public sector (the development of the targets according to the state budget expenditures in Ukraine remains a formality and it rarely complies with realities. Value/originality is specified in the proposed interpretation which differs from existing ones that provides clarification of budget planning purpose in financial management; classification of budget planning principles, which differs from previous

  10. Outcome of Breast Cancer in Moroccan Young Women Correlated to Clinic-Pathological Features, Risk Factors and Treatment: A Comparative Study of 716 Cases in a Single Institution.

    Directory of Open Access Journals (Sweden)

    Meriem Slaoui

    Full Text Available Breast cancer in young women is quite uncommon and shows more aggressive characteristics with major disparities between worldwide populations. Prognosis and outcome of breast cancer in young patients are widely studied, but still no consensus is available.We retrospectively included 716 cases of breast cancer women diagnosed in 2009 at the National Institute of Oncology of Rabat. Patients were divided into two groups according to their age: women aged ≤40 years (Group 1 and women aged >40 years (Group 2. Data were recorded from patients' medical files and analyzed using SPSS 13.0 software (IBM.Young patients represent 24.9% of all patients with breast cancer. The comparison between the two groups displayed significant differences regarding nulliparity (p = 0.001 and progesterone receptor negativity (p = 0.01. Moreover, more progression (Metastases/Relapse was registered in young women as compared to older women with breast cancer (p = 0.03. The estimated median follow-up period was 31 months. The 5-years Event-Free Survival (EFS of patients with local disease was 64.6% in young women and 71.5% in older women with breast cancer (p = 0.04. Multivariate analysis in young women showed that nulliparity (HR: 7.2; 95%CI: 1.16-44.54; p = 0.03, T3 tumors (HR: 17.39; 95%CI: 1.74-173.34; p = 0.01 and negative PgR status (HR: 19.85; 95%CI: 1.07-366.54; p = 0.04 can be considered as risk factors for poorer event free survival while hormone therapy was associated with better EFS (HR: 0.11; 95%CI: 0.00-0.75; p = 0.03. In Group 2, multivariate analysis showed that patients with inflammatory breast cancer, N+ status, absence of radiotherapy, absence of chemotherapy, and absence of hormone therapy are at increased risk of recurrence.In Morocco, breast cancer is more frequent in young women as compared to western countries. Breast cancer in young women is more aggressive and is diagnosed late, leading to an intensive treatment. Moreover, the main factors

  11. Budget impact of vildagliptin

    Directory of Open Access Journals (Sweden)

    Orietta Zaniolo

    2008-09-01

    Full Text Available Introduction: to evaluate the impact on the Italian National Health Service (NHS budget of the recent introduction of the DPP-4 inhibitor vildagliptin in combination treatment for NIDDM patients. Methods: NIDDM patients eligible to vildagliptin treatment were identified and quantified based on approved indications and prevalence data review; adequate alternative strategies were identified; direct medical costs associated with competing strategies were calculated according to national practice and prices (drug acquisition, therapeutic monitoring, cost for managing severe adverse events – severe hypoglycemia events, fractures, new heart failure cases and the NHS budgetary impact was estimated according to market penetration assumptions (base-case: 5% and 10% for the first and second year, respectively. Results: patients estimated eligible for vildagliptin in Italy are about 237,500: pts inadequately controlled with metformin monotherapy (166,500, pts inadequately controlled with sulfonylurea monotherapy and intolerant/contraindicated to metformin (70,200, and those inadequately controlled with thiazolidinedione monotherapy (800. Costing and comparing of the vildagliptin-based and competing strategies revealed differences in both directions, depending on patient subgroup. Assuming uniform penetration among identified patient subgroups, vildagliptin introduction is expected to raise NHS costs by 2,750,000 Euro in the first and by 5,500,000 Euro in the second year, respectively representing 1,6% and 3,2% of the estimated total management cost of this patient population. Conclusions: the introduction of vildagliptin in the treatment of Italian NIDDM patients offers a new therapeutic option for three inadequately controlled NIDDM subpopulations; the financial impact on Italian NHS expenditures depends on patient selection and can be expected not to exceed 2-3% of the currently dedicated budget in the first two years.

  12. Operational budgeting using fuzzy goal programming

    Directory of Open Access Journals (Sweden)

    Saeed Mohammadi

    2013-10-01

    Full Text Available Having an efficient budget normally has different advantages such as measuring the performance of various organizations, setting appropriate targets and promoting managers based on their achievements. However, any budgeting planning requires prediction of different cost components. There are various methods for budgeting planning such as incremental budgeting, program budgeting, zero based budgeting and performance budgeting. In this paper, we present a fuzzy goal programming to estimate operational budget. The proposed model uses fuzzy triangular as well as interval number to estimate budgeting expenses. The proposed study of this paper is implemented for a real-world case study in province of Qom, Iran and the results are analyzed.

  13. Danish Translation and Linguistic Validation of the U.S. National Cancer Institute's Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)

    DEFF Research Database (Denmark)

    Bæksted, Christina; Nissen, Aase; Pappot, Helle

    2016-01-01

    CONTEXT: The Common Terminology Criteria for Adverse Events (CTCAE) is the basis for standardized clinician-based grading and reporting of adverse events in cancer clinical trials. The U.S. National Cancer Institute has developed the Patient-Reported Outcomes version of the CTCAE (PRO-CTCAE) to i......CONTEXT: The Common Terminology Criteria for Adverse Events (CTCAE) is the basis for standardized clinician-based grading and reporting of adverse events in cancer clinical trials. The U.S. National Cancer Institute has developed the Patient-Reported Outcomes version of the CTCAE (PRO...

  14. Negotiating Creativity on a Small Budget

    DEFF Research Database (Denmark)

    Andersen, Mads Møller

    2017-01-01

    This article presents findings from a production analysis of the Danish public-service television channel DR3’s fiction production Anton 90, which was made in cooperation with a small independent production company called New Creations. In the context of intensified competition on the Danish market...... for fiction series, the ambivalent cooperation behind this production exemplifies the low-budget efforts of a traditional public service institution to produce the fiction series that their younger target audience desires. The article uses a narrative-discursive approach to creativity and develops the term...

  15. Motivation in Beyond Budgeting: A Motivational Paradox?

    DEFF Research Database (Denmark)

    Sandalgaard, Niels; Bukh, Per Nikolaj

    In this paper we discuss the role of motivation in relation to budgeting and we analyse how the Beyond Budgeting model functions compared with traditional budgeting. In the paper we focus on budget related motivation (and motivation in general) and conclude that the Beyond Budgeting model...

  16. Implementing Site-based Budgeting.

    Science.gov (United States)

    Sielke, Catherine C.

    2001-01-01

    Discusses five questions that must be answered before implementing site-based budgeting: Why are we doing this? What budgeting decisions will be devolved to the school site? How do dollars flow from the central office to the site? Who will be involved at the site? How will accountability be achieved? (Author/PKP)

  17. The CEA budget in 1982

    International Nuclear Information System (INIS)

    Anon.

    1981-01-01

    In 1982, the amount of the CEA budget will be 13.4 billions French Francs. The main characteristics are the priority for employment and investments. In this budget programs are adapted to fit R and D to the government policy: innovation, industrial valorization and fundamental research especially thermonuclear fusion and in the electronuclear field to safety, reprocessing and radioactive waste management [fr

  18. Budgeting for Efficiency and Effectiveness

    Science.gov (United States)

    Pereus, Steven C.

    2012-01-01

    For most districts, budgeting has become a cost-cutting exercise designed to close the gap between revenues and expenses. During this process, decision makers inherently assume that existing operations are efficient and effective--an assumption that is rarely validated by facts. Cutting programs and services balances budgets but does not…

  19. Building information modeling in budgeting

    Directory of Open Access Journals (Sweden)

    Strnad, Michal

    2017-12-01

    Full Text Available Construction activity is one of the financially demanding and ever-changing locations of implementation. The basic idea of the budget is to determine all the possible costs that will arise during construction work. The budget must be a transparent and effective way of communication in the context of supplier-customer relationships. For this reason it is essential to give the budget the structure that is now represented by the price system. It is important to adhere to the principles of budgeting and technical standards. It is necessary to have good documentation for budgeting such as project documentation and much more. However, the construction product range is one of the most extensive, the product group can be changed several times in the investment phase not only materially but also cost-effectively because of the longest production cycle in the construction industry.

  20. FLEXIBLE BUDGET OF SPORT COMPETITIONS

    Directory of Open Access Journals (Sweden)

    Dragan Vukasović

    2009-11-01

    Full Text Available Manager of sport competition has right to decide and also to take responsibility for costs, income and financial results. From economic point of wiev flexible budget and planning cost calculations is top management base for analyzing success level of sport competition. Flexible budget is made before sport competition with few output level, where one is always from static plan-master plan. At the end of competition when we have results, we make report of plan executing and we also analyzing plan variances. Results of comparation between achieved and planning level of static budget can be acceptable if achieved level is approximate to budget level or if we analyzing results from gross or net income. Flexible budget become very important in case of world eco- nomic crises

  1. Knowledge, attitude and practice of screening for cervical cancer among female students of a tertiary institution in South Eastern Nigeria.

    Science.gov (United States)

    Akujobi, C N; Ikechebelu, J I; Onunkwo, I; Onyiaorah, I V

    2008-09-01

    Cervical cancer is the second commonest cancer of females worldwide and the commonest cancer of the female genital tract in our environment. It can be prevented through early detection by cervical screening (Pap smear). The objective of this study is to determine the knowledge, attitude and practice of cervical cancer screening among female undergraduates. A pre tested questionnaire was administered to third and fourth year female students of the Faculty of Natural Sciences, Nnamdi Azikiwe University Awka, Nigeria. Out of the 220 students involved in the study, 134 (60.9) had knowledge of cervical cancer and 118 (53.6%) were sexually active with the average age at sexual debut being 21.2 years. The mean age of the students was 23.8 years and the age range was 17 to 39 years with 175 (80%) in the age range of 20-29 years. About 2/3 of the students did not know about Pap smear and worse still, none of them had undergone a Pap screening test before. This low participation in screening for cervical cancer was attributed to several reasons including ignorance of the existence of such a test, lack of awareness of centers where such services are obtainable, ignorance of the importance of screening and the risk factors to the development of cervical cancer. There is good level of awareness of cervical cancer among the female undergraduates but poor knowledge and participation in cervical cancer screening. The development of a comprehensive cervical cancer screening strategy is being recommended to improve participation with a view to prevent cervical cancer by early detection and treatment of the pre-malignant stages.

  2. Global Carbon Budget 2016

    Science.gov (United States)

    Quéré, Corinne Le; Andrew, Robbie M.; Canadell, Josep G.; Sitch, Stephen; Korsbakken, Jan Ivar; Peters, Glen P.; Manning, Andrew C.; Boden, Thomas A.; Tans, Pieter P.; Houghton, Richard A.; hide

    2016-01-01

    Accurate assessment of anthropogenic carbon dioxide (CO2) emissions and their redistribution among the atmosphere, ocean, and terrestrial biosphere the global carbon budget is important to better understand the global carbon cycle, support the development of climate policies, and project future climate change. Here we describe data sets and methodology to quantify all major components of the global carbon budget, including their uncertainties, based on the combination of a range of data, algorithms, statistics, and model estimates and their interpretation by a broad scientific community. We discuss changes compared to previous estimates and consistency within and among components, alongside methodology and data limitations. CO2 emissions from fossil fuels and industry (EFF) are based on energy statistics and cement production data, respectively, while emissions from land-use change (ELUC), mainly deforestation, are based on combined evidence from land-cover change data, fire activity associated with deforestation, and models. The global atmospheric CO2 concentration is measured directly and its rate of growth (GATM) is computed from the annual changes in concentration. The mean ocean CO2 sink (SOCEAN) is based on observations from the 1990s, while the annual anomalies and trends are estimated with ocean models. The variability in SOCEAN is evaluated with data products based on surveys of ocean CO2 measurements. The global residual terrestrial CO2 sink (SLAND) is estimated by the difference of the other terms of the global carbon budget and compared to results of independent dynamic global vegetation models. We compare the mean land and ocean fluxes and their variability to estimates from three atmospheric inverse methods for three broad latitude bands. All uncertainties are reported as +/- 1(sigma), reflecting the current capacity to characterize the annual estimates of each component of the global carbon budget. For the last decade available (2006-2015), EFF was 9

  3. Global Carbon Budget 2016

    Science.gov (United States)

    Le Quéré, Corinne; Andrew, Robbie M.; Canadell, Josep G.; Sitch, Stephen; Korsbakken, Jan Ivar; Peters, Glen P.; Manning, Andrew C.; Boden, Thomas A.; Tans, Pieter P.; Houghton, Richard A.; Keeling, Ralph F.; Alin, Simone; Andrews, Oliver D.; Anthoni, Peter; Barbero, Leticia; Bopp, Laurent; Chevallier, Frédéric; Chini, Louise P.; Ciais, Philippe; Currie, Kim; Delire, Christine; Doney, Scott C.; Friedlingstein, Pierre; Gkritzalis, Thanos; Harris, Ian; Hauck, Judith; Haverd, Vanessa; Hoppema, Mario; Klein Goldewijk, Kees; Jain, Atul K.; Kato, Etsushi; Körtzinger, Arne; Landschützer, Peter; Lefèvre, Nathalie; Lenton, Andrew; Lienert, Sebastian; Lombardozzi, Danica; Melton, Joe R.; Metzl, Nicolas; Millero, Frank; Monteiro, Pedro M. S.; Munro, David R.; Nabel, Julia E. M. S.; Nakaoka, Shin-ichiro; O'Brien, Kevin; Olsen, Are; Omar, Abdirahman M.; Ono, Tsuneo; Pierrot, Denis; Poulter, Benjamin; Rödenbeck, Christian; Salisbury, Joe; Schuster, Ute; Schwinger, Jörg; Séférian, Roland; Skjelvan, Ingunn; Stocker, Benjamin D.; Sutton, Adrienne J.; Takahashi, Taro; Tian, Hanqin; Tilbrook, Bronte; van der Laan-Luijkx, Ingrid T.; van der Werf, Guido R.; Viovy, Nicolas; Walker, Anthony P.; Wiltshire, Andrew J.; Zaehle, Sönke

    2016-11-01

    Accurate assessment of anthropogenic carbon dioxide (CO2) emissions and their redistribution among the atmosphere, ocean, and terrestrial biosphere - the "global carbon budget" - is important to better understand the global carbon cycle, support the development of climate policies, and project future climate change. Here we describe data sets and methodology to quantify all major components of the global carbon budget, including their uncertainties, based on the combination of a range of data, algorithms, statistics, and model estimates and their interpretation by a broad scientific community. We discuss changes compared to previous estimates and consistency within and among components, alongside methodology and data limitations. CO2 emissions from fossil fuels and industry (EFF) are based on energy statistics and cement production data, respectively, while emissions from land-use change (ELUC), mainly deforestation, are based on combined evidence from land-cover change data, fire activity associated with deforestation, and models. The global atmospheric CO2 concentration is measured directly and its rate of growth (GATM) is computed from the annual changes in concentration. The mean ocean CO2 sink (SOCEAN) is based on observations from the 1990s, while the annual anomalies and trends are estimated with ocean models. The variability in SOCEAN is evaluated with data products based on surveys of ocean CO2 measurements. The global residual terrestrial CO2 sink (SLAND) is estimated by the difference of the other terms of the global carbon budget and compared to results of independent dynamic global vegetation models. We compare the mean land and ocean fluxes and their variability to estimates from three atmospheric inverse methods for three broad latitude bands. All uncertainties are reported as ±1σ, reflecting the current capacity to characterise the annual estimates of each component of the global carbon budget. For the last decade available (2006-2015), EFF was 9

  4. Innovative Management of Budget Deficits: A Proportional Salary and Time Reduction Scheme.

    Science.gov (United States)

    Sloper, David

    1989-01-01

    An approach to institutional budgeting designed to alleviate accumulated deficits is described. The proposal introduces flexibility into the salary component, alleviating cash flow difficulties in the short to medium term and encouraging more proactive budgeting, by allowing employees to contract for reduced annual salary in exchange for reduced…

  5. Zero-Based Budgeting: Application to Chicano Studies at a Community College.

    Science.gov (United States)

    Luna, Pete R.

    Enrollment trends and zero-based budgeting techniques are employed to justify continued support of Rio Hondo College's Mexican American Cultural Institute. After introductory material discussing the usefulness of zero-based budgeting in assuring fiscal accountability, the report identifies three Chicano Studies alternatives: an Associate of Arts…

  6. 20 CFR 435.25 - Revision of budget and program plans.

    Science.gov (United States)

    2010-04-01

    ... GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, OTHER NON-PROFIT ORGANIZATIONS, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Financial and Program Management § 435.25 Revision of budget and program plans. (a) The budget plan is the financial expression of the project or...

  7. 38 CFR 49.25 - Revision of budget and program plans.

    Science.gov (United States)

    2010-07-01

    ... (CONTINUED) UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 49.25 Revision of budget and program plans. (a) The budget plan is the financial expression of...

  8. 22 CFR 145.25 - Revision of budget and program plans.

    Science.gov (United States)

    2010-04-01

    ... Section 145.25 Foreign Relations DEPARTMENT OF STATE CIVIL RIGHTS GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 145.25 Revision of budget and program plans. (a) The budget plan is the...

  9. 28 CFR 70.25 - Revision of budget and program plans.

    Science.gov (United States)

    2010-07-01

    ... REQUIREMENTS FOR GRANTS AND AGREEMENTS (INCLUDING SUBAWARDS) WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 70.25 Revision of budget and program plans. (a) The budget plan is the financial expression of the project or...

  10. 22 CFR 518.25 - Revision of budget and program plans.

    Science.gov (United States)

    2010-04-01

    ... GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 518.25 Revision of budget and program plans. (a) The budget plan is the financial expression of the project or program as approved during the...

  11. 45 CFR 2543.25 - Revision of budget and program plans.

    Science.gov (United States)

    2010-10-01

    ... AND COMMUNITY SERVICE GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 2543.25 Revision of budget and program plans. (a) The budget plan is the financial expression of the project or...

  12. 40 CFR 30.25 - Revision of budget and program plans.

    Science.gov (United States)

    2010-07-01

    ... FEDERAL ASSISTANCE UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 30.25 Revision of budget and program plans. (a) The budget plan is the financial...

  13. 34 CFR 74.25 - Revision of budget and program plans.

    Science.gov (United States)

    2010-07-01

    ... WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Financial and Program Management § 74.25 Revision of budget and program plans. (a) The budget plan is the financial expression of the project or program as approved during the award process. It may...

  14. 45 CFR 74.25 - Revision of budget and program plans.

    Science.gov (United States)

    2010-10-01

    ... ADMINISTRATIVE REQUIREMENTS FOR AWARDS AND SUBAWARDS TO INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, OTHER NONPROFIT ORGANIZATIONS, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Financial and Program Management § 74.25 Revision of budget and program plans. (a) The budget plan is the financial expression of...

  15. 15 CFR 14.25 - Revision of budget and program plans.

    Science.gov (United States)

    2010-01-01

    ... ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, OTHER NON-PROFIT, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Financial and Program Management § 14.25 Revision of budget and program plans. (a) The budget plan is the financial expression of the project or...

  16. Costing and Budgeting for Preservation and Conservation in the ...

    African Journals Online (AJOL)

    Within the Eastern and Southern Africa Regional Branch of the International Council on Archives (ESARBICA) region, little or no information is available on budgeting systems for archival institutions in the region to enhance preservation and conservation programs. Preservation and conservation requires both economic ...

  17. Computing energy budget within a crop canopy from Penmann's ...

    Indian Academy of Sciences (India)

    R. Narasimhan, Krishtel eMaging Solutions

    Computing energy budget within a crop canopy from. Penmann's formulae. Mahendra Mohan∗ and K K Srivastava∗∗. ∗Radio and Atmospheric Science Division, National Physical Laboratory, New Delhi 110012, India. ∗∗Department of Chemical Engineering, Institute of Technology, Banaras Hindu University, Varanasi.

  18. Global Carbon Budget 2015

    Science.gov (United States)

    Le Quéré, C.; Moriarty, R.; Andrew, R. M.; Canadell, J. G.; Sitch, S.; Korsbakken, J. I.; Friedlingstein, P.; Peters, G. P.; Andres, R. J.; Boden, T. A.; Houghton, R. A.; House, J. I.; Keeling, R. F.; Tans, P.; Arneth, A.; Bakker, D. C. E.; Barbero, L.; Bopp, L.; Chang, J.; Chevallier, F.; Chini, L. P.; Ciais, P.; Fader, M.; Feely, R. A.; Gkritzalis, T.; Harris, I.; Hauck, J.; Ilyina, T.; Jain, A. K.; Kato, E.; Kitidis, V.; Klein Goldewijk, K.; Koven, C.; Landschützer, P.; Lauvset, S. K.; Lefèvre, N.; Lenton, A.; Lima, I. D.; Metzl, N.; Millero, F.; Munro, D. R.; Murata, A.; Nabel, J. E. M. S.; Nakaoka, S.; Nojiri, Y.; O'Brien, K.; Olsen, A.; Ono, T.; Pérez, F. F.; Pfeil, B.; Pierrot, D.; Poulter, B.; Rehder, G.; Rödenbeck, C.; Saito, S.; Schuster, U.; Schwinger, J.; Séférian, R.; Steinhoff, T.; Stocker, B. D.; Sutton, A. J.; Takahashi, T.; Tilbrook, B.; van der Laan-Luijkx, I. T.; van der Werf, G. R.; van Heuven, S.; Vandemark, D.; Viovy, N.; Wiltshire, A.; Zaehle, S.; Zeng, N.

    2015-12-01

    Accurate assessment of anthropogenic carbon dioxide (CO2) emissions and their redistribution among the atmosphere, ocean, and terrestrial biosphere is important to better understand the global carbon cycle, support the development of climate policies, and project future climate change. Here we describe data sets and a methodology to quantify all major components of the global carbon budget, including their uncertainties, based on the combination of a range of data, algorithms, statistics, and model estimates and their interpretation by a broad scientific community. We discuss changes compared to previous estimates as well as consistency within and among components, alongside methodology and data limitations. CO2 emissions from fossil fuels and industry (EFF) are based on energy statistics and cement production data, while emissions from land-use change (ELUC), mainly deforestation, are based on combined evidence from land-cover-change data, fire activity associated with deforestation, and models. The global atmospheric CO2 concentration is measured directly and its rate of growth (GATM) is computed from the annual changes in concentration. The mean ocean CO2 sink (SOCEAN) is based on observations from the 1990s, while the annual anomalies and trends are estimated with ocean models. The variability in SOCEAN is evaluated with data products based on surveys of ocean CO2 measurements. The global residual terrestrial CO2 sink (SLAND) is estimated by the difference of the other terms of the global carbon budget and compared to results of independent dynamic global vegetation models forced by observed climate, CO2, and land-cover change (some including nitrogen-carbon interactions). We compare the mean land and ocean fluxes and their variability to estimates from three atmospheric inverse methods for three broad latitude bands. All uncertainties are reported as ±1σ, reflecting the current capacity to characterise the annual estimates of each component of the global

  19. Breast cancer screening in an era of personalized regimens: a conceptual model and National Cancer Institute initiative for risk-based and preference-based approaches at a population level.

    Science.gov (United States)

    Onega, Tracy; Beaber, Elisabeth F; Sprague, Brian L; Barlow, William E; Haas, Jennifer S; Tosteson, Anna N A; D Schnall, Mitchell; Armstrong, Katrina; Schapira, Marilyn M; Geller, Berta; Weaver, Donald L; Conant, Emily F

    2014-10-01

    Breast cancer screening holds a prominent place in public health, health care delivery, policy, and women's health care decisions. Several factors are driving shifts in how population-based breast cancer screening is approached, including advanced imaging technologies, health system performance measures, health care reform, concern for "overdiagnosis," and improved understanding of risk. Maximizing benefits while minimizing the harms of screening requires moving from a "1-size-fits-all" guideline paradigm to more personalized strategies. A refined conceptual model for breast cancer screening is needed to align women's risks and preferences with screening regimens. A conceptual model of personalized breast cancer screening is presented herein that emphasizes key domains and transitions throughout the screening process, as well as multilevel perspectives. The key domains of screening awareness, detection, diagnosis, and treatment and survivorship are conceptualized to function at the level of the patient, provider, facility, health care system, and population/policy arena. Personalized breast cancer screening can be assessed across these domains with both process and outcome measures. Identifying, evaluating, and monitoring process measures in screening is a focus of a National Cancer Institute initiative entitled PROSPR (Population-based Research Optimizing Screening through Personalized Regimens), which will provide generalizable evidence for a risk-based model of breast cancer screening, The model presented builds on prior breast cancer screening models and may serve to identify new measures to optimize benefits-to-harms tradeoffs in population-based screening, which is a timely goal in the era of health care reform. © 2014 American Cancer Society.

  20. Large institutional variations in use of androgen deprivation therapy with definitive radiotherapy in a population-based cohort of men with intermediate- and high-risk prostate cancer.

    Science.gov (United States)

    Ong, Wee Loon; Foroudi, Farshad; Evans, Sue; Millar, Jeremy

    2017-11-01

    To evaluate the pattern of use of androgen deprivation therapy (ADT) with definitive radiotherapy (RT) in men with prostate cancer (PCa) in a population-based study in Australia. This is a prospective cohort of men with intermediate- and high-risk PCa, captured in the population-based Prostate Cancer Outcome Registry Victoria, who were treated with definitive prostate RT between January 2010 and December 2015. The primary outcome of interest was ADT utilization. Chi-squared test for trend was used to evaluate the temporal trend in the use of ADT over the study period. Multivariate logistic regressions were used to evaluate the effects of patient-, tumour- and treatment-related factors, and treatment institutions (public/ private and metropolitan/ regional) on the likelihood of ADT utilization. A total of 1806 men were included in the study, 199 of whom (11%) had favourable National Comprehensive Cancer Network (NCCN) intermediate-risk disease (i.e. only one intermediate-risk feature, primary Gleason grade 3, and variation in the use of ADT between public vs private and metropolitan vs regional institutions. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

  1. Peer Mentoring at the Uganda Cancer Institute: A Novel Model for Career Development of Clinician-Scientists in Resource-Limited Settings

    Directory of Open Access Journals (Sweden)

    Warren Phipps

    2018-03-01

    Full Text Available Cancer centers are beginning to emerge in low- and middle-income countries despite having relatively few oncologists and specialists in related fields. Uganda, like many countries in sub-Saharan Africa, has a cadre of highly motivated clinician-scientists-in-training who are committed to developing the capacity for cancer care and research. However, potential local mentors for these trainees are burdened with uniquely high demands on their time for clinical care, teaching, institutional development, advocacy, and research. Facilitated peer mentoring helps to fill skills and confidence gaps and teaches mentoring skills so that trainees can learn to support one another and regularly access a more senior facilitator/role model. With an added consultant component, programs can engage limited senior faculty time to address specific training needs and to introduce junior investigators to advisors and even potential dyadic mentors. Two years after its inception, our facilitated peer mentoring career development program at the Uganda Cancer Institute in Kampala is successfully developing a new generation of researchers who, in turn, are now providing role models and mentors from within their group. This program provides a practical model for building the next generation of clinical scientists in developing countries.

  2. Programme budget 1980

    International Nuclear Information System (INIS)

    1979-10-01

    The fields of research done in the Hahn-Meitner institute are described. These concern heavy ion physics, radiation and photochemistry, solid state physics, radiochemistry, data processing and nuclear electronics. In addition some facts concerning the infrastructure and financial planning are presented. (HSI)

  3. [Architecture, budget and dignity].

    Science.gov (United States)

    Morel, Etienne

    2012-01-01

    Drawing on its dynamic strengths, a psychiatric unit develops various projects and care techniques. In this framework, the institute director must make a number of choices with regard to architecture. Why renovate the psychiatry building? What financial investments are required? What criteria should be followed? What if the major argument was based on the respect of the patient's dignity?

  4. Program budget 1976

    International Nuclear Information System (INIS)

    1976-01-01

    The tasks, the targets, the present situation of the Hahn-Meitner-Institut, and the main fields of research, in particular nuclear and atom physics, radiation chemistry, solid-state physics, nuclear chemistry, fusion reactor technology, data processing and electronics, are dealt with. The document contains also additional data on infrastructure, budgetary accounting and organization. (orig./LN) [de

  5. Internal budget control

    Directory of Open Access Journals (Sweden)

    MSc. Mervete Shala

    2011-06-01

    Generally, duties of internal control officers within ministries and institutions must be clearly divided to reduce the risk of inco-rrect behaviour. Operations of an efficient control mechanism influence and ensure conditions for rule of law, good governance, and democracy.

  6. Summary and Recommendations from the National Cancer Institute's Clinical Trials Planning Meeting on Novel Therapeutics for Non-Muscle Invasive Bladder Cancer

    NARCIS (Netherlands)

    Lerner, S.P.; Bajorin, D.F.; Dinney, C.P.; Efstathiou, J.A.; Groshen, S.; Hahn, N.M.; Hansel, D.; Kwiatkowski, D.; O'Donnell, M.; Rosenberg, J.; Svatek, R.; Abrams, J.S.; Al-Ahmadie, H.; Apolo, A.B.; Bellmunt, J.; Callahan, M.; Cha, E.K.; Drake, C.; Jarow, J.; Kamat, A.; Kim, W.; Knowles, M.; Mann, B.; Marchionni, L.; McConkey, D.; McShane, L.; Ramirez, N.; Sharabi, A.; Sharpe, A.H.; Solit, D.; Tangen, C.M.; Amiri, A.T.; Allen, E. Van; West, P.J.; Witjes, J.A.; Quale, D.Z.

    2016-01-01

    The NCI Bladder Cancer Task Force convened a Clinical Trials Planning Meeting (CTPM) Workshop focused on Novel Therapeutics for Non-Muscle Invasive Bladder Cancer (NMIBC). Meeting attendees included a broad and multi-disciplinary group of clinical and research stakeholders and included leaders from

  7. Budgeting in an imaging Department

    International Nuclear Information System (INIS)

    Nyalla, A. M.

    2006-01-01

    budgeting form an integral part of an imaging department. It is a plan to cope with necessary expenses in the future. It involves identifying the needs and income sources required to cover the needs.Covers specific items and time-usually a year and is expressed in monetary terms. The micro budget is put in the macro budget of the hospital. defines financial support for the department. Considers: a fiscal year, projection of patients, types of examinations, type of equipment, monetary exchange, and inflation rate

  8. Impact of tertiary Gleason pattern 5 on prostate cancer aggressiveness: Lessons from a contemporary single institution radical prostatectomy series

    Directory of Open Access Journals (Sweden)

    Zachary B. Koloff

    2015-01-01

    Conclusion: Our results emphasize the importance of TP5 and suggest that criteria for tertiary pattern reporting in prostate cancer should be standardized. Further studies are needed to evaluate the role of tertiary patterns in prognostic models.

  9. Concordance with World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) guidelines for cancer prevention and obesity-related cancer risk in the Framingham Offspring cohort (1991-2008).

    Science.gov (United States)

    Makarem, Nour; Lin, Yong; Bandera, Elisa V; Jacques, Paul F; Parekh, Niyati

    2015-02-01

    This prospective cohort study evaluates associations between healthful behaviors consistent with WCRF/AICR cancer prevention guidelines and obesity-related cancer risk, as a third of cancers are estimated to be preventable. The study sample consisted of adults from the Framingham Offspring cohort (n = 2,983). From 1991 to 2008, 480 incident doctor-diagnosed obesity-related cancers were identified. Data on diet, measured by a food frequency questionnaire, anthropometric measures, and self-reported physical activity, collected in 1991 was used to construct a 7-component score based on recommendations for body fatness, physical activity, foods that promote weight gain, plant foods, animal foods, alcohol, and food preservation, processing, and preparation. Multivariable Cox regression models were used to estimate associations between the computed score, its components, and subcomponents in relation to obesity-related cancer risk. The overall score was not associated with obesity-related cancer risk after adjusting for age, sex, smoking, energy, and preexisting conditions (HR 0.94, 95 % CI 0.86-1.02). When score components were evaluated separately, for every unit increment in the alcohol score, there was 29 % lower risk of obesity-related cancers (HR 0.71, 95 % CI 0.51-0.99) and 49-71 % reduced risk of breast, prostate, and colorectal cancers. Every unit increment in the subcomponent score for non-starchy plant foods (fruits, vegetables, and legumes) among participants who consume starchy vegetables was associated with 66 % reduced risk of colorectal cancer (HR 0.44, 95 % CI 0.22-0.88). Lower alcohol consumption and a plant-based diet consistent with the cancer prevention guidelines were associated with reduced risk of obesity-related cancers in this population.

  10. Higher complication risk of totally implantable venous access port systems in patients with advanced cancer - a single institution retrospective analysis.

    Science.gov (United States)

    Chang, Yi-Fang; Lo, An-Chi; Tsai, Chung-Hsin; Lee, Pei-Yi; Sun, Shen; Chang, Te-Hsin; Chen, Chien-Chuan; Chang, Yuan-Shin; Chen, Jen-Ruei

    2013-02-01

    Totally implantable port systems are generally recommended for prolonged central venous access in diverse settings, but their risk of complications remains unclear for patients with advanced cancer. The aim of this study was to assess the risk of port system failure in patients with advanced cancer. We conducted a retrospective cohort study in a comprehensive cancer centre. A detailed chart review was conducted among 566 patients with 573 ports inserted during January-June, 2009 (average 345.3 catheter-days). Cox regression analysis was applied to evaluate factors during insertion and early maintenance that could lead to premature removal of the port systems due to infection or occlusion. Port system-related infection was significantly associated with receiving palliative care immediately after implantation (hazard ratio, HR = 7.3, 95% confidence interval, 95% CI = 1.2-46.0), after adjusting for probable confounders. Primary cancer site also impacted the occurrence of device-related infection. Receiving oncologic/palliative care (HR = 3.0, P = 0.064), advanced cancer stage (HR = 6.5, P = 0.077) and body surface area above 1.71 m(2) (HR = 3.4, P = 0.029) increased the risk of port system occlusion. Our study indicates that totally implantable port systems yield a higher risk of complications in terminally ill patients. Further investigation should be carefully conducted to compare outcomes of various central venous access devices in patients with advanced cancer and to develop preventive strategies against catheter failure.

  11. [The survival prediction model of advanced gallbladder cancer based on Bayesian network: a multi-institutional study].

    Science.gov (United States)

    Tang, Z H; Geng, Z M; Chen, C; Si, S B; Cai, Z Q; Song, T Q; Gong, P; Jiang, L; Qiu, Y H; He, Y; Zhai, W L; Li, S P; Zhang, Y C; Yang, Y

    2018-05-01

    Objective: To investigate the clinical value of Bayesian network in predicting survival of patients with advanced gallbladder cancer(GBC)who underwent curative intent surgery. Methods: The clinical data of patients with advanced GBC who underwent curative intent surgery in 9 institutions from January 2010 to December 2015 were analyzed retrospectively.A median survival time model based on a tree augmented naïve Bayes algorithm was established by Bayesia Lab software.The survival time, number of metastatic lymph nodes(NMLN), T stage, pathological grade, margin, jaundice, liver invasion, age, sex and tumor morphology were included in this model.Confusion matrix, the receiver operating characteristic curve and area under the curve were used to evaluate the accuracy of the model.A priori statistical analysis of these 10 variables and a posterior analysis(survival time as the target variable, the remaining factors as the attribute variables)was performed.The importance rankings of each variable was calculated with the polymorphic Birnbaum importance calculation based on the posterior analysis results.The survival probability forecast table was constructed based on the top 4 prognosis factors. The survival curve was drawn by the Kaplan-Meier method, and differences in survival curves were compared using the Log-rank test. Results: A total of 316 patients were enrolled, including 109 males and 207 females.The ratio of male to female was 1.0∶1.9, the age was (62.0±10.8)years.There was 298 cases(94.3%) R0 resection and 18 cases(5.7%) R1 resection.T staging: 287 cases(90.8%) T3 and 29 cases(9.2%) T4.The median survival time(MST) was 23.77 months, and the 1, 3, 5-year survival rates were 67.4%, 40.8%, 32.0%, respectively.For the Bayesian model, the number of correctly predicted cases was 121(≤23.77 months) and 115(>23.77 months) respectively, leading to a 74.86% accuracy of this model.The prior probability of survival time was 0.503 2(≤23.77 months) and 0.496 8

  12. Gastrointestinal Stromal Tumors (GIST) of the Stomach: Retrospective Experience with Surgical Resection at the National Cancer Institute

    International Nuclear Information System (INIS)

    NAGUIB, Sh.F.; ZAGHLOUL, A.S.; El MARAKBY, H.

    2008-01-01

    Gastric Gist's account for more than half of all gastrointestinal stromal tumors and represent less than 5% of all gastric tumors. The peak age for harboring Gist of the stomach is around 60 years and a slight male preponderance is reported. These tumors are identified by expression of CD117 or CD34 antigen. Symptoms at presentation usually include bleeding, ab¬dominal pain or abdominal mass. Endoscopically, they typically appear as a submucosal mass with or without ulceration and on CT scans an extra gastric mass is usually seen. Complete surgical resection provides the only chance for cure, with only l-2 cm free margins needed. However, local recurrence and/or metastases supervene in almost half the patients treated with surgery alone, even when no gross residual is left. Thereby imatinib mesylate was advocated as an adjuvant to surgery, which appears to have improved disease-free and overall survival. Aim of the Work: The aim of this work was to assess clinico-pathological features of gastrointestinal stromal tumors (GIST) of the stomach and to appraise the results of treatment by surgery in patients treated at the National Cancer Institute (NCI) of Cairo between January 2002 and December 2007. Patients and Methods: Nineteen patients with histologically and immuno-histochemically proven GIST of the stomach were treated by surgery at the NCI during the 6-year study period. Preoperative assessment included detailed history, clinical examination, full laboratory tests, endoscopy, abdominal ultrasound and CT. General medical assessment included chest X-ray, ECG and echocardiography. Results: The patients' age ranged from 26 to 77 years with a median of 51 years. Obvious male/female preponderance was noticed (68.4% to 31.6%). Tumors were located at the upper 1/3 in 42.1%, at the middle 1/3 in 31.6% and at the lower 1/3 in 26.3%. The most common clinical presentation was related to bleeding (hematemesis, melena or anaemia) and was seen in 63.2%. No tumors were

  13. The National Institute for Health and Clinical Excellence (NICE) guidelines for early detection of ovarian cancer: the pivotal role of the clinical laboratory.

    Science.gov (United States)

    Sturgeon, Catharine M; Duffy, Michael J; Walker, Graeme

    2011-07-01

    The National Institute for Health and Clinical Excellence (NICE) has recently reviewed optimal means of early recognition and initial management of ovarian cancer, the leading cause of gynaecological death in the UK. The NICE guidelines state that general practitioners should measure serum CA125 in women presenting with persistent and continuous symptoms suggestive of ovarian cancer (e.g. abdominal distension, early satiety and loss of appetite or pelvic pain). If CA125 is ≥35 kU/L, the general practitioner should arrange an ultrasound scan of the abdomen and pelvis to enable calculation of the risk of malignancy score (RMI). Women with an RMI score of ≥250 should then be referred to a specialist multidisciplinary team. Successful implementation of these guidelines requires close liaison between primary care and laboratory medicine to ensure that CA125 is requested as a diagnostic aid only for women meeting the criteria stated in the guidelines. Preanalytical criteria must also be met and it is essential that both requestors and patients be aware of other possible causes of increases in CA125, as well as the fact that it is not raised in all patients with ovarian cancer. Guidance is being prepared to enable appropriate interpretation and implementation of the NICE guidelines. Continuous audit of the outcomes will also be essential to determine the effectiveness of this approach to early detection of ovarian cancer.

  14. Internal budget control

    OpenAIRE

    MSc. Mervete Shala

    2011-01-01

    Internal control is established by the Government to ensure effective and proper operations of ministries, institutions and generally of all public agencies, in compliance with the law, the goals and objectives stated by them, to provide protection against abuse and mismanagement or poor governance. The instrument of internal audit entails a series of mechanisms which aim at enabling budgetary policies compliance, such as: financial reporting; effective system of communication between mana...

  15. GEWEX Surface Radiation Budget (SRB)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The NASA/GEWEX Surface Radiation Budget (SRB) Release-3.0 data sets contains global 3-hourly, daily, monthly/3-hourly, and monthly averages of surface and top-of...

  16. US science spared budget axe

    Science.gov (United States)

    Gwynne, Peter

    2017-06-01

    Despite initial fears of significant funding cuts, America’s 2017 budget largely maintains support for research. But as Peter Gwynne reports, the relief may only be temporary and funding for science may be slashed next year instead

  17. Congress smiles on research budgets

    CERN Multimedia

    Reichhardt, T

    1998-01-01

    Congress has agreed to match or exceed most of the funding requests for the major science agencies requested by President Clinton in February. Many of them will receive their largest budget increases for years (11 paragraphs).

  18. Health care prices, the federal budget, and economic growth.

    Science.gov (United States)

    Monaco, R M; Phelps, J H

    1995-01-01

    Rising health care spending, led by rising prices, has had an enormous impact on the economy, especially on the federal budget. Our work shows that if rapid growth in health care prices continues, under current institutional arrangements, real economic growth and employment will be lower during the next two decades than if health price inflation were somehow reduced. How big the losses are and which sectors bear the brunt of the costs vary depending on how society chooses to fund the federal budget deficit that stems from the rising cost of federal health care programs.

  19. Efficiency of flexible budgetary institutions

    Czech Academy of Sciences Publication Activity Database

    Bowen, R. T.; Chen, Y.; Eraslan, H.; Zápal, Jan

    2017-01-01

    Roč. 167, January (2017), s. 148-176 ISSN 0022-0531 Institutional support: RVO:67985998 Keywords : budget negotiations * mandatory spending * discretionary spending Subject RIV: AH - Economic s OBOR OECD: Economic Theory Impact factor: 1.147, year: 2016

  20. Efficiency of flexible budgetary institutions

    Czech Academy of Sciences Publication Activity Database

    Bowen, R. T.; Chen, Y.; Eraslan, H.; Zápal, Jan

    2017-01-01

    Roč. 167, January (2017), s. 148-176 ISSN 0022-0531 Institutional support: Progres-Q24 Keywords : budget negotiations * mandatory spending * discretionary spending Subject RIV: AH - Economic s OBOR OECD: Economic Theory Impact factor: 1.147, year: 2016

  1. GH replacement therapy and second neoplasms in adult survivors of childhood cancer: a retrospective study from a single institution.

    Science.gov (United States)

    Brignardello, E; Felicetti, F; Castiglione, A; Fortunati, N; Matarazzo, P; Biasin, E; Sacerdote, C; Ricardi, U; Fagioli, F; Corrias, A; Arvat, E

    2015-02-01

    Growth hormone deficiency (GHD) is the most common endocrine late effect observed in childhood cancer survivors (CCS) previously submitted to cranial irradiation. Radiation therapy can also increase the risk of second neoplasms (SNs). Since in previous studies GH replacement therapy was associated with increased incidence of neoplasia, we explored the association between SNs and GH replacement therapy in a cohort of CCS with GHD. Within the clinical cohort of CCS referred to the Transition Unit for Childhood Cancer Survivors of Turin between November 2001 and December 2012, we considered all patients who developed GHD as a consequence of cancer therapies. GHD was always diagnosed in childhood. To evaluate the quality of data, our cohort was linked to the Childhood Cancer Registry of Piedmont. GHD was diagnosed in 49 out of 310 CCS included in our clinical cohort. At least one SN was diagnosed in 14 patients, meningioma and basal cell carcinoma being the most common SNs. The cumulative incidence of SNs was similar in GH-treated and -untreated patients (8 SNs out of 26 GH-treated and 6 out of 23 GH-untreated patients; p = 0.331). Age, sex and paediatric cancer type had no impact on SNs development. In our CCS, GH replacement therapy does not seem to increase the risk of SNs. Anyway, independently from replacement therapy, in these patients we observed an elevated risk of SNs, possibly related to previous radiation therapy, which suggests the need of a close long-term follow-up.

  2. Generic Advertising Optimum Budget for Iran’s Milk Industry

    Directory of Open Access Journals (Sweden)

    H. Shahbazi

    2016-05-01

    Full Text Available Introduction One of the main targets of planners, decision makers and governments is increasing society health with promotion and production of suitable and healthy food. One of the basic commodities that have important role in satisfaction of required human food is milk. So, some part of government and producer healthy budget allocate to milk consumption promotion by using generic advertising. If effectiveness of advertising budget on profitability is more, producer will have more willing to spend for advertising. Determination of optimal generic advertising budget is one of important problem in managerial decision making in producing firm as well as increase in consumption and profit and decrease in wasting and non-optimality of budget. Materials and Methods: In this study, optimal generic advertising budget intensity index (advertising budget share of production cost was estimated under two different scenarios by using equilibrium replacement model. In equilibrium replacement model, producer surplus are maximized in respect to generic advertising in retail level. According to market where two levels of farm and processing before retail exist and there is trade in farm and retail level, we present different models. Fixed and variable proportion hypothesis is another one. Finally, eight relations are presented for determination of milk generic advertising optimum budget. So, we use data from several resources such as previous studies, national (Iran Static center and international institute (Fao formal data and own estimation. Because there are several estimations in previous studies, we identify some scenarios (in two general scenarios for calculation of milk generic advertising optimum budget. Results and Discussion: Estimation of milk generic advertising optimum budget in scenario 1 shows that in case of one market level, fixed supplies and no trade, optimum budget is 0.4672539 percent. In case of one market level and no trade, optimum

  3. National Institutes of Health State-of-the-Science Conference Statement: Symptom management in cancer: pain, depression, and fatigue, July 15-17, 2002.

    Science.gov (United States)

    Patrick, Daniel L; Ferketich, Sandra L; Frame, Paul S; Harris, Jesse J; Hendricks, Carolyn B; Levin, Bernard; Link, Michael P; Lustig, Craig; McLaughlin, Joseph; Reid, L Douglas; Turrisi, Andrew T; Unützer, Jürgen; Vernon, Sally W

    2004-01-01

    Despite advances in early detection and effective treatment, cancer remains one of the most feared diseases. Among the most common side effects of cancer and treatments for cancer are pain, depression, and fatigue. Although research is producing increasingly hopeful insights into the causes and cures for cancer, efforts to manage the side effects of the disease and its treatments have not kept pace. The challenge that faces us is how to increase awareness of the importance of recognizing and actively addressing cancer-related distress. The National Institutes of Health (NIH) convened a State-of-the-Science Conference on Symptom Management in Cancer: Pain, Depression, and Fatigue to examine the current state of knowledge regarding the management of pain, depression, and fatigue in individuals with cancer and to identify directions for future research. Specifically, the conference examined how to identify individuals who are at risk for cancer-related pain, depression, and/or fatigue; what treatments work best to address these symptoms when they occur; and what is the best way to deliver interventions across the continuum of care. STATE-OF-THE-SCIENCE PROCESS: A non-advocate, non-Federal, 14-member panel of experts representing the fields of oncology, radiology, psychology, nursing, public health, social work, and epidemiology prepared the statement. In addition, 24 experts in medical oncology, geriatrics, pharmacology, psychology, and neurology presented data to the panel and to the conference audience during the first 1.5 days of the conference. The panel then prepared its statement, addressing the five predetermined questions and drawing on submitted literature, the speakers' presentations, and discussions held at the conference. The statement was presented to the conference audience, followed by a press conference to allow the panel to respond to questions from the media. After its release at the conference, the draft statement was made available on the Internet

  4. Can budget institutions counteract political indiscipline? / Stefania Fabrizio, Ashoka Mody

    Index Scriptorium Estoniae

    Fabrizio, Stefania

    2006-01-01

    Artiklis analüüsitakse finantsinstitutsioonide ning valitsuse poliitika mõju riigi eelarvepoliitikale ja finantskäitumisele EL uute liikmesriikide näitel aastatel 1997-2003. Tabelid, diagrammid, lisad. Artikli autoritega diskuteerivad Giancarlo Corsetti, Jonathan R.W. Temple

  5. TTI Phase 2 Institutional Support: Centre for Budget and ...

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

    ... as a leading think tank that provides research and evidence on public policy and governance issues ... sectors, agriculture and food security, vulnerability, fiscal decentralization, and taxation. ... New Cyber Policy Centres for the Global South.

  6. Survival in women with ovarian cancer before and after the introduction of adjuvant paclitaxel; a 25-year, single institution review.

    LENUS (Irish Health Repository)

    Shireen, R

    2012-02-01

    Adjuvant chemotherapy regime for ovarian cancer patients remains to be a contentious issue. The aim of this study was to compare the overall and progression-free survival of women with ovarian cancer before and after introduction of paclitaxel in our unit in 1992. A sample of 112 women who received adjuvant therapy following surgery for ovarian cancer was collected, 68 (61%) received platinum+alkylating agent before 1992 and later 44 (39%) received platinum+paclitaxel. Five-year survival was same in both treatment groups when there was no macroscopic disease after surgery (78% versus 70%) and when residual disease was <2 cm (50% versus 40%). Survival was greater in women with residual disease >2 cm in the platinum+paclitaxel group (50% versus 24%), (p = 0.04). However, progression-free survival was similar in both groups irrespective of stage or residual volume of disease. Therefore consideration to selective use of paclitaxel could reduce patient morbidity and costs significantly.

  7. proposition de budget

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

    Miller, Gustavo -SIA

    à-d. du personnel existant) dans le context de la création de compétences en recherche. En règle générale, le CRDI ne verse pas de suppléments salariaux aux employés à plein temps, c.-à-d. d'honoraires qui s'ajouteraient à leur salaire régulier, ni de salaires plus élevés que ceux que l'institution paierait normalement.

  8. Cancer Institute of New Jersey: University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey. Environmental Assessment

    Energy Technology Data Exchange (ETDEWEB)

    1994-06-01

    The Department of Energy (DOE) proposes to authorize the University of Medicine and Dentistry of New Jersey to proceed with the design, construction, and equipping of the proposed Clinical Treatment and Research Facility of the University of New Jersey on the New Brunswick campus. The facility will provide for the integration of new and existing clinical outpatient cancer treatment with basic and clinical research to expedite the application of new discoveries in cancer treatment. Based on the analysis in the environmental assessment, DOE has determined that the proposed action is not a major Federal action significantly affecting the quality of the human environment within the meaning of the National Environmental Policy Act (NEPA).

  9. Cycle-Based Budgeting Toolkit: A Primer

    Science.gov (United States)

    Yan, Bo

    2016-01-01

    At the core, budgeting is about distributing and redistributing limited financial resources for continuous improvement. Incremental budgeting is limited in achieving the goal due to lack of connection between outcomes and budget decisions. Zero-based budgeting fills the gap, but is cumbersome to implement, especially for large urban school…

  10. 42 CFR 457.140 - Budget.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Budget. 457.140 Section 457.140 Public Health... Child Health Insurance Programs and Outreach Strategies § 457.140 Budget. The State plan, or plan amendment that has a significant impact on the approved budget, must include a budget that describes the...

  11. Under Secretary of Defense (Comptroller) > Budget

    Science.gov (United States)

    functionalStatements OUSD(C) History FMR Budget Materials Budget Execution Financial Management Improving Financial Performance Reports Regulations Press Release | Budget Briefing | Transcripts: David L. Norquist, Under PDF document. Click on Excel icon for Excel document Overview - FY2019 Defense Budget Performance

  12. 24 CFR 968.225 - Budget revisions.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Budget revisions. 968.225 Section... Fewer Than 250 Units) § 968.225 Budget revisions. (a) A PHA shall not incur any modernization cost in excess of the total HUD-approved CIAP budget. A PHA shall submit a budget revision, in a form prescribed...

  13. 7 CFR 1744.64 - Budget adjustment.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 11 2010-01-01 2010-01-01 false Budget adjustment. 1744.64 Section 1744.64... Disbursement of Funds § 1744.64 Budget adjustment. (a) If more funds are required than are available in a budget account, the borrower may request RUS's approval of a budget adjustment to use funds from another...

  14. The prevalence of Beyond Budgeting in Denmark

    DEFF Research Database (Denmark)

    Sandalgaard, Niels

      The annual budget has been criticised in recent years. The critics claim, among other things, that the annual budget is not suitable for today's business environment, that annual budgets stimulate dysfunctional behaviour and furthermore that the use of budgets is too costly. This paper examines...... this critique as well as the current status of the traditional annual budget in a contingency perspective by using data from a survey among the largest Danish companies. The conclusion is that only 4% of the companies claim to have abandoned the traditional, annual budget, 2% have decided or are in the process...... of doing so and 11% are considering abandoning it. These "Beyond Budgeting" companies are more critical towards the traditional budget than other companies. The study also shows that the critical attitude towards annual budgets as well as the decision of abandoning the budget cannot be associated...

  15. Progression-free Survival Following Stereotactic Body Radiotherapy for Oligometastatic Prostate Cancer Treatment-naive Recurrence: A Multi-institutional Analysis.

    Science.gov (United States)

    Ost, Piet; Jereczek-Fossa, Barbara Alicja; As, Nicholas Van; Zilli, Thomas; Muacevic, Alexander; Olivier, Kenneth; Henderson, Daniel; Casamassima, Franco; Orecchia, Roberto; Surgo, Alessia; Brown, Lindsay; Tree, Alison; Miralbell, Raymond; De Meerleer, Gert

    2016-01-01

    The literature on metastasis-directed therapy for oligometastatic prostate cancer (PCa) recurrence consists of small heterogeneous studies. This study aimed to reduce the heterogeneity by pooling individual patient data from different institutions treating oligometastatic PCa recurrence with stereotactic body radiotherapy (SBRT). We focussed on patients who were treatment naive, with the aim of determining if SBRT could delay disease progression. We included patients with three or fewer metastases. The Kaplan-Meier method was used to estimate distant progression-free survival (DPFS) and local progression-free survival (LPFS). Toxicity was scored using the Common Terminology Criteria for Adverse Events. In total, 163 metastases were treated in 119 patients. The median DPFS was 21 mo (95% confidence interval, 15-26 mo). A lower radiotherapy dose predicted a higher local recurrence rate with a 3-yr LPFS of 79% for patients treated with a biologically effective dose ≤100Gy versus 99% for patients treated with >100Gy (p=0.01). Seventeen patients (14%) developed toxicity classified as grade 1, and three patients (3%) developed grade 2 toxicity. No grade ≥3 toxicity occurred. These results should serve as a benchmark for future prospective trials. This multi-institutional study pools all of the available data on the use of stereotactic body radiotherapy for limited prostate cancer metastases. We concluded that this approach is safe and associated with a prolonged treatment progression-free survival. Copyright © 2015. Published by Elsevier B.V.

  16. Fulfill Your Digital Preservation Goals with a Budget Studio

    Directory of Open Access Journals (Sweden)

    Yongli Zhou

    2016-04-01

    Full Text Available In order to fulfill digital preservation goals, many institutions use high-end scanners for in-house scanning of historical print and oversize materials. However, high-end scanners’ prices do not fit in many small institutions’ budget. As digital single-lens reflex (DSLR camera technologies advance and camera prices drop quickly, a budget photography studio can help to achieve institutions’ preservation goals.  This paper compares images delivered by a high-end overhead scanner and a consumer level DSLR camera, discusses pros and cons of using each method, demonstrates how to set up a cost efficient shooting studio, and presents a budget estimate for a studio.

  17. Coping with budget restraint in a Scandinavian welfare state

    DEFF Research Database (Denmark)

    Nielsen, Annemette Ljungdalh; Holm, Lotte; Lund, Thomas Bøker

    2015-01-01

    The purpose of this study was to investigate how different types of households react to experiences of food budget restraint in Denmark. The study applied a mixed method design, based on survey data and on qualitative interviews. The qualitative data source consisted of interviews with 30...... institute GfK ConsumerTracking Scandinavia. Using both data sources the study explored how shopping, storing, cooking and eating practices changed as a consequence of experienced restraints on the food budget. The quantitative results revealed how differences in terms of application of various types...... of strategies are related to different levels of food budget restrictions. Strategies applied to storing and cooking food in more efficient manners were widely practiced across all groups. Strategies which affected eating experiences, such as compromising the tastiness of food and giving up social ties involved...

  18. Reirradiation of recurrent node-positive non-small cell lung cancer after previous stereotactic radiotherapy for stage I disease. A multi-institutional treatment recommendation

    International Nuclear Information System (INIS)

    Nieder, Carsten; Ruysscher, Dirk de; Gaspar, Laurie E.; Guckenberger, Matthias; Mehta, Minesh P.; Cheung, Patrick; Sahgal, Arjun

    2017-01-01

    Practice guidelines have been developed for early-stage and locally advanced non-small cell lung cancer (NSCLC). However, many common clinical scenarios still require individualized decision making. This is true for locoregional relapse after initial stereotactic radiotherapy (stereotactic body radiation therapy or stereotactic ablative radiotherapy; SBRT or SABR), an increasingly utilized curative treatment option for stage I NSCLC. A consortium of expert radiation oncologists was established with the aim of providing treatment recommendations. In this scenario, a case was distributed to six radiation oncologists who provided their institutions' treatment recommendations. In this case, a patient developed local and mediastinal relapse after SABR (45 Gy, 3 fractions), comparable to the tumor burden in de novo stage IIIA NSCLC. Treatment recommendations were tabulated and a consensus conclusion was developed. Three institutions recommended evaluation for surgery. If the patient was not a surgical candidate, and/or refused surgery, definitive chemoradiation was recommended, including retreating the primary to full dose. European participants were more in favor of a non-surgical approach. None of the participants were reluctant to prescribe reirradiation, but two institutions prescribed doses lower than 60 Gy. Platinum-based doublets together with intensity-modulated radiotherapy were preferred. The institutional recommendations reflect the questions and uncertainties discussed in current stage III guidelines. All institutions agreed that previous SABR is not a contraindication for salvage chemoradiation. In the absence of high-quality prospective trials for recurrent NSCLC, all treatment options recommended in current guidelines for stage III disease can be considered in clinical scenarios such as this. (orig.) [de

  19. Validity and Reliability of the U.S. National Cancer Institute's Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)

    Science.gov (United States)

    Dueck, Amylou C.; Mendoza, Tito R.; Mitchell, Sandra A.; Reeve, Bryce B.; Castro, Kathleen M.; Rogak, Lauren J.; Atkinson, Thomas M.; Bennett, Antonia V.; Denicoff, Andrea M.; O'Mara, Ann M.; Li, Yuelin; Clauser, Steven B.; Bryant, Donna M.; Bearden, James D.; Gillis, Theresa A.; Harness, Jay K.; Siegel, Robert D.; Paul, Diane B.; Cleeland, Charles S.; Schrag, Deborah; Sloan, Jeff A.; Abernethy, Amy P.; Bruner, Deborah W.; Minasian, Lori M.; Basch, Ethan

    2016-01-01

    Importance Symptomatic adverse events (AEs) in cancer trials are currently reported by clinicians using the National Cancer Institute's (NCI) Common Terminology Criteria for Adverse Events (CTCAE). To integrate the patient perspective, the NCI developed a patient-reported outcomes version of the CTCAE (PRO-CTCAE) to capture symptomatic AEs directly from patients. Objective To assess the construct validity, test-retest reliability, and responsiveness of PRO-CTCAE items. Design Participants completed PRO-CTCAE items on tablet computers in clinic waiting rooms at two visits 1-6 weeks apart. A subset completed PRO-CTCAE items during an additional visit one business day after the first visit. Setting Nine U.S. cancer centers and community oncology practices. Participants 975 adult cancer patients undergoing outpatient chemotherapy and/or radiation enrolled between January 2011 and February 2012. Eligibility required participants to read English and be without clinically significant cognitive impairment. Main Outcome(s) and Measure(s) Primary comparators were clinician-reported Eastern Cooperative Oncology Group Performance Status (ECOG PS) and the European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire (QLQ-C30). Results 940/975 (96%) and 852/940 (91%) participants completed PRO-CTCAE items at each visit. 938/940 (99.8%) participants (53% female, median age 59, 32% high school education or less, 17% ECOG PS 2-4) reported having at least one symptom. All PRO-CTCAE items had at least one correlation in the expected direction with a QLQ-C30 scale (111/124 P<.05). Stronger correlations were seen between PRO-CTCAE items and conceptually-related QLQ-C30 domains. Scores for 94/124 PRO-CTCAE items were higher in the ECOG PS 2-4 versus 0-1 group (58/124 P<.05). Overall, 119/124 items met at least one construct validity criterion. Test-retest reliability was acceptable for 36/49 pre-specified items (median intra-class correlation coefficient

  20. High Dose Rate Brachytherapy in Two 9 Gy Fractions in the Treatment of Locally Advanced Cervical Cancer - a South Indian Institutional Experience.

    Science.gov (United States)

    Ghosh, Saptarshi; Rao, Pamidimukkala Bramhananda; Kotne, Sivasankar

    2015-01-01

    Although 3D image based brachytherapy is currently the standard of treatment in cervical cancer, most of the centres in developing countries still practice orthogonal intracavitary brachytherapy due to financial constraints. The quest for optimum dose and fractionation schedule in high dose rate (HDR) intracavitary brachytherapy (ICBT) is still ongoing. While the American Brachytherapy Society recommends four to eight fractions of each less than 7.5 Gy, there are some studies demonstrating similar efficacy and comparable toxicity with higher doses per fraction. To assess the treatment efficacy and late complications of HDR ICBT with 9 Gy per fraction in two fractions. This is a prospective institutional study in Southern India carried on from 1st June 2012 to 31st July 2014. In this period, 76 patients of cervical cancer satisfying our inclusion criteria were treated with concurrent chemo-radiation following ICBT with 9 Gy per fraction in two fractions, five to seven days apart. The median follow-up period in the study was 24 months (range 10.6 - 31.2 months). The 2 year actuarial local control rate, disease-free survival and overall survival were 88.1%, 84.2% and 81.8% respectively. Although 38.2% patients suffered from late toxicity, only 3 patients had grade III late toxicity. In our experience, HDR brachytherapy with 9 Gy per fraction in two fractions is an effective dose fractionation for the treatment of cervical cancer with acceptable toxicity.

  1. High rate of severe radiation dermatitis during radiation therapy with concurrent cetuximab in head and neck cancer: Results of a survey in EORTC institutes

    International Nuclear Information System (INIS)

    Giro, Christian; Berger, Bernhard; Boelke, Edwin; Ciernik, I. Frank; Duprez, Frederic; Locati, Laura; Maillard, Sophie; Ozsahin, Mahmut; Pfeffer, Raphael; Robertson, A. Gerry; Langendijk, Johannes A.; Budach, Wilfried

    2009-01-01

    Objective: Examination of the rate of grade III or grade IV radiation dermatitis during treatment of head and neck cancer (HNC) with radiotherapy (RT) and concurrent cetuximab in EORTC centres. Materials and method: A questionnaire was sent to all members of the EORTC Radiation Oncology Group and Head and Neck Group (111 institutions) to evaluate the widespread use of cetuximab and radiotherapy in HNC and to estimate the frequency of grades III and IV skin reactions in the radiation portals associated with this protocol. Co-morbidities, RT schedules and co-medications were also recorded. Results: We received responses from 28 institutions in 11 countries. A total of 125 HNC patients from 15 institutions were treated with cetuximab and concurrent RT. Information about the skin reactions was available from 71 patients. Of these 36 had no grade III/IV adverse effects in the RT field, 15 had a grade III and 20 had grade IV radiation dermatitis. No detectable relation of grades III and IV radiation dermatitis with co-morbidities such as liver insufficiency or renal dysfunction was found. Conclusion: According to the results of the questionnaire, grade III/IV radiation dermatitis is observed in 49% of HNC patients treated with cetuximab and concurrent RT. A systematic clinical monitoring of cutaneous side effects during RT plus cetuximab is advised to ensure the safety of this protocol

  2. Bladder preservation in non-metastatic muscle-invasive bladder cancer (MIBC): a single-institution experience.

    Science.gov (United States)

    Gerardi, Marianna A; Jereczek-Fossa, Barbara A; Zerini, Dario; Surgo, Alessia; Dicuonzo, Samantha; Spoto, Ruggero; Fodor, Cristiana; Verri, Elena; Rocca, Maria Cossu; Nolè, Franco; Muto, Matteo; Ferro, Matteo; Musi, Gennaro; Bottero, Danilo; Matei, Deliu V; De Cobelli, Ottavio; Orecchia, Roberto

    2016-01-01

    The aim of this study is to access the feasibility, toxicity profile, and tumour outcome of an organ preservation curative approach in non-metastatic muscle-invasive bladder cancer. A retrospective analysis was conducted on patients affected by M0 bladder cancer, who refused cystectomy and were treated with a curative approach. The standard bladder preservation scheme included maximal transurethral resection of bladder tumour (TURBT) and combination of radiotherapy and platin-based chemotherapy, followed by endoscopic evaluation, urine cytology, and instrumental evaluation. Thirteen patients fulfilled the inclusion criteria. TNM stage was cT2cN0M0 and cT2cNxM0, in 12 and one patients, respectively. All patients had transitional cell cancer. Twelve patients completed the whole therapeutic programme (a bimodal treatment without chemotherapy for one patient). Median follow-up is 36 months. None of the patients developed severe urinary or intestinal acute toxicity. In 10 patients with a follow-up > 6 months, no cases of severe late toxicity were observed. Response evaluated in 12 patients included complete response and stable disease in 11 patients (92%), and one patient (8%), respectively. At the time of data analysis (March 2016), 10 patients (77%) are alive with no evidence of disease, two patients (15%) died for other reasons, and one patient has suspicious persistent local disease. The trimodality approach, including maximal TURBT, radiotherapy, and chemotherapy for muscle-invasive bladder cancer, is well-tolerated and might be considered a valid and feasible option in fit patients who refuse radical cystectomy.

  3. Application of the Western-based adjuvant online model to Korean colon cancer patients; a single institution experience

    International Nuclear Information System (INIS)

    Jung, Minkyu; Shin, Sang Joon; Kim, Geon Woo; Jung, Inkyung; Ahn, Joong Bae; Roh, Jae Kyung; Rha, Sun Young; Chung, Hyun Cheol; Kim, Nam Kyu; Kim, Tae Il

    2012-01-01

    Adjuvant Online (AOL) is web-accessible risk-assessment model that predicts the mortality and the benefits of adjuvant therapy. AOL has never been validated for Asian colon cancer patients. Using the Yonsei Tumor Registry database, patients who were treated within the Yonsei University Health System between 1990 and 2005 for T1-4, N0-2, and M0 colon cancer were included in the calculations for survival. Observed and predicted 5-year overall survival was compared for each patient. The median age of the study population of 1431 patients was 60 years (range, 15–87 years), and the median follow-up duration was 7.9 years (range, 0.06–19.8 years). The predicted 5-year overall survival rate (77.7%) and observed survival (79.5%) was not statistically different (95% Confidential interval, 76.3–81.5) in all patients. Predicted outcomes were within 95% confidential interval of observed survival in both stage II and III disease, including most demographic and pathologic subgroups. Moreover, AOL more accurately predicted OS for patients with stage II than stage III. AOL tended to offer reliable prediction for 5-year overall survival and could be used as a decision making tool for adjuvant treatment in Korean colon cancer patients whose prognosis is similar to other Asian patients

  4. A multi-institutional analysis of 429 patients undergoing major hepatectomy for colorectal cancer liver metastases: The impact of concomitant bile duct resection on survival.

    Science.gov (United States)

    Postlewait, Lauren M; Squires, Malcolm H; Kooby, David A; Weber, Sharon M; Scoggins, Charles R; Cardona, Kenneth; Cho, Clifford S; Martin, Robert C G; Winslow, Emily R; Maithel, Shishir K

    2015-10-01

    Data are lacking on long-term outcomes of patients undergoing major hepatectomy requiring bile duct resection (BDR) for the treatment of colorectal cancer liver metastases. Patients who underwent major hepatectomy (≥3 segments) for metastatic colorectal cancer from 2000-2010 at three US academic institutions were included. The primary outcome was disease-specific survival (DSS). Of 429 patients, nine (2.1%) underwent BDR, which was associated with pre-operative portal vein embolization (25.0% vs. 4.3%; P = 0.049). There were no significant differences in age, ASA class, margin status, number of lesions, tumor size, cirrhosis, perineural invasion, or lymphovascular invasion. BDR was independently associated with increased postoperative major complications (OR: 6.22; 95%CI:1.44-26.97; P = 0.015). There were no differences in length of stay, reoperation, readmission, or 30-day mortality. Patients who underwent BDR had markedly decreased DSS (9.3 vs. 39.9 mo; P = 0.002). When accounting for differences between the two groups, the need for BDR was independently associated with reduced DSS (HR: 3.06; 95%CI:1.12-8.34; P = 0.029). Major hepatectomy with concomitant bile duct resection is seldom performed in patients undergoing resection of colorectal cancer liver metastases and is associated with higher major morbidity and reduced disease-specific survival compared to major hepatectomy alone. Stringent selection criteria should be applied when patients may need bile duct resection during hepatectomy for colorectal cancer liver metastases. © 2015 Wiley Periodicals, Inc.

  5. Long term mortality from cardiac disease and lung cancer after radiotherapy for breast cancer: a prospective cohort study of 7 711 women treated and followed-up at Institute Gustave Roussy (France)

    Energy Technology Data Exchange (ETDEWEB)

    Boukheris, H.; Rubino, C.; Le, M.; Giardini, M.; Brindel, P.; Doyon, F.; Paoletti, C.; Labbe, M.; Haouari, Z.; Vathaire, F. de [Institut Gustave Roussy, Unite 605 INSERM, 94 - Villejuif (France)

    2006-07-01

    Full text of publication follows: Women who are treated for early breast cancer with adjuvant radiation have a decreased risk of local recurrence but an increased risk of mortality from heart disease and lung cancer. Patients with left -sided breast tumors receive a higher dose of radiation to the heart than patients with right-sided tumors. In a previous study of about 300000 women treated for breast cancer during 1973-2001 and followed-up prospectively for cause-specific mortality until January 1, 2002, Sarah Darby showed that for women diagnosed during 1973-1982 and irradiated, the cardiac mortality ratio (left versus right tumor laterality) was 1.20 [1.04-1.38] less then 10 years afterwards, and 1.58 [1.29 - 1.95] after 15 years or more. Because radiation techniques have improved over time, such risks are expected to be reduced. A cohort was performed at Institute Gustave Roussy to investigate long term effects of breast cancer treatments. This cohort comprise 7711 women treated for beast cancer between 1954 and 1984. Mean age at the first treatment was 55 years [21 - 91], 61% were diagnosed before 1977 vs 39% after, 50.4% were left -sided breast cancer, 4832 (73.2 %) were recorded as having received external-beam radiotherapy as part of the initial treatment and 516 (8%) radiotherapy in association with chemotherapy. The aim of the present study is to investigate long term mortality and effects of radiotherapy on mortality from cardiac disease and second cancers. The originality of our study comparing to similar others is the homogeneity of the population studied and the longer follow-up. Vital status and causes of death of women of the cohort were obtained as well as mortality rates in the general French population. The cut off date was January 1, 2001. External and internal analysis were performed. Persons years at risk have been calculated for the entire follow-up period, less then 10 years, 10-19 years, 20-29 years, and 30 or more years afterwards. To

  6. Long term mortality from cardiac disease and lung cancer after radiotherapy for breast cancer: a prospective cohort study of 7 711 women treated and followed-up at Institute Gustave Roussy (France)

    International Nuclear Information System (INIS)

    Boukheris, H.; Rubino, C.; Le, M.; Giardini, M.; Brindel, P.; Doyon, F.; Paoletti, C.; Labbe, M.; Haouari, Z.; Vathaire, F. de

    2006-01-01

    Full text of publication follows: Women who are treated for early breast cancer with adjuvant radiation have a decreased risk of local recurrence but an increased risk of mortality from heart disease and lung cancer. Patients with left -sided breast tumors receive a higher dose of radiation to the heart than patients with right-sided tumors. In a previous study of about 300000 women treated for breast cancer during 1973-2001 and followed-up prospectively for cause-specific mortality until January 1, 2002, Sarah Darby showed that for women diagnosed during 1973-1982 and irradiated, the cardiac mortality ratio (left versus right tumor laterality) was 1.20 [1.04-1.38] less then 10 years afterwards, and 1.58 [1.29 - 1.95] after 15 years or more. Because radiation techniques have improved over time, such risks are expected to be reduced. A cohort was performed at Institute Gustave Roussy to investigate long term effects of breast cancer treatments. This cohort comprise 7711 women treated for beast cancer between 1954 and 1984. Mean age at the first treatment was 55 years [21 - 91], 61% were diagnosed before 1977 vs 39% after, 50.4% were left -sided breast cancer, 4832 (73.2 %) were recorded as having received external-beam radiotherapy as part of the initial treatment and 516 (8%) radiotherapy in association with chemotherapy. The aim of the present study is to investigate long term mortality and effects of radiotherapy on mortality from cardiac disease and second cancers. The originality of our study comparing to similar others is the homogeneity of the population studied and the longer follow-up. Vital status and causes of death of women of the cohort were obtained as well as mortality rates in the general French population. The cut off date was January 1, 2001. External and internal analysis were performed. Persons years at risk have been calculated for the entire follow-up period, less then 10 years, 10-19 years, 20-29 years, and 30 or more years afterwards. To

  7. Budget Brief: 2015 Proposed Budget Milwaukee Public Schools

    Science.gov (United States)

    Allen, Vanessa; Chapman, Anne; Henken, Rob

    2014-01-01

    In this report, the authors provide a detailed analysis of the major changes in revenue and expenditures in the Milwaukee Public Schools (MPS) 2015 proposed budget, and the manner in which MPS has responded to recent legislative changes and turbulent workforce challenges. The objective is to provide an independent assessment of the district's…

  8. Do budget balance rules anchor budget balance expectations? -- Some international evidence

    OpenAIRE

    Rülke, Jan-Christoph; Frenkel, Michael; Lis, Eliza

    2013-01-01

    This is the first study that analyzes whether budget balance expectations are anchored and whether budget balance rules effectively anchor expectations. To this end, we use a unique data set which covers budget balance expectations in 17 countries that implemented a budget balance rules. While our results are mixed concerning the general impact of budget balance rules on anchoring expectations, we do find that specific features of budget balance rules are important to successfully anchor budg...

  9. Stereotactic body radiotherapy in oligometastatic prostate cancer patients with isolated lymph nodes involvement: a two-institution experience.

    Science.gov (United States)

    Ingrosso, Gianluca; Trippa, Fabio; Maranzano, Ernesto; Carosi, Alessandra; Ponti, Elisabetta; Arcidiacono, Fabio; Draghini, Lorena; Di Murro, Luana; Lancia, Andrea; Santoni, Riccardo

    2017-01-01

    Stereotactic body radiotherapy (SBRT) is emerging as a treatment option in oligometastatic cancer patients. This retrospective study aimed to analyze local control, biochemical progression-free survival (b-PFS), and toxicity in patients affected by isolated prostate cancer lymph node metastases. Finally, we evaluated androgen deprivation therapy-free survival (ADT-FS). Forty patients with 47 isolated lymph nodes of recurrent prostate cancer were treated with SBRT. Mostly, two different fractionation schemes were used: 5 × 7 Gy in 23 (48.9 %) lesions and 5 × 8 Gy in 13 (27.7 %) lesions. Response to treatment was assessed with periodical PSA evaluation. Toxicity was registered according to RTOG/EORTC criteria. With a mean follow-up of 30.18 months, local control was achieved in 98 % of the cases, with a median b-PFS of 24 months. We obtained a 2-year b-PFS of 44 % with 40 % of the patients ADT-free at last follow-up (mean value 26.18 months; range 3.96-59.46), whereas 12.5 % had a mean ADT-FS of 13.58 months (range 2.06-37.13). Late toxicity was observed in one (2.5 %) patient who manifested a grade 3 gastrointestinal toxicity 11.76 months after the end of SBRT. Our study demonstrates that SBRT is safe, effective, and minimally invasive in the eradication of limited nodal metastases, yielding an important delay in prescribing ADT.

  10. Enteral Feeding During Chemoradiotherapy for Advanced Head-and-Neck Cancer: A Single-Institution Experience Using a Reactive Approach

    International Nuclear Information System (INIS)

    Clavel, Sebastien; Fortin, Bernard; Despres, Philippe; Donath, David; Soulieres, Denis; Khaouam, Nader; Charpentier, Danielle; Belair, Manon; Guertin, Louis; Nguyen-Tan, Phuc Felix

    2011-01-01

    Purpose: The optimal method for providing enteral nutrition to patients with head-and-neck cancer is unclear. The purpose of the present study was to evaluate the safety and efficacy of our reactive policy, which consists of the installation of a nasogastric (NG) feeding tube only when required by the patient's nutritional status. Methods and Materials: The records of all patients with Stage III and IV head-and-neck cancer treated with concomitant chemotherapy and radiotherapy between January 2003 and December 2006 were reviewed. The overall and disease-free survival rates were estimated using the Kaplan-Meier method and compared with the log-rank test. Results: The present study included 253 patients, and the median follow-up was 33 months. At 3 years, the estimated overall survival and disease-free survival rate was 82.8% and 77.8%, respectively, for the whole population. No survival difference was observed when the patients were compared according to the presence and absence of a NG tube or stratified by weight loss quartile. The mean weight loss during treatment for all patients was 10.4%. The proportion of patients requiring a NG tube was 49.8%, and the NG tube remained in place for a median duration of 40 days. No major complications were associated with NG tube installation. Only 3% of the patients were still dependent on enteral feeding at 6 months. Conclusion: These results suggest that the use of a reactive NG tube with an interdisciplinary team approach is a safe and effective method to manage malnutrition in patients treated with concomitant chemotherapy and radiotherapy for head-and-neck cancer.

  11. Efficacy of icotinib in lung squamous-cell cancer: A real-world experience from single institution.

    Science.gov (United States)

    Xu, Jianping; Liu, Xiaoyan; Yang, Sheng; Zhang, Xiangru; Shi, Yuankai

    2017-12-01

    Squamous cell carcinoma is a less common type of nonsmall cell lung cancer (NSCLC) which associates with a poor clinical prognosis and lacks specific therapy. This study aimed to evaluate the efficacy and safety of icotinib, an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor that has proven to be effective in EGFR-mutated NSCLC, in patients with lung squamous-cell cancer. Retrospective analysis was conducted in patients who had advanced lung squamous-cell cancer confirmed by cytology or histology. Patients were treated orally with icotinib (125 mg, three times daily) until event of unacceptable toxicity, disease progression or death. The primary endpoint was overall survival. The secondary endpoints were progression-free survival, overall response rate and disease control rate. Between January 2014 and May 2016, 20 patients were enrolled and evaluated for the efficacy and safety of icotinib. Overall, the median overall survival and progression-free survival were 9.93 months (95% confidence interval (CI): 3.46-16.40) and 3.0 months (95% CI: 0.00-8.35), respectively. The overall response rate and disease control rate were 20% and 70%, respectively. For treatment-naive patients (n = 11), the overall survival and progression-free survival were 9.93 months (95% CI: 0.00-23.49) and 6.27 months (95% CI: 0.00-12.61); the response rate and disease control rate were 27.3% and 54.5%, respectively. The overall survival and progression-free survival of patients treated with second- or multiple-line icotinib treatment (n = 9) were 6.5 months (95% CI: 0.80-12.20) and 1.2 months (95% CI: 1.10-1.30). A total of 11 patients experienced at least one treatment-related adverse event, most of which were mild to moderate. The most common manifestations were rash (n = 6, 30%) followed by diarrhea (n = 2, 10%). Icotinib has demonstrated a favorable efficacy and safety profile in patients with advanced lung squamous-cell cancer. © 2017 John Wiley & Sons Australia, Ltd.

  12. Conformal radiotherapy with intensity modulation and integrated boost in the head and neck cancers: experience of the Curie Institute

    International Nuclear Information System (INIS)

    Toledano, I.; Serre, A.; Bensadoun, R.J.; Ortholan, C.; Racadot, S.; Calais, G.; Alfonsi, M.; Giraud, P.; Graff, P.; Serre, A.; Bensadoun, R.J.; Ortholan, C.; Racadot, S.; Calais, G.; Alfonsi, M.; Giraud, P.

    2009-01-01

    The modulated intensity radiotherapy (I.M.R.T.) is used in the treatment of cancers in superior aero digestive tracts to reduce the irradiation of parotids and to reduce the delayed xerostomia. This retrospective study presents the results got on the fourteen first patients according an original technique of I.M.R.T. with integrated boost. It appears that this technique is feasible and allows to reduce the xerostomia rate without modifying the local control rate. To limit the average dose to the parotids under 30 Gy seems reduce the incidence of severe xerostomia. (N.C.)

  13. Morbidity associated to the transfusion support in pediatric patients with acute leukemia in the National Cancer Institute

    International Nuclear Information System (INIS)

    Vizcaino Valderrama, Martha; Suarez Mattos, Amaranto; Hernandez Kunzel, Jorge Alberto; Restrepo, Alexandra

    2002-01-01

    Acute leukemia represents the most common cancer in pediatrics. The current treatments made necessary a hematological support which increases the risks of complications, like fever, immunologic reaction, infections and, graft versus host disease. The objective of the present study was to determine the morbidity associated with transfusion support in pediatric patients with acute leukemia. In the pediatric population with diagnosis of acute leukemia in the INC during one and half year, the morbidity associated with transfusions was low and couldn't be related to the treatment given to the transfused products

  14. FUNDING PUBLIC INSTITUTIONS IN ROMANIA

    Directory of Open Access Journals (Sweden)

    Florin-Constantin, DIMA

    2014-11-01

    Full Text Available The development of this article started from the fact that in the field of public institutions accounting there have been many changes and it aims to capture the essential aspects of their financing. Thus the article covers a series of issues related to the credit officers, to employment, to settlement and payment of public institutions expenditure, to the budgeting and budgetary credits accounting. It also presents a brief classification of the public institutions according to several criteria, as well as their financing sources. The paper also practically presents the accounting of the budgetary credits and their sharing mechanism between the principal, secondary and tertiary budgetary credits officers.

  15. Socio-Demographic, Reproductive and Clinical Profile of Women Diagnosed with Advanced Cervical Cancer in a Tertiary Care Institute of Delhi.

    Science.gov (United States)

    Dahiya, Neha; Bachani, Damodar; Acharya, Anita S; Sharma, D N; Gupta, Subhash; Haresh, K P

    2017-02-01

    Cervical cancer is one of the leading cancers among Indian women with estimated 123,000 new cases and 67,477 deaths in 2012. Cervical cancer is a multi-etiological disease. Factors such as low socioeconomic status, tobacco use, sexual and reproductive factors, HIV and other sexually transmitted diseases and long-term oral contraceptive use have been suggested as determinants. Assessment of socio-demographic profile and reproductive history gives a better picture of the determinants of cervical carcinoma in low-resource settings. This hospital-based cross-sectional study was undertaken at a tertiary healthcare institute at New Delhi, India. Sixty-seven newly diagnosed women with advanced cervical cancer (stage 2B-4B), who were undertaking radio- and/or chemotherapy, were included to assess their socio-demographic, reproductive and clinical profile. The mean age of women at the time of detection of cervical cancer was 52.28 ± 11.29 years (range 30-75 years). More than 60 % of patients were illiterate and belonged to middle socioeconomic status. Thirty-nine percentage of the study subjects had their first sexual experience before 15 years of age. Nearly 54 % women had 5 or more pregnancies. Nearly 73 % of women had all deliveries at home. Majority (69 %) of women had symptoms suggestive of reproductive tract infection. Among them, unusual discharge from vagina (73.13 %) followed by bleeding after menopause (55.10 %) and pain in abdomen (44.77 %) were the most common presenting complaints. Pallor was present in nearly two-third (63.93 %) study subjects. More than half (56.72 %) study subjects had moderate anemia, and 7.46 % had severe anemia before treatment. Mean hemoglobin level of the study subjects was 10.35 ± 1.72 gm% before treatment and 9.69 ± 1.29 gm% after treatment. This difference was statistically significant. Around 97 % of the study subjects had squamous cell carcinoma of the cervix. Majority (53.73 %) of the study subjects were in

  16. Feminism, Budgeting and Gender Justice

    Science.gov (United States)

    Misra, S. N.; Ghadai, Sanjaya Kumar

    2017-01-01

    The Fourth Conference on Women at Beijing (1995) underlined the importance of gender mainstreaming; spurring India to provide for separate Gender Budgeting in 2005-06. The Constitution tries to make fine balance between right to equality and positive discrimination for promoting gender justice in India. Yet high levels of Gender Inequality Index…

  17. Kollektiivne vastutus ja gender budgeting

    Index Scriptorium Estoniae

    2005-01-01

    Vestlusringi teemad: riigieelarve koostamisel ei arvestata soolist võrdõiguslikkust; gender budgeting kui üks soolise võrdõiguslikkuse jälgimise viise; vabaabielu võib osutuda naisele palju ebasoodsamaks kui mehele; kogukonna kollektiivne vastutus perevägivalla korral. Vt. samas: Aasta 2004 suurte mõtlejate auhinnad

  18. Constituency Input into Budget Management.

    Science.gov (United States)

    Miller, Norman E.

    1995-01-01

    Presents techniques for ensuring constituency involvement in district- and site-level budget management. Outlines four models for securing constituent input and focuses on strategies to orchestrate the more complex model for staff and community participation. Two figures are included. (LMI)

  19. Monitoring personal budgets and restrictions

    NARCIS (Netherlands)

    Ab van der Torre; Ingrid Ooms; Mirjam de Klerk

    2013-01-01

    The personal budget is a sum of money which recipients can use to arrange and pay for their own care provider. Since its introduction, demand for this provision, which is funded through the Exceptional Medical Expenses Act (AWBZ) has grown rapidly, prompting the Dutch government to take a number

  20. Pain Relief for Budget Cuts.

    Science.gov (United States)

    Fultz, David A.

    1983-01-01

    The Grand Blanc (Michigan) Community School District sets budget priorities by (1) surveying students, taxpayers, and teachers to learn their preferences for current programs and services; (2) determining the costs of state-mandated programs; (3) listing nonmandated programs and determining their costs; and (4) considering proposed new programs.…